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Biomedical subjects

J R Heiman

Publications and source records attributed to J R Heiman.

34 records · Page 2Linked to original sources
PubMed1991

Self-reported and genital arousal changes in sexually dysfunctional men following a sex therapy program.

This investigation examined the question of whether differences in psychophysiological and self-reported sexual response between sexually dysfunctional men and sexually functional men are reduced following treatment in a sex therapy program. Patterns of sexual responding before and after treatment in nine men with erectile difficulties and/or low sexual desire were compared with those of nine age-matched controls tested at the same intervals. Results indicated: (1) increased genital and self-reported response during the post-test in dysfunctional men but not in controls; (2) conditions eliciting performance demand produced less inhibition during the post-test in dysfunctional men; and (3) moderate correlations in dysfunctional men between clinically-assessed improvement in sexual functioning and actual changes in penile and self-reported arousal from the first to the second laboratory session. The implications of these data for the understanding of variables responsible for improved sexual functioning, and therefore, to clinical assessment and therapy, are discussed. Possible cognitive strategies are provided to account for discrepancies in self-reported and physical sexual arousal in dysfunctional subjects, and the efficacy and limitations of using psychophysiological methods in studying sexual response in dysfunctional men are suggested.

Adult↗
PubMed1991

Treatment cost and rehospitalization rate in schizophrenic outpatients with a history of substance abuse.

Retrospective self-report data from 60 chronic schizophrenic outpatients in a community support program (CSP) were used to study the relationship between a history of substance abuse and rate of psychiatric rehospitalization and outpatient treatment cost. The sample showed a significant overall reduction in days spent in a psychiatric hospital or jail and in outpatient treatment expenses during the first year in the CSP. Although subjects with recent symptoms of substance abuse (N = 27) showed consistently smaller reductions than subjects with no history of substance abuse (N = 17) or subjects with no recent substance abuse symptoms (N = 16), the only significant difference between the groups was in the total number of days spent in an institution. However, the findings suggest that treatment of patients with concurrent substance abuse and schizophrenia is disproportionately more costly than that of patients without dual diagnoses.

Adult↗
PubMed1989

Defining and measuring stabilization of patients during 4 years of intensive community support.

The first 4 years of an intensive community support program were evaluated in terms of key variables of patient stabilization. Patients (N = 196) had previously demonstrated an inability to manage themselves without repeated and/or lengthy hospitalizations. During program participation, there were significant reductions in hospital days and events (80%), jail incarcerations and charges, billings per patient, and stressful events. Patients reported increased satisfaction both with their lives and the program. The results support the value of continued multidimensional and multimethod examinations of patient stabilization.

Activities of Daily Living↗
PubMed1987

Patterns of case management activity in an intensive community support program: the first year.

Changes in activity patterns of 12 case managers over the first year of an intensive community support program are described and a method and format for the collection and analysis of time budget data in case management are presented. During the first six months of the program case managers recorded the predominant activity for each 15 minute period throughout the day. Mean values of proportional time were 35.3% for direct services, 40.3% for indirect services, and 24.4% for nonclinical services. The relatively high (64.7%) combination of indirect and nonclinical services deserves careful consideration in program cost analysis.

Adolescent↗
PubMed1987

Endocrine, psychological and genital response to sexual arousal in men.

The endocrine, genital, and cognitive--affective responses of sexually functional men were compared under sexually arousing and non-arousing conditions. Sexually aroused subjects showed significantly higher serum luteinizing hormone concentrations than non-aroused subjects. Testosterone concentration was correlated with higher levels of penile response, but it did not prime further sexual arousal. Cortisol and prolactin concentrations decreased in both groups, more in the non-aroused group, and appeared to both inhibit and facilitate sexual response, depending on the level of anxiety reported by the subjects. Cortisol was correlated with self-reported worry, and testosterone with relaxation. These results support a multidimensional approach to the endocrine study of sexual arousal that includes both cognitive and genital response components.

Adolescent↗
PubMed1983

Clinical outcome of sex therapy. Effects of daily v weekly treatment.

The effectiveness of sex therapy has been questioned recently. The present outcome study of 69 lower-middle-class couples, who were not highly selected with respect to severity of personal and marital distress, used standardized instruments to measure change over five time periods: intake, history, posttherapy, three-month, and one-year follow-up. Using an own-control design, a 15-session weekly treatment was compared with a 15-session daily treatment. Overall, treatment was successful in improving sexual and marital satisfaction as well as specific symptom remission; there was little decline at the three-month and one-year follow-ups. The least symptomatic improvement occurred for erectile problems and female secondary inorgasmic dysfunction, and there was some suggestion of a gradual nonsignificant decline of overall sexual and marital satisfaction at follow-up. The outcome of daily v weekly treatment was generally not different, with only some indication of better results for secondary inorgasmia and erectile failure when treated in the weekly mode.

Adult↗
PubMed1983

Affective and physiological sexual response patterns: the effects of instructions on sexually functional and dysfunctional men.

To more clearly characterize the patterns of cognitive-affective and physiological responses concomitant with male sexual dysfunction, the present study compared 14 sexually dysfunctional and 16 sexually functional men. All individuals listened to two sexually explicit tapes and engaged in a self-generated fantasy, while genital, heart rate and scaled cognitive affective responses were recorded. Two types of instructions, a performance demand set and a non-demand sensate focus set, preceded the erotic tapes in counterbalanced order. As predicted, dysfunctional men showed less genital tumescence to tapes preceded by the demand than the non-demand instructions. Contrary to expectation, functional men showed greater penile tumescence to the tapes preceded by demand instructions. Self-reported sexual arousal did not follow the penile tumescence pattern but instead indicated that the dysfunctional sample was significantly less subjectively aroused to the tapes and fantasy. There were other significant differences between the groups. Dysfunctional men showed greater general psychological distress, as measured by the SCL-90, including elevated somaticism, anxiety and depression scores. During the experimental session, dysfunctional men also evidenced greater awareness of a variety of physiological responses, as well as more negative and fewer positive cognitive-affective states. These data are discussed in terms of the interaction of affective and physiological responses, differences in contextual meanings of instructional sets given the presence of a dysfunction, and theoretical and clinical conceptualizations of male sexual functioning.

Adult↗
PubMed1982

Multiaxial problem-oriented system for sexual dysfunctions: an alternative to DSM-III.

In a multiaxial system for classifying the sexual dysfunctions, the axes specify sexual problems associated with the desire, arousal, and orgasm phases of the sexual response cycle, as well as types of coital pain, dissatisfaction with the frequency of sex, and certain other information relevant to sexual functioning. In contrast to DSM-III and other existing diagnostic systems for sexual dysfunctions, this new multiaxial system is based on highly specific empirical descriptions of sexual behavior. There are no inferences made about the cause of the dysfunctions.

Adult↗
PubMed1980

Female sexual response patterns. Interactions of physiological, affective, and contextual cues.

This study examined physiological, affective, and contextual components of female sexual responsiveness and satisfaction. Fifty-five women, aged 21 to 58, 27 of whom were married participated in two psychophysiological laboratory sessions and completed a questionnaire. During each laboratory session, physiological and self-reported sexual arousal were measured in response to an erotic tape, film, and self-generated fantasies. Vaginal pulse amplitude responses showed married women to be less aroused to erotic materials during session 1 but not session 2. Self-reported sexual arousal was correlated with vaginal response only in the unmarried sample and only during the tape and film of session 1. Subjectively reported sexual arousal was also correlated with a constellation of positive affective states. Generally, negative correlations were found between vaginal response in the laboratory and reported sexual responsiveness at home. The patterning of the affective-physiological relationships suggests several interpretations with regard to female sexuality and models to human emotion.

Adult↗
PubMed1976

Issues in the use of psychophysiology to assess female sexual dysfunction.

The viability of psychophysiology as an assessment approach for female sexual function and dysfunction revolves around physiological measurement issues, subjective measurement issues, and the nature of the sexual difficulty. Recent data are presented and discussed as are the potentials and limitations inherent in a psychophysiological study of human sexuality. A case is made for the use of vaginal pressure pulse as a primary measure, vaginal blood volume as a secondary measure, correlations between subjective and objective measures of sexual arousal, and intercorrelations between various subjective affect scales.

Arousal↗