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PubMed1984

The effects of coronary bypass surgery on female sexual, psychological, and vocational adaptation.

This paper reports the first study of female sexual, psychological, and vocational adaptation to coronary artery bypass surgery (CABG). Semistructured interviews were used to obtain data on 17 women undergoing CABG. Four time periods were examined: prior to and after the onset of cardiac symptoms; four months and one year after CABG. Female sexual response differs from what is known about male adaptation to CABG in three ways: 1) women did not demonstrate a significant and profound decline in frequency of intercourse one year after surgery; 2) the component most vulnerable to disruption in women is desire, in men it is arousal; 3) women do not harbor the sexual fears commonly seen in men such as sudden death during intercourse or performance anxiety. Psychologically, women fared better than men, but were less likely to return to work. This indicates that more attention should be directed toward vocational counseling of working women undergoing CABG.

Adaptation, Psychological↗
PubMed1985

Use and misuse of behavioral homework exercises in sex therapy.

This paper examines uses of sexual exercises and their role in effecting changes in attitudes, behaviors, and feelings. In reaction to the charge that exercises are overly mechanistic, clinicians now underutilize exercises and/or give only general suggestions. The common errors of nonspecificity, use as a cookbook, quick abandonment, and setting performance criterion are discussed. The use of semistructured, written exercises which function as in vivo desensitization, facilitate development of verbal and stimulation skills, and provide a positive model of sexuality are most efficacious. A case example illustrating the multiple therapeutic benefits of exercises is presented.

Attitude↗
PubMed1985

Sexual dysfunction in gay men requesting treatment.

Until recent years, homosexuality was considered to be a psychiatric disorder and no attention was given to treating same-sex sexually dysfunctional partners--either male or female. This study reports on the treatment of approximately 500 sexually dysfunctional gay men by 10 Southern California psychotherapists over a five-year period. Six aspects of sexual dysfunction in gay males are explored: the psychotherapeutic process; characteristics of men reporting homosexual dysfunction; type and incidence of dysfunction; etiology of dysfunction; treatment and recidivism; and duration and impact of dysfunction. The literature in this area is also reviewed.

Adolescent↗
PubMed1985

Anaesthetic ejaculation.

Literature on the uncommon symptom of anaesthetic ejaculation and the relevant physiology is reviewed. Seven case vignettes describing the clinical pictures, background histories and common features of this problem are presented, along with some psychometric data. No physical causative factors could be elucidated. The main features shared in common by these men were problems in the recognition and expression of emotions, and a performance orientation. Treatment by sex-therapy procedures was ineffective.

Adult↗
PubMed1986

The relationship between traditional and innovative sex-role adaptations and innovative sex-role adaptations and sexual satisfaction among a homogeneous sample of middle-aged Caucasian women.

This paper examines sexual experiences and satisfaction among a homogeneous sample of middle-aged, middle and upper socioeconomic status, Caucasian women. The hypothesis that women who occupy more traditional social roles on the traditional-innovative continuum would have greater sexual satisfaction is rejected. Relationships among a variety of indicators of sexual satisfaction and position on the innovative-traditional continuum indicated lack of consistent directionality or strong associations. Voluntary association memberships serendipitously emerged as a relatively strong indicator of social activities related to sexual satisfaction.

Employment↗
PubMed1986

Psychological subtypes of anorgasmia: a marker variable approach.

Seventy-six women who presented with a principal complaint of anorgasmia were compared with a matched cohort of sexually functional controls on the domains of the Derogatis Sexual Functioning Inventory (DSFI). Patients were case matched with controls on age, race, marital status, and social class. Initial comparisons revealed significant differences between patient and control groups on a number of psychosexual characteristics, consistent with prior research. Based on evidence of heterogeneity within the patient sample and earlier research by our group, the anorgasmic cohort was partitioned by a "marker variable" approach into two anorgasmic subtypes. The marker variable used to create the subtypes was the presence of homosexual fantasies. Subsequent contrasts, both between the two anorgasmic subgroups, and with functional controls, revealed highly significant differences, and provided strong evidence for at least two psychologically distinct subtypes of anorgasmia.

Adult↗
PubMed1986

Sexual dysfunction and disorder patterns of husbands of working and nonworking women.

The sexual dysfunction and disorder patterns of 218 husbands of working and nonworking women were compared in a retrospective analysis of couples presenting for sexual and marital therapy at Masters & Johnson Institute. Results indicated that men who were married to women who were pursuing careers or to women who were employed in jobs presented only between one half and two-thirds as often with primary complaints of inhibited sexual excitement and inhibited sexual desire as husbands of unemployed women. The results are compared to findings for women in dual-earner and single-earner relationships. The findings are interpreted in terms of psychological and interpersonal stressors characterizing single-earner, conventional marital arrangements as compared with those typifying dual-earner partnerships.

Adult↗
PubMed1987

Intracavernosal injection in the treatment of impotence: a prospective study of sexual, psychological, and marital functioning.

This study assessed the sexual, psychosocial, and medical impact of intracavernosal injection of papaverine hydrochloride and phentolamine mesylate in the treatment of impotence. Ninety-six percent of patients initially achieved satisfactory erections with injections. Common side effects of self-injections included bruising (26%), nodule development (21%), abnormal liver function tests (7%), and pain (5%). No nodules resulted in penile bending or pain, and no patient discontinued treatment due to nodule development. Dropout rate to date was 35%. Self-injection treatment was associated with increases in erection quality, intercourse frequency, and sexual satisfaction, and decreases in masturbation frequency for patients. Partners also reported increases in intercourse frequency, coital arousal, and satisfaction. Decreases in general psychiatric symptomatology and increases in relationship satisfaction and self-esteem were apparent for patients, but not for partners.

Erectile Dysfunction↗
PubMed1987

Vaginoplasty outcome in male-to-female transsexuals.

This study investigated the cosmetic and functional adequacy of the neovagina in surgically reassigned male-to-female transsexuals. Subjects were 22 transsexuals with a mean postsurgical follow-up of 4.4 years. All were given structured interviews followed by pelvic examinations. The majority of subjects reported at least some postoperative sexual responsiveness. Vaginal depth, measured with a specially constructed probe, averaged 8.3 cm. Only a minority of subjects, however, complained that the neovagina was inadequate for coitus. It is possible that transsexuals accomplish coitus, despite short vaginas, by assuming positions that limit the depth of their partners' thrusting.

Adult↗
PubMed1990

Categorical and multi-axial diagnosis of male erectile disorder.

Diagnostic information was examined on 258 men with male erectile disorder in a multi-site study. Of the sample, 78% was diagnosed as having difficulty both in obtaining and maintaining erections; 20% had a secondary or tertiary diagnosis of hypoactive sexual desire disorder. There was minimal evidence that the multi-axial diagnostic system has advantages over the categorical DSM-III-R diagnosis of male erectile disorder.

Adult↗
PubMed1995

Sexual functioning and attitudes of eating-disordered women: a follow-up study.

The sexual experiences and attitudes of eating disorder patients are receiving increased professional attention. However, empirical work in this area has generally focused on these patients at the point of initial evaluation. In the current study we report the results of a follow-up questionnaire completed by women who had been treated in our clinic (N = 42) for either anorexia nervosa (restricting type) or bulimia nervosa (purging type). We found that former anorectic patients were less likely to return the questionnaire and, of those who did, there was a trend toward anorectic women's being less likely to be in a romantic/erotic relationship. Almost all of the women had engaged in sexual intercourse, and former anorectic patients did not differ from bulimics with regard to age at first coitus. Anorectics were less likely than bulimics to have engaged in masturbation and also scored lower on a measure of sexual esteem. Although there were no differences between the two groups with regard to current level of sexual functioning, erotophobia/erotophilia, or sexual satisfaction, the women in our sample exhibited less sexual interest and more negative affect during sex than did a normative sample. Also, nearly 40% of our sample indicated clinically significant levels of sexual discord with their current partner. Results are discussed with regard to prior research, interventions, and further study.

Adolescent↗
PubMed1995

The evaluation of some factors influencing the sexual life of women affected by breast cancer.

Although there is clinical evidence that cancer patients become less interested in sexuality and develop some difficulties in sharing feelings and thoughts with their spouses, systematic information on the factors influencing intimacy are lacking. The aim of this study is to explore the importance of variables such as reaction to illness and scarring, and marital satisfaction on the patients' capability to resume an enjoyable sexual life following surgery and radiation for the treatment of their tumors.

Adult↗
PubMed1996

Auto-erotic asphyxiation: three case reports.

Men who indulge in auto-erotic asphyxial practices are rarely encountered by psychiatrists. More often, they come to light at a coroner's inquest, and a verdict of "accidental death" is usually rendered (e.g., from hanging/suffocation). This paper describes and contrasts three cases of auto-erotic asphyxial practices. The first case, of accidental death by hanging, was an apparently highly successful young man who functioned at a high level and was without "serious psychopathology." In contrast, the other two, both survivors of asphyxial practices, manifested multiple paraphilias and other types of psychopathology. The syndrome may be extremely diverse, and survivors who consult psychiatrists require holistic assessment and treatment tailored to multifarious needs.

Adolescent↗
PubMedDate not supplied

The Golombok Rust Inventory of Sexual Satisfaction (GRISS): psychometric properties within a Dutch population.

The aim of this study was to investigate the psychometric properties of the Golombok Rust Inventory of Sexual Satisfaction (GRISS) in a Dutch population. The participants in this study were 373 heterosexual couples: 305 couples with a sexual problem and 68 student couples (test-retest). Evidence for a 12-factor solution corresponding to the original 12 subscales of GRISS was found, although some of the subscales were rather highly correlated. The homogeneity of the 12 GRISS subscales, as determined by mean interitem correlations, item-rest correlations, and Cronbach's coefficient alpha, was satisfactory to good. The test-retest reliability of the GRISS scales was sufficient. The GRISS subscales were reasonably stable with respect to age, duration of the relationship, and level of education. Furthermore, a higher order factor analysis on the 12 subscales suggested a male and a female sexual dissatisfaction factor.

Adult↗
PubMedDate not supplied

Life-long absence of sexual drive in a woman associated with 5-dihydrotestosterone deficiency.

A case of a woman who presented with life-long absence of sexual drive is reported. Although her history contained psychological factors that might have been etiologic in her presentation, she had not responded to sex therapy or cognitive-behavior psychotherapy undertaken at other clinics. When seen by the author, she was found to have poorly developed external genitalia. The only abnormality discovered on endocrinological evaluation was a reduced level of 5 dihydrotestosterone. Treatment with dihydrotestosterone gel applied to her vulva generated sexual drive and her ability to become sexually aroused.

Adult↗
PubMedDate not supplied

A possible dopaminergic mechanism in the serotonergic antidepressant-induced sexual dysfunctions.

The administration of antidepressant serotoninergic medication is associated with the presentation of sexual dysfunctions. This seems to be mediated by the activation of the 5-HT2 receptors. Segraves (1995) has proposed that the inhibition of noradrenergic transmission by serotonin may be the mechanism which causes the antidepressant-induced sexual dysfunctions. The inhibition which the 5-HT2 receptors carry out on dopaminergic transmission leads us to propose this mechanism as also participating in the antidepressant-induced sexual dysfunctions.

Animals↗
PubMed2005

Depression, anxiety, hostility and hysterectomy.

Sixty-five women (aged 32 - 54 yrs) were assessed at 2 months before to 8 months after total abdominal hysterectomy on four separate occasions. Beck's Depression Inventory (BDI), Taylor's Manifest Anxiety Scale (TMAS), the Buss-Durkee Hostility Inventory (BDHI), Measurement of Masculinity-Femininity (MF), Likert scales and semantic differentials for psychological, somatic and sexual factors varied as assessment tools. High-dysphoric and low-dysphoric women were compared with regard to hysterectomy outcomes. Married nulliparae suffered from enhanced depression post-surgery. Pre-surgery anxiety, back pain and lack of dyspareunia contributed to post-surgery anxiety. Pre-surgery anxiety was related to life crises. Pre- and post-surgery hostility occurred in conjunction with poor sexual gratification. Post-hysterectomy health improved, but quality of sexual relationship was impaired. Partner support and knowledge counteracted hysterectomy aftermath. Post-hysterectomy symptoms constituted a continuum to pre-surgery signs of depression, anxiety or hostility.

Adult↗