Retarded ejaculation is the persistent difficulty or inability to ejaculate despite the presence of adequate sexual desire, erection, and stimulation. The causes of this dysfunction may be organic, i.e., medical illness or drug ingestion (particularly medications with antiadrenergic effects), the result of surgical interventions, or secondary to inhibiting psychological factors. With regard to psychological determinants, fear, guilt, resentment, and passively have all been implicated, although objective studies are rare. The sexual object choice of men with retarded ejaculation has ben reported by several clinicians and investigators to be other than adult members of the opposite sex, while the marital relationship of these males has been considered etiological in other instances. Outcome assessment to date consists mostly of individual case reports or reports on small groups of patients treated without controls. To some extent, routine reliance on long-term traditional therapy has yielded to shorter, symptomatic learning-based treatments. While improved outcomes have been reported, many patients do not respond well. It is not yet possible to objectively predict succes or failure. Since it is our impression that this sexual dysfunction is more common than previously assumed (or is increasing in frequency), our present lack of data should soon be remedied.

Twenty-two anorgasmic women received 20 sessions of a multiple-technique behavioural therapy. The design included blind ratings by two independent assessors, multiple assessment instruments, and a waiting list control group. Treatment was significantly better than no treatment in terms of: (1) the percentage of patients experiencing orgasm during at least 50 per cent of sexual relations; (2) the percentage of women reporting satisfactory sexual relations at least 50 per cent of the time; (3) patients' ratings of positive reactions to various sexual behaviours; and (4) assessors' global clinical ratings. Significant improvement was also noted on the MMPI, IPAT, and Symptom Check List. Improvement was maintained at a follow-up average 9 months later. These results support the impression that a behavioural approach offers much promise in treating female orgasmic dysfunction.

This study was designed to obtain objective data on the personality profiles of two groups of males with a primary complaint of erectile failure and compare them to a group of psychiatric patients unselected for sexual dysfunction and to a sexually "normal" control group. Utilizing the Eysenck Personality Inventory, the Institute of Personality and Ability Testing Anxiety Scale, Symptom Checklist, and the Minnesota Multiphasic Personality Inventory, it was determined that males applying to a university/county hospital sex-dysfunction clinic appeared similar to patients seen in the same clinic who were unselected for sex dysfunction and more psychologically disturbed than patients with the same complaint applying for treatment at a private clinic. All three groups showed more psychopathology than sexually normal males. The implications of these findings are discussed.

MMPI scores of 37 general psychiatric outpatients unselected for sexual dysfunction were compared with those of 19 premature and 16 retarded ejaculators, and 19 non-patient controls screened for sexual disorders. The general psychiatric outpatients exhibited significantly more psychopathology than the premature and retarded ejaculators. Scores of the latter two groups tended to fall between those of the normal and psychiatric patient groups. The general psychiatric outpatients scored significantly higher than the non-patient group on all scales, with the exception of the Masculinity-Femininity and Mania scales. The significance of these findings is discussed.