To understand the sexual response patterns of men with premature ejaculation and erectile dysfunction, the authors compared genital and affective responses of sexually functional and dysfunctional men with 3 types of sexual stimulation: an erotic video, penile vibrotactile stimulation, and a combination of both. Genital response differed across both groups and stimulus conditions, with an interactive effect indicating that groups showed different response patterns depending on the stimulation. Affective responses also differed across groups and interacted with stimulus conditions. The combination genital and affective response was superior to either alone in distinguishing men with no sexual problems from those with erectile or ejaculatory problems (or both). These factors were particularly useful in discriminating men with premature ejaculation from those with combined premature ejaculation and erectile dysfunction.

Telepsychology is having a profound influence on professional practice. Currently, however, many psychologists lack the requisite knowledge and skill to provide ethical and competent telepractice services. Moreover, the field has lagged in developing the educational and supervised experiences required to achieve competency. Yet, there is great opportunity as well. The purpose of this article is to identify the natural integration of the pillars of counseling psychology with the major domains of telepractice and to link telepractice to the values and mission of counseling psychologists. We present aspects of telepsychology including ethical and legal factors, asynchronous and synchronous practice, and group-focused practice along with technologies and the rules that govern them. We also describe interjurisdictional practice, and introduce a proposed curriculum based upon the benchmark competencies for infusion of telepsychology into training across the professional lifespan.

Career indecision is reconceptualized as a complex, multidimensional problem composed of an undecided state and an indecisive trait.

Affective and cognitive responses to erotic stimulation were studied in sexually dysfunctional men before and after treatment in a sex therapy program. A comparison group of functional men was studied over the same time interval. A pool of 34 Likert-scaled items assessing various cognitions, affects, and perceptions was administered during baseline and following two erotic audiotapes and a self-generated sexual fantasy. To focus on global response patterns rather than individual item responses, five aggregate indices (sexual arousal, physicality, sensuality, negative affect, positive affect) were derived using a strategy that combined face-validity and reliability analysis. Cluster analysis was employed as an auxiliary technique to confirm the coherence of these groupings. All five indices differentiated dysfunctional men from controls, and further, three indices (physicality, sensuality, sexual arousal) showed significant variation across types of erotic stimulation. Correlations among the five indices, as well as with penile response, revealed two trends that differentiated dysfunctional men from controls during the pretest, but that diminished following sex therapy in the dysfunctional men. Future investigations might further rely on multiple-item indices as described here. Such measures may provide a more integrated view of sexual response in the laboratory and lead to greater understanding of affective and perceptual differences between functional and dysfunctional men.

Introduction A number of milestones in the treatment of premature ejaculation (PE) have occurred over the past five decades, including the development of various behavioral and cognitive techniques as well as pharmacotherapies that modify neurophysiological processes involved in ejaculation. Nevertheless, the notion that sexual responses such as PE are influenced by physiological, psychobehavioral, cultural, and relationship factors is as valid now as it was 50 years ago, and therefore, interventions should consider all such domains in the development of effective treatment strategies. Aim Provide an overview of which patients with PE are suitable to receive psychosexual treatment and the psychological approaches for managing this disorder. Methods Review of the literature. Main Outcome Measure Psychosexual treatments that integrate behavioral, psychological, and relationship functioning. Results PE is typically a couple's problem and, therefore, psychotherapy is best when the partner is involved. Before embarking on psychotherapy, the clinician should obtain a medical history pertaining to sexual-, psychological-, and relationship-related factors, so that the treatment strategy can be tailored to the needs of the individual. General strategies underpinning integrative, “process-oriented” elements of psychotherapy most relevant to PE are: developing the therapist–patient relationship; expressing empathy, genuineness, and positive regard; motivational interviewing, i.e., developing motivation to change; developing discrepancy; working through resistance; identifying PE-related affect, cognitions, and behaviors (including interaction with partners); and supporting self-efficacy. The four main domains that encompass psychotherapy techniques specific to the treatment of PE are: behavioral; cognitive; affective; and relational. Sustained positive outcomes in PE may be obtained using a combination treatment strategy that addresses all elements of PE, including psychological and biological factors. Conclusions Psychosexual treatments may help the patient with PE and his partner to address their sexual problems and improve their overall relationship. The effects of psychosexual therapy may be augmented by combining this intervention with pharmacotherapy.