Genital Responsiveness in Healthy Women With and Without Sexual Arousal Disorder

Laan, Ellen; Driel, Esther M. Van; Lunsen, Rik H. W. van

doi:10.1111/j.1743-6109.2008.00827.x

Cited by 98 publications

(65 citation statements)

References 31 publications

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“…The VPA response of women with subjective or combined symptoms (believed to constitute the majority of those who seek treatment) did not differ from those of a control group of women. Recently, Laan, van Driel, and van Lunsen (2008) evaluated whether women diagnosed with FSAD using DSM-IV criteria showed less genital response to visual sexual stimuli than a control group of women without sexual problems. They found no significant differences between the groups in VPA; however, women with FSAD reported less positive and slightly more negative affect in response to the erotic films.…”

Section: Criterion Amentioning

confidence: 99%

The DSM Diagnostic Criteria for Female Sexual Arousal Disorder

Graham

2009

Arch Sex Behav

147

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This article reviews and critiques the DSM-IV-TR diagnostic criteria for Female Sexual Arousal Disorder (FSAD). An overview of how the diagnostic criteria for FSAD have evolved over previous editions of the DSM is presented and research on prevalence and etiology of FSAD is briefly reviewed. Problems with the essential feature of the DSM-IV-TR diagnosis--"an inability to attain, or to maintain…an adequate lubrication-swelling response of sexual excitement"--are identified. The significant overlap between "arousal" and "desire" disorders is highlighted. Finally, specific recommendations for revision of the criteria for DSM-V are made, including use of a polythetic approach to the diagnosis and the addition of duration and severity criteria.

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Section: Criterion Amentioning

confidence: 99%

The DSM Diagnostic Criteria for Female Sexual Arousal Disorder

Graham

2009

Arch Sex Behav

147

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“…Ultimately, therapy strives towards optimal sexual functioning, which is most often defined in terms of painless vaginal penetration. However, when taking into account a cognitive-motivational perspective, it becomes clear that interventions should not rely solely on CBT-related fear-reduction techniques, but optimally concentrate on the psychosocial meaning of sexual stimulation [20] by working on pain cognitions, sexual selfworth, context variables and motivational factors, always holding the interactive relationship component in mind.…”

Section: The Role Of Motives and Relational Processesmentioning

confidence: 99%

Understanding sexual pain: A cognitive-motivational account

Dewitte

Lankveld

Crombez

2011

Pain

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Sexual pain 2 Introduction Sexual pain or dyspareunia is a prevalent and disabling health problem in women [21].It is generally defined as a recurrent or persistent pain during sexual activities, involving vaginal penetration or tactile stimulation of the vulva and vestibule [1]. In many patients, the pain is also elicited by nonsexual activities and is comparable to other pain syndromes in terms of severity, sensory characteristics, and neurological processes [25]. As yet, little is known about the etiology of sexual pain because current research is complicated by a number of factors. First, dyspareunia encompasses multiple pain conditions with varying etiologies, causing nosological confusion [4]. Second, evidence on causal factors is inconclusive because there are no controlled experimental studies that allow discerning cause and effect. Third, research has put more emphasis on physical markers -including neurogenic pelvic inflammation, neurochemical influences, central and peripheral sensitization, and increased vulva-vaginal innervations [35] -rather than considering psychosocial variables that may exacerbate and maintain sexual pain problems. Pain is, however, a multidimensional experience that needs to be addressed in all its dimensions, including biomedical as well as psychosocial aspects. Because much less is known about the psychological and relational determinants of sexual pain, this review focuses specifically on the role of cognitivemotivational factors in relation to pain. Such cognitive-motivational perspective is likely to inform both research and clinical practice. These physiological reactions may Sexual pain 3 then, in a self-fulfilling way, increase the pain during sexual intercourse. Hence, critical for the development of dyspareunia is the lack of genital arousal that is marked by insufficient lubrication and driven by anticipation-anxiety. In support of this model, research has shown that women react with involuntary pelvic floor muscle activity in response to threatening sexual stimuli [34] and impeded genital arousal -as measured through vaginal pulse amplitude signals -in response to appraisal (i.e., suggestion that a female actor experiences pain) and pain threat (i.e., threat of electrical pulses on the ankle) manipulations [6,7].Genital responsiveness was, however, not different in women with dyspareunia compared to healthy controls, although they did report lower subjective sexual arousal. Note that such discordance between physiological (i.e., genital) and psychological (i.e., subjective experience of) sexual arousal is commonly observed in women [26]. These results indicate the need for further study on the role of low vaginal vasocongestion and the importance of including subjective sexual arousal into research on dyspareunia. Furthermore, given that sexual arousal is not a unitary process, it is important to investigate not only the direct effect of pain on sexual arousal, but also how pain affects the cognitive and motivational processes that ultimately lead to differenti...

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“…Other researchers welcome this merging due to unpractical and unworkable nature of DSM IV TR FSAD definition based on impaired/absent genital responses and the high overlap of the two problems (26). Impaired genital responsiveness was not found to be a valid diagnostic criteria in healthy women with or without sexual arousal disorder (17). Additionally the authors suggested that "desire not being triggered by any sexual/ erotic stimulus" should be considered as a primary or "must" criterion for diagnosis of SIAD as the diagnosis can only be made when sexual incentives are present or sufficient.…”

Section: Diagnostic Criteria For Substance-induced Sexual Dysfunctionmentioning

confidence: 99%

“…Diagnostic classification should be separately made for males and females as women's sexual responses may not be analogous to men. Additionally given the complexity of sexual responses in women, classifications based on simple linear sexual response cycle may not be (17,18). Sexual thoughts may act as an internal sexual stimuli and desire or arousal may be viewed as responses to this internal stimuli which implies that sexual desire is not spontaneous but rather a response to covert internal triggering processes (19).…”

Section: Diagnostic Criteria For Substance-induced Sexual Dysfunctionmentioning

confidence: 99%