Clinical Sample Of Women Research Articles

Do appearance related safety behaviors contribute to distress intolerance? A Multi-method examination

Individuals elevated in distress intolerance (DI) may engage in dysfunctional behavioral strategies to cope with their distress. One behavioral strategy that may be related to DI is appearance related safety behavior (ARSB; i.e., maladaptive behavior that seeks to mitigate the feared consequences of the negative evaluation of appearance). We examined the relationship between DI and ARSBs in two separate samples of women. In Study 1 (N = 91), we found in an unselected sample that ARSBs were robustly associated with DI cross-sectionally while accounting for symptoms of depression and body dysmorphia. Further, greater ARSBs predicted increases in DI longitudinally. In Study 2, among a clinical sample of women with elevated appearance concerns (N = 94), we examined the experimental effect of reducing ARSBs compared to a self-monitoring control. Relative to control, instructions to reduce ARSBs led to lower DI, but this effect was only found for individuals low in baseline DI. Overall, we found preliminary evidence that ARSBs may be a salient factor in contributing to and maintaining DI; and SB fading may be a helpful strategy for reducing DI. We discuss these findings in the context of existing literature and provide directions for future research.

Guilt, alexithymia, and posttraumatic symptoms in the aftermath of intimate partner violence: A mediation analysis.

The objective of this article is to explore the relationships between two significant predictors, as indicated by existing literature, of posttraumatic stress disorder (PTSD) symptoms: guilt and alexithymia. The investigation centers on a clinical sample of women who have encountered intimate partner violence (IPV). A total of 740 women who had experienced IPV (Mage = 42.84, SD = 11.092) were recruited to participate in this study. Mediation analysis was employed to examine the mediating role of guilt and alexithymic difficulties in the relationship between IPV and PTSD symptoms. The findings of this study provide empirical support for the mediating effects of guilt and alexithymia in the link between IPV and PTSD symptoms. Specifically, higher levels of guilt and alexithymia were found to be associated with an increased likelihood of experiencing symptoms of PTSD among women with an IPV experience. The results of this study have important implications for the development of interventions tailored to the specific needs of women who have experienced IPV. In particular, interventions that target and address guilt and alexithymia hold promise for effectively mitigating symptoms of PTSD in this population. By addressing these underlying factors, interventions can help women navigate their trauma, facilitate emotional processing, and support their journey toward recovery and well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An experimental examination of appearance-related safety behaviors in a clinical sample of women.

Appearance-related safety behaviors (ARSBs) have been identified as a key mechanistic target in individuals with elevated appearance concerns, social anxiety symptoms, and body dissatisfaction. The aim of the present study was to experimentally test the effect of fading these behaviors in individuals with body dysmorphic disorder (BDD), social anxiety disorder, and/or an eating disorder (ED). Ninety-four female participants were randomized to either a 1-month text message-based ARSB fading condition (n = 47) or a self-monitoring control condition (n = 47). Findings demonstrated that individuals in the ARSB fading condition saw significantly greater reductions in postmanipulation appearance concerns, appearance importance, ED symptoms, general anxiety, and depression. ARSB fading also led to lower BDD and social anxiety disorder symptoms, though this was only found among those who met for these respective diagnoses. Furthermore, we found that changes in appearance importance partially mediated the effect of condition on appearance concerns, BDD symptoms, social anxiety symptoms, and ED symptoms. Compared to the control, the ARSB fading group also demonstrated less reactivity to an in vivo appearance-related stressor task. This study provides strong evidence for the importance of ARSBs in the maintenance of appearance-related psychopathology among a clinical sample. Findings demonstrate the potential utility of reducing ARSBs as an overarching treatment strategy for appearance-related psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Supplemental Material for An Experimental Examination of Appearance-Related Safety Behaviors in a Clinical Sample of Women

Supplemental Material for An Experimental Examination of Appearance-Related Safety Behaviors in a Clinical Sample of Women

Using network analysis to explore the association between eating disorders symptoms and aggressiveness in Bulimia nervosa

IntroductionAggressive behaviors have been reported to be more frequent in people with eating disorders (ED), especially bulimia nervosa (BN). Network Analysis (NA) is particularly useful or examining the interactions among symptoms of comorbid conditions through the identification of “bridge symptoms,” defined as those symptoms playing a key role in the connection between two syndromic clusters.Objectives The aim of the present study was to investigate the association of ED core symptoms and ED-related psychopathology with aggressiveness in a clinical sample of women with BN through NA.Methods A NA was conducted, including ED symptoms and aggressiveness measures. The bridge function was implied to identify symptoms bridging ED symptoms and aggressiveness.ResultsThe most connected nodes among communities were asceticism and impulsivity from ED-related psychopathology, drive for thinness from ED- core psychopathology and guilt and suspicion from aggressiveness domain. In particular, drive for thinness connected ED-core community to verbal hostility, while impulsivity connected ED-related symptoms to guilt and suspicion of aggressiveness community.Conclusions In conclusion the present study showed that in people with BN guilt is the specific negative emotion of the hostile dimensions that may be bidirectionally associated with ED symptoms.Disclosure of InterestNone Declared

PTSD, dissociative experiences, and depressive symptoms in a clinical sample of women who featured in pornographic productions

IntroductionThe mental health of the people who featured in Pornographic Productions (PP) is underexamined. However, PP frequently involve unsimulated violent acts mostly experienced by women. Furthermore, some women participating in PP also report being coerced into unwanted sexual acts. Therefore, featuring in a PP could be experienced as a traumatic event, and could be associated with negative mental health disorders.ObjectivesOur study examines mental health indicators among Women who have participated in at least one PP (WPP), and who consulted clinical psychologists, after referral by WPP support groups.MethodsThirty-six women were recruited by two clinical psychologists during an individual consultation. Participants completed the French versions of the post-traumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5), the Dissociative Experiences Scale (DES), as well as the 13-item Beck Depression Inventory (BDI-13). Data on socio-demographic characteristics, lifetime experience of sexual violence prior to participating in a PP, as well as the perceived effect of participating in a PP were also measured.ResultsThe mean age of participants was 31.2 (std=7), and the average age at first participation in a PP was 23.4 (std=6). The majority (78%) of participants reported lifetime experience of sexual violence prior to participation in a PP. Thirty women (83%) had a PCL5 score over 33 indicative of probable PTSD, and 28 women (78%) had a DES score of 30 or more indicating high levels of dissociation. Further, 16 participants (44%) reported a BDI-13 score over 16 indicating severe depression.ConclusionsThis study highlights the high prevalence of PTSD, dissociative experiences, and depressive symptoms in a clinical population of women who featured in at least one PP. Further studies are needed to better understand the scale of the problem and optimize care interventions.Disclosure of InterestNone Declared

Identification and validation of reference genes of circulating microRNAs for use as control in gestational toxoplasmosis

Toxoplasmosis causes serious harm to the fetus, as tachyzoite dissemination, during pregnancy in women developing the primo-infection. The microRNAs (miRNAs) are small non-coding RNAs, which have regulatory roles in cells by silencing messenger RNA. Circulating miRNA are promising biomarkers for diagnosis and prognosis of numerous diseases. The miRNAs levels are estimated by quantitative real-time PCR (qPCR), however, the relative quantification of each miRNA expression requires proper normalization methods using endogenous miRNAs as control. This study analyzed the expression of three endogenous miRNAs (miR-484, miR ‐423‐3p and miR-26b-5p) for use as normalizers in future studies of target miRNAs for gestational toxoplasmosis (GT). A total of 32 plasma samples were used in all assays divided in 21 from women with GT and 11 from healthy women. The stability of each endogenous miRNA was evaluated by the algorithm methods RefFinder that included GeNorm, Normfinder, BestKeeper and comparative delta-CT programs. The miR-484 was the most stably gene, and equivalently expressed in GT and NC groups. These results contribute to future studies of target miRNAs in clinical samples of women with gestational toxoplasmosis.

Dysmenorrhea catastrophizing and functional impairment in female pelvic pain.

Dysmenorrhea is suggested to increase the risk of chronic pain by enhancing central sensitization. However, little is known about whether emotional and cognitive responses induced by dysmenorrhea contribute to chronic pain interference. This study examined the association between catastrophizing specific to dysmenorrhea and both dysmenorrhea and chronic pelvic pain (CPP)-associated pain interference. Women (N = 104) receiving care for CPP through a tertiary gynecological pain clinic between 2017 and 2020 were recruited. They completed the Pain Catastrophizing Scale, the Brief Pain Inventory-pain interference, and a separate questionnaire regarding dysmenorrhea symptoms and treatment preceding the development of CPP. Dysmenorrhea catastrophizing and interference measures were developed and tested for internal consistency and construct validity. Multiple linear regression models examined dysmenorrhea catastrophizing in association with dysmenorrhea interference and CPP-associated pain interference. Dysmenorrhea catastrophizing and interference measures demonstrated excellent internal consistency (Cronbach's Alpha = 0.93 and 0.92 respectively) and evidence of construct validity (correlated with dysmenorrhea severity and treatment, Ps < 0.01). Dysmenorrhea catastrophizing was moderately correlated with pain catastrophizing (ρ = 0.30, P = 0.003), and was associated with greater dysmenorrhea interference (P < 0.001) and CPP-associated pain interference (P = 0.032) accounting for general pain catastrophizing and other outcome-specific confounders. Dysmenorrhea intensity was most predictive of dysmenorrhea catastrophizing. Among our clinical sample of women with CPP, dysmenorrhea catastrophizing was associated with greater dysmenorrhea interference and subsequent CPP-associated pain interference. More research is needed to determine whether reduction in dysmenorrhea catastrophizing leads to reduced pain interference associated with female pelvic pain.

Identification and Quantification of Waddlia Chondrophila in Women with Recurrent Pregnancy Loss

Background and Aims: Recurrent pregnancy loss (RPL) is one of the important complications of pregnancy. Only 50% of cases have a known cause of RPL. One of the causes of RPL is Waddlia Chondrophila (W. Chondrophila), but no information is available regarding its in Iran. This study aimed to develop a Taqman Real-Time polymerase chain reaction assay to detect recA Gene of W. Chondrophilain biological samples from women with RPL in Yazd city.&#x0D; Materials and Methods: Clinical samples of women with a history of RPL, normal childbirth, and standard strain WSU 86–1044 were provided. Primers and probes of W. Chondrophila were designed. Positive control was provided based on the PUC57 vector. Technical performance was examined using a control plasmid.&#x0D; Results: Analytical sensitivity was 5 ng/µl of control plasmid DNA. No cross-amplification was observed when testing other pathogens that can detect in human vaginitis. The Taqman Real-Time PCR assay exhibited good reproducibility. This Real-Time PCR was then applied to 100 vaginal swabs. No samples were revealed to be Waddlia positive.&#x0D; Conclusions: This new TaqMan Real-Time PCR assay represents a diagnostic tool that may be used to further study the prevalence of W. Chondrophila infection in clinical specimens.

Using network analysis to explore the association between eating disorders symptoms and aggressiveness in Bulimia nervosa

Aggressive behaviors have been reported to be more frequent in people with eating disorders (ED), especially bulimia nervosa (BN). Network Analysis (NA) is particularly useful or examining the interactions among symptoms of comorbid conditions through the identification of “bridge symptoms,” defined as those symptoms playing a key role in the connection between two syndromic clusters. The aim of the present study was to investigate the association of ED core symptoms and ED-related psychopathology with aggressiveness in a clinical sample of women with BN through NA. Two hundred and seventy-nine women with BN completed the Eating Disorder Inventory-2 and the Buss-Durkee Hostility Inventory. A NA was conducted, including ED symptoms and aggressiveness measures. The bridge function was implied to identify symptoms bridging ED symptoms and aggressiveness. The most connected nodes among communities were asceticism and impulsivity from ED-related psychopathology, drive for thinness from ED-core psychopathology and guilt and suspicion from aggressiveness domain. In particular, drive for thinness connected ED-core community to verbal hostility, while impulsivity connected ED-related symptoms to guilt and suspicion of aggressiveness community. In conclusion the present study showed that in people with BN guilt is the specific negative emotion of the hostile dimensions that may be bidirectionally associated with ED symptoms.

Dysmenorrhea and associated psychosocial and functional impact prior to the development of chronic pelvic pain

Chronic pelvic pain (CPP) in women is characterized by complex etiologies, psychosocial comorbidities, and treatment difficulties. Dysmenorrhea and the associated psychosocial and functional impairment beginning in adolescence may facilitate the transition into more debilitating CPP. This study describes dysmenorrhea history in a clinical sample of women with CPP and identifies predictors of dysmenorrhea catastrophizing (anxiously ruminating about dysmenorrhea symptoms) and functional impairment. From January-August 2020, we recruited 105 female patients (18+ years of age) with CPP receiving care through a tertiary center for chronic pelvic/vulvar pain. Patients completed a questionnaire that elicited dysmenorrhea information prior to the onset of their non-cyclical CPP. Questions included past dysmenorrhea symptoms and treatments, dysmenorrhea catastrophizing, and dysmenorrhea interference with activities of daily living. Multiple linear regression models identified predictors of dysmenorrhea catastrophizing and interference. On average, participants were 36 years of age and predominantly non-Hispanic white (82%). The majority (78%) experienced dysmenorrhea with each or most menstrual cycles, rated as moderate or greater intensity, within 5 years of menarche. Of these, 55% previously sought treatment. Over-the-counter pain medications, heating pad, and birth control pills/patch/ring were the most commonly reported dysmenorrhea treatments, and 10% of patients reported history of prescription opioids and 11% of marijuana use. Duration of dysmenorrhea within each menstrual period and dysmenorrhea intensity were most predictive of dysmenorrhea catastrophizing. Dysmenorrhea intensity and catastrophizing were predictive of dysmenorrhea interference, with catastrophizing mediating 62% (95% CI = 42%-83%) of the effect of dysmenorrhea intensity on interference. The majority of women in our sample reported dysmenorrhea prior to developing CPP, with some using opioids and marijuana for managing dysmenorrhea. The duration and intensity of dysmenorrhea were key predictors of dysmenorrhea catastrophizing, which in turn largely explained dysmenorrhea-associated functional impairment. These findings underscore the importance of early intervention for dysmenorrhea.

Contraste del Modelo Jerárquico Tetrafactorial para el Test de Actitud Corporal en Mujeres Mexicanas

El Body Attitude Test (BAT) fue desarrollado para evaluar la experiencia subjetiva hacia el propio cuerpo y las actitudes que se tienen con el mismo en muestra clínica de mujeres con desórdenes alimentarios. Objetivo. Este estudio toma la versión en español del BAT y analiza su estructura, su consistencia interna e invarianza factorial en una muestra de adolescentes mexicanas. Método. Se usó un análisis factorial confirmatorio para evaluar la estructura factorial subyacente e identificar la validez de constructo del modelo de medición, así como se realizó un análisis de la invarianza factorial. Participantes. La muestra se conformó por 571 mujeres con una media de edad de 15.2 (DE=2.51). Resultados. El análisis de consistencia interna mostró una alta confiabilidad para el conjunto de 20 ítems igual a la propuesta original. La estructura tetrafactorial fue confirmada en el total de la muestra mediante una validación cruzada de la misma, dividida en pares y nones obteniendo valores de bondad de ajuste adecuados (χ2/gl = 3.615; RMSEA = .068; CFI = .917; TLI = .903; IFI=.917; NFI= .889). La estructura modelada fue estrictamente invariante en los grupos analizados de preadolescentes y adolescentes. Conclusiones. Se concluye que el BAT posee propiedades psicométricas apropiadas para población no clínica de adolescentes, no obstante se requieren de futuras investigaciones que incluyan población clínica.

Eating Disorders and Sexual Function Reviewed: A Trans-diagnostic, Dimensional Perspective

Clinical observation and a growing body of empirical research point to an association between disordered eating and sexual function difficulties. The present review identifies and connects the current knowledge on sexual dysfunction in the eating disorders, and provides a theoretical framework for conceptualizing the association between these important health conditions. Research on sexuality and eating pathology has focused on clinical samples of women with anorexia nervosa (AN) and bulimia nervosa (BN). All aspects of sexual response can be impacted in women with an eating disorder, with sexual function in women with AN appearing to be more compromised than in women with BN. Research of this nature is extremely limited with respect to BED, non-clinical samples, men, and individuals with non-binary gender identities. Sexuality should be examined and addressed within the context of eating disorder treatment. Sexual dysfunction and eating disorders, along with commonly comorbid disorders of anxiety and mood, can be seen as separate but frequently overlapping manifestations of internalizing psychopathology. Psychological, developmental, sociocultural, etiological, and biophysical factors likely represent risk and maintenance factors for internalizing disorders. A dimensional, trans-diagnostic approach to disordered eating and sexuality has promising implications for future research and clinical interventions.

Is It Possible to Train the Focus on Positive and Negative Parts of One's Own Body? A Pilot Randomized Controlled Study on Attentional Bias Modification Training.

Dysfunctional body- and shape-related attentional biases are involved in the etiology and maintenance of eating disorders (ED). Various studies suggest that women, particularly those with ED diagnoses, focus on negatively evaluated parts of their own body, which leads to an increase in body dissatisfaction. The present study aims to empirically test the hypothesis that non-ED women show an attentional bias toward negative body parts and that the focus on positive and negative parts of one’s own body can be modified by attentional bias modification training based on a dot-probe task. Although several studies have measured body-related attentional biases by using pictures of participants’ own bodies, the approach of investigating attentional bias via a dot-probe task while presenting pictures of the participants’ own body parts and modifying the biased attention using such pictures is novel. Women (n = 60) rank-ordered 10 parts of their own body regarding their attractiveness. To examine and modify the attentional focus, pictures of the self-defined positive and negative parts of one’s own body were presented by means of a dot-probe task. A paired-sample t-test revealed no difference between reaction times to negative compared to positive body parts, indicating no attentional bias toward negative parts of one’s own body. A two-way ANOVA revealed a main effect of time for pictures of positive and negative parts of one’s own body, with a decrease in reaction times from pre- to post-training. However, there was no significant interaction between time and training condition concerning reaction times to positive and negative body parts. Our findings replicate previous evidence of a balanced attentional pattern regarding one’s own body in women without ED diagnoses. However, the dot-probe task failed to modify the attentional focus. As the modifiability of state body image increases with more pronounced body dissatisfaction, the next step would be to test this approach in clinical samples of women with ED diagnoses.

The Effects of Partner Presence and Sexual Stimulation on the Appraisal of Vaginal Pressure and Sexual Arousal

BackgroundSex research lacks experimental studies in which both partners participate in a laboratory procedure. This is relevant in the context of genital pain because painful vaginal sensations often occur in the presence of the partner. AimTo examine the effects of partner presence, sexual stimulation, and vaginal pressure on the appraisal of vaginal sensations and sexual arousal, ultimately aiming to increase the ecologic validity of laboratory designs. MethodsA community sample of 42 women and their male partners watched sexual and neutral films while separated or together. We induced gradually increasing vaginal pressure in the women using an intravaginal inflatable rubber balloon. OutcomesWomen reported on pleasant and painful vaginal pressure and perceived genital arousal. Men and women reported on subjective sexual arousal. We also examined whether these appraisals were moderated by relationship satisfaction. ResultsThe appraisal of vaginal pressure varied as a function of relationship satisfaction. Less satisfied women reported more painful pressure than women who were highly satisfied and highly satisfied women appraised the pressure as more pleasant in the context of a sex film and in the presence (vs absence) of their partner. In men and women, although partner presence had a negative effect on subjective sexual arousal, the presence of the partner did increase women's perception of genital arousal when vaginal pressure was induced during a sex film, particularly when women felt highly satisfied with their relationship. Also, the effects on subjective sexual arousal were moderated by relationship satisfaction. For couples in which the woman was less satisfied, the induction of vaginal pressure resulted in higher subjective sexual arousal when the partner was absent compared with when he was present, whereas when the man felt less satisfied, partner presence had a positive effect on sexual arousal. Clinical ImplicationsInterventions need to focus on the importance of sexual arousal during vaginal pressure stimulation and the way this is shaped by partner and relationship variables. Our results indicate that enhancing the relationship climate is an important target of intervention. Strengths and LimitationsWe did not include physical indices of genital arousal and did not use a clinical sample of women with genital pain. ConclusionsThe appraisal of vaginal sensations and sexual arousal are context-dependent responses that vary as a function of partner presence and sexual stimulation. Including both partners in the laboratory setting is important to create more valid models on sexual responding.Dewitte M, Schepers J, Melles R. The Effects of Partner Presence and Sexual Stimulation on the Appraisal of Vaginal Pressure and Sexual Arousal. J Sex Med 2018;15:539–549.

Sexual Inhibition is a Vulnerability Factor for Orgasm Problems in Women

BackgroundThe differential role of psychological traits in the etiology and maintenance of female orgasm difficulties is yet to be consistently established. AimTo investigate the contribution of different psychological trait features (personality, sexual inhibition and excitation, and sexual beliefs) to predict female orgasm and to assess the degree to which these dispositional factors moderate the association between sexual activity and orgasm occurrence in a large community sample of Portuguese women. Methods1,002 women (18–72 years, mean age = 26.27, SD = 8.74) completed questionnaires assessing personality traits (NEO-Five Factor Inventory), sexual inhibition and sexual excitation (Sexual Inhibition/Sexual Excitation Scales–Short Form [SIS/SES]), sexual beliefs (Sexual Dysfunctional Beliefs Questionnaire), sexual behavior (frequency of sexual activities and frequency of orgasm occurrence), and social desirability (Socially Desirable Response Set). Hierarchical multiple regression and moderation analyses were conducted while controlling for the effect of covariates such as social desirability, sociodemographic and medical characteristics, and relationship factors. OutcomesThe main outcome measurement was orgasm frequency as predicted and moderated by personality, SIS/SES dimensions, and sexual beliefs. ResultsResults of the hierarchical multiple regression analysis indicated a significant predictive role for sexual inhibition (associated with fear of performance failure [SIS1] and related to the threat of performance consequences) and body image beliefs in female orgasm occurrence. The significant predictive effect of extraversion and of sexual excitation on orgasm frequency ceased to be significant with the insertion of all trait predictors in the final model. Furthermore, SIS1 significantly moderated the relation between sexual activity and orgasm occurrence. Clinical ImplicationsAttention should be given to individual factors impairing orgasmic response in women, particularly sexual inhibition processes. The development of clinical strategies to address and regulate them is recommended. Strengths and LimitationsAlthough this study investigated a large community sample, this sample was composed of heterosexual, relatively young women and thus generalization of the present results demands some caution. Social desirability was controlled for in the analyses and questionnaires were not collected face to face, which constitutes a strength of this study because social desirability is lower in self-administered online questionnaires compared with paper-and-pencil questionnaires, particularly for more sensitive sexual issues. ConclusionSIS1 was found to be a vulnerability factor for female orgasmic difficulties. Future research should test these findings with different samples, particularly clinical samples of women with orgasmic problems, preferably with the use of longitudinal designs.Tavares IM, Laan ETM, Nobre PJ. Sexual Inhibition is a Vulnerability Factor for Orgasm Problems in Women. J Sex Med 2018;15:361–372.

Interoception and sexual response in women with low sexual desire.

Sexual concordance is defined as the association between genital response and self-reported sexual arousal. Though one might predict a strong association between sexual concordance and awareness of other internal physiological sensations (termed interoception), past research on sexually healthy women has not found these different domains to be related. The aim of the present study was to test the association between interoception and sexual concordance in a clinical sample of women with Sexual Interest/Arousal Disorder (SIAD). Fifty-two women with SIAD completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), a validated self-report measure of interoception, and completed a heart-beat accuracy test, an objective measure of interoception. They also participated in a laboratory-based assessment of physiological sexual arousal and self-reported sexual arousal while viewing an erotic film. Mental and physiological arousal were correlated at r = 0.27 (range -0.80 to 0.95). There was no significant association between sexual concordance and women’s heartrate awareness. However, five aspects of interoceptive awareness (noticing, emotional awareness, self-regulation, body-listening, and trusting), were predictive of lower, and one aspect (not-distracting) was predictive of higher sexual concordance. We discuss the findings in relation to the role of emotions and arousal states in the interoception-sexual concordance relationship.

Cognitive-Affective Dimensions of Female Orgasm: The Role of Automatic Thoughts and Affect During Sexual Activity

BackgroundCognitive-affective factors contribute to female sexual dysfunctions, defined as clinically significant difficulties in the ability to respond sexually or to experience sexual pleasure. Automatic thoughts and affect presented during sexual activity are acknowledged as maintenance factors for these difficulties. However, there is a lack of studies on the influence of these cognitive-affective dimensions regarding female orgasm. AimTo assess the role of automatic thoughts and affect during sexual activity in predicting female orgasm occurrence and to investigate the mediator role of these variables in the relation between sexual activity and orgasm occurrence. MethodsNine hundred twenty-six sexually active heterosexual premenopausal women reported on frequency of sexual activities and frequency of orgasm occurrence, cognitive factors, and social desirability. Participants completed the Sexual Modes Questionnaire–Automatic Thoughts Subscale, the Positive and Negative Affect Schedule, and the Socially Desirable Response Set. Multiple linear regressions and mediation analyses were performed, controlling for the effect of covariates such as social desirability, sociodemographic and medical characteristics, and relationship factors. OutcomesThe main outcome measurement was orgasm frequency as predicted and mediated by automatic thoughts and affect experienced during sexual activities. ResultsThe presence of failure thoughts and lack of erotic thoughts during sexual activity significantly and negatively predicted female orgasm, whereas positive affect experienced during sexual activity significantly and positively predicted female orgasm. Moreover, negative automatic thoughts and positive affect during sexual activity were found to mediate the relation between sexual activity and female orgasm occurrence. Clinical ImplicationsThese data suggest that the cognitive aspects of sexual involvement are critical to enhancing female orgasm experience and can aid the development of strategies that contemplate the central role of automatic thoughts and of positive emotions experienced during sexual activity. Strengths and LimitationsData were not collected face to face, which constitutes a strength of this study, because it is known that social desirability is lower in self-administered online questionnaires compared with traditional paper-and-pencil questionnaires, particularly for more sensitive sexual issues. The fact that the sample was composed of heterosexual, premenopausal, and relatively young women demands some caution regarding generalization of the present results. ConclusionThe findings support the contribution of cognitive and affective factors to female orgasmic functioning. It is recommended that future research confirm these findings with other samples, particularly clinical samples of women with orgasmic difficulties.Tavares IM, Laan ETM, Nobre PJ. Cognitive-Affective Dimensions of Female Orgasm: The Role of Automatic Thoughts and Affect During Sexual Activity. J Sex Med 2017;14:818–828.

Body-Image Acceptance and Action Questionnaire: Its deleterious influence on binge eating and psychometric validation

Background/Objectives: This study aimed to explore the psychometric properties of BI-AAQ (Body-Image Acceptance and Action Questionnaire) and the body image psychological flexibility role as a mediator in a pervasive path towards binge eating in Brazilian samples. Method: This cross-sectional study was conducted in clinical (overweight or obese women currently in treatment for weight loss; n= 330) and non-clinical (general population; n= 682) groups of women. Results: BI-AAQ has one-factor structure, excellent internal consistency, ability to detect differences between groups and measurement invariance across samples. It was also negatively associated with self-compassion and positively associated with binge eating severity, drive for thinness and self-criticism. Conclusions: This study provides data confirming the robust psychometric properties of BI-AAQ in qualitatively different samples. Furthermore, an additional study conducted in a clinical sample of women with overweight or obesity revealed that body image psychological inflexibility has emerged as a partial and significant mediator of the effect of self-criticism and drive for thinness on binge eating severity.

Depression during the menopause transition: impact on quality of life, social adjustment, and disability.

The impact of depression on quality of life (QOL) and social support has neither been well characterized in clinical samples of women with perimenopausal depression (PMD) nor have the relative contributions of depression and other menopausal symptoms (e.g., hot flushes) to declining QOL been clarified. In this study, we compared QOL measures, social support, and functional disability in PMD and non-depressed perimenopausal women. We evaluated women aged 40-60years who presented with menstrual cycle irregularity, elevated plasma FSH levels, and met criteria for perimenopause. A structured clinical interview was administered to determine the presence or absence of major and minor depression. Outcome measures included the Quality of Life Enjoyment Scale Questionnaire, the Sheehan Disability Scale, the Global Assessment of Functioning, the Social Adjustment Scale, and the Duke Social Support Index. Kruskal-Wallis tests and ANOVAs were used to compare outcome measures. Ninety women with PMD and 51 control women participated in this study. Women with PMD reported significantly decreased QOL, social support, and adjustment and increased disability compared with non-depressed perimenopausal women. Neither perimenopausal reproductive status alone nor the presence of hot flushes had a significant negative impact on QOL measures. PMD is accompanied by significant reductions in QOL, social support, and disability similar to depression in women at other stages of life. PMD may also contribute to decreased QOL in community- or clinic-based samples of perimenopausal women. It remains unclear whether the clinical characteristics we identified reflect pre-existing risk factors for depression during the perimenopause or the effects of a current depression. Future clinical and treatment studies in perimenopausal women should distinguish depressed women when outcome measures include QOL.