Sexual Arousal Patterns Research Articles

The Validity of Phallometric Assessment With Rapists: Comments on Looman & Marshall (2005)

In a recent article Looman and Marshall (2005) questioned the validity of phallometric assessment of rapists based on the results of a study of incarcerated rapists and child molesters. In this commentary we offer (1) a critique of the methods used and conclusions reached by Looman and Marshall and (2) a discussion of important methodological issues relevant to phallometry. We conclude that the correct inference from Looman and Marshall's study is that rapists, as a group, show a pattern of sexual arousal to audiotaped scenarios of coercive and non-coercive sex that significantly differs from the pattern of groups of non-sex offenders, in agreement with the general literature on this question.

Psychophysiological and subjective sexual arousal to visual sexual stimuli in new women

Conflicting data exist regarding the sexual arousal patterns of post-operative male-to-female (MTF) women with Gender Identity Disorder. The purpose of this study was to examine objective and subjective aspects of the sexual arousal response using a vaginal photoplethysmograph. Fifteen MTF women viewed neutral and erotic audiovisual film segments while their blood flow patterns were monitored. Subjective measures of affect and sexual arousal were taken before and immediately after the films. There was a significant increase in self-reported subjective arousal, perceived genital arousal, perceived autonomic arousal, and positive affect; however, movement artefacts interfered with our assessment of the genital arousal response. MTF women reported both low levels of pain and low levels of awareness of the vaginal probe during testing. These data are discussed in the context of differences in pelvic musculature between natal and new women and have implications for future studies that aim to measure sexual arousal objectively in MTF women.

Crystal Methamphetamine and Ecstasy Differ in Relation to Unsafe Sex Among Young Gay Men

Poly-substance use in gay social ('club') settings is common. Recent studies suggest a link between 'club' drug use and sexual risk behaviours. In this qualitative study, we compare and contrast two 'club' drugs: crystal methamphetamine and ecstasy (MDMA). Life history interviews were conducted with 12 HIV seroconverters and 12 age-matched controls recruited from a prospective cohort study of young gay and bisexual men in Vancouver, British Columbia. Textual data concerning illicit substance use and unsafe sex were analyzed using NUDIST software. Most men related a substantial knowledge of and experience with crystal and ecstasy. Both drugs had attributes that enhanced gay socialization and were used in the same venues. Crystal was used to remain awake and increase energy. Ecstasy was used to induce euphoria and group connectedness. However, unlike ecstasy, crystal was associated with a distinct pattern of sexual arousal that frequently included unprotected (sometimes group) sex, was more likely to be used regularly by HIV-positive men, and was reportedly highly addictive and problematic. Crystal and ecstasy are used in the same social venues but differ markedly in relation to sexual risk behaviour.

Sexual Arousal Patterns of Bisexual Men

There has long been controversy about whether bisexual men are substantially sexually aroused by both sexes. We investigated genital and self-reported sexual arousal to male and female sexual stimuli in 30 heterosexual, 33 bisexual, and 38 homosexual men. In general, bisexual men did not have strong genital arousal to both male and female sexual stimuli. Rather, most bisexual men appeared homosexual with respect to genital arousal, although some appeared heterosexual. In contrast, their subjective sexual arousal did conform to a bisexual pattern. Male bisexuality appears primarily to represent a style of interpreting or reporting sexual arousal rather than a distinct pattern of genital sexual arousal.

Measurement of Sexual Arousal in Postoperative Male-to-Female Transsexuals Using Vaginal Photoplethysmography

Men's sexual arousal patterns are category-specific: Men typically display significantly greater physiological responses to sexual stimuli depicting members of their preferred gender category. Category-specific patterns of sexual arousal have not been consistently reported in natal women. We used vaginal photoplethysmography to examine patterns of sexual arousal in 11 male-to-female (MtF) transsexuals following sex reassignment surgery (SRS) and in 72 natal women. Subjective arousal was measured with a continuous response lever. Video clips depicting sexual activity between two males, two females, or one male and one female were used as erotic stimuli. All transsexual participants displayed category-specific sexual arousal. Five homosexual transsexual participants (attracted exclusively to males before sex reassignment) showed greater genital and subjective responses to male than to female stimuli, while six nonhomosexual transsexual participants showed the opposite pattern. Vaginal pulse amplitude (VPA) was lower in transsexual participants than in natal women. The mean correlation between VPA and subjective responses was high in nonhomosexual transsexuals, but was significantly lower in homosexual transsexuals and in natal women. One transsexual participant who reported a change in sexual orientation following sex reassignment displayed VPA and subjective responses consistent with her pre-reassignment sexual orientation. We conclude that male-to-female transsexuals display male-typical category-specific sexual arousal following SRS, and that vaginal photoplethysmography is a promising methodology for studying patterns of sexual arousal in postoperative transsexuals.

The physiological basis of human sexual arousal: neuroendocrine sexual asymmetry

Normal sexual arousal and response suppose an integrated process involving both physiological and psychological processes. However, the current understanding of sexual arousal does not provide a coherent model that accounts for the integration of multiple physiological systems that subsequently generate a coordinated sexual response at both the spinal peripheral and cerebral central levels. Herein we suggest a model that involves both sympathetic and parasympathetic activation during sexual arousal via the two classes of gonadal hormones, androgens and oestrogens. We discuss the manner in which gonadal hormones may activate such a system, transforming pre-pubertal (non-erotic) genital stimulation to post-pubertal erogenization of stimulation and subsequent sexual arousal. Finally, we indicate that the different balance of androgens and oestrogens in men and women may generate asymmetric effects on each of the components of the autonomic nervous system, thereby explaining some of the differences in patterns of sexual arousal and the responses cycle across the sexes.

A sex difference in the specificity of sexual arousal.

Sexual arousal is category-specific in men; heterosexual men are more aroused by female than by male sexual stimuli, whereas homosexual men show the opposite pattern. There is reason to believe that female sexual arousal is organized differently. We assessed genital and subjective sexual arousal to male and female sexual stimuli in women, men, and postoperative male-to-female transsexuals. In contrast to men, women showed little category specificity on either the genital or the subjective measure. Both heterosexual and homosexual women experienced strong genital arousal to both male and female sexual stimuli. Transsexuals showed a category-specific pattern, demonstrating that category specificity can be detected in the neovagina using a photoplethysmographic measure of female genital sexual arousal. In a second study, we showed that our results for females are unlikely to be explained by ascertainment biases. These findings suggest that sexual arousal patterns play fundamentally different roles in male and female sexuality.

When an erection alone is not enough: biopsychosocial obstacles to lovemaking.

Giving men firm erections is relatively straightforward these days; getting them to make use of it regularly in lovemaking is more complicated. Discontinuation rates for any of the available medical treatments for erectile dysfunction, including sildenafil, have been found to range from 50% to 60%. Thus, there is a disproportionately high number of individuals who fail to continue using medical interventions compared to those for whom treatment is efficacious. If not efficacy, then what factors contribute to this puzzling dropout phenomenon? This article discusses the psychological resistances of men, women, and couples that contribute to their stopping treatment for erectile dysfunction. Some of the factors that may be responsible include: (1) the length of time the couple was asexual before seeking treatment; (2) the man's approach to resuming a sexual life with his partner; (3) the man's expectations of how sildenafil will change his life; (4) the partner's physical and emotional readiness to resume lovemaking; (5) the meaning for each partner of using a medical intervention to restore lovemaking; (6) the quality of the nonsexual relationship; and (7) unconventional sexual arousal patterns in the man. To be effective, clinicians must go beyond the simple restoration of erectile function to help patients become active lovemakers again.

Telephone scatologia: Comorbidity with other paraphilias and paraphilia-related disorders

The term scatologia is derived from the Greek word, skato, for dung and logos for speech (Gayford, 1997). Thus, telephone scatologia, also referred to as telephone scatophilia and telephonicophilia, is a paraphilia (PA) characterized by a pattern of sexual arousal associated with exposing an unsuspecting victim to sexual and obscene material over the phone (Milner & Dopke, 1997; Schewe, 1997). Telephone scatologia remains classified as a PA not otherwise specified (NOS) in the DSM-IV, because there has been insufficient description of the disorder in the literature to merit a separate category (American Psychiatric Association, 1994). Although specific PAs are distinguished by a characteristic paraphilic focus, all PAs feature recurrent, socially deviant, highly arousing sexual fantasies, urges, and activities that have a duration of at least 6 months and cause clinically significant distress or impairment (American Psychiatric Association, 1994). These latter diagnostic criteria would distinguish true telephone scatologists (TS) from telephone callers who just make a few obscene calls as a prank. Obscene telephone calling is a common behavior with more than 22,000 obscene phone call complaints filed in the Washington, DC area alone in 1989. This is particularly impressive considering that only 7–20% of sexually provocative calls are actually reported to the telephone company (Herold, Mantle, & Zemitis, 1979; Smith & Morra, 1994). Surveys

Human sexual arousal: A modern behavioral approach.

Recent developments in the analysis of derived relational responding have contributed to the behavioral analysis of a wide range of complex human behaviors, including sexual behaviors. In particular, recent research has demonstrated that human sexual arousal patterns can emerge in the absence of a history of instrumental learning or stimulus association. These findings considerably expand the traditional behavioral approach to the analysis of human sexual arousal. The current paper provides an overview of the traditional behavioral approach to the analysis of sexual arousal, and outlines Relational Frame Theory as a modern behavioral approach to human language, cognition, and complex behavior in general. A relational frame approach to the analysis of human sexual arousal is then outlined and its interpretative power in dealing with a range of complex human sexual behavior is demonstrated.

The development of sexual arousal patterns in humans: Implications arising from the derived transformation of functions.

The development of sexual arousal patterns in humans: Implications arising from the derived transformation of functions.

Summary of the Practice Parameters for the Assessment and Treatment of Children and Adolescents Who Are Sexually Abusive of Others

This summary provides an overview of the assessment and treatment recommendations contained in the Practice Parameters for the Assessment and Treatment of Children and Adolescents Who are Sexually Abusive of Others. The parameters were written to aid clinicians in the assessment and treatment of children and adolescents with symptoms of sexually abusive behavior. The assessment and treatment of children and adolescents with sexually abusive behavior requires an understanding of normal sexual development. A multiplicity of biological and psychosocial factors determines the child's sexual development, gender role, sexual orientation, patterns of sexual arousal, sexual cognitions, sexual socialization, and the integration of sexual and aggressive patterns of behavior. The individual's sexuality evolves in concert and as a result of interaction with family, ethnic, social, and cultural influences. These parameters summarize what we know about the epidemiology and phenomenology of sexually abusive youths and provide guidelines for the assessment and the selection of treatment interventions for these youths. Essential considerations in the assessment and treatment of sexually abusive youths, as well as the different categories of sexually abusive youths which should be recognized and which influence treatment decisions, are presented. The spectrum of currently available psychosocial and biological treatments will be summarized.

Assessing sexual interest in clients with learning disabilities using a card-sort task

Attention has turned in recent years to the assessment and treatment of sexual offenders who have a learning disability. Information gained from assessment is crucial in the formulation and evaluation of any treatment, and one aspect of this is assessing the client's sexual interest and arousal patterns. However, assessment methods currently available have significant drawbacks when used with this population. The present work describes how to create and administer a card-sort task that provides qualitative data about sexual interest as well as other information. The task overcomes many of the objections against currently available methods of assessment when used with this population. It places low demands on a client's verbal memory and comprehension skills, requires no reading ability, is easily administered and avoids problems of acquiescence by using open-ended questions. The task has been piloted across 20 clients living in both community and residential settings. Two case studies are presented to show how the task has been used clinically and how the results have been followed up. A lack of valid comparisons means that validating the test is a methodological challenge. However, standardizing the card sort would mean that it could be piloted across a wider population.

SEXUAL FUNCTIONING AFTER MULTIMODALITY TREATMENT FOR DISSEMINATED NONSEMINOMATOUS TESTICULAR GERM CELL TUMOR

SEXUAL FUNCTIONING AFTER MULTIMODALITY TREATMENT FOR DISSEMINATED NONSEMINOMATOUS TESTICULAR GERM CELL TUMOR

Characteristics and Treatment of Incest Offenders

SUMMARY Sexual abuse of children has emerged as a widespread, multifaceted social problem. This article presents a summary of the professional literature on one aspect of sexual abuse, namely incest offenders. It begins with a description of the characteristics of incest offenders, including gender, personality, sexual orientation, number of victims, patterns of sexual arousal, and neurological anomalies. A discussion then follows of treatment options for incest offenders, including individual, group, and family therapy, psychoeducational skills training, behavioral treatments, chemical castration, and relapse prevention. The article concludes with a review of available data on recidivism.

The effects of secondary stimulus characteristics on men's sexual arousal

The penile plethysmograph is believed by many researchers and clinicians to be the most valid and reliable instrument currently available for assessing male sexual arousal patterns. Stimuli used to elicit sexual arousal in research studies as well as in plethysmographic assessments, however, have varied considerably. We examined the effects of two stimulus characteristics that may greatly influence the measurement of male sexual arousal—the type of sexual behavior depicted and the presence of accompanying audio cues. The sexual arousal of 18 male college students was individually assessed via penile plethysmograph and self‐report while they viewed 60‐second erotic video clips. Each video clip depicted a single sexual behavior; half of the clips were presented with accompanying audio. Separate 2 (sound) x 6 (behavior) x 2 (session) repeated measures ANOVAs revealed significant main effects for sound and behavior for both the physiological and self‐report data, as well as a significant sound x behavior interaction for the self‐report data. The physiological data and self‐report data were also highly correlated (r = .78). Results are discussed in the context of implications for male sexual arousal research and penile plethysmographic assessments.

Empathy for the Victim and Sexual Arousal Among Rapists and Nonrapists

One explanation of the finding that rapists and nonrapists differ in their sexual arousal patterns is that when listening to rape stories, nonrapists, but not rapists, empathize with the rape victim and their sexual arousal is inhibited by her suffering. Fourteen heterosexual rapists and 14 men who were not sex offenders were presented with audiotaped narrations while their penile tumescence was measured. All stories described a male-female interaction and the categories included rape with victim enjoyment, rape with victim suffering, nonsexual assault by the man, and consenting sexual and nonsexual heterosocial interactions. In each category, stories were told from either the woman's or man's point of view. Overall, subjects showed higher arousal to stories described from a female perspective. Consistent with the lack of empathy account of rape, rapists were less empathic than nonrapists and deviant arousal was inversely related to self-reported empathy. The best discrimination between groups was obtained for rape stories told from the point of view of a suffering victim. However, the finding that all rapists, but no nonrapists, preferred rape stories over consenting sex stories suggested that the lack of empathy account of rape was incomplete. The present data suggest that cues of violence and victim distress contribute to sexual arousal among rapists.

Outpatient Treatment Of Child Molesters

Four motivational factors were examined as predictors of treatment effectiveness for 48 male child molesters seen in outpatient therapy. Clients participated in about one year of multi-modal cognitive/behavioral therapy. Acceptance of the problem, attendance, promptness, and level of participation in therapy sessions were used as predictors in regression analyses of two outcome variables: (1) mastery of the principles and concepts from the cognitive/behavioral therapies as measured by proficiency tests and (2) mastery of aversive conditioning procedures as measured by penile plethysmographic monitoring of sexual arousal. Results support earlier findings in the literature that client motivation is related to successful treatment outcome. Motivational factors were more predictive of mastery over cognitive/behavioral therapy approaches than of changes in sexual arousal patterns. Acceptance of responsibility for sexual deviancy consistently proved to be an effective predictor of favorable treatment outcome. Results thus appear to have important implications for handling child molesters in denial and/or who are not compliant with attendance requirements.

Effects of cyproterone acetate on sexual arousal patterns of pedophiles

The antiandrogen treatment of sexual offenders has been shown to reduce the recidivism rate. The mechanism of action has been assumed to be through asexualization with its secondary effects on sexual behavior. This study shows that the mechanism may be more complex and may involve a differential effect on sexual arousal patterns. Treatment responses may differ in high and low plasma testosterone groups.

The Evaluation and Treatment of Sexual Violence, Necrophilia, and Asphyxiophilia

At first sight the phenomena discussed in this paper may seem to have little in common. Yet on close scrutiny it becomes apparent that there is an interesting degree of overlap. Although sexual assaults in general clearly involve multiple causes or factors, social and cultural as well as individual, many sexual aggressors do show psychological or biologic abnormalities which require careful evaluation. Continued empiric study of the variables discussed in this paper is therefore important. The clinical as well as laboratory study of paraphilias with dangerous tendencies to themselves or others is also essential for a better understanding of the causes and relationships between these disorders.