Threat Of Performance Failure Research Articles

Hypoactive sexual desire disorder in women: new possibilities to ensure better understanding, diagnosis, and response to treatment.

Hypoactive Sexual Desire Disorder (HSDD) is a frequent sex-related problem in women; however, a specific tool to characterize HSDD subtypes based on sexual inhibitory and excitatory factors is still lacking. (1) To find a cutoff value in Sexual Inhibition Scale (SIS)/Sexual Excitation Scale (SES) scores predicting a diagnosis of HSDD in women consulting for sexual symptoms, (2) to explore the sexual inhibitory and excitatory profiles in women referred to a clinic for female sexual dysfunction by stratifying the sample according to the newfound cutoffs, and (3) to identify biopsychosocial factors significantly associated with the 2 profiles. An overall 133 women consulting for sexual symptoms were retrospectively evaluated for clinical, biochemical, and psychosexologic data collected at the first visit. A subgroup of 55 women treated with transdermal testosterone was retrospectively analyzed at baseline and the 6-month visit. Patients underwent physical and laboratory examinations and completed the SIS/SES, Female Sexual Function Index, Female Sexual Distress Scale-Revised, Emotional Eating Scale, and Middlesex Hospital Questionnaire. Specific cutoffs for SIS1 (≥32.5; indicating threat of performance failure) andSES (≤46.5) predicted HSDD diagnosis with an accuracy of 66.4% (P = .002) and 68.7% (P < .0001), respectively. Patients with impaired SIS1 scores showed higher distress and psychopathologic symptoms, while those with impaired SES scores demonstrated lower desire and arousal and a negative association with some metabolic and hormonal parameters. SES score also showed a significant predictive value on testosterone treatment efficacy for HSDD. A better characterization of HSDD would enable individualized treatment based on the main underlying etiologies. Limitations of the study include the small sample size and cross-sectional retrospective design, with the choice of treatment for HSDD limited to transdermal testosterone. Strengths comprise the thorough and multifactorial evaluation of every aspect potentially affecting inhibitory and excitatory components of sexual desire. Validated cutoffs of SIS/SES scores could allow deep characterization of women diagnosed with HSDD, thus ensuring better tailoring of therapy and prediction of the probability of response to specific treatments.

Validation of the Sexual Inhibition/Sexual Excitation Scales (SIS/SES) in Italy: Assessing Gender and Age Differences of Sexual Functioning

The Sexual Inhibition Scales and Sexual Excitation Scales (Janssen et al., 2002a), based on the dual control model by Bancroft and Janssen (2000), are part of a 45-item self-report questionnaire evaluating individual tendencies to sexual inhibition or excitation according to three factors: two inhibition factors, SIS1, threat of performance failure, and SIS2, threat of performance consequences, and one excitation factor, SES. In this paper, we aimed to validate and explore psychometric properties of the SIS/SES in a sample of 2260 Italian men and women aged 18 to 75 years. Confirmatory factor analyses showed that the three-factor structure proposed in the original version of the scales fit with our sample. Moreover, our data confirmed the results of the original validation sample: Women scored higher on the SIS and lower on the SES than men did, but no significant differences appeared in the factor scores by age group, except for a gender × age interaction, where younger women had higher SIS2 scores. The SIS/SES appeared to be an effective, appropriate cross-cultural measurement of human sexuality in Italian samples, also shedding light on sexual arousal differences in women and men in our country. We also discuss clinical and therapeutic aspects.

Sexual response in obsessive-compulsive disorder: the role of obsessive beliefs.

Sexual response in obsessive-compulsive disorder (OCD) research and practice is overlooked. According to the Dual Control Model, satisfactory sexual response is based upon a balance of sexual excitation and inhibition. The assessment of sexual response in OCD may have clinical implications, such as the integration of sex therapy in psychotherapeutic intervention. The present study was aimed at comparing sexual excitation and inhibition levels between OCD patients and matched control subjects, and investigating whether obsessive beliefs might predict sexual excitation/inhibition. Seventy-two OCD patients (mean age±standard deviation [SD]: 34.50±10.39years) and 72 matched control subjects (mean age±SD: 34.25±10.18) were included (62.50% men and 37.50% women in both groups). The Obsessive Compulsive Inventory-Revised (OCI-R), the Obsessive Beliefs Questionnaire-46 (OBQ-46), and the Sexual Inhibition/Sexual Excitation Scales (SIS/SES) were administered. Patients with OCD showed significantly higher levels of sexual excitation, inhibition due to threat of performance failure, and inhibition due to threat of performance consequences than the controls. In addition, the patients with more severe symptoms showed lower excitation than those with less severe symptoms, and those with higher perfectionism had stronger inhibition due to threat of performance failure than those with lower perfectionism. This is the first study exploring sexual response in OCD according to the Dual Control Model. Sexual response is an impaired quality of life outcome in OCD that should be assessed in routine clinical practice. These findings support the importance of addressing specific obsessive beliefs to improve sexuality in OCD patients.

An Exploratory Study of Factors Associated With Sexual Inhibition and Excitation: Findings From a Representative Survey in Flanders

The dual control model of sexual response was developed to account for individual differences in sexual excitation and inhibition. According to this model, the balance between excitation and inhibition is of crucial importance in determining an individual's sexual response to a stimulus. In this study, we aimed to contribute to the existing literature on sexual excitation and inhibition in two ways. First, we investigated the distribution of excitation and inhibition scores in a representative population sample. Second, we conducted an exploratory study of the factors associated with variation in excitation and inhibition. We used data from a representative survey on the sexual health of men and women in Flanders (N = 1,825; mean age = 43.77; SD = 17.98). The results indicated that excitation and inhibition had a near normal distribution among men and women. However, the scores for sexual inhibition due to threat of performance failure (SIS1) among men, and for sexual inhibition due to the threat of performance consequences (SIS2) among women, were somewhat skewed. Furthermore, age, gender, physical and mental health, education level, and attitudes toward sex were all to some extent associated with differences in inhibition, excitation, or both.

Anxiety and Female Sexual Functioning: An Empirical Study

Previous research regarding anxiety and female sexual functioning has yielded conflicting conclusions. This study examined the effect of state/trait anxiety and anxiety sensitivity on sexual responding and the propensity toward sexual inhibition/excitation in women without an anxiety disorder (n = 100, M age = 28.8 years) compared with women with an anxiety disorder (panic disorder or generalized anxiety disorder, n = 30, M age = 30.2 years). Participants completed self-report measures of state and trait anxiety, anxiety sensitivity, sexual functioning, and sexual inhibition/excitation. Women with an anxiety disorder reported worse sexual functioning compared with those without an anxiety disorder (except for desire, lubrication, and pain) and a greater propensity toward sexual inhibition, because of the threat of performance failure and its consequences. Dispositional anxiety and related worries significantly predicted various types of sexual dysfunctions. Findings suggested the importance of considering the relation between anxiety and sexual functioning to design optimal prevention and therapeutic interventions for women with anxiety disorders.

Unprotected Anal Intercourse in HIV-Positive and HIV-Negative Gay Men: The Relevance of Sexual Arousability, Mood, Sensation Seeking, and Erectile Problems

Reduction of unprotected anal intercourse (UAI) in gay men infected with HIV is important in preventing further spread of this infection. In previous studies, personality trait measures relevant to sexual arousability and the effects of anxiety have been shown to relate to UAI in both gay and heterosexual men. Are HIV+ gay men similar in these respects or are there other personality-related factors that influence their sexual risk taking? This question was addressed using a convenience sample of 156 HIV+ gay men and 155 HIV- gay men, matched for age and UAI risk. There were no significant differences between these two groups on measures of sexual arousability, inhibition of sexual arousal in risky situations, sensation seeking, depression and anxiety proneness, or tendency to increased sexual interest in negative mood states. HIV+ men were, however, more likely to report erectile problems and higher scores on an associated trait measure, inhibition of arousal due to threat of performance failure. As this association was not anticipated, questions about whether erectile problems preceded the seroconversion were not asked. Such problems could be associated with reluctance to use condoms, thus increasing the likelihood of seroconversion and/or disease transmission. Alternatively, erectile problems could be a consequence of HIV infection. In each case, this has implications for prevention. The associations among HIV status, erectile problems, and UAI need to be specifically addressed in future research.