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.

Premature Ejaculation Symptoms Are Associated with Sexual Excitability: Empirical Support for the Hyperarousability Model

Premature ejaculation (PE) is a common sexual complaint among men, but its etiology is poorly understood. Previous studies on the dual control model of sexuality has revealed that propensities for sexual excitation and inhibition can contribute to sexual dysfunctions, but few studies have included a measure of premature ejaculation. We sought to explore whether PE is associated with sexual excitation or inhibition. We applied structural equation models to data from a large population-based sample of Finnish adult men. The analyses supported a four-factor solution for the sexual inhibition/sexual excitation short-form scale. The clearest result was that increased symptoms of PE were associated with a greater propensity for sexual excitation (β = 151, p < 001, n = 2953). Importantly, this excitation was intrapersonal, as opposed to stemming from social activities. The results imply that men with PE may have stronger and more rapid reactions to sexual stimuli, which in turn may lead to ejaculating earlier than desired.

Sexual response in obsessive–compulsive disorder: the role of obsessive beliefs

Background. 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. Methods. Seventy-two OCD patients (mean age ± standard deviation [SD]: 34.50 ± 10.39 years) 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. Results. 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. Conclusions. 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.

Preliminary Evidence on How the Dual Control Model Predicts Female Sexual Response to a Bogus Negative Feedback

The Dual Control Model of sexual response has been mostly tested with men. As such, there is a lack of evidence on how such model applies to women’s experience of sexual arousal, particularly when they face a threatening situation such as the threat of sexual performance failure. The aim of the current study was to test whether the Dual Control Model dimensions predict women’s sexual responses to a bogus negative feedback about their sexual performance. In addition, 22 women were exposed to a sexually explicit film clip, while their genital arousal was being measured. During this presentation, a bogus negative feedback, aimed at increasing women’s anxiety about their sexual performance, was provided. Vaginal photopletismography and self-report questions were used as means to evaluate women’s genital and subjective sexual arousal, respectively. The Sexual Excitation/Sexual Inhibition Inventory for Women was further used to capture women’s sexual dynamics. Regression analysis on the high-order factors revealed that sexual excitation proneness was the only predictor of the subjective sexual responses, while none of the factors has predicted genital arousal. “Arousability” and “Concerns about sexual function” dimensions predicted subjective sexual arousal. Sexual arousability may prevent women of lowering their subjective sexual responses in a sexually demanding situation, while “Concerns about sexual function” may have the opposite role, thus being a target of clinical interest. This work provides new data on the Dual Control Model of sexual response, and particularly on its role in women’s sexual functioning.

The role of disgust propensity and sensitivity on sexual excitation and inhibition in obsessive-compulsive disorder

Sexuality is understudied in Obsessive-Compulsive Disorder (OCD). According to the Dual Control Model, low sexual excitation (SE) and high sexual inhibition (SI) are indicative of a higher probability of experiencing a sexual dysfunction. The present study investigated SE and SI in OCD patients compared with controls. It was hypothesized that OCD patients report lower SE and higher SI than controls. Given their potential role as inhibitors of sexual response, it was hypothesized that in the OCD group higher disgust propensity/sensitivity, contamination/washing symptoms, unacceptable thoughts, and obsessive beliefs predicted lower SE, higher SI due to Threat of Performance Failure, and higher SI due to Threat of Performance Consequences. Seventy-two OCD patients and 72 controls matched on gender/age completed the Disgust Propensity and Sensitivity Scale-Revised, Obsessive Beliefs Questionnaire-46, Obsessive Compulsive Inventory-Revised, and Sexual Inhibition/Sexual Excitation Scales. OCD patients had higher SE, SI due to Threat of Performance Failure, and SI due to Threat of Performance Consequences than controls. In the OCD group, higher disgust sensitivity, SI due to Threat of Performance Consequences, and perfectionism predicted higher SI due to Threat of Performance Failure. Higher SI due to Threat of Performance Failure and contamination/washing symptoms predicted higher SI due to Threat of Performance Consequences. These findings highlight the presence of sexual difficulties in OCD patients, particularly a higher SE and SI. The latter is especially relevant in those patients with higher disgust sensitivity, contamination/washing symptoms and perfectionism. Psychotherapists should assess and target sexuality during clinicalpractice with OCD patients.

Sexual Dysfunctions and Their Association with the Dual Control Model of Sexual Response in Men and Women with High-Functioning Autism

Adults with an Autism Spectrum Disorder (ASD) are characterized by impairments in social interaction and communication, repetitive and stereotyped interests and behaviours as well as hyper- and/or hyposensitivities. These disorder specific symptoms could be associated with the development of sexual disorders. The Dual Control Model of Sexual Response presents one approach that is frequently used to explain the emergence of sexual dysfunctions. The aim of the present study was to assess the extent of symptoms of sexual dysfunctions in men and women with ASD and to evaluate their association with the individual propensity of sexual excitation and inhibition as defined by the Dual Control Model. Both men and women with ASD were more likely to report about sexual dysfunctions than individuals from the control group. In men with ASD, sexual inhibition was significantly correlated with the emergence of sexual dysfunctions, while there was no association between sexual functioning and sexual excitation. In women, the opposite pattern was found. Especially the peculiarities in sensitive perception could be responsible for the observed problems with sexual functioning in individuals with ASD. The present findings highlight the great need for specialized treatment programs addressing the frequently observed sexuality-related problems in individuals with ASD. However, up to now such treatment programs are lacking.

Female Sexual Biochemistry (DRAFT)

“Female Sexual Biochemistry” reviews the key hormones and neurotransmitters that have a major role in female sexuality. Estrogens—estradiol, estrone, and estriol—as well as major androgens, such as testosterone and dihydrotestosterone (DHT), are presented with a discussion of their role in the support of the reproductive organs and genitals as well as their actions on the central nervous system to affect sexual desire, arousal, and responsiveness. The interaction and regulation of estrogen by progesterone and thyroid hormone is included. A review of the dual-control model of sexual responsiveness is presented, including excitatory and inhibitory factors, as well as a summary of major neurotransmitters that work to enhance sexual arousal or inhibit it. The sexual response cycle is reviewed and relevant changes in pregnancy, childbirth, perimenopause, and menopause are presented. Finally, there is mention of how synthetic hormones and environmental toxins with hormone activity may alter a woman’s sexual response.