A comparison of systematic desensitization and directed masturbation in the treatment of primary orgasmic dysfunction in females.

Assigned 30 females (19–42 yrs) seeking treatment for primary inorgasmia accompanied by sexual anxiety or aversion to 1 of 3 groups: systematic desensitization (SD), directed masturbation (DM), or waiting list control (WL). Following treatment, Ss were retested, and the WL group then received directed masturbation treatment. A 3rd testing constituted a follow-up for the SD and DM groups and a posttreatment testing for the WL. Both treatments were equally effective in improving Ss' sexual self-acceptance and increasing sexual pleasure. Changes in anxiety were negligible; however, sexual arousal and orgasm for DM and WL Ss increased. The gains of the WL group not only replicated the findings of the DM group but also were of greater magnitude. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex bias in the diagnosis of primary orgasmic dysfunction.

M. Kaplan proposed that some diagnostic categories are constructed with a built-in sex bias, making diagnosis of females more likely by the very way the disorder is defined. However, critics such as Williams and Spitzer have remained unpersuaded that such categories exist. After briefly analyzing the concept of sex bias, I argue that Masters and Johnson's widely used diagnostic criteria for primary orgasmic disorders are sex biased in several ways. Problematic consequences of such biases include inflated incidence estimates for women, the appearance of enormous gender differences in pathology, ill-founded ideas about female psychosexual vulnerability, and overconfidence in the efficacy of sex therapy. Finally, contrary to Kaplan's critical comments about DSM-III, I argue that DSM-III's diagnostic criteria for orgasmic dysfunction correct the sex biases in Masters and Johnson's approach and represent substantial progress in diagnostic logic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bibliotherapy in the treatment of female orgasmic dysfunction.

13 inorgasmic women were assigned to a minimal-contact condition or delayed-treatment information control to evaluate a self-help manual for orgasmic dysfunction (J. Heiman et al, 1976). Between- and within-group analyses on questionnaires, including the Sexual Arousal and Sexual Interaction Inventories, consistently revealed greater improvement of Ss in the manual condition, and these gains were maintained at a 6-wk follow-up. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bias and fairness in the diagnosis of primary orgasmic dysfunction in women.

Disagrees with J. C. Wakefield's (see record 1987-28660-001) argument that 2 kinds of sex bias, logical and factual bias, may influence the diagnosis of primary orgasmic dysfunction in women and suggests that instead of bias, there may be errors in the diagnostic criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Primary orgasmic dysfunction: Diagnostic considerations and review of treatment.

Reviews the literature on treatment for primary orgasmic dysfunction and for other female orgasmic disturbances. As a diagnostic category, primary orgasmic dysfunction includes all women who have never experienced orgasm under any circumstances except sleep or fantasy. However, the research samples of nonorgasmic women in clinical reports and empirical investigations are heterogeneous with regard to disruption of earlier phases of the sexual response cycle and emotional concomitants of the dysfunction. The major treatment models—systematic desensitization, sensate focus, directed masturbation, and hypnosis—are presented, and empirical support is reviewed. Separate discussion is included for investigations comparing treatment modalities. A strategy for future programmatic sex-therapy research is suggested within the broader context of psychotherapy outcome research. (92 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-administered relaxation training and money deposits in the treatment of recurrent anxiety.

Evaluated 2 self-administered relaxation manuals and a money deposit in the treatment of recurrent, nonphobic anxiety in 61 18–44 yr old Ss from a college population. Ss were randomly assigned to a self-monitoring-only control group or 1 of 4 active treatment conditions. Ss in active conditions received a progressive relaxation manual or a manual that called for the client to devise his or her own relaxation method and were assigned to deposit or nondeposit conditions. Improvement did not differ for the 2 relaxation procedures, but relaxation training groups improved significantly more than self-monitoring-only Ss on both self-report questionnaires and self-monitored measures of anxiety. The deposit did not produce greater amounts of relaxation practice or adherence to the program, although Ss in this condition reported being more relaxed in practice sessions and improved more on 2 pre–post measures of anxiety (including the State-Trait Anxiety Inventory). Ss' locus of control scores (Rotter's Internal–External Locus of Control Scale) were significantly related to a number of practice, adherence, and outcome variables, but Ss' ratings of the likelihood that they would practice and benefit from the program proved to be as good predictors. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparative evaluation of minimal therapist contact and 15-session treatment for female orgasmic dysfunction.

Compared a 4-session minimal therapist contact (MTC) program for treatment of lifelong global orgasmic dysfunction in women to a 15-session full therapist contact (FTC) program. 14 couples were treated in the MTC format, 29 couples in the FTC format. All spouses (aged 20–52 yrs) completed the Locke-Wallace Marital Adjustment Test, a sexual interaction inventory, and a sexual history form at intake, pretreatment, posttreatment, and 3-mo follow-up. Both programs were effective in producing female orgasm in masturbation, but the MTC program resulted in more frequent orgasms with vibrator stimulation. The programs were comparably effective in producing orgasm with the spouse both by manual stimulation and intercourse. Both programs resulted in improvements in satisfaction with the sexual relationship, and women in the MTC treatment reported greater happiness in marriage. It is concluded that for this sexual dysfunction, therapist contact time can be greatly reduced without loss of effectiveness. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of subjective female orgasmic responsiveness.

Results of psychological research show that although female orgasm appears to be a single process physiologically, subjective reports by women indicate that individual differences in their experience are multidimensional. The basis for the discrepant findings was analyzed in 2 studies of reported orgasmic experiences in women. One sample of 115 sexually experienced women (aged 18–52 yrs) yielded data that replicated the finding that coital and masturbatory orgasmic responsiveness can be statistically distinguished and independently assessed, thus indicating that sample selection associated with prior research could not explain the result. A separate sample of 101 sexually experienced women (aged 18–58 yrs) were given an instrument that assessed coital responsiveness but differentiated masturbatory responsiveness into dimensions associated with masturbation when alone and with a partner without intercourse. A confirmatory factor analysis substantiated the existence of the 3 dimensions of female orgasm. However, female orgasmic responsiveness was highly correlated across the 3 dimensions so that it was possible to isolate a large 2nd-order factor of general orgasmic responsiveness that is consistent with most of the physiological evidence on the unitary nature of orgasm. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief treatment of mild-to-moderate child depression using primary and secondary control enhancement training.

Elementary school children with mild-to-moderate depressive symptoms were randomly assigned to a control group or an 8-session Primary and Secondary Control Enhancement Training program. The program focused on (a) primary control (changing objective conditions to fit one's wishes; e.g., through activity selection and goal attainment) and (b) secondary control (changing oneself to buffer the impact of objective conditions; e.g., altering depressogenic thinking, practicing mood-enhancing cognitions ) . At immediate posttreatment and 9-month follow-up, the treatment group showed greater reductions than the control group in depressive symptomatology on the Children's Depression Inventory and the Revised Children's Depression Rating Scale, and treated children, more than controls, shifted from above to within the normal range on both measures. Future research is needed to test treatment effects with severely depressed youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexology of ictal masturbation in infancy

In 1952, under the title of "Masturbation in Infants," Bakwin reported three cases of females all younger than one year of age. Bakwin's type of so-called masturbation has been considered in the differential diagnosis of epilepsy in several papers published since 1975. The cases reported display a great similarity and underscore an ictal explanation of the syndrome.     

A training curriculum for professional psychologists in primary care.

Primary care psychology is a growing field that requires specific training opportunities for successful practice. The knowledge and skills that practitioners need for work in this setting are outlined here in detail. This curriculum integrates literature and experience in family psychology, health psychology, and pediatric psychology; considers multiple levels of education and training; and provides illustrative examples. It is a first attempt in an evolving process of integrating historical and cutting edge literature from many areas of psychology and other disciplines to contribute to comprehensive primary care psychology training. It can be used by programs and individual practitioners alike in designing education and training experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relative pilot aptitude and success in primary pilot training.

"Based on a sample of 216 aviation cadets… the analysis revealed that a cadet has a better chance of success if he is grouped with cadets of relatively lower aptitude than himself rather than with cadets of relatively higher aptitude. Thus, instructors in this study tended to have a relative frame of reference. To the extent that this phenomenon operates in other training situations, the nation is denied the services of the most highly qualified trained personnel, and the true validity of aptitude tests is underestimated. Methods of minimizing these dangers are discussed." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of a measure of negative attitudes toward masturbation.

Describes the development of a new, 30-item measure of negative attitudes toward masturbation and the relationships between negative attitudes toward masturbation, sex guilt, and frequency of masturbation in 96 male and 102 female undergraduates. 4 male and 4 female Es administered the Sex Guilt subscale of the Mosher Forced-Choice Guilt Inventory, a measure of sex experience by Brady and Levitt, and Abramson's measure of masturbation experience. Results provide validational evidence of the predictive usefulness of the measure. The item content, item analysis, factorial structure, and adequate split-half reliability (.75) attest to the psychometric soundness of the measure. Both guilt over sex and negative attitudes toward masturbation are suggested as 2 constructs with theoretical significance and usefulness in research in human sexuality as well as in treating some forms of sexual pathology. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relaxation training and expectation in the treatment of postpartum distress.

Examined the effectiveness of relaxation training in reducing postpartum distress for 48 18–35 yr old 1st-time mothers-to-be via a treatment-component strategy. Ss had completed routine childbirth education classes in which they had received labor-specific relaxation training. They were then randomly assigned to either additional relaxation training, extended relaxation training that also emphasized likely postpartum stressors, exposure only to postpartum stressors, or a control discussion of their history. The Beck Depression Inventory and other measures were assessed 1 mo prior to the child's birth, daily for 9 days following the birth, and 1 mo after birth. Compared with nonrelaxation conditions, both relaxation treatments reduced reported postpartal distress. The 2 conditions involving exposure to postpartum stressors reduced the degree of elation reported postpartally. It is concluded that relaxation techniques can be extended within childbirth preparation programs to assuage postpartum distress and possibly enhance the mother–child relationship. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group

BACKGROUND: Sildenafil is a potent inhibitor of cyclic guanosine monophosphate hydrolysis [corrected] in the corpus cavernosum and therefore increases the penile response to sexual stimulation. We evaluated the efficacy and safety of sildenafil, administered as needed in two sequential double-blind studies of men with erectile dysfunction of organic, psychogenic, and mixed causes. METHODS: In a 24-week dose-response study, 532 men were treated with oral sildenafil (25, 50, or 100 mg) or placebo. In a 12-week, flexible dose-escalation study, 329 different men were treated with sildenafil or placebo, with dose escalation to 100 mg based on efficacy and tolerance. After this dose-escalation study, 225 of the 329 men entered a 32-week, open-label extension study. We assessed efficacy according to the International Index of Erectile Function, a patient log, and a global-efficacy question. RESULTS: In the dose-response study, increasing doses of sildenafil were associated with improved erectile function (P values for increases in scores for questions about achieving and maintaining erections were <0.001). For the men receiving 100 mg of sildenafil, the mean score for the question about achieving erections was 100 percent higher after treatment than at base line (4.0 vs. 2.0 of a possible score of 5). In the last four weeks of treatment in the dose-escalation study, 69 percent of all attempts at sexual intercourse were successful for the men receiving sildenafil, as compared with 22 percent for those receiving placebo (P<0.001). The mean numbers of successful attempts per month were 5.9 for the men receiving sildenafil and 1.5 for those receiving placebo (P<0.001). Headache, flushing, and dyspepsia were the most common adverse effects in the dose-escalation study, occurring in 6 percent to 18 percent of the men. Ninety-two percent of the men completed the 32-week extension study. CONCLUSIONS: Oral sildenafil is an effective, well-tolerated treatment for men with erectile dysfunction.     

Sexual dysfunction associated with antidepressant treatment.

Psychologists rendering psychotherapeutic services to patients receiving pharmacological treatment with the newer antidepressants are becoming more familiar with their distinct therapeutic and side effect profiles. Increased attention has recently been directed at the sexual dysfunction associated with the use of these antidepressants. Among the newer agents, risk for the emergence of sexual side effects is greater with the selective serotonin reuptake inhibitors than with the atypical antidepressants. Psychologists who are aware of treatment-related sexual dysfunction may be more effective in collaborating with prescribing professionals to develop strategies that allow patients to minimize or better tolerate these side effects. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Cognitive problem-solving skills training and parent management training in the treatment of antisocial behavior in children.

Evaluated the effects of problem-solving skills training (PSST) and parent management training (PMT) on 97 children (aged 7–13 yrs) referred for severe antisocial behavior. Children and families were assigned randomly to 1 of 3 conditions: PSST, PMT, or PSST and PMT combined. It was predicted that (1) each treatment would improve child functioning (reduce overall deviance and aggressive, antisocial, and delinquent behavior, and increase prosocial competence); and (2) PSST and PMT combined would lead to more marked, pervasive, and durable changes in child functioning and greater changes in parent functioning (parental stress, depression, and overall symptoms). Expectations were supported by results at posttreatment and 1-yr follow-up. PSST and PMT combined led to more marked changes in child and parent functioning and placed a greater proportion of youth within the range of nonclinic (normative) levels of functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Serratus anterior dysfunction. Recognition and treatment

Recognition of scapular winging may be difficult, and potential errors in treatment can result. Such treatment errors may cause morbidity for the patient. In addition, electrical evidence of long thoracic nerve injury usually is required to confirm the etiology of scapular winging as being caused by serratus anterior dysfunction. Although various conditions may result in scapular winging, primary serratus anterior dysfunction can be treated effectively by transfer of the pectoralis major tendon; however, this surgical approach sometimes may given an unacceptable cosmesis, and there may be local morbidity to the donor site of the iliotibial band graft that is used to augment the tendon transfer. The authors report eight patients with primary chronic scapulothoracic winging refractory to conservative treatment. Five of these patients had an incorrect diagnosis, and this resulted in 17 surgical procedures without resolution of their pain or improvement of function. Of the eight patients who required additional surgery to stabilize the scapula, only five patients had an electromyographic study that showed long thoracic nerve palsy, although all patients had profound scapulothoracic winging. All patients underwent a modified pectoralis major transfer with autogenous semitendinosus and gracilis tendon augmentation using two small incisions. Although one patient had a postoperative infection develop, the remaining seven patients had resolution of their winging, improved function, and satisfactory cosmesis.