1. Sexual Dysfunction © 2005 John B. Pryor, Ph.D.
Department of Psychology
Illinois State University

2. Causal Factors in Sexual Dysfunction

3. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1994)
Sexual Desire Disorders
•Hypoactive Sexual Desire
Disorder
•Sexual Aversion Disorder

4. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1994)
Sexual Arousal Disorders
•Female Sexual Arousal
Disorder
•Male Erectile Disorder

5. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1994)
Orgasm Disorders
•Female Orgasmic Disorder
•Male Orgasmic Disorder
•Premature Ejaculation

6. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1994)
Sexual Pain Disorders
•Dyspareunia
•Vaginismus

7. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1994)
Sexual Dysfunction Due to a General Medical Condition
Substance-Induced Sexual Dysfunction
Sexual Dysfunction Not Otherwise Specified

8. How common is sexual dysfunction?
Laumann, Paik,
& Rosen (1999)
estimate about
40% of women
and about 30%
of men have
experienced
sexual
dysfunction
based on a
national survey
of Americans.
This makes
dysfunction the
most common
psychological
problem in US.

9. Sexual Dysfunction Assessed in a National Survey Laumann, Paik, & Rosen (1999)
Sexual dysfunction is highest among younger women, with 21 percent of women aged 18 to 29 reporting physical pain with intercourse. Twenty-seven percent reported experiencing non-pleasurable sex, and 16 percent reported sexual anxiety.
Women aged 50 to 59 are one third as likely as younger women to experience pain during sex and half as likely to report non-pleasurable sex and sexual anxiety.

10. Sexual Dysfunction Assessed in a National Survey- Laumann, Paik, & Rosen (1999)
Men experience greater difficulty as they age, with men aged 50 to 59 being three and a half times more likely to experience erection problems than the 18 to 29 age group. However, age is not a factor for men who report climaxing too early, anxiety about performance and non-pleasurable sex.
Married men and women report fewer problems with sex than those unmarried. Unmarried women are one and a half times more likely to have trouble climaxing than married women. Unmarried men are more likely to report lack of desire or erection problems than married men.

11. Sexual Dysfunction Assessed in a National Survey Laumann, Paik, & Rosen (1999)
High school dropouts are the most likely to have sexual problems. Among women, 42 percent who did not complete high school reported lacking the desire for sex, while only 24 percent of female college graduates had such an experience. Among men, college graduates were two-thirds as likely to report climaxing too early as compared to men who did not complete high school.

12. Some psychological processes that contribute to sexual dysfunction problems

13. Positive Feedback Loop Positive emotions Demand for
Accurate perception of
erection & arousal
Demand for
sexual
performance
Attention focused
on erotic thoughts
Positive
Feedback
Loop
Desire
Sex
Increaseed autonomic
arousal (sexual arousal)
Attention focused increasingly
on erotic thoughts
Successful functioning

14. Negative Feedback Loop Negative emotions (anxiety) Demand for
Inacccurate perception of
erection & arousal
Demand for
sexual
performance
Cognitive interference:
Attention on failure & other
non-erotic ideas
Negative
Feedback
Loop
Avoid
Sex
Increaseed autonomic
arousal (anxiety)
Increaseed cognitive
interference
Dysfunction

15. Some typical components of behavior treatment programs for sexual dysfunction
Education
Redirection of sexual behavior
Focus on giving sexual pleasure
Graded sexual exposure
Start with massage

16. Specific techniques: 1. Increase Self-Understanding
Education re: anatomy, physiology, sexual response cycle
Instruction on how to masturbate
Homework to masturbate in private & later in partner’s presence

17. Specific techniques: 2. Sensate Focus Exercises
Both partners remove clothes
One partner “gives” while the other “receives” (& gives feedback)
Initially, no “sexual” touching (gradually build up to touching genitals, orgasm & intercourse)
Gradual reawakening of sexual
interest

18. Specific techniques: 3. Stop-Start Technique
Manually stimulate penis until close to orgasm
Stop stimulation until calmer
Repeat
May be done by a partner or by masturbation

19. Specific techniques: 4. Change position

20. Specific techniques: 5. Communication
Why is it hard to talk about sex?
People sometimes lack the specific language
Use of “I” statements instead of speaking abstractly