Centre for Psychology at the University of Porto, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal.
Centre for Psychology at the University of Porto, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal.
J Sex Med. 2020 Nov;17(11):2220-2228. doi: 10.1016/j.jsxm.2020.08.005. Epub 2020 Sep 28.
Orgasmic difficulties are one of the most common sexual complaints among women. Although models of sexual dysfunction propose that cognitive-affective factors are involved in the development and maintenance of sexual difficulties, there is a need to further examine how these factors are associated with orgasmic difficulties specifically.
To analyze differences between women who reported orgasm difficulties and controls in regard to sexual inhibition, sexual excitation, sexual beliefs, as well as negative automatic thoughts and affect during sexual activity.
A total of 500 women, aged 18 to 72 years, completed a Web survey focused on cognitive-affective factors and sexual health. Two hundred fifty women reported orgasm difficulties and were compared with 250 age-matched women who reported no sexual difficulties.
Differences between groups regarding sexual inhibition and sexual excitation (Sexual Inhibition/Sexual Excitation Scales-Short Form), sexual beliefs (Sexual Dysfunctional Beliefs Questionnaire), negative automatic thoughts (Automatic Thoughts Subscale of the Sexual Modes Questionnaire), and affect (Positive and Negative Affect Schedule) during sexual activity.
Women with orgasm difficulties scored higher on sexual inhibition than controls. They also reported more negative automatic thoughts during sexual activity (concerning failure and disengagement, sexual abuse, lack of affection from partner, passivity, body image) and less erotic thoughts. Women with orgasm difficulties reported experiencing higher negative affect and lower positive affect during sexual activity than women who reported no sexual difficulties. No significant differences were found regarding sexual excitation and endorsement of sexual beliefs.
Helping women shift their focus from non-erotic, negative thoughts to erotic stimuli, as well as addressing sexual inhibition, can be relevant targets of interventions aimed at women's orgasm difficulties.
STRENGTHS & LIMITATIONS: Strengths of the study include the use of a large sample of women who reported orgasm difficulties, offering new insights into the clinical importance of these psychological processes. Limitations include the reliance on self-report measures and a relatively homogeneous sample regarding sexual orientation, education, and age.
Results highlight the role of cognitive-affective factors on women's orgasm difficulties and emphasize the potential benefit of cognitive-behavioral and/or mindfulness interventions for orgasm difficulties. Moura CV, Tavares IM, Nobre PJ. Cognitive-Affective Factors and Female Orgasm: A Comparative Study on Women With and Without Orgasm Difficulties. J Sex Med 2020;17:2220-2228.
性高潮困难是女性最常见的性抱怨之一。尽管性功能障碍模型提出认知情感因素与性困难的发展和维持有关，但仍需要进一步研究这些因素与性高潮困难的具体关系。
分析报告性高潮困难的女性与对照组在性抑制、性兴奋、性信念以及性活动期间的消极自动思维和情感方面的差异。
共有 500 名年龄在 18 至 72 岁之间的女性完成了一项专注于认知情感因素和性健康的网络调查。250 名女性报告有性高潮困难，与 250 名年龄匹配的无性困难的女性进行比较。
性高潮困难组在性抑制（性抑制/性兴奋量表-短表）、性信念（性功能障碍信念问卷）、性活动期间的消极自动思维（性模式问卷自动思维子量表）和情感（积极和消极情感量表）方面的得分高于对照组。性高潮困难的女性在性活动期间报告的消极自动思维更多（涉及失败和脱离、性虐待、伴侣缺乏关爱、被动、身体形象），而性唤起思维较少。与报告无性困难的女性相比，性高潮困难的女性在性活动期间报告的负面情绪更高，正面情绪更低。在性兴奋和性信念的认同方面没有发现显著差异。
帮助女性将注意力从非性唤起的消极思维转移到性唤起的刺激，以及解决性抑制，可能是针对女性性高潮困难的干预措施的重要目标。
该研究的优势包括使用了大量报告有性高潮困难的女性样本，为这些心理过程的临床重要性提供了新的见解。局限性包括依赖于自我报告的措施以及在性取向、教育和年龄方面相对同质的样本。
结果强调了认知情感因素对女性性高潮困难的作用，并强调了认知行为和/或正念干预对性高潮困难的潜在益处。
