Kilmann P R
J Sex Marital Ther. 1978 Fall;4(3):155-76. doi: 10.1080/00926237808403015.
This paper reviews the studies since 1970 which examined the treatment outcome of primary and secondary nonorgsmic women. The studies were evaluated within the following sections: subjects, therapists, time format, treatment, and outcome criteria. Many methodological deficiencies were found, most notably the lack of specificity regarding subject characteristics, a reliance on women's self-reports of outcome without obtaining partner validation, the failure to assess the influence of the woman's partner on her orgasmic responsivity, the failure to control for expectancy factors, and the use of different criteria for treatment success. The problems in the literature suggest that it is premature to place any confidence in the identification of the treatment format which is most successful for a defined population of women who experience a specific form of primary or secondary orgasmic dysfunction. The data tentatively suggest that (1) secondary nonorgasmic women would show greater gains than primary nonorgasmic women in treatments emphasizing sexual and nonsexual communication techniques, (2) primary nonorgasmic women would show greater gains than secondary nonorgasmic women in desensitization and sexual technique training procedures, (3) desensitization may be the appropriate treatment for women whose sexual anxiety contributes to secondary orgasmic dysfunction. These hypotheses should be examined in controlled research.
本文回顾了自1970年以来对原发性和继发性性高潮障碍女性治疗结果的研究。这些研究在以下几个部分进行了评估：研究对象、治疗师、时间形式、治疗方法和结果标准。发现了许多方法上的缺陷，最明显的是研究对象特征缺乏特异性，依赖女性对结果的自我报告而未获得伴侣的验证，未能评估女性伴侣对其性高潮反应性的影响，未能控制期望因素，以及使用不同的治疗成功标准。文献中的问题表明，对于确定的患有特定形式原发性或继发性性高潮功能障碍的女性群体，要确定最成功的治疗方式还为时过早。数据初步表明：（1）在强调性和非性沟通技巧的治疗中，继发性性高潮障碍女性比原发性性高潮障碍女性的改善更大；（2）在脱敏和性技巧训练程序中，原发性性高潮障碍女性比继发性性高潮障碍女性的改善更大；（3）脱敏可能是对性焦虑导致继发性性高潮功能障碍的女性的合适治疗方法。这些假设应在对照研究中进行检验。
