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报告有延迟射精症状男性的特征:为基于实证得出的诊断标准提供支持。

Characteristics of men who report symptoms of delayed ejaculation: providing support for empirically derived diagnostic criteria.

作者信息

Rowland David L, Attinger Drew R, Morrow Abigail L, Motofei Ion, Hevesi Krisztina

机构信息

Department of Psychology, Valparaiso University, Valparaiso, IN 46383, United States.

Department of Psychiatry, Carol Davila University, 020021 Bucharest, Romania.

出版信息

J Sex Med. 2023 Mar 31;20(4):426-438. doi: 10.1093/jsxmed/qdad008.

Abstract

BACKGROUND

Little is known regarding the demographic, sexual, and relationship characteristics of men with symptoms of delayed ejaculation (DE).

AIM

To identify differences between men with and without DE symptomology to validate face-valid diagnostic criteria and to identify various functional correlates of DE.

METHODS

A total of 2679 men meeting inclusion criteria were partitioned into groups with and without DE symptomology on the basis of their self-reported "difficulty reaching ejaculation/orgasm during partnered sex." Men were then compared on a broad array of demographic and relationship variables, as well as sexual response variables assessed during partnered sex and masturbation.

OUTCOMES

Outcomes included the identified differences between men with and without DE symptomology.

RESULTS

Men with DE-whether having comorbid erectile dysfunction or not-differed from men without DE on 5 face-valid variables related to previously proposed diagnostic criteria for DE, including ones related to ejaculation latency (P < .001); self-efficacy related to reaching ejaculation, as assessed by the percentage of episodes reaching ejaculation during partnered sex (P < .001); and negative consequences of the impairment, including "bother/distress" and (lack of) "orgasmic pleasure/sexual satisfaction" (P < .001). All such differences were associated with medium to large effect sizes. In addition, men showed differences on a number of functional correlates of DE, including anxiety, relationship satisfaction, frequency of partnered sex and masturbation, and level of symptomology during partnered sex vs masturbation (P < .001).

CLINICAL IMPLICATIONS

Face-valid criteria for the diagnosis of DE were statistically verified, and functional correlates of DE relevant to guiding and focusing treatment were identified.

STRENGTHS AND LIMITATIONS

In this first comprehensive analysis of its kind, we have demonstrated widespread differences on sexual and relationship variables relevant to the diagnosis of DE and to its functional correlates between men with and without DE symptomology during partnered sex. Limitations include participant recruitment through social media, which likely biased the sample; the use of estimated rather than clocked ejaculation latencies; and the fact that differences between men with acquired and lifelong DE were not investigated.

CONCLUSION

This well-powered multinational study provides strong empirical support for several face-valid measures for the diagnosis of DE, with a number of explanatory and control covariates that may help shed light on the lived experiences of men with DE and suggest focus areas for treatment. Whether or not the DE men had comorbid erectile dysfunction had little impact on the differences with men having normal ejaculatory functioning.

摘要

背景

关于患有射精延迟(DE)症状男性的人口统计学、性特征及关系特征,我们所知甚少。

目的

确定有和没有DE症状的男性之间的差异,以验证表面效度的诊断标准,并确定DE的各种功能相关因素。

方法

总共2679名符合纳入标准的男性,根据他们自我报告的“在性伴侣性行为中达到射精/性高潮困难”,被分为有和没有DE症状两组。然后,对男性在一系列广泛的人口统计学和关系变量,以及在性伴侣性行为和手淫过程中评估的性反应变量方面进行比较。

结果

有DE的男性——无论是否合并勃起功能障碍——在与先前提出的DE诊断标准相关的5个表面效度变量上,与没有DE的男性存在差异,包括与射精潜伏期相关的变量(P <.001);通过性伴侣性行为中达到射精的次数百分比评估的与达到射精相关的自我效能感(P <.001);以及该障碍的负面后果,包括“困扰/苦恼”和(缺乏)“性高潮快感/性满足”(P <.001)。所有这些差异都与中等到大的效应量相关。此外,男性在DE的一些功能相关因素上也存在差异,包括焦虑、关系满意度、性伴侣性行为和手淫的频率,以及性伴侣性行为与手淫期间的症状程度(P <.001)。

临床意义

DE诊断的表面效度标准得到了统计学验证,并确定了与指导和聚焦治疗相关的DE功能相关因素。

优点和局限性

在同类的首次综合分析中,我们证明了在与DE诊断及其在性伴侣性行为中有和没有DE症状的男性之间的功能相关因素相关的性和关系变量上存在广泛差异。局限性包括通过社交媒体招募参与者,这可能使样本产生偏差;使用估计的而非计时的射精潜伏期;以及未调查获得性DE和终身性DE男性之间的差异。

结论

这项样本量充足的跨国研究为DE诊断的几种表面效度测量提供了有力的实证支持,有一些解释性和控制性协变量,可能有助于阐明患有DE男性的生活经历,并为治疗指明重点领域。有DE的男性是否合并勃起功能障碍,对与射精功能正常男性的差异影响不大。

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