Ågmo Anders
Department of Psychology, University of Tromsø, 9037 Tromsø, Norway.
Behav Sci (Basel). 2025 May 9;15(5):642. doi: 10.3390/bs15050642.
There has been an extensive search for efficient pharmacological treatment of female sexual interest/arousal disorder and other sexual dysfunctions. However, available treatments have met limited success, except for the drugs used for treating erectile deficiency. A possible reason for this may be that both the preclinical and clinical evaluation of treatment effects have been inadequate. The present literature review shows that the intensity of sexual approach behaviors in non-human animals appears to be predictive of clinical effect whereas the traditional studies of copulatory behaviors and associated motor patterns have questionable predictive power regarding effects on human sexual desire. In clinical studies, it is essential to include the unconscious components of sexual motivation in any approach to its quantification. This basic fact is incompatible with the use of self-reports for evaluating treatment effects on motivation. Genital responses to sexual incentives are automatic and therefore outside of volitional control and can, therefore, provide unbiased estimates of the intensity of sexual motivation. These responses may be objectively quantified. Tests for implicit sexual motivation must also be used for capturing unconscious mental components. Including the unconscious components of sexual motivation as well as of objective measures of genital responses in clinical studies may improve evaluations of the effectiveness of drug treatment of low sexual interest/arousal disorder. In preclinical studies, predictive validity can be improved by quantifying sexual approach behaviors rather than copulatory behavior. The paradigm shift suggested here may finally allow for the discovery of efficient treatments for some sexual dysfunctions.
人们一直在广泛寻找治疗女性性兴趣/唤起障碍及其他性功能障碍的有效药物治疗方法。然而，除了用于治疗勃起功能障碍的药物外，现有治疗方法取得的成功有限。造成这种情况的一个可能原因可能是治疗效果的临床前和临床评估都不够充分。目前的文献综述表明，非人类动物的性接近行为强度似乎可以预测临床效果，而关于交配行为及相关运动模式的传统研究对人类性欲影响的预测能力则存在疑问。在临床研究中，在任何量化性动机的方法中纳入性动机的无意识成分至关重要。这一基本事实与使用自我报告来评估治疗对动机的效果不相容。对性刺激的生殖器反应是自动的，因此不受意志控制，因此可以提供对性动机强度的无偏估计。这些反应可以客观量化。还必须使用内隐性性动机测试来捕捉无意识的心理成分。在临床研究中纳入性动机的无意识成分以及生殖器反应的客观测量方法，可能会改善对低性兴趣/唤起障碍药物治疗效果的评估。在临床前研究中，通过量化性接近行为而非交配行为可以提高预测效度。这里提出的范式转变最终可能会促成一些性功能障碍有效治疗方法的发现。
