Heiman J R, Rowland D L
J Psychosom Res. 1983;27(2):105-16. doi: 10.1016/0022-3999(83)90086-7.
To more clearly characterize the patterns of cognitive-affective and physiological responses concomitant with male sexual dysfunction, the present study compared 14 sexually dysfunctional and 16 sexually functional men. All individuals listened to two sexually explicit tapes and engaged in a self-generated fantasy, while genital, heart rate and scaled cognitive affective responses were recorded. Two types of instructions, a performance demand set and a non-demand sensate focus set, preceded the erotic tapes in counterbalanced order. As predicted, dysfunctional men showed less genital tumescence to tapes preceded by the demand than the non-demand instructions. Contrary to expectation, functional men showed greater penile tumescence to the tapes preceded by demand instructions. Self-reported sexual arousal did not follow the penile tumescence pattern but instead indicated that the dysfunctional sample was significantly less subjectively aroused to the tapes and fantasy. There were other significant differences between the groups. Dysfunctional men showed greater general psychological distress, as measured by the SCL-90, including elevated somaticism, anxiety and depression scores. During the experimental session, dysfunctional men also evidenced greater awareness of a variety of physiological responses, as well as more negative and fewer positive cognitive-affective states. These data are discussed in terms of the interaction of affective and physiological responses, differences in contextual meanings of instructional sets given the presence of a dysfunction, and theoretical and clinical conceptualizations of male sexual functioning.
为了更清晰地描述与男性性功能障碍相伴的认知情感和生理反应模式，本研究对14名性功能障碍男性和16名性功能正常男性进行了比较。所有受试者聆听了两段露骨的性爱录音带并进行自我产生的幻想，同时记录生殖器反应、心率以及认知情感反应量表得分。在播放色情录音带之前，以平衡顺序给出两种指导语，一种是表现要求组，另一种是非要求的感官集中组。正如预期的那样，性功能障碍男性在要求组指导语之后的录音带刺激下，生殖器勃起程度低于非要求组指导语之后的录音带刺激。与预期相反，性功能正常男性在要求组指导语之后的录音带刺激下阴茎勃起程度更高。自我报告的性唤起情况并未遵循阴茎勃起模式，而是表明性功能障碍样本对录音带和幻想的主观唤起明显更低。两组之间还有其他显著差异。通过SCL-90测量，性功能障碍男性表现出更严重的总体心理困扰，包括躯体化、焦虑和抑郁得分升高。在实验过程中，性功能障碍男性还表现出对各种生理反应的更高意识，以及更多的消极和更少的积极认知情感状态。本文从情感和生理反应的相互作用、鉴于性功能障碍存在时指导语情境意义的差异以及男性性功能的理论和临床概念化等方面对这些数据进行了讨论。
