Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction

Lori Brotto, Sandrine Atallah, Crista Johnson, Talli Rosenbaum, Carmita Abdo, E. Sandra Byers, Cynthia Graham, Pedro Nobre, Kevan Wylie

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Introduction Psychological, interpersonal, and sociocultural factors play a significant role in making one vulnerable to developing a sexual concern, in triggering the onset of a sexual difficulty, and in maintaining sexual dysfunction in the long term. Aim To focus on psychological and interpersonal aspects of sexual functioning in women and men after a critical review of the literature from 2010 to the present. Methods This report is part 1 of 2 of our collaborative work during the 2015 International Consultation on Sexual Medicine for Committee 2. Main Outcome Measures Systematic review of the literature with a focus on publications since 2010. Results Our work as sexual medicine clinicians is essentially transdisciplinary, which involves not only the collaboration of multidisciplinary professionals but also the integration and application of new knowledge and evaluation and subsequent revision of our practices to ensure the highest level of care provided. There is scant literature on gender non-conforming children and adolescents to clarify specific developmental factors that shape the development of gender identity, orientation, and sexuality. Conversely, studies consistently have demonstrated the interdependence of sexual function between partners, with dysfunction in one partner often contributing to problems in sexual functioning and/or sexual satisfaction for the other. We recommend that clinicians explore attachment styles of patients, childhood experiences (including sexual abuse), onset of sexual activity, personality, cognitive schemas, infertility concerns, and sexual expectations. Assessment of depression, anxiety, stress, substance use and post-traumatic stress (and their medical treatments) should be carried out as part of the initial evaluation. Clinicians should attempt to ascertain whether the anxiety and/or depression is a consequence or a cause of the sexual complaint, and treatment should be administered accordingly. Cognitive distraction is a significant contributor to sexual response problems in men and women and is observed more consistently for genital arousal than for subjective arousal. Assessment of physical and mental illnesses that commonly occur in later life should be included as part of the initial evaluation in middle-aged and older persons presenting with sexual complaints. Menopausal status has an independent effect on reported changes in sex life and difficulties with intercourse. There is strong support for the use of psychological treatment for sexual desire and orgasm difficulties in women (but not in men). Combination therapies should be provided to men, whenever possible. Conclusion Overall, research strongly supports the routine clinical investigation of psychological factors, partner-related factors, context, and life stressors. A biopsychosocial model to understand how these factors predispose to sexual dysfunction is recommended.

Original languageEnglish (US)
Pages (from-to)538-571
Number of pages34
JournalJournal of Sexual Medicine
Volume13
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Fingerprint

Psychology
Orgasm
Arousal
Anxiety
Medicine
Depression
Sex Offenses
Sexuality
Therapeutics
Sexual Behavior
Infertility
Personality
Publications
Referral and Consultation
Outcome Assessment (Health Care)
Research

Keywords

  • Contextual Factors
  • Interpersonal
  • Partner Factors
  • Psychological
  • Treatment Outcome

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Urology

Cite this

Brotto, L., Atallah, S., Johnson, C., Rosenbaum, T., Abdo, C., Byers, E. S., ... Wylie, K. (2016). Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction. Journal of Sexual Medicine, 13(4), 538-571. https://doi.org/10.1016/j.jsxm.2016.01.019

Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction. / Brotto, Lori; Atallah, Sandrine; Johnson, Crista; Rosenbaum, Talli; Abdo, Carmita; Byers, E. Sandra; Graham, Cynthia; Nobre, Pedro; Wylie, Kevan.

In: Journal of Sexual Medicine, Vol. 13, No. 4, 01.04.2016, p. 538-571.

Research output: Contribution to journalArticle

Brotto, L, Atallah, S, Johnson, C, Rosenbaum, T, Abdo, C, Byers, ES, Graham, C, Nobre, P & Wylie, K 2016, 'Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction', Journal of Sexual Medicine, vol. 13, no. 4, pp. 538-571. https://doi.org/10.1016/j.jsxm.2016.01.019
Brotto, Lori ; Atallah, Sandrine ; Johnson, Crista ; Rosenbaum, Talli ; Abdo, Carmita ; Byers, E. Sandra ; Graham, Cynthia ; Nobre, Pedro ; Wylie, Kevan. / Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction. In: Journal of Sexual Medicine. 2016 ; Vol. 13, No. 4. pp. 538-571.
@article{131ef247e0e0438badc8f089f1f0a200,
title = "Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction",
abstract = "Introduction Psychological, interpersonal, and sociocultural factors play a significant role in making one vulnerable to developing a sexual concern, in triggering the onset of a sexual difficulty, and in maintaining sexual dysfunction in the long term. Aim To focus on psychological and interpersonal aspects of sexual functioning in women and men after a critical review of the literature from 2010 to the present. Methods This report is part 1 of 2 of our collaborative work during the 2015 International Consultation on Sexual Medicine for Committee 2. Main Outcome Measures Systematic review of the literature with a focus on publications since 2010. Results Our work as sexual medicine clinicians is essentially transdisciplinary, which involves not only the collaboration of multidisciplinary professionals but also the integration and application of new knowledge and evaluation and subsequent revision of our practices to ensure the highest level of care provided. There is scant literature on gender non-conforming children and adolescents to clarify specific developmental factors that shape the development of gender identity, orientation, and sexuality. Conversely, studies consistently have demonstrated the interdependence of sexual function between partners, with dysfunction in one partner often contributing to problems in sexual functioning and/or sexual satisfaction for the other. We recommend that clinicians explore attachment styles of patients, childhood experiences (including sexual abuse), onset of sexual activity, personality, cognitive schemas, infertility concerns, and sexual expectations. Assessment of depression, anxiety, stress, substance use and post-traumatic stress (and their medical treatments) should be carried out as part of the initial evaluation. Clinicians should attempt to ascertain whether the anxiety and/or depression is a consequence or a cause of the sexual complaint, and treatment should be administered accordingly. Cognitive distraction is a significant contributor to sexual response problems in men and women and is observed more consistently for genital arousal than for subjective arousal. Assessment of physical and mental illnesses that commonly occur in later life should be included as part of the initial evaluation in middle-aged and older persons presenting with sexual complaints. Menopausal status has an independent effect on reported changes in sex life and difficulties with intercourse. There is strong support for the use of psychological treatment for sexual desire and orgasm difficulties in women (but not in men). Combination therapies should be provided to men, whenever possible. Conclusion Overall, research strongly supports the routine clinical investigation of psychological factors, partner-related factors, context, and life stressors. A biopsychosocial model to understand how these factors predispose to sexual dysfunction is recommended.",
keywords = "Contextual Factors, Interpersonal, Partner Factors, Psychological, Treatment Outcome",
author = "Lori Brotto and Sandrine Atallah and Crista Johnson and Talli Rosenbaum and Carmita Abdo and Byers, {E. Sandra} and Cynthia Graham and Pedro Nobre and Kevan Wylie",
year = "2016",
month = "4",
day = "1",
doi = "10.1016/j.jsxm.2016.01.019",
language = "English (US)",
volume = "13",
pages = "538--571",
journal = "Journal of Sexual Medicine",
issn = "1743-6095",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction

AU - Brotto, Lori

AU - Atallah, Sandrine

AU - Johnson, Crista

AU - Rosenbaum, Talli

AU - Abdo, Carmita

AU - Byers, E. Sandra

AU - Graham, Cynthia

AU - Nobre, Pedro

AU - Wylie, Kevan

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Introduction Psychological, interpersonal, and sociocultural factors play a significant role in making one vulnerable to developing a sexual concern, in triggering the onset of a sexual difficulty, and in maintaining sexual dysfunction in the long term. Aim To focus on psychological and interpersonal aspects of sexual functioning in women and men after a critical review of the literature from 2010 to the present. Methods This report is part 1 of 2 of our collaborative work during the 2015 International Consultation on Sexual Medicine for Committee 2. Main Outcome Measures Systematic review of the literature with a focus on publications since 2010. Results Our work as sexual medicine clinicians is essentially transdisciplinary, which involves not only the collaboration of multidisciplinary professionals but also the integration and application of new knowledge and evaluation and subsequent revision of our practices to ensure the highest level of care provided. There is scant literature on gender non-conforming children and adolescents to clarify specific developmental factors that shape the development of gender identity, orientation, and sexuality. Conversely, studies consistently have demonstrated the interdependence of sexual function between partners, with dysfunction in one partner often contributing to problems in sexual functioning and/or sexual satisfaction for the other. We recommend that clinicians explore attachment styles of patients, childhood experiences (including sexual abuse), onset of sexual activity, personality, cognitive schemas, infertility concerns, and sexual expectations. Assessment of depression, anxiety, stress, substance use and post-traumatic stress (and their medical treatments) should be carried out as part of the initial evaluation. Clinicians should attempt to ascertain whether the anxiety and/or depression is a consequence or a cause of the sexual complaint, and treatment should be administered accordingly. Cognitive distraction is a significant contributor to sexual response problems in men and women and is observed more consistently for genital arousal than for subjective arousal. Assessment of physical and mental illnesses that commonly occur in later life should be included as part of the initial evaluation in middle-aged and older persons presenting with sexual complaints. Menopausal status has an independent effect on reported changes in sex life and difficulties with intercourse. There is strong support for the use of psychological treatment for sexual desire and orgasm difficulties in women (but not in men). Combination therapies should be provided to men, whenever possible. Conclusion Overall, research strongly supports the routine clinical investigation of psychological factors, partner-related factors, context, and life stressors. A biopsychosocial model to understand how these factors predispose to sexual dysfunction is recommended.

AB - Introduction Psychological, interpersonal, and sociocultural factors play a significant role in making one vulnerable to developing a sexual concern, in triggering the onset of a sexual difficulty, and in maintaining sexual dysfunction in the long term. Aim To focus on psychological and interpersonal aspects of sexual functioning in women and men after a critical review of the literature from 2010 to the present. Methods This report is part 1 of 2 of our collaborative work during the 2015 International Consultation on Sexual Medicine for Committee 2. Main Outcome Measures Systematic review of the literature with a focus on publications since 2010. Results Our work as sexual medicine clinicians is essentially transdisciplinary, which involves not only the collaboration of multidisciplinary professionals but also the integration and application of new knowledge and evaluation and subsequent revision of our practices to ensure the highest level of care provided. There is scant literature on gender non-conforming children and adolescents to clarify specific developmental factors that shape the development of gender identity, orientation, and sexuality. Conversely, studies consistently have demonstrated the interdependence of sexual function between partners, with dysfunction in one partner often contributing to problems in sexual functioning and/or sexual satisfaction for the other. We recommend that clinicians explore attachment styles of patients, childhood experiences (including sexual abuse), onset of sexual activity, personality, cognitive schemas, infertility concerns, and sexual expectations. Assessment of depression, anxiety, stress, substance use and post-traumatic stress (and their medical treatments) should be carried out as part of the initial evaluation. Clinicians should attempt to ascertain whether the anxiety and/or depression is a consequence or a cause of the sexual complaint, and treatment should be administered accordingly. Cognitive distraction is a significant contributor to sexual response problems in men and women and is observed more consistently for genital arousal than for subjective arousal. Assessment of physical and mental illnesses that commonly occur in later life should be included as part of the initial evaluation in middle-aged and older persons presenting with sexual complaints. Menopausal status has an independent effect on reported changes in sex life and difficulties with intercourse. There is strong support for the use of psychological treatment for sexual desire and orgasm difficulties in women (but not in men). Combination therapies should be provided to men, whenever possible. Conclusion Overall, research strongly supports the routine clinical investigation of psychological factors, partner-related factors, context, and life stressors. A biopsychosocial model to understand how these factors predispose to sexual dysfunction is recommended.

KW - Contextual Factors

KW - Interpersonal

KW - Partner Factors

KW - Psychological

KW - Treatment Outcome

UR - http://www.scopus.com/inward/record.url?scp=84988492983&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988492983&partnerID=8YFLogxK

U2 - 10.1016/j.jsxm.2016.01.019

DO - 10.1016/j.jsxm.2016.01.019

M3 - Article

C2 - 27045257

AN - SCOPUS:84988492983

VL - 13

SP - 538

EP - 571

JO - Journal of Sexual Medicine

JF - Journal of Sexual Medicine

SN - 1743-6095

IS - 4

ER -