Mindfulness-Based Sex Therapy Improves Genital-Subjective Arousal Concordance in Women With Sexual Desire/Arousal Difficulties
- 2.3k Downloads
There is emerging evidence for the efficacy of mindfulness-based interventions for improving women’s sexual functioning. To date, this literature has been limited to self-reports of sexual response and distress. Sexual arousal concordance—the degree of agreement between self-reported sexual arousal and psychophysiological sexual response—has been of interest due to the speculation that it may be a key component to healthy sexual functioning in women. We examined the effects of mindfulness-based sex therapy on sexual arousal concordance in a sample of women with sexual desire/arousal difficulties (n = 79, M age 40.8 years) who participated in an in-laboratory assessment of sexual arousal using a vaginal photoplethysmograph before and after four sessions of group mindfulness-based sex therapy. Genital-subjective sexual arousal concordance significantly increased from pre-treatment levels, with changes in subjective sexual arousal predicting contemporaneous genital sexual arousal (but not the reverse). These findings have implications for our understanding of the mechanisms by which mindfulness-based sex therapy improves sexual functioning in women, and suggest that such treatment may lead to an integration of physical and subjective arousal processes. Moreover, our findings suggest that future research might consider the adoption of sexual arousal concordance as a relevant endpoint in treatment outcome research of women with sexual desire/arousal concerns.
KeywordsSexual desire Sexual arousal Vaginal photoplethysmography Mindfulness DSM-5 Sexual dysfunction
The authors wish to thank Yvonne Erskine for overall coordination of this study. We also wish to thank group facilitators Miriam Driscoll, Shea Hocaloski, Gail Knudson, Brooke Seal, and Morag Yule. Our thanks to Dr. Rosemary Basson and Dr. Mijal Luria for developing the treatment manual used to deliver the mindfulness intervention. Funding for this study was provided by a BC Medical Services Grant to Lori Brotto.
Compliance with Ethical Standards
Conflict of interest
None of the authors have any conflicts of interest to disclose.
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: American Psychiatric Publishing.Google Scholar
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Google Scholar
- Both, S., Everaerd, W., & Laan, E. (2007). Desire emerges from excitement: A psychophysiological perspective on sexual motivation. In E. Janssen (Ed.), The psychophysiology of sex (pp. 327–339). Bloomington, IN: Indiana University Press.Google Scholar
- Brody, S., Laan, E., & van Lunsen, R. H. W. (2003). Concordance between women’s physiological and subjective sexual arousal is associated with consistency of orgasm during intercourse but not other sexual behavior. Journal of Sex and Marital Therapy, 29, 15–23. doi: 10.1080/00926230390154808.CrossRefPubMedGoogle Scholar
- Brotto, L. A., Basson, R., & Luria, M. (2008b). Group psychoeducation (PED) for women’s sexual desire and arousal difficulties. Unpublished treatment manual. Vancouver: University of British Columbia.Google Scholar
- Brotto, L. A., Erskine, Y., Carey, M., Ehlen, T., Finalyson, S., Heywood, M., … Miller, D. (2012a). A brief mindfulness-based cognitive behavioral intervention improves sexual functioning versus wait-list control in women treated for gynecologic cancer. Gynecologic Oncology, 125, 320–325. doi: 10.1016/j.ygyno.2012.01.035.
- Brotto, L. A., Heiman, J. R., Goff, B., Greer, B., Lentz, G. M., Swisher, E., … Van Blaricom, A. (2008c). A psychoeducational intervention for sexual dysfunction in women with gynecologic cancer. Archives of Sexual Behavior, 37, 317–329. doi: 10.1007/s10508-007-9196-x.
- Brotto, L. A., Seal, B. N., & Rellini, A. (2012b). Pilot study of a brief cognitive behavioral versus mindfulness-based intervention for women with sexual distress and a history of childhood sexual abuse. Journal of Sex and Marital Therapy, 38, 1–27. doi: 10.1080/0092623X.2011.569636.CrossRefPubMedGoogle Scholar
- Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31, 23–33. doi: 10.1007/s10865-007-9130-7.CrossRefPubMedGoogle Scholar
- Clayton, A. H., Segraves, R. T., Leiblum, S., Basson, R., Pyke, R., Cotton, D., & Wunderlich, G. R. (2006). Reliability and validity of the Sexual Interest and Desire Inventory-Female (SIDI-F), a scale designed to measure severity of female hypoactive desire disorder. Journal of Sex and Marital Therapy, 32, 115–135. doi: 10.1080/00926230500442300.CrossRefPubMedGoogle Scholar
- DeRogatis, L. R., Rosen, R., Leiblum, S., Burnett, A., & Heiman, J. (2002). The Female Sexual Distress Scale (FSDS): Initial validation of a standardized scale for assessment of sexually related personal distress in women. Journal of Sex and Marital Therapy, 28, 317–330. doi: 10.1080/00926230290001448.CrossRefPubMedGoogle Scholar
- Diamond, L. E., Earle, D. C., Heiman, J. R., Rosen, R. C., Perelman, M. A., & Harning, R. (2006). An effect on the subjective sexual response in premenopausal women with sexual arousal disorder by bremelanotide (PT-141), a melanocortin receptor agonist. Journal of Sexual Medicine, 3, 628–638. doi: 10.1111/j.1743-6109.2006.00268.x.CrossRefPubMedGoogle Scholar
- Gottman, J., & Silver, N. (1999). The seven principles for making marriage work: A practical guide from the country’s foremost relationship expert. New York: Three Rivers Press.Google Scholar
- Masters, W. H., & Johnson, V. E. (1966). Human sexual response. Boston: Little, Brown & Co.Google Scholar
- Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Boston: Little, Brown.Google Scholar
- Mercer, C. H., Fenton, K. A., Johnson, A. M., Wellings, K., Macdowall, W., McManus, S., … Erens, B. (2003). Sexual function problems and help seeking behaviour in Britain: National probability sample survey. British Medical Journal, 327, 426–427. doi: 10.1136/bmj.327.7412.426.
- Meston, C. M., Rellini, A. H., & McCall, K. (2010). The sensitivity of continuous laboratory measures of physiological and subjective sexual arousal for diagnosing women with sexual arousal disorder. Journal of Sexual Medicine, 7, 938–950. doi: 10.1111/j.1743-6109.2009.01548.x.CrossRefPubMedGoogle Scholar
- Mitchell, K. R., Mercer, C. H., Ploubidis, G. B., Jones, K. G., Datta, J., Field, N., & Wellings, K. (2013). Sexual function in Britain: Findings from the Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet, 382, 1817–1829. doi: 10.1016/S0140-6736(13)62366-1.CrossRefPubMedPubMedCentralGoogle Scholar
- Raudenbush, S. W., Bryk, A. S., & Congdon, R. (2004). HLM 6 for windows. Lincolnwood, IL: Scientific Software International Inc.Google Scholar
- Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., & D’Agostino, R. J. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy, 26, 191–208. doi: 10.1080/009262300278597.CrossRefPubMedGoogle Scholar
- Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8, 23–74.Google Scholar
- Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615–623. doi: 10.1037//0022-006X.68.4.615.CrossRefPubMedGoogle Scholar