Abstract
Cognitive factors play an important role in the etiology and maintenance of sexual difficulties. To date, research has mostly relied on self-report measures to assess negative cognitions related to low sexual function. To overcome the limitations of self-report questionnaires, a series of open-ended, ambiguous sexual scenarios were developed and presented to participants (N = 600, Mage = 34.2 years), who were asked to generate an ending by entering a continuation for each scenario. Valence of completed scenarios was rated by the participants, and scenario endings were coded by two independent raters on three dimensions, namely reference to sexual problems, sexual communication, and the use of sexually explicit language. Sexual function was assessed with the Female Sexual Function Index and the International Index of Erectile Function. Multiple regression analyses were performed to assess whether the scenario-based task was associated with sexual function above and beyond other predictors (e.g., sexual distress). Individuals with lower sexual function rated the completed scenarios more negatively, and their endings included more references to problems related to low sexual function. In women with low sexual function, fewer endings included sexual communication with a partner or sexually explicit language. Our findings suggest that individuals with low sexual function appraise ambiguous sexual situations more negatively than other individuals. Future studies may investigate whether such biases can be experimentally manipulated and whether changes in cognitive biases may, in turn, lead to improvements in sexual function.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abraham, L., Symonds, T., & Morris, M. F. (2008). Psychometric validation of a sexual quality of life questionnaire for use in men with premature ejaculation or erectile dysfunction. Journal of Sexual Medicine, 5, 595–601. https://doi.org/10.1111/j.1743-6109.2007.00749.x.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Press.
Baumeister, R. F., & Twenge, J. M. (2002). Cultural suppression of female sexuality. Review of General Psychology, 6, 166. https://doi.org/10.1037//1089-2680.6.2.166.
Beck, J. G., & Barlow, D. H. (1986). The effects of anxiety and attentional focus on sexual responding—I: Physiological patterns in erectile dysfunction. Behaviour Research and Therapy, 24, 9–17.
Berner, M. M., Kriston, L., Zahradnik, H.-P., Härter, M., & Rohde, A. (2004). Überprüfung der Gültigkeit und Zuverlässigkeit des deutschen Female Sexual Function Index (FSFI-d) [Inspection of the validity and reliability of the German Female Sexual Function Index (FSFI-d)]. Geburtshilfe und Frauenheilkunde, 64, 293–303. https://doi.org/10.1055/s-2004-815815.
Borg, C., de Jong, P. J., & Schultz, W. W. (2010). Vaginismus and dyspareunia: Automatic vs. deliberate disgust responsivity. Journal of Sexual Medicine, 7, 2149–2157. https://doi.org/10.1111/j.1743-6109.2010.01800.x.
Brauer, M., Leeuwen, M. Van, Janssen, E., Newhouse, S. K., Heiman, J. R., & Laan, E. (2012). Attentional and affective processing of sexual stimuli in women with Hypoactive Sexual Desire Disorder. Archives of Sexual Behavior, 41, 891–905. https://doi.org/10.1007/s10508-011-9820-7.
Brotto, L. A., Heiman, J. R., Goff, B., Greer, B., Lentz, G. M., Swisher, E., & Van Blaricom, A. (2008). A psychoeducational intervention for sexual dysfunction in women with gynecologic cancer. Archives of Sexual Behavior, 37, 317–329. https://doi.org/10.1007/s10508-007-9196-x.
Byers, E. S. (2011). Beyond the birds and the bees and was it good for you?: Thirty years of research on sexual communication. Canadian Psychology/Psychologie Canadienne, 52, 20–28. https://doi.org/10.1037/a0022048.
Carpenter, J. S., Reed, S. D., Guthrie, K. A., Larson, J. C., Newton, K. M., Lau, R. J., & Shifren, J. L. (2015). Using an FSDS-R item to screen for sexually related distress: A msflash analysis. Sexual Medicine, 3, 7–13. https://doi.org/10.1002/sm2.53.
Catania, J. A. (2013). Dyadic Sexual Communication scale. In T. D. Fisher, C. M. Davis, W. L. Yarber, & S. L. Davis (Eds.), Handbook of sexuality-related measures (3rd ed., pp. 130–132). New York, NY: Routledge.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
Cooper, M. (1997). Bias in interpretation of ambiguous scenarios in eating disorders. Behaviour Research and Therapy, 35, 619–626. https://doi.org/10.1016/S0005-7967(97)00021-1.
De Houwer, J. (2006). What are implicit measures and why are we using them? In R. W. Wiers & A. W. Stacy (Eds.), The handbook of implicit cognition and addiction (pp. 11–28). Thousand Oaks, CA: Sage.
Derogatis, L. R., Clayton, A., Lewis-D’Agostino, D., Wunderlich, G., & Fu, Y. (2008). Validation of the Female Sexual Distress Scale-Revised for assessing distress in women with Hypoactive Sexual Desire Disorder. Journal of Sexual Medicine, 5, 357–364. https://doi.org/10.1111/j.1743-6109.2007.00672.x.
Derogatis, L. R., Rosen, R. C., 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. https://doi.org/10.1080/00926230290001448.
Ferguson, C. J. (2011). Sexting behaviors among young Hispanic women: Incidence and association with other high-risk sexual behaviors. Psychiatric Quarterly, 82, 239–243. https://doi.org/10.1007/s11126-010-9165-8.
Gordon-Messer, D., Bauermeister, J. A., Grodzinski, A., & Zimmerman, M. (2013). Sexting among young adults. Journal of Adolescent Health, 52, 301–306. https://doi.org/10.1016/j.jadohealth.2012.05.013.
Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998). Measuring individual differences in implicit cognition: The Implicit Association Test. Journal of Personality and Social Psychology, 74, 1464.
Hertel, P. T., Brozovich, F., Joormann, J., & Gotlib, I. H. (2008). Biases in interpretation and memory in generalized social phobia. Journal of Abnormal Psychology, 117, 278–288. https://doi.org/10.1037/0021-843X.117.2.278.
Hirsch, C. R., Meeten, F., Krah, C., & Reeder, C. (2016). Resolving ambiguity in emotional disorders: The nature and role of interpretation biases. Annual Review of Clinical Psychology, 12, 281–305. https://doi.org/10.1146/annurev-clinpsy-021815-093436.
Janssen, E., Everaerd, W., Spiering, M., & Janssen, J. (2000). Automatic processes and the appraisal of sexual stimuli: Toward an information processing model of sexual arousal. Journal of Sex Research, 37, 8–23. https://doi.org/10.1080/00224490009552016.
Karpinski, A., & Steinman, R. B. (2006). The Single Category Implicit Association Test as a measure of implicit social cognition. Journal of Personality and Social Psychology, 91, 16.
Kilimnik, C. D., Boyd, R. L., Stanton, A. M., & Meston, C. M. (2018). Identification of nonconsensual nexual experiences and the sexual self-schemas of women: Implications for sexual functioning. Archives of Sexual Behavior, 47, 1633–1647. https://doi.org/10.1007/s10508-018-1229-0.
Klettke, B., Hallford, D. J., & Mellor, D. J. (2014). Sexting prevalence and correlates: A systematic literature review. Clinical Psychology Review, 34, 44–53. https://doi.org/10.1016/j.cpr.2013.10.007.
Kohler, P. K., Manhart, L. E., & Lafferty, W. E. (2008). Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. Journal of Adolescent Health, 42, 344–351. https://doi.org/10.1016/j.jadohealth.2007.08.026.
Lykins, A. D., Meana, M., & Minimi, J. (2011). Visual attention to erotic images in women reporting pain with intercourse. Journal of Sex Research, 48, 43–52. https://doi.org/10.1080/00224490903556374.
Mark, K. P., Herbenick, D., Fortenberry, J. D., Sanders, S., & Reece, M. (2014). A psychometric comparison of three scales and a single-item measure to assess sexual satisfaction. Journal of Sex Research, 51, 159–169.
Nobre, P. J., Gouveia, J. P., & Gomes, F. A. (2003). Sexual Dysfunctional Beliefs Questionnaire: An instrument to assess sexual dysfunctional beliefs as vulnerability factors to sexual problems. Sexual and Relationship Therapy, 18, 171–204. https://doi.org/10.1080/1468199031000061281.
Nobre, P. J., & Pinto-Gouveia, J. (2006). Dysfunctional sexual beliefs as vulnerability factors for sexual dysfunction. Journal of Sex Research, 43, 68–75. https://doi.org/10.1080/00224490609552300.
Nobre, P. J., & Pinto-Gouveia, J. (2008). Differences in automatic thoughts presented during sexual activity between sexually functional and dysfunctional men and women. Cognitive Therapy and Research, 32, 37–49. https://doi.org/10.1007/s10608-007-9165-7.
Nobre, P. J., & Pinto-Gouveia, J. (2009). Cognitive schemas associated with negative sexual events: A comparison of men and women with and without sexual dysfunction. Archives of Bexual Behavior, 38, 842–851. https://doi.org/10.1007/s10508-008-9450-x.
Roefs, A., Huijding, J., Smulders, F. T. Y., MacLeod, C. M., de Jong, P. J., Wiers, R. W., & Jansen, A. T. M. (2011). Implicit measures of association in psychopathology research. Psychological Bulletin, 137, 149–193. https://doi.org/10.1037/a0021729.
Rosen, R. C., Brown, J., Heiman, S., Leiblum, C., Meston, R., Shabsigh, D., & D’Agostino, R. (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. https://doi.org/10.1080/009262300278597.
Rosen, R. C., Cappelleri, J. C., & Gendrano, N. (2002). The International Index of Erectile Function (IIEF): A state-of-the-science review. International Journal of Impotence Research, 14, 226–244.
Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997). The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49, 822–830.
Rude, S. S., Wenzlaff, R. M., Gibbs, B., Vane, J., & Whitney, T. (2002). Negative processing biases predict subsequent depressive symptoms. Cognition and Emotion, 16, 423–440. https://doi.org/10.1080/02699930143000554.
van Lankveld, J. J. D. M., Bandell, M., Bastin-Hurek, E., van Beurden, M., & Araz, S. (2018). Implicit and explicit associations with erotic stimuli in women with and without sexual problems. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-018-1152-4.
van Lankveld, J. J. D. M., Odekerken, I., Kok-Verhoeven, L., Hooren, S., Vries, P., Hout, A., & Verboon, P. (2015). Implicit and explicit associations with erotic stimuli in sexually functional and dysfunctional men. Journal of Sexual Medicine, 12, 1791–1804. https://doi.org/10.1111/jsm.12930.
Velten, J., & Margraf, J. (2017). Satisfaction guaranteed? How actor, partner, and relationship factors impact sexual satisfaction within partnerships. PLoS ONE, 12, e0172855. https://doi.org/10.1371/journal.pone.0172855.
Wenzlaff, R. M., & Bates, D. E. (1998). Unmasking a cognitive vulnerability to depression: How lapses in mental control reveal depressive thinking. Journal of Personality and Social Psychology, 75, 1559.
Wiederman, M. W. (1999). Volunteer bias in sexuality research using college student participants. Journal of Sex Research, 36, 59–66. https://doi.org/10.1080/00224499909551968.
Wiegel, M., Meston, C., & Rosen, R. C. (2005). The Female Sexual Function Index (FSFI): Cross-validation and development of clinical cutoff scores. Journal of Sex and Marital Therapy, 31, 1–20. https://doi.org/10.1080/00926230590475206.
Wiltink, J., Hauck, E. W., Phädayanon, M., Weidner, W., & Beutel, M. E. (2003). Validation of the German version of the International Index of Erectile Function (IIEF) in patients with erectile dysfunction, Peyronie’s disease and controls. International Journal of Impotence Research, 15, 192–197. https://doi.org/10.1038/sj.ijir.3900997.
Woud, M. L., & Becker, E. S. (2014). Editorial for the special issue on cognitive bias modification techniques: An introduction to a time traveller’s tale. Cognitive Therapy and Research, 38, 83–88. https://doi.org/10.1007/s10608-014-9605-0.
Woud, M. L., Cwik, J. C., de Kleine, R. A., Blackwell, S. E., & Margraf, J. (2018). Assessing trauma-related appraisals by means of a scenario-based approach. Cognitive Therapy and Research. https://doi.org/10.1007/s10608-018-9956-z.
Woud, M. L., Fitzgerald, D. A., Wiers, R. W., Rinck, M., & Becker, E. S. (2012). “Getting into the spirit”: Alcohol-related interpretation bias in heavy-drinking students. Psychology of Addictive Behaviors, 26, 627–632. https://doi.org/10.1037/a0029025.
Woud, M. L., Pawelczak, S., Rinck, M., Lindenmeyer, J., Souren, P., Wiers, R. W., & Becker, E. S. (2014). Alcohol-related interpretation bias in alcohol-dependent patients. Alcoholism, Clinical and Experimental Research, 38, 1151–1159. https://doi.org/10.1111/acer.12334.
Funding
The authors received no specific funding for this work.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Velten, J., Blackwell, S.E., Margraf, J. et al. Assessing Cognitive Appraisals Related to Sexual Function: A Scenario-Based Approach. Arch Sex Behav 48, 781–794 (2019). https://doi.org/10.1007/s10508-019-1398-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-019-1398-5