Skip to main content
SpringerLink
Log in

Disentangling Desire and Arousal: A Classificatory Conundrum

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

A controversial proposal to collapse sexual disorders of desire and arousal is forthcoming in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) (DSM-5). Yet, no study has attempted to empirically distinguish these disorders by using explicit criteria to recruit and compare distinct groups of low desire and arousal sufferers. The goal of the current study was to test the feasibility of finding medically healthy men and women meeting clearly operationalized DSM-IV-TR criteria for disorders of desire and/or arousal and compare them to matched controls. To assess operational criteria, participants completed a comprehensive telephone screening interview assessing DSM-IV-TR and DSM-5 criteria, as well as standardized self-report measures of sexual functioning. The use of operationalized DSM-IV-TR criteria to recruit participants led to the exclusion of over 75 % of those reporting sexual difficulties, with the primary reason for exclusion being failure to meet at least one central diagnostic criterion. The application of the DSM-5 criteria was even more restrictive and led to the exclusion of all but four men and one woman using the original four-symptom criteria, and four men and five women using the revised three-symptom criteria. Cluster analyses supported the distinction between desire and genital arousal difficulties, and suggest that different groups with distinct clusters of symptoms may exist, two of which are consistent with the DSM-5 criteria. Overall, results highlight the need for revisions to the diagnostic criteria, which, as they stand, do not capture the full range of many people’s sexual difficulties.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Notes

  1. At the time of study administration and article preparation, revisions to the proposed 2010 DSM-5 criteria had not been released. While we have attempted to test the impact of the majority of these changes on inclusion rates (e.g., the 3 symptom requirement, instead of 4), others could not be examined (e.g., the intensity of sexual thoughts or sexual excitement). In addition, a major change in the 2011 criteria for SIAD is its exclusive reference to women, while the current study tested criteria for both men and women. Criteria presented in Table 1 are those proposed in the original 2010 version. See http://www.DSM-5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=432 for recent revisions to these criteria.

  2. The remaining text of the ad comprised a description of the procedure for the larger study, terms of confidentiality, and other ethical information presented in accordance with Research Ethics Board guidelines. The full textual content of advertisements is available upon request.

  3. The upper end of the age range was extended from 45 to 50 after a few months of study recruitment. Providing that women were not yet menopausal, there was no empirical reason to assume that women between the ages of 45 and 50 would differ from their slightly younger counterparts. Prior to this modification in criteria, one man and one woman between the ages of 45–50 were excluded.

  4. Since participants were being recruited for a larger psychophysiological study in which the sexual stimulus employed across all subjects was an erotic film clip depicting heterosexual activity, individuals who self-identified as non-heterosexual had to be excluded.

  5. Low desire and arousal participants were initially selected based on whether they met specific cutoff scores on the sexual functioning questionnaires (chosen in accordance with means reported by previous investigators for control and clinical groups) (Meston, 2003; Rosen et al., 2000). However, this criteria was later modified in recognition of the fact that the FSFI was not designed to be a diagnostic tool, and does not yet possess well-validated clinical cutoff scores for all sexual domains (for recent efforts at this, see Gerstenberger et al., 2010; Wiegel et al., 2005).

  6. Due to experimental error, questions about subjective arousal were not included in the initial version of the screening interview. The late addition of these questions resulted in missing data for this diagnostic criterion for the first 73 participants.

  7. Copies of this interview are available upon request.

  8. Drop-outs and those temporarily excluded from participating were not included in the calculation of overall exclusion rates or any further statistical analyses.

  9. An examination of participant responses to interview questions posed at the time of psychophysiological testing revealed high levels of consistency between reported levels of genital and non-genital sensations and lubrication/erectile difficulties (unpublished raw data).

  10. An examination of participant diagnoses obtained through comprehensive interviews at the time of psychophysiological testing revealed consistency with those provided at the time of screening.

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

  • American Psychiatric Association. (2011). Sexual interest/arousal disorder in women. In American Psychiatric Association DSM-5 Development. Retrieved July 14, 2011, from http://www.DSM-5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=432.

  • Andersson, E., Walén, C., Hallberg, J., Paxling, B., Dahlen, M., Almlöv, J., et al. (2011). A randomized controlled trial of guided Internet-delivered cognitive behavioral therapy for erectile dysfunction. Journal of Sexual Medicine, 8, 2800–2809.

    Article  PubMed  Google Scholar 

  • Arnow, B. A., Millheiser, L., Garrett, A., Lake Polan, M., Glover, G. H., Hill, K. R., et al. (2009). Women with hypoactive sexual desire disorder compared to normal females: A functional magnetic resonance imaging study. Neuroscience, 158, 484–502.

    Article  PubMed  Google Scholar 

  • Bancroft, J., Herbenick, D., Barnes, T., Hallam-Jones, R., Wylie, K., Janssen, E., et al. (2005). The relevance of the dual control model to male sexual dysfunction: The Kinsey Institute/BASRT collaborative project. Sexual and Relationship Therapy, 20, 13–30.

    Article  Google Scholar 

  • Basson, R. (2000). The female sexual response: A different model. Journal of Sex & Marital Therapy, 26, 51–64.

    Article  Google Scholar 

  • Basson, R. (2007). Hormones and sexuality: Current complexities and future directions. Maturitas, 57, 66–70.

    Article  PubMed  Google Scholar 

  • Basson, R., Leiblum, S., Brotto, L., Derogatis, L., Fourcroy, J., Fugl-Meyer, K., et al. (2003). Definitions of women’s sexual dysfunctions reconsidered: Advocating expansion and revision. Journal of Psychosomatic Obstetrics and Gynaecology, 24, 221–229.

    Article  PubMed  Google Scholar 

  • Berman, J. R., Berman, L. A., Lin, H., Flaherty, E., Lahey, N., Goldstein, I., et al. (2001). Effect of sildenafil on subjective and physiologic parameters of the female sexual response in women with sexual arousal disorder. Journal of Sex & Marital Therapy, 27, 411–420.

    Article  Google Scholar 

  • Berman, J. R., Berman, L. A., Toler, S. M., Gill, J., & Haughie, S. (2003). Safety and efficacy of sildenafil citrate for the treatment of female sexual arousal disorder: A double-blind, placebo controlled study. Journal of Urology, 170, 2333–2338.

    Article  PubMed  Google Scholar 

  • Bradford, A., & Meston, C. M. (2011). Behavior and symptom change among women treated with placebo for sexual dysfunction. Journal of Sexual Medicine, 8, 191–201.

    Article  PubMed  Google Scholar 

  • Brotto, L. A. (2010a). The DSM diagnostic criteria for hypoactive sexual desire disorder in women. Archives of Sexual Behavior, 39, 221–239.

    Article  PubMed  Google Scholar 

  • Brotto, L. A. (2010b). The DSM diagnostic criteria for hypoactive sexual desire disorder in men. Journal of Sexual Medicine, 7, 2015–2030.

    Article  PubMed  Google Scholar 

  • Brotto, L. A., Basson, R., & Gorzalka, B. B. (2004). Psychophysiological assessment in premenopausal sexual arousal disorder. Journal of Sexual Medicine, 1, 266–277.

    Article  PubMed  Google Scholar 

  • Brotto, L. A., Basson, R., & Luria, M. (2008). A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. Journal of Sexual Medicine, 5, 1646–1659.

    Article  PubMed  Google Scholar 

  • Brotto, L. A., Heiman, J. R., & Tolman, D. L. (2009). Narratives of desire in mid-age women with and without arousal difficulties. Journal of Sex Research, 46, 387–398.

    Article  PubMed  Google Scholar 

  • Brotto, L. A., Petkau, J., Labrie, F., & Basson, R. (2011). Predictors of sexual desire disorders in women. Journal of Sexual Medicine, 8, 742–753.

    Article  PubMed  Google Scholar 

  • Buster, J. E., Kingsberg, S. A., Aguirre, O., Brown, C., Breaux, J. G., Buch, A., et al. (2005). Testosterone patch for low sexual desire in surgically menopausal women: A randomized trial. Obstetrics and Gynecology, 105, 938–940.

    Article  Google Scholar 

  • Carrier, S., Brock, G. B., Pommerville, P. J., Shin, J., Anglin, G., Whitaker, S., et al. (2005). Efficacy and safety of oral Tadalafil in the treatment of men in Canada with erectile dysfunction: A randomized, double-blind, parallel, placebo-controlled clinical trial. Journal of Sexual Medicine, 2, 685–698.

    Article  PubMed  Google Scholar 

  • Caruso, S., Agnello, C., Intelisano, G., Farina, M., Di Mari, L., & Cianci, A. (2004). Placebo-controlled study on efficacy and safety of daily apomorphine SL intake in premenopausal women affected by hypoactive sexual desire disorder and sexual arousal disorder. Urology, 63, 955–959.

    Article  PubMed  Google Scholar 

  • Caruso, S., Intelisano, G., Lupo, L., & Agnello, C. (2001). Premenopausal women affected by sexual arousal disorder treated with sildenafil: A double-blind, cross-over, placebo-controlled study. British Journal of Obstetrics and Gynaecology, 108, 623–628.

    Article  PubMed  Google Scholar 

  • Carvalheira, A. A., Brotto, L. A., & Leal, I. (2010). Women’s motivations for sex: Exploring the Diagnostic and Statistical Manual, fourth edition, text revision criteria for hypoactive sexual desire and female sexual arousal disorders. Journal of Sexual Medicine, 7, 1454–1463.

    Article  PubMed  Google Scholar 

  • Chivers, M. L., Seto, M. C., Lalumière, M. L., Laan, E., & Grimbos, T. (2010). Agreement of self-reported and genital measures of sexual arousal in men and women. Archives of Sexual Behavior, 39, 5–56.

    Article  PubMed  Google Scholar 

  • Clayton, A. H., DeRogatis, L. R., Rosen, R. C., & Pyke, R. (2012). Intended or unintended consequences? The likely implications of raising the bar for sexual dysfunction diagnosis in the proposed DSM-V revisions: 1. For women with incomplete loss of desire or sexual receptivity. Journal of Sexual Medicine, 9, 2027–2039.

    Article  PubMed  Google Scholar 

  • Corona, G., Mannucci, E., Petrone, L., Giommi, R., Mansani, R., Fei, L., et al. (2004). Psychobiological correlates of hypoactive sexual desire in patients with erectile dysfunction. International Journal of Impotence Research, 16, 275–281.

    Article  PubMed  Google Scholar 

  • Davies, S., Katz, J., & Jackson, J. L. (1999). Sexual desire discrepancies: Effects on sexual and relationship satisfaction in heterosexual dating couples. Archives of Sexual Behavior, 28, 53–567.

    Article  Google Scholar 

  • DeRogatis, L. R., Allgood, A., Auerbach, P., Eubank, D., Greist, J., Bharmal, M., et al. (2010). Validation of a women’s sexual interest diagnostic interview–short form (WSID-SF) and a daily log of sexual activities (DLSA) in postmenopausal women with hypoactive sexual desire disorder. Journal of Sexual Medicine, 7, 917–927.

    Article  PubMed  Google Scholar 

  • DeRogatis, L. R., Allgood, A., Rosen, R. C., Leiblum, S., Zipfel, L., & Guo, C.-Y. (2008). Development and evaluation of the women’s sexual interest diagnostic interview (WSID): A structured interview to diagnose hypoactive sexual desire disorder (HSDD) in standardized patients. Journal of Sexual Medicine, 5, 2827–2841.

    Article  PubMed  Google Scholar 

  • DeRogatis, L., Rust, J., Golombok, S., Bouchard, C., Nachtigall, L., Rodenburg, C., et al. (2004). Validation of the Profile of Female Sexual Function (PFSF) in surgically and naturally menopausal women. Journal of Sex & Marital Therapy, 30, 25–36.

    Article  Google Scholar 

  • Donahey, K. M., & Carroll, R. A. (1993). Gender differences in factors associated with hypoactive sexual desire. Journal of Sex & Marital Therapy, 19, 25–40.

    Article  Google Scholar 

  • el Sakka, A. I. (2006). Efficacy of sildenafil citrate in treatment of erectile dysfunction: Impact of associated premature ejaculation and low desire. Urology, 68, 642–647.

    Article  PubMed  Google Scholar 

  • Everaerd, W., & Laan, E. (1995). Desire for passion: Energetics of sexual response. Journal of Sex & Marital Therapy, 21, 255–263.

    Article  Google Scholar 

  • Ferguson, D. M., Steidle, C. P., Singh, G. S., Alexander, J. S., Weihmiller, M. K., & Crosby, M. G. (2003). Randomized, placebo-controlled, double-blind, crossover design trial of the efficacy and safety of Zestra for Women in women with and without female sexual arousal disorder. Journal of Sex & Marital Therapy, 29, 33–44.

    Article  Google Scholar 

  • Fugl-Meyer, K. S., & Fugl-Meyer, A. R. (2002). Sexual disabilities are not singularities. International Journal of Impotence Research, 14, 487–493.

    Article  PubMed  Google Scholar 

  • Gerstenberger, E. P., Rosen, R. C., Brewer, J. V., Meston, C. M., Brotto, L. A., Wiegel, M., et al. (2010). Sexual desire and the Female Sexual Function Index (FSFI): A sexual desire cutpoint for clinical interpretation of the FSFI in women with and without hypoactive sexual desire disorder. Journal of Sexual Medicine, 7, 3096–3103.

    Article  PubMed  Google Scholar 

  • Giles, K. R., & McCabe, M. P. (2009). Conceptualizing women’s sexual function: Linear vs. circular models of sexual response. Journal of Sexual Medicine, 6, 2761–2771.

    Article  PubMed  Google Scholar 

  • Goldfischer, E. R., Breaux, J., Katz, M., Kaufman, J., Smith, W. B., Kimura, T., et al. (2011). Continued efficacy and safety of flibanserin in premenopausal women with hypoactive sexual desire disorder (HSDD): Results from a randomized withdrawal trial. Journal of Sexual Medicine, 8, 3160–3170.

    Article  PubMed  Google Scholar 

  • Goldstein, I., McCullough, A. R., Jones, L. A., Hellstrom, W. J., Bowden, C. H., Didonato, K., et al. (2012). A randomized, double-blind, placebo-controlled evaluation of the safety and efficacy of avanafil in subjects with erectile dysfunction. Journal of Sexual Medicine, 9, 1122–1133.

    Article  PubMed  Google Scholar 

  • Graham, C. A. (2010). The DSM diagnostic criteria for female sexual arousal disorder. Archives of Sexual Behavior, 39, 240–255.

    Article  PubMed  Google Scholar 

  • Graham, C. A., Sanders, S. A., Milhausen, R. R., & McBride, K. R. (2004). Turning on and off: A focus group study of the factors that affect women’s sexual arousal. Archives of Sexual Behavior, 33, 527–538.

    Article  PubMed  Google Scholar 

  • Heiman, J. R., Gittelman, M., Costabile, R., Guay, A., Friedman, A., Heard-Davison, A., et al. (2006). Topical alprostadil (PGE1) for the treatment of female sexual arousal disorder: In-clinic evaluation of safety and efficacy. Journal of Psychosomatic Obstetrics & Gynecology, 27, 31–41.

    Article  Google Scholar 

  • Janssen, E., McBride, K. R., Yarber, W., Hill, B. J., & Butler, S. M. (2008). Factors that influence sexual arousal in men: A focus group study. Archives of Sexual Behavior, 37, 252–265.

    Article  PubMed  Google Scholar 

  • Jones, L. M., & McCabe, M. P. (2011). The effectiveness of an Internet-based psychological treatment program for female sexual dysfunction. Journal of Sexual Medicine, 8, 2781–2792.

    Article  PubMed  Google Scholar 

  • Laan, E., & Both, S. (2008). What makes women experience desire? Feminism and Psychology, 18, 505–515.

    Article  Google Scholar 

  • Laan, E., van Driel, E. M., & van Lunsen, R. H. W. (2008). Genital responsiveness in healthy women with and without sexual arousal disorder. Journal of Sexual Medicine, 5, 1424–1435.

    Article  PubMed  Google Scholar 

  • Laumann, E. O., Nicolosi, A., Glasser, D. B., Paik, A., Gingell, C., Moreira, E., et al. (2005). Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. International Journal of Impotence Research, 17, 39–57.

    Article  PubMed  Google Scholar 

  • Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunctions in the United States: Prevalence and predictors. Journal of the American Medical Association, 281, 537–544.

    Article  PubMed  Google Scholar 

  • Levine, S. B. (2002). Reexploring the concept of sexual desire. Journal of Sex & Marital Therapy, 28, 39–51.

    Article  Google Scholar 

  • Liao, Q., Zhang, M., Geng, L., Wang, X., Song, X., Xia, P., et al. (2008). Efficacy and safety of alprostadil cream for the treatment of female sexual arousal disorder: A double-blind, placebo-controlled study in Chinese population. Journal of Sexual Medicine, 5, 1923–1931.

    Article  PubMed  Google Scholar 

  • Maserjian, N., Shifren, J., Parish, S. J., Segraves, R. T., Huang, L., & Rosen, R. (2012). Sexual arousal and lubrication problems in women with clinically diagnosed hypoactive sexual desire disorder: Preliminary findings from the hypoactive sexual desire disorder registry from women. Journal of Sex & Marital Therapy, 38, 41–62.

    Article  Google Scholar 

  • McCall, K., & Meston, C. M. (2006). Cues resulting in desire for sexual activity in women. Journal of Sexual Medicine, 3, 838–852.

    Article  PubMed  Google Scholar 

  • McCall, K., & Meston, C. M. (2007a). Differences between pre- and postmenopausal women in cues for sexual desire. Journal of Sexual Medicine, 4, 364–371.

    Article  PubMed  Google Scholar 

  • McCall, K., & Meston, C. M. (2007b). The effects of false positive and false negative physiological feedback on sexual arousal: A comparison of women with and without sexual arousal disorder. Archives of Sexual Behavior, 36, 518–530.

    Article  PubMed  Google Scholar 

  • McLachlan, G. J. (1992). Cluster analysis and related techniques in medical research. Statistical Methods in Medical Research, 1, 27–48.

    Article  PubMed  Google Scholar 

  • Meana, M. (2010). Elucidating women’s (hetero)sexual desire: Definitional challenges and content expansion. Journal of Sex Research, 47, 104–122.

    Article  Google Scholar 

  • Melnik, T., & Abdo, C. H. (2005). Psychogenic erectile dysfunction: Comparative study of three therapeutic approaches. Journal of Sex & Marital Therapy, 31, 243–255.

    Article  Google Scholar 

  • Meston, C. M. (2003). Validation of the Female Sexual Function Index (FSFI) in women with female orgasmic disorder and in women with hypoactive sexual desire disorder. Journal of Sex & Marital Therapy, 29, 39–46.

    Article  Google Scholar 

  • Meston, C. M. (2006). The effects of state and trait self-focused attention on sexual arousal in sexually functional and dysfunctional women. Behaviour Research and Therapy, 44, 515–532.

    Article  PubMed  Google Scholar 

  • Meston, C. M., & Gorzalka, B. B. (1996). Differential effects of sympathetic activation on sexual arousal in sexually dysfunctional and functional women. Journal of Abnormal Psychology, 105, 582–591.

    Article  PubMed  Google Scholar 

  • Meston, C. M., & McCall, K. M. (2005). Dopamine and norepinephrine responses to film-induced sexual arousal in sexually functional and sexually dysfunctional women. Journal of Sex & Marital Therapy, 31, 303–317.

    Article  Google Scholar 

  • Meston, C. M., Rellini, A. H., & McCall, K. M. (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.

    Article  PubMed  Google Scholar 

  • Meston, C. M., Rellini, A. H., & Telch, M. J. (2008). Short and long-term effects of ginkgo biloba extract on sexual dysfunction in women. Archives of Sexual Behavior, 37, 530–547.

    Article  PubMed  Google Scholar 

  • Meston, C. M., & Worcel, M. (2002). The effects of yohimbine plus l-arginine glutamate on sexual arousal in postmenopausal women with Sexual Arousal Disorder. Archives of Sexual Behavior, 31, 323–332.

    Article  PubMed  Google Scholar 

  • Meyer-Bahlburg, H. F. L., & Dolezal, C. (2007). The Female Sexual Function Index: A methodological critique and suggestions for improvement. Journal of Sex & Marital Therapy, 33, 217–224.

    Article  Google Scholar 

  • Morrell, M. J., Dixen, J. M., Carter, C. S., & Davidson, J. M. (1984). The influence of age and cycling status on sexual arousability in women. American Journal of Obstetrics and Gynecology, 148, 66–71.

    PubMed  Google Scholar 

  • Nobre, P. J. (2009). Determinants of sexual desire problems in women: Testing a cognitive-emotional model. Journal of Sex & Marital Therapy, 35, 360–377.

    Article  Google Scholar 

  • Nutter, D. E., & Condron, M. K. (1985). Sexual fantasy and activity patterns of males with inhibited sexual desire and males with erectile dysfunction versus normal controls. Journal of Sex & Marital Therapy, 11, 91–98.

    Article  Google Scholar 

  • Padma-Nathan, H., Brown, C., Fendl, J., Salem, S., Yeager, J., & Harninger, R. (2003). Efficacy and safety of topical Alprostadil cream for the treatment of female sexual arousal disorder (FSAD): A double-blind, multicenter, randomized, and placebo-controlled clinical trial. Journal of Sex & Marital Therapy, 29, 32–344.

    Article  Google Scholar 

  • Regan, P. C., & Berscheid, E. (1996). Beliefs about the state, goals and objects of sexual desire. Journal of Sex & Marital Therapy, 22, 110–120.

    Article  Google Scholar 

  • Regan, P. C., & Berscheid, E. (1999). Lust: What we know about human sexual desire. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Rosen, R. C., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., et al. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex & Marital Therapy, 26, 191–208.

    Article  Google Scholar 

  • Rosen, R. C., Cappelleri, J. C., Smith, M. D., Lipski, J., & Pena, B. M. (1999). Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. International Journal of Impotence Research, 11, 319–326.

    Article  PubMed  Google Scholar 

  • Rosen, R. C., Connor, M. K., & Maserejian, N. N. (2010). The HSDD registry for women: A novel patient registry for women with generalized acquired hypoactive sexual desire disorder. Journal of Sexual Medicine, 7, 1747–1756.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Rosen, R. C., Taylor, J. F., Leiblum, S. R., & Bachmann, G. A. (1993). Prevalence of sexual dysfunction in women: Results of a survey study of 329 women in an outpatient gynaecological clinic. Journal of Sex & Marital Therapy, 19, 171–188.

    Article  Google Scholar 

  • Rowland, D. L., & Heiman, J. (1991). Self-reported and genital arousal changes in sexually dysfunctional men following a sex therapy program. Journal of Psychosomatic Research, 35, 609–619.

    Article  PubMed  Google Scholar 

  • Sand, M., & Fisher, W. (2007). Women’s endorsement of models of female sexual response: The nurses’ sexuality study. Journal of Sexual Medicine, 4, 708–719.

    Article  PubMed  Google Scholar 

  • Sanders, S. A., Graham, C. A., & Milhausen, R. R. (2008). Predicting sexual problems in women: Relevance of sexual inhibition and sexual excitation. Archives of Sexual Behavior, 37, 241–251.

    Article  PubMed  Google Scholar 

  • Schiavi, R. C., Schreiner-Engel, P., White, D., & Mandeli, J. (1988). Pituitary-gonadal function during sleep in men with hypoactive sexual desire and in normal controls. Psychosomatic Medicine, 50, 304–318.

    PubMed  Google Scholar 

  • Schiavi, R. C., White, D., Mandell, J., & Levine, A. C. (1997). Effect of testosterone administration on sexual behavior and mood in men with erectile dysfunction. Archives of Sexual Behavior, 26, 231–241.

    Article  PubMed  Google Scholar 

  • Schnarch, D. (2000). Desire problems: A systematic perspective. In S. Leiblum & R. C. Rosen (Eds.), Principles and practice of sex therapy (3rd ed., pp. 17–56). New York: Guilford Press.

  • Schneider, T., Gleissner, J., Merfort, F., Hermanns, M., Beneke, M., & Ulbrich, E. (2011). Efficacy and safety of vardenafil for the treatment of erectile dysfunction in men with metabolic syndrome: Results of a randomized, placebo-controlled trial. Journal of Sexual Medicine, 8, 2904–2911.

    Article  PubMed  Google Scholar 

  • Segraves, R. T., Clayton, A., Croft, H., Wolf, A., & Warnock, J. (2004). Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women. Journal of Clinical Psychopharmacology, 24, 339–342.

    Article  PubMed  Google Scholar 

  • Segraves, R. T., Croft, H., Kavoussi, R., Ascher, J. A., Batey, S. R., Foster, V. J., et al. (2001). Bupropion sustained release (SR) for the treatment of hypoactive sexual desire (HSDD) in non-depressed women. Journal of Sex & Marital Therapy, 27, 303–316.

    Article  Google Scholar 

  • Segraves, R. T., & Segraves, K. B. (1991). Hypoactive sexual desire disorder: Prevalence and comorbidity in 906 subjects. Journal of Sex & Marital Therapy, 17, 55–58.

    Article  Google Scholar 

  • Singer, B., & Toates, F. (1987). Sexual motivation. Journal of Sex Research, 23, 481–501.

    Article  Google Scholar 

  • Spector, I. P., Carey, M. P., & Steinberg, L. (1996). The sexual desire inventory: Development, factor structure, and evidence of reliability. Journal of Sex & Marital Therapy, 22, 175–190.

    Article  Google Scholar 

  • Srilatha, B., Adaikan, P. G., & Chong, Y. S. (2007). Relevance of oestradiol-testosterone balance in erectile dysfunction patients’ prognosis. Singapore Medical Journal, 48, 114–118.

    PubMed  Google Scholar 

  • Stoleru, S., Redoute, J., Costes, N., Lavenne, F., Le Bars, D., Dechaud, H., et al. (2003). Brain processing of visual sexual stimuli in men with hypoactive sexual desire disorder. Psychiatry Research: Neuroimaging, 124, 67–86.

    Article  PubMed  Google Scholar 

  • Van Ahlen, H., Zumbé, J., Stauch, K., & Hanisch, J. U. (2010). The real-life safety and efficacy of vardenafil (REALISE) study: Results in men from Europe and overseas with erectile dysfunction and cardiovascular or metabolic conditions. Journal of Sexual Medicine, 7, 3161–3169.

    Article  PubMed  Google Scholar 

  • van Anders, S. (2012). Testosterone and sexual desire in healthy women and men. Archives of Sexual Behavior, 41, 1471–1484.

    Article  PubMed  Google Scholar 

  • van der Made, F., Bloemers, J., van Ham, D., El Yassem, W., Kleiverda, G., Everaerd, W., et al. (2009). Childhood sexual abuse, selective attention for sexual cues, and the effects of testosterone with or without vardenafil on physiological sexual arousal in women with sexual dysfunction: A pilot study. Journal of Sexual Medicine, 6, 429–439.

    Article  PubMed  Google Scholar 

  • van Goozen, S. H. M., Wiegant, V. M., Endert, E., Helmond, F. A., & van de Poll, N. E. (1997). Psychoendocrinological assessment of the menstrual cycle: The relationship between hormones, sexuality and mood. Archives of Sexual Behavior, 26, 359–382.

    Article  PubMed  Google Scholar 

  • Wiegel, M., Meston, C. M., & Rosen, R. C. (2005). The Female Sexual Function Index (FSFI): Cross-validation and development of clinical cutoff scores. Journal of Sex & Marital Therapy, 31, 1–20.

    Article  Google Scholar 

  • Witting, K., Santtila, P., Alanko, K., Harlaar, N., Jern, P., Johansson, A., et al. (2008). Female sexual function and its association with number of children, pregnancy and relationship satisfaction. Journal of Sex & Marital Therapy, 34, 89–106.

    Article  Google Scholar 

Download references

Acknowledgments

This work has been supported by a grant from the Canadian Institutes of Health Research (CIHR) and a fellowship from the Social Sciences and Humanities Research Council of Canada (SSHRC). The authors thank current and former members of the Binik lab for their thoughtful feedback on earlier versions of this manuscript and for their assistance with data collection and data entry (Tuuli Kukkonen, Marie-Andrée Lahaie, Alina Kao, Melissa Farmer, Laurel Paterson, Seth Davis, Caroline Maykut, Natalie Stratton, Catherine Moreau, Debra Langleben, Jackie Huberman, Marie Faaborg-Anderson, and Amber Lynch).

Author information

Authors and Affiliations

  1. Department of Psychology, McGill University, 1205 Dr. Penfield Ave., Montreal, QC, H3A 1B1, Canada

    Sabina Sarin, Rhonda M. Amsel & Yitzchak M. Binik

Authors
  1. Sabina Sarin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rhonda M. Amsel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yitzchak M. Binik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sabina Sarin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sarin, S., Amsel, R.M. & Binik, Y.M. Disentangling Desire and Arousal: A Classificatory Conundrum. Arch Sex Behav 42, 1079–1100 (2013). https://doi.org/10.1007/s10508-013-0100-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-013-0100-6

Keywords

Search

Navigation