Prevalence of sexual problems in Portugal: Results of a population-based study using a stratified sample of men aged 18 to 70 years 2 Abstract Despite the use of different methodologies, target populations, and clinical definitions of sexual problems, recent epidemiological studies have shown that the occurrence of sexual difficulties is a very common experience among men from the general population regardless of their age. The objective of this study was to present epidemiological data on the prevalence of sexual difficulties in a community sample of 650 sexually active Portuguese men, stratified by age, marital status, and educational level. Participants completed a self-reported questionnaire assessing sexual function in the previous four weeks (International Index of Erectile Function). Results showed that sexual difficulties were relatively common among this sample. Rapid ejaculation was the most frequently reported sexual difficulty (23.2%), followed by erectile difficulties (10.2%), orgasm problems (8.2%), and low desire (2.9%) in the previous four weeks. With the exception of rapid ejaculation, all categories showed agespecific prevalence rates, with sexual difficulties increasing gradually in men above the age of 45 years. Age was a significant predictor of all sexual difficulties except rapid ejaculation and lower educational levels were related to orgasm difficulties. Findings are consistent with the majority of epidemiological studies indicating a high prevalence of sexual difficulties among men in the general population and highlight the importance and the need to implement sexual health promotion programs in the target population.

The Sexual Inhibition and Sexual Excitation Scales (SIS/SES) were developed to assess individual propensities for sexual excitation and sexual inhibition in men and women. The objective of the present study was to validate the Portuguese version of the SIS/SES and to investigate the degree to which SIS/SES scores predict different dimensions of Portuguese men's and women's sexual functioning. Gender differences were also examined. A community sample of 370 Portuguese men and 373 women completed self-report measures of sexual function (IIEF, Rosen et al., 1997; FSFI, Rosen et al., 2000) and of the propensity for sexual inhibition and sexual excitation (SIS/SES, Janssen et al., 2002a). Exploratory factor analysis revealed a three-factor solution further supported by confirmatory factor analysis. The three factors identified resemble the original ones, and reliability analyses indicated they have both satisfactory internal consistency and stability over time. Age and Sexual Inhibition Due to the Threat of Performance Failure (SIS1) were both significant negative predictors of men's sexual desire, erectile function, and orgasm. Sexual Excitation (SES) was a positive predictor of sexual desire in both men and women and of men's erectile function and of women's lubrication and orgasm. Age was also a significant and negative predictor of women's sexual desire. Significant gender differences were found for all three SIS/SES scales with men having significantly higher excitation and lower inhibition scores as compared to women. The Portuguese version of the SIS/SES was shown to be suitable for use within the Portuguese population in both clinical and basic research. Our findings provide further cross-cultural validation of the Dual Control Model of Sexual Response and underscore the importance of the role of excitatory and inhibitory processes in women's and men's sexual functioning and response.

The present study examined men and women's sexual and affective responses to erotic film clips that were combined with different fantasy instructions. Men (n = 29) and women (n = 28) were presented with two types of erotic films (explicit vs. romantic) and two fantasy instructions (fantasizing about one's real-life partner vs. fantasizing about someone else). Genital response, subjective sexual arousal, and affective responses were assessed. Sexually explicit stimuli resulted in larger genital responses; women reported higher subjective sexual arousal than men; and fantasizing about one's partner resulted, overall, in higher subjective sexual arousal and higher levels of positive affect. Moreover, in women, the instruction to fantasize about one's partner resulted in stronger subjective sexual arousal to the explicit film than the instruction to fantasize about someone else. Results suggested that physiological, subjective, and affective responses to erotic film stimuli are impacted not only by stimulus characteristics but also by the viewer's interpretation of the depicted relationship.

Introduction The importance of the role played by personality variables in the etiology, development, and maintenance of most emotional disorders is strongly supported by empirical data. However, there is a lack of studies concerning the implication of these variables on sexual difficulties. Aim The purpose of the present study was to investigate the role played by personality dimensions and psychopathology on male sexual functioning as well as to clarify the way these variables discriminate men with and without sexual dysfunction. Methods A total of 229 men participated in the study (a community sample composed by 205 men and a clinical sample by 24 men with a DSM-IV diagnosis of sexual dysfunction). The community sample was subdivided into a control group (n = 152) and a subclinical group (n = 53), according to the cutoff scores of the International Index of Erectile Dysfunction. After giving informed consent, participants completed a set of clinical instruments. Partial correlations, regression analyses, and multivariate analyses of covariance were conducted. Main Outcomes Measures All participants completed a set of measures assessing personality dimensions, psychopathological symptoms, and sexual functioning. Results After controlling for psychopathology, men with sexual dysfunction presented significantly higher levels of neuroticism when compared to sexually healthy men. Moreover, regression analysis indicated neuroticism as the best predictor of sexual functioning (β = −0.24, P < 0.01). Regarding psychopathology, men with sexual problems presented significantly higher levels of depressive symptoms than the controls. Additionally, depressive symptoms were a significant predictor of sexual functioning (β = −0.41, P < 0.001). Conclusions Personality dimensions and psychopathology play an important role on male sexual functioning. The results may have important clinical implications.

Introduction Sexual offenders are believed to present marked sexual difficulties. However, most of the studies characterizing sex offenders' sexual functioning were conducted with samples of documented/incarcerated sexual aggressors. At the present state of the knowledge there is limited information on the sexual functioning profile of individuals reporting some form of sexual violence but who were not documented/apprehended by the judicial system. Aim The aim of this preliminary study was to characterize a sample of community sexual aggressors (college students) according to their sexual functioning. Results were expected to add information about the relationship between sexual functioning and sexual violence, and to impact strategies aimed at preventing sexual aggression on college campus. Methods One hundred sixty-one male college students participated in a cross-sectional study. Students were recruited at a Portuguese university using nonrandom methods. Among these students, 35 reported sexual aggression against women. The measures were completed individually and anonymously. Main Outcome Measures Participants completed a modified version of the International Index of Erectile Function, the Sexual Inhibition and Sexual Excitation Scales, the Sexual Self-Consciousness Scale, the Questionnaire of Cognitive Schema Activation in Sexual Context, and the Sexual-Esteem Scale. Results Results indicated that students reporting sexual aggression against women presented significantly more erectile and orgasmic difficulties, and more sexual inhibition due to the threat of performance failure than the control peers. Additionally, students reporting sexual aggression presented more sexual embarrassment, and more schemas of undesirability and incompetence. Conclusions Results pointed toward a possible relationship between sexual violence as reported by college students and sexual performance anxiety. These findings are expected to impact conceptual models on sexual aggression perpetrated by nonforensic individuals.