No abstract

Current definitions of asexuality focus on sexual attraction, sexual behavior, and lack of sexual orientation or sexual excitation; however, the extent to which these definitions are accepted by self-identified asexuals is unknown. The goal of Study 1 was to examine relationship characteristics, frequency of sexual behaviors, sexual difficulties and distress, psychopathology, interpersonal functioning, and alexithymia in 187 asexuals recruited from the Asexuality Visibility and Education Network (AVEN). Asexual men (n = 54) and women (n = 133) completed validated questionnaires online. Sexual response was lower than normative data and was not experienced as distressing, and masturbation frequency in males was similar to available data for sexual men. Social withdrawal was the most elevated personality subscale; however, interpersonal functioning was in the normal range. Alexithymia was elevated in 12%. Social desirability was also in the normal range. Study 2 was designed to expand upon these quantitative findings with 15 asexuals from Study 1 through in-depth telephone interviews. The findings suggest that asexuality is best conceptualized as a lack of sexual attraction; however, asexuals varied greatly in their experience of sexual response and behavior. Asexuals partnered with sexuals acknowledged having to "negotiate" sexual activity. There were not higher rates of psychopathology among asexuals; however, a subset might fit the criteria for Schizoid Personality Disorder. There was also strong opposition to viewing asexuality as an extreme case of sexual desire disorder. Finally, asexuals were very motivated to liaise with sex researchers to further the scientific study of asexuality.

A brief mindfulness-based intervention was effective for improving sexual functioning. Geographic restrictions permitted only a select sample of survivors to participate, thus, the generalizability of the findings is limited. Future studies should aim to develop online modalities for treatment administration to overcome this limitation.

This article places a magnifying glass on psychology's current training realities in the context of global health developments, particularly those of the Canadian health-care system. The authors argue that curriculum review and revision is needed to solidify psychology as a true health care profession; such a review should be proactive and must consider the likely changes in our overall health-care system. In preparing for anticipated changes in health care, it is proposed that curricula modifications be made to better reflect how psychology can contribute (in a broad fashion) to the health of Canadians. Two particular models for psychology's future role are offered for discussion: a) a modified, comprehensive parallel/vertical model that sees psychologists similar to other health-care providers; versus, b) a more innovative horizontal/cross-cutting model in which psychologists provide a unique blend of education, innovation, teaching, system consultation, prevention, as well as direct service provision, to patients with physical and mental health problems.

Multi-drug rescue therapy (MDRT) is often used for the treatment of highly experienced patients who harbor HIV variants with decreased susceptibility to multiple antiretrovirals. Patients on MDRT typically have limited treatment options, and without treatment, their prognosis can be poor. Yet the decision to go on MDRT is not always straightforward as MDRT can be associated with significant challenges including multiple daily doses, higher pill burden, emerging toxicities, and drug interactions. All of these may compromise adherence, which is often a major reason why patients may need MDRT in the first place. Little is known about how patients and health care providers (HCPs) experience MDRT. This study sought to explore areas of convergence and divergence between patients and HCPs in order to identify gaps in treatment and factors that may impact adherence to MDRT. A qualitative interview method based on grounded theory was used. Twelve patients and seven HCPs completed a 60-minute semistructured interview. Patients were asked about challenges, facilitative aspects of staying on MDRT, the decision to initiate treatment, their role, and the role of HCPs in their health care. HCPs were asked about their experience working with MDRT patients, their role, and the role of the patient. Congruent themes emerged from the two groups: developing a working relationship, treatment factors, information requirements, and readiness for treatment. There were no discrepancies in role perspectives. Patients and HCPs agreed on the need to optimize patients' readiness, willingness, and ability to embark on MDRT to maximize adherence. HCPs assumptions about beginning MDRT based solely on medical indications must be checked and discussed to ensure patients' motivation. In conclusion, adherence to MDRT demands a substantial behavior change, recognized as a major challenge by patients. Allocating the time to make a commitment to treatment can optimize adherence. It is therefore crucial that patients be provided with time to make informed decisions, explore and resolve their willingness and readiness to commit to treatment, and maintain supportive relationships with their HCPs, all of which can optimize adherence to MDRT.