A cognitive-physiological process model of sexual arousal and response.

Abstract

Three decades of research have focused on identifying cognltive and physiological processes in human emotion. The mechanisms by which these components interact to mediate sexual arousal u. unknown, 8nd rientffic knowledge on women is lacking. New findings have identified (4 key components of sexual response, (b) mechanisms by which cognitive and physiological processes form a feedback loop in the mediation of soxual MUUI, and (c) 8 method to increaso genital response and cognitive expect8ncy, via pairing goner81 autonomic activation 8nd physiological g e n u fwdback. This approach intempted the dysfunctional process and initiated a positive cognitive-physiological feodback loop of sexual arousal to levels comparable wlth sexudly functlond women within 3 mln. This empirically dorived process model idontiiies a cognitive-physiological pathway for sexual response, and a potential common pathway for emotion processing and an integrated beh8vioral medicine approach to women's health. sexual uousal; sexual dysfunction, emotion processing, cognitive processes, physiological processes, bohavlorcll modicine. [ctrn Psychof Sci Pmc 2:37&384, 19951 Key wordr: Three decades of research have been directed toward identieing the interrelations between subjective and physiological response components in the determination of human emotion. Since Schachter and Singer's (1962) two-hctor theory of emotion, and Valins's (1966) Address reprint requests and correspondence to Eileen M. Palace, Department of Psychology, University of Minnesota, 75 E. River Rd., Minneapolis, MN 55455.reformulated cognitive theory, extensive research has been devoted to clarifjmg these processes in the mediation of emotions such as fear and anxiety. In contrast, psychophysiological research to identify key response components and mechanisms that medlate sexual arousal has just begun, and the study of women has lagged far behind that of men. Investigation of these issues has major implications for defining the construct of sexual arousal, deriving an etiological theory of sexual dysfunction, determining valid and reliable assessment instruments, and developing effective treatment methods for the alleviation of sexual dysfunction in women. Further, identification of these processes in sexual arousal has direct implications for identifjmg the nature of these processes in the mediation of other types of emotion processing.This article presents (a) new empirical findings on cognitive and physiological response patterns and processes of sexual response in sexually functional and dysfunctional women, (b) a new empirically derived process model of mechanisms of sexual arousal in women, and (c) an intervention, which &om preliminary research has been found to reverse these dysfunctional processes. Before presenting this model, a brief review of cognitive and physiological theories of emotion and empirical findings on the role of cognitive and physiological components in sexual arousal are presented. COGNITIVE A N D PHYSIOLOGICAL C O M r O N E N T S OF E M O T I O N ...

The Effects of False Physiological Feedback on Sexual Arousal in Sexually Dysfunctional and Functional Males

“…Interestingly, in these studies, women were found to be less susceptible than men to the distracting effects of anxiety or sexual performance demands. More recently, Sbrocco and Barlow (1996) and Palace (1995b) 53 have shown that confidence in one's ability to perform and expectations of future performance are important cognitive mediating factors in sexual performance. They cite results from a number of studies (e.g.• Cranston-Cuebas.…”

“…Most of what will be reviewed in this paper pertains to males -an unfortunate reflection of the current state of the literature. However, an important line of research by Palace (1990Palace ( , 1992Palace ( , 1995aPalace ( , 1995b, although focusing on female sexual dysfunction, appears to have significant application to the study of male sexuality as well.…”

“…Autonomic arousal was highly efficient in enhancing physiological sexual response. This enhancing effect of autonomic arousal on sexual arousal has been replicated three times in Palace's program, using both within-subject and between-subject designs, and across heterogeneous samples of women with sexual dysfunctions including desire, arousal and orgasm phase disorders, coital pain disorders, and histories of sexual abuse (Palace, 1995b). Interestingly, autonomic arousal was also successful in increasing expectations of sexual arousaL It was not, however, immediately effective in modifying subsequent genital response or perceptions of sexual arousal.…”

“…Interestingly, autonomic arousal was also successful in increasing expectations of sexual arousaL It was not, however, immediately effective in modifying subsequent genital response or perceptions of sexual arousal. A process flow diagram developed by Palace (1995b) shows the results of the A-E no-feedback group in The finding that false VBV feedback was more effective in increasing expectations and genital response in the A-E as compared to the N-E condition indicates that the effectiveness of false feedback is facilitated by increased autonomic arousal (Palace, 1995b). Because autonomic arousal-eliciting stimuli enhanced genital response, the false feedback was less "false" for these women; that is.…”

The Effect of Feedback on Penile Tumescence in Sexually Functional Men

“…More recently, Sbrocco and Barlow (1996), Palace (1995b), and Stone, Sbrocco, & Lewis (1999) have shown that confidence in one's ability to perform and expectations of future performance are important cognitive mediating factors in sexual performance. Results from a number of studies (e.g., Cranston-Cuebas, Barlow, Mitchell, & Athanasiou, 1993;Bach, Brown, & Barlow, 1999;Palace, 1995a) suggest that manipulating subjects' confidence, expectations, and attention profoundly affects their sexual performance.…”