A review of experimental research on anxiety and sexual arousal: Implications for the treatment of sexual dysfunction using cognitive behavioral therapy

Abstract

Clinical models of sexual response link anxiety to the etiology of sexual dysfunction. Furthermore, some cognitive behavioral therapies (CBTs) for sexual dysfunction have included strategies targeting anxiety reduction. This review examines the experimental literature on the effects of manipulating aspects of the anxiety response (e.g., anxious sensations, thoughts, attentional focus) on genital and self-reported sexual arousal. An additional aim was to use this literature to elucidate potential mechanisms that may be useful for CBT for sexual dysfunction. Our review suggested that anxiety sometimes facilitates, inhibits, or has no effect on sexual arousal. These findings suggest that caution is warranted incorporating anxiety-focused interventions in the treatment of sexual dysfunctions. Importantly, little experimental research has utilized precise manipulations of anxiety (e.g., manipulating fear of penetration) that are related to current CBT interventions. To better understand the relationship between anxiety and sexual dysfunction, future research should explore the question of why and how anxiety exerts a variable effect on sexual arousal rather than simply if anxiety exerts an effect on sexual arousal. Importantly, experimental research

Association between Psychopathological Dimensions and Sexual Functioning/Sexual Arousal in Young Adults

“…In men, anxiety-related symptoms negatively and significantly affected desire, sexual arousal, orgasm, and satisfaction [ 63 , 64 , 65 , 66 , 67 , 68 , 69 ]. This could be due to a feedback loop in which, due to anticipatory fear, arousal responses are inhibited, or sexual performance worsens, accelerating possible orgasm and ejaculation problems [ 66 , 70 ]. In addition to anxiety, somatization were significant explanatory variables of male sexual desire, according to previous findings [ 71 ].…”

“…Specifically, moderate levels of anxiety could facilitate sexual arousal in healthy women [ 85 , 86 ], but not in women with a sexual arousal dysfunction [ 87 , 88 ]. These discrepancies may be related, on the one hand, to the fact that sexual arousal is a category that involves physiological and subjective components, whose measurements may be discordant [ 89 ], and on the other hand, to the type of anxiety (e.g., trait or state), the instruments used to account for it, and the experimental strategies applied to evaluate it [ 66 , 87 ].…”

Innovations and advances in cognitive behavioral therapy: Insights from experimental psychopathology

“…Indeed, this important study provides yet another example of how applying evidence-based theory to practice results in improvements for patients and clients. Kane et al (2019) reviewed experimental research focused on the effects of anxiety on sexual arousal to better understand whether anxiety is helpful, unhelpful, or has no influence on sexual arousal. The authors set out to provide suggestions for developing and refining current CBT interventions for sexual dysfunction.…”

Has the Kama Sutra Not Made a Difference? Making Psychologists in India Explore Sexual Functioning and Master Sex Therapy

“…Manual-based newer forms of therapy may not help one to explore and unravel the "dynamics." 17 It is also quite possible that the prospective therapist's own anxiety and "unfinished business" are leading to the discomfort in exploring the sexual functioning of clients, identification of the problems and providing them with appropriate treatment. While asking to list down the personal problems faced by the postgraduate students of psychology of a prestigious university in the country, there were omissions of issues related to sexuality and gender.…”

“…A lack of familiarity with the concepts and the neglect of orienting the trainees to the psychodynamic psychotherapy deprived the psychology student the opportunity to become aware of the importance of sexuality. Manual-based newer forms of therapy may not help one to explore and unravel the “dynamics.” 17…”