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See detailL'éjaculation précoce et son traitement : Le critère d’une minute maximum de pénétration en question
Kempeneers, Philippe ULg

Scientific conference (2014, March 15)

Il existe actuellement une tendance à réserver le diagnostic de trouble de l‘éjaculation précoce (EP) aux seuls cas caractérisés par des durées de pénétration inférieures ou égales à une minute environ ... [more ▼]

Il existe actuellement une tendance à réserver le diagnostic de trouble de l‘éjaculation précoce (EP) aux seuls cas caractérisés par des durées de pénétration inférieures ou égales à une minute environ. L’idée sous-jacente est que ces situations relèveraient d’une étiologie essentiellement bio-constitutionnelle et qu’un traitement pharmacologique au long cours constituerait l’unique option thérapeutique valable. À l’examen de la littérature cependant, les évidences scientifiques invoquées en soutien de cette proposition apparaissent assez faibles. Bon nombre de personnes souffrant d’éjaculer trop rapidement présentent en effet des durées de pénétration supérieures à une minute, et il semble que les formes sévères d’EP puissent aussi répondre favorablement à des traitements psycho-sexologiques. En outre, s’il s’avère certain que des variables biologiques influencent la latence éjaculatoire, rien ne permet cependant de prétendre qu’elles jouent, dans les formes sévères d’EP, un rôle exclusif de facteurs étiologiques psychosociaux. Il apparaît ainsi « prématuré » de fonder le diagnostic d’EP sur une durée de pénétration d’une minute maximum, ce critère détermine plutôt un gradient de sévérité du trouble. Considérant que, en matière de durée de pénétration, les critères d’aspiration se situent souvent au delà des normes biologiques, il semble délicat de soutenir que seules les formes d’EP les plus sévères auraient une origine bio-constitutionnelle. Dans tous les cas au demeurant, la constitution s’avère relativement plastique, sensible aux apprentissages à visée adaptative. Ceux-ci sont sans doute plus difficiles à réaliser par les porteurs d’une forme sévère du trouble, mais pas impossibles. La question de l’indication d’un traitement pharmacologique ou psycho-sexologique gagnerait à se dégager d’un simple critère de latence éjaculatoire. [less ▲]

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See detailThe premature ejaculation ‘disorder ’: Questioning the criterion of one minute of penetration
Kempeneers, Philippe ULg; Desseilles, Martin ULg

in Sexologies : Revue Européenne de Santé Sexuelle = European Journal of Sexual Health (2014)

The current trend is to reserve the diagnosis of premature ejaculation (PE) for cases where penetration lasts for about one minute or less. The rationale is that the aetiology is primarily bio ... [more ▼]

The current trend is to reserve the diagnosis of premature ejaculation (PE) for cases where penetration lasts for about one minute or less. The rationale is that the aetiology is primarily bio-constitutional, and that long-term pharmacological treatment is the only viable option. However, the literature contains little scientific evidence to support this argument. In fact, a good number of individuals who suffer from overly rapid ejaculation present with penetration duration exceeding one minute, and even severe forms of PE have responded favourably to psycho-sexological treatment. Moreover, although certain biological variables are known to influence ejaculation latency time, nothing indicates that they play an exclusive role of psychosocial etiological factors in severe PE. Therefore, it would be ‘premature’ to base a PE diagnosis on a maximum penetration duration of one minute, which should instead be considered a severity gradient. Given that desired criteria for penetration duration often exceed biological norms, it would be inappropriate to propose that only the most severe forms of PE have constitutional origins. In any case, the constitution is relatively flexible, and can respond to adaptive learning. An adaptive learning approach would undoubtedly be more difficult to apply in severe cases, but not impossible. The issue of whether to use pharmacological versus psycho-sexological treatment could be side-stepped by moving beyond the single criterion of ejaculation latency. [less ▲]

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See detailLe « trouble » de l’éjaculation précoce : Le critère d’une minute maximum de pénétration en question
Kempeneers, Philippe ULg; Desseilles, Martin ULg

in Sexologies : Revue Européenne de Santé Sexuelle = European Journal of Sexual Health (2014)

The current trend is to reserve the diagnosis of premature ejaculation (PE) for cases where penetration lasts for about one minute or less. The rationale is that the aetiology is primarily bio ... [more ▼]

The current trend is to reserve the diagnosis of premature ejaculation (PE) for cases where penetration lasts for about one minute or less. The rationale is that the aetiology is primarily bio-constitutional, and that long-term pharmacological treatment is the only viable option. However, the literature contains little scientific evidence to support this argument. In fact, a good number of individuals who suffer from overly rapid ejaculation present with penetration duration exceeding one minute, and even severe forms of PE have responded favourably to psycho-sexological treatment. Moreover, although certain biological variables are known to influence ejaculation latency time, nothing indicates that they play an exclusive role of psychosocial etiological factors in severe PE. Therefore, it would be ‘premature’ to base a PE diagnosis on a maximum penetration duration of one minute, which should instead be considered a severity gradient. Given that desired criteria for penetration duration often exceed biological norms, it would be inappropriate to propose that only the most severe forms of PE have constitutional origins. In any case, the constitution is relatively flexible, and can respond to adaptive learning. An adaptive learning approach would undoubtedly be more difficult to apply in severe cases, but not impossible. The issue of whether to use pharmacological versus psycho-sexological treatment could be side-stepped by moving beyond the single criterion of ejaculation latency. [less ▲]

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See detailPsychopathologie, alimentation et sexualité
Desseilles, Martin; Kempeneers, Philippe ULg

in Sexualités Humaines : Revue de Sexologie des Professionnels de Santé (2014), 22

L'alimentation et la sexualité entretiennent des liens de réciprocité principalement indirects tant dans les premiers stades de développement psychosexuel de l'individu que dans les mécanismes ... [more ▼]

L'alimentation et la sexualité entretiennent des liens de réciprocité principalement indirects tant dans les premiers stades de développement psychosexuel de l'individu que dans les mécanismes physiologiques ou physiopathologiques. Dans cet article nous passerons en revue ces interrelations en essayant d'y apporter un éclairage nuancé et clinique [less ▲]

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See detailL’éjaculation précoce : une revue de questions
Kempeneers, Philippe ULg; ANDRIANNE, Robert ULg; Lequeux, Armand et al

in Revue Francophone de Clinique Comportementale et Cognitive (2014), 19(2), 35-60

Premature ejaculation (PE) is a disorder characterized by three components: (1) a rapid ejaculation, (2), a feeling of lack of control upon ejaculation, (3) and a distress related to this condition. The ... [more ▼]

Premature ejaculation (PE) is a disorder characterized by three components: (1) a rapid ejaculation, (2), a feeling of lack of control upon ejaculation, (3) and a distress related to this condition. The criterion of rapidity appears to be most controversial: some authors refer only to subjects’ judgment, while other ones set a maximum ejaculatory latency. Although it focused some criticisms related to a lack of objective latency criteria, the definition of PE propounded by the DSM-IV(-TR) remains most currently used. PE affects about 15 to 30% of the male population. However, the estimations can vary widely depending on populations and methodologies. Several factors contribute to the occurrence of the disorder: one may very probably charge bio-constitutional risks, learning factors, cultural and cognitive influences and the role of anxiety. No robust data allow to implicate personality factors other than anxiety. The influence of the age remains a controversial topic. Cognitive-behavioral techniques appear to be quite efficient in the treatment of PE. However the success rates are variable, and the precise nature of the therapeutic active process remains unclear. Serotonergic drugs and local anesthetics are also efficient, but their action remains strictly symptomatic. The usefulness of phosphodiesterase-5 inhibitors is disputed. Combining psychological and pharmacological approaches might be promising. Unfortunately, there is a lack of clinical trials in this field. Although effective treatments do exist, only a few affected people appear to use them satisfactorily. Efforts have still to be made in order to train adequately heath practitioners and to make the treatments more accessible to the public. [less ▲]

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See detailL’éjaculation précoce : une revue de questions
Kempeneers, Philippe ULg; ANDRIANNE, Robert ULg; Lequeux, Armand et al

in Revue Francophone de Clinique Comportementale et Cognitive (2014), 19(2), 35-60

Premature ejaculation (PE) is a disorder characterized by three components: (1) a rapid ejaculation, (2), a feeling of lack of control upon ejaculation, (3) and a distress related to this condition. The ... [more ▼]

Premature ejaculation (PE) is a disorder characterized by three components: (1) a rapid ejaculation, (2), a feeling of lack of control upon ejaculation, (3) and a distress related to this condition. The criterion of rapidity appears to be most controversial: some authors refer only to subjects’ judgment, while other ones set a maximum ejaculatory latency. Although it focused some criticisms related to a lack of objective latency criteria, the definition of PE propounded by the DSM-IV(-TR) remains most currently used. PE affects about 15 to 30% of the male population. However, the estimations can vary widely depending on populations and methodologies. Several factors contribute to the occurrence of the disorder: one may very probably charge bio-constitutional risks, learning factors, cultural and cognitive influences and the role of anxiety. No robust data allow to implicate personality factors other than anxiety. The influence of the age remains a controversial topic. Cognitive-behavioral techniques appear to be quite efficient in the treatment of PE. However the success rates are variable, and the precise nature of the therapeutic active process remains unclear. Serotonergic drugs and local anesthetics are also efficient, but their action remains strictly symptomatic. The usefulness of phosphodiesterase-5 inhibitors is disputed. Combining psychological and pharmacological approaches might be promising. Unfortunately, there is a lack of clinical trials in this field. Although effective treatments do exist, only a few affected people appear to use them satisfactorily. Efforts have still to be made in order to train adequately heath practitioners and to make the treatments more accessible to the public. [less ▲]

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See detailL’éjaculation précoce : une revue de questions
Kempeneers, Philippe ULg; ANDRIANNE, Robert ULg; Lequeux, Armand et al

in Revue Francophone de Clinique Comportementale et Cognitive (2014), 19(2), 35-60

Premature ejaculation (PE) is a disorder characterized by three components: (1) a rapid ejaculation, (2), a feeling of lack of control upon ejaculation, (3) and a distress related to this condition. The ... [more ▼]

Premature ejaculation (PE) is a disorder characterized by three components: (1) a rapid ejaculation, (2), a feeling of lack of control upon ejaculation, (3) and a distress related to this condition. The criterion of rapidity appears to be most controversial: some authors refer only to subjects’ judgment, while other ones set a maximum ejaculatory latency. Although it focused some criticisms related to a lack of objective latency criteria, the definition of PE propounded by the DSM-IV(-TR) remains most currently used. PE affects about 15 to 30% of the male population. However, the estimations can vary widely depending on populations and methodologies. Several factors contribute to the occurrence of the disorder: one may very probably charge bio-constitutional risks, learning factors, cultural and cognitive influences and the role of anxiety. No robust data allow to implicate personality factors other than anxiety. The influence of the age remains a controversial topic. Cognitive-behavioral techniques appear to be quite efficient in the treatment of PE. However the success rates are variable, and the precise nature of the therapeutic active process remains unclear. Serotonergic drugs and local anesthetics are also efficient, but their action remains strictly symptomatic. The usefulness of phosphodiesterase-5 inhibitors is disputed. Combining psychological and pharmacological approaches might be promising. Unfortunately, there is a lack of clinical trials in this field. Although effective treatments do exist, only a few affected people appear to use them satisfactorily. Efforts have still to be made in order to train adequately heath practitioners and to make the treatments more accessible to the public. [less ▲]

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See detailL’éjaculation précoce : une revue de questions
Kempeneers, Philippe ULg; ANDRIANNE, Robert ULg; Lequeux, Armand et al

in Revue Francophone de Clinique Comportementale et Cognitive (2014), 19(2), 35-60

Premature ejaculation (PE) is a disorder characterized by three components: (1) a rapid ejaculation, (2), a feeling of lack of control upon ejaculation, (3) and a distress related to this condition. The ... [more ▼]

Premature ejaculation (PE) is a disorder characterized by three components: (1) a rapid ejaculation, (2), a feeling of lack of control upon ejaculation, (3) and a distress related to this condition. The criterion of rapidity appears to be most controversial: some authors refer only to subjects’ judgment, while other ones set a maximum ejaculatory latency. Although it focused some criticisms related to a lack of objective latency criteria, the definition of PE propounded by the DSM-IV(-TR) remains most currently used. PE affects about 15 to 30% of the male population. However, the estimations can vary widely depending on populations and methodologies. Several factors contribute to the occurrence of the disorder: one may very probably charge bio-constitutional risks, learning factors, cultural and cognitive influences and the role of anxiety. No robust data allow to implicate personality factors other than anxiety. The influence of the age remains a controversial topic. Cognitive-behavioral techniques appear to be quite efficient in the treatment of PE. However the success rates are variable, and the precise nature of the therapeutic active process remains unclear. Serotonergic drugs and local anesthetics are also efficient, but their action remains strictly symptomatic. The usefulness of phosphodiesterase-5 inhibitors is disputed. Combining psychological and pharmacological approaches might be promising. Unfortunately, there is a lack of clinical trials in this field. Although effective treatments do exist, only a few affected people appear to use them satisfactorily. Efforts have still to be made in order to train adequately heath practitioners and to make the treatments more accessible to the public. [less ▲]

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See detailFunctional and Psychological Characteristics of Belgian Men with Premature Ejaculation and Their Partners
Kempeneers, Philippe ULg; ANDRIANNE, Robert ULg; Bauwens, Sabrina et al

in Archives of Sexual Behavior (2013), 42

Physiological, behavioral, cognitive, and emotional factors are generally acknowledged to play a role in premature ejaculation (PE). However, the nature and the extent of their etiological impact remain ... [more ▼]

Physiological, behavioral, cognitive, and emotional factors are generally acknowledged to play a role in premature ejaculation (PE). However, the nature and the extent of their etiological impact remain largely imprecise. The present study examined functional and psychometric dynamics at work in a PE population. A total of 461 men with PE and 80 partners completed an online questionnaire. The main outcome measures were self-reported ejaculatory latency time, the feeling of control upon ejaculation, sexual satisfaction, distress related to PE, trait anxiety (STAI-B), sexual cognitions (SIQ), social anxiety (LSAS and SISST), and personality traits (TCI-R). In our sample, the median latency time to ejaculation was between 1 and 2 minutes. Sexual satisfaction and distress correlated more strongly with the feeling of control than with the self-reported latency time. Men experienced more distress and dissatisfaction related to PE than did their partners while overestimating their partners’ distress and dissatisfaction. PE participants’ scores differed significantly, albeit slightly, from STAI-B, SIQ, LSAS, and SISST norms. The differences were negligible on TCI-R. Some differences became stronger when subtypes were considered. Participants combining generalized and lifelong PE with self-reported latency times of < 30 sec reported lower sexual satisfaction and control, higher distress, higher social anxiety, and harm avoidance (TCI-R/HA) scores. By contrast, the situational subtype of PE was found to be characterized by a higher level of satisfaction, a greater feeling of control, less distress, and higher trait anxiety scores. However, the trends remained statistically discrete. [less ▲]

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See detailClinical outcomes of a new self-help booklet for premature ejaculation
Kempeneers, Philippe ULg; ANDRIANNE, Robert ULg; Bauwens, Sabrina et al

in Journal of Sexual Medicine (2012), 9

INTRODUCTION. Premature ejaculation (PE) is quite common. Although effective treatments do exist, only a few affected people consult a practitioner in order to overcome their problem. At the same time ... [more ▼]

INTRODUCTION. Premature ejaculation (PE) is quite common. Although effective treatments do exist, only a few affected people consult a practitioner in order to overcome their problem. At the same time, studies have shown that reading didactical documents about their PE problem (bibliotherapy) can be useful to men. AIM. The aim of this study was to improve the bibliotherapy approach using up to date knowledge and techniques. The expected benefits were: (1) an effective manual shorter than previous ones, (2) easier to assimilate therapeutic principles and (3) a method thereby made accessible to a broad population most of whom usually do not consult for this type of sexual problem. METHOD. A short bibliotherapy titled The Practical Guide of PE [in French] was tested among PE subjects who were diagnosed with PE according to DSM-IV-TR criteria. Assessments were made at baseline (N = 421), at 4-8 months (N = 120) and at 10-14 months (N = 79) after they read The Practical Guide. A control group of 66 subjects was left on a waiting list and was assessed two months after baseline. MAIN OUTCOME MEASURES. Self-reported ejaculatory latency time, feeling of control upon ejaculation, sexual satisfaction, distress related to PE, anxiety experienced during sexual intercourse and sexual cognitions (SIQ). RESULTS. Significant improvements were found for all the self-reported parameters, both at 4-8 and at 10-14 months after the bibliotherapy. The improvements were associated with an adjustment of sexual cognitions. The response to treatment seemed better for those subjects with moderate PE. Although the severity criteria used in this study did not precisely meet the ISSM criteria for lifelong PE, they were likely related. The response did not seem to be affected by variables such as age, education or personality. CONCLUSION. Its cost/benefit ratio makes The Practical Guide a valuable therapeutic tool. [less ▲]

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See detailLes implications conjugales et la prise en charge du couple dans le traitement du désir sexuel hypoactif
Kempeneers, Philippe ULg

in Louvain Medical (2010), 129(9), 105-110

Hypoactive sexual desire is generally a multifactorial disorder, needing several parallel treatment modalities. Relational variables are always involved in the difficulty. In order to provide some ... [more ▼]

Hypoactive sexual desire is generally a multifactorial disorder, needing several parallel treatment modalities. Relational variables are always involved in the difficulty. In order to provide some practical landmarks to clinicians, this paper suggests approaching this part of the problem following two main axis: the management of the erotic fantasies in the couple and the management of the tensions between the partners. Some therapeutic techniques applicable in such contexts are considered. [less ▲]

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See detailClinical outcomes of a new cognitive-behaviour bibliotherapy for premature ejaculation
Kempeneers, Philippe ULg; Andrianne, Robert ULg; Bauwens, Sabrina et al

Conference (2010, October 08)

INTRODUCTION. Premature ejaculation (PE) is a common sexual disorder. However, only few affected people consult clinicians in order to overcome this problem. Although no definitive consensus about its ... [more ▼]

INTRODUCTION. Premature ejaculation (PE) is a common sexual disorder. However, only few affected people consult clinicians in order to overcome this problem. Although no definitive consensus about its aetiology emerges, some mechanisms of PE are now well known. This allows more precise and efficient treatments, both at pharmacological as well as cognitive-behavioural levels. Further, studies have shown that reading didactical documents about their PE problem might be useful to men. Such approach is called “bibliotherapy”. AIM. The aim of the present study was to improve the bibliotherapy approach on the basis of up to date knowledge and techniques. The expected benefits were: (1) an efficient manual shorter than previous ones, (2) therapeutic principles easier to assimilate and (3) a method thereby made accessible to a large public which usually does not consult for this type of sexual problem. METHOD. A short bibliotherapy named Practical Guide of PE [in French] was tested among 421 PE subjects (DSM-IV diagnosis criteria). Self-reported anxiety, sexual satisfaction, ejaculatory latency time, feeling of control and distress were measured: (1) at baseline, (2) at 4-8 months and (3) at 10-14 months after reading the Practical guide of PE. A control condition was composed by 67 subjects left on a waiting-list for two months after baseline. RESULTS. Significant improvements were found for all the self-reported parameters, either at 4-8 and at 10-14 months after the bibliotherapy. The improvements were associated with an adjustment of sexual cognitions (SIQ, McCormick & Jordan). The response to treatment seemed better when the severity of PE was moderate, but did not seem related to variables such as age, educational level and personality traits (TCI-R, Cloninger; STAI Y-B, Spielberger.) CONCLUSION: Its cost/benefit ratio makes the Practical Guide an ideal first line therapeutic tool. Its large diffusion might be useful in order to improve sexual health in populations [less ▲]

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See detailLes cycles du désir sexuel (saison 3)
Kempeneers, Philippe ULg

in Sexualités humaines (2010), 7

Au terme de ce triptyque sur le désir et ses différentes figures, un cas clinique très éclairant

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See detailLes outils bibliothérapeutiques : un adjuvant pour promouvoir la santé sexuelle de nos patients?
Kempeneers, Philippe ULg; Hubin, Alexandra; Lex, Olivier et al

in Revue des Hôpitaux de Jour Psychiatriques et des Thérapies Institutionnelles (2010), 12

It’s known that sexual health of people with psychiatric and psychological disorders is often highly impoverished. Mental health professionals may feel helpless against these sexual difficulties, because ... [more ▼]

It’s known that sexual health of people with psychiatric and psychological disorders is often highly impoverished. Mental health professionals may feel helpless against these sexual difficulties, because of being poorly trained to treat them and lacking the means to do it. In this context, it seems important to inform patients about sexual difficulties and treatment options. Although it’s impossible to assign a sex therapist to each mental health service, it could be very useful to use bibliotherapeutic documentation to guide people with sexual difficulties in finding solutions. This mode of treatment which consists in putting information and therapeutic guidelines on writing is called « bibliotherapy ». Some bibliotherapies have already been developed and tested in the field of sexual disorders. Others, experimental, are nowadays under clinical evaluation, notably by three of the authors of the present paper. Bibliotherapy could be a helpful adjunct in improving the sexual health of dayhospital patients. [less ▲]

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See detailLes cycles du désir sexuel (saison 2)
Kempeneers, Philippe ULg

in Sexualités humaines (2010), 6

Cette deuxième saison au pays du désir nous conduit aux confins de la passion amoureuse, entre animalité et profonde humanité

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See detailEvaluation d'une nouvelle bibliothérapie de l'éjaculation précoce
Kempeneers, Philippe ULg; Andrianne, Robert ULg; Bauwens, S. et al

in Revue Francophone de Clinique Comportementale et Cognitive (2010)

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See detailLe désir au rythme de la passion
Kempeneers, Philippe ULg

in Sexualités humaines (2010), 5

C’est à travers le prisme rationnel des données scientifiques et comportementales que l’auteur montre la complexité du désir humain, celle des sentiments amoureux et de la passion dans ses aspects ... [more ▼]

C’est à travers le prisme rationnel des données scientifiques et comportementales que l’auteur montre la complexité du désir humain, celle des sentiments amoureux et de la passion dans ses aspects fluctuants et individuels [less ▲]

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See detailThe cognitive effects of anxiety on sexual arousal
Kempeneers, Philippe ULg; Pallincourt, Romain; Blairy, Sylvie ULg

in Weingarten, S.P.; Penat, H.O (Eds.) Cognitive psychology research developments (2009)

Anxiety and sexual arousal have often been considered as incompatible. Since the end of the 20th Century, however, researches have impaired theories centred on the inhibitory effect of the stress and on ... [more ▼]

Anxiety and sexual arousal have often been considered as incompatible. Since the end of the 20th Century, however, researches have impaired theories centred on the inhibitory effect of the stress and on peripheral explanations; they rather focus attention on the complexity of the relations between the two states and on cognitive mechanisms. Now sexual arousal tends to be regarded as a complex response that requires the convergent interpretation of internal and external stimuli. Anxiety may have different effects on this process, sometimes neutral, sometimes facilitating and sometimes inhibitory. On the one hand, anxiety can trigger a vegetative emotional reaction that may be associated to a concomitant erotic stimulation. Thus, anxiety facilitates the sexual response: this can be called a priming effect. This effect is regularly observed in labs, mainly among women. It likely also works in certain compulsive sexual behaviours or, more commonly, in those numerous persons that report being sexually aroused when stressed. On the other hand, anxiety can cause a massive irruption of non erotic cues in working memory. Therefore, cognitive function available for treating erotic stimuli is diminished and sexual response is impaired. This is an effect of cognitive interference. A trait called erotophobia could be regarded as a vulnerability factor to cognitive interference. Erotophobic subjects are characterized by a trend to focus upon danger-related information when they are in a sexual situation and by a higher risk of sexual dysfunction. [less ▲]

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