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Attentional and Affective Processing of Sexual Stimuli in Women with Hypoactive Sexual Desire Disorder

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Abstract

Hypoactive sexual desire disorder (HSDD) is the most common sexual problem in women. From an incentive motivation perspective, HSDD may be the result of a weak association between sexual stimuli and rewarding experiences. As a consequence, these stimuli may either lose or fail to acquire a positive meaning, resulting in a limited number of incentives that have the capacity to elicit a sexual response. According to current information processing models of sexual arousal, sexual stimuli automatically activate meanings and if these are not predominantly positive, processes relevant to the activation of sexual arousal and desire may be interrupted. Premenopausal U.S. and Dutch women with acquired HSDD (n = 42) and a control group of sexually functional women (n = 42) completed a single target Implicit Association Task and a Picture Association Task assessing automatic affective associations with sexual stimuli and a dot detection task measuring attentional capture by sexual stimuli. Results showed that women with acquired HSDD displayed less positive (but not more negative) automatic associations with sexual stimuli than sexually functional women. The same pattern was found for self-reported affective sex-related associations. Participants were slower to detect targets in the dot detection task that replaced sexual images, irrespective of sexual function status. As such, the findings point to the relevance of affective processing of sexual stimuli in women with HSDD, and imply that the treatment of HSDD might benefit from a stronger emphasis on the strengthening of the association between sexual stimuli and positive meaning and sexual reward.

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Notes

  1. Automatic cognitive processes refer to fast and unintentional responses, whereas deliberate (or controlled) cognitive processes refer to responses that are under intentional control (cf. Moors & De Houwer, 2006).

  2. Note that the constructs measured by implicit measure are not necessarily unconscious constructs. Participants may be unaware what the test measures, but that does not imply that they are also unaware of their evaluations (Fazio & Olson, 2003). Hence, in the present context, the term automatic is not equivalent to the term unconscious, but rather means that an implicit measure leaves insufficient time for participants to purposefully control their response.

  3. In 1999 an international classification committee sponsored by the American Urological Association Foundation met to deliberate and propose alternative criteria to sexual dysfunctions experienced by women. With respect to sexual desire problems a Sexual Interest/Desire Disorder was proposed, emphasizing that lack of sexual desire prior to engaging in sexual activity was not symptomatic of a sexual dysfunction if the woman was able to become sexually excited and experience desire during the sexual encounter. Instead, this diagnosis was given if there was also a lack of responsive sexual desire during the sexual interaction or following sexual arousal.

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Acknowledgement

This investigator-initiated study was financially supported by an unrestricted grant from Pfizer Central Research, Sandwich, UK to Ellen Laan and Julia R. Heiman.

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Authors and Affiliations

  1. Department of Sexology and Psychosomatic Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Marieke Brauer & Ellen Laan

  2. Department of Social and Cultural Psychology, Radboud University Nijmegen, Nijmegen, The Netherlands

    Matthijs van Leeuwen

  3. Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA

    Erick Janssen, Sarah K. Newhouse & Julia R. Heiman

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  1. Marieke Brauer
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  2. Matthijs van Leeuwen
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Correspondence to Marieke Brauer.

Appendix

Appendix

See Tables 6 and 7.

Table 6 ST-IAT stimuli in the “positive” and “negative” attribute categories for the U.S. and NL site
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Table 7 PAT stimuli in the positive and negative attribute categories for the U.S. and NL site
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Brauer, M., van Leeuwen, M., Janssen, E. et al. Attentional and Affective Processing of Sexual Stimuli in Women with Hypoactive Sexual Desire Disorder. Arch Sex Behav 41, 891–905 (2012). https://doi.org/10.1007/s10508-011-9820-7

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