BERKELEY, CA (UroToday.com) - The importance of the role played by personality dimensions on male sexual functioning has not been systematically studied in sex research.
The purpose of the present study was to explore the role of personality dimensions and psychopathology on male sexual functioning as well as to investigate how these variables discriminate men with and without sexual dysfunction. Specific personality dimensions such as neuroticism were hypothesized to constitute a predisposing risk factor for the development and maintenance of sexual problems and psychopathological symptoms.
A total of 229 men participated in the study (a community sample composed by 205 men and a clinical sample by 24 men with a DSM-IV-TR diagnosis of sexual dysfunction). The community sample was subdivided into a control group (n = 152) and a subclinical group (n = 53), according to the cutoff scores of the International Index of Erectile Dysfunction. After giving informed consent, participants completed a set of clinical instruments, assessing personality dimensions, psychopathological symptoms, and sexual functioning.
Findings demonstrated that neuroticism was the single significant predictor of sexual functioning and discriminated men with and without sexual dysfunction, after controlling for psychopathology. Additionally, results showed that men experiencing sexual difficulties presented significantly higher levels of depressive symptoms when compared to sexually healthy men, and depressive symptoms also constituted the only psychopathological significant predictor of sexual functioning. These findings suggested that an enduring and pervasive propensity to experience psychological distress may be a dispositional characteristic of individuals experiencing poorer levels of sexual functioning. In this sense, when confronted with a hypothetical negative sexual situation (e.g., a sporadic failure in erection), individuals with high predisposition for neuroticism would experience intense negative affect and co-occurring cognitions related with incompetence and negative consequences of an imminent failure. In addition, individual’s perception of incipient sexual skills and coping strategies to deal with the threat of not performing would interfere with information processing of erotic and sexual stimuli, and impair sexual response. In future sexual situations, a state of “anxious apprehension” would interfere with sexual response in neurotic individuals, and the experience of repeated sexual failure along with inability to break the cycle would lead to sexual dysfunction. Although psychopathology was found to be relatively independent of the relationship between neuroticism and sexual dysfunction, it is important to highlight that the presence of psychopathology may intensify the existence of sexual difficulties and strengthen the cycle mentioned earlier. We should note, however, that given the cross-sectional nature of the research design, we cannot entirely address the question of directionality between personality dimensions or psychopathology and sexual dysfunction (what comes first?). Only future studies using a longitudinal design could address the question of directionality.
Some important clinical implications may be drawn from these findings. Recognizing that personality traits such as neuroticism along with depressive symptoms play an important role in the experience and expression of male sexual functioning (risk factors for sexual dysfunction) will allow clinicians to incorporate differentiated psychotherapeutic techniques when addressing sexual problems. Evaluating individual’s dispositional characteristics and proneness for psychopathology should be considered and integrated into sex therapy protocols. Additionally, the use of a cognitive-behavioral sex therapy approach oriented to restructure dysfunctional personality traits and behavior patterns could be an important therapeutic strategy when addressing sexual difficulties and co-occurring depressive symptoms.
The authors hope that these findings contribute to a better comprehension of the vulnerability/risk factors and maintenance factors involved in male sexual dysfunction.
Ana Luísa Quinta Gomes, PhD student as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.