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The effects of learned sex-disgust associations on female sexual response

Both, S1; Borg, C2; Wijenborg, P3

1: Leiden University Medical Center, Netherlands; 2: University of Groningen; 3: Leiden University Medical Center

Objectives: There is increasing evidence for disgust as a potential mechanism involved in female sexual dysfunction. Disgust is also increasingly recognized as a common and persistent reaction associated with sexual victimization. Taken together, these findings indicate that the development of strategies to reduce sex related disgust is essential. Importantly, there are also indications that exposure, the basic strategy in cognitive behavioural treatment in treating anxiety, is relatively ineffective in reducing maladaptive disgust responses. To investigate the underlying mechanisms of sex related disgust, we conducted the first experimental study on the learning and ‘unlearning’ of sex-disgust associations. It was hypothesized that the association of sex with disgust inhibits genital and subjective sexual arousal, and results in defensive pelvic floor muscles contractions, and that these learned responses are resistant to extinction.

Materials and Methods: A classical conditioning experiment was conducted with 35 sexually asymptomatic women. Two sexual film clips were used as conditional stimuli. During the acquisition procedure, one of these stimuli (the CS+) was repeatedly paired with a disgust-inducing film clip, while the other (CS-) was paired with neutral film. After this, an extinction procedure followed with repeated presentations (i.e., exposure) of the two sexual stimuli without pairing with the disgust stimulus. We measured the physiological (Vaginal Pulse Amplitude, VPA and pelvic floor Electromyography, EMG), self-reports (positive-negative affect, sexual arousal, and disgust), and behavioral responses towards the sexual stimuli.

Results: Interim analysis in 18 participants showed lower VPA in response to the CS+ compared to the CS- during the acquisition procedure. Also, disgust ratings were higher, and positive affect and sexual arousal ratings were lower in response to the CS+. At the end of the extinction procedure, VPA in response to the CS+ was still significantly lower, and disgust ratings significantly higher in response to the CS+. The complete results, including pelvic floor EMG and behavioural response data, will be presented at the ISSM/ESSM conference.

Conclusions: The preliminary results show a negative effect of learned sex-disgust associations on genital and subjective sexual responses. Moreover, the results show that an extinction-based procedure (exposure) is only partly effective in repairing these negative effects, and that other strategies are needed.


Work supported by industry: no.

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