Attention, arousal and expectancies in anxiety and sexual disorders
Section snippets
General introduction
Emotions can be discriminated according to whether they prepare for approach or for avoidance/escape. In this respect, anxiety and sexual arousal represent opposite extremes of a continuum; anxiety promoting avoidance and sexual arousal stimulating approach. The function of anxious avoidance and sexual approach are identical from an evolutionary perspective: optimizing chances that the subjects’ genes are preserved in the genetic pool. But although sex and anxiety are functional emotions par
Selective attention and anxiety
Selective attention to threatening cues vis-à-vis neutral cues has been studied most prominently with the so-called ‘emotional Stroop task’ that requires subjects to name the color of printed words, as quickly as possible, whilst ignoring the meaning of the words. Words of the emotional Stroop task have a neutral (e.g. ‘HOUSE’) or threatening (e.g. ‘DEAD’) content. If a subject tends to slow down on color-naming threat words as compared to neutral words, it is deduced that attentional resources
Selective attention and sex
While it was found that anxiety in itself does not induce erectile dysfunctioning, the clinical impression was that dysfunctionals do feel anxious in the context of sexual performance. Anxiety is associated with a marked selectivity of attention (see above) and it was hypothesized that, in dysfunctionals, there is an anxiety–dysfunction association but that this association is mediated by attention selectivity, or a ‘narrowing’ of attention. In dysfunctionals, anxiety may lead to a focus on
Processing of response information in anxiety disorders
While fear stimuli in anxiety disorders typically relate to external cues, such as animals, social situations, and dirt, a prominent exception is Panic Disorder. In panic patients, acute anxiety is triggered by the perception of feared bodily sensations like dizziness, palpitations or unsteadiness; sensations that are typically, though not invariably, part of the anxiety response. Experimental evidence for the interoceptive nature of cues that trigger panic comes mainly from two sources.
Processing of response information in sexual dysfunction
Inferring threat from anxious responding may serve to increase fear. While such self-perpetuating process may be clearly maladaptive in the case of anxiety, the opposite may hold true for sexual responding. Several studies investigated effects of processing response information in sexually functional and dysfunctional participants.
To test these implications, Abramson et al. (1989) used a genital feedback paradigm originated in Barlow’s laboratory. Once again, two groups comprised of sexually
Expectations in anxiety
Physiologically and behaviorally, anxiety patients react as if feared cues predict harm. For too long the view has been, certainly in Europe, that anxiety patients (‘neurotics’) are subjectively well aware of the irrationality of their fears and do ‘not really’ expect phobic cues to be followed by harm. Anxiety disorders are held to be egodystonic and responses are held to be discordant (Rachman and Hodgson, 1974): strong physiological and behavioral responses, but no subjective belief.
Do
Expectations in sex
The idea that expectations may become self-supporting because they prioritize processing of confirmatory evidence may be as relevant for sexual disorders as for anxiety disorders. In both anxiety and sexual disorders the expectations relate to cue–harm association; in sexual dysfunction the pertinent harm is unsuccessful performance. Results from the reverse placebo or misattribution studies, previously mentioned (Cranston-Cuebas et al., 1993, Cranston-Cuebas and Barlow, 1998) can fruitfully be
Summarizing conclusions
Studies on attention, response information and expectancy bias in anxiety and sexual disorders were reviewed. With regards to the regulation of attention, there is firm evidence that anxious patients selectively attend towards sources of perceived threat. This attentional bias does not require awareness of the stimuli that are processed and selective attention and anxiety appear to be reciprocally related. As to sexual stimuli, it appears that, relative to normal subjects, dysfunctionals tend
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2016, Journal of Anxiety DisordersGenital Image, Sexual Anxiety, and Erectile Dysfunction Among Young Male Military Personnel
2015, Journal of Sexual MedicineCitation Excerpt :When sexual performance demands are made, individuals who feel competent in their ability to perform will pay attention to erotic cues and become more aroused [43]. However, those who fear they cannot sexually perform competently will pay more attention to this concern as opposed to erotic cues, which will lead to poor performance [42]. This highlights the need to carefully consider multiple factors in conjunction with one another and what they mean to the specific individual to understand their implications for SFPs.
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2013, Journal of Sexual MedicineCitation Excerpt :Most current psychological views of sexual behavior consider sexual dysfunction to be a consequence of a negative emotional reaction to erotic stimulation, which then becomes the focus of attention [1,2]. In line with this, there is considerable evidence that anxiety and (fear of) pain are involved in various sexual dysfunctions [3-5]. Recently, it has been argued that disgust may similarly play a role in the development of sexual dysfunctions [6].