Abnormal Psychology

506 CHAPTER 11

Some medications can interfere with normal sexual response, including:

• SSRIs and other dopamine-blocking medications such as traditional anti-
  psychotics,


• beta-blockers and other medications that treat high blood pressure,


• antiseizure medication,


• estrogen and progesterone medications,


• HIV medications, and


• narcotics and sedative-hypnotics.

Alcohol can also disrupt the normal sexual response cycle.

Aging

Researchers have found that normal aging can affect sexual function-

ing among older people (George & Weiler, 1981). For instance, as

we’ve seen, older women often have a vaginal lubrication problem that

arise with menopause; when the lubrication problem is not addressed

(for instance, with an over-the-counter lubricant such as Astroglide or

K-Y Jelly), the dryness can cause intercourse to be painful and lead to

dyspareunia.

In addition, as men age, their testosterone levels decrease signifi -

cantly, often making prolonged tactile stimulation necessary to attain

erections. Older men are likely to experience reduced penile hardness,

decreased urgency to reach climax, and a longer refractory period

(Butler & Lewis, 2002; Masters & Johnson, 1966).

In addition to the normal biological changes that arise with age,

older people of both sexes may develop illnesses or diseases that make

sexual activity physically more challenging. They also may take medica-

tions that have side effects that interfere with their sexual response. However, most

older people say that they continue to enjoy sex.

Psychological Factors: Predisposing, Precipitating, and

Maintaining Sexual Dysfunctions

Certain beliefs and experiences can predispose individuals to develop sexual dys-

functions (see Table 11.7). For example, a woman may believe that women in gen-

eral lose their sexual desire as they age and a man may believe that “real men”

have intercourse twice a day and that only rock-hard erections will satisfy women

(Nobre & Pinto-Gouveia, 2006). Such a belief can lead to a self-fulfi lling prophecy,

if the belief produces the perception of a dysfunction and that perception in turn

leads to a real dysfunction. For example, a man who believes that women are only

Men and women often experience changes in

aspects of sexual performance as they get older,

which may disrupt sexual activity. However,

most will still experience pleasure from sexual

activities (Leiblum & Seagraves, 2000).

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Event Effect

The view that sex is dirty

and sinful

Early learning of such negative attitudes toward sex and

misinformation leads to fears and inhibitions, which can lead to

problems of desire, arousal, orgasm, and vaginismus.

Early negative

conditioning

experiences

In men, premature ejaculation can develop after hurrying to have

an orgasm quickly for fear of being “caught.” In women, a fear of

pregnancy or being “caught” can lead to anxiety that contributes to

sexual dysfunction.

Sexual trauma Sexual trauma can produce negative conditioning and can lead to a

fear of sex, as well as arousal and desire problems.

Sources: Bartoi & Kinder, 1998; Becker & Kaplan, 1991; Kaplan, 1981; Laumann, Paik, & Rosen, 1999; LoPiccolo &

Friedman, 1988; Masters & Johnson, 1970; Silverstein, 1989.

Table 11.7 • Predisposing Events for Sexual Dysfunctions