Abnormal Psychology

Gender and Sexual Disorders 507

satisfi ed by very hard erections may develop a problem as he ages: He may notice

that his erections are not as hard as they were when he was younger and then be-

come self-conscious and preoccupied during sex, which does in fact lead him to fail

to satisfy his partner.

In addition, having been sexually abused as a child also predisposes a person

later to develop sexual dysfunctions. Consider the fact that male victims of child-

hood sexual abuse are three times more likely to have erection problems and twice

as likely to have desire problems and premature ejaculation than their peers who did

not experience childhood sexual abuse (Laumann, Paik, & Rosen, 1999). Similarly,

women who were victims of childhood sexual abuse are more likely than women

who were not abused to report sexual problems (although not necessarily problems

that meet the DSM-IV-TR criteria for sexual dysfunctions; Westerlund, 1992).

Factors that are thought to precipitate, or trigger, sexual dysfunctions generally

involve sexual situations in which an individual feels anxious—for example, situa-

tions in which a man becomes nervous about not “performing” adequately. Such

preoccupations can lead to disorders of sexual desire and arousal. Here are some

examples of different types of problematic preoccupations:

• focusing attention on sex-related fears and worries, which distract and detract

during a sexual encounter;

• feeling uncomfortable with how one’s body may look or feel to a partner (Berman

& Berman, 2001); and

• worrying about nonsexual matters, such as work or family problems.

Once someone has a problem with desire, arousal,

or orgasm, he or she may become anxious that it will

happen again, which sets up a self- fulfi lling proph-

ecy and becomes a maintaining factor. For instance,

when a single sexual experience was perceived as a

“failure,” an individual may become anxious dur-

ing subsequent sexual experiences, monitoring his

or her responsiveness (and so thinking about the

sexual response rather than experiencing it)—which

in turn can interfere with a normal sexual response

and create a sexual dysfunction (Bach, Brown, &

Barlow, 1999).

Social Factors

Although sexuality involves how we see ourselves, it

usually also involves other people. The sexual rela-

tions of a couple are infl uenced by how the partners

relate to each other, specifi cally: (1) how confl ict is

expressed and resolved, (2) how they communicate

their needs and desires, their likes and dislikes, (3)

how they handle stress, and (4) how strongly at-

tracted they each are to each other (Tiefer, 2001). For example, Mike’s sexual secret

from Laura led him to pull away from her sexually. She thought he wasn’t interested

in sex. That is, from her vantage point, he appeared to have a sexual desire prob-

lem, and she herself then lost interest.

FEEDBACK LOOPS IN ACTION: Sexual Dysfunctions

Just as neurological, psychological, and social factors infl uence each other and con-

tribute to a normal sexual response, feedback loops among these factors can con-

tribute to sexual dysfunctions (see Figure 11.4). Such feedback loops best explain

why some people, and not others, develop sexual dysfunctions. For instance, peo-

ple’s sexual beliefs (“My body looks ugly” or “I won’t be able to have an orgasm”;

psychological factors) can infl uence their sexual functioning: The beliefs create fears

Being chronically preoccupied and anxious about

something—including how your body might look

or feel to a partner—while engaged in sexual

activity can interfere with the normal sexual re-

sponse cycle, and lead to a sexual dysfunction.

Jeff Greenberg/Photo Edit Justin Pumfrey/Getty Images

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