Psychological Perceptions of Women With Sexual Arousal Disorder: A Qualitative Study in Iranian Culture
Abstract
Objective: Psychological perceptions are concerned with how a person perceives and psychologically frames life with an illness. The current study sought to examine the psychological perceptions of women suffering from Female Sexual Interest/Arousal Disorder in the setting of Isfahan, Iran.
Materials and methods: The study was done according a qualitative design, and it was conducted in Isfahan, Iran, from July 2018 to February 2019. Twenty in-depth interviews were performed with 20 patients who were recruited on the purposeful method. The thematic analysis approach was used to analyze the data. The data were organized using MAXQDA software (version 12).
Results: The following four themes were extracted: (i) Dysfunctional cognition, which includes five
sub-themes: attention bias, belief bias, memory bias, perceptual bias, and cognitive distortion; and (ii) Relationship and partner factors, which include four sub-themes: psychological maltreatment, aggression, deception, and betrayal.; (iii) lack of life skills, which includes four sub-themes: poor problem-solving, poor sexual knowledge, poor understanding and intimate relationships, and immature defense mechanisms; and (iv) lack of motivation and genuine interest, which includes two sub-themes: forced marriage and lack of initial affection and attraction to the husband.
Conclusion: Internal and interpersonal factors were shown to have a role in the creation of sexual arousal disorder in Iranian women, according to the study. As a result, designing scenarios for cognitive bias modification and educational programs for improving interpersonal skills would be beneficial.
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2. Kingsberg SA, Althof S, Simon JA, Bradford A, Bitzer J, Carvalho J, et al. Female sexual dysfunction—medical and psychological treatments, committee 14.J Sex Med 2017; 14: 1463-91.
3. Goldstein I, Clayton AH, Goldstein AT, Kim NN, Kingsberg SA, editors. Textbook of female sexual function and dysfunction: Diagnosis and treatment. Wiley-Blackwell 2018.
4. Chivers ML, Brotto LA. Controversies of women’s sexual arousal and desire. European Psychologist 2017; 22: 5-26.
5. Thomas EJ, Gurevich M. Difference or dysfunction? Deconstructing desire in the DSM-5 diagnosis of Female Sexual Interest/Arousal Disorder. Feminism & Psychology 2021; 31: 81-98.
6. Tabaghdehi MH, Keramat A, Khosravi A. Prevalence of female sexual dysfunction in Iran: a meta-analysis study. International Journal of Health Studies 2017; 2: 10-3.
7. Ramezani MA, Ahmadi K, Ghaemmaghami A, Marzabadi EA, Pardakhti F. Epidemiology of sexual dysfunction in Iran: A systematic review and meta-analysis. Int J Prev Med 2015; 6: 43.
8. Meston CM, Stanton AM. Understanding sexual arousal and subjective–genital arousal desynchrony in women. Nat Rev Urol 2019; 16: 107-20.
9. Dewitte M. Female Genital Arousal: A Focus on How Rather than Why. Arch Sex Behav 2022; 51:743-9.
10. Dewitte M, Schepers J, Melles R. The effects of partner presence and sexual stimulation on the appraisal of vaginal pressure and sexual arousal. J Sex Med 2018; 15: 539-49.
11. Pascoal PM, Rosa PJ, Silva EPd, Nobre PJ. Sexual beliefs and sexual functioning: the mediating role of cognitive distraction. International Journal of Sexual Health 2018; 30: 60-71.
12. Rancourt KM, MacKinnon S, Snowball N, Rosen NO. Beyond the bedroom: Cognitive, affective, and behavioral responses to partner touch in women with and without sexual problems. J Sex Res 2017; 54: 862-76.
13. Cacioppo S. Neuroimaging of female sexual desire and hypoactive sexual desire disorder. Sex Med Rev 2017; 5: 434-44.
14. Kane L, Dawson SJ, Shaughnessy K, Reissing ED, Ouimet AJ, Ashbaugh AR. A review of experimental research on anxiety and sexual arousal: Implications for the treatment of sexual dysfunction using cognitive behavioral therapy. Journal of Experimental Psychopathology 2019; 10: 14-22.
15. Anderson AB, Hamilton LD. Assessment of distraction from erotic stimuli by nonerotic interference. J Sex Res 2015; 52: 317-26.
16. Handy AB, Stanton AM, Meston CM. Understanding women's subjective sexual arousal within the laboratory: Definition, measurement, and manipulation. Sex Med Rev 2018; 6: 201-16.
17. Silva E, Pascoal PM, Nobre P. Beliefs about Appearance, Cognitive Distraction and Sexual Functioning in Men and Women: A Mediation Model Based on Cognitive Theory. J Sex Med 2016; 13: 1387-94.
18. Tavares IM, Moura CV, Nobre PJ. The Role of Cognitive Processing Factors in Sexual Function and Dysfunction in Women and Men: A Systematic Review. Sex Med Rev 2020; 8: 403-30.
19. Pascoal PM, Lopes CR, Rosa PJ. The mediating role of sexual self-disclosure satisfaction in the association between expression of feelings and sexual satisfaction in heterosexual adults. Revista Latinoamericana de Psicología 2019; 51: 74-82.
20. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology 2006; 3: 77-101.
21. Vilarinho S, Laja P, Carvalho J, Quinta-Gomes AL, Oliveira C, Janssen E, et al. Affective and cognitive determinants of women's sexual response to erotica. J Sex Med 2014; 11: 2671–8.
22. Stanton AM, Hixon JG, Nichols LM, Meston CM. One session of autogenic training increases acute subjective sexual arousal in premenopausal women reporting sexual arousal problems. J Sex Med 2018; 15: 64-76.
23. Oliveira C, Nobre PJ. Cognitive structures in women with sexual dysfunction: the role of early maladaptive schemas. J Sex Med 2013; 10: 1755-63.
24. Gagnon JH, Simon W. Sexual conduct: The social sources of human sexuality. 2nd Edition, Rutledge 2017.
25. Abdolmanafi A, Nobre P, Winter S, Tilley PJM, Jahromi RG. Culture and sexuality: cognitive–emotional determinants of sexual dissatisfaction among Iranian and New Zealand women. J Sex Med 2018; 15: 687-97.
26. Abdolsalehi-Najafi E, Beckman LJ. Sex Guilt and Life Satisfaction in Iranian-American Women. Arch Sex Behav 2013; 42: 1063–71.
27. Samadi P, Maasoumi R, Salehi M, Ramezani MA, Kohan S. Iranian Couples Conceptualization of the Role of Sexual Socialization in Their Sexual Desire: A Qualitative Study. Iranian Journal of Psychiatry and Behavioral Sciences 2018; 12: 234-47.
28. Woo JS, Brotto LA, Gorzalka BB. The role of sex guilt in the relationship between culture and women's sexual desire. Arch Sex Behav 2011; 40: 385-94.
29. Santos-Iglesias P, Sierra JC, Vallejo-Medina P. Predictors of sexual assertiveness: the role of sexual desire, arousal, attitudes, and partner abuse. Arch Sex Behav 2013; 42: 1043-52.
30. Klein SR, Renshaw KD, Curby TW. Emotion regulation and perceptions of hostile and constructive criticism in romantic relationships. Behav Ther 2016; 47: 143-54.
31. Jong DC, Reis H, Brett J, Cody R. The role of implicit sexual desire in romantic relationships. Personality and Individual Differences 2019; 149: 46-56.
32. Pascoal PM, Narciso I, Pereira NM. Emotional intimacy is the best predictor of sexual satisfaction of men and women with sexual arousal problems. International Journal of Impotence Research 2013; 25: 51-5.
33. Sohrabzade M, Mansorian Ravandi F. Women's Lived Experience of Verbal Violence in The Family (Case Study: Women in Kashan) 2017; 9: 245-64. [In Persian].
34. Takyi BK, Lamptey E: Faith and marital violence in Sub-Saharan Africa: exploring the links between religious affiliation and intimate partner violence among women in Ghana. Journal of Interpersonal Violence 2020; 35: 25-52.
35. Ahinkorah BO, Dickson KS, Seidu AA. Women decision-making capacity and intimate partner violence among women in sub-Saharan Africa. Arch Public Health 2018; 76: 5.
36. Eldoseri HM, Sharps P. Risk factors for spousal physical violence against women in Saudi Arabia.J Interpers Violence 2020; 35: 1269-93.
37. Cross EJ, Overall NC, Low RST, McNulty JK. An interdependence account of sexism and power: Men’s hostile sexism, biased perceptions of low power, and relationship aggression. J Pers Soc Psychol 2019; 117: 338-63.
38. Kohut T, Fisher WA, Campbell L. Perceived effects of pornography on the couple relationship: Initial findings of open-ended, participant-informed, “bottom-up” research. Arch Sex Behav 2017; 46: 585-602.
39. Roggensack KE, Sillars A. Agreement and understanding about honesty and deception rules in romantic relationships. Journal of Social and Personal Relationships 2014; 31: 178-99.
40. Lee GY, Lee DY. Effects of a life skills-based sexuality education programme on the life-skills, sexuality knowledge, self-management skills for sexual health, and programme satisfaction of adolescents. Sex Education 2019; 19: 519-33.
41. Iyer P, Aggleton P. Seventy years of sex education in Health Education Journal: a critical review. Health Education Journal 2015; 74: 3-15.
42. Afshar M, Mohammad-Alizadeh-Charandabi S, Merghti-Khoei ES, Yavarikia P. The effect of sex education on the sexual function of women in the first half of pregnancy: a randomized controlled trial. J. Caring Sci 2012; 1: 173-81.
43. Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. Effects of sex education and Kegel exercises on the sexual function of postmenopausal women: a randomized clinical trial. J Sex Med 2017; 14: 959-67.
44. Mosavi SA, Babazadeh R, Najmabadi KM, Shariati M. Assessing Iranian adolescent girls' needs for sexual and reproductive health information. J Adolesc Health 2014; 55: 107-13.
45. Brogan KM, Rapp JT, Niedfeld AM, Thompson KR, Burkhart BR. Using arousal suppression exercises to decrease inappropriate sexual arousal in detained adolescent males: Three clinical demonstrations. Behav Anal Pract 2020; 13: 348-59.
46. Costa RM, Brody S. Immature defense mechanisms are associated with lesser vaginal orgasm consistency and greater alcohol consumption before sex. J Sex Med 2010; 7: 775-86.
47. Bird ER, Seehuus M, Clifton J, Rellini AH. Dissociation during sex and sexual arousal in women with and without a history of childhood sexual abuse. Arch Sex Behav 2014; 43: 953-64.
48. Dewitte M. Gender differences in implicit processing of sexual stimuli. European Journal of Personality 2016; 30: 107-24.
49. Van Lankveld J, Wolfs K, Grauvogl A. Gender differences in the relationship of sexual functioning with implicit and explicit sex liking and sex wanting: A community sample study. J Sex Res 2018; 57: 860-.71.
50. Bockaj A, Rosen NO, Muise A. Sexual motivation in couples coping with female sexual interest/arousal disorder: A comparison with control couples. J Sex Marital Ther 2019; 45: 796-808.
51. Muise A, Impett EA. Applying theories of communal motivation to sexuality. Social and Personality Psychology Compass 2016; 10: 455-67.
2. Kingsberg SA, Althof S, Simon JA, Bradford A, Bitzer J, Carvalho J, et al. Female sexual dysfunction—medical and psychological treatments, committee 14.J Sex Med 2017; 14: 1463-91.
3. Goldstein I, Clayton AH, Goldstein AT, Kim NN, Kingsberg SA, editors. Textbook of female sexual function and dysfunction: Diagnosis and treatment. Wiley-Blackwell 2018.
4. Chivers ML, Brotto LA. Controversies of women’s sexual arousal and desire. European Psychologist 2017; 22: 5-26.
5. Thomas EJ, Gurevich M. Difference or dysfunction? Deconstructing desire in the DSM-5 diagnosis of Female Sexual Interest/Arousal Disorder. Feminism & Psychology 2021; 31: 81-98.
6. Tabaghdehi MH, Keramat A, Khosravi A. Prevalence of female sexual dysfunction in Iran: a meta-analysis study. International Journal of Health Studies 2017; 2: 10-3.
7. Ramezani MA, Ahmadi K, Ghaemmaghami A, Marzabadi EA, Pardakhti F. Epidemiology of sexual dysfunction in Iran: A systematic review and meta-analysis. Int J Prev Med 2015; 6: 43.
8. Meston CM, Stanton AM. Understanding sexual arousal and subjective–genital arousal desynchrony in women. Nat Rev Urol 2019; 16: 107-20.
9. Dewitte M. Female Genital Arousal: A Focus on How Rather than Why. Arch Sex Behav 2022; 51:743-9.
10. Dewitte M, Schepers J, Melles R. The effects of partner presence and sexual stimulation on the appraisal of vaginal pressure and sexual arousal. J Sex Med 2018; 15: 539-49.
11. Pascoal PM, Rosa PJ, Silva EPd, Nobre PJ. Sexual beliefs and sexual functioning: the mediating role of cognitive distraction. International Journal of Sexual Health 2018; 30: 60-71.
12. Rancourt KM, MacKinnon S, Snowball N, Rosen NO. Beyond the bedroom: Cognitive, affective, and behavioral responses to partner touch in women with and without sexual problems. J Sex Res 2017; 54: 862-76.
13. Cacioppo S. Neuroimaging of female sexual desire and hypoactive sexual desire disorder. Sex Med Rev 2017; 5: 434-44.
14. Kane L, Dawson SJ, Shaughnessy K, Reissing ED, Ouimet AJ, Ashbaugh AR. A review of experimental research on anxiety and sexual arousal: Implications for the treatment of sexual dysfunction using cognitive behavioral therapy. Journal of Experimental Psychopathology 2019; 10: 14-22.
15. Anderson AB, Hamilton LD. Assessment of distraction from erotic stimuli by nonerotic interference. J Sex Res 2015; 52: 317-26.
16. Handy AB, Stanton AM, Meston CM. Understanding women's subjective sexual arousal within the laboratory: Definition, measurement, and manipulation. Sex Med Rev 2018; 6: 201-16.
17. Silva E, Pascoal PM, Nobre P. Beliefs about Appearance, Cognitive Distraction and Sexual Functioning in Men and Women: A Mediation Model Based on Cognitive Theory. J Sex Med 2016; 13: 1387-94.
18. Tavares IM, Moura CV, Nobre PJ. The Role of Cognitive Processing Factors in Sexual Function and Dysfunction in Women and Men: A Systematic Review. Sex Med Rev 2020; 8: 403-30.
19. Pascoal PM, Lopes CR, Rosa PJ. The mediating role of sexual self-disclosure satisfaction in the association between expression of feelings and sexual satisfaction in heterosexual adults. Revista Latinoamericana de Psicología 2019; 51: 74-82.
20. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology 2006; 3: 77-101.
21. Vilarinho S, Laja P, Carvalho J, Quinta-Gomes AL, Oliveira C, Janssen E, et al. Affective and cognitive determinants of women's sexual response to erotica. J Sex Med 2014; 11: 2671–8.
22. Stanton AM, Hixon JG, Nichols LM, Meston CM. One session of autogenic training increases acute subjective sexual arousal in premenopausal women reporting sexual arousal problems. J Sex Med 2018; 15: 64-76.
23. Oliveira C, Nobre PJ. Cognitive structures in women with sexual dysfunction: the role of early maladaptive schemas. J Sex Med 2013; 10: 1755-63.
24. Gagnon JH, Simon W. Sexual conduct: The social sources of human sexuality. 2nd Edition, Rutledge 2017.
25. Abdolmanafi A, Nobre P, Winter S, Tilley PJM, Jahromi RG. Culture and sexuality: cognitive–emotional determinants of sexual dissatisfaction among Iranian and New Zealand women. J Sex Med 2018; 15: 687-97.
26. Abdolsalehi-Najafi E, Beckman LJ. Sex Guilt and Life Satisfaction in Iranian-American Women. Arch Sex Behav 2013; 42: 1063–71.
27. Samadi P, Maasoumi R, Salehi M, Ramezani MA, Kohan S. Iranian Couples Conceptualization of the Role of Sexual Socialization in Their Sexual Desire: A Qualitative Study. Iranian Journal of Psychiatry and Behavioral Sciences 2018; 12: 234-47.
28. Woo JS, Brotto LA, Gorzalka BB. The role of sex guilt in the relationship between culture and women's sexual desire. Arch Sex Behav 2011; 40: 385-94.
29. Santos-Iglesias P, Sierra JC, Vallejo-Medina P. Predictors of sexual assertiveness: the role of sexual desire, arousal, attitudes, and partner abuse. Arch Sex Behav 2013; 42: 1043-52.
30. Klein SR, Renshaw KD, Curby TW. Emotion regulation and perceptions of hostile and constructive criticism in romantic relationships. Behav Ther 2016; 47: 143-54.
31. Jong DC, Reis H, Brett J, Cody R. The role of implicit sexual desire in romantic relationships. Personality and Individual Differences 2019; 149: 46-56.
32. Pascoal PM, Narciso I, Pereira NM. Emotional intimacy is the best predictor of sexual satisfaction of men and women with sexual arousal problems. International Journal of Impotence Research 2013; 25: 51-5.
33. Sohrabzade M, Mansorian Ravandi F. Women's Lived Experience of Verbal Violence in The Family (Case Study: Women in Kashan) 2017; 9: 245-64. [In Persian].
34. Takyi BK, Lamptey E: Faith and marital violence in Sub-Saharan Africa: exploring the links between religious affiliation and intimate partner violence among women in Ghana. Journal of Interpersonal Violence 2020; 35: 25-52.
35. Ahinkorah BO, Dickson KS, Seidu AA. Women decision-making capacity and intimate partner violence among women in sub-Saharan Africa. Arch Public Health 2018; 76: 5.
36. Eldoseri HM, Sharps P. Risk factors for spousal physical violence against women in Saudi Arabia.J Interpers Violence 2020; 35: 1269-93.
37. Cross EJ, Overall NC, Low RST, McNulty JK. An interdependence account of sexism and power: Men’s hostile sexism, biased perceptions of low power, and relationship aggression. J Pers Soc Psychol 2019; 117: 338-63.
38. Kohut T, Fisher WA, Campbell L. Perceived effects of pornography on the couple relationship: Initial findings of open-ended, participant-informed, “bottom-up” research. Arch Sex Behav 2017; 46: 585-602.
39. Roggensack KE, Sillars A. Agreement and understanding about honesty and deception rules in romantic relationships. Journal of Social and Personal Relationships 2014; 31: 178-99.
40. Lee GY, Lee DY. Effects of a life skills-based sexuality education programme on the life-skills, sexuality knowledge, self-management skills for sexual health, and programme satisfaction of adolescents. Sex Education 2019; 19: 519-33.
41. Iyer P, Aggleton P. Seventy years of sex education in Health Education Journal: a critical review. Health Education Journal 2015; 74: 3-15.
42. Afshar M, Mohammad-Alizadeh-Charandabi S, Merghti-Khoei ES, Yavarikia P. The effect of sex education on the sexual function of women in the first half of pregnancy: a randomized controlled trial. J. Caring Sci 2012; 1: 173-81.
43. Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. Effects of sex education and Kegel exercises on the sexual function of postmenopausal women: a randomized clinical trial. J Sex Med 2017; 14: 959-67.
44. Mosavi SA, Babazadeh R, Najmabadi KM, Shariati M. Assessing Iranian adolescent girls' needs for sexual and reproductive health information. J Adolesc Health 2014; 55: 107-13.
45. Brogan KM, Rapp JT, Niedfeld AM, Thompson KR, Burkhart BR. Using arousal suppression exercises to decrease inappropriate sexual arousal in detained adolescent males: Three clinical demonstrations. Behav Anal Pract 2020; 13: 348-59.
46. Costa RM, Brody S. Immature defense mechanisms are associated with lesser vaginal orgasm consistency and greater alcohol consumption before sex. J Sex Med 2010; 7: 775-86.
47. Bird ER, Seehuus M, Clifton J, Rellini AH. Dissociation during sex and sexual arousal in women with and without a history of childhood sexual abuse. Arch Sex Behav 2014; 43: 953-64.
48. Dewitte M. Gender differences in implicit processing of sexual stimuli. European Journal of Personality 2016; 30: 107-24.
49. Van Lankveld J, Wolfs K, Grauvogl A. Gender differences in the relationship of sexual functioning with implicit and explicit sex liking and sex wanting: A community sample study. J Sex Res 2018; 57: 860-.71.
50. Bockaj A, Rosen NO, Muise A. Sexual motivation in couples coping with female sexual interest/arousal disorder: A comparison with control couples. J Sex Marital Ther 2019; 45: 796-808.
51. Muise A, Impett EA. Applying theories of communal motivation to sexuality. Social and Personality Psychology Compass 2016; 10: 455-67.
| Files | ||
| Issue | Vol 16, No 2 (June 2022) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/jfrh.v16i2.9478 | |
| Keywords | ||
| Perception Psychological Sexual Dysfunctions Qualitative Research | ||
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How to Cite
1.
Halvaiepour Z, Oreyzi HR, Nosratabadi M, Yazdkhasti F. Psychological Perceptions of Women With Sexual Arousal Disorder: A Qualitative Study in Iranian Culture. J Family Reprod Health. 2022;16(2):106-115.
