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BACKGROUND: Musicians' dystonia (MD) is a movement disorder with several established risk factors, but the exact pathophysiology remains unknown. Recent research suggests dysfunction in sensory-motor, basal ganglia, cerebellar, and limbic loops as potential causes. Adverse childhood experiences are also considered risk factors. OBJECTIVE: This study aimed to investigate whether MD patients have experienced more childhood trauma, leading to increased stress reactivity and neural vulnerability to movement disorders. METHODS: Using functional magnetic resonance imaging and the Montreal Imaging Stress Task, 40 MD patients were compared with 39 healthy musicians (HMs). Whole-brain analysis and regions of interest analysis were performed. Parameter estimates and subjective stress levels were compared between groups and correlated with the Childhood Trauma Questionnaire. RESULTS: MD patients reported significantly higher childhood trauma scores than healthy control subjects, but they did not differ in their subjective stress experiences. Stress-related activity of limbic areas was neither found in the whole sample nor between the two groups. Instead, increased activity of visual association and temporal areas was observed, but this activation did not differ between patients and HMs. However, patients showed a tendency toward reduced precuneus activity under stress. Adverse childhood experiences were negatively correlated with precuneus, thalamus, and substantia nigra activity across all participants. CONCLUSIONS: Overall, MD patients and HMs had similar subjective and neurological reactions to stress but differed in childhood trauma experiences and precuneus activity under stress. Further research about the functional connectivity between precuneus, cerebellum, thalamus, and basal ganglia in musicians is needed. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Meta-analyses suggest a sustained alleviation of depressive symptoms through glabellar botulinum toxin (BTX) injections. This can be explained by the disruption of facial feedback loops, which may moderate and reinforce the experience of negative emotions. Borderline personality disorder (BPD) is characterized by excessive negative emotions. Here, a seed-based resting-state functional connectivity (rsFC) analysis following BTX (N = 24) or acupuncture (ACU, N = 21) treatment in BPD is presented on areas related to the motor system and emotion processing. RsFC in BPD using a seed-based approach was analyzed. MRI data were measured before and 4 weeks after treatment. Based on previous research, the rsFC focus was on limbic and motor areas as well as the salience and default mode network. Clinically, after 4 weeks both groups showed a reduction of borderline symptoms. However, the anterior cingulate cortex (ACC) and the face area in the primary motor cortex (M1) displayed aberrant rsFC after BTX compared to ACU treatment. The M1 showed higher rsFC to the ACC after BTX treatment compared to ACU treatment. In addition, the ACC displayed an increased connectivity to the M1 as well as a decrease to the right cerebellum. This study shows first evidence for BTX-specific effects in the motor face region and the ACC. The observed effects of BTX on rsFC to areas are related to motor behavior. Since symptom improvement did not differ between the two groups, a BTX-specific effect seems plausible rather than a general therapeutic effect.
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Transtorno da Personalidade Borderline , Toxinas Botulínicas , Humanos , Transtorno da Personalidade Borderline/diagnóstico por imagem , Transtorno da Personalidade Borderline/tratamento farmacológico , Emoções , Giro do Cíngulo , Imageamento por Ressonância Magnética , Toxinas Botulínicas/farmacologia , Toxinas Botulínicas/uso terapêuticoRESUMO
Musical training can improve fine motor skills and cognitive abilities and induce macrostructural brain changes. However, it is not clear whether the changes in motor skills occur simultaneously with changes in cognitive and neurophysiological parameters. In this study, 156 healthy, musically naïve and right-handed older adults were recruited and randomly assigned to a piano training or a music listening group. Before, after 6 and 12 months, participants were scanned using MRI and assessed for fine motor skills, auditory working memory and processing speed. A Bayesian multilevel modelling approach was used to examine behavioural and neurophysiological group differences. The relationships between motor and cognitive and between motor and neurophysiological parameters were determined using latent change score models. Compared with music listening, practicing piano resulted in greater improvement in fine motor skills and probably working memory. Only in the piano group, unimanual fine motor skills and grey matter volume of the contralateral M1 changed together during the 6-12-month period. Additionally, M1 co-developed with ipsilateral putamen and thalamus. Playing piano induced more prevalent coupling between the motor and cognitive domains. However, there is little evidence that fine motor control develops concurrently with cognitive functions. Playing an instrument promotes motor, cognitive and neural development into older age. During the learning process, the consolidation of piano skills appears to take place in sensorimotor networks, enabling musicians to perform untrained motor tasks with higher acuity. Relationships between the development of motor acuity and cognition were bidirectional and can be explained by a common cause as well as by shared resources with compensatory mechanisms.
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Encéfalo , Música , Humanos , Idoso , Teorema de Bayes , Encéfalo/diagnóstico por imagem , Cognição/fisiologia , Aprendizagem , Destreza Motora/fisiologiaRESUMO
The hypothalamus regulates sexual behavior and is simultaneously associated with aggression and violence. Consequently, this brain region is relevant in research of pedophilia and child sexual offenses (CSO). The distinction between these two phenomena is of great importance and was the object of consideration of this study. We analyzed exclusively men, including 73 pedophilic offenders who committed CSO, an equal number of people with pedophilia but without such offenses, and 133 non-pedophilic, non-offending subjects who formed the control group. All data were collected in a multicenter in vivo study and analyzed using a semi-automated segmentation algorithm for 3-Tesla magnetic resonance images. Men with pedophilia who committed CSO on average had a 47 mm3 smaller hypothalamus per side than people without committed CSO. This effect was driven by both the group of non-offending people with pedophilia and the control group. By contrast, the exploratory comparison of pedophilic persons without CSO with the control group showed no significant difference. The present study demonstrates a deviant hypothalamic structure as a neurobiological correlate of CSO in pedophiles, but not in people with pedophilia who have not committed CSO. Thus, it strengthens the argument to distinguish between sexual offending and paraphilic sexual preferences.
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Pedofilia , Delitos Sexuais , Masculino , Humanos , Criança , Pedofilia/diagnóstico por imagem , Comportamento Sexual , Encéfalo/patologia , Hipotálamo/diagnóstico por imagem , Hipotálamo/patologiaRESUMO
A series of clinical studies have shown that botulinum toxin can treat major depression. Subjects suffering from unipolar depression may experience a quick, strong, and sustained improvement in the symptoms of depression after a single glabellar treatment with botulinum toxin.Preliminary data suggest that botulinum toxin therapy may also be effective in the treatment of other mental disorders characterized by an excess of negative emotions, such as borderline personality disorder.The mood-lifting effect of botulinum toxin therapy is probably mediated by the interruption of a proprioceptive feedback loop from the facial musculature to the emotional brain.
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Toxinas Botulínicas Tipo A , Fármacos Neuromusculares , Toxinas Botulínicas Tipo A/uso terapêutico , Depressão/tratamento farmacológico , Expressão Facial , Músculos Faciais/efeitos dos fármacos , HumanosRESUMO
BACKGROUND: Recent data suggest that musical practice prevents age-related cognitive decline. But experimental evidence remains sparse and no concise information on the neurophysiological bases exists, although cognitive decline represents a major impediment to healthy aging. A challenge in the field of aging is developing training regimens that stimulate neuroplasticity and delay or reverse symptoms of cognitive and cerebral decline. To be successful, these regimens should be easily integrated in daily life and intrinsically motivating. This study combines for the first-time protocolled music practice in elderly with cutting-edge neuroimaging and behavioral approaches, comparing two types of musical education. METHODS: We conduct a two-site Hannover-Geneva randomized intervention study in altogether 155 retired healthy elderly (64-78) years, (63 in Geneva, 92 in Hannover), offering either piano instruction (experimental group) or musical listening awareness (control group). Over 12 months all participants receive weekly training for 1 hour, and exercise at home for ~ 30 min daily. Both groups study different music styles. Participants are tested at 4 time points (0, 6, and 12 months & post-training (18 months)) on cognitive and perceptual-motor aptitudes as well as via wide-ranging functional and structural neuroimaging and blood sampling. DISCUSSION: We aim to demonstrate positive transfer effects for faculties traditionally described to decline with age, particularly in the piano group: executive functions, working memory, processing speed, abstract thinking and fine motor skills. Benefits in both groups may show for verbal memory, hearing in noise and subjective well-being. In association with these behavioral benefits we anticipate functional and structural brain plasticity in temporal (medial and lateral), prefrontal and parietal areas and the basal ganglia. We intend exhibiting for the first time that musical activities can provoke important societal impacts by diminishing cognitive and perceptual-motor decline supported by functional and structural brain plasticity. TRIAL REGISTRATION: The Ethikkomission of the Leibniz Universität Hannover approved the protocol on 14.08.17 (no. 3604-2017), the neuroimaging part and blood sampling was approved by the Hannover Medical School on 07.03.18. The full protocol was approved by the Commission cantonale d'éthique de la recherche de Genève (no. 2016-02224) on 27.02.18 and registered at clinicaltrials.gov on 17.09.18 ( NCT03674931 , no. 81185).
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Música , Idoso , Encéfalo/diagnóstico por imagem , Cognição , Alemanha , Humanos , Plasticidade Neuronal , SuíçaRESUMO
PURPOSE: The neuropeptide oxytocin (OXT) has a variety of physiological functions in maternal behavior and attachment including sexual behavior. Based on animal research and our previous human studies, we set out to investigate intranasal administration of OXT and hypothesized that OXT should be able to modulate sexual function in women. METHODS: In a double-blind, placebo-controlled, crossover laboratory setting, the acute effects of intranasal administered OXT (24 international units) on sexual drive, arousal, orgasm, and refractory aspects of sexual behavior were analyzed in 27 healthy females (mean age ± SD, 27.52 ± 8.04) together with physiological parameters using vaginal photoplethysmography. FINDINGS: Oxytocin administration showed no effect on subjective sexual parameters (eg, postorgasmic tension; P = 0.051). Physiological parameters (vaginal photoplethysmography amplitude and vaginal blood volume) showed a response pattern towards sexual arousal but were not affected by OXT. IMPLICATIONS: Using a well-established laboratory paradigm, we did not find that intranasal OXT influences female sexual parameters. Also, sexual drive and other functions were not affected by OXT. These findings indicate that OXT is not able to significantly increase subjective and objective parameters of sexual function in a setting with high internal validity; however, this might be different in a more naturalistic setting.
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Nível de Alerta/efeitos dos fármacos , Ocitócicos/administração & dosagem , Ocitocina/administração & dosagem , Comportamento Sexual/efeitos dos fármacos , Administração Intranasal , Adulto , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , Orgasmo/efeitos dos fármacos , Ocitócicos/farmacologia , Ocitocina/farmacologia , Fotopletismografia/métodos , Adulto JovemRESUMO
INTRODUCTION: Exploratory analysis of characteristics and reduction of risk factors for child sexual abuse (CSA) in a sample treated in the Prevention Projects Dunkelfeld Hannover and Regensburg. AIM: To evaluate a treatment program aimed at reducing dynamic risk factors (DRF) for CSA. METHODS: Using a psychometric test battery based on self-report questionnaires, intergroup analysis between treatment group (TG, n = 35), treatment refusers (TR, n = 51), and drop-out group (DO, n = 14) was conducted with pretreatment data. Intragroup analysis compared data of TG from pre- and posttreatment. The test battery included sociodemographic and sociosexual data, as well as questionnaires measuring DRF. MAIN OUTCOME MEASURE: This study investigated effects of treatment on pedophilic men who are at risk for offending and observed reductions in important risk factors for CSA. RESULTS: TG, TR (consisting of persons who were offered but refused therapy), and DO did not differ regarding sociodemographic and sociosexual variables before therapy. There were no significant differences in education, relationship status, living solitarily, and being a father/stepfather. TR and DO lived farther away from treatment site than TG. In the TG, a reduction in offense-supportive attitudes, coping self-efficacy deficits, and child identification were revealed at second assessment. In TG no participants started the consumption of child abuse content during the course of the study. CLINICAL IMPLICATIONS: Future treatment concepts should focus on the reduction of empirically relevant risk factors for child sexual offending. STRENGTH & LIMITATIONS: The present article is the first that compares TG to TR and DO before assessment regarding DRF and sociosexual variables. Moreover, it is only the second study that investigated treatment effects on a population of pedophilic men who are at risk for offending. These preliminary findings are limited by moderate group size and a missing control group. CONCLUSION: A reduction in some but not all assessed risk factors for sexual offending against minors could be seen within the time frame of therapy. Findings are in line with results from a previous evaluation study. Engel J, Körner M, Schuhman P. Reduction of risk factors for pedophilic sexual offending. J Sex Med 2018;15:1629-1637.
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Abuso Sexual na Infância/prevenção & controle , Criminosos , Participação do Paciente , Pedofilia/prevenção & controle , Adulto , Criança , Terapia Cognitivo-Comportamental , Demografia , Alemanha/epidemiologia , Humanos , Masculino , Pedofilia/epidemiologia , Psicometria , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
Human and animal data indicate that the dopaminergic system plays a crucial role in sexual drive and function. Using a double-blind, placebo-controlled crossover design, this prototype study investigated the effect of the D2 dopamine agonist cabergoline on sexual parameters in 13 healthy women. Cardiovascular and genital parameters were monitored continuously. Sexual drive and function were measured using self-report sexual experience scales. In contrast to previous theories and assumptions, we found that cabergoline did not alter objective and subjective sexual parameters in healthy women. This finding suggests that there may be sex differences in the influence of the dopaminergic system on human sexual functioning.
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Nível de Alerta/efeitos dos fármacos , Agonistas de Dopamina/administração & dosagem , Ergolinas/administração & dosagem , Comportamento Sexual/efeitos dos fármacos , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Adulto , Cabergolina , Método Duplo-Cego , Feminino , HumanosRESUMO
Neurobehavioral models of pedophilia and child sexual offending suggest a pattern of temporal and in particular prefrontal disturbances leading to inappropriate behavioral control and subsequently an increased propensity to sexually offend against children. However, clear empirical evidence for such mechanisms is still missing. Using a go/nogo paradigm in combination with functional magnetic resonance imaging (fMRI) we compared behavioral performance and neural response patterns among three groups of men matched for age and IQ: pedophiles with (N = 40) and without (N = 37) a history of hands-on sexual offences against children as well as healthy non-offending controls (N = 40). As compared to offending pedophiles, non-offending pedophiles exhibited superior inhibitory control as reflected by significantly lower rate of commission errors. Group-by-condition interaction analysis also revealed inhibition-related activation in the left posterior cingulate and the left superior frontal cortex that distinguished between offending and non-offending pedophiles, while no significant differences were found between pedophiles and healthy controls. Both areas showing distinct activation pattern among pedophiles play a critical role in linking neural networks that relate to effective cognitive functioning. Data therefore suggest that heightened inhibition-related recruitment of these areas as well as decreased amount of commission errors is related to better inhibitory control in pedophiles who successfully avoid committing hands-on sexual offences against children. Hum Brain Mapp 38:1092-1104, 2017. © 2016 Wiley Periodicals, Inc.
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Criminosos/psicologia , Inibição Psicológica , Pedofilia/fisiopatologia , Pedofilia/psicologia , Córtex Pré-Frontal/fisiopatologia , Adulto , Tomada de Decisões , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Oxigênio/sangue , Pedofilia/diagnóstico por imagem , Córtex Pré-Frontal/diagnóstico por imagem , Tempo de Reação/fisiologia , Adulto JovemRESUMO
OBJECTIVES: Pedophilia (P) is a psychiatric disease associated with sexual attraction toward children and often accompanied by child sexual offending (CSO). Consequently, it is important to address the understanding of executive dysfunctions that may increase the probability of CSO. Moreover, this research field has been lacking to disentangle executive deficits associated with pedophilia (as a deviant sexual preference) from those associated with CSO (as a deviant sexual behavior). METHODS: The German multi-sided research network NeMUP offers the opportunity to overcome these limitations. By applying the Cambridge Automated Neuropsychological Test Battery in four carefully matched groups of men: (1) pedophiles with (N=45) and (2) without (N=45) a history of sexual offending against children; (3) child molesters without pedophilia (N=19), and (4) non-offending controls (N=49), we were able to analyze executive functioning in pedophilia and CSO independently. RESULTS: Both CSO groups as compared to both non-CSO groups exhibited worsened response inhibition ability. However, only non-pedophilic offenders showed additionally disabled strategy use ability. Regarding set-shifting abilities, the P+CSO group showed the best performance. We also found that performances were affected by age: only in pedophiles, response inhibition worsened with age, while age-related deficits in set-shifting abilities were restricted to non-pedophilic participants. The latter also differentiated between both sexual preference groups. CONCLUSIONS: Our results are the first to demonstrate that executive dysfunctions are related to offense status rather than pedophilic preference. Furthermore, there was evidence for differentiating age and performance correlations between pedophiles and non-pedophiles, which warrants further investigation. (JINS, 2017, 23, 460-470).
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Abuso Sexual na Infância , Função Executiva/fisiologia , Inibição Psicológica , Pedofilia/fisiopatologia , Adulto , Criança , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Few studies have investigated placebo and nocebo effects in a human sexuality context. Studying placebo and nocebo responses in this context may provide insight into their potential to modulate sexual drive and function. To examine such effects in sexual medicine, 48 healthy, male heterosexual participants were divided into four groups. Each group received instruction to expect stimulating effects, no effect, or an inhibitory effect on sexual functions. Only one group received the dopamine agonist cabergoline; all other groups received placebo or nocebo. Modulations in sexual experience were examined through an established experimental paradigm of sexual arousal and masturbation-induced orgasm during erotic film sequences with instruction to induce placebo or nocebo effects. Endocrine data, appetitive, consummatory, and refractory sexual behavior parameters were assessed using the Arizona Sexual Experience Scale (ASEX) and the Acute Sexual Experience Scale (ASES). Results showed increased levels of sexual function after administration of cabergoline with significant effects for several parameters. Placebo effects were induced only to a small degree. No negative effects on sexual parameters in the nocebo condition were noted. This paradigm could induce only small placebo and nocebo effects. This supports the view that healthy male sexual function seems relatively resistant to negative external influences.
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Efeito Nocebo , Efeito Placebo , Comportamento Sexual , Adulto , Humanos , Libido , Masculino , OrgasmoRESUMO
BACKGROUND/AIMS: Agitation is a burdening phenomenon that occurs in a variety of psychiatric disorders. The aim of this study was to give a first direction for agitation occurrence in depression, anxiety disorder, and borderline personality disorder (BPD) as well as in healthy controls with and without psychiatric record. METHODS: Using the Hamburg-Hannover Agitation Scale (H2A), an instrument that allows for the measurement of agitation independently of the presence of a specific disorder, a patient sample (n = 158) and a healthy control group (n = 685) with (n = 94) and without (n = 591) psychiatric record were examined. The data were mainly analysed using ANOVAs and post hoc tests. RESULTS: Patients showed significantly higher H2A agitation levels than healthy controls. Within the clinical sample, BPD patients exhibited the strongest manifestation of agitation, scoring significantly higher than the depression and the anxiety disorder sample, while these two subgroups did not significantly differ from each other. Moreover, healthy subjects with a psychiatric record experienced a significantly stronger agitation than subjects without a psychiatric record. CONCLUSION: Further studies are needed with larger, more balanced, and differentiated sample sizes including a wider range of clinical pictures. The results demonstrate that agitation occurs and differs in psychiatric patients as well as in healthy controls.
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Ansiedade/psicologia , Transtorno da Personalidade Borderline/psicologia , Depressão/psicologia , Autoavaliação Diagnóstica , Inquéritos e Questionários/normas , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agitação Psicomotora , Reprodutibilidade dos Testes , AutoimagemRESUMO
BACKGROUND: Pedophilia is a disorder recognized for its impairment to the individual and for the harm it may cause to others. However, the neurobiology of pedophilia and a possible propensity to sexually abuse children are not well understood. In this study, we thus aimed at providing new insights in how functional integration of brain regions may relate to pedophilia or child sexual abuse (CSA). METHOD: By using functional magnetic resonance imaging (fMRI) technique, we compared functional connectivity at rest (RSFC) between pedophiles who engaged (P+CSA; N = 12) or did not engage (P-CSA; N = 14) in CSA and healthy controls (HCs; N = 14) within two networks: (i) the default mode network and (ii) the limbic network that has been linked to pedophilia before. RESULTS: Pedophiles who engaged in CSA show diminished RSFC in both networks compared with HC and P-CSA. Most importantly, they showed diminished RSFC between the left amygdala and orbitofrontal as well as anterior prefrontal regions. Though significant age differences between groups could not be avoided, correlation control analysis did not provide evidence for the assumption that the RSFC effects were related to age differences. CONCLUSION: We found significantly diminished RSFC in brain networks critically involved in widespread motivational and socio-emotional processes. These results extend existing models of the functional neuroanatomy of pedophilia and CSA as altered RSFC between these regions were related to CSA rather than pedophilia and thus may account for an increased propensity to engage in CSA in people suffering from pedophilia.
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Abuso Sexual na Infância , Neuroimagem Funcional , Sistema Límbico/fisiopatologia , Imageamento por Ressonância Magnética , Vias Neurais/fisiopatologia , Pedofilia/psicologia , Delitos Sexuais , Adulto , Fatores Etários , Encéfalo/fisiopatologia , Criança , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , DescansoRESUMO
Knowledge about the effects of the neuropeptide oxytocin (OXT) on human sexual behaviors and partner interactions remains limited. Based on our previous studies, we hypothesize that OXT should be able to positively influence parameters of sexual function and couple interactions. Employing a naturalistic setting involving 29 healthy heterosexual couples (n=58 participants), we analyzed the acute effects of intranasally administered OXT (24IU) on sexual drive, arousal, orgasm and refractory aspects of sexual behavior together with partner interactions. Data were assessed by psychometric instruments (Acute Sexual Experiences Scale, Arizona Sexual Experience Scale) as well as biomarkers, such as cortisol, α-amylase and heart rate. Intranasal OXT administration did not alter "classical" parameters of sexual function, such as sexual drive, arousal or penile erection and lubrication. However, analysis of variance and a hierarchical linear model (HLM) revealed specific effects related to the orgasmic/post-orgasmic interval as well as parameters of partner interactions. According to HLM analysis, OXT increased the intensity of orgasm, contentment after sexual intercourse and the effect of study participation. According to ANOVA analysis, these effects were more pronounced in men. Men additionally indicated higher levels of sexual satiety after sexual intercourse with OXT administration. Women felt more relaxed and subgroups indicated better abilities to share sexual desires or to empathize with their partners. The effect sizes were small to moderate. Biomarkers indicated moderate psychophysiological activation but were not affected by OXT, gender or method of contraception. Using a naturalistic setting, intranasal OXT administration in couples exerted differential effects on parameters of sexual function and partner interactions. These results warrant further investigations, including subjects with sexual and relationship problems.
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Relações Interpessoais , Orgasmo/fisiologia , Ocitocina/farmacologia , Comportamento Sexual/fisiologia , Parceiros Sexuais , Administração Intranasal , Adulto , Coito/fisiologia , Coito/psicologia , Estudos Cross-Over , Método Duplo-Cego , Características da Família , Feminino , Frequência Cardíaca/fisiologia , Heterossexualidade/fisiologia , Heterossexualidade/psicologia , Humanos , Hidrocortisona/metabolismo , Libido/efeitos dos fármacos , Libido/fisiologia , Masculino , Pessoa de Meia-Idade , Orgasmo/efeitos dos fármacos , Ocitocina/administração & dosagem , Placebos , Saliva/química , Fatores Sexuais , Comportamento Sexual/efeitos dos fármacos , Comportamento Sexual/psicologia , Fatores de Tempo , Adulto Jovem , alfa-Amilases/metabolismoRESUMO
INTRODUCTION: The population of individuals reporting hypersexual behavior is heterogeneous. Prior research has implicated the importance of personal distress and functional impairment, as both may serve as indicators of problem severity and relevance. Still, little is known about associations with distress and impairment following hypersexuality. AIM: The purpose of this study was to investigate personal distress and functional impairment in a community sample of male self-identified "sex addicts" and to explore the associations with related variables. METHODS: Three hundred forty-nine men completed an online survey that included questions about personal distress, functional impairment, motivation for behavior change, type of hypersexual behaviors, time spent on sexual behavior, and progression of sexual urges. The survey included the Sexual Addiction Screening Test-Revised (SAST-R) core. MAIN OUTCOME MEASURE: Specific survey questions about personal distress and functional impairment in six life areas were used to assess these variables. Chi-square and P-values were calculated to explore the interrelations among them. RESULTS: There were 75.3% (N = 253) who reported feeling distressed due to hypersexual behavior. Functional impairment in at least one life area was specified by 77.4% (N = 270), and most participants (56.2%) reported impairment regarding partner relationships. Personal distress and functional impairment in three areas were associated with a strong motivation for behavior change. Distress was associated with online pornography use, masturbation, and/or sexual contact with changing partners. The progression of sexual urges was related to distress, while time spent on sexual behavior was not. There were 92.9% of the distressed participants who scored above the SAST-R core scale cut-off, but also 59.0% of the participants with little or no distress scored in this range. CONCLUSIONS: Results underline the particular role of problems in social or intimate relationships in association with hypersexuality. Clustering individuals with regard to their specific sexual behavior and impairment pattern seems to be promising for further research.
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Ansiedade/epidemiologia , Transtornos Parafílicos/epidemiologia , Transtornos Parafílicos/psicologia , Comportamento Sexual , Adolescente , Adulto , Idoso , Coito/psicologia , Humanos , Relações Interpessoais , Libido , Masculino , Masturbação/psicologia , Pessoa de Meia-Idade , Motivação , Parceiros Sexuais/psicologia , Adulto JovemRESUMO
INTRODUCTION: Sexual intercourse, orgasm, and sexual satisfaction are associated with well-being and improved quality of life. The pituitary hormone prolactin (PRL) may have an important role in regulating (and thus indexing) sexual satiety and satisfaction. AIM: Physiological indices to quantify the quality and resulting satisfaction from female orgasm would be valuable. Therefore we aim to validate associations of orgasm-induced PRL surges with women's orgasm quality and subsequent sexual satisfaction. METHODS: In a prospective study, with a pre-post, single-blinded, cross-over design in a naturalistic field setting, we analyzed the correlation of women's post-orgasmic serum PRL surges following sexual intercourse with women's perceived quality of orgasm and resulting sexual satisfaction, as measured by a questionnaire. MAIN OUTCOME MEASURES: PRL levels prior to and following penile-vaginal intercourse with and without orgasm, and scores from the Acute Sexual Experience Scale (ASES) on quality of orgasm and sexual satisfaction. RESULTS: An analysis of variance of the blood samples in nine women indicated large magnitude, significant effects of intercourse orgasm on PRL levels (P = 0.004, eta squared = 0.78), as well as an interaction with the effect of multiple orgasms (P = 0.008, eta squared = 0.80). PRL post/pre ratios and arithmetic difference correlated strongly with orgasm quality (r = 0.85, P = 0.016, and r = 0.69, P = 0.08) and sexual satisfaction (r = 0.75, P = 0.05 and r = 0.77, P = 0.045). CONCLUSION: Women's intercourse orgasm induced PRL surges are strongly related to the quality of orgasm and subsequent sexual satisfaction. This implies that post-orgasmic PRL surges are an objective index of orgasm and orgasm quality. PRL might be used in future studies on basic research as well as a treatment target in sexual disorders in women.
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Coito/fisiologia , Orgasmo/fisiologia , Satisfação Pessoal , Prolactina/sangue , Precursores de Proteínas/sangue , Adulto , Feminino , Humanos , Qualidade de Vida , Inquéritos e Questionários , Adulto JovemRESUMO
Inhibiting the facial expression of negative emotions via botulinum toxin A (BTX) has been shown to mitigate symptoms of clinical depression in randomized controlled trials. This retrospective case study sought to reproduce the beneficial effects of BTX in a naturalistic setting for major depressive disorder and collect casuistic data on its effect on other mental disorders. Moreover, we describe symptom development across multiple treatment cycles with BTX, and assess the implementation of additional injection targets in the lower face region. Participants were N = 51 adult psychiatric outpatients mainly seeking treatment for depression. Over 50% suffered from comorbid psychiatric conditions, predominantly generalized anxiety disorder (GAD) or borderline personality disorder (BPD). A pre-post case series design was adapted. All participants received BTX-injections in the glabellar region on at least one occasion. Some received additional injections in the mouth region and over multiple treatment cycles. Treatment response was followed up by self-rated scales at varying time intervals post treatment. The results showed that BTX may yield favorable outcomes across multiple and comorbid mental disorders, especially, however, for patients suffering from depression. It potentially prevents the recurrence of clinical symptoms if applied regularly. Adding additional regions of the face does not seem to be superior over applying it to the glabellar region alone. The results add to the growing evidence that BTX therapy is effective in alleviating symptoms of depression. Positive effects can be sustained and reinstated, when applied over multiple treatment cycles. Observed symptom reduction in other psychiatric disorders was less pronounced. Further research is needed to understand the mechanisms by which BTX therapy reduces psychiatric symptoms.
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Toxinas Botulínicas Tipo A , Transtorno Depressivo Maior , Transtornos Mentais , Fármacos Neuromusculares , Adulto , Humanos , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/induzido quimicamente , Estudos Retrospectivos , Fármacos Neuromusculares/uso terapêutico , Toxinas Botulínicas Tipo A/efeitos adversos , Transtornos Mentais/tratamento farmacológico , Resultado do TratamentoRESUMO
Background and aims: Hypersexual disorder is characterized by recurrent and intense sexual fantasies, sexual urges, or sexual behaviors that can lead to clinically relevant levels of distress and adverse consequences for affected individuals. Earlier research has established a connection between sexual phenomena, such as compulsive sexual behavior, and personality features. The aim of the present study was to gain further insights into the associations of personality maladjustment and HD. Methods: The present study applied the dimensional approach of personality maladjustment presented in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to connect compulsive sexual behavior to personality maladjustment. We investigated 47 men suffering from HD (age: M = 36.51, SD = 11.47) and 38 matched men without HD (age: M = 37.92, SD = 12.33) regarding personality maladjustment using a 100-item version of the Personality Inventory for DSM-5 (PID-5-BF). Results: The men with HD showed higher levels of personality maladjustment regarding all PID-5-BF domains (negative affect, detachment, psychoticism, antagonism, and disinhibition) and significantly differentiated from men without HD in the level of subordinate facets. However, no domain of personality differentiated significantly between groups using a binary stepwise logistic regression analysis. Discussion and conclusions: In sum, the findings of the study underline the extent of personality maladjustment in men with HD. Interpersonal difficulties which men with HD frequently experience can contribute to clinically relevant levels of distress and adverse consequences reported by affected individuals.