Childhood Adversity and Offense-Supportive Cognitions Among Czech Adults with a Sexual Interest in Violence or Children.

Individuals with paraphilic interests in sexual violence or children may be more likely to sexually offend if they possess offense-supportive cognitions. These cognitions may develop in response to childhood adversity. However, this idea is largely based on research in men convicted of sexual offenses and may not generalize to non-incarcerated adults with paraphilic interests. In a sample of 178 adults screened for paraphilic interests in violence or children (from the general Czech population), we hypothesized that childhood sexual abuse and emotional neglect would be associated with offense-supportive cognitions about rape and child molestation. Participants came from a nationally representative sample of Czech adults and were selected if they self-reported high levels of sexual interest in violence and/or children. Participants completed an online survey with self-report measures of sexual orientation, offense-supportive cognitions (Bumby RAPE and MOLEST scales), and childhood sexual abuse and emotional neglect (Childhood Trauma Questionnaire). Controlling for gender, age, and sexual orientation, we found that both rape-supportive cognitions and child molestation-supportive cognitions were significantly associated with higher levels of childhood sexual abuse, but not emotional neglect. These findings indicate that childhood sexual abuse may lead to offense-supportive cognitions among men and women with paraphilia.

Eye-tracking does not reveal early attention processing of sexual copulatory movement in heterosexual men and women.

Men and women respond differently when presented with sexual stimuli. Men's reaction is gender-specific, and women's reaction is gender-nonspecific. This might be a result of differential cognitive processing of sexual cues, namely copulatory movement (CM), which is present in almost every dynamic erotic stimulus. A novelty eye-tracking procedure was developed to assess the saliency of short film clips containing CM or non-CM sexual activities. Results from 29 gynephilic men and 31 androphilic women showed only small and insignificant effects in attention bias and no effects in attentional capture. Our results suggest that CM is not processed differently in men and women and, therefore, is not the reason behind gender-nonspecific sexual responses in women.

Sex Surveys in Europe: Reflections on over Four Decades of Sexual Behavior and Sexual Health Surveillance.

Sexual expression is fundamental to human existence and an important topic of enquiry in its own right. Understanding sexual behavior is also essential to establish effective sexual health prevention activities (e.g., education), services and policies, and to assess the progress of policies and action plans. Questions on sexual health are rarely included in general health surveys, and therefore dedicated population studies are required. Many countries lack both funding and sociopolitical support to conduct such surveys. A tradition of periodic population sexual health surveys exists in Europe but the methods used (e.g., in questionnaire construction, recruiting methods or interview format) vary from one survey to another. This is because the researchers within each country are confronted with conceptual, methodological, sociocultural and budgetary challenges, for which they find different solutions. These differences limit comparison across countries and pooling of estimates, but the variation in approaches provides a rich source of learning on population survey research. In this review, survey leads from 11 European countries discuss how their surveys evolved during the past four decades in response to sociohistorical and political context, and the challenges they encountered. The review discusses the solutions they identified and shows that it is possible to create well designed surveys which collect high quality data on a range of aspects of sexual health, despite the sensitivity of the topic. Herewith, we hope to support the research community in their perennial quest for political support and funding, and ongoing drive to advance methodology in future national sex surveys.

Testing effects of partner support and use of oral contraception during relationship formation on severity of nausea and vomiting in pregnancy.

BACKGROUND: A recent study focusing on dietary predictors of nausea and vomiting in pregnancy (NVP) found that women with higher levels of partner support, and those who had used oral contraception (OC) when they met the father, both tended to report less severe NVP compared with previous non-users or those with less supportive partners. We provide a further test of these factors, using a large sample of women from four countries who retrospectively scored their NVP experience during their first pregnancy. METHODS: We recruited women who had at least one child to participate in a retrospective online survey. In total 2321 women completed our questionnaire including items on demographics, hormonal contraception, NVP, and partner support. We used general linear models and path analysis to analyse our data. RESULTS: Women who had used OC when they met the father of their first child tended to report lower levels of NVP, but the effect size was small and did not survive adding the participant's country to the model. There was no relationship between NVP and partner support in couples who were still together, but there was a significant effect among those couples that had since separated: women whose ex-partner had been relatively supportive reported less severe NVP. Additional analyses showed that women who were older during their first pregnancy reported less severe NVP, and there were also robust differences between countries. CONCLUSIONS: These results provide further evidence for multiple influences on women's experience of NVP symptoms, including levels of perceived partner support.

Changes in Intimacy and Sexuality During the COVID-19 Pandemic: A Qualitative Analysis of Data from a Survey on Partnered Individuals in Eight European Countries.

This qualitative study explores experiences of intimacy and sexuality during the first phase of the COVID-19 pandemic of 3357 participants from Croatia, the Czech Republic, the Netherlands, France, Germany, Portugal, Sweden, and Turkey. Data were collected through open-ended questions within a survey on sexuality during the pandemic. Based on a reflexive thematic analysis three themes occurred. The first theme No change was described by 41% when summarizing their sex life during the pandemic. The second theme Positive change was experienced by 25%, and the third theme Negative change by 21%. An overarching theme then emerged as: "Still the same trajectories, but the pandemic could be a catalyst for improved or worsened sex- life." For those intimate partnered individuals who already had problems with intimacy and sexuality before the COVID-19 pandemic it seemed to remain the same or deteriorated throughout the pandemic. For those with positive experiences of intimacy and sexuality before the COVID-19 pandemic it remained the same or improved throughout the pandemic. These findings are relevant for researchers and clinicians in developing preventive and supportive interventions in the context of crisis and social isolation.

The International Sexual Health And REproductive Health during COVID-19 (I-SHARE) Study: A Multicountry Analysis of Adults from 30 Countries Prior to and During the Initial Coronavirus Disease 2019 Wave.

BACKGROUND: There is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of coronavirus disease 2019 (COVID-19). To address this gap, our team organized a multicountry, cross-sectional online survey as part of a global consortium. METHODS: Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service use, and we compared 3 months prior to and during policy measures to mitigate COVID-19. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence. RESULTS: Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%), and 640 (14.1%) reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063 of 15 144, 7.0%) compared to before COVID-19 measures (1469 of 15 887, 9.3%). COVID-19 measures impeded access to condoms (933 of 10 790, 8.7%), contraceptives (610 of 8175, 7.5%), and human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing (750 of 1965, 30.7%). Pooled estimates from meta-analysis indicate that during COVID-19 measures, 32.3% (95% confidence interval [CI], 23.9%-42.1%) of people needing HIV/STI testing had hindered access, 4.4% (95% CI, 3.4%-5.4%) experienced partner violence, and 5.8% (95% CI, 5.4%-8.2%) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy. CONCLUSIONS: Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.

Perceived Changes in Sexual Interest and Distress About Discrepant Sexual Interest During the First Phase of COVID-19 Pandemic: A Multi-Country Assessment in Cohabiting Partnered Individuals.

Due to COVID-19 pandemic, different restrictive measures in terms of physical distancing and lockdowns have been introduced in most European countries, affecting all facets of social life. Currently, little is known about how partnered individuals perceive changes in their sexual life during this complex emergency. This study explored retrospectively assessed changes in sexual interest for one's partner and levels of distress related to perceived sexual interest discrepancy during the first phase of the pandemic in a large-scale online sample of partnered individuals (n = 4813; Mage = 38.5 years, SD = 10.74) recruited between May and July 2020 in seven European Union countries and Turkey. We also examined the possible role of approach/avoidance motives for sex in reported changes in sexual interest and associated distress. Most participants (53%) reported no change in their sexual interest during the pandemic, followed by those who reported an increase (28.5%). The pattern was similar across the eight countries. Distress about discrepant sexual interest, which was only weakly related to changes in sexual interest, was significantly associated with relationship quality and emotional closeness with a partner, coping with and worrying about the pandemic, and specific motivation for sex. In contrast to avoidant and relationship-focused approach motivation, ego-focused approach motivation was related to stable sexual interest during the pandemic. The current study contributes to the understanding of the link between sexual interest and complex emergencies. Considering that the COVID-19 pandemic continues, the reported experiences and perceptions are prone to change.

The COVID-19 Pandemic and Intimate Partner Violence against Women in the Czech Republic: Incidence and Associated Factors.

Intimate partner violence (IPV) is a burning social issue worldwide. According to global statistics, the incidence of IPV has increased during the COVID-19 pandemic due to restrictive measures (e.g., reduced social contacts, the need to stay at home often with a perpetrator in the same household). This study aims to provide data about the incidence of IPV and its associated factors during the COVID-19 pandemic in the Czech Republic. A representative online sample of 429 Czech women living with a partner at least 3 months before COVID-19 participated in the study. In an online interview, women reported IPV incidents 3 months before and during the first and second waves of the COVID-19 pandemic. Using non-parametric repeated measures ANOVA, a significant difference between the total IPV score and the given time periods was found. In addition, the results of the research showed a significant effect of the tension in the relationship with the partner, depression rate, and partner support on the total IPV score in the first and second wave of the COVID-19 pandemic. These results bring important insights into IPV incidence during the COVID-19 pandemic and suggest factors that might lead to an increased risk of IPV.

The International Sexual Health And Reproductive Health Survey (I-SHARE-1): A Multi-Country Analysis of Adults from 30 Countries Prior to and During the Initial COVID-19 Wave.

BACKGROUND: The COVID-19 pandemic forced billions of people to shelter in place, altering social and sexual relationships worldwide. In many settings, COVID-19 threatened already precarious health services. However, there is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of COVID-19 disease. To address this gap, our team organized a multi-country, cross-sectional online survey as part of a global consortium. METHODS: Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service utilization, and we compared three months prior to and three months after policy measures to mitigate COVID-19. We used established indicators and analyses pre-specified in our protocol. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence using Cochrane methods. Descriptive analyses included 22,724 individuals in 25 countries. Five additional countries with sample sizes <200 were included in descriptive meta-analyses. RESULTS: Respondents were mean age 34 years; most identified as women (15160; 66.7%), cis-gender (19432; 86.6%) and heterosexual (16592; 77.9%). Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%) people and 640 (14.1%) people reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063/15144, 7.0%) compared to the period before COVID-19 measures (1469/15887, 9.3%). COVID-19 measures impeded access to condoms (933/10790, 8.7%), contraceptives (610/8175, 7.5%), and HIV/STI testing (750/1965, 30.7%). Pooled estimates from meta-analysis indicate during COVID-19 measures, 32.3% (95% CI 23.9-42.1) of people needing HIV/STI testing had hindered access, 4.4% (95% CI 3.4-5.4) experienced partner violence, and 5.8% (95% CI 5.4-8.2) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy. CONCLUSION: Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.

Attention Bias and Recognition of Sexual Images in Depression.

Depression greatly affects sexuality. Theoretical and empirical evidence account for the existence of attention bias to sex-related stimuli. This attention bias might be impaired in depression, resulting in sexual problems. A sample of 13 patients with depression and 13 matched healthy controls were tested using the dot-probe and picture recognition task to measure attention to erotic images. No difference in attention to sex-related stimuli (ω2 = 0, p = 0.22) and in memory bias (ω2 = 0, p = 0.72) was found between the two groups. Explorative analyses were conducted to identify the sexual content-induced delay effect in the data, assess variability differences, and compare trial-level bias score-based indexes between groups. Across all analyses, there was little evidence for depression affecting sexual-related cognitive processing, and even this might be explained by other means. Our results suggest that restrained attention is probably not the main factor behind sexual problems in depression.

Commitment, Dominance, and Mate Value: Power Bases in Long-Term Heterosexual Couples.

We assessed the relative contribution of economic, personal, and affective power bases to perceived relationship power. Based on evolutionary studies, we predicted that personality dominance and mate value should represent alternative personal power bases. Our sample was comprised of 84 Czech heterosexual couples. We measured the economic power base using self-report scales assessing education, income and work status. Personal power bases were assessed using self-report measures of personality dominance (International Personality Item Pool Dominance and Assertiveness subscale from NEO Personality Inventory-Revised Extraversion scale), and partner-report measures of mate value (Trait-Specific Dependence Inventory, factors 2-6). The first factor of Trait-Specific Dependence Inventory, which measures agreeableness/commitment was used to assess the affective power base. Our results show that perceived relationship power is associated with a perception of partner's high agreeableness/commitment. Moreover, women's personality dominance and mate value are also linked with perceived relationship power, which supports our evolutionary prediction of dominance and mate value working as power bases for women. The stronger effect of women's than men's power bases may be due to gender differences in investment into relationships and/or due to transition to more equal relationships currently sought by women in the Czech Republic.

The Prevalence of Paraphilic Interests in the Czech Population: Preference, Arousal, the Use of Pornography, Fantasy, and Behavior.

The number of population-based studies focused on the prevalence of paraphilic sexual interests in men is very low and for women, the subject remains largely unexplored. The two main aims of this study are to investigate the prevalence of paraphilias and to explore sex differences in an online representative sample of Czech men and women using various dimensions of sexual experience. We collected data about sexual motivations and behavior from a representative online sample of 10,044 Czechs (5,023 men and 5,021 women). In a standardized online interview, participants answered questions about selected dimensions of sexual experience within specific paraphilic patterns: sexual preferences, sexual arousal, sexual fantasies in the past 6 months, pornography use in the past 6 months, and experience with paraphilic behaviors. Our results show that 31.3% of men (n = 1,571) and 13.6% of women (n = 683) admitted to at least one paraphilic preference. Moreover, 15.5% of men and 5% of women reported more than one paraphilic preference. Except for beating/torture and humiliation/submission, in terms of real experience with such behaviors almost all paraphilias were more common among men than among women. Our results indicate that the high prevalence of some paraphilic patterns might render their pathologization problematic.

Attention Bias and Recognition of Sexual Images.

Attention to sexual stimuli is necessary for the development of sexual response, yet while there is some evidence of attention bias in favor of sexual stimuli, the direction and magnitude of the effect remain unknown. A high-powered sample of 113 participants was tested using the dot-probe task (DPT) and picture recognition task (PRT) to measure visuospatial attention to erotic images. Participants showed no attention bias in the DPT (r B = 0.201, p = 0.064) but were significantly better at recognizing erotic rather than neutral or training pictures (d = 1.445 and 1.461, respectively, both p < 0.001). This indicates that spatial attention bias to sexual pictures is small, negligible, possibly even non-existent, or else the DPT is not a reliable tool to assess it. Results of the PRT, on the other hand, show that sexual stimuli are prioritized in memory and this should be explored in future research.

Kamasutra in Practice: The Use of Sexual Positions in the Czech Population and Their Association With Female Coital Orgasm Potential.

INTRODUCTION: A limited number of scientific studies explore the frequency with which various sexual positions are used in human populations and the potential of particular sexual position to facilitate female coital orgasm. AIM: The aim of this study was to provide data about the prevalence and frequency of various sexual positions, their rated pleasurability, and their association with female coital orgasm consistency (COC). METHODS: A sample of Czech heterosexual population (11,225 men/9,813 women) were presented with a list of 13 sexual positions in black-and-white silhouettes. For each position, they indicated frequency and pleasurability. COC was assessed as the proportion of penile-vaginal intercourse with a current partner which led to orgasm. MAIN OUTCOME MEASURE: Participants reported the frequency of use of sexual positions and rated their pleasurability. Using ordinal logistic regression, association between the COC and frequency of use of coital positions was tested. RESULTS: In both men and women, the most commonly used sexual positions were face to face/male above, face to face/female above, and kneeling/rear entry. Nonetheless, there emerged some gender differences in the rating of pleasurability of various positions (all P < .001). We found that a higher proportion of female coital orgasms are positively associated with the frequency of use of face to face/female above (odds ratio [OR] = 1.005, P < .001) and sitting/face-to-face positions (OR = 1.003, P < .001) and negatively associated with the frequency of kneeling/rear entry position (OR = 0.996, P < .001). CONCLUSIONS: Our findings suggest that there are no gender differences in the frequency of use of sexual positions, but their rated pleasurability differs between men and women, and higher frequency of use of face-to-face positions with female above increases the likelihood of achieving coital orgasm during penile-vaginal intercourse. Most results, however, were of small effect sizes, and more research is needed to further explore this issue. Krejcová L, Kuba R, Flegr J, et al. Kamasutra in Practice: The Use of Sexual Positions in the Czech Population and Their Association With Female Coital Orgasm Potential. Sex Med 2020;8:767-776.

Power Distribution and Relationship Quality in Long-Term Heterosexual Couples.

Power imbalance in romantic couples is associated with lower relationship quality. Reasons underlying this phenomenon remain, however, unclear. In 192 Czech and Slovak long-term heterosexual couples, we measured relationship quality (Dyadic Adjustment Scale) and assessed its link with perceived relationship power, control, decision making, and personality dominance. Decreased relationship quality was found in power-imbalanced couples, and power distribution affected perceived relationship quality especially in men. In women, lower perceived relationship quality was associated with their partners' control and personality dominance. Results are discussed in the context of interdependence and approach/inhibition theories of power, and some culturally specific explanations are provided.

The pharmacologic treatment of problematic sexual interests, paraphilic disorders, and sexual preoccupation in adult men who have committed a sexual offence.

This paper provides an international perspective on the use of medications to treat problematic sexual interests, paraphilic disorders, and sexual preoccupation in men who have committed a sexual offence. Experts from Canada, the Czech Republic (CR), Russia, the United Kingdom, and the United States met in Prague, CR in May 2017 to review and compare their treatment approaches. This report is a summary of their discussions, including empirical data from CR and Russia which have not previously been published in the English language. All participants agreed that continuing international collaboration would be very useful for the development of ethical international prescribing guidelines, as well as pooling data from studies on the efficacy and utility of pharmacological and other biological treatments for people who have committed sexual offences.

Psychological treatment of problematic sexual interests: cross-country comparison.

This paper reviews the use of psychotherapeutic approaches to treat individuals who have committed sex crimes and/or have problematic sexual interests (PSI); including types of psychotherapy used, descriptions of preventive and reintegration programmes, and highlighting specific theoretical controversies. In the second part, experts from Canada, the Czech Republic, Russia, the United Kingdom, and the United States, who participated in an International Consensus Meeting held in Prague (2017), summarize treatment programmes in their countries. The comparison revealed some general findings: each country has variability between its own programmes; most countries have different programmes for people who are in custody and who are in the community; the state-directed treatment programmes are primarily focused on criminal individuals, while non-criminal individuals are treated in preventive programmes and/or in special clinics or are untreated; the presence of PSI in patients is acknowledged in most programmes, although specific programmes exclusively for individuals with PSI rarely exist. Studies on effectiveness are difficult to compare due to methodologic, political, and cultural differences. Further communication between more countries to share knowledge about successful treatments and preventive approaches is needed, especially enhanced international collaboration between researchers and clinicians to verify the effectiveness of current clinical and experimental program, rs.

Stimuli used in the measurement of problematic sexual interests.

Penile plethysmography (PPG) is the primary physiologic assessment method used to gauge sexual responses in adult men. Depending on the country or jurisdiction of assessment, stimuli used to elicit arousal can include videos, still images, and audio materials. It can depict a variety consenting and non-consenting sexual scenarios as well as neutral, non-sexual scenarios. Models in visual stimuli can be clothed, semi-clothed, or nude. Variation in stimuli modality and the type of sexual interest being tested can have a large impact on PPG outcomes. This paper reviews research on types of PPG stimuli, the different sexual interests being assessed, reliability and validity, and the impact of anonymizing models depicted in assessment materials. Innovations in stimuli development in three labs located in Canada, the United States, and the Czech Republic are also discussed. The work done in these three labs and the broader range of research on assessment stimuli are presented to highlight the need for a unified, multi-site, standardized approach to assess problematic sexual interests and their change in response to treatment.

International review of sexual behaviour assessment labs.

This article provides a comparison and comprehensive analysis of varied approaches to the assessment of sexual interest and behaviours at different international sexual behaviour assessment labs. The assessment protocols are described for four sexual behaviour laboratories: the Royal Ottawa Mental Health Centre's Sexual Behaviours Clinic in Canada; the Medical University of South Carolina's Sexual Behaviours Clinic and Laboratory in the US; the Laboratory of Evolutionary Sexology and Psychopathology in the Czech Republic; and the Laboratory of Forensic Sexology in Russia. An overview of examinee demographics and types of cases assessed is provided for each lab. Assessment protocols, including psychometric measures and objective measures of sexual interest and arousal, such as penile plethysmography or eye-tracking, are also reviewed. The differences across labs may lead to interesting and productive cross-cultural investigations and studies about the efficacy of specific assessment methods.