The Effectiveness of Online Sensate Focus Exercises in Enhancing Sexual Function and Intimacy Among Chinese Heterosexual Couples: A Randomized Controlled Trial.

We investigated the effectiveness of online Sensate Focus exercises, delivered online as a series of 11 animation videos, in improving participants' sexual functioning and enhancing intimacy, relationship and sexual satisfaction. We studied 35 Chinese heterosexual couples, assessed them at pretest, post-test, and a three-month follow-up. Compared to the waitlist control group, the experimental group showed improvement in orgasm in women, and this was maintained at follow-up. Also, for those with a lower function at pretest, the intervention was possibly effective in improving erectile function among men, as well as overall sexual function and pain among women. These improvements were maintained at follow-up as well. Findings from the current study suggest that online Sensate Focus intervention has potential in treating sexual dysfunction of Chinese heterosexual couples. It may also serve as the first part of a stepped care approach or be integrated with other medication or cognitive behavioral therapy treatment.

Elucidating the role of negative parenting in the genetic v. environmental influences on adult psychopathic traits.

BACKGROUND: Psychopathic traits involve interpersonal manipulation, callous affect, erratic lifestyle, and antisocial behavior. Though adult psychopathic traits emerge from both genetic and environmental risk, no studies have examined etiologic associations between adult psychopathic traits and experiences of parenting in childhood, or the extent to which parenting practices may impact the heritability of adult psychopathic traits using a genetically-informed design. METHODS: In total, 1842 adult twins from the community reported their current psychopathic traits and experiences of negative parenting during childhood. We fit bivariate genetic models to the data, decomposing the variance within, and the covariance between, psychopathic traits and perceived negative parenting into their genetic and environmental components. We then fit a genotype × environment interaction model to evaluate whether negative parenting moderated the etiology of psychopathic traits. RESULTS: Psychopathic traits were moderately heritable with substantial non-shared environmental influences. There were significant associations between perceived negative parenting and three of four psychopathy facets (interpersonal manipulation, erratic lifestyle, antisocial tendencies, but not callous affect). These associations were attributable to a common non-shared environmental pathway and not to overlapping genetic effects. Additionally, we found that primarily shared environmental influences were stronger on psychopathic traits for individuals with a history of greater negative parenting. CONCLUSIONS: Utilizing a genetically-informed design, we found that both genetic and non-shared environmental factors contribute to the emergence of psychopathic traits. Moreover, perceptions of negative parenting emerged as a clear environmental influence on the development of interpersonal, lifestyle, and antisocial features of psychopathy.

Neuroelectric Correlates of Human Sexuality: A Review and Meta-Analysis.

Many reviews on sexual arousal in humans focus on different brain imaging methods and behavioral observations. Although neurotransmission in the brain is mainly performed through electrochemical signals, there are no systematic reviews of the electrophysiological correlates of sexual arousal. We performed a systematic search on this subject and reviewed 255 studies including various electrophysiological methods. Our results show how neuroelectric signals have been used to investigate genital somatotopy as well as basic genital physiology during sexual arousal and how cortical electric signals have been recorded during orgasm. Moreover, experiments on the interactions of cognition and sexual arousal in healthy subjects and in individuals with abnormal sexual preferences were analyzed as well as case studies on sexual disturbances associated with diseases of the nervous system. In addition, 25 studies focusing on brain potentials during the interaction of cognition and sexual arousal were eligible for meta-analysis. The results showed significant effect sizes for specific brain potentials during sexual stimulation (P3: Cohen's d = 1.82, N = 300, LPP: Cohen's d = 2.30, N = 510) with high heterogeneity between the combined studies. Taken together, our review shows how neuroelectric methods can consistently differentiate sexual arousal from other emotional states.

Actual and Desired Masturbation Frequency, Sexual Distress, and Their Correlates.

We investigated the prevalence of problematic masturbation using different criteria. We also investigated if masturbation-related distress was associated with sexual abuse history, family attitudes towards sexuality during childhood, and depression and anxiety symptoms. Here, 12,271 Finnish men and women completed a survey reporting masturbation frequency, desired masturbation frequency, sexual distress, childhood sexual abuse, sex-positive family background, as well as depression and anxiety symptoms. Among both sexes, those whose masturbation frequency did not match with desired frequency experienced more sexual distress. Different conceptualizations of problematic masturbation resulted in different proportions of individuals categorized as having it (i.e., 8.3% of men and 2.7% of women experienced self-perceived problematic masturbation, that is masturbating more than they desired and experiencing sexual distress; 2% of men and 0.6% of women masturbated more frequently than average and meanwhile experienced self-perceived problematic masturbation; 6.3% of men and 2.1% of women masturbated less frequently than average but still experienced self-perceived problematic masturbation). Moreover, among both sexes, self-perceived problematic masturbation was positively associated with childhood sexual abuse, depression, and anxiety, while negatively associated with a sex-positive family background. Our results point to the complexity of defining problematic masturbation. Causes of sexual distress related to masturbation need to be carefully examined case by case to choose an appropriate clinical approach.

Predictors of attitudes toward potentially having a lesbian, gay, or bisexual child among Chinese heterosexual adults.

Parental acceptance is a robust protective factor for lesbian, gay, or bisexual (LGB) individuals' mental health, yet its predictors have not been frequently studied in China. The present study examined predictors of Chinese heterosexual adults' attitudes toward potentially having an LGB child. Participants were 700 Chinese nationals (37.6% women and 62.4% men) aged 18-64 who identified as exclusively heterosexual and did not have an LGB child. We found that beliefs about the changeability of sexual orientation and beliefs in negative outcomes of being LGB predicted negative attitudes toward having an LGB child in domains of emotion, cognition, and behavior. Moreover, more exposure to LGB individuals predicted reduced disapproval and negative actions as well as increased positive actions. These findings revealed the key factors to changing Chinese people's attitudes toward having an LGB child. Clinical implications for therapists and counselors working with Chinese LGB individuals and their parents are discussed.

One and a half centuries of serial homicide in Italy: offender, victim and offence characteristics.

The present study reports offender, victim and offence characteristics of the entire population of known serial homicide offenders identified in Italy between 1848 and 2019 (59 offenders, 244 victims, of whom 50.4% were men, and 21.7% were sex workers). We found that most of the offenders (72.4%) had a personality disorder. The offenders' age during their series was 35.1 (SD = 11.3) years, on average. Sexual elements were found in 28.4% of the crime scenes. The median time interval between homicides was 2.8 months. Also, we investigated the consistency of the offence characteristics over the series and found significant correlations between the offence characteristics between a previous and the subsequent homicide.

The Effects of Acute Transcranial Direct Current Stimulation on Attentional Bias in Pedophilic Disorder: A Preregistered Pilot Study.

OBJECTIVES: Individuals with pedophilic disorder (PD) experience personal and interpersonal difficulties and are at risk of sexually offending against children. As such, innovative and empirically validated treatments are needed. Recent studies have indicated that men who have sexually offended against children (SOC) with PD display an automatic attention bias for child-related stimuli as well as reduced activity in the dorsolateral prefrontal cortex (dlPFC), a brain area involved in cognitive control, including control over sexual arousal. In this preregistered pilot study, we are the first to investigate whether acutely increasing prefrontal activity could reduce the putative pedophilic attention bias. MATERIALS AND METHODS: We delivered a single 20-min session of active anodal versus sham transcranial direct current stimulation (tDCS) over the left dlPFC to 16 SOC with PD and 16 matched healthy controls, while they performed a task requiring controlled attention to computer-generated images of clothed and nude children and adults. We collected responses unobtrusively by recording eye movements. RESULTS: Our results did not support the presence of the expected automatic attention bias across outcome measures. Nonetheless, we found a response facilitation with child targets in patients and, unexpectedly, in controls, likely due to unwanted salience effects. Active versus sham tDCS reduced this bias across groups, as indicated by a significant group*condition interaction (p = 0.04). However, no attentional bias and no tDCS effects on attentional responses to child and adult images emerged following tDCS. CONCLUSIONS: These results suggest enhanced cognitive control in response to salient stimuli during active tDCS. Thus, to assist future studies on neuromodulation in PD, we provide suggestions for design improvement.

The distance threshold of reliable eyewitness identification.

Increased distance between an eyewitness and a culprit decreases the accuracy of eyewitness identifications, but the maximum distance at which reliable observations can still be made is unknown. Our aim was to identify this threshold. We hypothesized that increased distance would decrease identification, rejection accuracy, confidence and would increase response time. We expected an interaction effect, where increased distance would more negatively affect younger and older participants (vs. young adults), resulting in age-group specific distance thresholds where diagnosticity would be 1. We presented participants with 4 live targets at distances between 5 m and 110 m using an 8-person computerized line-up task. We used simultaneous and sequential target-absent or target-present line-ups and presented these to 1,588 participants (age range = 6-77; 61% female; 95% Finns), resulting in 6,233 responses. We found that at 40 m diagnosticity was 50% lower than at 5 m and with increased distance diagnosticity tapered off until it was 1 (±0.5) at 100 m for all age groups and line-up types. However, young children (age range = 6-11) and older adults (age range = 45-77) reached a diagnosticity of 1 at shorter distances compared with older children (age range = 12-17) and young adults (age range = 18-44). We found that confidence dropped with increased distance, response time remained stable, and high confidence and shorter response times were associated with identification accuracy up to 40 m. We conclude that age and line-up type moderate the effect distance has on eyewitness accuracy and that there are perceptual distance thresholds at which an eyewitness can no longer reliably encode and later identify a culprit. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Bayesian Decision-Support Tool for Child Sexual Abuse Assessment and Investigation.

In assessments of child sexual abuse (CSA) allegations, informative background information is often overlooked or not used properly. We therefore created and tested an instrument that uses accessible background information to calculate the probability of a child being a CSA victim that can be used as a starting point in the following investigation. Studying 903 demographic and socioeconomic variables from over 11,000 Finnish children, we identified 42 features related to CSA. Using Bayesian logic to calculate the probability of abuse, our instrument-the Finnish Investigative Instrument of Child Sexual Abuse (FICSA)-has two separate profiles for boys and girls. A cross-validation procedure suggested excellent diagnostic utility (area under the curve [AUC] = 0.97 for boys and AUC = 0.88 for girls). We conclude that the presented method can be useful in forensic assessments of CSA allegations by adding a reliable statistical approach to considering background information, and to support clinical decision making and guide investigative efforts.

Genetic Variants Associated With Male Pedophilic Sexual Interest.

INTRODUCTION: The etiology of sexual preference disorders (paraphilias) in general and pedophilia in particular remains unknown. There are some indications of biological factors related to pedophilic interest and pedophilic disorder. AIM: To examine single-nucleotide polymorphisms (SNPs) potentially associated with pedophilic sexual interest. METHODS: The sample consisted of 1,672 men 18 to 45 years old from the Genetics of Sex and Aggression sample who had submitted saliva samples. Fifty-four SNPs were genotyped and relevant SNPs were analyzed. MAIN OUTCOME MEASURES: A self-report questionnaire designed specifically for the Genetics of Sex and Aggression sample was used to measure sexual interest in and sexual behavior toward children and adolescents. DNA extraction and genotyping were used to measure possible associations between male pedophilia and SNPs. RESULTS: Before controlling for multiple testing, statistically significant associations were found for SNPs linked to androgen, estrogen, prolactin, corticotrophin, serotonin, and oxytocin. No associations remained significant after controlling for multiple testing. CONCLUSION: The results of the present study suggest a complex biological mechanism affecting adult sexual interest in children. Very small effect sizes characterized the findings, and several polymorphisms related to different hormonal functioning were initially related to the phenotype.

Topography of Human Erogenous Zones.

Touching is a powerful means for eliciting sexual arousal. Here, we establish the topographical organization of bodily regions triggering sexual arousal in humans. A total of 704 participants were shown images of same and opposite sex bodies and asked to color the bodily regions whose touching they or members of the opposite sex would experience as sexually arousing while masturbating or having sex with a partner. Resulting erogenous zone maps (EZMs) revealed that the whole body was sensitive to sexual touching, with erogenous hotspots consisting of genitals, breasts, and anus. The EZM area was larger while having sex with a partner versus while masturbating, and was also dependent on sexual desire and heterosexual and homosexual interest levels. We conclude that tactile stimulation of practically all bodily regions may trigger sexual arousal. Extension of the erogenous zones while having sex with a partner may reflect the role of touching in maintenance of reproductive pair bonds.

Paraphilic Sexual Interests and Sexually Coercive Behavior: A Population-Based Twin Study.

Prior research with selected clinical and forensic samples suggests associations between paraphilic sexual interests (e.g., exhibitionism and sexual sadism) and sexually coercive behavior. However, no study to date used a large, representative and genetically informative population sample to address the potential causal nature of this association. We used self-report data on paraphilic and sexually coercive behavior from 5990 18- to 32-year-old male and female twins from a contemporary Finnish population cohort. Logistic regression and co-twin control models were employed to examine if paraphilic behaviors were causally related to coercive behavior or if suggested links were confounded by familial (genetic or common family environment) risk factors. Results indicated that associations between four out of five tested paraphilic behaviors (exhibitionism, masochism, sadism, and voyeurism, respectively) and sexually coercive behavior were moderate to strong. Transvestic fetishism was not independently associated with sexual coercion. Comparisons of twins reporting paraphilic behavior with their paraphilic behavior-discordant twin further suggested that associations were largely independent of shared genetic and environmental confounds, consistent with a causal association. In conclusion, similar to previously reported predictive effects of paraphilias on sexual crime recidivism, paraphilic behavior among young adults in the general population increases sexual offending risk. Further, early identification of paraphilic interest and preventive interventions with at-risk individuals might also reduce perpetration of first-time sexual violence.

Genetic variation of the growth hormone secretagogue receptor gene is associated with alcohol use disorders identification test scores and smoking.

The multifaceted gut-brain peptide ghrelin and its receptor (GHSR-1a) are implicated in mechanisms regulating not only the energy balance but also the reward circuitry. In our pre-clinical models, we have shown that ghrelin increases whereas GHSR-1a antagonists decrease alcohol consumption and the motivation to consume alcohol in rodents. Moreover, ghrelin signaling is required for the rewarding properties of addictive drugs including alcohol and nicotine in rodents. Given the hereditary component underlying addictive behaviors and disorders, we sought to investigate whether single nucleotide polymorphisms (SNPs) located in the pre-proghrelin gene (GHRL) and GHSR-1a gene (GHSR) are associated with alcohol use, measured by the alcohol use disorders identification test (AUDIT) and smoking. Two SNPs located in GHRL, rs4684677 (Gln90Leu) and rs696217 (Leu72Met), and one in GHSR, rs2948694, were genotyped in a subset (n = 4161) of a Finnish population-based cohort, the Genetics of Sexuality and Aggression project. The effect of these SNPs on AUDIT scores and smoking was investigated using linear and logistic regressions, respectively. We found that the minor allele of the rs2948694 SNP was nominally associated with higher AUDIT scores (P = 0.0204, recessive model) and smoking (P = 0.0002, dominant model). Furthermore, post hoc analyses showed that this risk allele was also associated with increased likelihood of having high level of alcohol problems as determined by AUDIT scores ≥ 16 (P = 0.0043, recessive model). These convergent findings lend further support for the hypothesized involvement of ghrelin signaling in addictive disorders.

Rigorous tests of gene-environment interactions in a lab study of the oxytocin receptor gene (OXTR), alcohol exposure, and aggression.

Naturalistic studies of gene-environment interactions (G X E) have been plagued by several limitations, including difficulty isolating specific environmental risk factors from other correlated aspects of the environment, gene-environment correlation (rGE ), and the use of a single genetic variant to represent the influence of a gene. We present results from 235 Finnish young men in two lab studies of aggression and alcohol challenge that attempt to redress these limitations of the extant G X E literature. Specifically, we use a latent variable modeling approach in an attempt to more fully account for genetic variation across the oxytocin receptor gene (OXTR) and to robustly test its main effects on aggression and its interaction with alcohol exposure. We also modeled aggression as a latent variable comprising various indices, including the average and maximum levels of aggression, the earliest trial on which aggression was expressed, and the proportion of trials on which the minimum and maximum levels of aggression were expressed. The best fitting model for the genetic variation across OXTR included six factors derived from an exploratory factor analysis, roughly corresponding to six haplotype blocks. Aggression levels were higher on trials in which participants were administered alcohol, won, or were provoked. There was a significant main effect of OXTR on aggression across studies after controlling for covariates. The interaction of OXTR and alcohol was also significant across studies, such that OXTR had stronger effects on aggression in the alcohol administration condition. © 2015 Wiley Periodicals, Inc.

Sexual Function in Patients Operated on for Bladder Exstrophy and Epispadias.

PURPOSE: Bladder exstrophy and epispadias complex is a rare congenital malformation that may have detrimental effects on sexual function. We evaluated sexual function of patients with bladder exstrophy and epispadias complex using validated questionnaires and compared the results with age matched controls. MATERIALS AND METHODS: Patients with bladder exstrophy and epispadias complex treated between 1956 and 1992 were identified from our hospital operative database. A total of 63 patients were mailed questionnaires up to 3 times, resulting in 32 replies (51%). Men were mailed the International Index of Erectile Function-15 questionnaire and women were mailed the Female Sexual Function Index questionnaire, and all patients were asked auxiliary questions regarding children, satisfaction with external genitalia and urinary continence. RESULTS: There were no differences in sexual function between sexually active men with bladder exstrophy and epispadias complex and age matched controls on different erectile function domain scores according to the International Index of Erectile Function-15 questionnaire. The Female Sexual Function Index questionnaire among women yielded comparable results on different domain scores, except for median total score, which was higher in patients (33.6, IQR 29.4 to 34.9) than in controls (30.1, IQR 26.4 to 32.4, p = 0.049), suggesting better sexual function in patients with bladder exstrophy and epispadias complex. A greater proportion of patients with bladder exstrophy and epispadias complex had not become sexually active, compared to controls (35% vs 11%, p = 0.008). Patients with bladder exstrophy and epispadias complex were less likely to have children than controls (22% vs 45%, p = 0.021). CONCLUSIONS: Men and women with bladder exstrophy and epispadias complex had good long-term outcomes on erectile and general sexual function tests. However, there is a likelihood that these individuals start their sexual life later than the general population, and fewer have children compared to controls.

A study of possible associations between single nucleotide polymorphisms in the estrogen receptor 2 gene and female sexual desire.

INTRODUCTION: Female sexual desire and arousal problems have been shown to have a heritable component of moderate size. Previous molecular genetic studies on sexual desire have mainly focused on genes associated with neurotransmitters such as dopamine and serotonin. Nevertheless, there is reason to believe that hormones with more specific functions concerning sexuality could have an impact on sexual desire and arousal. AIM: The aim of the present study was to investigate the possible effects of 17 single nucleotide polymorphisms (SNPs) located in estrogen receptor genes on female sexual desire and subjective and genital arousal (lubrication). Based on previous research, we hypothesized that ESR1 and ESR2 are relevant genes that contribute to female sexual desire and arousal. MAIN OUTCOME MEASURES: The desire, arousal, and lubrication subdomains of the Female Sexual Function Index self-report questionnaire were used. METHODS: The present study involved 2,448 female twins and their sisters aged 18-49 who had submitted saliva samples for genotyping. The participants were a subset from a large-scale, population-based sample. RESULTS: We found nominally significant main effects on sexual desire for three ESR2 -linked SNPs when controlled for anxiety, suggesting that individuals homozygous for the G allele of the rs1271572 SNP, and the A allele of the rs4986938 and rs928554 SNPs had lower levels of sexual desire. The rs4986938 SNP also had a nominally significant effect on lubrication. No effects for any of the SNPs on subjective arousal could be detected. CONCLUSIONS: The number of nominally significant results for SNPs in the ESR2 gene before correcting for multiple testing suggests that further studies on the possible influence of this gene on interindividual variation in female sexual functioning are warranted. In contrast, no support for an involvement of ESR1 was obtained. Our results should be interpreted with caution until replicated in independent, large samples.

Sexually coercive behavior following childhood maltreatment.

Child maltreatment is associated with adult sexually coercive behavior. The association may be causal or confounders that increase the risk of both childhood victimization and sexually coercive behavior might explain the observed links. We examined if childhood maltreatment was related to sexual coercion independently of familial (genetic or common family environment) risk factors, thereby addressing potential causality. Participants were 6,255 18 to 33-year-old twins from the Finnish population-based study "Genetics of Sex and Aggression" who responded to self-report questionnaires of child maltreatment and sexually coercive behavior. We used generalized estimating equations to elucidate risk of sexual coercion in maltreated compared to unrelated, non-maltreated individuals. To adjust for unmeasured familial factors, we used the co-twin control method and compared sexual coercion risk within maltreatment-discordant twin pairs. Further, we examined possible differential effects of maltreatment subtypes and compared mean differences in maltreatment summary scores between sexually coercive individuals and controls. Sexual coercion was moderately more common among individuals maltreated as children versus unrelated controls (38.3 vs. 22.8 %; age- and gender-adjusted odds ratio, aOR = 2.31, 95 % CI 1.75-3.05) and the risk increase remained similar within maltreatment-discordant twins (OR = 2.82, 95 % CI 1.42-5.61). Moreover, different maltreatment subtypes predicted sexual coercion equally well and effect sizes remained similar within discordant twin pairs. We conclude that associations between child maltreatment and sexual coercion are largely independent of shared familial confounds, consistent with a causal inference. Importantly, detection and targeted interventions for maltreated children should remain a priority to reduce societal sexually coercive behavior.

Readiness and motivation for change among young women with broadly defined eating disorders.

Readiness and motivation for change were examined in 32 women with broadly defined eating disorders who took part in a 10-week Cognitive Behavioral Therapy (CBT)-based group intervention. Readiness for change and eating disorder psychopathology were assessed before and after the intervention. The results revealed significant negative associations between degree of eating disorder symptoms and degree of readiness for change before the intervention started. In particular, higher levels of eating concern, shape concern, and body dissatisfaction were associated with lower motivation for change. No significant associations between degree of readiness for change before the intervention started and changes in eating disorder symptoms at the end of intervention were found. Readiness for change increased from the beginning to the end of the intervention, indicating that group CBT may be a cost-effective and time-efficient way of enhancing readiness and motivation for change in individuals with eating psychopathology.

Men's sexual interest in children: one-year incidence and correlates in a population-based sample of Finnish male twins.

In a study of 1,310 Finnish adult male twins we found that sexual interest in children aged 12 or younger was reported by 0.2% of the sample. Sexual interest in children aged 15 or younger was reported by 3.3%. Participants reporting sexual interest in children aged 15 or younger were younger, reported stronger sexual desire, and had experienced more childhood sexual and nonsexual abuse. The present study is the first to give a population-based estimate of the incidence of sexual interest in children among adult men. The 12-month incidence of sexual interest in children below the age of 16 years is roughly comparable to the one-year incidence of major depression or the lifetime prevalence of transvestitic fetishism.