Psychosocial Functioning in Women with Symptoms of Persistent Genital Arousal

Persistent genital arousal disorder (PGAD) is characterized by physiological sexual arousal (vasocongestion, sensitivity of the genitals and nipples) that is described as distressing, and sometimes painful. Although awareness of PGAD is growing, there continues to be a lack of systematic research on this condition. The vast majority of published reports are case studies. Little is known about the symptom characteristics, biological factors, or psychosocial functioning associated with the experience of persistent genital arousal (PGA) symptoms. This study sought to characterize a sample of women with PGA (Study One); compare women with and without PGA symptoms on a series of biopsychosocial factors (Study Two); and undertake an exploratory comparison of women with PGA, painful PGA, and genital pain (Study Three)—all within a biopsychosocial framework. Symptom-free women, women with PGA symptoms, painful PGA, and genital pain, completed an online survey of biological factors (medical history, symptom profiles), psychological factors (depression, anxiety) and social factors (sexual function, relationship satisfaction). Study One found that women report diverse symptoms associated with PGA, with almost half reporting painful symptoms. In Study Two, women with symptoms of PGA reported significantly greater impairment in most domains of psychosocial functioning as compared to symptom-free women. In particular, catastrophizing of vulvar sensations was related to symptom ratings (i.e., greater severity, distress) and psychosocial outcomes (i.e., greater depression and anxiety). Finally, Study Three found that women with PGA symptoms reported some overlap in medical comorbidities and symptom expression as those with combined PGA and vulvodynia and those with vulvodynia symptoms alone; however, there were also a number of significant differences in their associated physical symptoms. These studies indicate that PGA symptoms have negative consequences for the psychosocial functioning of affected women. As such, future research and clinical care may benefit from a biopsychosocial approach to PGA symptoms. These studies highlight areas for more targeted research, including the role of catastrophizing in PGA symptom development and maintenance, and the potential conceptualization of both PGA and vulvodynia (and potentially other conditions) under a general umbrella of ‘genital paraesthesias’ (i.e., disorders characterized by abnormal sensations, such as tingling and burning).

EXAMINING HOW SAME-GENDER AND MIXED-GENDER COUPLES NAVIGATE SEXUAL ISSUES IN THEIR RELATIONSHIPS

Sexual scripts—the definitions and expectations that individuals hold for sexual interactions—are thought to play an important role in the maintenance of sexual well-being. Sexual scripts can be rigid or flexible, and they can be concordant or discordant between members of a couple. Sex therapists support sexual script flexibility for maintaining sexual and relationship satisfaction when couples are navigating sexual issues. However, empirical research examining the role of sexual script flexibility and the degree of script concordance/discordance in couples’ sexual well-being has been limited, due in part to the limited measures available. Furthermore, within the existing research, there has been an unfortunate tendency to exclude individuals in same-gender relationships – perpetuating the long-standing knowledge gap in the literature on positive sexuality in diverse relationships. To address these gaps in the literature, we conducted a series of online studies that recruited individuals in diverse relationships. A measure of individual sexual script flexibility in response to sexual issues was developed (Chapter 2); in addition, the structure of an existing measure assessing couple sexual scripts in response to a sexual issue was evaluated (Chapter 3). Chapter 4 examined how individuals in diverse relationships compared on measures of individual sexual script flexibility and on couple sexual scripts. Findings suggest that there are more similarities than differences across diverse couples. Chapter 5 explored how flexibility in an individual’s approach to sexual issues relates to sexual well-being, specifically by assessing sexual communication and partner responses as mediators. Results suggest that individual sexual script flexibility relates to sexual well-being through reciprocal partner processes. Collectively, this research program suggests that more similarities than differences exist between individuals in same- and mixed-gender relationships, and that partners are important to consider in the relationship between individual sexual script flexibility and sexual well-being. These findings have implications for sex and couple therapy; these results emphasize the importance of interventions that target both members of the couple, and further our understanding of sexuality in same- and mixed-gender relationships.

Just Need Some Satisfaction: Examining the Relationship between Passion for Exercise and the Basic Psychological Needs

Individuals often pursue activities for which they are passionate about, and this passion is operationalized as being harmonious (an autonomous desireto engage in the activity) or obsessive (a controlled desire to engage in the activity) in nature (Vallerand et al., 2003). With regard to harmonious passion, Vallerand et al. (2003) suggests that it is fostered in environments that nurture innate needs for autonomy, competence, and relatedness. The purpose of the present study was to explore the nature of the passion-basic psychological needs (competence, autonomy, relatedness) relationship. Kinesiology students (N = 917; Mage = 18.54 SD = 1.66) completed the Passion Scale (Vallerand et al., 2003) and the Psychological Need Satisfaction in Exercise Scale (Wilson et al., 2006). Results from the SEM path analysis indicated that harmonious passion was positively related to competence (SPE = .43) and relatedness (SPE = .43) and obsessive passion was negatively related to autonomy (SPE = -.18)(CFI = .90, RMSEA = .07, SRMR = .07). Implications for exercise participation/enjoyment are discussed.

Experience in Competitive Youth Sport and Needs Satisfaction: The Singapore Story

The purpose of this study was to examine the relationship between sport experiences and psychological needs satisfaction of Singapore high school athletes who were involved in inter-school competition. A total of 1250 school athletes from 22 sports participated in the study. The athletes were between 13 and 18 years old and had an average of 3 years of experience in school sport (SD=.18). Cluster analysis was employed to identify homogenous groups based on the seven developmental experiences domains of the Youth Experience Survey (YES 2.0; Hansen & Larson, 2005). A one-way analysis of variance (ANOVA) was conducted to determine whether differences existed among the clusters in terms of psychological needs satisfaction (i.e., sense of autonomy, perceived competence and relatedness). The results of the cluster analysis showed that there were different subgroups of athletes with distinct developmental experiences, and they varied in the degree to which their psychological needs were satisfied. Generally, subgroups that had high levels of positive experiences and low levels of negative experiences in sport had better fulfillment of psychological needs. It is important to ensure that policies and programmes are formulated, delivered and monitored effectively to promote positive experiences for youth who are involved in competitive sports.