Date of Award

2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

Antonio Cepeda-Benito

Abstract

Despite the availability of safe and effective medications for sexual dysfunction such as phosphodiesterase type 5 (PED5) inhibitors, many men continue to experience sexual dysfunction even when the physical ability to gain an erection is restored. The persistence of such difficulties evidences the indispensable role of psychological factors during sexual arousal. Prominent theories of sexual arousal underscore the important role that attention plays in this process (e.g., Barlow, 1986; Janssen, Everaerd, Spiering, & Janssen, 2000). While the extant literature on sexual function describes differences in attentional processing of sexual stimuli for men with and without sexual dysfunction, questions remain regarding why men with greater sexual dysfunction tend to focus on negative and non-sexual stimuli and make more negative interpretations of sexual stimuli compared to men with decreased sexual dysfunction. Considering the similarities between social anxiety (Mogg et al., 2002) and psychogenic sexual dysfunction (Barlow, 1986), it is possible that men with sexual dysfunction possess greater vigilance for stimuli which would convey threat to sexual performance (e.g., penile flaccidity). Individuals with sexual dysfunction may be vigilant toward facial expressions during partnered sex considering the amount of time men spend looking at the faces of nude females portrayed in sexual stimuli (Rupp and Wallen, 2004). Interestingly, facial expressions during heightened sexual arousal have been shown to be ambiguous (Fernandez-dolls et al., 2011; Wyatt & Rellini, In Preparation). Considering that men who are repeatedly exposed to unsuccessful sexual situations tend to develop sexual dysfunction schemas (Nobre, 2010), and because we tend to rely more heavily on schemas when faced with ambiguity (Labert & wedell, 1991), facial expressions during heightened states of sexual arousal may act as canvases for sexual dysfunction schemas to act upon during partnered sex. Correspondingly, we hypothesized that men with greater sexual dysfunction 1) would report greater pain in ambiguous sexual faces, that this effect would be mediated by sexual dysfunction schemas, and that this mediating effect would be moderated and thus significantly greater on trials primed with sexual stimuli; 2) would react faster to probes replacing pain faces, that this effect would be mediated by sexual dysfunction schemas, and that this mediating effect would be moderated and thus significantly greater on trials primed with sexual stimuli. Results from hierarchical linear modeling did not support these hypotheses. However, ancillary analyses revealed a partial mediation effect of helplessness schemas on associations between sexual dysfunction and interpretations of pain in ambiguous faces (indirect effect = β = 0.02, SE = 0.01, Z = 2.27, p = .023; c′ = 0.07, SE = 0.03, Z = 2.57, p = .001). Surprisingly, mediation analyses for predicting reaction time revealed a suppressing effect of undesirability/rejection schemas (β = -0.04, SE = 0.004, Z = -4.46, p < .001) that, when included in the model resulted in an increase in effect from the total effect (β = 0.09, SE = 0.01, Z = 4.35, p < .001) to the direct effect ( β = 0.14, SE = 0.01, Z = 5.64, p < .001), suggesting a dual-process model in which sexual dysfunction slows reaction to pain faces, while sexual schemas enhance attentional vigilance. This suppression effect was further witnessed for Incompetence, Self-Deprecation, and Difference-Loneliness schemas. Moreover, the suppression effects were witnessed in neutral face reaction times, suggesting possible spill-over effects between sexual and neutral-primed trials. Future directions are discussed considering the study’s methodological limitations.

Language

en

Number of Pages

120 p.

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