Books helpful to patients with sexual and marital problems

Providing patients with helpful and timely resource materials requires clinicians to be familiar with an ever-changing and over-whelmingly large body of information. To assist clinicians in the task of assembling current useful materials, we surveyed members of the Society for Sex Therapy and Research by mail and an electronic listserve. The survey forms requested respondents to list books, videotapes, and Internet sites that they recommended to their patients with specific sexual/marital problems. Fifty-two of 216 surveys were returned for a response rate of 24%. Responses were included if they were cited at least three times. Each citation was verified for accuracy and developed into an acceptable journal-quality reference. Frequency counts for responses were calculated, and a bibliography was developed.     

Does marital therapy enhance the effectiveness of treatment for sexual dysfunction?

A controlled treatment trial was conducted with couples in which the woman suffered from secondary forms of sexual dysfunction. To test whether marital therapy is helpful in enhancing the effectiveness of symptom-specific therapy for sexual dysfunction, two treatment conditions were compared to a waiting list control group. All couples received 12 sessions of therapy directed to the sexual symptom. One half of the couples received nine sessions of relaxation and information before sex therapy, and the other half, nine sessions of marital therapy before sex therapy. Whereas both treatment conditions showed clinical and statistical improvement at termination and follow-up, treatment gains were more pronounced and more comprehensive for the couples who received the combination of marital and sex therapy. Generalization from marital therapy to sexual functioning was greater than generalization from sex therapy to marital adaptation.     

Social work practice and sex counseling

Sexual health is an important part of total health as sexual problems can disrupt health, quality of life, and general wellbeing, causing in many instances marital problems or marriage dissolution, and emotional impoverishment. Social workers involved in sex counseling have wider responsibilities in view of increase incidence of sexually transmitted diseases and AIDS (acquired immune deficiency syndrome). Sex counselors and Clinical Psychologist today need to understand the changing social environment and challenging role in making people accept normal sexual practices, abstaining from perversion and safe sexual rehabilitation by behavioral therapy and counseling for having happy marital life. Challenges in sex counseling, existing sex practices in society and mode for future counselling has been discussed.     

Marital and sexual satisfaction in Chinese families: exploring the moderating effects

This study examines the relationship between marital satisfaction and sexual satisfaction in Chinese families. Hierarchical multiple regression using data from the 1993 China Housing Survey indicates that, when controlling for the other variables, sexual satisfaction has considerable impact on marital satisfaction. We also found that the effects of sexual satisfaction on marital satisfaction are moderated by gender and education. The study suggests that marriage counseling, with an emphasis on promoting awareness of sexual quality, would be helpful in addressing marital problems in Chinese families.     

Sexual desire and relationship functioning: the effects of marital satisfaction and power

The present study examined the association among marital satisfaction, marital power, and sexual desire in a sample of 60 community couples. We predicted that marital satisfaction would be positively correlated with sexual desire and that this association would be moderated by marital power, such that marital satisfaction would be more strongly correlated with sexual desire among individuals who perceive themselves as having less power in their relationship. Results indicated that marital satisfaction was significantly associated with sexual desire, but there was no evidence for the moderating effects of various forms of marital power.     

Evaluation of Sex Education Curricula: Measuring Up to the SIECUS Guidelines

ABSTRACT: Most sexuality education curricula developed the past 20 years were not thoroughly evaluated. This study provides results from a content analysis of 10 sexuality education curricula for junior and senior high school students. Nine nationally available sexuality education curricula and one curriculum guide comprised the sample. The basis for analysis was the Guidelines for Comprehensive Sexuality Education, developed by the Sex Information and Education Council of the U.S. (SIECUS) and an instrument developed to measure bias in the curricula. Trained coders found that Sex Respect and Teen Aid addressed less than half the topics suggested by the SIECUS guidelines. Several of the curricula contained gender and sexual orientation bias. Certain key concepts such as "Sexual Behavior" and "Society and Culture" were not adequately addressed by most of the curricula. Findings indicate that of 10 curricula, only six are considered acceptable for educating junior and senior high school students.     

Enhancing marital sexuality: an evaluation of a program for the sexual enrichment of normal couples

The popular but little researched sexual enrichment program developed by LoPiccolo and Miller was modified and the revised Enhancing Marital Sexuality (EMS) program was evaluated using the Sexual Interaction Inventory (SII) and the Dyadic Adjustment Scale (DAS). A pretest-posttest-follow-up control group design was used to assess the effectiveness of EMS in improving couples' sexual and marital satisfaction. Thirty-four couples were randomly assigned (with replacements) to either the no-treatment control condition or the 11-hour EMS program. Results indicated extensive short-term improvements in sexual satisfaction for both sexes and some short-term gains in marital satisfaction for couples. At 3-month follow-up, improvement was sustained on SII scales of perceptual accuracy for both sexes, and on self-acceptance and pleasure scales for females. No marital satisfaction gains were evident at follow-up. It was concluded that long-term sexual satisfaction gains, especially for females, justify the continued use and refinement of the EMS program. Findings also indicated that marital satisfaction may be too broad a category to be affected by educational training with as specific a focus as sexual enhancement. Suggestions are made for further research.     

未婚流产少女男伴首次性行为的年龄及其影响因素

目的:了解北京和济南两地未婚流产少女男伴首次性行为的年龄及其影响因素。方法:采用自编结构式问卷对北京和济南两地共467名未婚流产少女的男性伴侣进行调查。结果:未婚流产少女的男性伴侣首次发生性行为的平均年龄为(20.25±2.72)岁,首次性行为的前两位原因依次为"好奇,想知道性交感受"(43.0%),"生理需要"(32.3%)。单因素分析结果表明,首次性行为年龄(≤18岁组和>18岁组)与性态度、首次接触描写性行为的书刊/录像/网站的年龄、被迫性行为、紧急避孕、吸烟、饮酒、暴力冲突等13个因素有关(P<0.05)。多元因素分析结果提示,接触描写性行为书刊/录像/网站的年龄过早和过去1年与家人发生冲突的次数多是过早发生性行为的危险因素。结论:未婚流产少女男伴首次性行为的年龄较早,过早发生性行为的男伴健康危险行为和不安全性行为的发生率较高。     

The medicalization of female sexual dysfunction: the need for caution

The use of drugs such as Viagra to treat sexual dysfunction in women may be beneficial in a proportion of cases. However, there are a number of barriers to understanding and predicting which women are likely to benefit, and caution is required in approaching this clinical issue. Three relevant issues are discussed: (1) Male-female differences in sexuality. Three complimentary ways in which male and female sexuality differs are considered--women have less need for their sexuality to be influenced by reproductive hormones; their needs for sexual enjoyment and orgasm are not well met by conventional vaginal intercourse; and, as a result of the disjunction between female sexual response and reproduction and a possibly greater propensity for central inhibition of sexual response, women are more susceptible to the repressive effects of social constraints on sexuality; (2) Sex therapy. While conventional forms of sex therapy are well designed to address the particular psychological needs of women as well as men, the interface between psychological processes and physiological response is not well understood. For the same reason, we should expect difficulty in predicting when pharmacological effects on sexual response will be beneficial; (3) When is a sexual problem a sexual dysfunction? It is likely that many cases of impaired sexual response or interest in women are psychologically understandable and hence adaptive reactions to problems in the sexual relationship, and hence not dysfunctions. Until we can distinguish between such adaptive inhibitions of response and those that are maladaptive dysfunctions, we will have difficulty in predicting when pharmacological treatment will be helpful.     

The influence of marital therapy on sexual satisfaction

The influence of behavioral marital therapy on sexual satisfaction was assessed in 44 consecutive cases for which pre and post data were obtained. There were significant increases in both marital and sexual satisfaction associated with marital therapy. Sexual problems were presented in approximately 40% of the cases, but whether sex was presented as a problem or not generally did not affect therapy outcome. Positive feelings toward spouse or caring for one's spouse improved significantly from pre- to posttherapy.     

Risk factors of sexually transmitted infections among migrant and non-migrant sexual partnerships from rural South Africa

In October 1998, cohorts of circular migrant men and their non-migrant sexual partners, and non-migrant men and their non-migrant sexual partners from rural South Africa were recruited and followed-up every 4 months until October 2001. At each visit, information on sociodemographic, sexual behaviour, sexually transmitted infections (STIs) and HIV was collected. In total, 553 individuals aged between 18 and 69 years were recruited. A man and his sexual partner(s) form a sexual partnership. Migration status, age, marital status, age at sexual debut, recent sexual partners and HIV status were found to be important determinants of STI. The risk of STI varies (sigma2 = 1.45, P < 0.001) significantly across sexual partnerships even after controlling for important determinants. The variance implies substantial correlation (0.59) between members of the same sexual partnership. Ignoring this correlation leads to incorrect inference. Migration contributes significantly to the spread of STIs. Community interventions of HIV/STI should target co-transmitter sexual partnerships rather than high-risk individuals.     

The effect of chronological and theoretical birth order on sexual attitudes and behaviors

A survey designed to evaluate the impact that both chronological and theoretical birth order may have on sexual attitudes and behaviors was completed by 441 respondents (221 male, 220 female). The attitudes and behaviors investigated were aggressive sexual behavior, social relationship attitudes, emotional relationship attitudes, total heterosexual behavior, and total orgasmic behavior. The data revealed no difference between male and female in terms of total sexual behavior. However, males had significantly higher sexual aggression, social attitudes, emotional attitudes, and total orgasm scores. These results suggest that while there may be equity between the sexes in terms of heterosexual behavior, there are still significant differences between the sexes in terms of specific behaviors and attitudes. No differences were found on any of the scales based on either chronological or theoretical birth order. These results suggest that sexual behavior and attitudes may be influenced to a greater degree by biological and cohort factors than by sibling position.An earlier version of this paper was presented at the Joint Annual Meeting of the Midcontinent Region of the Society for the Scientific Study of Sex and the Indiana/Illinois section of the American Association of Sex Educators, Counselors, and Therapists, Bloomington, Indiana, April 1987.     

Sexual and marital counseling with men treated for testicular cancer

Testicular cancer patients are at risk for sexual and marital problems because their cancer and its treatment reduce their fertility and disrupt intimate relationships at a crucial life stage (age 15-34). Chemotherapy, radiotherapy and surgery have successfully increased survival rates, but at the price of infertility and sexual dysfunction. A survey of men treated for nonseminomatous tumors revealed that 20% had low levels of sexual activity, 10% had erectile dysfunction, 6% had difficulty reaching orgasm, and 38% reported decreased orgasmic pleasure. Sexual anxiety related to cancer treatment accounts for much of this dysfunction, but organic factors such as hormonal, vascular or neurologic damage may also contribute. Reactions of couples to infertility and marital conflicts common in this group are discussed. Suggestions for sexual and marital counseling are offered.     

Sexual behavior among truck drivers

A cross-sectional study was conducted on Lucknow highway in Bareilly district of Uttar Pradesh to study the knowledge of truck drivers about HIV transmission and prevention and to study the sexual behaviour of these drivers with reference to HIV/AIDS. Age, marital status, education, income, drinking alcohol, length of stay away from home, knowledge about transmission and prevention of HIV, and HIV-prone behavior of truck drivers were studied. Chi-square, mean, and SD were calculated. In all, 289 (97.6%) drivers had heard about HIV/AIDS. Only 242 (81.8%) were aware of HIV transmission by heterosexual route. Misconceptions such as HIV transmission by mosquito bites, living in same room, shaking hands, and sharing food were found. Out of 174 (58.8%) who visited Commercial Sex Workers (CSW), 146 (83.9%) used a condom. 38 (12.8%) visited more than 5 CSW in the last 3 months. Time away from home on the road, marital status, alcohol use, and income class were associated with visiting CSW. High-risk behavior was established in the study population. Safe sex and use of condoms need to be promoted among the truck drivers and better condom availability needs to be assured on highways.     

Factors related to sexual functioning in male patients undergoing hemodialysis and with kidney transplants

The sexual functioning of 13 male patients undergoing renal dialysis and 13 male patients who had received kidney transplants was compared. Standardized interviews were used to assess the frequency of intercourse before illness, during dialysis, and after transplantation and to assess sexual difficulties experienced during these periods. In addition, plethysmographic recordings of erection levels were obtained for three dialysis and three transplant patients at eight separate time periods corresponding to particular points in the dialysis cycle. Assessments of depression and anxiety (IDA scale) and renal functioning (Marital Patterns Test) were also carried out. Dialysis patients were less able to gain and maintain erections than transplant patients and intercourse was less frequent for couples where the husband was on dialysis. Dialysis patients were more depressed than transplant patients, although transplant patients showed greater levels of anxiety. More marital difficulties were experienced by patients on dialysis than patients who had received transplants. The implications of these findings for the treatment of sexual problems in these patients are discussed.