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Efficacy of Online Psychoeducation and Cognitive Behavior Therapy on Female Sexual Interest/Arousal Disorder: Single Case Design 网络心理教育与认知行为治疗对女性性兴趣/觉醒障碍的疗效:单例设计
Pub Date : 2022-08-01 DOI: 10.1177/26318318221108336
Dauda Akwai Saleh
This case report of brief research communication utilized single case design aimed at studying the efficacy of online psychoeducation and cognitive behavior therapy (CBT) on female sexual interest/arousal disorder. Arizona Sexual Experience Scale (ASEX) was used for data collection. Findings of the study showed that client’s pretest and posttest results significantly differ after online psychoeducation and CBT; sexual arousal, sex drive (desire), vaginal lubrication, orgasm, and orgasm satisfaction significantly improved. Furthermore, significant improvement in the frequency of sexual relationship was found. Outcome of this study should guide clinical psychologists in the area of intervention for sexual disorder, especially among women. It should also serve as a reference material for women suffering with sexual dysfunction and serve as an encouragement not to die in silence but seek for professional help.
本案例报告采用了个案设计,旨在研究在线心理教育和认知行为疗法(CBT)对女性性兴趣/性唤起障碍的疗效。采用亚利桑那性经验量表(ASEX)进行数据收集。研究结果表明,在线心理教育和CBT后,客户的前测和后测结果存在显著差异;性唤起、性欲(欲望)、阴道润滑、性高潮和性高潮满意度显著提高。此外,还发现性关系的频率显著提高。这项研究的结果应该指导临床心理学家在性障碍干预领域,尤其是在女性中。它还应该作为患有性功能障碍的妇女的参考材料,并鼓励她们不要在沉默中死去,而是寻求专业帮助。
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引用次数: 0
Secondary Koro Presenting as Delusional Disorder: A Case Series 继发性Koro表现为妄想障碍:一个病例系列
Pub Date : 2022-07-21 DOI: 10.1177/26318318221110188
A. Chakraborty, D. Bhattacharjee, U. Bandyopadhyay
Koro, a culture-bound syndrome originating from Southeast Asia is characterized by a perception of acute retraction of the penis, accompanied by an acute panic-like reaction of impending danger or death. Koro-like symptoms are considered variants of classical Koro syndrome and differ from it phenomenologically. We described here a case series of secondary Koro, presenting as a delusional disorder who remitted on treatment with antipsychotics and maintained the improvement on follow-up. It is important to differentiate between classical Koro with Koro-like syndrome, with exploration of any delusional core during clinical assessment for better categorization and management.
Koro是一种起源于东南亚的文化束缚综合征,其特征是阴茎急性回缩,并伴有对即将到来的危险或死亡的急性恐慌样反应。Koro样症状被认为是经典Koro综合征的变体,在现象学上与之不同。我们在这里描述了一系列继发性Koro的病例,表现为一种妄想症,在接受抗精神病药物治疗后病情缓解,并在随访中保持改善。区分经典Koro和Koro样综合征很重要,在临床评估中探索任何妄想核心,以更好地分类和管理。
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引用次数: 0
Antidepressants and Sexual Dysfunction: Is Vortioxetine Among the Exceptions? 抗抑郁药与性功能障碍:沃替西汀是例外吗?
Pub Date : 2022-07-01 DOI: 10.1177/26318318221116038
T. Rao, C. Andrade
Depression is associated with impaired sexual functioning.1 Most antidepressant drugs include reduced sexual desire, erectile dysfunction, or orgasmic dysfunction in their adverse effect profile.2 So, in patients who are treated with antidepressants, antidepressant-related sexual dysfunction may replace depression-related sexual dysfunction, creating a situation that is far from desirable. What is the mechanism of antidepressant-induced sexual adverse effects? Antidepressant drugs that inhibit serotonin reuptake, such as the selective serotonin reuptake inhibitors (SSRIs), may decrease sexual desire and delay or prevent sexual orgasm.3,4 Antidepressant drugs that are anticholinergic, such as the tricyclic antidepressants, may interfere with erection.5 Obviously, antidepressants that have both mechanisms, such as clomipramine, could have a wider range of negative action on sexual functioning.6 Few antidepressants that are presently available carry a low to no risk of treatment-emergent sexual dysfunction. These include bupropion, mirtazapine, agomelatine, vilazodone, and vortioxetine.7-9 Agomelatine has failed as an antidepressant in India; bupropion and vilazodone do not enjoy a large market share; and mirtazapine, while effective and popular as an antidepressant, carries the disadvantage of increasing sleep, appetite, and weight.8 So, that leaves vortioxetine. But first, both vilazodone and vortioxetine inhibit the reuptake of serotonin; so why are they free from sexual adverse effects? A possible explanation is that both also act on 5HT1a receptors at which vilazodone is a partial agonist10 and vortioxetine is a full agonist11; this action may be a mitigating element against the sexual dysfunction that is related to serotonin reuptake inhibition. If one discounts atypical antidepressants such as brexanolone and esketamine, vortioxetine is the most recent antidepressant, worldwide. Vortioxetine was approved for the treatment of major depressive disorder (MDD) by the US Food and Drug Administration in September 2013, and by the European Medicinal Agency in October 2013. Since then, vortioxetine has been approved for marketing in about 80 countries across the world, and, very recently, in India, the second largest country by population. Vortioxetine is associated with a favorable adverse effect profile, with most of its treatment-emergent adverse events reported at or near placebo level;12 it carries a low risk of treatment-emergent suicidal ideation12 and, because of its long half-life,13 a low risk of discontinuation syndrome, even upon sudden withdrawal of the drug.12 So, what is the evidence for the favorable sexual adverse effect profile of vortioxetine? In the regulatory, industry-driven, short-term randomized controlled trials (RCTs), the incidence of treatment-emergent sexual adverse events was 1.6% to 1.8% with vortioxetine (5-20 mg/d) as compared with 1.0% with placebo.12 In an industry-driven RCT conducted in 361 healthy adult volunteer
抑郁症与性功能受损有关大多数抗抑郁药物的副作用包括性欲减退、勃起功能障碍或性高潮障碍因此,在接受抗抑郁药治疗的患者中,与抗抑郁药相关的性功能障碍可能会取代与抑郁症相关的性功能障碍,从而造成一种远非理想的情况。抗抑郁药引起的性不良反应的机制是什么?抑制5 -羟色胺再摄取的抗抑郁药物,如选择性5 -羟色胺再摄取抑制剂(SSRIs),可能会降低性欲,延迟或阻止性高潮。抗胆碱能类抗抑郁药,如三环类抗抑郁药,可能会干扰勃起显然,具有这两种机制的抗抑郁药,如氯丙咪嗪,可能会对性功能产生更大范围的负面作用目前可用的抗抑郁药很少有治疗性性功能障碍的风险,甚至没有风险。这些药物包括安非他酮、米氮平、阿戈美拉汀、维拉唑酮和伏替西汀。阿戈美拉汀作为抗抑郁药在印度已经失败;安非他酮和维拉唑酮的市场份额不大;米氮平作为一种抗抑郁药,虽然有效且广受欢迎,但其缺点是会增加睡眠、食欲和体重那么就剩下伏替西汀了。但首先,维拉唑酮和沃替西汀都抑制血清素的再摄取;那么为什么它们没有性副作用呢?一种可能的解释是,两者也作用于5HT1a受体,其中维拉唑酮是部分激动剂10,沃替西汀是完全激动剂11;这种作用可能是一种减轻与血清素再摄取抑制有关的性功能障碍的因素。如果不考虑非典型抗抑郁药,如布雷沙诺酮和艾氯胺酮,伏替西汀是世界范围内最新的抗抑郁药。沃替西汀于2013年9月被美国食品和药物管理局批准用于治疗重度抑郁症(MDD),并于2013年10月被欧洲药品管理局批准。从那时起,沃替西汀已被批准在全球约80个国家销售,最近,在印度,人口第二大的国家。沃替西汀有良好的不良反应,大多数治疗后出现的不良事件与安慰剂水平相当或接近安慰剂水平12;治疗后出现自杀意念的风险很低12,由于其半衰期长,即使突然停药,发生停药综合征的风险也很低12那么,vortioxetine的有利性副作用的证据是什么呢?在监管、行业驱动的短期随机对照试验(rct)中,沃替西汀(5- 20mg /d)组治疗后出现的性不良事件发生率为1.6% - 1.8%,而安慰剂组为1.0%在一项针对361名健康成年志愿者的行业驱动的随机对照试验中,与安慰剂相比,13名帕罗西汀(20mg /d)而非沃替西汀(10和20mg /d)与性不良反应增加相关;与帕罗西汀相比,两种剂量的沃替西汀的性不良反应更少,但只有10mg /d的剂量才有统计学意义。在对重度抑郁症或广泛性焦虑症患者进行的7项短期、行业驱动的随机对照试验的汇总分析中,Jacobsen等人14发现,与安慰剂相比,任何剂量的沃替西汀(5- 20mg /d)治疗后出现的性不良事件都没有显著增加;然而,只有5mg /d的剂量不低于安慰剂。建立了合并分析的检测灵敏度,与安慰剂、沃替西汀5 mg/d和沃替西汀10 mg/d(但不是沃替西汀15和20 mg/d)相比,60mg /d的度洛西汀组的性不良事件明显更高。也许最重要的随机对照试验是Jacobsen等人的试验。15这些作者在沃替西汀和艾司西酞普兰的直接比较中检查了性不良事件。样本包括447名对舍曲林、帕罗西汀或西酞普兰有反应的患者。样本的平均年龄约为40岁。样本中59%是女性。这些患者随机接受沃替西汀(10- 20mg /d)或艾司西酞普兰(10- 20mg /d)治疗8周;每组中超过四分之三的人收到了
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引用次数: 1
Love, Veritably—A Mélange of Love, Intimacy, Attraction, and Sensuality 爱,真实——爱、亲密、吸引力和感觉的混合体
Pub Date : 2022-07-01 DOI: 10.1177/26318318221102126
Keya Das, T. Rao
Love forms the theme of various poems, plays, historic as well as contemporary literature, and is glorified in art and music, deliberated upon in speeches, celebrated on the silver-screen. Nevertheless, the scientific basis of love remains wrapped in mysticism although there have been advances in pinpointing the hormones, neurotransmitters, and more recently the anatomical pathways that play a role in love, with evidence in imaging modalities. We aim at demystifying the role, function, and workings of love and its counterparts—intimacy, attraction, attachment, and sensuality—in this review.
爱情构成了各种诗歌、戏剧、历史文学和当代文学的主题,在艺术和音乐中得到了赞美,在演讲中得到了思考,在银屏上得到了庆祝。尽管如此,爱情的科学基础仍然被神秘主义所包裹,尽管在精确定位激素、神经递质以及最近在爱情中发挥作用的解剖途径方面取得了进展,并在成像模式中获得了证据。在这篇综述中,我们旨在揭开爱及其对应物——亲密感、吸引力、依恋和性感——的角色、功能和运作方式的神秘面纱。
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引用次数: 0
Greater Perceptions of Economic Deprivation in Childhood are Associated with More Sexual Risk Behaviors in Adulthood via Younger Age of Sexual Initiation. 儿童时期对经济剥夺的感知程度越高,成年后性行为的风险就越大。
Pub Date : 2022-07-01 Epub Date: 2022-06-29 DOI: 10.1177/26318318221102375
Julia F Hammett, Kelly Cue Davis
Introduction: Sexual risk behaviors are a public health concern. Although sexual risk behaviors are overrepresented among economically disadvantaged individuals, the mechanisms underlying the link from economic deprivation to sexual risk behaviors are not well understood. Aim: The purpose of this study was to investigate whether one of the earliest indicators of sexual risk, age of sexual initiation, mediates the link between young men’s perceptions of economic deprivation while growing up and sexual risk behaviors in adulthood. Method: Six-hundred twenty-four men provided data on background variables and risk. Path analyses were conducted in Mplus Version 8. Results: Perceptions of economic deprivation while growing up were related to younger age of sexual initiation, which in turn was related to higher risk for sex earlier in a relationship, condomless sex, sexually transmitted infections, unintended pregnancy, and condom use resistance. Conclusion: These findings highlight important avenues for sexual health and health equity promotion.
引言:性风险行为是一个公共卫生问题。尽管性风险行为在经济弱势群体中的比例过高,但经济剥夺与性风险行为之间联系的机制尚不清楚。目的:本研究的目的是调查性风险的最早指标之一,性行为开始的年龄,是否介导了年轻男性在成长过程中对经济剥夺的感知与成年后的性风险行为之间的联系。方法:624名男性提供了有关背景变量和风险的数据。在Mplus版本8中进行了路径分析。结果:成长过程中对经济剥夺的感知与性行为开始的年龄较小有关,而性行为开始年龄较小又与关系早期发生性行为的风险较高、无避孕套性行为、性传播感染、意外怀孕和避孕套使用耐药性有关。结论:这些发现突出了促进性健康和健康公平的重要途径。
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引用次数: 0
Understanding Adolescent Sexuality: A Developmental Perspective 从发展的角度理解青少年性行为
Pub Date : 2022-07-01 DOI: 10.1177/26318318221107598
Anupama V. Hegde, Suhas Chandran, J. Pattnaik
Adolescence is a period of transition from childhood to adulthood, during which the individual undergoes significant biological, psychological, and social changes. The development of sexuality, though begins at conception, gets shaped during this period. The changes occurring differ in males and females not just in terms of biopsychosocial organization but sexual behavior and functioning as well. Adolescent sexuality is although highly acknowledged but is quite complex and needs in-depth understanding. Challenges faced by adolescents include being vulnerable to risky sexual behaviors, unprotected sex, nonconsensual sexual interactions, sexually transmitted infections, stigmatization from society, and so on. In developing countries such as India, adolescents deal with additional challenges with higher risk associated with early marriages, unplanned pregnancies, sexual abuse, patriarchy, and insufficient information regarding sexual behavior and risks. This article is an attempt to review the nuances of adolescent sexuality, particularly in developing countries, to ensure appropriate culturally sensitive yet scientifically sound intervention programs.
青春期是从童年到成年的过渡期,在此期间,个人经历了重大的生理、心理和社会变化。性的发展,虽然始于受孕,但在这一时期形成。男性和女性发生的变化不仅在生物心理社会组织方面不同,而且在性行为和功能方面也不同。青少年性行为虽然得到高度认可,但相当复杂,需要深入了解。青少年面临的挑战包括易受危险性行为、无保护性行为、非感官性行为、性传播感染、社会污名化等的影响。在印度等发展中国家,青少年面临着与早婚、计划外怀孕、性虐待、父权制、,关于性行为和风险的信息不足。这篇文章试图回顾青少年性行为的细微差别,特别是在发展中国家,以确保适当的文化敏感但科学合理的干预计划。
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引用次数: 3
Theta Burst Stimulation for Male Sexual Dysfunction in Bipolar Depression—A Case Series Theta爆裂刺激治疗男性双相抑郁性功能障碍——一系列病例
Pub Date : 2022-07-01 DOI: 10.1177/26318318221102125
Gunjan Malik, Namdev Chawan, Preeti Mishra, Shobit Garg, S. Tikka, Priya Tyagi
1 Department of Clinical Psychology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India 2 Department of Psychiatry, ESIC Medical College, Gulbarga, Karnataka, India 3 Department of Psychiatry, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India 4 Department of Psychiatry, All India Institute of Medical Sciences (AIIMS) Bibinagar, Hyderabad, Telangana, India
1临床心理学系,Shri Guru Ram Rai医学和健康科学研究所,德拉敦,北阿坎德邦,印度,2精神学系,ESIC医学院,古尔巴加,卡纳塔克邦,印度,3精神学系,Shri Guru Ram Rai医学和健康科学研究所,德拉敦,北阿坎德邦,印度,4精神学系,全印度医学科学研究所(AIIMS)比比纳加尔,海得拉巴,泰伦加纳邦,印度
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引用次数: 0
Psychosexual Advantages of Physical Adaptation 生理适应的心理性优势
Pub Date : 2022-07-01 DOI: 10.1177/26318318221108116
Sujita Kumar Kar, Garima Singh
Physical adaptation is a process by which an organism attempts to adjust successfully with the changes happening in the environment continuously. Organisms adapting effectively in this process have an advantage of long survivability. During the process of evolution, several physical (structural) changes happened in humans that gives them a reproductive advantage. This article discusses the specific physical adaptations that gives psychosexual advantages in human.
生理适应是生物体试图成功地适应环境不断发生的变化的过程。在这一过程中有效适应的生物具有长期生存的优势。在进化过程中,人类发生了一些生理(结构)变化,使他们具有生殖优势。本文讨论了人类在性心理方面的特殊生理适应。
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引用次数: 0
Attitudes Toward Transgender Persons Among Medical Students of a Tertiary Health-Care Center: A Cross-Sectional Exploratory Study 某三级医疗保健中心医学生对跨性别者态度的横断面探索性研究
Pub Date : 2022-07-01 DOI: 10.1177/26318318221107350
H. Jain, Karthick Subramanian, Keni Gowsi, A. Sankaran
Background: Inadequate knowledge and awareness about transgenderism among doctors can lead to inadequate health-care services to transgender persons. Objective: To assess the prevalent attitudes and beliefs toward transgender persons amongst medical undergraduates. Materials and Methods: The present cross-sectional observational study included medical undergraduates of both gender in a tertiary care hospital. The students belonged to “early clinical phase” (yet to start clinical postings). The sociodemographic characteristics and academic and social exposure to transgender-related issues were recorded using a semi-structured proforma. Transgender Attitudes and Beliefs Scale was used to assess the attitudes and beliefs toward transgender persons. Statistical significance was set at P < .05. Results: Of the 170 second-year medical students, majority reported negligible social exposure (71.3%) and academic exposure (81.6%) to transgenderism. Female students displayed better attitudes and beliefs toward transgender persons than their male counterparts. Conclusions: Medical undergraduates require systematic academic exposure to transgender-related health issues. Gender differences exist among medical undergraduates in the beliefs and attitudes toward transgenderism.
背景:医生对变性的认识和认识不足可能导致对变性人的医疗服务不足。目的:了解医学本科生对跨性别者的普遍态度和信仰。材料和方法:本横断面观察性研究包括一家三级护理医院的男女医学本科生。这些学生属于“早期临床阶段”(尚未开始临床实习)。使用半结构化形式表记录了跨性别相关问题的社会人口学特征以及学术和社会暴露情况。跨性别态度和信仰量表用于评估对跨性别者的态度和信仰。统计学显著性设定为P<0.05。结果:在170名二年级医学生中,大多数人报告称,他们对变性的社会接触(71.3%)和学业接触(81.6%)微不足道。女生对跨性别者表现出比男生更好的态度和信念。结论:医学本科生需要系统的学术接触跨性别相关的健康问题。医学生对变性的信仰和态度存在性别差异。
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引用次数: 0
Intimate Relationships Among Physicians—A Critical Revisit 医生之间的亲密关系——一个批判性的回顾
Pub Date : 2022-07-01 DOI: 10.1177/26318318221108522
C. Peisah, Kiran Lele
The psychosexual health of doctors and the “medical marriage” has been scrutinized since the dawn of doctors’ health science in the late 1980s.1,2 However, the traditional prototype of hard-working physician-husband and self-sacrificing, stay at home wife, with the latter “waiting for someday” has evolved into a plethora of relationship and role configurations amongst heterosexual and same sex partnerships at various stages of the medical life cycle.3,4 A range of social and systemic changes within and external to the medical profession—including but not limited to the “feminization” of the profession and the rise in dual physician households— have influenced the norms and frames of reference among male and female doctors alike.5,6 These diverse personal, relational, and cultural aspects means that stereotypes and broad assumptions regarding doctors’ relationships are no longer applicable. Notwithstanding these variations, established links between well-being, job satisfaction, and marital satisfaction7,8 and ultimately, patient care9 mandates understanding the unique aspects of doctors’ relationships for the benefit of doctors and patients alike. In this article, we explore medical relationships from a contemporary lens, recognizing this diversity as well as examining the effects of the COVID pandemic. We also posit potential solutions.
自20世纪80年代末医生健康科学出现以来,医生的性心理健康和“医学婚姻”一直受到关注。1,2然而,勤劳的医生丈夫和自我牺牲的全职妻子的传统原型,随着后者的出现,“等待某一天”已经演变成医学生命周期各个阶段异性恋和同性伴侣之间的大量关系和角色配置。3,4医学行业内外的一系列社会和系统性变化,包括但不限于该行业的“女性化”和双重医生的兴起家庭——影响了男性和女性医生的规范和参考框架。5,6这些不同的个人、关系和文化方面意味着关于医生关系的刻板印象和广泛假设不再适用。尽管存在这些差异,但在幸福感、工作满意度和婚姻满意度之间建立了联系7,8最终,患者护理9要求了解医生关系的独特方面,以造福医生和患者。在这篇文章中,我们从当代的角度探讨了医学关系,认识到这种多样性,并研究了新冠肺炎疫情的影响。我们还提出了潜在的解决方案。
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引用次数: 1
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Journal of Psychosexual Health
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