Research into the efficacy and cost-effectiveness of brief, free of charge and anonymous sex counselling to improve (mental) health in youth: Design of a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>The capacity to form romantic relationships and sexual health of adolescents in the Netherlands are compromised by several factors, including young age of first intercourse and adolescent depression. Several thresholds like own expenses, trust and embarrassment prevent adolescents to seek help for their sexual problems. To overcome these thresholds, brief sex counselling has been developed. It has been used since 2006 within the Rotterdam-Rijnmond Public Health Service, but there is lack of information about the (cost-) effectiveness. In the current study we will evaluate the (cost-) effectiveness of brief sex counselling for sexual problems in adolescents and young adults between 18 and 25 years of age.</p> <p>Methods</p> <p>In a randomised controlled trial we will compare (1) brief sex counselling with (2) intensive sexological treatment, and (3) delayed treatment (waiting list). Embedded in this RCT will be a trial-based economic evaluation, looking at the cost-effectiveness and cost-utility of brief sex counselling versus the two other interventions. Four hundred fifty adolescents (aged 18-25) with sexual problems will be recruited among the persons who visit the Public Health Service (PHS) and through various websites. After a screening procedure, eligible participants will be randomly allocated to one of the three intervention groups. Primary outcome measure of the clinical evaluation is the severity of sexual problems. Other outcomes include psychological distress, especially depression. The economic evaluation will be performed from a societal perspective. Costs will be assessed continuously by a retrospective questionnaire covering the last 3 month. All outcome assessments (including those for the economic evaluation) will take place via the internet at baseline, and at 3, 6, 9, and 12 months after baseline.</p> <p>Discussion</p> <p>The proposed research project will be the first study to provide preliminary data about the effect and cost-effectiveness of brief sex counselling in youth in comparison with intensive sexological treatment and delayed treatment. It is anticipated that positive results in (cost-) effectiveness of the proposed intervention will contribute to the improvement of sexual health care for adolescents and young adults.</p> <p>Trial registration</p> <p>The study has been registered at the Netherlands Trial Register, part of the Dutch Cochrane Centre (NTR1952)</p

De rol van psychische klachten in de samenhang tussen seksueel functioneren en de ervaren relatietevredenheid bij vrouwen

Het doel van deze studie was om de samenhang tussen seksueel functioneren en relatietevredenheid te onderzoeken bij Nederlandse vrouwen met een heteroseksuele relatie. Daarnaast is onderzocht in welke mate psychische klachten de samenhang tussen seksueel functioneren en relatietevredenheid modereert. Er werd een significante positieve samenhang tussen seksueel functioneren en relatietevredenheid gevonden, en een significante negatieve samenhang tussen psychische klachten en seksueel functioneren en tussen psychische klachten en relatietevredenheid. Het negatieve verband tussen relatietevredenheid en seksueel functioneren werd versterkt door de aanwezigheid van hogere depressieniveaus. Een potentiële implicatie van de huidige bevindingen voor de klinische praktijk is dat het secuur uitvragen van de problemen en beschermende factoren op alle bovenstaande gebieden relevant is. Op deze manier kan de behandeling beter aansluiten bij de mogelijke comorbiditeit en kan recidive van seksuele en relationele problematiek worden voorkomen

Associations Between Personality Disorder Characteristics, Psychological Symptoms, and Sexual Functioning in Young Women

Abstract Background Recently, the etiology of sexual dysfunctions in women has been approached from different angles. In clinical practice and in previous studies, it has been observed that women with sexual problems experience anxiety problems and express more rigid and perfectionistic personality traits than women without these problems. Aim To investigate whether personality disorder characteristics according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) and psychological symptoms are associated with sexual problems in women. Methods 188 women 18 to 25 years old participated in this cross-sectional study. Questionnaires measuring sexual functioning (Female Sexual Function Index), personality disorder characteristics (Assessment of DSM-IV-TR Personality Disorders Questionnaire), and psychological symptoms (Brief Symptom Inventory and Center for Epidemiological Studies Depression Scale) were used. Outcome The main outcome measure used was sexual functioning assessed by self-report. Results Results, using analysis of variance, indicated that women with sexual problems report significantly more cluster A (specifically schizoid) and C (specifically avoidant and obsessive-compulsive) personality disorder characteristics than women without sexual problems. Furthermore, using multiple regression analyses, higher cluster A (specifically schizoid) and lower cluster B (specifically borderline and antisocial) personality disorder characteristics indicated lower levels of sexual functioning. Psychological symptoms partly mediated the effect of cluster A personality disorder characteristics on sexual functioning. Clinical Implications The results of this study indicate that clinical practice should extend its scope by focusing more on improving adaptive personality characteristics, such as extraversion and individualism seen in cluster B personality characteristics, and decreasing the perfectionistic, introvert, and self-doubting characteristics seen in cluster C personality characteristics. Strengths and Limitations Because of the correlational design and use of self-report measures, causal relations cannot be established between personality disorder characteristics and sexual functioning. Conclusion Overall, the results indicate that personality disorder characteristics can play an important associative role in the development and maintenance of sexual functioning problems in women. </jats:sec

Associations of Implicit and Explicit Sexual Double Standard Endorsement and Sexual Assertiveness with Sexual and Interactional Competence in Emerging Adults

In this study, among emerging adults, we investigated the interrelationships of explicit and implicit measures of sexual assertiveness (SA) and sexual double standard endorsement (SDS) on the one hand, and different aspects of sexual and interactional competence (SAIC) on the other hand, using Partial Least Squares Path Modeling (PLS-PM) of cross-sectional data. Participants were 159 sexually active, heterosexual individuals in the Netherlands between 18 and 25 years. No exclusion criteria were used. The Sexual Competence and Interaction Competence in Youth and lifetime number of sexual partners were used to measure SAIC. Explicit SA was measured using the Hurlbert Index of Sexual Assertiveness, while Explicit SDS was assessed using the Scale for the Assessment of Sexual Standards in Youth. Two implicit association tests were performed to measure implicit SA and SDS. Participants accessed these computerized reaction time tasks via a secure online data collection platform. Results showed a strong association between the latent factors of sexual attitudes and SAIC. Greater SA and lower SDS were associated with a greater competence level. No gender effects were found.</p