Gender differences in cognitive interference with sexual arousal

It is well documented that cognitive interference detrimentally influences sexuality, but little is known about the content of that interference. This study compared the self-reports of 220 college men and 337 college women on two types of cognitive interference during sex, performance-oriented and appearance-oriented. Also assessed via use of the Derogatis Sexual Functioning Inventory and the Sexual History Form were: sexual satisfaction, psychological distress, sexual knowledge, sexual experiences, sexual attitudes, sexual fantasy, body image, affect, and sexual functioning, all areas thought to be related to sexual functioning. As predicted, findings indicated that women were more concerned with their own appearance during sexual activity than were men. Contrary to our hypothesis, however, men and women did not differ significantly in self-reported performance-interference. Data also suggested that certain constructs were gender-specific predictors of the two types of interference, as psychological distress was predictive for women and sexual attitudes were predictive for men only. Most constructs were non gender-specific, as sexual satisfaction, body image and our covariate, length of relationship, were predictive in both men and women. Implications are discussed, as results point to the need for gender-specific treatments for sexual dysfunction

Remembering the pain: Psychosocial factors related to endometriotic pain and its recall

Endometriosis is a chronic and debilitating disease, affecting women of childbearing years in a variety of ways, including infertility, dyspareunia, dysmenorrhea, and chronic pelvic pain. Diagnosis and treatment planning are guided primarily by retrospective pain recall, regardless of the fact that (1) there is only a tenuous relationship between pain reports and physical pathology and (2) the accuracy of pain recall has never been assessed in this population. The current study investigated the accuracy of endometriotic pain recall over a 30-day period, as well as potential psychological mediators to pain recall accuracy, including general psychological wellbeing, distress specific to infertility, passive and active coping, and pain present at time of recall. Contrary to expectations, findings indicated that women were relatively accurate in their recall of pain. Only passive coping and pain present at recall were predictive of accuracy, with greater passive coping and lower pain at recall predictive of higher recalled than recorded pain. Study implications are discussed, including: (1) report of pain over a 30-day duration appears credible for the majority of endometriotic patients and (2) women exhibiting greater passive coping may benefit from psychological treatment in addition to medical intervention

Remembering the pain: Accuracy of pain recall in endometriosis

Endometriosis diagnosis and treatment planning are guided primarily by retrospective pain recall, despite the facts that (1) there is only a tenuous relationship between pain reports and physical pathology, and (2) the accuracy of pain recall has never been assessed in this population. The current study investigated the accuracy of endometriotic pain recall for pain experienced over a 30-day period, as well as potential psychological mediators of pain recall accuracy, including psychological wellbeing, distress specific to infertility, passive and active coping, and pain present at time of recall in 100 women with endometriosis. Findings indicated that women were relatively accurate in their recall of pain. Only passive coping and pain present at recall were predictive of accuracy, with greater passive coping and lower pain at recall predictive of overestimation of past pain. Study implications are discussed, including: (1) report of pain over a 30-day duration appears credible for the majority of patients with endometriosis and (2) women exhibiting greater passive coping may benefit from psychological treatment in addition to medical intervention

Gender differences in the content of cognitive distraction during sex

This study compared 220 college men and 237 college women on two types of self‐reported cognitive distraction during sex, performance‐ and appearance‐based. We assessed affect, psychological distress, sexual knowledge, attitudes, fantasies, experiences, body image, satisfaction, and sexual function with the Dewgatis Sexual Functioning Inventory and the Sexual History Form to determine associations with distraction. Between‐gender analyses revealed that women reported higher levels of overall and appearance‐based distraction than did men, but similar levels of performance‐based distraction. Within‐gender analyses revealed that women reported as much of one type of distraction as the other, while men reported more performance‐ than appearance‐based distraction. In women, appearance‐based distraction was predicted by negative body image, psychological distress, and not being in a relationship, while performance‐based distraction was predicted by negative body image, psychological distress, and sexual dissatisfaction. In men, appearance‐based distraction was predicted by negative body image, sexual dissatisfaction, and not being in a relationship, while performance‐based distraction was predicted by negative body image and sexual dissatisfaction. Investigating the content of cognitive distraction may be useful in understanding gender differences in sexual experience and in refining cognitive components of sex therapy

Female veterans of the OEF/OIF conflict: Concordance of PTSD symptoms and substance misuse

This study examined the post-deployment rates of comorbid PTSD and substance abuse in a cohort of female veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Female OEF/ OIF veterans and reservists (N=36) completed a battery of assessments as part of a larger study. Of the 36 participants, 11 (31%) screened positive for posttraumatic stress disorder (PTSD), 17 (47%) screened positive for high-risk drinking and 2 (6%) screened positive for drug abuse. Higher scores on measures of alcohol and drug use predicted positive PTSD status (p≤0.01) and alcohol misuse was significant in explaining unique variance of PTSD status (p≤0.05). Our findings suggest a trend toward increased problematic drinking among female OEF/OIF veterans and reservists and a relationship between substance misuse and PTSD. Future research should investigate needs for gender-specific PTSD and substance-abuse treatment needs

Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans.

Previous studies have found an association between childhood maltreatment (CM) and health-related quality of life (HRQoL), and to a lesser extent have considered whether psychiatric symptoms may explain the relationship. This study aimed to further our understanding of the link between CM and HRQoL by testing whether posttraumatic stress disorder (PTSD) or depressive symptoms mediate the relationship between childhood maltreatment and physical HRQoL. Mediation models were examined in a sample of male Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) active duty and combat veterans (n=249). PTSD and depressive symptoms mediated the relationship between CM and overall physical HRQoL, as well as participation in daily activities due to physical health, bodily pain, and social functioning. Mediation of the relationship between childhood maltreatment and physical and social functioning by depression and PTSD symptoms may lend support to neurobiological hypotheses that childhood maltreatment sensitizes the nervous system and after repeated trauma may lead to the development of psychiatric symptoms, which have a major impact on morbidity and mortality

Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans.

Previous studies have found an association between childhood maltreatment (CM) and health-related quality of life (HRQoL), and to a lesser extent have considered whether psychiatric symptoms may explain the relationship. This study aimed to further our understanding of the link between CM and HRQoL by testing whether posttraumatic stress disorder (PTSD) or depressive symptoms mediate the relationship between childhood maltreatment and physical HRQoL. Mediation models were examined in a sample of male Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) active duty and combat veterans (n=249). PTSD and depressive symptoms mediated the relationship between CM and overall physical HRQoL, as well as participation in daily activities due to physical health, bodily pain, and social functioning. Mediation of the relationship between childhood maltreatment and physical and social functioning by depression and PTSD symptoms may lend support to neurobiological hypotheses that childhood maltreatment sensitizes the nervous system and after repeated trauma may lead to the development of psychiatric symptoms, which have a major impact on morbidity and mortality

Alcohol-Related Consequences Mediating PTSD Symptoms and Mental Health-Related Quality of Life in OEF/OIF Combat Veterans.

Veterans returning from Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) have been found to be at increased risk for post-traumatic stress disorder (PTSD) and alcohol use disorders, leading to negative mental health-related quality of life (MHRQoL). The current study examined the unique impact of alcohol consumption levels versus alcohol-related consequences on the relationship between PTSD symptoms and MHRQoL in a sample of OEF/OIF combat veterans (N = 205, median age 29, 95% men). Mediation analyses indicated that the effect of PTSD symptoms on MHRQoL was explained only by alcohol-related consequences and not by alcohol consumption. Findings highlight the importance of including alcohol-related consequences in clinical assessment and intervention programs for OEF/OIF veterans. Additionally, this study enhances knowledge regarding the underlying mechanisms of functional impairment related to PTSD and alcohol use disorders

Conflicts of interest in the context of end of life care for potential organ donors in Australia

End-of-life (EOL) care has become an integral part of intensive care medicine and includes the exploration of possibilities for deceased organ and tissue donation. Donation physicians are specialist doctors with expertise in EOL processes encompassing organ and tissue donation, who contribute significantly to improvements in organ and tissue donation services in many countries around the world. Donation physicians are usually also intensive care physicians, and thus they may be faced with the dual obligation of caring for dying patients and their families in the intensive care unit (ICU), whilst at the same time ensuring organ and tissue donation is considered according to best practice. This dual obligation poses specific ethical challenges that need to be carefully understood by clinicians, institutions and healthcare networks. These obligations are complementary and provide a unique skillset to care for dying patients and their families in the ICU.In this paper we review current controversies around EOL care in the ICU, including the use of palliative analgesia and sedation specifically with regards to withdrawal of cardio respiratory support, the usefulness of the so-called doctrine of double effect to guide ethical decision-making, and the management of potential or perceived conflicts of interest in the context of dual professional roles

The Peritraumatic Behavior Questionnaire: development and initial validation of a new measure for combat-related peritraumatic reactions

Abstract Background Posttraumatic stress disorder (PTSD) is one of the most commonly observed stress-related conditions following combat exposure and its effective prevention is a high health-care priority. Reports of peritraumatic reactions have been shown to be highly associated with PTSD among combat exposed service members. However, existing instruments measuring peritraumatic symptoms were not specifically developed to assess combat-related peritraumatic stress and each demonstrates a different peritraumatic focus. We therefore developed the Peritraumatic Behavior Questionnaire (PBQ), a new military-specific rating scale focused upon the wide range of symptoms suggestive of combat-related peritraumatic distress in actively deployed Service Members. This study describes the development of the PBQ and reports on the psychometric properties of its self-rated version (PBQ-SR). Methods 688 Marine infantry service members were retrospectively assessed by the PBQ-SR within the scope of the Marine Resiliency Study after their deployment to war zone. Participants have been additionally assessed by a variety of questionnaires, as well as clinical interviews both pre and post-deployment. Results The PBQ-SR demonstrated satisfactory internal consistency, convergent and discriminant validity, as well as high correlation with trait dissociation prior to deployment. Component analysis suggested a latent bi-dimensional structure separating a peritraumatic emotional distress and physical awareness factor. The PBQ-SR total score showed high correlation to general anxiety, depression, poorer general health and posttraumatic symptoms after deployment and remained a significant predictor of PTSD severity, after controlling for those measures. The suggested screening cut-off score of 12 points demonstrated satisfactory predictive power. Conclusions This study confirms the ability of the PBQ-SR to unify the underlying peritraumatic symptom dimensions and reliably assess combat-related peritraumatic reaction as a general construct. The PBQ-SR demonstrated promise as a potential standard screening measure in military clinical practice, while It’s predictive power should be established in prospective studies