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Article Excerpt
A small body of research indicates that men have some voluntary control over sexual arousal, as assessed using penile plethysmography (PPG; Abel, Blanchard, & Barlow, 1981; Adams, Motsinger, McAnulty, & Moore, 1992; Freund, 1963, 1965, 1967; Golde, Strassberg, & Turner, 2000; Henson & Rubin, 1971; Laws & Rubin, 1969; Mahoney & Strassberg, 1991; McAnulty & Adams, 1991; Quinsey & Bergersen, 1976; Quinsey & Carrigan, 1978). This research was largely motivated by concern among forensic practitioners that sexual preference testing using PPG may be vulnerable to faking by some sexual offenders. Sexual preference testing for sexual offenders is an essential component of comprehensive offender management, as inappropriate sexual preference (i.e., preference for sexual violence or underage targets) is a strong predictor of risk for reo-ffence (e.g., Hanson & Morton-Bourgon, 2004). The PPG, which is applied on the assumption that degree of erection is a valid peripheral indicator of central sexual arousal (e.g., Geer & Head, 1990), is currently the best measure of inappropriate sexual preference.
In past PPG faking studies, participants were asked to either suppress penile responses to preferred stimuli, maximize responses to non-preferred stimuli, or both. Early evidence showed that arousal could be suppressed (Abel, Blanchard, & Barlow, 1981; Freund, 1963, 1965, 1967; Quinsey & Bergersen, 1976; Quinsey & Carrigan, 1978). However, sample sizes were very small, and no techniques were used to control for distraction. It was quite possible that, when instructed to try to suppress arousal, participants merely distracted themselves from the stimuli by looking away from them, closing their eyes, or focusing on sexually repulsive thoughts. This oversight was corrected in later, well-controlled studies (Henson & Rubin, 1971; Laws & Rubin, 1969; Mahoney & Strassberg, 1991; McAnulty & Adams, 1991). Various techniques were used to ensure that participants focused on the sexual stimuli presented. Such techniques included embedded signal detection tasks (e.g., button pressing in response to an embedded flashing dot), tests for stimulus content memory, and ongoing descriptions of sexual stimuli during presentation.
Findings from those studies revealed that men can suppress physiological and self-reported sexual arousal to preferred stimuli but are unable to enhance arousal to non-preferred stimuli. Average suppression rates range from 26% to 38% maximum erection, with some men able to entirely suppress their sexual arousal and others unable to suppress whatsoever (Adams et al., 1992; Golde et al., 2000; Mahoney & Strassberg, 1991; McAnulty & Adams, 1991). According to results reported by McAnulty and Adams, men are more successful at suppressing cognitive than physiological arousal. McAnulty and Adams proposed that this was the result of "emotional distancing" (p. 574), and that participants processed the stimuli as cognitively arousing but were able to suppress physiological arousal. Similarly, they in the study performed by Adams et al. claimed that, although they were unable to control cognitive arousal, they did experience a sense of control over penile response. During debriefing, participants in the Mahoney and Strassberg study were asked to describe techniques they used to suppress, and most indicated that they tried to view the stimuli in as detached a way as possible.
From these comments, it seems that the tactic most effectively used to minimize physiological sexual arousal is emotional detachment (Mahoney & Strassberg, 1991; McAnulty & Adams, 1991). This is not surprising, as emotional detachment is fundamental to emotion regulation (Gross, 1998a, 1998b, 1999, 2002; Ochsner & Gross, 2005), and various researchers and theorists have suggested that sexual arousal can be best understood within the rubric of emotional function (Everaerd, 1989; Everaerd, Laan, Both, & Spiering, 2001; Frijda, 1986; Geer, Lapour, & Jackson, 1993; Janssen & Everaerd, 1993; Janssen, Everaerd, Spiering, & Janssen, 2000; Lambie & Marcel, 2002; Rosen & Beck, 1988). Emotions are distinct from moods in that they are incited by specific triggers. They are characterized by experiential, behavioral, and physiological changes (Cacioppo, Berntson, Larsen, Poehlmann, & Ito, 2000). They may be unlearned responses to stimuli with intrinsic emotional value or learned responses to stimuli with acquired emotional significance. Multiple appraisal processes can be involved in determining the reward value of emotion-inducing stimuli (Scherer, Schorr, & Johnstone, 2001). Sexual arousal appears to meet these criteria.
According to Gross (1998b), emotion regulation is the means by which individuals can influence their emotional responses. Through emotion regulation, individuals are able to exert control on which emotions they have and how they experience and express those emotions. Emotion regulation can be automatic or controlled and conscious or unconscious, and can occur during processing of emotional cues or after responses are activated. Gross (2002) suggested that two distinct processes may be at play: reappraisal and suppression. He defined reappraisal as the process by which a potentially emotion-eliciting situation is refrained in non-emotional terms. This can be accomplished by detaching oneself from, or reappraising the meaning of, an emotion-eliciting stimulus. Lambie and Marcel (2002) described a similar process whereby an individual can regulate his or her emotional response to an emotion-evoking stimulus by taking an objective perspective.
Emotional suppression, on the other hand, does not change the emotional experience, but does affect its expression (Gross, 2002). The behavior that would normally follow the emotional experience is inhibited. Suppression is more cognitively taxing than reappraisal, as the expressive behavior must be muted while the emotional experience remains unchanged. Although laboratory studies have shown that both reappraisal (Beauregard, Levesque, & Bourgouin, 2001; Jackson, Malmstadt, Larson, & Davidson, 2000; Levesque et al., 2003; Ochsner, Bunge, Gross, & Gabrieli, 2002; Ochsner et al., 2004) and suppression (Colby, Lanzetta, & Kleck, 1977; Gross, 1998a; Gross & Levenson, 1993, 1997) are effective in regulating emotional response, reappraisal appears to be a far more robust strategy in reducing emotional experience.
In the decade preceding the emergence of emotion regulation in the literature, Everaerd (1989) suggested a similar regulatory process with respect to sexual arousal. He proposed that voluntary control of sexual arousal is achievable when an individual can subdue emotional responses to sexual stimuli while still cognitively attending to them. In the only study to address this proposition directly, participants either attempted to inhibit sexual responses by detaching or distancing themselves from the sexual stimuli (i.e., reappraisal) or made no attempt to inhibit their sexual responses (Beauregard et al., 2001). Subsequently, participants were asked to self-report their sexual arousal. During stimulus presentation, functional MRI identified regions of the brain implicated in regulation of sexual arousal. Participants self-reported 60% less sexual arousal when they attempted to inhibit sexual responses, and inhibition of sexual arousal was associated with increased activation in cortical regions that have been associated with regulation of other emotions (Levesque et al., 2003; Ochsner et al., 2002; Ochsner et al., 2004). Beauregard et al. did not include a physiological measure of sexual arousal, so it is unclear how penile response was affected by sexual arousal regulation.
Although it has been established in the research literature that men, on average, have some voluntary control over their physiological sexual arousal, and that the tactic used most successfully to regulate arousal appears to be reappraisal (i.e., emotional detachment), no previous studies have provided participants with reappraisal strategy instructions while also including measures of both self-reported and physiological sexual arousal. One of the goals of our study was to address this issue. Because there appear to be individual differences in the ability to regulate other emotions (e.g., Jackson et al., 2000; Levesque et al., 2003; Ochsner et al., 2004), we predicted that men would also vary in their capacity to regulate sexual arousal. We hypothesized that men's abilities to regulate sexual arousal would be related to their general emotion regulation capability. In other words, those men best able to regulate sexual arousal would be most adept at regulating other emotions. Given that self-reported sexual arousal correlates reasonably well with physiological arousal (Haywood, Grossman, & Cavanaugh, 1990; Sakheim, Barlow, Beck, & Abrahamson, 1985), we expected that the two measures would remain related when men attempted to regulate sexual arousal. This would provide evidence that sexual arousal regulation, as an application of emotion regulation, can affect both cognitive and physiological sexual response.
We also predicted that other factors associated with sexual responding might influence a man's ability to regulate his sexual arousal. Bancroft and Janssen (2000) proposed that sexual response is controlled by two independent neurophysiological systems: sexual excitation and sexual inhibition. Together, they modulate the affective, physiological, and behavioral experiences that accompany sexual arousal. A strong sexual excitation system would contribute to robust sexual responding, whereas a strong sexual inhibition system would reduce sexual response. Janssen, Bancroft, and their colleagues constructed the Sexual Inhibition and Sexual Excitation Scales (SIS/SES) to measure the strength of the sexual excitation and inhibition systems (Janssen, Vorst, Finn, & Bancroft, 2002a, b). Items were created to describe situations that would increase or decrease sexual arousal and penile response. Those items clustered to form three subscales: (a) propensity for sexual excitation, (b) propensity for sexual inhibition due to threat of performance failure (i.e., erectile failure), and (c) propensity for sexual inhibition due to threat of performance consequences (i.e., risk of sexually transmitted infections, pregnancy, or legal repercussions). Research has shown that sexual excitation is associated with increased sexual responsivity in the laboratory, a greater frequency of sexual behaviors, and increased partnered and solitary sexual desire (SSD; Bancroft & Vukadinovic, 2004; Janssen et al., 2002a, b; Winters, Christoff, & Gorzalka, 2008). Sexual inhibition due to threat of performance consequences is inversely related to frequency of unprotected intercourse and partnered and SSD, and is positively associated with sexual restrictiveness. Based on these associations, we predicted that increased sexual excitation and decreased sexual inhibition would be related to poorer sexual arousal regulation performance. Similarly, we hypothesized that heightened dyadic sexual desire (DSD) would also be related to decreased regulation success. An increased appetitive sexual drive and propensity for sexual excitation, in conjunction with muted sexual inhibition, should theoretically make it more difficult to regulate sexual arousal when one is confronted with sexually arousing stimuli.
Another factor that we hypothesized should be related to sexual arousal regulation is sexual compulsivity. Sexual compulsivity, or compulsive sexual behavior, is characterized by disinhibited or undercontrolled sexual thoughts, feelings, and behaviors, as identified by the individual (Coleman, 2003; Kalichman & Cain, 2004). This may culminate in distress sufficient to instigate treatment-seeking behavior, as personal, social, or occupational life...
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