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Sheffield, United Kingdom

Newbury R.,Private Practice | Hayter M.,University of Hull | Wylie K.R.,Porterbrook Clinic | Riddell J.,Tavistock Institute
Sexual and Relationship Therapy | Year: 2012

This study describes how a sample of six psychosexual therapists regard the use of sexual fantasy in their work with couples presenting with sexual dysfunctions. The study used a qualitative approach, adopting a thematic analysis to explore the common threads in the therapists' experiences. Five themes emerged from analysis: The importance of fantasizing, Help with fantasizing, Accepting fantasies, Assessing disclosure of fantasies and Partner replacement fantasies as necessary. The research highlights the importance of an informal attachment assessment of the partners before the introduction of fantasy. It also briefly considers the possibilities of an approach to "fantasy training" that takes into account how Schnarch's concept of "differentiation" might help to promote personal growth and couple intimacy. © 2012 Copyright Taylor and Francis Group, LLC.

Wood A.,Eastglade Center | Runciman R.,Rotherham Hospital | Wylie K.R.,Porterbrook Clinic | McManus R.,Royal Hallamshire Hospital
Aging and Disease | Year: 2012

Numerous studies have now demonstrated that many older women retain an interest in their sexual lives. Yet, how many old age psychiatrists commonly check with older women about whether the depression they are treating, or the SSRIs (Selective Serotonin Re-uptake Inhibitors) they have prescribed, have adversely affected their patient's sexual lives? We consider the latest evidence regarding cultural, social and medical influences on older women's sexual lives and some specific issues which affect lesbian and transsexual people. We examine how mental illness and psychotropic medication in particular can adversely affect older women's sexual functioning and at how difficult it often proves to be for women to seek help. We also focus on why doctors and in particular psychiatrists may not take a sexual history, look for sexual side effects or refer for appropriate treatment, especially when interviewing older women patients. Most published information about psychiatric training and sexual issues focuses on the younger male patient. We therefore aimed to provide a broad-ranging review of the literature regarding female sexual functioning in old age, the difficulties that can arise and the role that old age psychiatrists have an opportunity to fulfil, in this often neglected aspect of their patients' treatment. From our review it was clear that, in the light of the increasing cultural acceptability of discussions regarding sexuality and older women, the training of student doctors and trainee psychiatrists needs to reflect this change so that old age psychiatrists can enhance the quality of their patient care.

Veale D.,Kings College London | Miles S.,Kings College London | Read J.,Kings College London | Troglia A.,Kings College London | And 5 more authors.
Body Image | Year: 2015

Men with body dysmorphic disorder (BDD) may be preoccupied with the size or shape of the penis, which may be causing significant shame or impairment. Little is known about the characteristics and phenomenology of such men and whether they can be differentiated from men with small penis anxiety (SPA) (who do not have BDD), and men with no penile concerns. Twenty-six men with BDD, 31 men with SPA, and 33 men without penile concerns were compared on psychopathology, experiences of recurrent imagery, avoidance and safety-seeking behaviours. Men with BDD had significantly higher scores than both the SPA group and no penile concern group for measures of imagery, avoidance, safety seeking and general psychopathology. The groups differed on the phenomenology of BDD specific to penile size preoccupation clearly from the worries of SPA, which in turn were different to those of the men without concerns. The common avoidance and safety seeking behaviours were identified in such men that may be used clinically. © 2014 Elsevier Ltd.

Veale D.,Kings College London | Veale D.,Center for Anxiety Disorders | Miles S.,Kings College London | Read J.,Kings College London | And 6 more authors.
Archives of Sexual Behavior | Year: 2015

Penile dysmorphic disorder (PDD) is shorthand for men diagnosed with body dysmorphic disorder, in whom the size or shape of the penis is their main, if not their exclusive, preoccupation causing significant shame or handicap. There are no specific measures for identifying men with PDD compared to men who are anxious about the size of their penis but do not have PDD. Such a measure might be helpful for treatment planning, reducing unrealistic expectations, and measuring outcome after any psychological or physical intervention. Our aim was, therefore, to validate a specific measure, termed the Cosmetic Procedure Screening Scale for PDD (COPS-P). Eighty-one male participants were divided into three groups: a PDD group (n = 21), a small penis anxiety group (n = 37), and a control group (n = 23). All participants completed the COPS-P as well as standardized measures of depression, anxiety, social phobia, body image, quality of life, and erectile function. Penis size was also measured. The final COPS-P was based on nine items. The scale had good internal reliability and significant convergent validity with measures of related constructs. It discriminated between the PDD group, the small penis anxiety group, and the control group. This is the first study to develop a scale able to discriminate between those with PDD and men anxious about their size who did not have PDD. Clinicians and researchers may use the scale as part of an assessment for men presenting with anxiety about penis size and as an audit or outcome measure after any intervention for this population. © 2015, Springer Science+Business Media New York.

McCabe M.,Deakin University | Althof S.E.,University of Miami | Althof S.E.,And Center for Marital and Sexual Health of South Florida | Assalian P.,McGill University | And 4 more authors.
Journal of Sexual Medicine | Year: 2010

Introduction: There are limited outcome data on the etiology and efficacy of psychological interventions for male and female sexual dysfunction as well as the role of innovative combined treatment paradigms. Aim: This study aimed to highlight the salient psychological and interpersonal issues contributing to sexual health and dysfunction, to offer an etiological model for understanding the evolution and maintenance of sexual symptoms, and to offer recommendations for clinical management and research. Methods: This study reviewed the current literature on the psychological and interpersonal issues contributing to male and female sexual dysfunction. Main Outcome Measure: This study provides expert opinion based on a comprehensive review of the medical and psychological literature, widespread internal committee discussion, public presentation, and debate. Results: Medical and psychological therapies for sexual dysfunctions should address the intricate biopsychosocial influences of the patient, the partner, and the couple. The biopsychosocial model provides an integrated paradigm for understanding and treating sexual dysfunction. Conclusions: There is need for collaboration between healthcare practitioners from different disciplines in the evaluation, treatment, and education issues surrounding sexual dysfunction. In many cases, neither psychotherapy alone nor medical intervention alone is sufficient for the lasting resolution of sexual problems. The assessment of male, female, and couples' sexual dysfunction should ideally include inquiry about predisposing, precipitating, maintaining, and contextual factors. Research is needed to identify efficacious combined and/or integrated treatments for sexual dysfunction. © 2010 International Society for Sexual Medicine.

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