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Examining the treatment utility of the approach-avoidance motivation model for sexual interest/arousal disorder in women and non-binary individuals Jabs, Faith

Abstract

One third of cisgender women report experiencing low sexual desire and 8% of these women meet the diagnostic criteria for Sexual Interest/Arousal Disorder (SIAD), yet treatment research for SIAD remains scarce. Research on sexual concerns among transgender women and non-binary individuals is also scarce and requires further investigation to better inform clinical practice. The Approach-Avoidance Motivation Model may be relevant to addressing sexual concerns. This model posits that different motivations for sex can be classified as either pursuing desired outcomes (approach motivation) or avoiding unwanted outcomes or consequences (avoidance motivation), and these reasons are related to sexual outcomes. The treatment utility of the Approach-Avoidance Motivation Model for SIAD was tested in a sample of cis- and transgender women, and non-binary individuals, who either met criteria for SIAD or reported no sexual concerns. Sixty-seven participants with SIAD and 96 participants with no sexual concerns completed baseline measures of sexual motivation, sexual desire, sexual satisfaction, relationship satisfaction, and partnered sexual behaviours. Participants then completed an online assessment from home that involved a writing exercise previously found to increase the salience of approach or avoidance sexual motivation, or a control writing task, then viewed a nature film and erotic film while self-reporting levels of attention. Seventy-two hours following the online assessment participants completed sexual outcome measures again. A repeated measures MANOVA assessing the impact of SIAD status and writing task condition found that participants with SIAD in the approach condition significantly increased in approach sexual motivation immediately following the manipulation but these improvements did not persist at 72 hours follow up. Interestingly participants without SIAD were found to decrease in avoidance motivation, dyadic sexual desire, and partnered sexual behaviours 72 hours following the manipulation, regardless of writing condition. There were no differences in self-reported attention to the erotic film between those with and without SIAD, or between writing condition groups. Overall, these findings did not show support for the treatment utility of this approach-avoidance motivation manipulation for SIAD given that increases in approach motivation were not maintained. Future studies might explore more long-term interventions targeting approach-avoidance motivation to address sexual difficulties.

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