Cognitions, emotions, and sexual response: analysis of the relationship among automatic thoughts, emotional responses, and sexual arousal.

The relationship between automatic thoughts and emotions presented during sexual activity and their correlation with sexual arousal was investigated. A total of 491 individuals (163 women and 232 men without sexual problems and 47 women and 49 men with a DSM-IV diagnosis of sexual dysfunction) completed the Sexual Modes Questionnaire (SMQ; Nobre and Pinto-Gouveia, Journal of Sex Research, 40, 368-382, 2003). Results indicated several significant correlations among automatic thoughts, emotions, and sexual arousal. Erection concern thoughts in the men and failure/disengagement thoughts and lack of erotic thoughts in the women presented the most significant negative correlations with sexual arousal. Additionally, sadness and disillusion were positively related to these negative cognitions and negatively associated with sexual arousal in both sexes. On the other hand, pleasure and satisfaction were negatively associated with the above-mentioned negative cognitions and positively associated with subjective sexual arousal in both men and women. Overall, findings support the hypothesis that cognitive, emotional, and behavioral dimensions are closely linked and suggest a mode typical of sexual dysfunction composed of negative automatic thoughts, depressive affect, and low subjective sexual arousal.