(005) When Paying Attention is Inconvenient: The Effect of Negative Thoughts During Sex on Female Sexual Response
Authors: Bittoni C , Kiesner J , Pastore M , Galfano G 
Published: May 2023

Abstract

Introduction
To evaluate the presence of negative thoughts and how these interfere with sexual functioning (as hypothesized by Barlow, 1986), Nobre and Pinto-Gouveia (2003) developed the Automatic Negative Thoughts scale (ANT). Research using this scale has shown that negative thoughts during sex interferes with subjective sexual arousal (SSA), lubrication, and orgasm (Cuntim and Nobre, 2011; Nobre & Pinto-Gouveia, 2003). While this early work has made a crucial contribution toward understanding how negative thoughts are associated with female sexual response, the ANT has important limitations. One limitation is that some items are not relevant to the constructs they are supposed to measure (e.g., “I have more important matters to deal with” is part of the “Sexual Abuse Thoughts” factor; and “This way of having sex is immoral” is part of the “Partner’s Lack of Affection” factor), and thus in some cases it is not clear what the scales themselves are measuring. Moreover, effect sizes on sexual functioning are modest, and the full measure is long.

Objective
The aim of this study was to test a new measure of negative thoughts during sex (NTs) and to investigate the associations between specific types of NTs and specific domains of sexual functioning. Using fewer and more focused questions we also aimed at having a shorter and more precise measure.

Methods
A sample of 138 female university students completed questionnaires investigating frequency of specific NTs and female sexual functioning (measured through the FSFI). Structural equation modelling was used to test the effect of NTs, as a latent construct, on three dimensions of sexual functioning, namely SSA, lubrication, and orgasm. Next, the effect of the four individual domains of NTs (i.e., orgasm, body image, fear of being hurt, and external thoughts) on SSA, lubrication and orgasm, was tested.

Results
The first SEM model fits the data well (CFI = .97; NFI = .93; RMSEA = .08). This model is presented in Figure 1 and shows that NTs have strong direct negative effects on SSA (78% variance explained), lubrication (76% variance explained), and orgasm (63% variance explained). Moreover, NTs also have an indirect effect on lubrication, mediated by SSA. The effects of single domains of NTs are presented in Figure 2 (saturated model). Overall, NTs about orgasm and fear of being hurt showed negative associations with orgasm and SSA, external thoughts showed an effect on SSA and lubrication, and NTs about body image showed no significant association.

Conclusions
The new measure of NTs has advantages of brevity, specificity, and stronger effect sizes as compared to the ANT. These data provide increasingly strong evidence that NTs significantly interfere with women’s sexual response, and that some domains of NTs have a stronger impact than others on different domains of sexual functioning. More work is needed to understand the sources and types of NTs, and their role in different aspects of sexual response. Furthermore, neuroimaging technology should be exploited to shed light on the neural pathways involved in cognitive interference and sexual inhibition, which are expected to be linked with the presence of NTs.

Disclosure
No