Review
The Role of Cognitive Processing Factors in Sexual Function and Dysfunction in Women and Men: A Systematic Review

https://doi.org/10.1016/j.sxmr.2020.03.002Get rights and content

Abstract

Introduction

Cognitive factors are conceptualized as playing a role in maintaining psychological disorders—including sexual dysfunction—by influencing the way in which individuals ascribe meaning, and ultimately respond, to sexual events.

Objectives

To systematically review and integrate the findings from studies on cognitive processing factors and sexual function and dysfunction in women and men.

Methods

A systematic search of major electronic databases was conducted from inception to July 2019 to identify peer-reviewed studies examining cognitive processing factors associated with sexual function and dysfunction. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.

Main Outcome Measure

The main outcome measure was the association of cognitive processing variables with women's and men's sexual function and dysfunction.

Results

From 122 studies, 67 studies were deemed eligible for inclusion. Studies demonstrated a consistent association between cognitive processing factors and dimensions of sexual functioning in women and men. The main cognitive processing factors associated with sexual functioning include cognitive distraction and attentional focus, automatic thoughts and sexual cognitions, causal attributions to negative sexual events, efficacy expectations, and perceived performance demands. Specific associations between cognitive processing factors and particular male and female sexual dysfunctions were identified and discussed.

Conclusion

Overall, research supports the critical role of cognitive processing factors in predicting women's and men's sexual (dys)function. Evidence suggests that these dimensions should be systematically addressed during the assessment of sexual dysfunction and one of the main treatment targets of psychological interventions.

Tavares IM, Moura CV, Nobre PJ. The Role of Cognitive Processing Factors in Sexual Function and Dysfunction in Women and Men: A Systematic Review. Sex Med 2020;8:403–430.

Section snippets

Search Strategy

This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses.5 To identify as many relevant articles as possible for this review, we conducted a literature search using the PubMed, Web of Science, and EBSCOhost databases (Academic Search Complete, PsycARTICLES, Medline, and Psychology and Behavioral Sciences Collection) using the following search expression: (process∗ OR cognit∗ OR causal attribution∗ OR efficacy expectation∗ OR

Results

The study selection process is outlined in Figure 1. The database search yielded a total of 10,261 articles initially, with 30 additional records identified through other sources. Once duplicates were excluded, 122 articles remained for screening. Of these, 41 were removed because they discussed topics such as general cognitions, affective factors, or non-processing cognitive factors (ie, sexual beliefs), assessed populations with clinical health conditions (ie, fibromyalgia), or were secondary

Conclusion

This review provides an up-to-date and systematic overview of the cognitive processing dimensions implicated in women's and men's sexual function and dysfunction. Cognitive processing factors are considered to maintain sexual difficulties by influencing how one processes and responds to sexual episodes, which ultimately makes a critical contribution to the way in which individuals anticipate and react to future sexual events. To comprehensively examine this premise, a total of 67 studies,

Statement of authorship

Category 1

  1. (a)

    Conception and Design

    • Inês M. Tavares; Catarina V. Moura; Pedro J. Nobre

  2. (b)

    Acquisition of Data

    • Inês M. Tavares; Catarina V. Moura; Pedro J. Nobre

  3. (c)

    Analysis and Interpretation of Data

    • Inês M. Tavares; Catarina V. Moura; Pedro J. Nobre

Category 2
  1. (a)

    Drafting the Article

    • Inês M. Tavares; Catarina V. Moura; Pedro J. Nobre

  2. (b)

    Revising It for Intellectual Content

    • Inês M. Tavares; Catarina V. Moura; Pedro J. Nobre

Category 3
  1. (a)

    Final Approval of the Completed Article

    • Inês M. Tavares; Catarina V. Moura; Pedro J. Nobre

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    Conflict of Interest: The authors report no conflicts of interest.

    Funding: This work was supported by grants from the Portuguese Foundation for Science and Technology (FCT) and the COMPETE 2020 program (CPUP UID/PSI/00050/2013, POCI-01-0145-FEDER-0072). Dr Tavares is supported by a grant from FCT (SFRH/BD/131808/2017).

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