Claudia Sánchez Bravo, Norma Patricia Corres Ayala, Bertha Blum Grynberg
En el Departamento de Psicología del Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes" (INPERIER), se detectó un alto porcentaje de parejas con problemas en su vida sexual. Por ello se abrió una línea de investigación en sexualidad humana, mediante la cual se han realizado estudios exploratorios para determinar la prevalencia y frecuencia de las disfunciones sexuales de la población atendida. Los resultados muestran que 52% de las mujeres estudiadas y 38.8% de los hombres estudiados presentaron una o más disfunciones sexuales.
Objetivo El objetivo de este estudio es identificar la relación y la combinación, entre el deseo sexual hipoactivo y algunas variables catalogadas como factores de personalidad —el papel del género, la autoestima y el locus de control— y como antecedentes sexuales —experiencia sexual infantil traumática, información sexual, temores a la sexualidad, masturbación y problemas de pareja— con el fin de proponer un perfil de factores relacionados con el deseo sexual hipoactivo, tanto femenino como masculino.
Material y método Se realizó un estudio no experimental de campo, retrospectivo y transversal, con un diseño correlacional–multivariado de dos muestras independientes divididas en cuatro grupos, seleccionados mediante un muestreo intencional por cuota.
Este trabajo forma parte de una investigación más amplia sobre el estudio de algunos factores de riesgo en las disfunciones sexuales femeninas y masculinas, cuya muestra original constó de 400 participantes. De éstos sólo se tomaron los participantes con deseo sexual hipoactivo que fueron 58 mujeres y 55 hombres. Este grupo se comparó con el mismo número de participantes que no tuvieron ninguna disfunción sexual. Las muestras se clasificaron en dos grupos: como grupo 1 sin disfunciones sexuales y como grupo 2 con deseo sexual hipoactivo.
Tanto el grupo de mujeres como el de hombres debieron cubrir todos los criterios de inclusión. Para la clasificación de los grupos y la captura de los antecedentes sexuales se utilizaron la Historia Clínica Codificada de la Sexualidad Femenina (HCCSF) y el Cuestionario de Sexualidad Versión Hombres. La medición de los factores de personalidad estudiados se realizó con el Inventario de Masculinidad y Feminidad IMAFE, el Inventario de Autoestima de Coopersmith, y la Escala de locus de control interno–externo. Primero se capturó la muestra de hombres y posteriormente la de mujeres.
Resultados Los resultados obtenidos indican que las mujeres con deseo sexual hipoactivo presentan un decremento en las características de masculinidad y en los niveles de autoestima, y un incremento en las características de sumisión. Los resultados acerca de los antecedentes sexuales, en este grupo, mostraron que el deseo sexual hipoactivo se relaciona estrechamente con la experiencia sexual infantil traumática, los temores a la sexualidad y los problemas conyugales. En el análisis discriminante se obtuvo un solo factor por medio de las seis variables aisladas previamente, con el 75% de los casos correctamente clasificados. Los hombres con deseo sexual hipoactivo mostraron un decremento en las características de masculinidad y de feminidad, al igual que en los grados de autoestima, y un incremento en las características de sumisión. Los resultados que se obtuvieron acerca de los antecedentes sexuales mostraron que el deseo sexual hipoactivo tiene una relación estrecha con los temores a la sexualidad y los problemas conyugales. En el análisis discriminante se obtuvo un solo factor con las seis variables aisladas previamente, con el 68.6% de los casos correctamente clasificados.
Conclusiones La investigación arrojó diferencias principalmente en dos sentidos. Por un lado tanto en las mujeres como en los hombres hay un decremento en las características de masculinidad y en la autoestima. Además, en los hombres también se presentó un decremento en los rasgos de feminidad. Este decremento muestra que estos tres factores constituyen indicadores de riesgo para el ejercicio satisfactorio de la sexualidad. Tanto las características de masculinidad como de feminidad pueden presentarse independientes o de manera combinada.
Por otro lado, tanto las mujeres como los hombres muestran un incremento de las características de sumisión, lo que constituye otro indicador de riesgo. En cuanto a los antecedentes sexuales en las mujeres se encontró relación entre las experiencias sexuales infantiles traumáticas, los temores a la sexualidad y los problemas conyugales. En el caso de los antecedentes sexuales de los hombres, los temores a la sexualidad y los problemas conyugales fueron factores importantes.
El aislamiento de variables para detectar los factores relacionados con la presencia del deseo sexual hipoactivo, aporta indicadores importantes tanto protectores como de riesgo encaminados a examinar elementos que muestren una mayor especificidad en la combinación de los factores relacionados.
At the Department of Psychology of the Instituto Nacional de Perinatología 'Isidro Espinosa de los Reyes' (INPERIER), a hospital specialized in reproductive problems, we have detected a high proportion of couples with sexual problems. Therefore we decided to develope a line of research on human sexuality. Ever since, several exploratory studies have taken place with the aim of assessing the prevalence and the frequency of sexual dysfunction in both women and men attending the INPERIER. Our studies showed that 52% of women had one or more sexual dysfunctions and 38.8% of men had one or more sexual dysfunctions.
Objective The main purpose of the study was to identify (in women and men) the relationship and the combination between hypoactive sexual desire disorder and some intervening variables catalogued as personality factors: gender role, self–esteem and locus of control. We also analysed sexual backgrounds by indentifying: child sexual traumatic experience, sexual information available, sex fears, masturbation and couple problems; in order to propose a profile of the relationship between psychological factors and hypoactive sexual desire in women and men.
Material and methods A non–experimental, retrospective, transversal, field study with a correlation–multivariate design was used, which consisted of two independent samples divided into four groups selected through intentional sampling by quotas.
This study is part of a larger research study aimed to assess risk factors for feminine and masculine sexual dysfunctions, whose original sample size was 400 participants. Out of this sample only participants with hypoactive sexual desire were selected, so in the end the groups included 58 women and 55 men. However, they were compared with the same number of participants with no sexual dysfunction. The groups were organized as follows: Group 1, women or men with no sexual dysfunction; Group 2, women or men who presented hypoactive sexual desire disorder.
The participants included in the study were INPERIER regular patients. Samples were handled individually. In order to have an accurate sample all participants had to cover the selection criteria. Additionally, in order to place participants in the right group we used the Codified Clinical History Form on Female Sexuality (CCHFFS) for women —which also was used to examine their sexual background information— and in the case of men, we used the Male Sexuality Questionnaire. Furthermore the measurement of personality items was done by using the Inventory of Masculinity and Femininity IMAFE, the Coppersmith Self–Esteem Inventory and the Internal–External Locus of Control Scales. Sexuality questionnaires as well as other measurement instruments were applied at the External Clinic area during a single session followed by the transcription of data.
In order to analyse the results we applied measures of central tendency to describe the socio–demographic factors (such as: age, civil status and education); for the analysis of personality factors (role of gender, self–esteem and locus of control) and its relationship with hypoactive sexual desire disorder we used the Student's T–test and estimated the Eta coefficient. The analysis of sexual background (child sexual traumatic experience, sexual information, sex fears, masturbation and couple problems) and its relationship with hypoactive sexual desire disorder was calculated by χ2 and Cramer's V. Data analysis was performed with the statistical and data management package SPSS version 11.
Results The thrown results showed that the descriptive analysis of data from women and men had a normal distribution. Also, results indicate that women with a hypoactive sexual desire disorder present a decrease in masculinity features and in their self–esteem level, and an increase in the submissive features when compared to women with no sexual dysfunction. When we analyzed the results of the sexual background in this group, we found a relationship between hypoactive sexual desire and child sexual traumatic experience, and between sex fears and couple problems, suggesting that these variables significantly intervene in the presence of hypoactive sexual desire disorder during women's adult life. In the discriminant analysis we obtained just one factor out of the six previously isolated variables with 75% of the cases correctly classified, indicating that this proportion of women with hypoactive sexual desire disorder are related to such indicators, the variables discriminated were an approximate explanation for the disorder.
The results in the other group showed that in men with hypoactive sexual desire disorder there is a decrease in masculinity and femininity features and in the levels of self–esteem, plus an increase in the submissive features when compared to men with no sexual dysfunction. When we analyzed sexual background information, we found in the group with hypoactive sexual desire disorder that sex fears and couple problems significantly intervene in men's adult life. The discriminant analysis revealed a single factor with the six variables previously isolated, with 68.6% of cases correctly classified, which shows that men with hypoactive sexual desire disorder also have a relationship with the indicators, being the discriminated variables an approximate explanation.
Conclusions When we discussed the results, we observed differences in two ways. First, for both women and men there was a decrease in masculinity features, defined as conducts directed to action, with well–defined, self–affirmed and self–reflective targets. Also there was a decrease in self–esteem, defined as the personal value judgment expressed as the individual's attitudes towards himself and the subjective experience transmitted to others; when masculinity features and self–esteem are diminished they may have an impact on sexuality, becoming a risk factor. In the group of men we also observed a decrease in the femininity features, defined as the traits aimed at feelings and abstraction, the expression of affection, the desire to provide protection as well as to experience nature feelings. When these three factors predominate they turn out to be a protective factor for an adequate practice of sexuality; both masculinity and femininity features could appear together or independently.
In a second way, both in women and men we observed an increase in the submissive behavior, a risk indicator for the development of sexuality, because of the presence of self–denial, dependency, conformism, shyness and the capacity to endure suffering, features all shown as particular conducts.
When it comes to sexual background in women, we found a close relationship with child sexual traumatic experience, sex fears and couple problems. In the case of men, the hypoactive sexual desire disorder was related to sex fears and couple problems.
In this respect, in the review made by Basson, she mentions a new body of evidence that confirms what we have found in this study. She indicates that there are psychological factors that inhibit sexuality in women, for example, a history of child sexual traumatic experience may have a major impact in their sexual development, particularly in desire.
As to sex fears, the same author indicates that fears to sexual response are due to fears of getting pregnant, fear of not reaching orgasm, a lack of response to the couple's expectations reinforced with a lack of experience. Thence, fear is the limit to attain an adequate sexual response. Reissing reports he found a relation between low sexual desire in women, fear of sexuality and low self–esteem, due to a negative perception of sexual self–efficiency. This could be researched in depth by exploring types of fears and the degrees of low self–esteem.
Conjugal problems were detected both in women and men. Some studies indicate that hypoactive sexual desire is conjugal dysfunction–related and that the presence of sexual desire is closely related to intimacy and is dependent upon the context and couple's satisfaction; therefore, conjugal problems turn out to be a determinant factor when treating hypoactive sexual desire. Hogan and Friedman indicate that masculine low sexual desire is usually couple problem related, because it is a way to maintain the equilibrium in a relationship with unbalanced power, and also it is a way to keep an emotional distance through a passive–aggressive behavior. These indicators are coincident with what came upon in the study: a tendency to present submissive characteristics and conjugal problems.
In conclusion, we can say that when variables are isolated for the sake of detecting factors related with hypoactive sexual desire disorder, the aim is to provide indicators both protective or risky, so as to avoid generalizations.
Investigative studies should be addressed to create profiles for every sexual dysfunction, always considering coincidences and differences of the related indicators. Such profiles should facilitate a psychological intervention when proposing more specific treatments for each of the sexual dysfunctions known.
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