A review of experimental research on anxiety and sexual arousal: Implications for the treatment of sexual dysfunction using cognitive behavioral therapy

Clinical models of sexual response link anxiety to the etiology of sexual dysfunction. Furthermore, some cognitive behavioral therapies (CBTs) for sexual dysfunction have included strategies targeting anxiety reduction. This review examines the experimental literature on the effects of manipulating aspects of the anxiety response (e.g., anxious sensations, thoughts, attentional focus) on genital and self-reported sexual arousal. An additional aim was to use this literature to elucidate potential mechanisms that may be useful for CBT for sexual dysfunction. Our review suggested that anxiety sometimes facilitates, inhibits, or has no effect on sexual arousal. These findings suggest that caution is warranted incorporating anxiety-focused interventions in the treatment of sexual dysfunctions. Importantly, little experimental research has utilized precise manipulations of anxiety (e.g., manipulating fear of penetration) that are related to current CBT interventions. To better understand the relationship between anxiety and sexual dysfunction, future research should explore the question of why and how anxiety exerts a variable effect on sexual arousal rather than simply if anxiety exerts an effect on sexual arousal. Importantly, experimental research examining individual differences in beliefs about anxiety and sex may be helpful in answering this important question and help advance and improve CBT interventions for sexual dysfunctions