(59%). 99 of the 188 (53%) reported subjective symptoms of FSD. This compares to 80 (42%) who den... more (59%). 99 of the 188 (53%) reported subjective symptoms of FSD. This compares to 80 (42%) who denied symptoms of FSD. Nine participants did not respond. This gives a RR of 1.16, with p¼0.19. When comparing those who participated in FBSAP, and engaged in sexual intercourse prior to marriage, 98 responses were gathered. 61 of 98 (62%) reported symptoms of FSD, versus 33 of 98 (34%) who did not. The RR for this was 1.33, with p¼0.03. Conclusions: The causes of female sexual dysfunction are many, and have only recently started being investigated in earnest. The sexually formative years of adolescence are often overlooked as a time when non-traumatic causes of FSD arise, and extracurricular activities as cause for dysfunction are rarely investigated. As demonstrated above, participation in faith-based sexual abstinence programs may lead to a higher risk of developing FSD, especially if premarital sexual activity occurs.
Background and Aims Nonalcoholic fatty liver disease (NAFLD) has reached pandemic proportions. Ea... more Background and Aims Nonalcoholic fatty liver disease (NAFLD) has reached pandemic proportions. Early detection can identify at-risk patients who can be linked to hepatology care. The vibration-controlled transient elastography (VCTE) controlled attenuation parameter (CAP) is biopsy validated to diagnose hepatic steatosis (HS). We aimed to develop a novel clinical predictive algorithm for HS using the CAP score at a Veterans' Affairs hospital. Methods We identified 403 patients in the Greater Los Angeles VA Healthcare System with valid VCTEs during 1/2018-6/2020. Patients with alcohol-associated liver disease, genotype 3 hepatitis C, any malignancies, or liver transplantation were excluded. Linear regression was used to identify predictors of NAFLD. To identify a CAP threshold for HS detection, receiver operating characteristic analysis was applied using liver biopsy, MRI, and ultrasound as the gold standards. Results The cohort was racially/ethnically diverse (26% Black/African American; 20% Hispanic). Significant positive predictors of elevated CAP score included diabetes, cholesterol, triglycerides, BMI, and self-identifying as Hispanic. Our predictions of CAP scores using this model strongly correlated (r = 0.61, p < 0.001) with actual CAP scores. The NAFLD model was validated in an independent Veteran cohort and yielded a sensitivity of 82% and specificity 83% (p < 0.001, 95% CI 0.46-0.81%). The estimated optimal CAP for our population cutoff was 273.5 dB/m, resulting in AUC = 75.5% (95% CI 70.7-80.3%). Conclusion Our HS predictive algorithm can identify at-risk Veterans for NAFLD to further risk stratify them by non-invasive tests and link them to sub-specialty care. Given the biased referral pattern for VCTEs, future work will need to address its applicability in non-specialty clinics.
Background A number of studies have found that hypersexuality is associated with a high propensit... more Background A number of studies have found that hypersexuality is associated with a high propensity for sexual excitation. In comparison, less is known about the relationship between hypersexuality and sexual arousal at the state level. Also, previous research has revealed a relationship between hypersexuality and negative mood. However, the possibility that sexual response might not be as negatively impacted by negative mood in hypersexual individuals has, as yet, not been tested. Aim The purpose of this study was to investigate sexual responsivity and the effects of negative mood on sexual arousal in hypersexual men who have sex with men (MSM). Methods A total of 211 MSM were assigned to a hypersexuality (N = 81) or a control (N = 130) group using an interview patterned with a semi-structured Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders format. Participants filled out questionnaires and were shown neutral, sexual, and anxiety- and sadness-...
The Oxford Handbook of Positive Emotion and Psychopathology, 2019
Sexual responses are some of the strongest primary rewards used in research and, arguably, in nat... more Sexual responses are some of the strongest primary rewards used in research and, arguably, in nature. Sexual response often is considered only in isolation as a reflection of good general health or relevant solely for reproduction. Yet, altered responsiveness to sexual rewards is evident in a number of affective disorders not limited to sexual difficulties. Sexual stimulation has been neglected for its potential to treat a range of general physical and mental health problems. Relative to other emotion sciences, sexual psychophysiology is underdeveloped. The chapter reviews how sexual responses are affected in general emotional disorders, then attempts to distinguish these, often unsuccessfully, from related sexual difficulties.
Background Hypersexual behaviours could reflect psychopathology, in part, because they impair int... more Background Hypersexual behaviours could reflect psychopathology, in part, because they impair interactions with intimate partners. Methods Hypersexual concerns were measured as: (1) concern about inability to control one’s own sexual behaviours; and (2) sexual films viewed. The outcome, sexual arousal, was measured using two indicators: (1) self-reported sexual arousal (before/after); and (2) skin conductance response from the person stimulated (continuously). Two-hundred and fifty participants completed Orgasmic Meditation (OM), a coupled, structured, 15-min manual-genital stroking. Results Reported difficulty controlling their own sexual behaviours was not related to sexual arousal reports. Participants who viewed more sexual films reported more sexual arousal before starting OM than participants who viewed less sexual films. Strokers who viewed more sexual films were associated with a higher skin conductance response in the stroked partner. Conclusions Despite statistical power a...
"Reboot", especially NoFap, promote abstinence from masturbation and/or pornography to treat "por... more "Reboot", especially NoFap, promote abstinence from masturbation and/or pornography to treat "pornography addiction", an unrecognized diagnosis. While the intention of Reboot/NoFap is to decrease distress, qualitative studies have consistently suggested that "Reboots" paradoxically cause more distress. The distress appears to occur in response to (1) the abstinence goal, which recasts common sexual behaviors as personal "failures", and (2) problematic and inaccurate Reboot/NoFap forum messaging regarding sexuality and addiction. This preregistered survey asked men about their experience with perceived "relapse" and NoFap forums. Participants reported that their most recent relapse was followed by feeling shameful, worthless, sad, a desire to commit suicide, and other negative emotions. A novel predictor of identifying as a pornography addict in this lower religiosity sample was higher narcissism. Participants reported that NoFap forums contained posts that were misogynist (73.7% of participants), bullying (49.1%), anti-LGBT (42.9%), antisemitic (32.0%), instructing followers to harm or kill themselves (23.5%), or threats to hurt someone else (21.1%). More engagement in NoFap online forums was associated with worse symptoms of erectile dysfunction, depression, anxiety, and more sex negativity. Results support and expand previously documented harms and problems with Reboot/NoFap claims of treating pornography addiction from qualitative research.
"Reboot," especially NoFap, promotes abstinence from masturbation and/or pornography to treat "po... more "Reboot," especially NoFap, promotes abstinence from masturbation and/or pornography to treat "pornography addiction," an unrecognized diagnosis. While the intention of Reboot/NoFap is to decrease distress, qualitative studies have consistently suggested that "Reboots" paradoxically cause more distress. The distress appears to occur in response to (1) the abstinence goal, which recasts common sexual behaviors as personal "failures," and (2) problematic and inaccurate Reboot/NoFap forum messaging regarding sexuality and addiction. This preregistered survey asked men about their experience with perceived "relapse" and NoFap forums. Participants reported that their most recent relapse was followed by feeling shameful, worthless, sad, a desire to commit suicide, and other negative emotions. A novel predictor of identifying as a pornography addict in this lower religiosity sample was higher narcissism. Participants reported that NoFap forums contained posts that were misogynist (73.7% of participants), bullying (49.1%), anti-LGBT (42.9%), antisemitic (32.0%), instructing followers to harm or kill themselves (23.5%), or threats to hurt someone else (21.1%). More engagement in NoFap online forums was associated with worse symptoms of erectile dysfunction, depression, anxiety, and more sex negativity. Results support and expand previously documented harms and problems with Reboot/NoFap claims of treating pornography addiction from qualitative research.
“Reboot” coaches claiming to treat pornography addiction increasingly claim to treat erectile dys... more “Reboot” coaches claiming to treat pornography addiction increasingly claim to treat erectile dysfunction (ED). They view ED as due to pornography viewing. However, anxiety has long been the best predictor of ED. We hypothesized that those involved in Reboot treatments would report erectile difficulties predicted by anxiety symptoms and not pornography viewing. Six-hundred and sixty-nine participants familiar with Reboot treatments completed a series of online questionnaires. Among those who participated in Reboot treatments, anxiety symptoms predicted ED. Pornography viewing frequency did not mediate or moderate this relationship. Licensed providers should work to dispel this apparent health disinformation by life “Reboot” coaches.
Introduction: Time spent viewing sexual stimuli (VSS) has the potential to habituate the sexual r... more Introduction: Time spent viewing sexual stimuli (VSS) has the potential to habituate the sexual response and generalize to the partner context. Aim: Examine whether the time spent viewing VSS is related to sexual responsiveness felt in the laboratory or with a sexual partner. Methods: Non-treatment seeking men (N=280) reported their weekly average VSS viewing in hours. VSS hours were examined in relation to the sexual arousal experienced while viewing a standardized sexual film in the laboratory and erectile problems experienced with a sexual partner. Main outcome measures: Self-reported sexual arousal in response to sexual films and erectile problems on the International Index of Erectile Function. Results: More hours viewing VSS was related to stronger experienced sexual responses to VSS in the laboratory, unrelated to erectile functioning with a partner, and stronger desire for sex with a partner. Conclusions: VSS use within the range of hours tested is unlikely to negatively imp...
(59%). 99 of the 188 (53%) reported subjective symptoms of FSD. This compares to 80 (42%) who den... more (59%). 99 of the 188 (53%) reported subjective symptoms of FSD. This compares to 80 (42%) who denied symptoms of FSD. Nine participants did not respond. This gives a RR of 1.16, with p¼0.19. When comparing those who participated in FBSAP, and engaged in sexual intercourse prior to marriage, 98 responses were gathered. 61 of 98 (62%) reported symptoms of FSD, versus 33 of 98 (34%) who did not. The RR for this was 1.33, with p¼0.03. Conclusions: The causes of female sexual dysfunction are many, and have only recently started being investigated in earnest. The sexually formative years of adolescence are often overlooked as a time when non-traumatic causes of FSD arise, and extracurricular activities as cause for dysfunction are rarely investigated. As demonstrated above, participation in faith-based sexual abstinence programs may lead to a higher risk of developing FSD, especially if premarital sexual activity occurs.
Background and Aims Nonalcoholic fatty liver disease (NAFLD) has reached pandemic proportions. Ea... more Background and Aims Nonalcoholic fatty liver disease (NAFLD) has reached pandemic proportions. Early detection can identify at-risk patients who can be linked to hepatology care. The vibration-controlled transient elastography (VCTE) controlled attenuation parameter (CAP) is biopsy validated to diagnose hepatic steatosis (HS). We aimed to develop a novel clinical predictive algorithm for HS using the CAP score at a Veterans' Affairs hospital. Methods We identified 403 patients in the Greater Los Angeles VA Healthcare System with valid VCTEs during 1/2018-6/2020. Patients with alcohol-associated liver disease, genotype 3 hepatitis C, any malignancies, or liver transplantation were excluded. Linear regression was used to identify predictors of NAFLD. To identify a CAP threshold for HS detection, receiver operating characteristic analysis was applied using liver biopsy, MRI, and ultrasound as the gold standards. Results The cohort was racially/ethnically diverse (26% Black/African American; 20% Hispanic). Significant positive predictors of elevated CAP score included diabetes, cholesterol, triglycerides, BMI, and self-identifying as Hispanic. Our predictions of CAP scores using this model strongly correlated (r = 0.61, p < 0.001) with actual CAP scores. The NAFLD model was validated in an independent Veteran cohort and yielded a sensitivity of 82% and specificity 83% (p < 0.001, 95% CI 0.46-0.81%). The estimated optimal CAP for our population cutoff was 273.5 dB/m, resulting in AUC = 75.5% (95% CI 70.7-80.3%). Conclusion Our HS predictive algorithm can identify at-risk Veterans for NAFLD to further risk stratify them by non-invasive tests and link them to sub-specialty care. Given the biased referral pattern for VCTEs, future work will need to address its applicability in non-specialty clinics.
Background A number of studies have found that hypersexuality is associated with a high propensit... more Background A number of studies have found that hypersexuality is associated with a high propensity for sexual excitation. In comparison, less is known about the relationship between hypersexuality and sexual arousal at the state level. Also, previous research has revealed a relationship between hypersexuality and negative mood. However, the possibility that sexual response might not be as negatively impacted by negative mood in hypersexual individuals has, as yet, not been tested. Aim The purpose of this study was to investigate sexual responsivity and the effects of negative mood on sexual arousal in hypersexual men who have sex with men (MSM). Methods A total of 211 MSM were assigned to a hypersexuality (N = 81) or a control (N = 130) group using an interview patterned with a semi-structured Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders format. Participants filled out questionnaires and were shown neutral, sexual, and anxiety- and sadness-...
The Oxford Handbook of Positive Emotion and Psychopathology, 2019
Sexual responses are some of the strongest primary rewards used in research and, arguably, in nat... more Sexual responses are some of the strongest primary rewards used in research and, arguably, in nature. Sexual response often is considered only in isolation as a reflection of good general health or relevant solely for reproduction. Yet, altered responsiveness to sexual rewards is evident in a number of affective disorders not limited to sexual difficulties. Sexual stimulation has been neglected for its potential to treat a range of general physical and mental health problems. Relative to other emotion sciences, sexual psychophysiology is underdeveloped. The chapter reviews how sexual responses are affected in general emotional disorders, then attempts to distinguish these, often unsuccessfully, from related sexual difficulties.
Background Hypersexual behaviours could reflect psychopathology, in part, because they impair int... more Background Hypersexual behaviours could reflect psychopathology, in part, because they impair interactions with intimate partners. Methods Hypersexual concerns were measured as: (1) concern about inability to control one’s own sexual behaviours; and (2) sexual films viewed. The outcome, sexual arousal, was measured using two indicators: (1) self-reported sexual arousal (before/after); and (2) skin conductance response from the person stimulated (continuously). Two-hundred and fifty participants completed Orgasmic Meditation (OM), a coupled, structured, 15-min manual-genital stroking. Results Reported difficulty controlling their own sexual behaviours was not related to sexual arousal reports. Participants who viewed more sexual films reported more sexual arousal before starting OM than participants who viewed less sexual films. Strokers who viewed more sexual films were associated with a higher skin conductance response in the stroked partner. Conclusions Despite statistical power a...
"Reboot", especially NoFap, promote abstinence from masturbation and/or pornography to treat "por... more "Reboot", especially NoFap, promote abstinence from masturbation and/or pornography to treat "pornography addiction", an unrecognized diagnosis. While the intention of Reboot/NoFap is to decrease distress, qualitative studies have consistently suggested that "Reboots" paradoxically cause more distress. The distress appears to occur in response to (1) the abstinence goal, which recasts common sexual behaviors as personal "failures", and (2) problematic and inaccurate Reboot/NoFap forum messaging regarding sexuality and addiction. This preregistered survey asked men about their experience with perceived "relapse" and NoFap forums. Participants reported that their most recent relapse was followed by feeling shameful, worthless, sad, a desire to commit suicide, and other negative emotions. A novel predictor of identifying as a pornography addict in this lower religiosity sample was higher narcissism. Participants reported that NoFap forums contained posts that were misogynist (73.7% of participants), bullying (49.1%), anti-LGBT (42.9%), antisemitic (32.0%), instructing followers to harm or kill themselves (23.5%), or threats to hurt someone else (21.1%). More engagement in NoFap online forums was associated with worse symptoms of erectile dysfunction, depression, anxiety, and more sex negativity. Results support and expand previously documented harms and problems with Reboot/NoFap claims of treating pornography addiction from qualitative research.
"Reboot," especially NoFap, promotes abstinence from masturbation and/or pornography to treat "po... more "Reboot," especially NoFap, promotes abstinence from masturbation and/or pornography to treat "pornography addiction," an unrecognized diagnosis. While the intention of Reboot/NoFap is to decrease distress, qualitative studies have consistently suggested that "Reboots" paradoxically cause more distress. The distress appears to occur in response to (1) the abstinence goal, which recasts common sexual behaviors as personal "failures," and (2) problematic and inaccurate Reboot/NoFap forum messaging regarding sexuality and addiction. This preregistered survey asked men about their experience with perceived "relapse" and NoFap forums. Participants reported that their most recent relapse was followed by feeling shameful, worthless, sad, a desire to commit suicide, and other negative emotions. A novel predictor of identifying as a pornography addict in this lower religiosity sample was higher narcissism. Participants reported that NoFap forums contained posts that were misogynist (73.7% of participants), bullying (49.1%), anti-LGBT (42.9%), antisemitic (32.0%), instructing followers to harm or kill themselves (23.5%), or threats to hurt someone else (21.1%). More engagement in NoFap online forums was associated with worse symptoms of erectile dysfunction, depression, anxiety, and more sex negativity. Results support and expand previously documented harms and problems with Reboot/NoFap claims of treating pornography addiction from qualitative research.
“Reboot” coaches claiming to treat pornography addiction increasingly claim to treat erectile dys... more “Reboot” coaches claiming to treat pornography addiction increasingly claim to treat erectile dysfunction (ED). They view ED as due to pornography viewing. However, anxiety has long been the best predictor of ED. We hypothesized that those involved in Reboot treatments would report erectile difficulties predicted by anxiety symptoms and not pornography viewing. Six-hundred and sixty-nine participants familiar with Reboot treatments completed a series of online questionnaires. Among those who participated in Reboot treatments, anxiety symptoms predicted ED. Pornography viewing frequency did not mediate or moderate this relationship. Licensed providers should work to dispel this apparent health disinformation by life “Reboot” coaches.
Introduction: Time spent viewing sexual stimuli (VSS) has the potential to habituate the sexual r... more Introduction: Time spent viewing sexual stimuli (VSS) has the potential to habituate the sexual response and generalize to the partner context. Aim: Examine whether the time spent viewing VSS is related to sexual responsiveness felt in the laboratory or with a sexual partner. Methods: Non-treatment seeking men (N=280) reported their weekly average VSS viewing in hours. VSS hours were examined in relation to the sexual arousal experienced while viewing a standardized sexual film in the laboratory and erectile problems experienced with a sexual partner. Main outcome measures: Self-reported sexual arousal in response to sexual films and erectile problems on the International Index of Erectile Function. Results: More hours viewing VSS was related to stronger experienced sexual responses to VSS in the laboratory, unrelated to erectile functioning with a partner, and stronger desire for sex with a partner. Conclusions: VSS use within the range of hours tested is unlikely to negatively imp...
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Papers by Nicole Prause