Psihoterapevtski pristopi in metode ter njihova učinkovitost pri obravnavi orgazmične disfunkcije pri ženskah

Avtorji

  • Cita Jenko Univerza na Primorskem, Fakulteta za matematiko, naravoslovje in informacijske tehnologije, Koper
  • Maša Žvelc Univerza na Primorskem, Fakulteta za matematiko, naravoslovje in informacijske tehnologije, Koper

DOI:

https://doi.org/10.20419/2024.33.584

Ključne besede:

orgazmična disfunkcija, terapevtski pristopi, terapevtske metode, obravnava, orgazem

Povzetek

Orgazmična disfunkcija je spolna motnja, pri kateri se orgazem ne pojavi ali pa je zakasnel. Prevalenca orgazmične disfunkcije se giblje med 16 % in 28 % v Evropi, Ameriki in celinski Kitajski ter med 30 % in 46 % v drugih azijskih državah. Vzroki so lahko fiziološki, nevrološki in psihosocialni. Naredili smo pregled literature, katerega namen je bil preučiti, kateri psihoterapevtski pristopi in metode se uporabljajo pri obravnavi orgazmične disfunkcije, in preveriti izsledke njihove učinkovitosti. Za pridobivanje virov smo uporabili podatkovni bazi Scopus in EbscoHost. Po pregledu vseh zadetkov, odstranitvi duplikatov in z upoštevanjem vseh kriterijev smo v pregled vključili 15 raziskav. Terapevtski pristopi in metode, pri katerih je dokazana učinkovitost pri odpravljanju orgazmične disfunkcije, so: skupinska seksualna terapija in seksualna terapija parov, vedenjski pristopi (metoda Masters in Johnson, sistematična desenzitizacija), na čuječnosti temelječi programi (na čuječnosti temelječa kognitivna terapija – MBCT, na čuječnosti temelječa vedenjska in kognitivna terapija), metoda Betty Dodson (kombinacija kratkotrajne psihodinamične skupinske terapije in metod samozadovoljevanja) in samopomočni programi, ki temeljijo na sledenju videoposnetkom, temelječih na kognitivno-vedenjski terapiji (KVT) in MBCT ter priročnikih psihoseksualne terapije. Nekateri samopomočni programi vsebujejo tudi minimalen stik s terapevtom. Omenjeni pristopi se med seboj prekrivajo (npr. seksualna terapija integrira vedenjske metode). Rezultati in pregled služijo kot podlaga za uporabo učinkovitih intervencij in možnosti izboljšav na področju obravnave orgazmične disfunkcije.

Literatura

Adam, F., De Sutter, P., Day, J. in Grimm, E. (2020). A randomized study comparing video-based mindfulness-based cognitive therapy with video-based traditional cognitive behavioral therapy in a sample of women struggling to achieve orgasm. Journal of Sexual Medicine, 17(2), 312–324. https://doi.org/10.1016/j.jsxm.2019.10.022

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https:// doi.org/10.1176/appi.books.9780890425596

Barbach, L. G. (1974). Group treatment of preorgasmic women. Journal of Sex and Marital Therapy, 1(2), 139– 145. https://doi.org/10.1080/00926237408405281

Basson, R. (2002). A model of women’s sexual arousal. Journal of Sex & Marital Therapy, 28(1), 1–10. https:// doi.org/10.1080/009262302317250963

Birnbaum, G. E. (2003). The meaning of heterosexual intercourse among women with female orgasmic disorder. Archives of Sexual Behavior, 32(1), 61–71. https://doi. org/10.1023/A:1021845513448

Brotto, L. A. in Basson, R. (2014). Group mindfulness-based therapy significantly improves sexual desire in women. Behaviour Research and Therapy, 57(1), 43–54. https:// doi.org/10.1016/j.brat.2014.04.001

Brotto, L. A. in Heiman, J. R. (2007). Mindfulness in sex therapy: Applications for women with sexual difficulties following gynecologic cancer. Sexual and Relationship Therapy, 22(1), 3–11. https://doi. org/10.1080/14681990601153298

De Sutter, P., Day, J. in Adam, F. (2014). Who are the orgasmic women? Exploratory study among a community sample of French-speaking women. Sexologies, 23(3), e51–e57. https://doi.org/10.1016/j.sexol.2014.05.003

Dodge, L. T., Glasgow, R. E. in O’Neill, H. K. (1982). Bibliotherapy in the treatment of female orgasmic dysfunction. Journal of Consulting and Clinical Psychology, 50(3), 442–443. https://doi. org/10.1037/0022-006X.50.3.442

Everaerd, W. in Dekker, J. (1982). Treatment of secondary orgasmic dysfunction: A comparison of systematic desensitization and sex therapy. Behaviour Research and Therapy, 20(3), 269–274. https://doi. org/10.1016/0005-7967(82)90145-0

Fichten, C. S., Libman, E. in Brender, W. (1983). Methodological issues in the study of sex therapy: Effective components in the treatment of secondary orgasmic dysfunction. Journal of Sex and Marital Therapy, 9 (3), 191–202. https://doi.org/10.1080/00926238308405847

Heiman, J., LoPiccolo, L. in LoPiccolo, J. (1976). Becoming orgasmic: A sexual growth program for women. Prentice-Hall.

Hucker, A. in McCabe, M. P. (2014). An online, mindfulness-based, cognitive-behavioral therapy for female sexual difficulties: Impact on relationship functioning. Journal of Sex and Marital Therapy, 40(6), 561–576. https://doi.or g/10.1080/0092623X.2013.796578

IsHak, W. W., Bokarius, A., Jeffrey, J. K., Davis, M. C. in Bakhta, Y. (2010). Disorders of orgasm in women: A literature review of etiology and current treatments. The Journal of Sexual Medicine, 7(10), 3254–3268. https:// doi.org/10.1111/j.1743-6109.2010.01928.x

Kelly, M. P., Strassberg, D. S. in Turner, C. M. (2006). Behavioral assessment of couples’ communication in female orgasmic disorder. Journal of Sex & Marital Therapy, 32(2), 81–95. https://doi.org/10.1080/00926230500442243

Kilmann, P. R., Mills, K. H., Caid, C., Davidson, E., Bella, B., Milan, R., Drose, G., Boland, J., Follingstad, D., Montgomery, B. in Wanlass, R. (1986). Treatment of secondary orgasmic dysfunction: An outcome study. Archives of Sexual Behavior, 15(3), 211–229. https://doi. org/10.1007/BF01542413

Kingsberg, S. A. in Knudson, G. (2011). Female sexual disorders: Assessment, diagnosis, and treatment. CNS Spectrums, 16(2), 49–62. https://doi.org/10.1017/ s109285291200017x

Kohlenberg, R. J. (1974). Directed masturbation and the treatment of primary orgasmic dysfunction. Archives of Sexual Behavior, 3(4), 349–356. https://doi.org/10.1007/ BF01636440

Laan, E., Rellini, A. H. in Barnes, T. (2013). Standard operating procedures for female orgasmic disorder: Consensus of the international society for sexual medicine. The Journal of Sexual Medicine, 10(1), 74–82. https://doi.org/10.1111/j.1743-6109.2012.02880.x

Libman, E., Fitchten, C. S., Brender, W., Burstein, R., Cohen, J. in Binik, Y. M. (1984). A comparison of three therapeutic formats in the treatment of secondary orgasmic dysfunction. Journal of Sex & Marital Therapy, 10(3), 147–159. https://doi.org/10.1080/00926238408405940

LoPiccolo, J. in Lobitz, W. C. (1972). The role of masturbation in the treatment of orgasmic dysfunction. Archives of Sexual Behavior, 2(2), 163–171. https://doi.org/10.1007/BF01541865

Lykins, A. D., Janssen, E. in Graham, C. A. (2006). The relationship between negative mood and sexuality in heterosexual college women and men. Journal of Sex Research, 43(2), 136–143. https://doi. org/10.1080/00224490609552308

Marchand, E. (2021). Psychological and behavioral treatment of female orgasmic disorder. Sexual Medicine Reviews, 9(2), 194–211. https://doi.org/10.1016/j.sxmr.2020.07.007

McGovern, K. B., Stewart, R. C. in LoPiccolo, J. (1975). Secondary orgasmic dysfunction. I. Analysis and strategies for treatment. Archives of Sexual Behavior, 4(3), 265–275. https://doi.org/10.1007/BF01541626

Meston, C. M., Levin, R. J., Sipski, M. L., Hull, E. M. in Heiman, J. R. (2004). Women‘s orgasm. Annual review of sex research, 15, 173–257.

Moher, D., Liberati, A., Tetzlaff, J. in Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), članek e1000097. https://doi.org/10.1371/journal. pmed.1000097

Morokoff, P. J. in LoPiccolo, J. (1986). A comparative evaluation of minimal therapist contact and 15-session treatment for female orgasmic dysfunction. Journal of Consulting and Clinical Psychology, 54(3), 294–300. https://doi.org/10.1037/0022-006X.54.3.294

Munjack, D., Cristol, A., Goldstein, A., Phillips, D., Goldberg, A., Whipple, K., Staples, F. in Kanno, P. (1976). Behavioural treatment of orgasmic dysfunction: A controlled study. The British Journal of Psychiatry, 129(5), 497–502. https://doi.org/10.1192/bjp.129.5.497

Nobre, P. J. in Pinto-Gouveia, J. (2008). Cognitive and emotional predictors of female sexual dysfunctions: Preliminary findings. Journal of Sex & Marital Therapy, 34(4), 325– 342. https://doi.org/10.1080/00926230802096358

Palacios, S., Castaño, R. in Grazziotin, A. (2009). Epidemiology of female sexual dysfunction. Maturitas, 63(2), 119–123. https://doi.org/10.1016/j.maturitas.2009.04.002

Pastirk, S. (2011). Vedenjsko kognitivna terapija [Behavioural cognitive therapy]. V M. Žvelc, M. Možina in J. Bohak (ur.), Psihoterapija (str. 253–284). Založba IPSA.

Paterson, L. Q. P., Handy, A. B. in Brotto, L. A. (2017). A pilot study of eight-session mindfulness-based cognitive therapy adapted for women’s sexual interest/arousal disorder. Journal of Sex Research, 54(7), 850–861. https://doi.org/10.1080/00224499.2016.1208800

Schneidman, B. in McGuire, L. (1976). Group therapy for nonorgasmic women: Two age levels. Archives of Sexual Behavior, 5(3), 239–247. https://doi.org/10.1007/ BF01541375

Sidi, H., Puteh, S. E. W., Abdullah, N. in Midin, M. (2007). The prevalence of sexual dysfunction and potential risk factors that may impair sexual function in Malaysian women. The Journal of Sexual Medicine, 4(2), 311–321. https://doi.org/10.1111/j.1743-6109.2006.00319.x

Silverstein, R. G., Brown, A. C. H., Roth, H. D. in Britton, W. B. (2011). Effects of mindfulness training on body awareness to sexual stimuli: Implications for female sexual dysfunction. Psychosomatic Medicine, 73(9), 817– 825. https://doi.org/10.1097/PSY.0b013e318234e628

Struck, P. in Ventegodt, S. (2008). Clinical holistic medicine: Teaching orgasm for females with chronic anorgasmia using the Betty Dodson method. The Scientific World Journal, 8, 883–895. https://doi.org/10.1100/tsw.2008.116

Tavares, I. M., Laan, E. T. M. in Nobre, P. J. (2018). Sexual inhibition is a vulnerability factor for orgasm problems in women. The Journal of Sexual Medicine, 15(3), 361–372. https://doi.org/10.1016/j.jsxm.2017.12.015

Vandenberghe, L., de Oliveira Nasserb, K. C. F. in e Silva, D. P. (2010). Couples therapy, female orgasmic disorder and the therapist-client relationship: Two case studies in functional analytic psychotherapy. Counselling Psychology Quarterly, 23(1), 45–53. https://doi. org/10.1080/09515071003665155

Ventegodt, S. (1998). Sex and the quality life in Denmark. Archives of Sexual Behavior, 27(3), 295–307. https://doi. org/10.1023/A:1018655219133

Ventegodt, S., Kandel, I., Neikrug, S. in Merric, J. (2005). Clinical holistic medicine: Holistic treatment of rape and incest trauma. The Scientific World Journal, 5, 288–297. https://doi.org/10.1100/tsw.2005.38

Ventegodt, S., Morad, M., Hyam, E. in Merrick, J. (2004). Clinical holistic medicine: Holistic sexology and treatment of vulvodynia through existential therapy and acceptance through touch. The Scientific World Journal, 4, 571–580. https://doi.org/10.1100/tsw.2004.115

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25.03.2024

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Kako citirati

Jenko, C., & Žvelc, M. (2024). Psihoterapevtski pristopi in metode ter njihova učinkovitost pri obravnavi orgazmične disfunkcije pri ženskah. Psihološka Obzorja, 1-12. https://doi.org/10.20419/2024.33.584