Sexology
Week 1 introduction to sexology
No reading required (not exam material)
Week 2 the sexual response – hardware
Artikel 1: Agmo & Laan (2023) The Sexual Incentive Motivation Model and Its
Clinical Applications
An incentive motivation model is proposed to explain sexual behavior from the perception
of sexually relevant stimuli through postcoital (after sexual intercourse) emotional
responses. Central idea: accumulated emotional outcomes of sexual experiences shape the
incentive value of sexual cues, which in turn influences sexual motivation.
Incentive motivation model of sexual motivation
Early thinkers: sexual arousal not spontaneous, but activated by sensory cues.
Later models: exposure to sexual stimuli > physiological responses > cognitive evaluations >
approach behaviors > sexual activity.
Recent theories: sexual desire in terms of incentive (stimulating) motivation. Limitation:
exclusive focus on humans.
The sexual incentive stimulus
the sexual incentive stimulus = any cue that activates sexual motivation, produces genital
responses and can lead to sexual approach behavior.
The central motive state
the central motive state is the set of neural processes that link sensory input to organized
action (ex. Food is only attractive when hungry)
Sexual approach behavior
whether a person acts on sexual motivation depends on cognitive evaluations. Non-human
animals approach without complex cognitive filtering.
,Viscerosomatic responses
sexually relevant stimuli trigger unconscious visceral responses (vaginal lubrication/penile
erection). Genital responses are one of the most precise indicators of sexual motivation;
genital arousal and orgasm can occur in non-consent situations; physiological reactions are
largely independent of conscious intention of desire.
Sexual behavior (copulation)
sexual behavior; any action that leads to sexual reward. In this meaning, fantasizing with
ejaculation would be seen as sex, while with goals as money would not.
Aftereffects of sexual activity
sexual activity is generally assumed to produce a rewarding state characterized by positive
affect. But, sexual activity can also lead to negative emotional states. Guilt, shame, anxiety
(postcoital dysphoria, pregnancy).
Long-term consequences of postcoital emotional reactions
pairing sexual stimuli with aversive (nl: onaangename) events can reduce both genital
responses and subjective sexual arousal
Clinical applications
the incentive motivation model is particulary useful for understanding human sexual
dysfunctions (hypoactive sexual desire disorder). In DSM-5 this category was divided
- Female sexual interest/arousal disorder (characterized by diminished or absent
interest in sexual activities)
- Male hypoactive sexual desire disorder (low/absent sexual desire)
For both: symptoms must persist > 6 months. Not bothered by it or identifying as asexual is
not a disorder!
Etiology
laboratory studies show that genital responses to sexual stimuli remain intact in both
asexual individuals and those diagnosed with hypoactive sexual desire/interest disorder, so
low desire does not reflect low activity in the sexual central motive state. Low sexual desire
can be explained without assuming intrinsic central motive deficits. Two primary
mechanisms are proposed:
1. Failure of the incentive stimulus to activate the central motive state: if a stimulus is
cognitively evaluated as unlikely to produce sexual reward, or as potentially aversive,
it will not trigger sexual motivation
2. Activation of the central motive state without behavioral approach: the stimulus may
be recognized as sexually rewarding, triggering genital responses, but conscious
decision-making or negative predictions about sexual activity prevent actual
approach or participation.
Low sexual desire can be situational or generalized:
, - Generalized: likely caused by low activity of the central motive state, resulting in
reduced genital responses to all sexual stimuli
- Situational: caused by reduced impact of specific sexual incentives, with genital
responses intact for some stimuli but not others. (mainly supported by current
evidence)
Other factors, such as absence of postcoital reward (orgasm) or painful intercourse, can
reduce the positive reinforcement of sexual stimuli, further diminishing desire.
Contextual conditioning: the central motive state remains responsive, but cognitive
processes and learned associations influence the decision to engage in sexual activity.
Treatment
financial investment in psychotherapeutic treatments is far smaller than that for drug
treatments. Long term therapies remain underexplored, but some evidence suggests
benefits may persist for at least six months.
Elements of psychotherapeutic treatment
all the therapeutic approaches share several common features:
1. Sensate focus training: main goal is to help patients explore and become aware of
their own (genital) sensations. (ex. Examine each others and own genitals and tactile
stimulation, abstain from sexual activity)
2. Cognitive and emotional restructuring: modifying thoughts and feelings about
sexual activities, partner, and the relationship, as well as the emotional responses to
these elements
3. Sexual activity guided by desire: engage in sexual activity only when fully aroused
and motivated. Alternative forms then penile-vaginal (because this is not the most
effective way for many women to achieve orgasm) are encouraged.
4. Duration and structure: some programs require 15-20 sessions, newer mindfulness-
based approaches only 3 combined with extensive home practive.
Treatment interpreted in terms of the incentive motivation model
1. Enhancing the incentive value of sexual stimuli: the initial phase of therapy focuses
on attention to and appreciation of the sensory experience provided by nearby
sexual stimuli, such as genital sensations
2. Cognitive restructuring and decision-making: the cognitive component of therapy
modifies how patients evaluate the sexual situation, influencing their conscious
decision to approach sexual activity rather than withdraw
3. Positive reinforcement through orgasm: emphasizing techniques that maximize the
probability of orgasm ensures that sexual activity produces positive affect, reducing
or eliminating negative postcoital emotions
4. Genital responses remain intact: woman retain unconscious genital responses to
sexual stimuli; therapy does not necessarily change this physiological response.
Week 1 introduction to sexology
No reading required (not exam material)
Week 2 the sexual response – hardware
Artikel 1: Agmo & Laan (2023) The Sexual Incentive Motivation Model and Its
Clinical Applications
An incentive motivation model is proposed to explain sexual behavior from the perception
of sexually relevant stimuli through postcoital (after sexual intercourse) emotional
responses. Central idea: accumulated emotional outcomes of sexual experiences shape the
incentive value of sexual cues, which in turn influences sexual motivation.
Incentive motivation model of sexual motivation
Early thinkers: sexual arousal not spontaneous, but activated by sensory cues.
Later models: exposure to sexual stimuli > physiological responses > cognitive evaluations >
approach behaviors > sexual activity.
Recent theories: sexual desire in terms of incentive (stimulating) motivation. Limitation:
exclusive focus on humans.
The sexual incentive stimulus
the sexual incentive stimulus = any cue that activates sexual motivation, produces genital
responses and can lead to sexual approach behavior.
The central motive state
the central motive state is the set of neural processes that link sensory input to organized
action (ex. Food is only attractive when hungry)
Sexual approach behavior
whether a person acts on sexual motivation depends on cognitive evaluations. Non-human
animals approach without complex cognitive filtering.
,Viscerosomatic responses
sexually relevant stimuli trigger unconscious visceral responses (vaginal lubrication/penile
erection). Genital responses are one of the most precise indicators of sexual motivation;
genital arousal and orgasm can occur in non-consent situations; physiological reactions are
largely independent of conscious intention of desire.
Sexual behavior (copulation)
sexual behavior; any action that leads to sexual reward. In this meaning, fantasizing with
ejaculation would be seen as sex, while with goals as money would not.
Aftereffects of sexual activity
sexual activity is generally assumed to produce a rewarding state characterized by positive
affect. But, sexual activity can also lead to negative emotional states. Guilt, shame, anxiety
(postcoital dysphoria, pregnancy).
Long-term consequences of postcoital emotional reactions
pairing sexual stimuli with aversive (nl: onaangename) events can reduce both genital
responses and subjective sexual arousal
Clinical applications
the incentive motivation model is particulary useful for understanding human sexual
dysfunctions (hypoactive sexual desire disorder). In DSM-5 this category was divided
- Female sexual interest/arousal disorder (characterized by diminished or absent
interest in sexual activities)
- Male hypoactive sexual desire disorder (low/absent sexual desire)
For both: symptoms must persist > 6 months. Not bothered by it or identifying as asexual is
not a disorder!
Etiology
laboratory studies show that genital responses to sexual stimuli remain intact in both
asexual individuals and those diagnosed with hypoactive sexual desire/interest disorder, so
low desire does not reflect low activity in the sexual central motive state. Low sexual desire
can be explained without assuming intrinsic central motive deficits. Two primary
mechanisms are proposed:
1. Failure of the incentive stimulus to activate the central motive state: if a stimulus is
cognitively evaluated as unlikely to produce sexual reward, or as potentially aversive,
it will not trigger sexual motivation
2. Activation of the central motive state without behavioral approach: the stimulus may
be recognized as sexually rewarding, triggering genital responses, but conscious
decision-making or negative predictions about sexual activity prevent actual
approach or participation.
Low sexual desire can be situational or generalized:
, - Generalized: likely caused by low activity of the central motive state, resulting in
reduced genital responses to all sexual stimuli
- Situational: caused by reduced impact of specific sexual incentives, with genital
responses intact for some stimuli but not others. (mainly supported by current
evidence)
Other factors, such as absence of postcoital reward (orgasm) or painful intercourse, can
reduce the positive reinforcement of sexual stimuli, further diminishing desire.
Contextual conditioning: the central motive state remains responsive, but cognitive
processes and learned associations influence the decision to engage in sexual activity.
Treatment
financial investment in psychotherapeutic treatments is far smaller than that for drug
treatments. Long term therapies remain underexplored, but some evidence suggests
benefits may persist for at least six months.
Elements of psychotherapeutic treatment
all the therapeutic approaches share several common features:
1. Sensate focus training: main goal is to help patients explore and become aware of
their own (genital) sensations. (ex. Examine each others and own genitals and tactile
stimulation, abstain from sexual activity)
2. Cognitive and emotional restructuring: modifying thoughts and feelings about
sexual activities, partner, and the relationship, as well as the emotional responses to
these elements
3. Sexual activity guided by desire: engage in sexual activity only when fully aroused
and motivated. Alternative forms then penile-vaginal (because this is not the most
effective way for many women to achieve orgasm) are encouraged.
4. Duration and structure: some programs require 15-20 sessions, newer mindfulness-
based approaches only 3 combined with extensive home practive.
Treatment interpreted in terms of the incentive motivation model
1. Enhancing the incentive value of sexual stimuli: the initial phase of therapy focuses
on attention to and appreciation of the sensory experience provided by nearby
sexual stimuli, such as genital sensations
2. Cognitive restructuring and decision-making: the cognitive component of therapy
modifies how patients evaluate the sexual situation, influencing their conscious
decision to approach sexual activity rather than withdraw
3. Positive reinforcement through orgasm: emphasizing techniques that maximize the
probability of orgasm ensures that sexual activity produces positive affect, reducing
or eliminating negative postcoital emotions
4. Genital responses remain intact: woman retain unconscious genital responses to
sexual stimuli; therapy does not necessarily change this physiological response.
