Attentional and Affective Processing of Sexual Stimuli in Women with Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder (HSDD) is the most common sexual problem in women. From an incentive motivation perspective,
HSDD may be the result of a weak association between sexual stimuli and rewarding experiences. As a consequence, these stimuli
may either lose or fail to acquire a positive meaning, resulting in a limited number of incentives that have the capacity
to elicit a sexual response. According to current information processing models of sexual arousal, sexual stimuli automatically
activate meanings and if these are not predominantly positive, processes relevant to the activation of sexual arousal and
desire may be interrupted. Premenopausal U.S. and Dutch women with acquired HSDD (n = 42) and a control group of sexually functional women (n = 42) completed a single target Implicit Association Task and a Picture Association Task assessing automatic affective associations
with sexual stimuli and a dot detection task measuring attentional capture by sexual stimuli. Results showed that women with
acquired HSDD displayed less positive (but not more negative) automatic associations with sexual stimuli than sexually functional
women. The same pattern was found for self-reported affective sex-related associations. Participants were slower to detect
targets in the dot detection task that replaced sexual images, irrespective of sexual function status. As such, the findings
point to the relevance of affective processing of sexual stimuli in women with HSDD, and imply that the treatment of HSDD
might benefit from a stronger emphasis on the strengthening of the association between sexual stimuli and positive meaning
and sexual reward.