Non-Erotic Thoughts, Attentional Focus, and Sexual Problems in a Community Sample

According to Barlow’s model of sexual dysfunction, anxiety in sexual situations leads to attentional focus on sexual performance
at the expense of erotic cues, which compromises sexual arousal. This negative experience will enhance anxiety in future sexual
situations, and non-erotic thoughts (NETs) relevant to performance will receive attentional priority. Previous research with
student samples (Purdon & Holdaway, 2006; Purdon & Watson, 2010) has found that people experience many types of NETs in addition to performance-relevant thoughts, and that, consistent with
Barlow’s model, the frequency of and anxiety evoked by these thoughts is positively associated with sexual problems. Extending
this previous work, the current study found that, in a community sample of women (N = 81) and men (N = 72) in long-term relationships, women were more likely to report body image concerns and external consequences of the sexual
activity, while men were more likely to report performance-related concerns. Equally likely among men and women were thoughts
about emotional consequences of the sexual activity. Regardless of thought content, experiencing more frequent NETs was associated
with more sexual problems in both women and men. Moreover, as per Barlow’s model, greater negative affect in anticipation
of and during sexual activity predicted greater frequency of NETs and greater anxiety in response to NETs was associated with
greater difficulty dismissing the thoughts. However, greater difficulty in refocusing on erotic thoughts during sexual activity
uniquely predicted more sexual problems above the frequency and dismissability of NETs. Together, these data support the cognitive
interference mechanism implicated by Barlow’s causal model of sexual dysfunction and have implications for the treatment of
sexual problems.