Two New Physiological Methods to Assess the Specificity of Sexual Responses Megan Leona Sawatsky A thesis submitted in partial fulfillment of the requirements for the Doctorate in Philosophy degree in Clinical Psychology School of Psychology Faculty of Social Science University of Ottawa © Megan Leona Sawatsky, Ottawa, Canada, 2020 ii Author Declaration I hereby declare that I am the major contributing author of this dissertation. This is a true copy of the dissertation, including any required final revisions, as accepted by my examiners. I authorize the University of Ottawa to lend this dissertation to other institutions or individuals for the purpose of scholarly research. I further authorize the University of Ottawa to reproduce this dissertation by photocopying or by other means, in total or in part, at the request of other institutions or individuals for the purpose of scholarly research. I understand that my dissertation may be made electronically available to the public. Megan Leona Sawatsky iii Abstract Psychophysiological methods to study sexual response patterns in laboratory settings have revealed an intriguing, and puzzling, gender/sex difference in the cue-specificity of genital responses. Men’s penile responses differ across stimuli depending on the presence or absence of specific sexual cues (e.g., gender and age of individuals in a sexual stimulus), with substantial responses observed for cues that correspond with sexual preferences and much less response to nonpreferred cues. This is not the case for women. Women’s genital responses (vaginal vasocongestion) are elicited by almost any sexual cue and the response magnitude is much less affected by sexual preferences, particularly for heterosexual women. Even sexual stimuli rated as sexually non-arousing and unappealing can elicit substantial vaginal responses. These findings have inspired several research questions. In particular, what is the function of relatively low cue- specificity in women? Are gender/sex differences in cue-specificity an artifact of the methods used to assess genital responses in women and men? The four studies in this dissertation address these questions by employing two novel devices to measure either genital lubrication or anal vasocongestion. Results from two studies suggest that the degree of cue-specificity in women depends on which aspect of the genital response is assessed: Genital lubrication was specific to preferred sexual stimuli, whereas vaginal vasocongestion demonstrated low cue-specificity across the entire stimulus duration. The other two studies focussed on developing and testing methodologies related to anal photoplethysmography. The results indicate that, in its current configuration, it would be premature to use anal photoplethysmography to study gender/sex differences in sexual response patterns. Taken together, the research program highlights the impact of measurement devices on sexual response patterns and underscores the importance of a multidisciplinary, multi-methodology approach to studying sexual response patterns in women and men. iv Preface In addition to the General Introduction and General Discussion chapters, this dissertation comprises four scientific reports in separate chapters. Versions of the reports are either published or under review for publication. The references below provide relevant publication information. Formatting, language, and referencing styles are consistent with the standards of the journal to which the reports were submitted. Tables, figures, and references are presented at the end of each report. All reports were written in full by the first author. Dr. Martin Lalumière was a co-author for all reports and served as the dissertation supervisor; he contributed to study planning, conceptualisation, and editing of drafts. Chapter Two is published in Biological Psychology and was co-authored by Dr. Samantha Dawson. Dr. Dawson contributed to the conceptualisation and provided manuscript feedback and editing. Chapter Three was accepted for publication in The Canadian Journal of Human Sexuality and was co-authored by Ms. Sofija Lavrinsek and Dr. Dawson who provided manuscript feedback. Ms. Lavrinsek was also involved in data preparation and Dr. Dawson provided statistical consultation. Chapter Four is published in The Journal of Sexual Medicine. Chapter Five consists of a manuscript that is under review with Archives of Sexual Behavior. The manuscript was co-authored by Dr. Kelly Suschinsky, Ms. Lavrinsek, and Dr. Meredith Chivers who provided manuscript feedback. Dr. Suschinsky also consulted on data and result interpretation, and she and Dr. Chivers provided conceptual assistance. Ms. Lavrinsek was involved in data collection. Dr. Jonathan Huber is acknowledged for providing consultation on anatomy and participant inclusion criteria. Chapter Two: Sawatsky, M. L., Dawson, S. J., & Lalumière, M. L. (2018). Genital lubrication: A cue-specific sexual response? Biological Psychology, 134, 103–113. doi:10.1016/j.biopsycho.2018. v 02.003 Chapter Three: Sawatsky, M. L., Lavrinsek, S., Dawson, S. J., & Lalumière, M. L. (2020). Time course of genital response cue-specificity. The Canadian Journal of Human Sexuality. Advanced online publication. doi:10.3138/cjhs.2019-0064 Chapter Four: Sawatsky, M. L., & Lalumière, M. L. (2020). Effect of a condom cover on vaginal photoplethysmographic responses. The Journal of Sexual Medicine, 17, 702–715. doi:10.1016/j.jsxm.2019.12.021 Chapter Five: Sawatsky, M. L., Suschinsky, K. D., Lavrinsek, S., Chivers, M. L., & Lalumière, M. L. (2020). Can the vaginal photoplethysmograph and its associated methodology be used to assess anal vasocongestion in women and men? Manuscript under review with Archives of Sexual Behavior. vi Acknowledgements First and foremost, I would like to thank my supervisor, Dr. Martin Lalumière. Though it was over eight years ago, I still remember our first meeting in Lethbridge, Alberta, when you accepted me into your laboratory as a research assistant. I left that meeting feeling that my life was forever changed, and it was so! I am grateful for the many opportunities you provided me and, above all, your belief in me. The skills you imparted and the wisdom you shared have extended beyond the academic arena. Your thoughtful, encouraging, and approachable supervision style leave students feeling confidant to tackle the challenges inherent to completing a PhD. The scientific rigour you demonstrated was balanced with “Martin’isms” and humour that made research fun. To my parents who instilled in me a curiosity about the world, a value in learning, and a desire to meaningfully contribute to the lives of others, I cannot thank you enough. Your unwavering support and belief in my success have carried me through my academic journey. To my Ottawa chosen family, your encouragement and support have extended well-beyond academics. Our sharing of ideas and experiences has shaped me in immeasurable ways. It is my privilege to thank my lab mates and colleagues in the clinical program whom I have learned from and been inspired by. To Drs. Samantha Dawson and Kelly Suschinsky, your mentorship has substantially contributed to my development as a researcher. Thank you to my thesis committee and other researchers in the field who provided feedback on this work. I would like to extend gratitude to the University of Ottawa and the broader training program for your commitment to student learning. Thank you also to the funding agencies that generously provided financial support. Finally, I would like to acknowledge that this work would not be possible without the participants who took interest in contributing to research. vii Table of Contents Author Declaration.................................................................................................................. ii Abstract .................................................................................................................................. iii Preface.................................................................................................................................... iv Acknowledgements ................................................................................................................ vi Table of Contents .................................................................................................................. vii List of Tables .......................................................................................................................... x List of Figures ........................................................................................................................ xi CHAPTER 1 General Introduction ................................................................................................................ 1 The Genital Response ............................................................................................................. 3 Male Genital Response ....................................................................................................... 3 Female Genital Response .................................................................................................... 4 Models of Sexual Response .................................................................................................... 5 Psychophysiological Measures ............................................................................................... 7 Self-Report Measures.........................................................................................................