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Sexual Arousal, Orgasm and Pleasure, As Much As Possible Using a Prospective, Laboratory Paradigm

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Sexual Arousal, Orgasm and Pleasure, As Much As Possible Using a Prospective, Laboratory Paradigm AN INVESTIGATION OF SELECTED TRADITIONAL ASSUMPTIONS ABOUT SEXUAL AROUSAL, ORGASM AND PLEASURE LAUREL Q. P. PATERSON B.A. Department of Psychology McGill University Montréal, Québec, Canada April 2013 A thesis submitted to McGill University in partial fulfillment of the requirements of the degree of Doctor of Philosophy Laurel Q. P. Paterson (2013) ACKNOWLEDGEMENTS I would like to express my gratitude to the many people who have helped me complete this thesis. First and foremost, I would like to thank my supervisor, Dr. Irv Binik, for his invaluable guidance and support throughout my PhD, and for his enthusiasm about bringing the study of orgasm back into the laboratory. I have been fortunate to share my laboratory with a wonderful group of researchers and friends: my fellow graduate students, Seth Davis, Melissa Farmer, Alina Kao, Tuuli Kukkonen, Marie-Andrée Lahaie, and Sabina Sarin; our dedicated research coordinators, Natalie Cartright, Marie Faaborg-Andersen, Jackie Huberman, Caroline Maykut, and Louise Overington; and my research assistants Ayelet Germanski, Ellie Shuo Jin, Natalie Stratton, and Lindsay Sycz. These bright women and man have stimulated research ideas, pushed me to overcome logistical obstacles, and made the laboratory a fun place to work. I will forever be grateful for the friendship and support of my classmates, Crystal Holly, Ilana Kronick, and Julie Mercier. Finally, I would like to thank my family and Peter for their unwavering support and encouragement. Throughout my graduate studies, I have been supported by generous research scholarships from the Canadian Institutes of Health Research (CIHR), McGill University Faculty of Graduate Studies, McGill University Health Centre Research Institute, Fonds de recherche du Québec – Santé (FRSQ), and the Natural Sciences and Engineering Research Council (NSERC). The original research included in this thesis was made possible by CIHR operating grants to my supervisor, Dr. Irv Binik. ii CONTRIBUTION OF AUTHORS As the first author on all of the manuscripts, I took the lead role in the research design, implementation, data analyses and interpretation, and writing of all manuscripts. The first manuscript is co-authored by Sabina Sarin, a fellow graduate student, who wrote the section on psychological treatment of female orgasmic disorder. The second manuscript is co-authored by Seth Davis, a fellow graduate student, who assisted in the literature review. The third and fourth manuscripts are co-authored by Rhonda Amsel, a statistics professor in the Department of Psychology, who provided guidance on the data analyses. The fourth manuscript is also co-authored by Ellie Shuo Jin, an undergraduate research assistant, who assisted in data collection and interpretation. My supervisor, Dr. Irv Binik, senior author on all manuscripts, provided substantial input into study design and data analyses and interpretation. He also provided excellent editorial comments throughout the preparation of the manuscripts. iii TABLE OF CONTENTS ACKNOWLEDGEMENTS ........................................................................................................... ii CONTRIBUTION OF AUTHORS .............................................................................................. iii LIST OF TABLES ......................................................................................................................... vi LIST OF FIGURES ...................................................................................................................... vii LIST OF APPENDICES ............................................................................................................. viii ABSTRACT ................................................................................................................................... ix RÉSUMÉ ........................................................................................................................................ xi GENERAL INTRODUCTION ..................................................................................................... 1 References ................................................................................................................................... 5 MANUSCRIPT ONE: Disorders of Female Orgasm .................................................................. 6 Abstract ....................................................................................................................................... 7 Female Orgasm and Orgasmic Difficulties ................................................................................. 9 Triggers and Mechanisms of Orgasm ..................................................................................... 9 Correlates of Orgasmic Functioning .................................................................................... 11 Prevalence and Correlates of Orgasmic Difficulties and Distress ....................................... 13 Assessment of Orgasmic Difficulties ........................................................................................ 16 Signs of Orgasm .................................................................................................................... 16 Clinical Assessment Recommendations ................................................................................ 21 Diagnostic Criteria for Female Orgasmic Disorder (FOD) ................................................. 22 Treatment of Female Orgasmic Disorder .................................................................................. 26 Pharmacological Treatment ................................................................................................. 26 Psychological Treatment....................................................................................................... 27 Conclusions ............................................................................................................................... 39 References ................................................................................................................................. 42 TRANSITION ............................................................................................................................... 65 References ................................................................................................................................. 66 MANUSCRIPT TWO: Female Genital Mutilation/Cutting and Orgasm Before and After Surgical Repair ............................................................................................................................. 67 Abstract ..................................................................................................................................... 68 Orgasm in Women with FGM/C ............................................................................................... 71 Methodological Considerations ............................................................................................ 71 Comparisons to Women without FGM/C .............................................................................. 72 Orgasm without an External Clitoris .................................................................................... 74 The Effect of Surgical Repair of FGM/C on Orgasm ................................................................ 77 Defibulation .......................................................................................................................... 77 iv Clitoral Reconstruction ......................................................................................................... 78 Conclusions ............................................................................................................................... 80 References ................................................................................................................................. 82 TRANSITION ............................................................................................................................... 91 References ................................................................................................................................. 94 MANUSCRIPT THREE: Pleasure and Pain: The Effect of (Almost) Having an Orgasm on Genital and Non-Genital Sensitivity ...................................................................................... 95 Abstract ..................................................................................................................................... 96 Methods ................................................................................................................................... 103 Participants ......................................................................................................................... 103 Measures ............................................................................................................................. 104 Procedure ............................................................................................................................ 106 Data Analyses ..................................................................................................................... 108 Results ..................................................................................................................................... 109 Sexual Functioning and Laboratory Masturbation Characteristics ................................... 109 Sensitivity ...........................................................................................................................
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