Effects of Depression on Processing and Evaluation of Sexual Stimuli in Women

J Sex Med. 2022 Mar;19(3):441-451. doi: 10.1016/j.jsxm.2021.12.008. Epub 2022 Jan 6.


Background: Sexual dysfunctions are commonly associated with depression by which women are particularly affected.

Aim: In the following study, we looked at which stage-early attention-related processes or later evaluation-related processes-of the processing of sexual stimuli deviations occur in depressed individuals.

Methods: We examined 96 women who either suffered from a major depressive disorder, or had recovered from it, and a healthy control group. The early level of attention processes was represented by reaction time tasks (dot probe, line orientation, picture categorization). In addition, implicit approach and avoidance behavior was tested by the Approach-Avoidance Task. Later evaluation of the visual material was determined with the help of a questionnaire for recording automatic negative thoughts regarding sexuality.

Outcomes: Reaction times and explicit ratings as well as the Becks Depression Inventory (BDI II), the Trait Sexual Motivation Questionnaire (TSMQ), the Sexual Modes Questionnaire (SMQ) and a screening for sexual dysfunction were used.

Results: Depressed women did not differ significantly from healthy women in their attention processes and approach-avoidance behavior. However, there were clear differences in explicit assessment and automatic thoughts about sexual stimuli. Women who had recovered from depression lay between the 2 groups.

Clinical implications: The results indicated that the therapy of sexual dysfunction in depressed patients should focus more on automatic thoughts than on attention processes.

Strengths & limitations: This study is the first to experimentally research the attention processes of depression towards sexual stimuli. However, participants were only tested on one occasion so that change of attention processes and evaluation of sexual stimuli over the course of a depression could not be assessed.

Conclusion: Our novel findings demonstrate the role of attention processes in sexual dysfunctions of depressed women and suggest potential mechanisms that may underlie the observed correlation between depression and sexual dysfunction. Baranowski AM, Noll A-K, Golder S, et al. Effects of Depression on Processing and Evaluation of Sexual Stimuli in Women. J Sex Med 2022;19:441-451.

Keywords: Approach-Avoidance; Attention; Automatic Thoughts; Depression; Remission; Sexual Dysfunction; Women.

MeSH terms

  • Depression
  • Depressive Disorder, Major* / complications
  • Female
  • Humans
  • Sexual Behavior
  • Sexual Dysfunction, Physiological*
  • Sexual Dysfunctions, Psychological*
  • Sexuality