Developing a Measure for Classification, Differentiation, and Diagnosis of Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia and Hypersexuality

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Mulroy, Maeve
sexual arousal , sexual desire , sexual health , hypersexuality , PGAD/GPD , PGAD , Persistent Genital Arousal Disorder , Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia
Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia (PGAD/GPD) is characterized by persistent, distressing genital sexual arousal sensations in absence of mental sexual arousal and sexual desire (Goldstein et al., 2021; Jackowich et al., 2016; Jackowich, Pink, Gordon, Poirier, & Pukall, 2018a). Symptoms of PGAD/GPD can be reduced by engaging in frequent sexual behaviours (Jackowich et al., 2016; Goldstein et al., 2021), which may sometimes be considered to be “hypersexual” in nature (excessive and out-of-control sexual behaviours, see Finlayson et al., 2001; Rinehart & McCabe, 1997) when encountered in clinical contexts. If clinicians are not aware of PGAD/GPD and do not complete a comprehensive differential diagnostic process, PGAD/GPD can be misdiagnosed as hypersexuality (Anzellotti et al., 2010; Leiblum & Seehuus, 2009; Jackowich et al., 2016), and receiving a misdiagnosis contributes to significant barriers to treatment (Jackowich et al., 2017; Jackowich, Boyer et al., 2020). The present research program aimed to develop a measure capable of accurately distinguishing between these two conditions. Study One used archival data collected as part of a larger study (see Jackowich et al., 2018a and 2018b), in which the Hypersexual Behaviour Inventory (HBI-19) (Reid et al., 2011) was administered to a sample of women with PGAD/GPD symptoms. Exploratory factor analysis suggested a two-factor structure (Coping, Negative Affect). Correlations among HBI-19 items and ratings of PGAD/GPD symptom severity and distress suggested that women with PGAD/GPD symptoms identified with items involving sexual behaviour interfering with their lives, but not with items related to coping with negative emotions through sexual behaviour. Significant positive correlations between the new Coping and Negative Affect factors and anxiety symptoms were observed. In Study Two, results of Study One informed development of the Sexual Arousal, Desire, Activity, and Impulses Questionnaire (SADAIQ). The SADAIQ was administered online to a sample of participants with PGAD/GPD and/or hypersexuality. Exploratory and Confirmatory Factor Analysis were used to evaluate the factor structure of the scale, with a six-factor structure being observed. Results of the present program of research present opportunities for a more accurate diagnostic process and conceptualization of distressing issues related to sexual arousal.
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