Shires, A & Miller, D 1998, 'A preliminary study comparing psychological factors associated with erectile dysfunction in heterosexual and homosexual men', Sexual and Marital Therapy, vol. 13, no. 1, pp. 37-49.
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This study examined whether a group of homosexual men experiencing erectile difficulties showed differences from heterosexual men with the same clinical presentations in a number of affective and cognitive variables associated with erectile difficulties. In particular it was hypothesized that homosexual participants would present with a different set of cognitions surrounding the erectile dysfunction (and would be less affected by performance anxiety, a construct shown to be a significant variable in the aetiology of erectile dysfunction in heterosexual couples). Results drawn from standarized and purpose-designed questionnaires indicated that heterosexual men in the participant group were significantly more likely to be affected by performance anxiety, and showed higher levels of general anxiety, depression and lower levels of self-esteem than their homosexual counterparts. The homosexual group was found to be more affected by a number of cognitive variables including HIV anxiety, internalized homophobia, and intimacy issues. Findings fit with the model of erectile dysfunction proposed by Barlow, in which cognitive interference in the form of specific cognitive beliefs and schemata have an impact on sexual arousal when combined with anxiety about the consequences of erectile loss.
