Creating emotionally-enhanced genital sexual arousal in a community sample: A pilot study

A recently proposed incentive motivational model of sexual deviance (IMMSD;
Smid & Wever, 2017) suggests that paraphilic sexual interests may be born from
the need to enhance sexual arousal by means of other emotional stimuli, a
process referred to as *excitation transfer*.

According to this perspective, sexual arousal is an emotional reaction,
comparable to other emotions coupled with strong bodily reactions. Sexual
arousal and other emotions can influence each other back and forth, leading to
various expressions of emotional self-regulation and sexual self-regulation.
With regard to paraphilic interests, the IMMSD suggests that other emotions can
be used (consciously or unconsciously) to regulate sexual arousal. At the core
of this paraphilic sexual self-regulation is the process of excitation transfer
(Zillmann, 1996). If an emotion surges while another lingering emotion is still
present it will *inseparably combine with the excitatory reaction to the
present stimuli and thereby intensify both emotional behavior and emotional
experience* (p. 250). In other words: one emotion lifts the other, or builds on
the other. Consistent with this hypothesis, a number of deviant sexual
interests/paraphilia*s exist that appear to be associated with certain
emotions. Disgust may, for example, play a role in paraphilia*s like
scatophilia, sexual attraction to feces, or necrophilia, sexual attraction to
(dissected) dead bodies. Another example is embarrassment, which may play a
role in exhibitionism.

Excitation transfer has never before been studied in the specific context of
sexual arousal and not with genital sexual arousal in men as an outcome
measure. In this pilot study we primarily aim to assess whether it is possible
to enhance genital sexual arousal in men by means of excitation transfer.
Extending this pilot study to a subsequent main study is a first step to
increase knowledge on the etiology of nonparaphilic sexual interests.
Eventually, this might help to increase our knowledge on the nature and
development of paraphilic sexual interests, which in turn might be useful in
treatment of (potential) sexual offenders.

The current pilot study aims to assess whether it is possible to create a
genital reaction by means of excitation transfer and what are the optimal
parameters to induce this effect.

The current study is of experimental nature with a combined within-subjects and
between-subjects design. Thirty volunteers will be presented with the same
stimuli in counterbalanced order to prevent order effects. Participants are
randomly assigned to condition A or B, which differ in the moment of
vibrostimulation relative to emotion induction.

Genital arousal will be induced by a vibrostimulator and assessed by penile
circumference as well as by subjective ratings following each phase of
vibrostimulation. Subjects view neutral film clips and film clips inducing two
negative and two positive emotions. The affective reaction to each of the
emotional stimuli will be assessed by means of the self-assessment manikin
(Bradley & Lang, 1994). Condition A and B differ in the moment of
vibrostimulation with respect to emotion induction: i.e. in condition A
vibrostimulation happens simultaneous to emotion induction, whereas in
condition B, emotion induction precedes vibrostimulation.
Pre-measurement, participants will fill in the International Index of Erectile
Function (Rosen et al., 1997), and the Sexual Inhibition Scale/Sexual Exitation
Scale (Janssen, Vorst, Finn, & Bancroft, 2002). They will fill in an adapted
version of the Sexual Opinion Survey (Fisher, White, Byrne, & Kelley, 1988)
both pre- and post-measurement. Throughout the experiment, heart rate will be
measured continuously.

There are no major risks associated with participation. It is however possible
that the participants find genital vibrostimulation and measures of penile
circumference intrusive. However, research indicates that people experience the
assessment of penile circumference as minimally intrusive (Huberman & Chivers,
2015). To maximize comfort, participants are left in the room unsupervised
during the experiment, sit underneath a blanket, and get recovery time after
the experiment.

Participants receive a ¤35,- reimbursement for participation. Participants may
always withdraw from the experiment without any consequences.