Evidence for Persistence of Sexual Evaluative Learning Effects

Introduction: Several studies demonstrated that genital arousal and enhanced positive affect toward neutral stimuli due to sexual conditioning did not extinguish during a brief extinction phase, but other studies showed contrasting results. Possible resistance to extinction of conditioned human sexual response has, however, not been studied using extensive extinction trials. Aim: To study resistance to extinction of conditioned sexual response in men and women. Methods: Healthy sexually functional men (N = 34) and women (N = 32) participated in a differential conditioning experiment, with neutral pictures as conditioned stimuli (CSs) and genital vibrostimulation as unconditioned stimulus. Only one CS (the CS+) was followed by the unconditioned stimulus during the acquisition phase. Main Outcome Measure: Penile circumference and vaginal pulse amplitude were assessed, and ratings of affective value and subjective sexual arousal were obtained. In addition, a stimulus response compatibility task was included to assess automatic approach and avoidance tendencies. Results: Men and women rated the CS+ as more positive than the CS− during all 24 extinction trials and demonstrated a slight tendency to approach the CS+ directly after the extinction procedure. Participants rated the CS+ as more sexually arousing than the CS− during 20 extinction trials. No evidence was found for conditioned genital sexual response. Clinical Implications: Learned sexual evaluations may be difficult to modify through an extinction procedure; therefore, unwanted but persistent subjective sexual evaluations may be better targeted by interventions such as the deployment of emotion regulation strategies. Strength & Limitations: Extensive extinction trials were used; however, only relatively short-term effects within one experimental session were studied and there was no (unpaired) control condition. Conclusion: The results provide evidence that conditioned sexual likes are relatively persistent, also at the behavioral level. Both S, Brom M, Laan E, et al. Evidence for Persistence of Sexual Evaluative Learning Effects. J Sex Med 2020;17:505–517.