Thursday, March 1, 2018

The Dual Control Model of Sexual Arousal

I have talked in previous posts about the importance of thinking about both sexual arousal and sexual inhibition when dealing with libido differences. Because this is so important to understanding libido and sex drive, I want to come back to the subject and add some background and additional depth.

Most people first encounter this model by reading Emily Nagoski's excellent book, Come As You Are: The Surprising New Science that Will Transform Your Sex Life. Many readers will have also taken the Sexual Temperament Questionnaire, which is intended to help you understand where you fit in terms of the sensitivity of your "Sexual Excitation System" (SES) and the sensitivity of your "Sexual Inhibitory System" (SIS).

The SES/SIS questionnaire that Dr. Nagoski uses comes from what is known as the "Dual Control Model of Sexual Arousal." Because she teaches at Smith, a mostly-women's university, she uses a version of the questionnaire that is oriented somewhat more towards women. But the model and the SES/SIS questionnaire actually originated with research on men and their sexual problems.

For people who haven't read Nagoski's book, here's a brief description of the DCM, from an article I wrote about it a few years ago:
Eric Janssen and John Bancroft of the Kinsey Institute for Sex Research observed that most physiological systems in the body have dual control systems. For example, insulin responds to high blood sugar by lowering it, while glucagon responds to low blood sugar by raising it. Similarly, sweating responds to high body temperature by cooling you off, while shivering responds to low body temperature by warming you up.
At the most basic level, we know that neurons can be wired to either excite or inhibit other neurons when they fire. And at the highest level, we know that the sympathetic and parasympathetic branches of the autonomic nervous system have complex reciprocal and counteractive effects, where each is responsible for turning some activities on that the other one turns off, and vice versa.
Janssen & Bancroft's hypothesis, which has been born out by a great deal of research and experience in the last 20 years, is that sexual arousal is also controlled by two different systems in the brain. In effect, one of these is the accelerator pedal and the other is the brake. And this matters, because if the brakes are fully engaged – by stress, anxiety, fear, fatigue, frustration, or any other stressors – pushing down harder on the accelerator will create arousal only with difficulty, if at all, and it is not likely to be very enjoyable.
Janssen & Bancroft called the accelerator the Sexual Excitation System, or SES, and they called the brake the Sexual Inhibitory System, or SIS. And they found that people differ a great deal in the sensitivity of both of these systems.
This dual control model actually grew out of 30+ years of theorizing about and research on performance anxiety in men. Janssen and Bancroft began developing the model in the 1990s as a reaction to the inadequacy of single-scale approaches to male arousal.

For example, this paper from 2002 discusses use of the SIS and SES specifically with men:
The Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales: I. Measuring sexual inhibition and excitation proneness in men.

By that point they had established the validity of their theoretical framework for men. The obvious question was whether it also applied to women, especially since there were obvious parallels in terms of the effects of stress versus arousal on female low libido and anorgasmia.

Research since then has illuminated some gender differences, but it has also has shown that the dual control model is a remarkably good general explanatory framework for many psychogenic sexual problems for both sexes. It remains the best meta-level model for explaining what researchers see happening in terms of both physiological and psychological processes.

As J&B wrote in 2007:
Although the concepts of excitation and inhibition are probably just as relevant (if not more; cf. Bjorkland & Kipp, 1996) to women's sexual responses, and although the SIS/SES questionnaire has demonstrated its value in research in women (Carpenter, Graham, Janssen, Vorst, & Wicherts, 2006), the measure was originally developed for use in men because the available research underlying the dual control model was largely restricted to the neurophysiology and psychophysiology of male sexual response. ...
We now also have a substantial amount of data from women on the role of sexual excitation and inhibition and of the relationship between mood and sexuality. ... Confirmatory factor analyses of women's SIS/SES scores provided moderate support for the higher-level model found in men. As we had previously found in men, correlations in women between the sexual excitation (SES) factor and the two sexual inhibition factors (SIS1 and SIS2) were low, while the SIS1 and SIS2 factors exhibited a modest positive correlation.
However, the original questionnaire had a tilt toward men's problems, so they developed alternatives that would be more gender neutral, or more suitable for women:
Gender differences were found, with women scoring higher on the ... inhibition factors and lower on the sexual excitation factor in comparison with men. The test-retest reliability and convergent and discriminant validity of women's SIS/SES scores, using the original factor structure, were similar to those we found for men. In this study we also developed and tested a short version of the SIS/SES questionnaire (SIS/SES--Short Form), which features items with similar psychometric properties in women and men. The 14-item version of the SIS/SES showed to be associated with test-retest reliability and convergent/discriminant validity that closely resemble the longer, 45-item measure.
While these preliminary findings suggest that the SIS/SES questionnaire may also be of value in research on sexual response, functioning, and behavior in women, substantial progress has been made in work on the development of a new measure, designed specifically for use in women (Graham, Sanders, Milhausen, & McBride, 2004). One of the starting points of this project is that the SIS/SES questionnaire may not tap all relevant sources of sexual excitation and inhibition in women, including effects of body self-consciousness, concerns related to reputation, and relationship variables.
The version used by Nagoski is the one developed for women ~2004 and later revised.

The Kinsey Institute for Sex Research is located at Indiana University. Nagoski was a graduate student at IU at the time this research was going on, and received her PhD in 2006. Although her own research and dissertation were in a different area, this was one of the hottest topics in her department in ~2001-2005 when she was doing her graduate coursework.

For a longer, gender-neutral version, google "SESII-W/M" or "Sexual Excitation Sexual/Inhibition Inventory for Women and Men" and follow the scoring instructions.

This article is an excellent summary of the inspiration, the concepts, and the research that has gone into the design of the various DCM questionnaires, as well as what researchers have learned from using them: The Dual Control Model of Sexual Response by J.Bancroft and E.Janssen.

Janssen's 2007 book, The Psychophysiology of Sex, is also excellent if you want to dig into this further. Or google 'the Dual Control Model of Sexual Arousal' for lots of additional information.

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