Comparing the Effectiveness of the Culture-Sensitive Integrated Model and the Cognitive-Behavioral Model on Sexual Function and Quality of the Marital Relationship of Women with Sexual Interest /Arousal Disorder

Document Type : Original


1 Ph. D. Student in Psychology, Department of Psychology, University of Lorestan University, Lorestan, Iran.

2 Associate Professor, Department of Psychology, Lorestan University, Lorestan, Iran.

3 Associate Professor, Department of Psychology, Lorestan University, Lorestan, Khorramabad, Iran.


Background: Female Sexual Interest-Arousal Disorder is one of the most common sexual problems in women and a multifactorial disorder. Objective: This study aimed to compare the effectiveness of the newly developed treatment of female sexual interest-arousal disorder and cognitive-behavioral therapy (CBT) on sexual function and the quality of the marital relationship of women with female sexual interest-arousal disorder. Method: The research method was experimental with a pretest-posttest design with a control group. The statistical population included women with female sexual interest-arousal disorder referred to counseling centers in Isfahan, from which 45 people were selected by purposive sampling and randomly assigned to three groups (15 people in each group). Subjects of all three groups were evaluated in the pre-test stage with scales. Then the experimental groups underwent an 8-session weekly intervention and the control group did not receive any intervention. At the end of the intervention sessions, the members of all three groups were re-evaluated with research tools. The female Sexual Function Index Scale (Isidori, Pozza, Esposito, Giugliano, Morano, et al, 2010) and relationship Quality Scale(Chonody, Gabb, Killian &Dunk-West,2018)were the instruments in this study. Findings: The results of multivariate analysis of covariance showed that both interventions affect therapeutic goals and the experimental groups witnessed positive changes in the post-test of sexual function and quality of marital relationship compared to the control group. Regarding the competitive validation of the interventions, the results showed that in the sexual function, the effectiveness is more in favor of the psychotherapy protocol of female sexual interest-arousal disorder (P<0.05), but no significant difference was observed between the two interventions in the quality of the marital relationship(P>0.05). Conclusion According to these results, it can be said that the psychotherapy protocol for the female sexual interest-arousal disorder has the necessary effectiveness in modulating the symptoms of this disorder and can be used as a suitable treatment option along with other psychotherapy models for this disorder.


Main Subjects

Attar, S., Behnia Asal, F., Heidari, Z., Mahmoudi, N. (2020). Evaluation of the effectiveness of cognitive-behavioral therapy (CBT) on increasing sexual intimacy and reducing body image anxiety in women with sexual dysfunction (sexual reluctance) referred to counseling centers in Shiraz. Recent Advances in Behavioral Sciences, 5(43), 85-94. [persian] URL:۱-۴۳۴-fa.html
Azartash, F., Shafiabadi, A., Falsafi Nezhad, M.R. (2022). Effectiveness of the Cognitive-Behavioral Therapy on the Women’s Hypoactive Sexual Desire. Women's Research Journal, 13(39), 1-17. [persian]. doi: 10.30465 / ws.2021.36131.3282
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th Ed.). Washington, DC: Author.
Antle, B.F., Owen, J.J., Eells, T.D., Wells, M.J., Harris, L.M., Cappiccie, A., Wright, B., Williams, S.M., Wright, J.H. (2019). Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care. Contemporary Clinical Trials, 78, 46-.25. 10.1016/j.cct.2018.11.001
 Both, S. (2017). Recent developments in psychopharmaceutical approaches to treating female sexual interest and arousal disorder. Current Sexual Health Reports, 9(4), 192-199. 10.1007/s11930-017-0124-3
Brotto L.A. (2017). Evidence-based treatments for low sexual desire in women. Front Neuroendocrinol, 45, 11–17. doi: 10.1016/j.yfrne.2017.02.001. 
Chonody, J. M., Gabb, J., Killian, M., & Dunk-West, P. (2018). Measuring relationship quality in an international study: Exploratory and confirmatory factor validity. Research on Social Work Practice, 28(8), 920-930.‌
Eshghi, R., Bahrami, F., Fatehizadeh, F., Keshavarz, A. (2015). Studying the Effectiveness of Couples Sexual Cognitive–Behavioral Therapy on Improvement of Women's Hypoactive Sexual Desire Disorder in Isfahan. QJCR, 14(53)  111-130. [persian] URL:
Frost, R. & Donovan, C. (2019). A qualitative exploration of the distress experienced by long-term heterosexual couples when women have low sexual desire. Sexual and Relationship Therapy, 25, 22-45.
Frühauf, S., Gerger, H., Schmidt, H. M., Munder, T., & Barth, J. (2013). Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Archives of sexual behavior, 42(6)  915–933.
Ghaderi, F., akrami, N., namdari, K., abedi, A. (2020). Developing an integrated psychotherapy model of generalized anxiety disorder comorbid with emotional disorders: a qualitative approach. IJRN.6(4), 70-82.
Ghassami, M., Shairi, M. R., Asghari Moghadam, M. A., Rahmati, N. (2014). The Study of the psychometric properties of the 6-item version of the female sexual function index (FSFI-6) amongst Iranian. Nurse Midwifery Journal, 12(7), 532-543. [Persian] URL:
Ghasemi, N., Rezaei, F., Sadeghi, M. (2022). Development of psychotherapy Protocol for female sexual interest-arousal disorder; Qualitative Study. Iranian Journal of Rehabilitation Research in Nursing, 8(4), 50-64. URL:۱-۶۹۶-fa.html
Hertlein, K., Weeks, G., Gambescia, N. (2015). Systemic Sex Therapy. London: ‌ Routledge.
Isidori, A. M., Pozza, C., Esposito, K., Giugliano, D., Morano, S., Vignozzi, L., Corona, G., Lenzi, A., & Jannini, E. A. (2010). Development and validation of a 6-item version of the female sexual function index (FSFI) as a diagnostic tool for female sexual dysfunction. The Journal of sexual medicine, 7(3), 1139–1146.
‌ Khan, S., Amjad A., Rowland, A.D. (2019). Potential for Long-Term Benefit of Cognitive Behavioral Therapy as an Adjunct Treatment for Men with Erectile Dysfunction. The Journal of Sexual Medicine, 16(2), 300-306.
Malary, M., Khani, S., Pourasghar, M., Moosazadeh, M. & Hamzehgardeshi, Z. (2015). Biopsychosocial Determinants of Hypoactive Sexual Desire in Women. Mayo Foundation for Medical Education and Research, 27(6), 383-389.
Meston, C. M., & Stanton, A. M. (2017). Treatment of Female Sexual Interest/Arousal Disorder. In The Textbook of Clinical Sexual Medicine (pp. 165-168). Springer: Cham.
Naghdi, H., Hatami, M., Kiamanesh, A., Nawabi Nejad,S.h. (2017). Evaluation of the effect of emotion-focused couple therapy with problem-oriented systemic therapy on the marital conflict in the spouses of men undergoing substance abuse treatment. Family Counseling and Psychotherapy, 7(1), 23-44.[Persian]
Newman, J.L.E., Falligant, J.M., Thompson, K.R., Gomez, M.D., Burkhart, B.R. (2018). Trauma-focused cognitive behavioral therapy with adolescents with illegal sexual behavior in a secure residential treatment facility. Children and Youth Services Review, 91, 431-438.
Pyke, R.E., Clayton, A.H. (2015). Psychological treatment trials for hypoactive sexual desire disorder: a sexual medicine critique and perspective. The Journal of sexual medicine, 12(12), 2451-2458.
Rosen, N. O., Dubé, J. P., Corsini-Munt, S., & Muise, A. (2019). Partners experience consequences, too: A comparison of the sexual, and relational. & psychological adjustment of women with sexual interest/arousal disorder and their partners to control couples. The Journal of sexual medicine, 16(1), 83-95.‌
Shifren, J. L., Monz, B. U., Russo, P. A., Segreti, A., & Johannes, C. B. (2008). Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol, 112(5), 970-978.
Shubina, I. (2015). Cognitive-behavioral Therapy of Patients with Ptsd: Literature Review. Procedia - Social and Behavioral Sciences, 165, 208-.612.
Soltani, A., Rezaei, F., Razavi, V. (2014). The effectiveness of Barlow's cognitive-emotional counseling on improving sexual coldness in women in Isfahan. Knowledge and Research in Psychology, 17(3), 81-89.[persian]
Stephenson, K. R., Zippan, N., & Brotto, L. A. (2021). Feasibility of a cognitive behavioral online intervention for women with Sexual Interest/Arousal Disorder. Journal of Clinical Psychology, 77(9), 1877–1893.
Taqizadeh Firouzjaei, I., Sadat Z., Taghadosi M., Turki Habibabadi B. (2018). Psychometric Properties of the Relationship Quality Scale (RQ). Payesh, 17(1)  85-94. [persian]
Tasew, A.S. & Koye, K.J. (2021). Marital conflict among couples: The case of Durbete town, Amhara Region, Ethiopia. Cogent Psychology, 8(1), 541-549.
Thomas, E. J., & Gurevich, M. (2021). Difference or dysfunction?: Deconstructing desire in the DSM-5 diagnosis of female sexual interest/arousal disorder. Feminism & Psychology, 31(1), 81-98.