Disruptions in the sexual response cycles of women with Sexual Interest/Arousal Disorder

Basson’s popular, if controversial,  model of sexual response((Basson, R. (2002). A model of women’s sexual arousal. Journal of Sex & Marital Therapy, 28(1), 1–10. https://doi.org/10.1080/ 009262302317250963 Medline:11928174)) is a circular model that distinguishes between spontaneous and responsive sexual desire. It also suggests that sexual desire follows sexual arousal.

This study of 53 women looked for “breaks”, or disruptions in this cycle for the women studied. Results provide support for previous research and mindfulness interventions.



The sample included 53 women 19-64 (M=39) who were primarily caucasian (81%) and well educated. Most (75%) were in a relationship.

The inclusion criteria were as follows: between the ages of 19–65, fluent in English, and meeting diagnostic criteria for SIAD. Women who had a psychiatric or medical condition that would prevent group participation or comple- tion of daily homework were excluded. As well, those with Borderline Personality Disorder were excluded.Fourteen (14) were married, and all individuals were between 21 and 47 years old. They were highly educated and lived in either the US or Canada. Ten (10) identified no religion, five Christian, two Jewish, and one stated Muslim.


After educating the participants on Basson’s Sexual Response Cycle, women were given a worksheet that provided boxes for each stage of the response cycle for them to complete at home illustrating their own sexual experiences.

Worksheets were then evaluated coding the responses and looking for “breaks”. “”Breaks were defined as negative responses or the absence of positive responses”. Frequency of responses was also calculated for repondents.


Women experienced an average of 5.1 breaks out of a possible 11 breaks.

A total of 34% of the women reported a break in their cycle leading up to sexual arousal, and nearly half the women noted that sexual arousal did not trigger desire for them. Moreover, 43.4% of the women reported that the out- come of the sexual encounter did not reinforce a positive motivation for sex on future encounters.

The following infographic identifies the three most frequently endorsed responses for each component of the sexual response cycle.


Notable findings included the following:

  • More than 80% of the total reasons for sex reported were positive/approach reasons.
  • Over half (56%) of the 46 reasons listed for sex were unique.
  • The majority of women listed touching or cuddling as a required stimulus for sexual arousal (63%).
  • Few women (6%) reported lacking the context they needed to experience sexual arousal. Almost half of women reported the need for privacy, and one-quarter of women reported the need for a sexual encounter to occur not too late and to be not rushed.
  • Less than 19% identified biological facilitators but 87.7% identified biological hinderances.
  • Almost a third of women (32%) reported pain or discomfort while 26% of women reported fatigue as a hindering biological factor.
  • Over 90% of women reported psychological limiting factors with only 21% listing a psychological facilitating factor.
  • A third (31%) of women reported being distracted as a hindering factor, as well as 26% of women reported memories of past experiences hindering their sexual arousal.
  • Positive body image as a psychological facilitator was only listed by 2% of the women while 25% listed it as a hindering factor.
  • While most women (94%) reported relevant sexual stimuli needed to facilitate sexual arousal, one-third of women did not report the experience of sexual arousal even with the presence of sexual stimuli.
  • Almost half of women reported that the outcome of the sexual encounter did not reinforce a positive motivation for future sexual encounters.

While only one third of women did not experience sexual arousal, almost half of women did not experience feelings of responsive desire. These findings confirm that among women with SIAD responsive desire, even in the presence of sexual arousal, may not take place. Other factors beyond the awareness of one’s own sexual arousal may impact responsive desire, such as psychological factors. Women may not have a positive reaction to feelings of sexual arousal nor does the experience of arousal necessarily result in the desire to continue with a sexual encounter (Basson, 2002).

Much of the research looking at the impact of negative sexual experiences has focused on trauma, such as childhood sexual abuse (e.g., Aaron, 2012; Najman, Dunne, Purdie, Boyle, & Coxeter, 2005), and as such, there is a need to also empirically examine the impact of consensual but disappointing or undesired sexual experiences on future sexual encounters.


This research suffers from the same issues most all sex research suffers from – highly limited sample. Not only is the sample only 53 women, it is largely a homogeneous group (white, educated) and almost 40% of the women did not complete the study for a variety of reasons. Redeeming the smaller sample size is the fact that this is a qualitative study more than a quantitative study and sample sizes for qualitative studies are typically smaller. One glaring omission is the authors did not identify how the women were diagnosed with FSIAD despite this being a rather large factor in the sample. A larger sample size would allow for more interpretation with some of the numbers. For example, the authors report 85.7% of the helping psychological factors identified were unique, but with only 14 total responses that means there were 12 unique and 2 repeat answers. It would take a larger sample to know if that is meaningful or not, and to see if the repeated answers were consistent. Even with these distractors, as the authors point out…

This study is the first to empirically examine Basson’s composite circular model of sexual response with the goal of identifying the breaks that occur throughout the cycle for women with SIAD. The findings presented here provide support for the utility of this model in identifying where and how often women with low desire experience disruptions in their sexual response cycles.

So What? …

First, it is important to remember that the sample for this study is women diagnosed with FSIAD. Thus, this is a clinical sample and not a normative sample of women.
Generalizing these findings to all (non-clinical) women would not be accurate.

That being said, there are take-aways that are valuable, not the least of which is helping guide inquiry for women who might be experiencing FSIAD.

For example, attention to where the breaks occur and the general nature of those breaks is valuable. What do they, and do they not observe in themselves and their response cycle? While it could be argued that failure to list a factor doesn’t mean it wasn’t present, that it wasn’t part of the focus is still important. For example, only 21% of women listed a psychological facilitator. While there may have been (likely were?) facilitating psychological factors in more of the women, that these factors weren’t present enough in their mind to identify them may still be telling. This may be supportive of the mindfulness approaches that help women be more focused on the positive (facilitating) factors.

What would be very interesting is to repeat this study with a non-clinical sample and compare their responses. Do non-clinical women identify facilitators, for example? If so, this could be a clear diagnostic variable. It is already a treatment focus.

Finally, the authors recommend utilizing the worksheet in a general clinical setting. It could be interesting to provide it for assessment or even as an intervention. The worksheet they provided is available here, but please post it (or email it to me to post) if you develop one. 

Let us know your thoughts and how you use this study by adding a comment below.


Jabs, F., & Brotto, L. A. (2018). Identifying the disruptions in the sexual response cycles of women with Sexual Interest/Arousal Disorder. The Canadian Journal of Human Sexuality, 27(2), 123-132.




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