ABSTRACT
Introduction 111
Diagnostic Criteria 113
Proposed Sexual Aversion Criteria Revision 115
Case Example: Joyce 115
Case Discussion 117
General Treatment Considerations 117
Cognitive Behavioral Treatment 118
Insight-Oriented Treatment 118
Pharmacology 119
Conclusion 120
References 120
INTRODUCTION
Crenshaw (1) has been credited for first describing the sexual aversion syndrome.
Her description, published in 1985, remains one of two comprehensive manu-
scripts describing this disorder, joined only by Kaplan’s 1987 book (2), Sexual
Aversion, Sexual Phobias and Panic Disorder. Kaplan suggested that sexual aver-
sion is best conceptualized as encompassing a dual diagnosis, sexual anxiety and
panic disorder. Kaplan believed that one must treat the underlying organic panic
disorder with medication before addressing the sexual aversion. Her model
served to de-emphasize the aversion elements of the diagnosis in favor of the
panic component. Seen in historical context, however, she had identified the
biological underpinnings of the sexual disorders in ways that current conceptual
formulations take for granted. Recently, others have again underscored the
relationship between sexual aversion and panic disorder (3).