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).