Asexuality vs. sexual interest/arousal disorder: Examining group differences in initial attention to sexual stimuli

PLOS ONE RESEARCH ARTICLE Asexuality vs. sexual interest/arousal disorder: Examining group differences in initial attention to sexual stimuli Julia Bradshaw ID1*, Natalie Brown ID1, Alan Kingstone1, Lori Brotto2 1 Department of Psychology, University of British Columbia, Vancouver, Canada, 2 Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada * a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Bradshaw J, Brown N, Kingstone A, Brotto L (2021) Asexuality vs. sexual interest/ arousal disorder: Examining group differences in initial attention to sexual stimuli. PLoS ONE 16(12): e0261434. https://doi.org/10.1371/journal. pone.0261434 Editor: Desmond J. Oathes, University of Pennsylvania Perelman School of Medicine, UNITED STATES Received: July 27, 2021 Accepted: November 29, 2021 Published: December 16, 2021 Copyright: © 2021 Bradshaw et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: This project has been registered and all relevant data have been made available on the Open Science Framework (DOI: 10. 17605/OSF.IO/J23HE). Funding: The authors received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist. Abstract Attention is considered to be a critical part of the sexual response cycle, and researchers have differentiated between the roles of initial (involuntary) and subsequent (voluntary) attention paid to sexual stimuli as part of the facilitation of sexual arousal. Prior studies using eye-tracking methodologies have shown differing initial attention patterns to erotic stimuli between men and women, as well as between individuals of different sexual orientations. No study has directly compared initial attention to sexual stimuli in asexual individuals, defined by their lack of sexual attraction, to women with Sexual Interest/Arousal Disorder (SIAD), a disorder characterized by a reduced or absent interest in sex coupled with significant personal distress. The current study tested differences in the initial attention patterns of 29 asexual individuals (Mage = 26.56, SD = 4.80) and 25 heterosexual women with SIAD (Mage = 27.52, SD = 4.87), using eye-tracking. Participants were presented with sexual and neutral stimuli, and their initial eye movements and initial fixations to both image types and areas of erotic contact within sexual images were recorded. Mixed-model ANOVAs and ttests were used to compare the two groups on the speed with which their initial fixations occurred, the duration of their initial fixations, and the proportion of initial fixations made to sexual stimuli. On two indices of initial attention, women with SIAD displayed an initial attention preference for sexual stimuli over neutral stimuli compared to asexual participants. This study adds to a growing literature on the distinction between asexuality and SIAD, indicating that differences in early attention may be a feature that differentiates the groups. Introduction Defining asexuality Asexuality is defined as a sexual orientation characterized variably as a lack of sexual attraction [1, 2]. Prevalence estimates for asexuality in the general population range from 0.4% to 1% [1, 3, 4]. A more recent study found 3.3% of women and 1.5% of men from a Finnish population had not experienced sexual attraction within the past year [5]. Many asexual individuals report a longstanding disinterest in sex, and for some, identification as asexual occurs after a period PLOS ONE | https://doi.org/10.1371/journal.pone.0261434 December 16, 2021 1 / 18 PLOS ONE Asexuality vs. SIAD: Group differences in initial attention to sexual stimuli of confusion or feeling markedly “different” than allosexual peers (i.e., people who experience sexual attraction) [6]. Other asexual individuals adopt this sexual identity after subsequent education about the asexual label and community. Research suggests that significant heterogeneity exists within the asexual community [2, 7, 8]. Asexuality exists on a spectrum, and asexual persons use a variety of terms to describe their position on this “ace” spectrum [8]. While approximately two-thirds of ace individuals identify specifically as asexual, just over 10% refer to themselves as “gray-asexual”, experiencing occasional attraction in isolation or with specific partners, to varying levels [8]. Other members of the ace community identify as “demisexual” (approximately 10%), only experiencing sexual attraction when an emotional bond is formed [8]. Asexual individuals also describe a variety of romantic orientations, including but not limited to biromanticism and heteroromanticism [7, 8]. In fact, diversity of romantic experiences within the asexual community has prompted researchers to examine differences between aromantic asexual persons (do not experience romantic attraction to others) and romantic asexual persons, and have found dissimilarities between these groups on variables such as number of romantic and sexual partners, selfreported desire, and personality traits like warmth and nurturance [7]. Additionally, asexual individuals identify as transgender or gender nonbinary at a higher rate (between 12.6% and 25%) than allosexual individuals, indicating considerable gender diversity within the community [7, 8]. The variation observed in the community is not a surprise, as a range of preferences, experiences, and chosen labels also exists amongst other sexual minorities [9]. Defining Sexual Interest/Arousal Disorder (SIAD) Sexual Interest/Arousal Disorder (SIAD), a disorder defined by the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is a sexual dysfunction wherein individuals experience reduced or absent sexual interest and/or arousal, coupled with significant personal distress [10]. Though there is variability in symptom presentation, women must have at least three of the following symptoms for six months to obtain a diagnosis: decreased or absent sexual interest, decreased sexual thoughts or fantasies, a decreased desire to initiate sex or respond to a partner’s initiations, decreased physiological sensations during sexual activity, decreased feelings of sexual pleasure or excitement, and decreased sexual interest/arousal in response to sexual cues [10]. There are two subtypes of SIAD based on symptom duration: (1) lifelong SIAD: symptoms since becoming sexually active; and (2) acquired SIAD: symptoms beginning after a period of satisfactory sexual desire and/or arousal levels [10]. Differentiating asexuality from SIAD Some debate has existed in the academic community as to whether asexuality is better understood as a sexual dysfunction [11]. Asexual individuals are sometimes compa (...truncated)