BACKGROUND:This study investigates the clinical evolution of Belgian individuals following an inpatient treatment for substance use disorder (SUD), based on the presence or absence of alexithymia, as defined by difficulties in emotional identification and expression. OBJECTIVES:The objective of this study was to examine differences in clinical evolution during inpatient SUD treatment between individuals with high versus low levels of alexithymia. Among 119 inpatients, 92 were classified into two groups based on TAS-20 scores: a high-alexithymia group (n1 = 51, 42.86%, TAS-20 > 60) and a low-alexithymia group (n2 = 41, 34.45%, TAS-20 < 52). Clinical assessments were conducted at baseline, during the first week of hospitalization, and then at 2 weeks (n1 = 35, n2 = 29), and after 4 weeks of treatment (n1 = 24, n2 = 14). RESULTS:At baseline, high alexithymia scores were associated with higher anxiety, emotional reactivity, and depressive symptoms. However, differences in addiction-related indicators, such as craving and self-efficacy, were less pronounced. All patients showed improvements in clinical symptoms during treatment, particularly in perceived stress and ruminations, but those with high alexithymia retained higher symptom severity. While both groups reported similar levels of craving, patients with alexithymia appeared to struggle more with emotional regulation. CONCLUSIONS:These findings suggest that alexithymia may negatively impact emotional regulation during SUD treatment and potentially affect long-term recovery. The results highlight the need for increased interventions that enhance emotional processing in individuals with alexithymia. Limitations include the small sample size and reliance on self-report measures, which may affect generalizability. Overall, this research enhances understanding of alexithymia's contribution to SUD treatment and supports the necessity for tailored therapeutic approaches, warranting further investigation into long-term effects and specific interventions for alexithymic traits.

Background: Impulsivity is a multifaceted construct that plays a prominent role in substance use disorder (SUD). The UPPS-P model distinguishes five impulsivity components (positive urgency, negative urgency, lack of perseverance, lack of premeditation, and sensation seeking). This study aimed to explore the structure of the UPPS-P in patients hospitalized for SUDs and to investigate the relationship between the dimensions of impulsivity and clinical variables. Method: Inpatients of a residential detoxification service (n = 125) were recruited. A confirmatory factor analysis was performed, and associations were assessed between the components of impulsivity and clinical indexes. Results: The factor analysis supported a model of impulsivity with five interrelated latent variables. Good internal consistency was found. External validity was supported by relationships with psychological difficulties. Multiple correlations (Kendall) suggested that, except for its sensation-seeking component, impulsivity is a significant risk factor for both the severity of addictive problems and their comorbidities. Conclusion: This study provides further evidence in favor of the 5-dimensional model of impulsivity. It highlights impulsivity as a transdiagnostic risk factor that should be considered in the management of SUD.

Objectives: This study aimed to explore past studies that have focused exclusively on the sexuality of adults older than 65 from a positive public health approach. Methods: We performed a critical interpretive synthesis, starting with the literature review on sexual behaviors in later life, adding policy documents on aging sexuality, and bringing new perspectives. Results: Older adults continue to be sexually active. Healthcare professionals lack knowledge and communication skills surrounding aging sexuality and no policies before 2013 mention aging sexuality. Conclusions: We posit that society's view of later life sexuality reflects on practice, policies, and research on this topic, which influence back society's view.

Introduction: Impulsivity is a multifaceted construct that plays a prominent role in substance use disorder (SUD). The UPPS-P model distinguishes five impulsivity components (positive urgency, negative urgency, lack of perseverance, lack of premeditation, sensation seeking). The aim of this study was to explore the structure of the UPPS-P in patients hospitalised for SUDs, and to investigate the relationship between the dimensions of impulsivity and clinical and psychological variables.Method: One hundred and twenty-five participants admitted to a residential detoxification service were recruited. A confirmatory factor analysis was performed, and associations were assessed between the components of impulsivity and SUD severity indexes, anxiety (STAI-Y), emotional reactivity (ERS), depressed mood (CES-D), perceived stress (PSS), self-esteem (RSE), mental rumination (PTQ) and alexithymia (TAS-20).Results: The factor analysis supported a model with five interrelated latent variables compared to a unitary or a hierarchical model. Good internal consistency was found. External validity was supported by relationships with psychological difficulties. Specifically, feelings of self-efficacy about becoming abstinent were negatively correlated with lack of perseverance. The intensity and frequency of perceived craving were positively correlated with lack of premeditation and lack of perseverance. Negative urgency, positive urgency, lack of premeditation, and lack of perseverance were positively correlated with mental rumination, emotional reactivity, state anxiety, depressed mood, perceived stress, and alexithymia (except for lack of perseverance). Conversely, these four dimensions of the UPPS-P were negatively correlated with self-esteem. The sensation-seeking dimension was only positively correlated with emotional reactivity.Conclusion: This study provides further evidence in favour of the 5-dimensional model of impulsivity and it highlights impulsivity as a transdiagnostic risk factor to be considered as a necessary clinical management focus to improve clinical outcomes in SUD.

La présente revue vise à tirer les enseignements généraux de plusieurs décennies de recherches empiriques consacrées aux traitements psycho-comportementaux de l'éjaculation prématurée. Trente-trois essais faisant état de mesures avant et après traitements psycho-sexologiques ont été rassemblés et analysés. Les taux d'amélioration associés aux sexothérapies s'échelonnent de 25 % à 100 %, leur taille d'effet globale (d) se situe entre 0,83 et 3,75. L'efficacité des traitements requière la réalisation d'exercices de stimulation pénienne avec pauses (« stop-start ») et/ou d'exercices visant à la régulation des composantes discrètes de l'excitation (approche « régulatrice » ou « sexo-fonctionnelle »). Il n'est pas sûr que les variantes faisant appel à des pincements (« squeeze »), à l'utilisation d'un vibreur ou à un mode particulier de masturbation produisent un surcroît d'efficacité. Quant aux exercices centrés sur le renforcement de la musculature pelvienne, ils ne semblent guère pertinents. Les traitements les plus efficaces sont également ceux qui permettent un accompagnement visant à optimiser l'intégration par les bénéficiaires des principes thérapeutiques et à aborder avec eux d'éventuelles difficultés associées. En cela les formules d'auto-traitement apparaissent moins performantes. La combinaison d'une sexothérapie et d'une pharmacothérapie donne généralement lieu à des résultats supérieurs à ceux obtenus individuellement de chacune de ces deux options. Les recherches empiriques cumulées sur plusieurs décennies accréditent l'utilité des sexothérapies dans le domaine de l'éjaculation prématurée et spécifient leurs conditions d'efficacité. The aim of this review is to draw general lessons from several decades of empirical research on psycho-behavioural treatments for premature ejaculation. Thirty-three trials reporting measures pre- and post-sex therapy were collected and assessed. The improvement rates associated with sex therapies ranged from 25 % to 100 %, the overall effect size (d) was between 0.83 and 3.75. The effectiveness of the interventions requires penile stimulation exercises with pauses ("stop-start") and/or exercises aimed at regulating discrete components of sexual arousal ("regulatory" or "sexual-functional" approach). It is not clear whether variations involving squeezing, use of a vibratory device or a particular mode of masturbation are more effective. Exercises that focus on strengthening the pelvic muscles do not appear to be particularly effective. The most effective treatments are also those that allow for support of the beneficiaries in order to ensure an adequate integration of the therapeutic principles and to address any associated difficulties. In this respect, self-treatment formulas appear less effective. The combination of sex therapy and drug therapy generally yields better results than either of these two options alone. Empirical research accumulated over several decades supports the usefulness of sex therapies in the field of premature ejaculation and specifies their conditions of effectiveness.

Le questionnaire des schémas de Young (YSQ-S3) et celui des tempéraments et des caractères de Cloninger (TCI-R) ont été remplis par 49 femmes et 56 hommes présentant un trouble lié à l’utilisation d’une substance, tel que défini par le DSM-IV-TR. Pour 84,8 % des personnes, le principal produit incriminé était l’alcool, soit à titre unique (73,3 %), soit en combinaison avec d’autres produits. Leur âge moyen est de 45,5 ans et s’étend de 21 à 64 ans. Pour le YSQ-S3, on relève une sur-activation de cinq schémas précoces inadaptés (SPI) dans l’échantillon : manque affectif, abandon/instabilité, abnégation, négativité/pessimisme et idéaux exigeants. Pour le TCI-R, on observe une surpondération des notes d’évitement du danger et une sous-pondération des notes d’autodétermination. D’un autre côté, des régressions linéaires montrent qu’une faible autodétermination, telle que mesurée par le TCI-R, permet de prédire une large palette de SPI. À un degré moindre, l’évitement du danger apparaît, également, comme un prédicteur significatif des SPI. Par ailleurs, la particularité d’un profil de réponse au TCI-R ne paraît guère à même de prédire un profil de réponse particulier au YSQ-S3.

Self-treatments have previously shown some efficacy in treating premature ejaculation (PE). It has been hypothesized that adding professional support to cognitive-behaviour bibliotherapy could improve self-treatment outcomes. Therefore, the aim of this study was to compare treatment outcomes for participants with PE who used bibliotherapy alone (pure self-treatment) versus those who used the bibliotherapy with brief support from a health professional (guided self-treatment). Health professionals were not experienced sex therapists, but had attended a short training session in order to equip them to support the self-help process. In total, 135 men reporting difficulties with PE were recruited between February and June 2013. Seventy-one (52.59%) completed the protocol: 37 in the pure self-treatment condition, 34 in the guided self-treatment condition. Thirty-five participants (50%) met criteria for ISSM definition of lifelong PE, 14 (20%) for acquired PE, and 22 (30%) presented other forms of PE complaints. At 4-8 months post-treatment, improvements were found in both groups and in each subtype of PE on self-reported measures of sexual functioning and sexual cognitions. Univariate analyses indicated slightly greater treatment effects in the guided self-treatment group, but multivariate tests failed to identify a significant effect of therapist support. These mixed findings raise questions regarding the amount and quality of therapist input used in this study, and also about a possible ceiling effect of cognitive-behaviour therapy for PE.

This study examined trait anxiety and sexual cognitions in 610 men with premature ejaculation (PE) (DSM-IV-TR criteria) and in 107 partners of these men, and compared their scores to normative data. Sexual anxiety, intravaginal ejaculatory latency time, feeling of control over ejaculation, and PE-related distress were also assessed. The scores of 343 participants (56.23%) with clearly identifiable subtypes of PE according to Waldinger's classification system (lifelong, acquired, variable, and subjective subtypes) were compared in these domains. Finally, the predictive value of these factors in determining PE-related distress was explored. The following conclusions can be summarized from the results: (1) Men affected by PE are more distressed by the problem than their partners; (2) there is no evidence that levels of trait anxiety in individuals with PE are dissimilar to those found in the general population; (3) "dysfunctional" sexual cognitions likely play a role in PE, especially with regard to PE-related distress; (4) different subtypes of PE have similar profiles on measures of trait anxiety, sexual anxiety, and sexual cognitions; (5) differences between subtypes are only apparent with regard to feeling of control over ejaculation, with men with lifelong or acquired PE scoring significantly lower than those with a subjective form of the problem.

Objective: The BibliothEP study aimed to assess the efficacy of a bibliotherapy for premature ejaculation (PE) Design and Method: The study was conducted in two phases. First, a sample of 120 participants suffering from PE read a concise cognitive behavioural self-help manual for PE (51 A5 pages including illustrations) and were compared after treatment to 66 waiting list controls. Second, 36 subjects received and read the self-help manual and were compared after treatment to 32 subjects having received the same manual plus a complementary brief guidance (45-90 minutes) from a coach not specialized in sex therapy, but who had been specifically trained to support the bibliotherapy intervention (by attending a 5-hour training module). The main outcome measures were self-determined latency time to ejaculation, feelings of control, sexual satisfaction, PE-related distress and subjective impression of improvement. Results: At 6-month posttreatment, all participants showed significant improvements as compared to waiting list condition. The improvements were maintained at 12 month. They were slightly greater in the case of complementary therapist support. Improvements were demonstrated for all forms of PE, but the intervention appeared to be slightly more effective when the problem was of moderate severity. In all cases, improvements in sexual functioning were accompanied by improvements in sexual cognitions. Conclusions: The cost-effectiveness of the self-help manual makes it a valuable first-line treatment for any form of PE. Moreover, the outcome of the bibliotherapy process might be increased by coaching from a health worker specifically trained to this aim.

The BibliothEP study aimed to assess the efficacy of a bibliotherapy for premature ejaculation (PE). The study was conducted in two phases. First, a sample of 120 participants suffering from PE read a concise cognitive behavioural self-help manual for PE (51 A5 pages including illustrations) and were compared after treatment to 66 waiting list controls. Second, 36 subjects received and read the self-help manual and were compared after treatment to 32 subjects having received the same manual plus a complementary brief guidance (45-90 minutes) from a coach not specialised in sex therapy, but who had been specifically trained to support the bibliotherapy intervention (by attending a 5-hour training module). The main outcome measures were self-determined latency time to ejaculation, feelings of control, sexual satisfaction, PE-related distress and subjective impression of improvement. At 6-month posttreatment, all participants showed significant improvements as compared to waiting list condition. The improvements were maintained at 12 month. They were slightly greater in the case of complementary therapist support. Improvements were demonstrated for all forms of PE, but the intervention appeared to be slightly more effective when the problem was of moderate severity. In all cases, improvements in sexual functioning were accompanied by improvements in sexual cognitions.

Objectif L’éjaculation précoce (EP) touche environ un homme sur cinq. Le projet BibliothEP (évaluation d’une bibliothérapie de l’EP) s’est fixé comme objectif d’élaborer un traitement à la fois efficace, simple, facile d’accès, bon marché, libre de toute toxicité et éventuellement applicable sans l’intrusion d’un tiers. Méthode L’étude s’est déroulée en deux phases. La première comprenait 120 participants souffrant d’EP. Un manuel concis (51 pages A5) d’auto-traitement cognitivo-comportemental de l’EP leur a été donné à lire, suite à quoi ils ont été comparés à 66 sujets laissés en liste d’attente. La seconde phase comparait 36 sujets ayant lu le manuel à 32 autres qui, en plus du manuel, recevaient un bref accompagnement (45 à 90 minutes) par un professionnel de la santé. Les accompagnants n’étaient pas spécialisés en thérapie sexuelle mais ont reçu une formation de 5 heures les habilitant à soutenir et faciliter le processus d’auto-traitement. Les paramètres évalués après traitement comprenaient la latence éjaculatoire auto-estimée, le sentiment de contrôle sur l’éjaculation, la satisfaction sexuelle, la détresse relative à la situation et l’impression subjective d’amélioration. Résultats Six mois après le traitement, tous les participants ont montré des améliorations significatives en comparaison des sujets laissés en liste d’attente. Ces améliorations persistaient à 12 mois. Elles étaient légèrement supérieures pour les participants ayant bénéficié d’une assistance. Des améliorations ont été trouvées pour toutes les formes du trouble mais l’intervention semble avoir été légèrement plus efficace lorsque l’EP était de sévérité modérée. Dans tous les cas, les améliorations du fonctionnement sexuel se sont accompagnées d’une amélioration des cognitions sexuelles. Conclusions Le rapport coût/efficacité de la bibliothérapie en fait un instrument thérapeutique idéal en première ligne. Il semble en outre possible de majorer l’efficacité de la formule en la doublant d’une assistance par un intervenant expressément formé à cette fin.