(766) The Impact of an Aversive Pain Conditioning Procedure on Sexual Arousal in Heterosexual Women

Introduction Sexual problems are highly prevalent among women, with 10-28% suffering from pain-related female sexual dysfunctions (FSD). Repeated painful sexual experiences may link sexual cues with pain, forming pain expectancies that have been proposed as a potential aetiological or maintaining factor in pain-related FSDs by discouraging sexual approach behaviour, heightening vigilance to threat, and undermining sexual arousal. Objective This study tested if a specific sexual cue could indeed acquire predictive value for pain through a contingent pain experience in the context of a differential conditioning procedure. As a second aim, it was examined whether such acquired unconditional stimulus (US) expectancies would reduce sexual arousal and positive affect toward the erotic stimuli as potential early trajectories toward dysfunctional responding. As a novel extension of previous work, this study included trial-by-trial ratings of US expectancy alongside ratings of sexual arousal, disgust, and affective valence. Methods Two similar yet distinguishable 8-second pornographic film fragments served as the conditional stimuli. During acquisition, one conditional stimulus (CS+) was paired with the painful US (600 ms electrical stimulation to the middle finger of the non-dominant hand), whereas the other conditional stimulus (CS-) was never paired with the US. A sample of predominantly heterosexual women without sexual dysfunctions (N = 32) viewed the stimuli across 20 acquisition trials with 100% CS+-US contingency, followed by 20 extinction CS-only trials (no US). After the extinction procedure, participants were asked to indicate their willingness to rewatch the CS+ and the CS- video and completed a forced-choice behavioural test in which they chose either video. We hypothesised that conditioning would induce pain expectancies, reducing subjective sexual arousal and increasing negative affect toward the CS+ relative to the CS-. Furthermore, we expected that a CS-only extinction procedure would reduce differential pain expectancies and attenuate affective and arousal differences between the CS+ and CS-. We additionally expected preferential avoidance of the CS+ in the choice-based behavioural test. Results The CS+ elicited significantly higher pain expectancies than the CS-, demonstrating successful differential conditioning, and these expectancies remained elevated across extinction, indicating persistence of threat learning despite the absence of the US. Contrary to expectations, the CS+ was rated as overall more sexually arousing than the CS-. In the choice-based behavioural test, the CS+ was selected more frequently than the CS-, but this difference did not reach statistical significance. No evaluative conditioning effects were observed for affect. Conclusions These findings indicate that contingent sex-pain experiences produce robust and persistent pain expectancies supporting a proposed learning pathway relevant to pain-related FSDs. However, the absence of reduced arousal suggests a more complex, potentially ambivalent interplay between pain expectancy and sexual motivation in non-clinical populations. Disclosure No