Metacognitions in heterosexual, bisexual, and homosexual men: with or without premature ejaculation and erectile dysfunction

Behav Cogn Psychother. 2021 Sep;49(5):612-625. doi: 10.1017/S1352465820000879. Epub 2020 Dec 18.

Abstract

Background: Premature ejaculation (PE) and erectile dysfunction (ED) are prevalent sexual problems, with evidence to suggest variation across sexual orientation. Contributing factors have traditionally been divided into organic and psychological categories. While limited research has found support for the influence of metacognitive beliefs, these studies did not investigate potential differences in sexual orientation.

Aim: The current study aimed to investigate the differences in metacognitive beliefs in men with or without PE and/or ED and whether these varied according to sexual orientation.

Method: A sample of 531 men was recruited (65 met criteria for PE only, 147 for ED, 83 with PE and ED, and 236 healthy controls). Within this sample, 188 men identified as heterosexual, 144 as bisexual, and 199 as homosexual. Participants completed a cross-sectional online survey consisting of psychometric measures.

Results: Participants with PE and ED were significantly higher in cognitive confidence, thoughts concerning uncontrollability and danger, and need to control thoughts than PE only, ED only, and healthy controls. Furthermore, the PE only group was significantly higher than healthy controls for cognitive confidence, with the ED significantly higher for thoughts concerning uncontrollability and danger. There were no significant differences between differing sexual orientations for men with/or without PE and/or ED.

Conclusions: Congruent with previous research, metacognitive beliefs play a role in PE and/or ED, although this is not exclusive to sexual orientation. The findings highlight that assessment and intervention regarding metacognitive beliefs may be beneficial for men of all sexual orientations with PE and/or ED.

Keywords: erectile dysfunction; metacognition; metacognitive beliefs; premature ejaculation; sexual dysfunction; sexual orientation.

MeSH terms

  • Cross-Sectional Studies
  • Erectile Dysfunction*
  • Female
  • Heterosexuality
  • Humans
  • Male
  • Metacognition*
  • Premature Ejaculation*
  • Sexual Behavior
  • Sexual and Gender Minorities*
  • Surveys and Questionnaires