Copyright 2001 by the American Psychological Association Inc 0021-843X/01/S5.00 DOI: 10.1037//0021-843X. 110.2.

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Causal Attributions and Male Sexual Arousal: The Impact of Attributions for a Bogus Erectile Difficulty on Sexual Arousal, Cognitions, and Affect
Risa B. Weisberg
University at Albany, State University of New York

Timothy A. Brown
Boston University

John P. Wincze
Boston University and Brown University

David H. Barlow Boston University

After viewing 2 sexually explicit films, 52 sexually functional participants were given bogus feedback indicating a low erectile response. The men were given either an external, fluctuating attribution (i.e., poor films) or an internal, stable attribution (i.e., problematic thoughts about sex) for the low arousal. As hypothesized, participants in the external, fluctuating group evidenced greater erectile response and subjective arousal during a 3rd film than did participants given the internal, stable attribution. This may indicate that after an occasion of erectile difficulty, the cause to which the difficulty is attributed plays an important role in future sexual functioning.

According to Barlow's (1986) model of sexual functioning, men with erectile disorder differ from sexually functional men in their cognitive-affective response to a sexual performance demand. Sexually functional men respond to erotica with positive affect, positive expectancies, and perceived erectile control. Men with erectile dysfunction approach a sexual situation with negative affect, negative expectancies, and a lack of perceived control. These differing affective and cognitive states are thought to lead to differential attentional focus and, consequently, differential erectile responding. This is a positive-feedback model; because they have a history of functional erectile performance, men with sexual problems approach a new occasion of sexual activity with continued positive expectancies and affect. In contrast, men who have previously experienced erectile difficulty are thought to approach the next sexual situation with negative affect and negative expectancies. Empirical support for Barlow's (1986) model has accumulated (e.g., Abrahamson, Barlow, & Abrahamson, 1989; Abrahamson, Barlow, Sakheim, Beck, & Athanasiou, 1985; Bach, Brown, &

Risa B. Weisberg, Department of Psychology, University at Albany, State University of New York; Timothy A. Brown and David H. Barlow, Sexuality Research and Treatment Program, Center for Anxiety and Related Disorders, Boston University; John P. Wincze, Sexuality Research and Treatment Program, Center for Anxiety and Related Disorders, Boston University, and Department of Psychiatry and Human Behavior, Brown University. This work was supported in part by National Institute of Mental Health Grant 5 R01 MH033533. These data were collected in partial fulfillment of the requirements for a PhD at the University of Albany, State University of New York, for Risa B. Weisberg under the direction of David H. Barlow. Correspondence concerning this article should be addressed to Risa B. Weisberg, who is now at the Department of Psychiatry and Human Behavior, Brown University, Box G-BH, Duncan Building, Providence, Rhode f.siand 029/2. Electronic mail may be sent to risa_weisberg@ brown.edu.

Barlow, 1999; Beck & Barlow, 1986a, 1986b; Mitchell, Marten, Williams, & Barlow, 1990). What remains unexplained by the model is why men begin to respond so differently to sexual situations. In other words, how does the feedback loop begin? Whereas some men have experienced erectile difficulty all of their sexual lives, the majority of men with psychogenic male erectile disorder have a history of healthy sexual functioning before the onset of their problem (Masters & Johnson, 1970; Renshaw, 1988). Therefore, for most men with psychogenic male erectile disorder, the dysfunction begins with an occasion of erectile difficulty. Nevertheless, occasional erectile difficulty is normative. Interview data from community populations indicate that between 65% and 90% of men will experience an occasion of sexual activity at some point in their lives in which they are unable to attain or maintain an erection (e.g., Carter & Sokol, 1989; Hite, 1981). Whereas many men experience these occasional difficulties without an effect on their overall sexual functioning, others develop chronic erectile problems. A large body of research has established a relationship between causal attributions and cognitions, affect, and behavior. Attributing a negative event or failure experience to an internal and/or temporally stable cause has been found to be related to negative affect (e.g., Mone & Baker, 1992; Sweeney, Anderson, & Bailey, 1986) and perceptions of uncontrollability (e.g., Abramson, Seligman, & Teasdale, 1978; Peterson, Maier, & Seligman, 1993). Further, individuals who attribute a failure experience to a temporally stable event are more likely to expect future failure at the task (e.g., Heilman & Guzzo, 1978; Hospers, Kok, & Strecher, 1990; Neale & Friend, 1972). Evidence also shows that attributing failure at a task to internal and/or stable causes may be associated with poor performance during future attempts at the task (e.g., Dweck, 1975; Dweck & Reppucci, 1973; Peterson & Barrett, 1987). One paradigm used in this area of research has been the creation of an insoluble task or a bogus failure. Attributions for this failure are examined, manipulated, or both. Participants are then asked to attempt a similar
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task, without failure being a certain outcome. Such studies have frequently found that internal, stable attributions for failure are associated with less successful performance on the subsequent attempt at the task (e.g., Anderson, 1983; Tennen & Eller, 1977). For example, Seligman, Nolen-Hoeksema, Thorton, and Thorton (1990) examined performance in college swimmers. Athletes were given limes for their swim that were significantly slower than their actual performance. After a 30-minute rest, participants were asked to complete another timed swim in the same event. In genera., swimmers with a pessimistic attributional style swam significantly worse during the second swim than they had in the first. Swimmers with an optimistic attributional style did not experience this deterioration in their performance after the bogus feedback. Many men may conceptualize an occasion of erectile difficulty as failure at a task (Zilbergeld, 1992). We might then expect that internal and stable attributions for this difficulty would be associated with difficulty during a subsequent attempt to become aroused. Further, internal and stable attributions for an occasion of erectile difficulty might be associated with negative affect, negative expectancies, and a lack of perceived control, the same constellation of cognitive-affective variables that Barlow (1986) proposes influence erectile functioning. However, a paucity of research exists on the role of causal attributions in sexual functioning. The few studies that have been reported suggest a possible relationship of this nature. Fichten, Spector, and Libman (1988) and Simkins-Bullock, Wildman, Bullock, and Sugrue (1992) asked men who were presenting for treatment at sex therapy clinics to what they attributed their sexual problems. Both studies found that men with sexual dysfunction gave internal attributions for their difficulties. Similarly, Weisberg, Bach, and Barlow (1995a) examined the attributions that participants in a physiological arousal measurement session gave for their erectile performance. Compared with men with erectile dysfunction, sexually functional men identified more external factors that might have interfered with their ability to get an erection. Additionally, Weisberg et al. (1998) modified the Attributional Style Questionnaire (Peterson et al., 1982) :o measure a traitlike attributional style for sexual events. They f:)und that for negative sexual situations, men with erectile disorder rated their attributions as significantly more internal and stable lhan did sexually functional men. Although this research has begun to offer support for a relationship between attributions for sexual performance and psychogenic male erectile disorder, interpretation of the results of these studies is limited. In the aforementioned research, participants with sexual dysfunction were patients at sex therapy clinics. They were experiencing sexual problems that were sufficiently chronic and distressing to motivate them to seek help; thus, their erectile difficulties likely occurred with temporal stability across a variety of situations. Therefore, their attributions for their erectile difficulty might have been a consequence, rather than a cause, of their continued erectile problems. Additionally, the men were presenting for treatment of sexual problems, identifying themselves as in need of help. This likely caused a selection bias in that men with sexual dysfunction who saw the problem as having an internal cause might have been more apt to present for therapy. The present research is. to the best of our knowledge, the first to examine the effects on subsequent sexual functioning of causal attributions for an erectile difficulty. After viewing two sexually

explicit films, participants were told that they did not become as aroused as did the typical study participant. The experimenter then provided one group of participants with an external, temporally fluctuating attribution for the cause of the poor erectile performance. The other group was given an internal, stable attribution for the cause. All participants then viewed a third film.

Hypotheses Primary Hypotheses

Hypothesis I: Sexual arousal after the bogus feedback. Relative to participants in the external-fluctuating attribution group, participants in the internal-stable condition were expected to evidence less erectile response and lower levels of subjective arousal during the third film. Hypothesis 2: Cognitive-affective responding after the bogus feedback. Men in the internal-stable attribution group were expected to evidence a greater degree of negative affect, less positive affect, more negative expectancies for their performance, and less perceived erectile control after the negative feedback than would men in the external-fluctuating group.

Secondary

Hypotheses

Hypothesis 3: Impact of attributional style on sexual arousal. In previous research (e.g., Anderson, 1983), trait attributional style has accounted for variance not explained by an attributional manipulation. Therefore, in addition to the attributional manipulation, trait attributional style was expected to impact sexual arousal to the third film. Attributional style was expected to have both direct and moderating effects. That is, in comparison to participants with a style of making external, fluctuating attributions for negative events, individuals with a tendency to make internal, stable attributions were expected to experience lower levels of sexual arousal after the manipulation. Further, participants in the internal-stable condition who had a tendency toward internal, stable attributions were expected to evidence less arousal during the third film than participants in the same attributional condition who had a traitlike tendency to form external, fluctuating attributions for negative events. Similarly, participants in the external-fluctuating condition who had a tendency to make external, fluctuating attributions were expected to evidence greater sexual arousal during the third film than their counterparts with a traitlike tendency toward internal, stable attributions. Cross-situational consistency for attributional style may be low (Compas, Forsythe, & Wagner, 1988). For this reason, attributional style specific to sexual events was examined, as well as general attributional style. It was expected that sexspecific attributional style would account for a greater degree of variance in erectile response and subjective arousal to the third film than would general attributional style. Hypothesis 4: Relations/lip of cognitive-affective response and sexual arousal. Barlow's (1986) model proposes that a cognitive-affective response to erotica influences sexual arousal. On the basis of this theorizing, it was expected that the impact of the attributional condition on sexual arousal would be mediated by negative affect, perceived erectile control, and performance expectancies.

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Method Participants

WEISBERG, BROWN, WINCZE, AND BARLOW

Table 1 Demographic and Dispositional Characteristics of Study Participants

Group Measure Internal-stable 20.73 3.28 External-fluctuating 20.88 1.81

Participants were 52 sexually functional males recruited from a major East Coast university community. They were paid $40 for their participation. Recruitment was conducted through flyers posted on and near campus. The exclusion criteria were as follows. Because this study sought to investigate factors that might be causal in the development of erectile problems, it was important that participants had not already experienced sexual difficulties chronic and distressing enough to warrant a diagnosis. Therefore, men with current or past sexual dysfunction were excluded. Further, it was important that study participants had not experienced many situations in which they were unable to attain an erection. Men experiencing this on multiple occasions might have already established attributions for these difficulties and therefore might be more resistant to the manipulation. It was likely that younger men had experienced fewer occasions of normative erectile difficulty. For this reason, men over the age of 35 were excluded. Participants were at least 18 years of age to be able to provide consent for their participation. Individuals who, during the interview, reported a history of sexual trauma were excluded from the study. This was because of the possibility that the internal-stable attributional manipulation might be particularly distressing to these participants. Erotic stimuli depicting heterosexual activity were presented to participants in this study. Men with homosexual or bisexual orientation might have found these films less arousing; therefore, only men identifying themselves as heterosexual in orientation were included. As the study sought to examine change in erectile responding to erotic stimuli, factors that might interfere with erectile response, such as substance dependence and certain medications and physical conditions, were exclusionary criteria. Sixty-seven potential participants were screened to obtain the final sample of 52 men. All participants were interviewed to determine their eligibility for the study. The Sexual Dysfunction Inventory (SDI; Sbrocco, Weisberg, & Barlow, 1992) was used to assist in the diagnosis of sexual dysfunction and to assess eligibility. Potential participants were excluded from the study for the following reasons: (a) current or past sexual dysfunction that met DSM-IV criteria (n = 2); (b) age younger than 18 or older than 35 (n = 1); (c) reported history of sexual trauma (n = 1); (d) homosexual or bisexual orientation (n = 1); (e) alcohol or substance dependence (n = 1); and (f) a medical problem (e.g., diabetes) or medication (e.g., antihypertensive medication) that might interfere with erectile performance (n = 1). Additionally, one individual was excluded from the study because he had a limited ability to read and understand spoken English. Two participants completed the questionnaire and interview session and were eligible for the physiological session but declined to participate. Data from 5 participants were excluded after the physiological session. Two individuals were excluded because of extreme movement artifacts in their physiological data. For these two participants, who had difficulty sitting still throughout the session, it was not possible to distinguish changes in physiological data points that were due to movement from those due to erectile responding. Two other individuals were excluded because they reported on the debriefing measure that they did not believe the bogus feedback. A final participant was excluded because he reported during debriefing that he had been trying to suppress his erection. These individuals were dropped from the sample and replaced. The final sample of 52 eligible participants had a mean age of 20.81 years (SD = 2.63; range, 18 to 35 years). Demographic information is provided in Table 1.

Age
M SD Ethnicity (n) Caucasian African American Asian/Asian American Hispanic Indian/Indian American Other Education (n) Partial college College degree Graduate or professional degree Attributional style (ASQ-neg)

19 2 1 1 2 1 23 2 1
4.23 0.72 4.04 0.81

17 1 1 4 1 2 24 2 0
4.21 0.61 4.08 0.64

M SD
Sex-specific attributional style (Sex-ASQ-neg)

M
SD

Note. ASQ-neg = negative-events subscale of the Attributional Style Questionnaire. Sex-ASQ-neg = negative-events subscale of the SexSpecific ASQ. Questionnaire (Sex-ASQ). The ASQ assesses causal attributions given for positive and negative life events. The questionnaire consists of 12 hypothetical events, half of which are positively valenced and half of which are negatively valenced. For each event, the participant is instructed to imagine being in the situation and to "write down the one major cause" of the event, as he or she feels would be the cause if it happened to him or her. The participant then rates the cause on the attributional dimensions of internality, stability, and globality. The participant uses a scale of 1 to 7 to indicate whether the cause is totally due to other people or circumstances (1) versus totally due to me (1) for the internality dimension; will never again be present (1) versus will always be present (7) for the stability dimension; and influences just this particular situation (1) versus influences all situations in my life (7) to rate the globality dimension. The questionnaire can be scored to achieve two composite scores (one for positive and one for negative events). In an undergraduate sample, test-retest reliability analyses yielded correlations of .70 for positive events and .64 for negative events (Peterson et al., 1982). The negative events subscale (ASQ-neg) was used in the present study. In an attempt to examine men's attributional style specific to sexual events, a modified ASQ was developed in our laboratory. Eight sexual situations (four positive and four negative) were embedded within the ASQ to form the Sex-Specific ASQ. In a recent study (Weisberg et al., 1998), scores on the negative events subscale of the Sex-ASQ were found to differentiate men with erectile disorder from sexually functional men. The negative events subscale (Sex-ASQ-neg) was used in the present study. Genital measurement. Erectile response was operationalized as penile circumference and was measured with a mercury-in-rubber strain gauge. Data were recorded and stored using the Farrall Computer Assisted Therapy System (CAT600) and an IBM-compatible computer. Erectile data were sampled once per second, yielding 180 data points for each of the three 3-minute films. Prestimuli measure. Before viewing each film, participants completed an expectancy measure designed specifically for this study. Participants

Measures
Questionnaires. Participants completed the Attributional Style Questionnaire (ASQ; Peterson et al., 1982) and Sex-Specific Attributional Style

ATTRIBUTIONS AND MALE SEXUAL AROUSAL indicated on a Likert scale of 0 to 7 the degree of erection they expected to attain during the film. Poststimuli measures. After each film, participants completed the state versions of the Positive and Negative Affect Scales (PANAS; Watson, Clark, & Tellegen, 1988). The PANAS consists of two 10-item scales: positive affect (PA) and negative affect (NA). Each of the 20 items is a mood descriptor (e.g., guilty). Participants indicate on a 5-point scale the degree to which they experienced each mood state during a specified timeframe. For the present study, participants were asked to respond to each item with reference to the way they feel "right now, that is, at the present moment." The PANAS has good internal consistency when administered with present-moment instructions (coefficient alpha for PA = .88 and for NA = .85; Watson et al., 1988). Further, the scales have been shown to correlate with measures of related constructs (e.g., the Beck Degression Inventory [Beck, Ward, Mendelson, Mock, & Erlbaugh, 1961]; the State-Trait Anxiety Inventory State Anxiety Scale [Spielberger, Gorusch, & Lushene, 1970]). Participants also completed a questionnaire on which they rated the following on a scale of 0 to 7: their level of subjective arousal, erection obtained, and perceived control over their erection level. Postmanipulation measure. After the presentation of bogus feedback and the attributional manipulation, participants completed two O-to-7 Likert scales. They rated the degree to which their erection level, during the last film, was due to something about them or to something about other people or circumstances. Additionally, they rated the degree to which they believed the cause of their erection level, during the last film, to be present during the next film. These two items were used as an attributional manipulation check. To divert attention from the actual purpose of these items, the Likert scales were included on the poststimuli measure given after each film, although only response after the second film was of interest. Debriefing measure. After the laboratory session, participants completed a measure designed to assess whether or not they believed the bogus feedback and whether or not they were aware of the actual purpose of the study. Participants indicated whether their response during each film was greater than, equal to, or less than that of the average participant. Additionally, participants were asked to describe the purpose of the study.

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bogus feedback. Two films were shown to enhance the credibility of the bogus feedback and in keeping with prior bogus feedback methods (Bach et al.. 1999). When the second film was over, all participants were asked the following over an intercom: Are you finding it difficult to become aroused? . . . The information that I am getting on the computer isn't what we usually see for someone who is feeling very aroused. I'm going to see if I can print out the results from that last film so that I can take a closer look at them. It should just take a minute. The experimenter then paused briefly and said, "I have the results from the second film. I'd like to come back into the room now to explain them to you." Upon entering the laboratory room, she showed the participant a printed graph of an erectile response. The graph had a gradual slope and showed a moderate, unsteady response. The experimenter stated, "This is your response to the last film. I didn't print out your response to the first film because it was pretty much the same." A transparency of a graph of an erectile response was also used. This transparency showed a graphed line that had a steep slope, and depicted a strong, steady response. The experimenter told the participant, "I brought in this sheet, too. We use it to help score the data. It's what a typical response looks like. We don't usually show it to participants, but I thought it might help you see what I mean." The experimenter showed the graph, covered by the transparency, to the participant and stated, "Your responseyour erectionwas weaker than most participants' in these studies. It wasn't as strong as people who are really feeling aroused." This negative bogus feedback was provided in the same manner to all study participants.'

Attributional Manipulation
After the experimenter provided the bogus feedback, she presented the participant with a causal attribution for this poor erectile response. Before beginning the experiment, study participants were randomly assigned to one of two groups. Half of the participants were provided with an externalfluctuating attribution for their perceived response; the other half were given an internal-stable attribution for the poor performance. In the external-fluctuating attribution condition, participants were told the following: I'm actually not that surprised that this happened. I think the problem is the films that you watched. I've been showing different films to different people. Most of the men who watched the two films that you watched didn't become very aroused. I'm actually thinking of getting rid of those two particular videos. Let's go ahead and finish the assessment. There is one more film. We can talk more about the two films you just saw after we are through. Men in the internal-stable attribution condition were told the following: I'm actually not that surprised that this happened. I looked over the questionnaires you filled out today. The way you filled them o u t . . . and . . . well . . . some of your answers in the interview . . . you seem to have a type of beliefs about sex that sometimes makes it difficult to

Laboratory Setting
The laboratory consisted of two adjoining rooms: the participant room and the experimenter room. These rooms were connected by a door and an intercom. The participant room was equipped with a large chair and a video monitor. The experimenter room contained the CAT600, a computer monitor, and a videocassette player.

Stimulus Materials
Films. Three 3-minute, sexually explicit videotapes were used that depicted a heterosexual couple engaging in various sexual behaviors. The films were selected to be equated in terms of arousability, based on the judgment of three independent raters. The order of films was counterbalanced across the three trials. In addition, a 10-minute erotic film was used at the beginning of the laboratory session for the purpose of calibrating the pen le strain gauge. Participants masturbated until full, or 100%, penile responding, while viewing this film. Erectile responding to this calibration film was used only for transformation of data into percentage of full erectile response, not for premanipulation-postmanipulation comparisons. Bogus feedback. Bogus feedback methodology was derived from previous work in our laboratory (Bach et al., 1999). Participants were informed that the penile gauge was recording their erectile response. They were told that the gauge was attached to a computer that graphed their arousal pattern and that the computer was attached to a printer. All participants viewed and made ratings in response to two films before the

We provided no cover story for why participants were being shown their erectile response. Though it is possible that participants questioned this part of the protocol, none of the men verbalized this question. The laboratory situation is quite unusual and novel for most participants. We therefore think it likely that they may not have wondered why the experimenter was showing them the graph (there was so much else about the situation that likely appeared equally unusual). This is the second study using this bogus feedback paradigm in our laboratory. According to the authors of the first study (Bach et al.. 1999), participants in their research also did not question the experimenter about the graph.

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WE1SBERG, BROWN, WINCZE, AND BARLOW get aroused here in our lab. Let's go ahead and finish the assessment. There is one more film. We can talk more about your beliefs in sex after we are through. pants were given a tour of the laboratory and shown the penile strain gauge. They then read a consent form detailing the laboratory procedure and explaining that some information about the nature of the study was being withheld but would be provided as soon as the physiological session was completed. At this point, two potential participants declined to continue in the study, citing as the reason discomfort with the physiological measurement procedure. All other participants agreed to the physiological session and signed the consent form. To ensure participant privacy and confidentiality, a numerical code was assigned to each participant. All data were identified by code only; the participant's name and other identifying information did not appear on any of the questionnaires or data forms. Consent forms with participants' names and signatures were kept in a locked file, separate from the data. Each participant was escorted to the laboratory. He was instructed to disrobe and put on a paper gown after the experimenter left the room. The paper robe served to create a barrier to viewing erectile response and was used, in part, to increase the credibility of the bogus feedback. The experimenter then instructed the participant to position the penile gauge three quarters of the way from the tip of his penis. The participant was

Procedure
All recruitment materials referred to the study title as "Normative Sexual Arousal." Participants and potential participants were told that the study was being conducted to gather normative data on sexual arousal. The study consisted of both a questionnaire and interview session and a physiological session. These sessions were conducted on the same day, with the physiological session immediately following the questionnaire and interview session. A flowchart outlining the steps of the experimental procedure is provided in Figure 1. Upon arrival, each participant read and signed a consent form describing the questionnaire and interview process. Participants then completed the questionnaire battery and were administered the SDI interview (Sbrocco et al., 1992). Participants who met inclusion criteria were asked to participate in the physiological session. These partici-

Informed Consent for Questionnaire and Interview Session Questionnaire and Interview Session SDI interview Complete ASQ and Sex-ASQ

Informed Consent for Physiological Session (including tour of the lab) Physiological Session Calibration Procedure Prestimuli Questionnaires, Film 1 Filml Poststimuli Questionnaires, Film 1 Prestimuli Questionnaires, Film 2 Film 2 Bogus Feedback (all 52 participants) Attributional Manipulation (26 participants given internal-stable attribution, 26 given external-fluctuating attribution) Poststimuli Questionnaires, Film 2 Postmanipulation Questionnaire Prestimuli Questionnaires, Film 3 Film3 Poststimuli Questionnaires, Film 3

Debriefing Debriefing Questionnaire Debriefing Interview Figure 1. Flowchart of experimental procedure. SDI = Sexual Dysfunction Inventory; ASQ = Attributional Style Questionnaire; Sex-ASQ = Sex-Specific ASQ.

ATTRIBUTIONS AND MALE SEXUAL AROUSAL instructed not to touch the gauge after it had been placed. After stabilization of the penile-gauge measure, a 5-minute adaptation period was timed to allow the participant to become acclimated to the setting. During this time, the experimenter began the procedure to record 0% and 100% tumescence. The lowest point of the participant's erectile response was recorded as 0% tumescence. After the adaptation, the participant was shown Ihe calibration film and was instructed (over the intercom) to manually stimulate his penis until he believed he had a full erection. This point was recorded as 100% tumescence. At that time, the film was stopped to allow for detumescence. After detumescence (defined as a return to 10% or less of the participant's full erection), a board was placed over the participant's lap. The board rested on the arms of the chair and did not touch the participant's penis or the strain gauge. The participant was told that the purpose of the board was to provide a surface to lean on while completing the questionnaires. The board covered the participant's penis, such that he was unable to view his actual erectile response. The participant completed the prestimuli measure, and then one of the three 3- ninute video clips was presented. After the first film, the experimenter instructed the participant to complete the poststimuli questionnaires and the pre-stimuli questionnaire for Film 2. After at least 5 minutes elapsed to allow for penile detumescence, the second film was shown. When the second film was over, the experimenter presented the bogus feedback and attributional manipulation. Next, the participant was asked to complete: the poststimuli questionnaires for the second film and the prestimuli questionnaire for the third film. When the participant indicated that he was :hrough, the third video clip was presented. The participant then completed the remaining questionnaires. Because of the sensitive nature of this study and the use of deception, participants underwent extensive debriefing. Immediately after the laboratory session, the participant met with the experimenter in a private interview ronm. The participant completed the debriefing measure, and the experimenter explained the actual purpose of the study and detailed the deception that was used. It was explained that not only was the rationale given for the study untrue but that the feedback given regarding the participant's erectile response was bogus. The reason for using deception was explained. 2

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ASQ-neg could be examined (at Step 2) after controlling for variance due to individual differences in premanipulation levels of arousal (entered at Step 1). The interaction terms (or moderator variables) were entered at Step 3 so that potential moderating effects could be examined after controlling for the direct effects. This method of hierarchical regression to assess direct and moderating effects is described and recommended by Holmbeck (1997) in his article on moderating and mediating variables. The plan for analysis of Hypothesis 4 also comes from the procedure outlined by Holmbeck (1997). According to this procedure, four conditions were necessary for a cognitive-affective variable to be a mediator in this study. First, the attributional condition must have been significantly associated with the cognitive-affective variable. Second, the attributional condition must have been significantly associated with postmanipulation arousal. Next, the cognitive-affective variable must be significantly associated with postmanipulation arousal. Last, the attributional condition must predict less of the variance in arousal after controlling for the cognitive-affective variable. Thus, the analysis plan was to conduct a series of multiple regression analyses to test each of these four conditions. As this plan called for numerous analyses to be conducted, the chance of making a Type I error was inflated. Because of this, rf was computed for the between-groups hypotheses (1 and 2), and multiple R2 and semipartial correlation coefficients are provided for the dimensional analyses (Hypothesis 3). Eta-square, R2, and the squared semipartial correlation coefficients all provide measures of the proportion of explained variance and are not influenced by Type I error. In this way, they supplement interpretation of the findings beyond that of the p values. Further, / (a measure of effect size for ANCOVA) and R2 were used to calculate observed power for the analyses, using the methods outlined by Cohen (1988).

Manipulation Check Results Analyses Plan

The main hypotheses (Hypotheses 1 and 2) were related to expected group differences between the internal-stable attribution group a::id the external-fluctuating group. Two steps were used in examining these hypotheses. First, independent samples t tests were conducted to check for between-group differences before the manipulation (i.e., failure of the random assignment). Analyses of covariance (ANCOVA) was then used in which between-group differences on postmanipulation erectile response and subjective arousal (Hypothesis 1) and cognitions and affect (Hypothesis 2) were examined after controlling for premanipulation scores. Secondary hypotheses were examined using hierarchical multiple-regression analyses. Hypothesis 3 was examined in two separate multiple regression analyses, one in which the criterion was postmanipulation maximum percentage of full erection and one in which it was postmanipulation subjective arousal. Predictors were premanipulation arousal (either erectile or subjective response), which was entered at Step 1; scores on the ASQ-neg, Sex-ASQ-neg, and a dummy coded group variable, entered at Step 2; and interaction terms ASQ-neg X Group and Sex-ASQ-neg X Group, entered at Step 3. These hierarchical regressions were designec such that the direct effects of the ASQ-neg and SexBefore the hypotheses were examined, a test of the attributional manipulation was conducted using data from the postmanipulation measure. To examine whether participants were more likely to attribute the negative feedback to the type of cause given by the experimenter, two one-tailed, independent-samples / tests were conducted. Likert scores on the postmanipulation measure were compared between the internal-stable group and the externalfluctuating group. The internal-stable group rated the cause of their erection level as significantly more internal (that is, as more due to something about them than due to something about other people or circumstances; M 3.12, SD = 1.6) than did the external-fluctuating group (M = 2.42, SD = 1.21), f(50) = 1.76,
On the debriefing form, no participant correctly stated the study's purpose. None of the men indicated awareness that we were focusing on attributions and causal explanations. Only one of the participants came close to guessing the focus of the study. He stated that we were trying "to see how being nervous or uncertain about your sexual performance would affect your arousal during the third film." This participant also did not believe that he became less aroused than the typical participant and understood that this feedback was part of the manipulation. This participant was excluded. Further, during the verbal debriefing interview, participants were told the actual purpose of the study. At that point, they were verbally asked whether they had guessed the study's purpose. All stated no.

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p < .05, T)2 = .06. Degree of temporal stability of the attribution (degree to which the cause was believed to be present during the next film) did not differ between groups (M = 4.85, SD = 1.41 for the internal-stable group; M = 4.73, SD = 1.08 for the externalfluctuating group), /(50) < .5.

Test of Hypothesis 1: The Effect of the Manipulation on Sexual Arousal After the Bogus Feedback
Data reduction. Strain gauge data were reduced to yield a mean and maximum percentage of full erectile responding for each film. This was done by averaging the 180 data points for each of the three stimuli films to form a mean for each film. The largest point of penile circumference during each film was selected as the maximum score. These means and maximum scores were then converted to percentage of full erectile response, using the point of greatest responding during the calibration procedure as 100% of full erectile response. For all three films, mean and maximum percentage of full erectile response were each highly correlated (Film 1: r = .90; Film 2: r = .86; Film 3: r = .92; ps < .001). Therefore, erectile response data was analyzed using only maximum percentage of full erectile response. Three different erotic videotapes (A, B, C) were counterbalanced across the three time periods (Film 1, Film 2, Film 3). Potential effects due to the different video clips were investigated in a one-way analysis of variance (ANOVA) examining the degree of erectile response during Film 1 among the three videotapes. No significant difference was found, suggesting that the video clips were effectively matched for degree of physiological arousability, F(2, 49) < 1. Analyses were also conducted to determine whether participants evidenced differential levels of erectile responding to Films 1 and 2 (i.e., before the manipulation). Strain gauge data were examined in a 2 (group: internal-stable, external-fluctuating) X 2 (time: Film 1, Film 2) ANOVA. Because no significant main or interaction effects were found, these data were collapsed to form an average score for erectile response across the two premanipulation films. Hypothesis testeffect of the manipulation on erectile response. After the reduction of data, the first hypothesis was tested. It was expected that participants in the internal-stable group would evidence less erectile responding to the third film than would participants in the external-fluctuating group. An independent-samples t test was conducted to examine whether the two groups exhibited differential levels of erectile response before the manipulation. No difference between groups was found in premanipulation erectile response, ?(50) < 1. The effect of the attributional manipulation on erectile response was examined in a oneway analysis of covariance (ANCOVA). Maximum percent of erectile response during Film 3 was compared between the two groups with erectile response before the manipulation (the combined score for Films 1 and 2) as the covariate. A significant between-group difference was found, F(l, 49) = 6.09, p < .05, 7)2 = .07. As shown in Table 2 and Figure 2, consistent with predictions, the maximum percentage of full erectile response was significantly lower in the group that received the internal-stable

manipulation than it was in the group that received the externalfluctuating manipulation. Hypothesis testeffect of the manipulation on subjective arousal. Poststimuli measures (i.e., PANAS and Likert scales) for Film 2 were given after the bogus feedback and attributional manipulation; therefore, they were not used as premanipulation measures. Thus, self-report measures for Film 1 only were used as premanipulation scores. Results of a two-tailed independent samples t test indicated that the groups did not differ significantly on premanipulation subjective arousal, r(50) < .5. Subjective arousal after the manipulation was examined between groups using ANCOVA, with subjective arousal before the manipulation as the covariate. A significant between-group difference was obtained, F(l, 49) = 8.58, p < .01, T)2 = .11. Subjective arousal during Film 3 was significantly lower in the internal-stable group than it was in the external-fluctuating group (see Table 2 and Figure 3).

Test of Hypothesis 2: The Effect of the Manipulation on Cognitive-Affective Responding After the Bogus Feedback
Independent-samples t tests identified no significant betweengroup differences on each of the cognitive-affective variables (PANAS-NA, PANAS-PA, perceived erectile control scale, expected degree of erection) before the manipulation, f(50) < 1.4 for all analyses. A series of four ANCOVAs were conducted to test the effect of the manipulation on the cognitive-affective variables. Contrary to hypotheses, no significant group effects were found for these measures. Further, effect size for these analyses was quite small (see Table 2).

Test of Hypothesis 3: Impact of Attributional Style on Sexual Arousal

Examination of the dispositional measures. Psychometric properties of the ASQ and Sex-ASQ were examined in the present sample to assess whether the data fulfilled the assumptions required for multiple regression analyses and because the Sex-ASQ is a new measure. Internal consistency was examined using Cronbach's coefficient alpha. The ASQ-neg had acceptable internal consistency, with an alpha of .73. Sex-ASQ-neg yielded an alpha of .66. Scores on both of the dispositional measures (ASQ-neg and Sex-ASQ-neg) were normally distributed in the present sample. Mean scores on the ASQ-neg (M = 4.22, SD = .66) appeared comparable to those of the undergraduates in the sample of Peterson et al. (1982; M = 4.12, SD = .64). To test for potential redundancy, the correlation between the ASQ-neg and Sex-ASQneg was examined. The measures were correlated with each other at r = .63, p < .01. Though this correlation was significant, it was less than .80, which is often used as the standard for assessing multicollinearity in regression analyses (Licht, 1995; Stevens, 1992). Therefore, both variables were examined as possible predictors of postmanipulation response. Hypothesis testdirect and moderating effects of attributional style on erectile response. The influence of dispositional attributional style (ASQ-neg, Sex-ASQ-neg) on erectile response was first examined. Pearson correlations indicated no significant association between ASQ-neg and premanipulation erectile response (r = .03) or between Sex-ASQ-neg and premanipulation erectile response (r = .06).

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331

Table 2 Physiological Responses and Subjective Ratings Before and After the Attributional Manipulation
Internal-stable Measure Maximum % of full erectile response Premanipulation Postmanipulation Subjective arousal Premanipulation Postmanipulation PANAS Negative Affect Premanipulation Postmanipulation PANAS Positive Affect Premanipulation Postmanipulation Perceived erectile control Premanipulation Postmanipulation Expected degree of erection Premanipulation Postmanipulation Externalfluctuating

SD

SD

r)2

Power

75.92 53.52

28.41 34.45 1.56 1.96 4.80 6.01 6.91 6.96 1.87 2.19 1.16 1.85

74.13 70.56 4.08 3.85 13.31 13.85

27.27 25.27

29.38 32.68

6.09* 8.58**
<1

.07 .11 .00 .01 .02 .00

.28 .34 .01 .12 .13 .01

.43 .58 .06 .10 .10 .06

4.23 2.65 13.87 14.24 29.15 ' 25.04 3.31 2.81 4.65 4.00

1.60 1.87 2.63 4.50 7.56 7.62 1.65 1.52 1.69 1.91

1.87 1.39
<1

2.65 2.81 4.73 4.04

Note. For maximum percentage of full erectile response, premanipulation measure is based on mean response across Films 1 and 2. In all other cases, premanipulation data are based on ratings for Film 1. Fs were determined using an analyses of covariance in which between-group differences in postmanipulation scores were examined after accounting for premanipulation scores. Power is observed power, calculated on the basis of power tables given in Cohen (1988). PANAS = Positive and Negative Affect Scales, State version. * p < .05. ** p < .01.

Hierarchical regression analysis was conducted to examine the potential direct and moderating effects of dispositional attributional style (ASQ-neg, Sex-ASQ-neg) on postmanipulation erectile responding. Postmanipulation erectile response was the criterion. Predictors were premanipulation erectile response, attributional manipulation group (which was dummy coded), scores on the

ASQ-neg, and Sex-ASQ-neg, and moderator variables of ASQneg X group and Sex-ASQ-neg X group. Premanipulation erectile response was entered at Step 1 and accounted for 34% of the variance in postmanipulation erectile response (R2 = .34, p < .001). Group, ASQ-neg, and Sex-ASQ-neg were entered at Step 2.

Postmaniptilation B Internal-constant group I External-fluctuating group Q Internal-constant group I External-fluctuating group

Figure 2. Premanipulation and postmanipulation measures of average maximum percentage of full erectile response. Premanipulation = average response for Films 1 and 2. Postmanipulation = response for Film 3.

Figure 3. Premanipulation and postmanipulation measures of mean subjective arousal. Premanipulation = Likert scale score for Film 1. Postmanipulation = Likert scale score for Film 3.

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WEISBERG. BROWN, WINCZE, AND BARLOW

Together, these variables accounted for 12% of the variance in postmanipulation erectile response (R2 change = .12, p < .05). However, contrary to hypotheses, ASQ-neg and Sex-ASQ-neg did not evidence a significant direct effect on postmanipulation erectile responding. Only attributional group was a significant predictor at this step, accounting for 8% of the variance (B = .28, p < .05, /;p = .28). At Step 3, the product terms ASQ-neg X Group and Sex-ASQ-neg X Group were entered. These predictors did not account for a significant proportion of the variance (R2 change = .000). Observed power for the complete model (at the last step) was found to be high (.86). Hypothesis testdirect and moderating effects of attributional style on subjective arousal. The potential direct and moderating effects of ASQ-neg and Sex-ASQ-neg on postmanipulation subjective arousal were examined in the same way that these effects on postmanipulation erectile responding were analyzed. Pearson correlations were first conducted and indicated no significant association between ASQ-neg and premanipulation subjective arousal (r = .02) or between Sex-ASQ-neg and premanipulation subjective arousal (r = .01). Next, in a hierarchical regression analysis, premanipulation subjective arousal was entered at Step 1 and accounted for 27% of the variance (R2 = .27, p < .001). Group, ASQ-neg, and Sex-ASQ-neg were entered at Step 2 and together accounted for 15% of the variance (R2 change = .15, p < .05). Neither of the attributional-style measures accounted for a significant proportion of the variance however. Only group was significant at this step (B = .34, p < .01, rsp = .34). At Step 3, ASQ-neg X Group and Sex-ASQ-neg X group did not account for a significant proportion of the variance (R2 change = .001). Observed power for the complete model was .90.

Test of Hypothesis 4: The Relationship Between Cognitive-Affective Response and Arousal

It was hypothesized that cognitive-affective responding would mediate the impact of the attributional condition on sexual arousal. Because (as seen in testing Hypothesis 2) the attributional condition was not significantly associated with cognitive-affective responding, this hypothesis was not supported, and further analyses were not completed.

Discussion
As predicted, in comparison to the external-fluctuating attribution, the internal-stable attribution was associated with less physiological and subjective sexual arousal after a bogus erectile failure. Examination of the erectile response data shows that before the manipulation, both groups evidenced approximately 75% of a full erectile response. After participants were told that they did not become as aroused as the average participant, the two groups differed in erectile response. The group given the externalfluctuating attribution appeared relatively unaffected by the false negative feedback. The group provided with the internal-stable attribution evidenced a mean decline of over 22% of a full erectile response. Counter to prediction, the attributional manipulation did not have a significant effect on affect, perceived erectile control, or expected degree of erection. Though it should be noted that we had low power to observe these effects, the effect sizes for the

cognitive-affective analyses were extremely low. A possible explanation for this outcome is that participants did not consider their erection level during the experiment to be important. Attributional theorists (e.g., Abramson, Metalsky, & Alloy, 1989) have proposed that people tend to experience a negative mood when they make internal attributions for failure at a task they hold to be important. In the present study, the internal-stable attribution stated that the participants' beliefs about sex were the type associated with low sexual arousal "in our lab." This wording was used to ensure that participants did not worry about their erectile performance outside of the lab. However, this statement likely reduced the importance of the feedback. The attributional condition also had no effect on expected degree of erection. Examination of the data indicates that this decreased slightly in both groups after the manipulation. This is consistent with findings from Bach et al. (1999), in which expectancies were reduced after the provision of bogus negative feedback about erection level. In the present study, it was hypothesized that degree of expected erection would decrease less in the group given an external-fluctuating attribution for the bogus feedback. As previously noted, the attributional manipulation did not appear to successfully alter the temporal constancy of attributions. Overall, both groups rated the cause of their erection level as more likely than not to be present during the next film. The relative stability of an attribution is thought to determine expectancies for future performance (Weiner, 1985). Thus, it is probable that the attributional manipulation did not affect expected degree of erection because both groups of participants believed that the cause of their low arousal during the first two films was likely to be present during the third film. Overall, the attributional manipulation was related to performance but not to cognitions and affect in this study. Although counter to prediction, the lack of effect on emotion, perceived erectile control, and expected erection may have important implications. These findings suggest that the decline in sexual arousal was not due solely to changes in cognitive-affective states brought on by the negative feedback. Also, they indicate that even when attributions are not associated with negative affect, they may still influence sexual responding. The lack of influence exerted by attributional style (both general and sex specific) was also counter to prediction. This finding is inconsistent with prior research indicating that a pessimistic attributional style was associated with poor athletic (e.g., Seligman et al., 1990) and scholastic (e.g., Peterson & Barrett, 1987) performance. It appears that the attributional manipulation was a better predictor of sexual arousal than was attributional style. Thus, in the present study, what was said to the participant after a negative sexual event had much more influence on future sexual arousal than did the dispositional variables. This may have important implications regarding the power of comments made by a sexual partner, or by oneself, after an occasion of erectile difficulty. Also contrary to hypotheses, the cognitive-affective variables were not found to mediate the impact of the attributional condition on sexual arousal. It was proposed that attributions for an occasion of sexual difficulty would lead to altered cognitive-affective responding in a sexual situation, which in turn would lead to differing sexual response. Because this relationship was not evidenced in the data, the mechanism of action underlying the current findings remains unclear. One possibility is that the internal-stable

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333

attribution led to a change in attention. Barlow (1986, 1988) proposed that an internal self-evaluative shift in attention is a key mechanism in the development of sexual dysfunction as well as other emotional disorders. In the present study, it is possible that the internal-stable manipulation led to a greater focus on selfevaluative factors during the third film. For example, participants in this group may have attended to their own sexual beliefs and difficulty becoming as aroused as the typical participant. Alternatively, they may have been worrying about or focusing on what the experimenter was going to tell them about their sexual beliefs after Film 3 This focus on nonerotic cues may have then led to the reduced arousal evidenced in the internal-stable group. Participants in the external-fluctuating group, on the other hand, may not have experienced this shift inward in attention because the manipulation encouraged them to look outside themselves for a cause of the bOj4us erectile difficulty. Further, it is possible that this manipulation served to further focus their attention on the third film, which was an erotic cue. Unfortunately, attentional focus was not directK studied in the present research. Future research should examire the relationship between internal attributions for a sexual difficulty and attentional focus during a sexual task. A caveat is necessary in interpretation of the results. Participants in the internal-stable group did not rate their attributions as more stable than did participants in the external-fluctuating group. It is thus possible that the manipulation exerted the desired effect on the inteTnality but not the constancy, of attributions. Results of this study snould be interpreted with caution in regard to the relationship of stable attributions and sexual arousal. Further, a limitation of the present design is that the internal-external and stablefluctuaiing dimensions of attributions were manipulated together and thus confounded. Therefore, it is unclear which dimension was the determinant of outcome. Limitations to the generalizability of the results also exist. The experimenter was female. It is possible that effects of the feedback and attributional manipulation would have differed if they had been presented by a male experimenter. Additionally, the participants v/ere all young men. The effects may have varied if the sample had been made up of older, sexually functional men. Moreover, the external validity of the laboratory setting is low. This setting is likely quite dissimilar from participants' typical sexual situations. Thus, there are limitations to the extent to which arousal patterns in a laboratory setting can be compared with those that occur in other sexual situations. Despite these limitations, the present findings suggest numerous theoretical and clinical implications. Results may have implications for theories of cognitive vulnerability to emotional disorders other than sexual dysfunction. Barlow (1988, 1991; Barlow et al., 1996) postulated that individuals may experience basic emotions as "falss alarms." That is, normative and typically adaptive emotional reactions may occur in a context during which they have no clearly adaptive purpose. These alarms do not necessarily predict future difficulty. Rather, Barlow (1988) hypothesizes that cognitive reactions to a false alarm, including attributions, are important determinants of future alarms and the development of emotional disorders. An occasion of erectile difficulty may be viewed as a false alarm. It is a bodily reaction (or lack of a reaction) that occurs normatively but serves no clearly adaptive purpose in the context in which it occurs. In the present study, participants in the external-fluctuating group did not appear to experience any de-

crease in sexual performance after the negative feedback. The design of the present study did not include a control group (given the bogus feedback but no attribution). Therefore, it is unclear whether the internal-stable attribution was associated with a decrease in arousal or whether the external-fluctuating attribution perhaps led to an increase in arousal over what would have been expected given the negative feedback alone. However, because the external-fluctuating group, on average, evidenced similar arousal levels before and after the negative feedback, the idea that negative events or false alarms, in and of themselves, may not lead to future difficulties is supported. Rather, the impact of negative events may be dependent on one's cognitive reaction. Results of this study may also have clinical importance. Recently, sex therapy has become increasingly cognitive in focus (Rosen & Leiblum, 1992; Weisberg, Bach, & Barlow, 1995b). The meaning that patients attribute to their sexual problems is often a target of treatment (e.g., McCarthy, 1992). To date, there has been a paucity of sex research on which to base these strategies. The present study is the first to establish a link between attributions for a perceived sexual failure and future sexual performance. This finding supports the current practice of many sex therapists and may inform others. In addition to informing the treatment of male erectile disorder, the results of the present study may begin to guide prevention techniques. Occasional erectile difficulty is prevalent, affecting the vast majority of men at some point in their lives. Results suggest that men who attribute this occurrence to internal causes may be at increased risk for future sexual difficulty. Informing sexually functional men about the numerous external factors that may affect their penile responding may prove to be a useful tactic for preventing the development of psychogenic male erectile disorder. Future research in this area seems warranted.

References
Abrahamson, D. J., Barlow, D. H., & Abrahamson, L. S. (1989). Differential effects of performance demand and distraction on sexually functional and dysfunctional males. Journal of Abnormal Ps\cholog\, 98, 241-247. Abrahamson, D. J.. Barlow, D. H., Sakhalin, D. K., Beck, J. G.. & Athanasiou, R. (1985). Effects of distraction on sexual responding in functional and dysfunctional men. Behavior Therapy. 16, 503-515. Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psvchological Review, 96, 358-372. Abramson, L. Y., Seligman, M. E. P., & Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 49-74. Anderson, C. A. (1983). Motivational and performance deficits in interpersonal settings: The effects of attributional style. Journal of Personality and Social Psychology, 45, 1136-1147. Bach, A. K., Brown, T. A., & Barlow, D. H. (1999). The effects of false negative feedback on efficacy expectancies and sexual arousal in sexually functional males. Behavior Therapv, 30, 79-95. Barlow, D. H. (1986). Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, 54, 140-148. Barlow, D. H. (1988). Anxiety and its disorders: The nature and treatment of anxiety and panic. New York: Guilford Press. Barlow, D. H. (1991). Disorders of emotion. Psychological Inquiry. 2, 58-71.

334

WEISBERG. BROWN, WINCZE, AND BARLOW mance among university freshmen. Journal of Personality and Social Psychology, 53, 603-607. Peterson, C., Maier, S. F., & Seligman, M. E. P. (1993). Learned helplessness: A theory for the age of personal control. New York: Oxford University Press. Peterson, C., Semmel, A., von Baeyer, C., Abramson, L. Y., Metalsky, G. I., & Seligman, M. E. P. (1982). The Attributional Style Questionnaire. Cognitive Therapy and Research, 6, 287-300. Renshaw, D. C. (1988). Profile of 2,376 patients treated at Loyola Sex Clinic between 1972 and 1987. Sex and Marital Therapy, 3, 111-117. Rosen, R. C., & Leiblum, S. R. (1992). Erectile disorders: Assessment and treatment. New York: Guilford Press. Sbrocco, T., Weisberg, R. B., & Barlow, D. H. (1992). Sexual Dysfunction Interview (SDl). Unpublished semi-structured interview, Center for Stress and Anxiety Disorders, Albany, NY. Seligman, M. E. P., Nolen-Hoeksema, S., Thorton, K. M., & Thorton, N. (1990). Explanatory style as a mechanism of disappointing athletic performance. Psychological Science, I, 143-146. Simkins-Bullock, J., Wildman, B. G., Bullock, W. A., & Sugrue, D. P. (1992). Etiological attributions, responsibility attributions, and marital adjustment in erectile dysfunction patients. Journal of Sex and Marital Therapy, 18, 83-103. Spielberger, C. D., Gorusch, R. L., & Lushene, R. E. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press. Stevens, J. (1992). Applied multivariate statistics for the social sciences (2nd ed.). Hillsdale, NJ: Erlbaum. Sweeney, P. D., Anderson, K., & Bailey, S. (1986). Attributional style in depression: A meta-analytic review. Journal of Personality and Social Psychology, 50, 974-991. Tennen, H., & Eller, S. J. (1977). Attributional components of learned helplessness and facilitation. Journal of Personality and Social Psychology, 35, 265-27'1. Watson, D., Clark, L., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063-1070. Weiner, B. (1985). An attributional theory of achievement motivation and emotion. Psychological Review, 92, 548-573. Weisberg, R. B., Bach, A. K., & Barlow, D. H. (1995a, November). Sexually functional and dysfunctional males' attributions for erectile performance during a physiological measurement session. Paper presented at the annual convention of the Association for Advancement of Behavior Therapy, Washington, DC. Weisberg, R. B., Bach, A. K., & Barlow, D. H. (1995b, November). "The dysfunctional mentality": Research findings and clinical implications of attributional style in erectile dysfunction. In T. Sbrocco (Chair), Behavioral sex therapy: Developing a working relationship between clinicians and researchers. Symposium conducted at the annual convention of the Association for Advancement of Behavior Therapy, Washington, DC. Weisberg, R. B., Bach, A. K., Wiegel, M., Brown, T. A., Wincze, J. P., & Barlow, D. H. (1998, November). Attributional style specific to sexual events: A comparison of men with and without erectile disorder. Paper presented at the annual convention of the Association for Advancement of Behavior Therapy, Washington, DC. Ziibergeld, B. (1992). The new male sexuality. Boston: Little, Brown.

Barlow, D. H.. Chorpita. B. F.. & Turovsky. J. (1996). Fear, panic, anxiety, and disorders of emotion. In D. A. Hope (Ed.). Nebraska Svmposium on Motivation: Perspectives on anxiety, panic, and fear (Vol. 43. pp. 251-328). Lincoln: University of Nebraska Press. Beck. J. G.. & Barlow. D. H. (1986a). The effects of anxiety and attentional focus on sexual responding: 1. Physiological patterns in erectile dysfunction. Behaviour Research and Therap\, 24, 9 17. Beck. J. G.. & Barlow. D. H. (1986b). The effects of anxiety and attentional focus on sexual responding: II. Cognitive and affective patterns in erectile dysfunction. Behaviour Research and Therapv, 24, 19-26. Beck, A. T., Ward, C. H.. Mendelson. M., Mock, J.. & Erlbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4. 561-571. Carter, S.. & Sokol. J. (1989). What really happens in bed: A demystification of sex. New York: Evans. Cohen. J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale. NJ: Erlbaum. Compas. B. E.. Forsythe. C. J., & Wagner, B. M. (1988). Consistency and variability in causal attributions and coping with stress. Cognitive Therapy and Research. 12, 305-320. Dweck. C. S. (1975). The role of expectations and attributions in the alleviation of learned helplessness. Journal of Personality and Social Psychology. 31, 674-685. Dweck, C. S.. & Reppucci. N. D. (1973). Learned helplessness and reinforcement responsibility in children. Journal of Personality and Social Psychology. 25, 109-116. Fichten. C. S., Spector. 1.. & Libman, E. (1988). Client attributions for sexual dysfunction. Journal of Sex and Marital Therapy. 14, 208-224. Heilman, M. E.. & Guzzo. R. A. (1978). The perceived causes of work success as a mediator of sex discrimination in organizations. Organizational Behavior and Hitman Performance, 21, 346-357. Hite. S. (1981). The Hite report on male sexualitv. New York: Ballantine. Holmbeck. G. N. (1997). Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures. Journal of Consulting and Clinical Psychology. 65, 599-610. Hospers, H. J., Kok. G., & Strecher, V. J. (1990). Attributions for previous failure and subsequent outcomes in a weight reduction program. Health Education Quarterly, 17, 409-415. Licht, M. H. (1995). Multiple regression and correlation. In L. G. Grimm & P. R. Yarnold (Eds.), Reading and understanding multivariate statistics (pp. 19-64). Washington, DC: American Psychological Association. Masters. W.. & Johnson, V. (1970). Human sexual inadequacy. Boston: Little. Brown. McCarthy. B. W. (1992). Treatment of erectile dysfunction with single men. In R. C. Rosen & S. R. Leiblum (Eds.). Erectile disorders: Assessment and treatment (pp. 313-340). New York: Guilford Press. Mitchell, W. B.. Marten, P. A.. Williams. D. M., & Barlow, D. H. (1990, November). Control of sexual arousal in sexually functional and dysfunctional males. Paper presented at the annual convention of the Association for Advancement of Behavior Therapy, San Francisco, CA. Mone. M. A.. & Baker, D. B. (1992). A social-cognitive, attributional model of personal goals: An empirical evaluation. Motivation and Emotion, 16, 297-321. Neale. J. M.. & Friend. R. M. (1972). Attributional determinants of reactions to performance in academic situations. Perceptual and Motor Skills. 34, 35-40. Peterson. C.. & Barrett, L. (1987). Explanatory style and academic perfor-

Received March 27, 2000 Revision received November 24, 2000 Accepted November 29, 2000