An exploratory study examining the relationship between sexual self efficacy and premature ejaculation mediated by depression, anxiety and sexual fantasy among a British cohort

Lay summary: Little is known about the mechanisms involved in premature ejaculation (PE) and we wanted to understand more about whether depression, anxiety or sexual fantasy intervened between sexual self-efficacy and PE. Sixty British men with and without PE took part in this online survey. The outcomes of this study suggested that applying the sexual self-efficacy theory was successful with outcome expectancy being a significant predictor of PE. Anxiety intervened between sexual self-efficacy and PE and that higher levels of anxiety were reported among those with acquired than life-long or no PE. Sexual fantasies were also reportedly different between PE and non-PE groups where PE groups tended to have self-derogatory sexual fantasies, perhaps as a means of delaying ejaculation. Premature ejaculation (PE) is a commonly reported sexual dysfunction in men and yet research remains scarce when looking at the psychopathological mechanisms involved in PE. This study aimed to establish whether depression, anxiety and sexual fantasy mediated the relationship between sexual self- efficacy and PE. Sixty British participants with and without PE aged between 18 and 50 years took part in an online cross-sectional survey consisting of questionnaires measuring PE, sexual self-efficacy, sexual fantasy, depression, anxiety and demographic information. The total and direct effects of sexual self- efficacy on PE were significant. Further, anxiety mediated the relationship between PE and sexual self-efficacy. However, depression and sexual fantasy did not mediate the relationship between these variables. Higher levels of depression, anxiety, and lower levels of sexual self-efficacy were reported among the PE group than the non-PE group. Sexual fantasies further differed between PE and non-PE groups where 'self-derogatory' sexual fantasies such as "embarrassment due to failure of a sex act" were commonly reported among the PE group. The preliminary findings from this pilot study suggest the possible use of performance anxiety reduction techniques in the treatment of PE.