Randomized-controlled comparison of two online-interventions: How effective are cognitive-behavioral and mindfulness-based sexual therapy in improving sexual desire in women with Hypoactive Sexual Desire Disorder?

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Problems with sexual function are common and distressing. The most frequent sexual difficulty in women is a lack of sexual desire with a prevalence of 20-30%. When low sexual desire is experienced over several months and causes significant personal distress, a sexual dysfunction can be diagnosed (Hypoactive Sexual Desire Disorder: HSDD). A distressing lack of desire is reported by 6% of sexually active women. Psychological interventions are the treatment of choice for women with HSDD. Promising treatment approaches include cognitive-behavioral and mindfulness-based interventions. A recent meta-analysis also showed that Internet-delivered programs are a valid alternative to face-to-face treatments. However, there are significant research gaps. So far, most studies have included multi-method treatments for mixed sexual dysfunctions. The effectivity of specific treatment approaches for women with HSDD is unclear. In addition, most studies have serious methodological flaws, like small samples sizes (N < 50), non-standardized treatments, or no control condition. These criticisms are especially relevant to the five published studies of Internet-based treatments for women with sexual concerns. Aim of this project is to close these research gaps and to assess the effectivity of two eight-week online-programs consisting of cognitive-behavioral (COPE) and mindfulness-based (MIND) interventions for women with HSDD. Both treatments will be compared to a waitlist-control group. We will address four research questions: Are COPE and/or MIND effective to improve sexual desire in women with HSDD? Which factors contribute to or mediate the effectivity of COPE and/or MIND? Which participants can benefit the most from COPE and/or MIND? For this project, two well-established group-treatment manuals will be translated into German and adapted to a multimedia online-environment. All participants will be guided through the programs by well-qualified online-counsellors. Sexuality is very sensitive subject and many people are hesitant to talk about sexual issues. In addition, only few psychotherapists specialize in sexual therapy. Thus, there is a great need for evidence-based online-treatments, that are easily accessible and offer anonymous help. Should COPE and/or MIND prove effective, they can be disseminated into clinical practice to provide help for women with HSDD, who do not have access to appropriate face-to-face treatment.