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Marshall, E, 2023. Medication to manage problematic sexual arousal: exploring avenues to assist individuals with problematic sexual arousal in the community. PhD, Nottingham Trent University.
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Abstract
Problematic sexual arousal (PSA), especially sexual preoccupation, is a risk factor for sexual offending. Despite this, psychological interventions fail to address sexual preoccupation. Individuals with PSA are unable to concentrate on psychological interventions due to their intrusive sexual thoughts. In attempts to bridge this gap in interventions, the use of medication to manage problematic sexual arousal (MMPSA) was introduced in 2007. Evidence suggests that MMPSA effectively reduces PSA in individuals serving custodial sentences. To date, there is little evidence of the effectiveness of MMPSA in the community. The thesis was designed using a mixed methods approach to address the following research aims: (1) to illustrate the characteristics of males who had been assessed as suitable for the use of MMPSA in custody and outline how this may assist them when released into the community; (2) to understand the experiences of individuals seeking help for PSA in the community; (3) to understand the views of community-based General Practitioners of using MMPSA to treat PSA.
Study one addressed the first research aim and demonstrates how individuals with PSA exhibit higher levels of sexual compulsivity, anxiety and depression when compared with other clinical samples. The study presents evidence to show how with the use of MMPSA, levels of sexual compulsivity, anxiety and depression can be lowered to resemble that of individuals without PSA. The study also explores the relationships between sexual compulsivity and protective factors enabling individuals to achieve desistance from offending and provides evidence that emotion regulation may be an important factor to consider when treating PSA. Study two provides an insight into the experiences of individuals living with PSA in the community. The study identified three superordinate themes from the data; (1) infinite torment, (2) Facing the music to fall on deaf ears, and (3) quietening the beast. The first superordinate theme illustrates the torment individuals felt when living with PSA. The second superordinate theme highlights the challenges faced when seeking help for their PSA and how they felt they were “facing the music to fall on deaf ears”. The study also demonstrates how individuals with PSA were able to “quieten the beast” following treatment for their PSA, enabling them to live better lives. The study proposes recommendations for practice to encourage help seeking in the community and remove the shame associated with living with PSA. The findings from study three have illustrated the barriers General Practitioners face when treating PSA in primary care. The study identified two superordinate themes; ‘a balancing act’ and ‘the problematic prescribing of MMPSA’. The first superordinate theme ‘a balancing act’ illustrates the difficulties GPs encounter when attempting to balance the potential risk of an individual whilst also encouraging them to be open about their problematic sexual arousal. The second superordinate theme ‘the problematic prescribing of MMPSA’ illustrates the xi potential challenges in prescribing MMPSA in primary care. The study proposes recommendations for practice, which if implemented, will improve the transition of individuals from custody into the community but will also contribute to secondary prevention, ensuring individuals are able to seek help prior to coming into contact with the CJS.
| Item Type: | Thesis |
|---|---|
| Creators: | Marshall, E. |
| Contributors: | Name Role NTU ID ORCID |
| Date: | September 2023 |
| Rights: | The copyright in this work is held by the author. You may copy up to 5% of this work for private study, or personal, non-commercial research. Any re-use of the information contained within this document should be fully referenced, quoting the author, title, university, degree level and pagination. Queries or requests for any other use, or if a more substantial copy is required, should be directed to the author. |
| Divisions: | Schools > School of Social Sciences |
| Record created by: | Jeremy Silvester |
| Date Added: | 01 Oct 2025 10:38 |
| Last Modified: | 01 Oct 2025 10:38 |
| URI: | https://irep.ntu.ac.uk/id/eprint/54486 |
https://orcid.org/0000-0002-9118-679XActions (login required)
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