Background: Marital satisfaction is an integral part of the life of Pakistani women. Married women cannot get satisfied with their lives without marital satisfaction. But previous studies hint at the possible role of sexual satisfaction in addition to marital satisfaction to bring about overall satisfaction with life in married women. Aims: This study was designed with an objective to assess the mediating role of sexual satisfaction in marital satisfaction as a predictor and satisfaction with life as an outcome in married Pakistani women. Previous studies have demonstrated a possible link among marital satisfaction, sexual satisfaction, and satisfaction with life. Settings and Design: One hundred married women of childbearing age (18-48 years, M = 29 years) were recruited by a convenient sampling method from the three hospitals of Bahawalpur in the South Punjab state of Pakistan. Methods and Material: Three questionnaires (a) Kansas Marital Satisfaction Scale; (b) Index of Sexual Satisfaction, and (c) Satisfaction with Life Scale, were administered to collect the data. Statistical Analysis: The results were analyzed by the Statistical Package for the Social Sciences (IBM, USA), version 25, and Process Macro, version 3.4, and expressed in the form of descriptive statistics (mean, standard deviation, and frequencies), mediation analysis, analysis of co-variance, analysis of variance and t test. Results and Conclusion: The unstandardized indirect effects yielded a significant mediation (IE = 0.4757, SE = 0.1786, P < .05, LL = 0.1736, UL = 0.8681). The sexual satisfaction fully mediated the relationship between marital satisfaction and satisfaction with life in married women. It was concluded that married women cannot get marital satisfaction and satisfaction with life without a satisfied sexual life.

Introduction: An increasing number of young men have been found to develop nonorganic erectile dysfunction (NOED) in recent years. The NOED has been shown to respond better to cognitive behavior sex therapy (CBST) in a few past studies. Aim: The present research aims to establish the efficacy of CBST as a promising treatment option in young men suffering from NOED by administering a feasibility pilot trial. Methods: 28 young men (M = 31 years) out of a total of 39 men (7 excluded, 4 quit treatment) diagnosed with NOED from sexual health clinics in Pakistan were recruited to receive CBST treatment (n = 13) on average twice a week for a period of 50 minutes per session for a period of 4, 6, 8, and 12 weeks for the mild, mild to moderate, moderate, and severe forms of NOED, respectively, and sildenafil citrate group (n = 15) receiving sildenafil citrate 50 mg on demand. The trial design was sequential random assignment clinical trial. Main Outcome Measures: International Index of Erectile Functoning-5 and Depression Anxiety Stress Scale-21 were used before treatment, after treatment, and in follow-up as the main outcome measures. Results: The repeated measures analysis of covariance established a nonsignificant difference between CBST and sildenafil citrate 50 mg in NOED scores improvement, NOED severity reduction, and reduction in depression scores at posttreatment assessment. There were significant differences among different CBST modalities in improving NOED scores, reduction in NOED severity, and depression scores. There was significant difference in CBST and sildenafil citrate 50 mg in anxiety reduction at posttreatment assessment. The covariates age, age groups, and NOED duration did not significantly impact the treatment outcome for both treatment groups except age which impacted the interaction of treatment and anxiety scores. Conclusion: The CBST is an emerging and promising treatment choice in younger men suffering from NOED.

Introduction: The integrated treatment combining phosphodiesterase-type 5 inhibitors (PDE5i) and Cognitive Behavior Sex Therapy (CBST) has been shown to yield promising results in the treatment of Non Organic Erectile Dysfunction (NOED) in young men. Aim: The current study aimed to establish the efficacy of integrated treatment combining Sildenafil Citrate (SC) 50mg and CBST as a treatment of choice in young Pakistani men with NOED. Methods: One hundred thirty-seven young men were recruited to participate in the study out of 164 men referred from sexual health clinics in Pakistan. They were randomized sequentially into 4 treatment groups namely SC = 35, CBST = 34, integrated treatment = 35, and placebo = 33. 7, 4, 6, and 4 men were dropped out of each treatment group respectively. The data of 116 men were analyzed. The on demand SC 50 mg, twice weekly 50 minutes sessions and home assignments, a combination of SC and 50 minutes sessions, and placebo were administered to firsst, second, third, and fourth group respectively for a period of 12 weeks. The follow-up assessment was done after 12 weeks of post-treatment for all groups. Main Outcome Measures: The Urdu standardized versions of International Index of Erectile Functoning-5 (IIEF-5) and Depression Anxiety Stress Scale-21 (DASS-21) were the main outcome measures. Results: The mixed repeated measures analysis of co-variance yielded significant impact of both CBST and integrated treatment groups in improving IIEF-5 scores at post treatment as compared to placebo. The CBST group experienced reduction in depression scores at post treatment as compared to both SC and integrated treatment. Only the integrated treatment brought reduction in anxiety scores at post treatment as compared to SC. The covariates age and NOED duration did not significantly impact the treatment outcome for all treatment groups. Clinical Implications: The efficacy of integrated treatment approach for improving symptoms of NOED and associated depression and anxiety is strong clinical implication of the study. Strengths & Limitations: The effectiveness of integrated treatment approach in the improvement of NOED symptoms and associated depression and anxiety scores is the main strength of the study. The improvement in depression scores is the added strength of CBST component of integrated treatment approach. The study should have included other PDE5i to compare their effects with the CBST or placebo groups. Conclusion: The study concludes that the CBST and integrated treatments are treatment of choice for NOED and associated depression and anxiety in young men.

The previous studies have found an association between Big Five personality traits and postpartum depression in women. The present study aimed to find out an association between Big Five personality traits and postpartum depression in a sample of Pakistani fathers. A total of 400 Pakistani fathers who had birth of a child in the past 1 month to 1 year period and had been living with their married partners were recruited purposively by using Google Form based survey from the major cities of Pakistan. The Urdu translated versions of Big Five Personality Inventory (BFI) and Edinburgh Postnatal Depression Scale (EPDS) were used as the main outcome measures to assess the relationship between personality traits and postpartum depression. The results found a significant negative and moderate association between Big Five personality traits and paternal postpartum depression except openness which had a weak association and neuroticism which had a positive and moderate association with PPPD (r(398) = .45). The multiple linear regression analysis found that Big Five personality traits significantly predicted paternal postpartum depression (F(5, 394) = 53.33,p= .001) except openness (B = .007,p= .98). The analysis of variance (ANOVA) found significant differences in paternal postpartum depression for age of father (F(2, 397) = 6.65,p= .001, ηp²= .03), spouse age (F(2, 393) = 5.97,p= .003, ηp²= .02), employment type (F(2, 395) = 9.69,p= .001, ηp²= .04) and time spent at home (F(2, 397) = 6.23,p= .002, ηp²= .03) while there were found no significant differences for education (F(2, 397) = 1.29,p= .27, ηp²= .006), marital duration (F(2, 397) = 2.17,p= .11, ηp²= .01), and birth number of recent child (F(2, 397) = 1.48,p= .22, ηp²= .007). The study concluded that Big Five personality traits are significantly correlated with and predict paternal postpartum depression except openness which did not predict paternal postpartum depression. The occurrence of paternal postpartum depression varied significantly for age of father, age of spouse, type of employment and time spent at home.

This abstract gives the case description of a married woman in her 30s who suffered from persistent genital arousal disorder for a decade. This paper reviews the efficacy of mindfulness-based cognitive therapy (MBCT) in the management of her disorder. The client had been reported as experiencing persistent genital arousal, vaginal engorgement, accompanied by feelings of distress, irritability and psychosocial impairment. She had a history of marital discord with her husband as well and never get sexual satisfaction. Besides, she had also suffered from dysthymia for the last eight years. She was prescribed antidepressants for dysthymia and local anesthetic ointment for genital irritability. She appeared normal in her medical evaluations. She reported mild relief in her genital arousal and dysthymia in response to psychiatric medication. She was treated with MBCT for a period of six months. Six months periodical follow-up reported a moderate improvement in symptoms of dysthymia, distress, and persistent genital arousal. She had been advised to see her therapist at regular intervals for periodic evaluation and administration of MBCT. She has been instructed to practice mindfulness exercises on her home regularly to keep the effects intact.

Background: Some studies have reported methodological flaws and shortcomings in the International Index of Erectile Functioning-5 (IIEF-5) which is a self-report measure for the assessment of erectile dysfunction (ED). Aim: The aim of this research is to point out methodological flaws and shortcomings in IIEF-5 when used with Pakistani men. Settings and Design: Two independent clinical trials were run to assess the efficacy of different forms of treatment for ED in young Pakistani men. Materials and Methods: The IIEF-5 in Urdu version was employed to diagnose and assess the severity of ED in young men at 3 time points. Results and Conclusions: Several flaws and shortcomings were noted including the unidimensionality of the scale, categorization of the scale into severity categories based on cutoff points, the inability of the scale to differentiate between organic and nonorganic ED, double barrel item statement, and lack of standardized translation in local or regional languages of Pakistan. The validity of IIEF-5 can be increased if the above-mentioned flaws and shortcomings are addressed.