Sexual conflicts in panic disorder: a multi-case study
| DOI | https://doi.org/10.1108/MHRJ-02-2017-0012 |
| Published date | 11 December 2017 |
| Date | 11 December 2017 |
| Pages | 300-314 |
| Author | Khadeeja Munawar,Iram Zehra Bokharey,Fahad Riaz Choudhry |
| Subject Matter | Health & social care,Mental health |
Sexual conflicts in panic disorder:
a multi-case study
Khadeeja Munawar, Iram Zehra Bokharey and Fahad Riaz Choudhry
Abstract
Purpose –Problems related to sexual functioning have been reported in patients with anxiety disorders in
general and panic disorder in particular. The past literature has shown the association of sexual conflicts of
panic disorder patients with sadomasochism, and revealed the themes of: guilt, self-punishment, role of
unconscious conflicts about sexuality, anger and separation. The purpose of this paper is to explore sexual
conflicts in patients with panic disorder and their beliefs regarding guilt around sexual fantasies and dreams.
Design/methodology/approach –Interpretative paradigm and case study method was employed.
For collecting data, semi-structured interviews were recorded, transcribed and subjected to within and
cross-case analyses. Clarifying researcher’s bias and rich thick description were used for verification of data.
Findings –Cross-case analyses revealed themes of negative emotions, positive emotions and ambivalence.
Negative emotions (i.e. guilt and anger) were experienced as threatening and harmful and caused distress to
participants. Positive emotions, such as, satisfaction, pleasure and happiness were revealed in response to
questions related to sexual fantasies, thoughts dreams, emotional attachment and sexual relations.
Ambivalence was shown in response to questions related with reactions toward sexual fantasies,
masturbatory practices, sexual relations and/or emotional attachment.
Research limitations/implications –The participants of this study consisted of two self-selected
individuals who had diagnosis of panic disorder with agoraphobia. The main limitation of the study is a small
sample size comprising of men only. This research can provide grounds for more Asian studies in future
especially by including females.
Practical implications –The findings point toward addressing sexual conflict in therapeutic intervention of
panic disorder.
Social implications –The findings have implications in society in expanding the awareness and knowledge
about sexual conflicts in clinical population and general population suffering from anxiety symptoms.
Originality/value –This research study adds understanding of psychological issues in Pakistan’s
socio-cultural context.
KeywordsPositive emotions, Case study, Negative emotions, Ambivalence, Panic disorder, Sexual conflicts
Paper type Case study
Introduction
The presence of problems in sexual functioning has been reported in patients with anxiety
disorders in general and panic disorder in particular (Aksoy et al., 2012). Various research
studies have reported problems in sexual functioning such as sexual desire disorder, sexual
avoidance, erectile dysfunction and premature ejaculation in patients with panic disorder
(Aksaray and Yelken, 2001; Figueira and Possidente, 2001; Goldstein et al., 2005; Mercan et al.,
2006; Van Minnen and Kampman, 2000). It has been found that lifetime prevalence
estimates are 22.7 percent for panic attacks only, 0.8 percent for panic attack with agoraphobia
without panic disorder, 3.7 percent panic disorder only and 1.1 percent for panic disorder
with agoraphobia (Kessler et al., 2006). Likewise, other studies have also shown lifetime
prevalence of panic attacks with agoraphobia without panic disorder as 1.4 percent, panic
disorder only as 4.7 percent, panic disorder with agoraphobia as 1.1 percent and panic attacks
as 28.3 percent (Stern et al., 2015; Tsuang et al., 2011; Zun et al., 2013). Various research
studies showed that prevalence of panic disorder in women was higher as compared to men
Received 3 February 2017
Revised 24 August 2017
Accepted 16 October 2017
Khadeeja Munawar is a
Lecturer at the Department of
Psychology, University of Wah,
Wah, Pakistan.
Iram Zehra Bokharey is a
Principal Clinical Psychologist
at the Department of
Psychiatry, Services Institute of
Medical Sciences, Lahore,
Pakistan.
Fahad Riaz Choudhry is based
at the Department of
Psychology, Monash University
(Malaysia Campus),
Bandar Sunway, Malaysia.
PAGE300
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MENTALHEALTH REVIEW JOURNAL
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VOL. 22 NO. 4 2017, pp. 300-314, © Emerald Publishing Limited, ISSN 1361-9322 DOI 10.1108/MHRJ-02-2017-0012
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