title: [Self-concept and erectile dysfunction in 45-year-old men : Results of a corollary study of the PROBASE trial].
abstract: BACKGROUND
  Self-concept consists of self-perceptions and is influenced by the life course of the person.
  
  
  OBJECTIVE
  This study investigated associations between self-concept and erectile dysfunction (ED) in 45-year-old German men.
  
  
  METHODS
  Forty-five-year-old, heterosexual men who had participated in the PROBASE-study were included. Erectile Function was evaluated using the International Index of Erectile Function (IIEF-6). The presence of ED was defined by IIEF-6 score ≤ 25. Self-concept was assessed using the facets "body image" (three items from the Dresden Body Image Inventory, DKB-35), "perception of masculinity" (three items from the Male Role Norms Scale, MRNS), "perceived social pressure with regard to sexual performance" (four newly constructed items), and "sexual self-esteem" (three newly constructed items). Scores for these facets of self-concept can range from 1 to 5. Higher scores indicate a more positive body image, higher sexual self-esteem, a more modern understanding of masculinity, and greater perceived social pressure. Differences in self-concept between men with ED and without ED were analyzed using the Mann-Whitney-U-test. Furthermore, Cohen's d effect sizes (ES d) were calculated.
  
  
  RESULTS
  The responses of 3143 men were analyzed. Men with ED (16.2 %) have significantly lower scores regarding body image (mean 3.6 ± 0.6 vs 3.8 ± 0.5; p < 0.001; ES d = -0.5), perception of masculinity (mean 3.4 ± 0.7 vs 3.7 ± 0.6; p < 0.001; ES d = -0.4), and sexual self-esteem (mean 3.6 ± 0.6 vs 3.9 ± 0.5; p < 0.001, ES d = -0.4) than men without ED. Furthermore, they had significantly higher scores for perceived social pressure (mean 2.1 ± 0.7 vs 1.5 ± 0.5; p < 0.001; ES d = 1.2).
  
  
  CONCLUSIONS
  Self-concept and ED are associated in 45-year-old men. Men with ED have a more negative body image, a more traditional understanding of masculinity, more negative sexual self-esteem, and greater perceived social pressure with regard to sexual performance than men without ED.
authors.affiliation: Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
authors.forename: A M
authors.initials: AM
authors.lastname: Kögel
authors.affiliation: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Dinkel
authors.affiliation: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Marten-Mittag
authors.affiliation: Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Baron
authors.affiliation: Klinik für Urologie, Medizinische Fakultät, Universität Düsseldorf, Düsseldorf, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Albers
authors.affiliation: Klinik für Urologie, Medizinische Fakultät, Universität Düsseldorf, Düsseldorf, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Arsov
authors.affiliation: Klinik für Urologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Hadaschik
authors.affiliation: Klinik für Urologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Hohenfellner
authors.affiliation: Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Imkamp
authors.affiliation: Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Kuczyk
authors.affiliation: Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
authors.forename: J E
authors.initials: JE
authors.lastname: Gschwend
authors.affiliation: Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland. kathleen.herkommer@tum.de.
authors.forename: K
authors.initials: K
authors.lastname: Herkommer
mesh_terms: D001828:Body Image / Q000523:psychology*; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D054526:Men's Health / Q000706:statistics & numerical data; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology*
keywords: Body image; Erectile dysfunction; Masculinity; Self-concept; Sexual behavior