Development of Sexual Dysfunction Can Be Viewed as a "Vicious

Development of sexual dysfunction can be viewed as a "vicious circle" since the typical case progresses in the following manner:

A) initial dysfunction may be triggered by an event such as substance use; concern about the dysfunction then leads to more dysfunction, and sex itself becomes associated with negative feelings.
B) initial dysfunction may be triggered by an event such as substance use; this causes a strain on the relationship and reduces the intimacy in the relationship, which then leads to anxiety about one's desirability.
C) initial dysfunction occurs through slow and gradual deterioration, possibly due to a medical condition; as the medical condition develops, the individual's concern with failing sexuality increases, resulting in relationship problems.
D) a general medical condition triggers the first dysfunction, which is followed by increased anxiety; as the anxiety increases, the sexual dysfunction becomes more severe over time and causes loss of interest in sex.