Chapter 10 Flashcards
2 Types of disorders associated with sexual functioning
Sexual dysfunction
Paraphilic disorder.
Not specifically a sexual disorder, but rather a marked incongruence between one’s natal (biological) sex and the gender one experiences identifies with.
Gender dysphoria
A heterogenous group of disorders that are
typically characterized by a clinically
significant disturbance of a person’s ability
to respond sexually or experience sexual
pleasure.
SEXUAL DYSFUNCTIONS
Sexual problem that has been present from first sexual experiences
Lifelong
Sexual dysfunctions that develop after a period of relatively normal sexual function
Acquired
Sexual difficulties that are not limited to certain types of stimulation, situations, or partners
Generalized
Sexual difficulties that only occur with certain types of stimulation, situations, or partners.
Situational
A. Persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity. The judgment of deficiency is made by the clinician, taking into account factors that affect sexual functioning, such as age and general and sociocultural contexts of the individual’s life.
Male Hypoactive Sexual Desire Disorder
A. Lack of, or significantly reduced, sexual
interest/arousal, as manifested by at
least three of the following:
- Absent/reduced interest in sexual activity.
- Absent/reduced sexual/erotic thoughts or fantasies.
- No/reduced initiation of sexual activity, and typically unreceptive to a partner’s attempts to initiate.
- Absent/reduced sexual excitement/pleasure during sexual activity in almost all or all (approximately 75%–100%) sexual encounters (in identified situational
contexts or, if generalized, in all contexts). - Absent/reduced sexual interest/arousal in response to any internal or external sexual/erotic cues (e.g., written, verbal, visual).
- Absent/reduced genital or non-genital sensations during sexual activity in almost all or all (approximately 75%–100%) sexual encounters (in identified situational
contexts or, if generalized, in all contexts).
Female Sexual Interest/Arousal Disorder
A. At least one of the three following symptoms must be experienced on almost all or all (approximately 75%–100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts):
1. Marked difficulty in obtaining an erection during sexual activity.
2. Marked difficulty in maintaining an erection until the completion of sexual activity.
3. Marked decrease in erectile rigidity
Erectile Disorder
Widely used descriptive term (including in ICD-10) that refers to difficulty getting and
maintaining an erection.
Erectile Dysfunction
A. Either of the following symptoms must be
experienced on almost all or all occasions
(approximately 75%–100%) of partnered sexual activity (in identified situational contexts or, if generalized, in all contexts), and without the individual desiring delay:
- Marked delay in ejaculation.
- Marked infrequency or absence of ejaculation
Delayed Ejaculation
A. A persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately 1 minute following vaginal penetration and before the individual wishes it.
Premature (Early) Ejaculation
A. Presence of either of the following symptoms and experienced on almost all or all (approximately 75%–100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts):
- Marked delay in, marked infrequency of, or
absence of orgasm. - Markedly reduced intensity of orgasmic
sensations
Female Orgasmic Disorder
A. A. Persistent or recurrent difficulties with one (or more) of the following:
- Vaginal penetration during intercourse.
- Marked vulvovaginal or pelvic pain during
vaginal intercourse or penetration attempts. - Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration.
- Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration.
Genito Pelvic Pain/Penetration Disorder
A. A clinically significant disturbance in sexual function is predominant in the clinical picture.
Substance/Medication-Induced Sexual Dysfunction
Refers to the distress that may accompany
the incongruence between one’s
experienced or expressed gender and
one’s assigned gender.
Gender Dysphoria
Sexual interest greater than or equal to
nonparaphilic sexual interests.
Paraphilia
Paraphilia that is currently causing distress or impairment to the individual, or cause personal harm, or the risk of harm to others.
Paraphilic disorder
Achievement of sexual arousal by observing people who are naked, disrobing, or engaging in sexual activity.
Voyeurism
A. Over a period of at least 6 months, recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviors.
Voyeuristic disorder
This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in voyeuristic behavior are restricted.
In full remission
A. Over a period of at least 6 months, recurrent and intense sexual arousal from the exposure of one’s genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors.
Exhibitionistic disorder
A. Over a period of at least 6 months, recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors.
Frotteuristic Disorder
A. Over a period of at least 6 months, recurrent and
intense sexual arousal from the act of being
humiliated, beaten, bound, or otherwise made to
suffer, as manifested by fantasies, urges, or
behaviors.
Sexual Masochism Disorder
If the individual engages in the practice of achieving sexual arousal related to restriction of breathing.
With asphyxiophilia
Used to refer to a wide range of behaviors
that individuals with sexual masochism and/or sexual sadism (as well as other individuals with similar sexual interests) engage in, such as restraints or restriction, discipline, spanking, slapping, sensory deprivation (e.g., using blindfolds), and dominance-submission role-play involving themes such as master/enslaved person,
owner/pet, or kidnapper/victim.
Bondage-domination-sadism-masochism
(BDSM)
A. Over a period of at least 6 months, recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors.
Sexual Sadism Disorder
Over a period of at least 6 months, recurrent,
intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).
Pedophilic Disorder
Children are the person’s relatives
Incest
A. Over a period of at least 6 months, recurrent and intense sexual arousal from either the use of nonliving objects or a highly specific focus on nongenital body part(s), as manifested by fantasies, urges, or behaviors.
Fetishistic Disorder
The term “fetishism” originates from the
Portuguese word:
feitico = “obsessive fascination”
2 classes of objects or activities of Fetishistic Disorder
- an inanimate object or
- a source of specific tactile stimulation
Source of attraction which is a part of the body, such as the foot, buttocks, or hair.
Partialism
A. Over a period of at least 6 months, recurrent and intense sexual arousal from cross-dressing, as manifested by fantasies, urges, or behaviors.
Transvestic Disorder
Fantasies and behaviors may focus on the idea of exhibiting female physiological
functions
Autogynephilia
Procedure that is carried out entirely in the imagination of the patient.
Covert sensitization
Procedures directed at changing the associations and context from arousing and pleasurable to neutral.
Behavioral therapy
Patients are instructed to masturbate to their usual fantasies but to substitute more desirable ones just before ejaculation.
Orgasmic reconditioning
Care must be taken to provide the patient with coping skills to prevent slips or relapses.
Relapse prevention treatment
