Chapter 10 Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria Flashcards
Sexual dysfunction
find it difficult to function adequately while having sex; for example, they may not become aroused or achieve orgasm.
paraphilic disorders
- sexual deviation; sexual arousal occurs primarily in the context of inappropriate objects or individuals
- Have little to do with sexual dysfunctions except for the fact that they both involvesexual behavior.
Philia
A strong attraction or liking
Para
Indicates the attraction is abnormal
Paraphilic arousal patterns
Tend to be focused rather narrowly, often precluding mutually consenting adult partners, even if desired.
Gender dysphoria
- incongruence & psychological distress & dissatisfaction w/ the gender 1 has been assigned at birth (boy or girl). The disorder is not sexual but rather a disturbance in the person’s sense of being a male or a female.
- The disorder is not sexual but rather a disturbance in the person’s sense of being a male or a female.
Heterosexual behavior
Sex with the opposite sex
Homosexual behavior
Sex with the same sex
Acquired
A disorder that begins after sexual activity has been relatively normal
Generalized
occurring every time the individual attempts sex
Situational
occurring with some partners or at certain times but not with other partners or at other times
Male hypoactive sexual desire disorder
Dysfunction in which a man feels distress from having little or no sexual interest.
Female sexual interest/arousal disorder
Recurrent inability in some women to attain or maintain adequate lubrication and sexual excitement swelling responses until completion of sexual activity
Hypoactive sexual desire disorder
Apparent lack of interest in sexual activity or fantasy that would not be expected considering the person’s age and life situation
Erectile disorder
Recurring inability in some men to attain or maintain adequate penile erection until completion of sexual activity.
The old and somewhat derogatory terms for male erectile disorder and female interest and arousal difficulties are __________ and _________, but these are imprecise labels that do not identify the specific phase of the sexual response in which the problems are localized.
impotence and frigidity
Delayed ejaculation
- Males who achieve orgasm only w/ great difficulty or not at all meet criteria for a condition
- Disorder in which a man achieves orgasm only with great difficulty
Female orgasmic disorder
Recurring delay or absence of orgasm in some women following a normal sexual excitement phase, relative to their prior experience and current stimulation. Also known as inhibited orgasm (female)
Retrograde ejaculation
in which ejaculatory fluids travel backward into the bladder rather than forward
Premature ejaculation
- ejaculation that occurs well before the man & his partner wish it to; defined as approximately 1 minute after penetration in DSM-5
- Recurring ejaculation before the person wishes it, with minimal sexual stimulation
Genito-pelvic pain/penetration disorder
- includes difficulties w/ penetration during intercourse due in many cases to painful contractions or spasms of the vagina
- Sexual dysfunction in which a woman experiences pain or difficulty with penetration during intercourse; may include vaginismus
Vaginismus
- in which the pelvic muscles in the outer third of the vagina undergo involuntary spasms when intercourse is attempted
- Recurring involuntary muscle spasms in the outer third of the vagina that interfere with sexual intercourse
Penile strain gauge
measures penile erection
Vaginal photoplethysmograph
A light source at the tip of the instrument & 2 light-sensitive photoreceptors on the sides of the instrument measure the amount of light reflected back from the vaginal walls. B/c blood flows to the vaginal walls during arousal, the amount of light passing through them decreases w/ increasing arousal
Antihypertensive medications
Drug treatments for high blood pressure
Erotophobia
many people learn early that sexuality can be negative & somewhat threatening, & the responses they develop reflect this belief
Script theory of sexual functioning
according to which we all operate by following “scripts” that reflect social & cultural expectations & guide our behavior
Sensate focus & nondemand pleasuring
couples are instructed to refrain from intercourse or genital caressing & simply to explore & enjoy each other’s body through touching, kissing, hugging, massaging, or similar kinds of behavior
papaverine or prostaglandin
drugs dilate the blood vessels, allowing blood to flow to the penis & thereby producing an erection w/in 15 minutes that can last from 1 to 4 hours
Penile prostheses
Implants has been a surgical option for almost 100 years
Vacuum Device Therapy
works by creating a vacuum in a cylinder placed over the penis. The vacuum draws blood into the penis, which is then trapped by a specially designed ring placed around the base of the penis
Paraphilic disorders
- sexual deviation; sexual arousal occurs primarily in the context of inappropriate objects or individuals
- Sexual disorders and deviations in which sexual arousal occurs almost exclusively in the context of inappropriate objects or individuals
Frotteuristic disorder
Paraphilic disorder in which the person gains sexual gratification by rubbing against unwilling victims in crowds from which they cannot escape
Fetishistic disorder
Long-term, recurring, intense sexually arousing urges, fantasies, or behavior that involve the use of nonliving, unusual objects and that cause distress or impairment in life functioning
Partialism
third source of attraction in is a part of the body, such as the foot, buttocks, or hair (Fetishistic disorder)
Voyeuristic disorder
Paraphilic disorder in which sexual arousal is derived from observing unsuspecting individuals undressing or naked
Exhibitionistic disorder
Is achieving sexual arousal and gratification by exposing genitals to unsuspecting strangers
Transvestic disorder
Paraphilia in which individuals, usually males, are sexually aroused or receive gratification by wearing clothing of the opposite sex.
Sexual sadism
Paraphilia in which sexual arousal is associated with inflicting pain or humiliation
Sexual masochism
Paraphilia in which sexual arousal is associated with experiencing pain or humiliation
Hypoxiphilia
Something goes wrong and the individual accidentally hangs himself, an event that should be distinguished from the closely related condition called hypoxiphilia, which involves self-strangulation to reduce the flow of oxygen to the brain and enhance the sensation of orgasm.
Pedophilia
Paraphilia involving strong sexual attraction toward children
Incest
Deviant sexual attraction (pedophilia) directed toward a family member; often the attraction of a father toward a daughter who is maturing physically
Covert sensitization
Cognitive-behavioral intervention to reduce unwanted behaviors by having clients imagine the extremely aversive consequences of the behaviors and establish negative rather than positive associations with them.
Orgasmic reconditioning
Learning procedure to help clients strengthen appropriate patterns of sexual arousal by pairing appropriate stimuli with the pleasurable sensations of masturbation
Relapse prevention
Extending therapeutic progress by teaching the client how to cope with future troubling situations
Cyproterone acetate
The most popular drug used to treat individuals with paraphilic disorders is an antiandrogen- cyproterone acetate
Medroxyprogesterone
A hormonal agent that reduces testosterone
-May be useful for dangerous sexual offenders who do not respond to alternative treatments or to temporarily suppress sexual arousal in patients who require it, but it is not always successful.
Gender dysphoria
- incongruence & psychological distress & dissatisfaction w/ the gender 1 has been assigned at birth (boy or girl). The disorder is not sexual but rather a disturbance in the person’s sense of being a male or a female.
- Psychological dissatisfaction with biological gender, a disturbance in the sense of identity as a male or female. The primary goal is not sexual arousal but rather to live the life of the opposite gender.
autogynephilia
Another specifier for transvestism that describes a pattern of sexual arousal associated not w/ clothing itself but rather w/ thoughts or images of oneself as a female
Gender noncomformity
A phenomenon in which pre-pubescent children do not identify with their biological sex, but instead identify strongly with the gender of the opposite sex and display varying degrees of behavior more characteristic of the opposite sex
Bisexuality
Attraction to both same-and opposite-sex sexual partners
Sex reassignment surgery
Surgical procedures to alter a person’s physical autonomy to confirm to that person’s psychological gender identity
monogamous
one partner
masturbate
self-stimulate to orgasm
fraternal birth order hypothesis
each additional older brother increases the odds of being gay by 1/3
3 stages of the sexual response cycle associated w/ sexual dysfunction?
desire; arousal; orgasm
Lifelong
refers to a chronic condition that is present during a person’s entire sexual life
sexual dysfunction of desire for men?
Male hypoactive sexual desire disorder (little or no desire to have sex)
sexual dysfunction of desire for women?
Female sexual interest/arousal disorder (little or no desire to have sex)
sexual dysfunction of desire for women?
sexual dysfunction of arousal for men?
Erectile disorder (difficulty attaining or maintaining erections)
sexual dysfunction of arousal for women?
Female sexual interest/arousal disorder (little or no desire to have sex)
sexual dysfunction of orgasm for women?
Female orgasmic disorder
sexual dysfunction of orgasm for men?
Delayed ejaculation; premature (early) ejaculation
sexual dysfunction of pain for women?
genito-pelvic pain/penetration disorder
3 major aspects to the assessment of sexual behavior?
interviews; thorough medical evaluation; psychophysiological assessment
psychophysiological assessment
directly measure the physiological aspects of sexual arousal
thorough medical evaluation
rule out the variety of medical conditions that can contribute to sexual problems
interviews
usually supported by numerous questionnaires because patients may provide more information on paper than in a verbal interview
arterial insufficiency
constricted arteries, which makes it difficult for blood to reach the penis
venous leakage
blood flows out too quickly for an erection to be maintained
squeeze technique
treat premature ejaculation in which the penis is stimulated, usually by the partner, to nearly full erection.
Criteria for Fetishistic Disorder?
- Over a period of at least 6 months, recurrent & intense sexual arousal from the use of nonliving objects or a highly specific focus on nongenital body part(s), as manifested by fantasies, urges, or behaviors.
- The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The fetish objects aren’t limited to articles of clothing used in cross-dressing (as in transvestic disorder) or devices specifically designed for the purpose of tactile genital stimulation
Criteria for Voyeuristic?
- Over a period of at least 6 months, recurrent & 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.
- The person has acted on these sexual urges w/ a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The individual experiencing the arousal &/or acting on the urges is at least 18 years of age.
Criteria for Transvestic Disorder?
-Over a period of at least 6 months, recurrent & intense sexual arousal from cross-dressing, as manifested by fantasies, urges, or behaviors.
The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
-Specify if:
–W/ fetishism
–W/ autogynephilia
(Choose the correct answer from the following: male hypoactive sexual desire disorder; vaginismus; penile strain gauge; male orgasmic disorder)
After Bob’s football team won the championship, his interest in sexual activity diminished. All his thoughts & fantasies centered on football & winning again next season & his wife was threatening to leave him. Bob is probably displaying
male hypoactive sexual desire disorder
(Choose the correct answer from the following: sexual insecurities; hypoactive sexual desire disorder; boredom; female sexual interest/ arousal disorder)
Kelly has no real desire for sex. She has sex only b/c she feels that otherwise her husband may leave her. Kelly suffers from
female sexual interest/ arousal disorder
(Choose the correct answer from the following: erectile disorder; stress; premature ejaculation)
Aadarsh lacks the ability to control ejaculation. The majority of the time he ejaculates w/in seconds of penetration. He suffers from
premature ejaculation
(Choose the correct answer from the following: female orgasmic disorder; female sexual interest/arousal arousal disorder; vaginismus; dislike for her husband)
Samantha came into the office b/c she is unable to reach orgasm. She loves her husband but stopped initiating sex. She is most likely suffering from
female orgasmic disorder
(True/False): Many physical & medical conditions & their treatments (for example, prescription medications) contribute to sexual dysfunction; however, many doctors are unaware of the connection.
True
(True/False): Anxiety always decreases or even eradicates sexual arousal.
False-sometimes increases arousal
(True/False): Sexual dysfunctions can result from a growing dislike for a partner, traumatic sexual events, or childhood lessons about the negative consequences of sexual behavior.
True
(True/False): A simple, effective treatment for many disorders is education.
True
(True/False): All sexual dysfunctions are treated w/ the same psychosocial technique.
False
(True/False): Most surgical & pharmacological treatments of recent years have focused on erectile disorder.
True
Mae enjoys being slapped with leather whips during foreplay. Without such stimulation, she is unable to achieve orgasm during sex. (Choose from exhibitionistic disorder, voyeuristic disorder, fetishistic disorder, or sexual masochism disorder)
Sexual masochism disorder
Kai has a collection of women’s panties that arouse him. He loves to look at, collect, and wear them. (Choose from exhibitionistic disorder, voyeuristic disorder, fetishistic disorder, or sexual masochism disorder)
fetishistic disorder
Sam finds arousal in walking up to strangers in the park and showing them his genitals. (Choose from exhibitionistic disorder, voyeuristic disorder, fetishistic disorder, or sexual masochism disorder)
exhibitionistic disorder
Peeping Tom loves to look through Susie’s bedroom window and watch her undress. He gets extremely excited as she disrobes. He is practicing ________. (Choose from exhibitionistic disorder, voyeuristic disorder, fetishistic disorder, or sexual masochism disorder)
voyeuristic disorder
What Peeping Tom does not realize is that Susie knows that he is watching. She is aroused by slowly undressing while others are watching, and she fantasizes about what they are thinking. Susie’s behavior is called ________.
(Choose from exhibitionistic disorder, voyeuristic disorder, fetishistic disorder, or sexual masochism disorder)
exhibitionistic disorder
What Pepping Tom will be shocked to find out is that “Susie” is actually Scott, a man who can become aroused only if he wears feminine clothing. Scott’s behavior is _________.
(Choose from exhibitionistic disorder, voyeuristic disorder, fetishistic disorder, or sexual masochism disorder)
fetishistic disorder
Name some gender differences that exist in sexual attitudes and sexual behavior.
More men masturbate and do it more often; men are more permissive about casual sex; women want more intimacy from sex, and so on.
Which sexual preference or preferences are normal, and how are they developed?
Both heterosexuality and homosexuality are normal; genetics appear to play some role in the development of sexual preference.
Charlie always felt out of place with the boys. At a young age, he preferred to play with girls and insisted that his parents call him “Charlene.” He later claimed that he felt like a woman trapped in a man’s body. What disorder could Charlie have?
Gender dysphoria
What could be the cause(s) of Charlie’s disorder?
Abnormal hormone levels during development; social or parental influences
What treatments could be given to Charlie?
Sex reassignment surgery; psychosocial treatment to adjust to expressed or desired gender.
