Chapter 13 - Sex disorders Flashcards

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1
Q

What was the Human Sexual Response Cycle according to Masters and Johnson?

A

1) Sexual excitement - engagement of sexual organs
2) Plateau - level off of the degree of excitement
3) Orgasm - Climax (one for penis, can have multiple for vaginas)
4) Resolution - mainly for the penis, vaginas do not experience this

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2
Q

How would you define a sexual disorder?

A
  • Disorders that interfere with the sexual functioning and enjoyment of a sexual activity
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3
Q

What’s the Human Sexual Response Cycle according to Helen Singer Kaplan?

A

1) Desire (especially for women)
2) Excitement
3) Orgasm

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4
Q

What are common requirements that must be met to diagnose a sexual dysfunction?

A
  • Must include recurrence of problems over 6 months and clear distress or interpersonal difficulty
  • No diagnosis will be made if there’s no distress
  • Must not be explainable by other disorders or a medical condition
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5
Q

T/F: People with paraphilias who do not experience their sexual activity as distressing and who do not cause harm to others are not diagnosed.

A
  • TRUE
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6
Q

T/F: A lot of sexual dysfunctions are associated with medical conditions

A
  • TRUE
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7
Q

Lifelong sexual dysfunction vs. an acquired sexual dysfunction?

A
  • Lifelong - They have had it since they can remember
  • Acquired - has only developed recently in all situations. Important to uncover why this is
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8
Q

Generalized sexual dysfunction vs. situational sexual dysfunction?

A
  • Generalized - The problem occurs in all situations
  • Situational - The problem only arises in certain situations
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9
Q

What are male hypoactive sexual disorders?

A
  • Persistent/recurrent deficient or absent sexual/erotic thoughts or fantasies and desire for sexual activity
  • i.e., they’re not interested/don’t think about it
  • May be difficult for the partner
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10
Q

What’s female sexual interest/arousal disorder?

A
  • Lack of sexual interest and arousal
  • Lack of capacity to become aroused
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11
Q

What’s erectile disorder?

A
  • Difficulties with obtaining an erection during sexual activity, maintaining an erection until completion of activity, and/or marked decrease in erectile rigidity in 75% and 100% of sexual occasions
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12
Q

What are the sexual desire and arousal phase disorders?

A
  • Male hypoactive sexual disorders
  • Female sexual interest/arousal disorder
  • Erectile disorder
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13
Q

What are the orgasmic phase disorders?

A
  • Delayed ejaculation
  • Female orgasmic disorder
  • Premature ejaculation
    *Must be partnered encounters
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14
Q

What’s delayed ejaculation?

A
  • Marked delay in ejaculation or marked infrequency or absence of ejaculation present in 75%-100% of sexual occasions with a partner for over six months
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15
Q

What’s female orgasmic disorder?

A
  • Marked infrequency or delay or absence of orgasm, or marked reduced intensity of orgasmic sensation in 75%-100% of sexual encounters
  • Often requires a medical condition prior to diagnosis
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16
Q

What’s premature ejaculation?

A
  • Persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately one minute following vaginal penetration, before the individual wishes it
  • Individual is displeased that they cannot control the ejaculation
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17
Q

What’s another term for hypersexuality?

A
  • Often referred to as a sex addiction
  • Individual has a lack of control/compulsivity in sexual activity
  • Not in the DSM-5 but the IDM has it
  • Not really a withdrawal from sex
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18
Q

What’s genito-pelvic pain/penetration disorder?

A

Persistent or recurrent difficulties with one or more of the following:
- Vaginal penetration during intercourse
- Marked vulvovaginal and pelvic pain during vaginal intercourse and penetration attempts
- Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation, during, or as a result of vaginal penetration
- Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration

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19
Q

What 2 former disorders does genito-pelvic pain/penetration disorder roll into one disorder?

A
  • Dyspareunia and vaginismus
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20
Q

T/F: Genital pain in men is rare and is often linked to a disease.

A
  • TRUE
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21
Q

Which sexual disorders do people sought treatment for the most?

A
  • Mostly for erectile disorder, female orgasmic disorder, premature orgasm (in men)
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22
Q

T/F: Sexual desire problems have become more frequent.

A
  • TRUE
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23
Q

T/F: Erectile dysfunction is completely unrelated to vascular dysfunction

A
  • FALSE
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24
Q

T/F: Tobacco, alcohol, and cannabis can affect arousal and sexual dysfunction

A
  • TRUE
  • Affects alertness. concentration, etc.
  • Hard to treat damage caused by substances
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25
Q

How do SSRIs affect sexual function?

A
  • They can cause delayed ejaculation and orgasmic dysfunction
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26
Q

How can neurological disorders impact sexual functions in men and women?

A
  • Neurological disorders can cause erectile dysfunction in men (i.e., damage to peripheral nerves)
  • Neurological disorders, pelvic disease, hormonal dysfunctions can interfere with vaginal swelling, lubrication
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27
Q

What are some of the social factors that contribute to the etiology of sex disorders?

A
  • Major influence of culture and belief systems
  • Childhood socialization (attitudes towards sex vary considerably)
  • Women born in recent decades report fewer orgasmic problems
  • Women with orgasmic disorder are less likely to talk about sex. They hold negative attitudes about masturbation and feel more guilt about sex
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28
Q

What are the psychological factors that contribute to the etiology of sex disorders?

A
  • Performance anxiety (especially for men, keep evaluating themselves and become spectators of their performance)
  • Relationship factors (poor communication)
  • Assertiveness problems, lack of social skills, discomfort about sex (especially for women)
  • Previous harmful experience (i.e., sexual assualt/trauma)
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29
Q

What’s the PLISSIT model?

A

A model of treatment for sexual disorders (most common):
- Permission (consent)
- Limited information (what access do they currently have?)
- Specific suggestions (what info do they need?)
- Intensive therapy (for those who need serious help)

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30
Q

What are some of the best ways to prevent sexual disorders?

A
  • For both genders, prevention of sexual disorders, involves healthy communication between partners, staying sexually active, smoking cessation, reducing alcohol intake to within healthier limits, and regular exercise
31
Q

What’s the sensate focus?

A
  • A type of treatment for sexual disorders
  • A technique used to reduce anxiety concerning sex where a slow habituation process is used to make the person more comfortable with sex
32
Q

What are some treatments used for premature ejaculation?

A
  • Stop-start technique
  • Squeeze technique
33
Q

What are some other general treatments for sexual disorders?

A
  • Scheduling time for sexual activity
  • Cognitive restructuring and education
  • Communications training
34
Q

What are some treatments used for genito-pelvic pain/penetration disorder?

A
  • Relaxation training
  • Changes to sexual approaches
  • Interventions targeting body image
  • Therapy for relational problems (partner may be too physically aggressive)
35
Q

What are some of the biomedical treatments for GPPPD?

A

Focus is on ways to reduce pain upon intercourse:
- vaginal moisturizers and lubricants
- Topical estrogen
- Vaginal dilators
- Pelvic floor muscle relaxation
- Topical lidocaine to reduce pain

36
Q

What are some of the biomedical treatments for erectile dysfunction?

A
  • PDE 5 inhibitors (Viagra, Cialis, Levitra; do not cause psychological arousal)
  • Injections of neurotransmitters
  • Surgery (rarely, not super effective, open up blood vessels near prostate)
  • Mechanical devices (usually last resort, not easy to do)
37
Q

What’s the definition of paraphilia?

A
  • Intense, persistent sexual interest other than sexual interest in genital stimulation, or preparatory fondling with phenotypically normal, physically mature, consenting human partners
38
Q

What are the typical symptoms of paraphilias?

A
  • Sexual fantasies are strong, long-standing, unusual, very persistent
  • Fantasies usually do not involve reciprocal loving with an adult partner
  • Themes of aggression, revenge, and hostility dominate many paraphilic fantasies, particularly those leading to criminal offences
  • Compulsion, lack of flexibility
39
Q

What are some types of people with paraphilias?

A
  • Many people with sexual paraphilias, particularly those who do not constitute criminal offences, are generally well-adjusted
  • Others are often timid, submissive, socially inept
  • Some are aggressive, domineering, rigid, self-indulgent
  • A few could be described as confused, disorganized, sometimes mentally ill or intellectually deficient
40
Q

What’s the difference between transvestism and transvestic fetishism?

A
  • Transvestism - Most often men, where they dress as opposite gender for fun
  • Transvestic fetishism - get sexual reward/stimulation from dressing as the opposite gender, may be an indicator of a gender identity disorder
    *Only diagnosed if it causes harm to the individual
41
Q

What’s hypoxyphilia?

A
  • Deriving sexual pleasure from being choked
42
Q

What’s the difference between sexual sadism and masochism?

A
  • Sexual sadism - like inflicting pain upon others
  • Masochism - like receiving pain
43
Q

What are some of the major paraphilias?

A

(usually constitute criminal offences)
- Exhibitionistic disorder - chooses to show themself undressed in public (includes streaking)
- Voyeuristic disorder - Person makes effort to see people naked or having sex
- Pedophilic disorder - Usually men who are attracted to underage people/early teenagers

44
Q

What’s the difference between primary pedophiles and secondary pedophiles?

A
  • Primary - Children are primary objects of sexual attraction
  • Secondary - May have older, more mature relationships but are still attracted to kids
45
Q

What’s the difference between child molesters and pedophiles?

A
  • Pedophiles - the experience of recurrent intense sexually arousing fantasies and urges involving sexual activities with a prepubescent child (around 13 years or younger)
  • Child molesters - adult heterosexual males who usually have one or more adult relationships and also interact sexually with children and/or teenagers
    *For both, most victims are girls, the most common contact is genital fondling
46
Q

What are the types of relationships found between child victims and their perpetrators?

A
  • Most of the time, the child victims know the perpetrator. Most incidents occur in the child’s home or the perpetrator’s home
  • Incestuous relationships take place between blood relatives or”step-relatives”
  • About half the men who sexually abuse their children are also abusing children outside the family
47
Q

T/F: Most men who sexually abuse children are victims of sexual abuse themselves.

A
  • TRUE
  • It’s a toxic cycle where victims keep turning into perpetrators
48
Q

What are the different character types found among pedophiles?

A
  • Many are passive, sensitive, and relatively non-threatening (relatively normal)
  • A few are domineering, controlling, and aggressive (dangerous, may isolate children, seen in cult leaders)
  • Others are disorganized, socially incompetent, or suffer from other mental disorders
  • Don’t know why they’re attracted to children, can cause a lot of distress
49
Q

What are some of the statistics regarding sexual assault?

A
  • About 6% of women report having been raped
  • 21% report having been sexually assaulted
    *Most likely underreported
  • Rape occurs to men often in prison
50
Q

T/F: In sexual assault, the victims usually don’t know the perpetrators.

A
  • FALSE, they often do
  • Rape by a stranger is rare, except during war
51
Q

What’s the recidivism rate among rapists?

A
  • About 25% of rapists will commit another sexual assault after spending 5 to 10 years in the community
52
Q

What’s the common intent for rape?

A
  • Rape is motivated at least partly (in some cases) primarily by aggression
  • In other cases, sexual arousal and pleasure are linked to the suffering of the victim. Many people who commit sexual assaults do so to hurt, humiliating, and degrade their victims
53
Q

T/F: People who exhibit one form of paraphilia often exhibit others.

A
  • TRUE
54
Q

What are some of the biological factors that contribute to the etiology of paraphilias?

A
  • Biological etiology is poorly understood
  • Some evidence of hormonal (testosterone) dysfunction and temporal lobe dysfunction
55
Q

How does Freud’s courtship theory contribute to the psychosocial etiology of paraphilias?

A
  • Believed that paraphilias are the result of courtship behaviours gone awry. Similar to animals, there’s a visual appraisal, physical touching, and then sexual touching that should progress normally
  • Hard to test, not applied very often
56
Q

What’s the feminist theory for why sexual assault occurs?

A
  • The idea that we live in a predominately paternalistic society where men have most of the power, making it easier to assault women
  • Some evidence for this, since countries where men have more power/control are correlated to higher levels of sexual assault
57
Q

What are some other psychosocial factors pertaining to the etiology of paraphilias and sexual assault?

A
  • Integrative theories: Sexual abuse, inappropriate modelling of sex behaviour and values, low self-esteem, poor social competence, poor knowledge of sexuality
  • Failure to achieve intimacy combined to poor social skills
  • Reinforcement provided by sexual pleasure, empowerment, high risk-taking (hard to get data on this)
58
Q

What are some common treatments for paraphilias?

A
  • Aversion therapy - have people imagine performing paraphilic scenarios while on unpleasant medication (not super effective)
  • CBT
  • Hormone therapy (not super common, may include chemical castration)
  • Integrated programs - combine a bunch of interventions, used for sexual assault (success is difficult to estimate)
59
Q

What’s gender identity disorder?

A
  • Characterized by a firm conviction that one is a member of the opposite sex.
  • Not everyone who has this problem is “dysphoric” or otherwise dysfunctional
  • Feelings of belonging to the other gender often arise early in childhood
60
Q

What are some criticisms/concerns regarding GID?

A
  • Many have questioned whether GID should be a mental disorder.
  • Many see the diagnosis as a pathologization of gender diversity (gender diversity is a fact of life)
  • Often culturally dependent; a large number of distinct cultures allow for multiple gender/sexes
61
Q

What is some of the known etiology concerning gender dysphoria?

A
  • Very poorly understood (has not been researched long)
  • Gender identity appears minimally influenced by environmental experiences
  • Some researchers have theorized that discordance between gender/sex assigned at birth and perception of one’s own gender is related to variations in parental hormone exposure (evidence is lacking)
  • Oedipal complications are lacking in evidence
62
Q

What are the different dimensions of gender?

A
  • Chromosomal gender
  • Gonadal gender
  • Prenatal hormonal gender
  • Internal organs
  • External genital appearance
  • Gender identity
63
Q

What’s androgen insensitivity syndrome?

A
  • When the body does not register androgen well. Recognized as male at birth, but does not appear male
  • Relatively rare
64
Q

T/F: GID is a very common disorder.

A
  • FALSE
  • rare, just gets a lot of attention in the media
  • More common in children than adults
65
Q

What are some common treatments for GID?

A
  • Psychotherapy is important to explore gender identity issues and psychological distress, not to encourage gender-appropriate behaviour nor to discourage a strong desire for sex reassignment
  • Therapy usually involves a period (about one year) where the individual lives in a gender role congruent with their gender identity
  • Hormonal treatment and sex reassignment surgery
66
Q

What are the standards of care from the World Professional Association for Transgender Health?

A

1) Persistent and well-documented gender dysphoria
2) Capacity to make fully informed decisions and consent to treatment
3) Age of majority in a given country
4) Any significant medical and/or mental health concerns must be well controlled.
5) 12 continuous months of hormone therapy, and for some genital surgeries the individual must live 12 consecutive months in living in a gender role that is consistent with their gender identity

67
Q

What are the most common sexual dysfunctions among men and women?

A
  • Men - Premature ejaculation and erectile disorders
  • Women - desire and arousal issues
68
Q

Who was the first to systematically collect data on orgasm in women?

A
  • Alfred Kinsey
  • Discovered women were more likely to experience an orgasm through masturbation rather than through penetration
69
Q

What’s provoked vestibulodynia?

A
  • Most common form of dyspareunia
  • A severe, sharp/burning pain at the entrance of vagina in response to any kind of pressure
70
Q

How can anxiety interfere with sexual performance?

A
  • May interfere with the activation of the parasympathetic branch that is aroused during sexual activity
71
Q

What’s an intracavernous treatment and a vestibulectomy?

A
  • Intracavernous treatment - needle injection to treat erectile dysfunction
  • Vestibulectomy - a surgical treatment for women who have a particular form of GPPPD
72
Q

What’s apotemnophilia?

A
  • A fetish for amputation and genital mutilation
73
Q

What’s a penile plethysmography?

A
  • A method to measure arousal in those with penises