Chapter 13 - Sexual and Gender Identity Disorders Flashcards
What are the diagnostic issues of sexual disorders?
Subjectivity
Requires distress as criteria for diagnoses
Homosexuality as a disorder
In DSM-III, what was egodystonic homosexuality?
Attracted to same sex and experiences conflict
What was egodystonic homosexuality changed to in DSM-III-R and DSM-IV?
Persistent/marked distress about sexual orientation
What are the 4 stages of the sexual response cycle?
Excitement
Plateau
Orgasm
Resolution
What are the differences in resolution stage for men and women?
Men refractory period (unresponsive to stimulation)
Females multiple orgasms possible
Who created the sexual response cycle?
Masters and Johnson
What are the 3 stages of the alternative model by Helen Singer Kaplan?
Desire
Excitement
Orgasm
In the alternative model, desire is primarily a…
Psychological component to sexual response
Most people agree that satisfactory sex is…
Essential to maintenance of relationship
What are the most common male challenges?
Early ejaculation
Erection difficulties
What are the most common female challenges?
Lack of interest
Lubrication difficulties
How does the DSM-5 classify sexual dysfunction?
By which stage affected
What are the categories for sexual dysfunction?
Desire and arousal
Orgasmic
Other
Which disorders would be under desire and arousal category?
Female sexual interest/arousal disorder
Male hypoactive sexual desire disorder
Erectile disorder
Which disorders would be under orgasmic category?
Delayed ejaculation
Female orgasmic disorder
Premature orgasm
What types of disorders would be under the other category?
Pain during intercourse
Difficulty with vaginal penetration
What are the diagnostic criterion for sexual disorders?
Symptoms experienced almost all occasions
Symptoms persisted 6+ months
Causes distress
What are the specifiers of sexual disorders?
Subtypes and severity
What are the 4 subtypes and what do they mean?
Lifelong: since sexually active
Acquired: began after relatively normal functioning
Generalized: not limited to certain stimulation/situations/partners
Situational: only occurs with certain stimulation/situations/partners
What are the 3 severities?
Mild
Moderate
Severe
How is severity determined?
Amount of distress over symptoms
Individuals can experience ______________ without being _____________ with sexual relationships/function.
Sexual difficulties; dissatisfied
What is male hypoactive sexual desire disorder and female sexual interest/arousal disorder?
Persistent/recurrent lack of sexual fantasies and desires for sexual activity
Why is it difficult to define hypoactive desire?
Contextual
Unrealistic social pressures/expectations
What are sexual arousal disorders?
Difficulty becoming physically aroused when desired
What is erectile disorder?
Difficulty obtaining/maintaining erection during sexual activity
What is female orgasmic disorder?
Delay, infrequency, or absence of orgasm
Reduced intensity of orgasmic sensations
What is delayed ejaculation?
Delay, infrequency, or absence of ejaculation
Orgasm can be possible with ___________ but not ___________.
Oral/manual stimulation or erotic dreams; intercourse
What is premature ejaculation?
Persistent pattern of ejaculation occurring within 1 minute of intercourse and before individual wishes
In genito-pelvic pain/penetration disorder, the 4 areas of persistent difficulties are…
Vaginal penetration
Vulvovaginal/pelvic pain
Fear/anxiety
Tensing/tightening of pelvic floor muscles
What is hypersexuality?
“Addiction to sex”
Loss of control over sexual urges/behaviours
Some proposed that those with hypersexuality have ___________ per week over ____________.
7+ orgasms; 6 months
Higher ___________ within relationships correlated with higher ___________.
Sexual frequency; psychological functioning
Those with hypersexuality often engage in sexual activity to…
Regulate negative emotional states
What are the subtypes of hypersexuality?
Paraphilias
Pornography/masturbation
Infidelity
Imposed norms of sexuality
What is the etiology of sexual dysfunction?
Almost everyone experiences @ some point
Perspective influences development/maintenance
What is the etiology for sexual desire and arousal disorders?
Similar to depression
Psychological factors
Hormonal imbalance
Performance anxiety
What are the psychological factors leading to sexual desire and arousal disorders?
Dysfunctional attitudes about sex
Relationship problems
Strict upbringing leading to guilt
What did Weisberg and colleagues discover through showing erectile response films?
Attributions influence sexual performance
What is the etiology for orgasmic disorders?
Primary and secondary premature ejaculation
What is primary premature ejaculation?
Conditioned response to ejaculate rapidly out of convenience (masturbation)
What is secondary premature ejaculation?
Trauma to SNS, abdominal/pelvic injuries, withdrawal from narcotics
What is the psychological etiology for genito-pelvic pain/penetration disorder?
Negative sexual attitudes
Unpleasant/traumatic experiences
Cognitive styles associated with anxiety
What is the physical etiology for genito-pelvic pain/penetration disorder?
Pelvic floor muscle dysfunction
What are the psychological interventions of treatment for sexual dysfunction?
Communication and exploration
Sensate focus
Behavioural approaches
What categorizes communication and exploration?
Sex education
Communication between partners
Acceptance/awareness of own body
What is sensate focus?
Desensitization of sexual fears
What are the steps of sensate focus?
Step 1: undress in light
Step 2: nonsexual mutual touch
Step 3: sexual touch
Step 4: sexual intercourse
What are the behavioural approaches of psychological interventions?
Stop-start and squeeze techniques
Vaginal dilation
What is the stop-start and squeeze technique?
Stop stimulation before orgasm then continue
What is vaginal dilation?
Relaxation of vaginal area and muscles
What is genito-pelvic pain/penetration disorder also known as?
Vaginismus
What are the physical treatments for sexual disorders?
Intracavernous treatment
Antidepressants
Phosphodiesterase inhibitors
Surgical interventions
What are intracavernous treatments?
Injected into penis to facilitate erection
Which disorder are antidepressants used for?
Premature ejaculation
What do phosphodiesterase inhibitors do?
Increase blood flow and stronger erections
What is gender identity?
Person’s basic sense of self as male or female
What is gender role?
Collection of characteristics society defines as masculine or feminine
What is intersex?
When biological variables do not fit typical male or female
What is gender dysphoria?
Biological variables consistent but discordant with person’s sense of self
What are the criterion for gender dysphoria in children?
Incongruence between expressed gender and assigned gender
6+ months
Rates of gender dysphoria in children are __________ for those born ________. Among teenagers, these differences tend to __________.
Greater; boys; disappear
What is the biological etiology of gender dysphoria?
Excess/absence of prenatal hormones
What are the psychological influences of gender dysphoria?
Failure to individuate from opposite-sex parent
Inconsistency in parenting
Lack of same-sex modelling
What is the treatment for gender dysphoria?
Hormonal treatment
Gender-affirming surgery
Treatment for gender dysphoria typically involves helping individuals ____________ and live as ____________.
Cope; preferred gender
What are the 6 minimum eligibilities for sex-reassignment surgery?
Well documented gender dysphoria
Consent
Age of majority
Controlling physical/mental health concerns
Hormone therapy
Congruent gender role and identity
What is paraphilia?
Intense atypical sexual interests
What is paraphilic disorder?
When one engages in paraphilias and harms others/experiences distress
What is fetishistic disorder?
Recurrent/intense sexual arousal from non-living object or specific body part(s)
What would make a fetishistic not meet criteria for disorder?
Acceptance of feelings and ways to meet desires without harming others
What is transvestic disorder?
Cross-dressing accompanied by sexual excitement which causes emotional distress/impairment of functioning
________________ are not transvestites unless they are sexually excited by their work.
Drag queens
What is sexual sadism?
Sexual preferences toward inflicting pain/psychological suffering on others
What is sexual masochism?
Enjoy experiencing pain/humiliation from another individual
Could include hypoxphilia
What is hypoxphilia?
Deliberate unconsciousness by oxygen deprivation
What is associated disorder?
When individual acts on urges with non-consenting person, or urges cause distress/impairment
What is exhibitionistic disorder?
Sexual arousal from exposure of one’s genitals to unsuspecting person
Many exhibitionists also engage in ___________ and ____________.
Voyeurism; rape
What is voyeuristic disorder?
Sexual arousal from observing unsuspecting naked person
People with voyeuristic disorder typically do not seek ___________ with person being watched, but often ___________ while watching/remembering.
Sexual relations; masturbate
What is frotteuristic disorder?
Sexual arousal from touching/rubbing against non-consenting person in crowded places
Frotteuristic disorder can sometimes be brief and appear ____________, but other times can be _____________, a form of rape.
Accidental; intrusive/aggressive
What is pedophilic disorder?
Sexual arousal involving fantasies/sexual activities with prepubescent child
Individuals with pedophilic disorder must be at least _____ years old and _____ years older than child.
16; 5
What is the difference between child molester and pedophile?
Child molester: engages
Pedophile: fantasizes
In Canada, rape was originally defined as…
Forced penetration of unwilling female’s vagina by male assailant’s penis
What are the diagnostic issues of rape?
No formal diagnosis for people preferring non-consented sex
Diagnosed with sexual sadism
Arousal patterns
What are the 3 distinct arousal patterns?
Biastophilia
Sadism
Antisociality
What is biastophilia?
Sexual preference towards nonconsenting/resisting but not necessarily physical suffering
What is sadism?
Preference towards suffering and humiliation of others
What is antisociality?
Indifference to interests/desires of others
What is the etiology of sexual offending?
Conditioning theories
Feminist theories
Neurodevelopmental theories
Childhood/social developmental theories
What are the conditioning theories of sexual offending?
Pairing unusual experiences of sexual arousal produces patterns of atypical sexual arousal
Courtship disorder theory
What is courtship disorder theory?
During 4 stages of courtship of potential partner, fixation in any stage leads to sexual offending
What are the feminist theories of sexual offending?
Typically see sexual abuse as arising naturally out of socio-cultural environment
How do roles of socialization influence rape?
Women taught to be submissive, men taught to be dominant
Power differential giving power to men
What is Juliet Darke’s feminist theory?
Rape seen as offenders’ anger towards women
What is Sanday’s feminist theory?
Rape more common in patriarchal societies, less common in societies where where women equal to men
What are the neurodevelopmental theories of sexual offending?
Neurodevelopmental problems
Head injuries
Lower IQ
What are the childhood/social developmental theories of sexual offending?
Maladaptive childhood experiences
Aggression and self-centeredness
Low social skills
What are empirical risk factors of sexual offending?
Sexual deviance
Antisocial traits
Intimacy deficits
What are the treatments for sexual offending?
Medical interventions
Aversion therapy
Comprehensive programs
What are the factors of comprehensive programs?
Cognitive-behavioural perspective
Responsibility of actions
Risk/need/responsivity model
Positive psychology influence (life worth living)
What is the risk/need/responsivity model?
Risk: assess risk factors
Need: tailor treatment
Responsivity: accessible to client
What are common risk factors of the risk/need/responsivity model?
Self-regulation
Sexuality-related factors
Social skills
