Chapter 13 - Sexual and Gender Identity Disorders Flashcards

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1
Q

Categories of Sexual disorders in DSM5

A

1) Paraphilic disorders - sexual “deviance”
2) Sexual dysfunctions - sexual “malfunctioning”
3) Gender dysphoria - transgender

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2
Q

Key criteria for all sexual disorders

A
  • emotional discress
  • impairment (esp interpersonal)
  • harm to others
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3
Q

Examples of impact of cultural norms on diagnoses

A
  • homosexuality and masturbation

- both now widely accepted

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4
Q

Criteria for paraphilic disorders

A

Para (outside) philia (love)

  • recurrent, intense, arousing fantisies, urges or beh
    • non-human
    • suffering or humiliation
    • children or non-consenting
  • 6mos +
  • clinical distress or impairment
  • acting on urges if illegal (not duration dependent… acting alone will gain diagnosis)
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5
Q

Associated features of paraphilia

A
  • acting, hobbies, collections, dimension of distress experience
  • highly comorbid: anxiety, mood, substance
  • interpersonal difficulties
  • sometimes sex dysfunctions
  • personality disorder
  • multiple paraphilias
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6
Q

Course of paraphilia

A
  • chronic, begins in childhood/adolescence (puberty)
  • fluctuates w stress
  • declines w age
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7
Q

Paraphilia in men/women

A
  • almost exclusive w men

- except S&M

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8
Q

Types of paraphilias - “variations” (consenting)

A

1) Fetishes
- media vs form
- form = object, usually related to human body
2) Transvestic fetishes
- aroused by dressing
3) S&M
- ritual

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9
Q

T or F: rape is a mental disorder

A
  • false. Sick vs bad
  • crime
  • may be named paraphilic coercive disorder
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10
Q

Types of paraphilias - “offenses” (non consenting)

A

1) Voyerisum
2) Exhibitionism - most common arrested
3) Frotteurism - rubbing
4) Pedophilia

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11
Q

T or F: child molestation is same as pedophilia

A
  • False
  • not all molesters are pedo
  • sometimes just who is available
  • patient must be at least 15, victim at least 5 years younger
  • will rationalize beh as being in love
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12
Q

Conditioning views of paraphilia

A

Classical: fetish - masturbate holding something, become conditioned

Operant: orgasm while activities is positively reinforcing

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13
Q

Etiology of paraphilia

A
  • vulnerabilities in childhood
    • conditioning experiences
    • disrupted childhood (i.e. abuse)
    • personality disturbance (low empathy, egocentric)
    • poor social skills, relationships
    • low self-confidence
  • sociocultural factors (feminist theory)
    • patriarchial structures, male dominance, violence, power
  • precipitated by stress
    • anger, depression, boredom, intoxication
    • poor coping skills
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14
Q

Draw diagram of paraphilia

A

see word doc

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15
Q

Treatment of paraphilia

A

Objective: keep out of prison, forensic setting

  • Meds: SSRIs, antiandrogens
  • Beh techniques: aversion therapy (classical conditioning)
  • Cog/Beh:
  • covert sensitization (consequences)
  • restructuring - attitudes & beliefs
  • social skills training
  • stress management training

3-40% reduction in recidivism rates vs no treatment

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16
Q

Phases of sex (response cycle)

A

1) Desire
2) Arousal
3) Plateau
4) Orgasm
5) Resolution

17
Q

Describe sexual dysfunctions

A
  • ego dystonic
  • disturbances in response cycle
  • typically in: desire, arousal and orgasm phase
  • often more than one dysfunction
18
Q

Subtypes of sex dysf

A
  • lifelong vs acquired
  • generalized vs situational
  • psych factors vs combined factors
19
Q

Describe sex desire disorders

A

1) hypoactive (persisent, recurrent, deficient or absent)
- often there’s other sex issues
2) Sex aversion disorder - like a phobia, panic

20
Q

Describe sex arousal disorder

A

1) Male erectile disorder (aka impotence)
- most common why men seek therapy
- sympathetic activation interferes w parasympathetic
2) Femal sexual arousal disorder

21
Q

Describe orgasmic disorder

A

1) Biomedical factors - diabetes, cardiov, hormone (testos, estro)
2) Psychological factors
- situational: anxiety, spectatoring, bad communicate, lack stimulation, neg cognitions
- longer-term: prior experiences, relationship probs, fear intimacy

22
Q

Define spectatoring

A

observing one’s selt, self-aware, self-conscious

23
Q

Treatment of sexual dysfunctions

A

1) Sex therapy (beh) approaches (M&Johnson)
- education
- eliminate performance anxiety
- sensate focus (systematic desensitation)
- squeeze technique
- masturbation

2) Couples
3) Individ psychoth
4) Medical interventions - drugs, surgery

24
Q

Difference between transgender and transsexual

A

Xgender: which gender you identify with, not necessarily outwardly

Xsexual: once start living as opposite sex

25
Q

Diagnostic criteria of gender dysphoria

A
  • strong, persistent cross-gender id
  • gender dysphoria (persistent discomfort w one’s bio sex)
  • clin sig distress or impairment in social, occupational or other functioning (i.e. pub washrooms)
26
Q

Prevalence of Gender dysphoria

A

more common in kids than adults

  • 3% in boys, 1% in girls
  • 1/30k men vs 1/100k women sex reassignment
  • actual prevalence is unknown
27
Q

Course - childhood

A
  • dysphoria in childhood
  • rarely continues to adulthood
    • transgendered identity
    • attracted to same bio sex
  • more commonly develops in to homo or bisexual orientation w/out transgendered identity
  • most likely to desire sex reassignment surgery
28
Q

Course - late adolescent or adult

A
  • often starts w transvestic fetishism (arousal in xdressing)
  • most likely heterosexual
  • ambivalent re sex reassingment surgery
29
Q

Etiology of gender dysphoria

A
  • cause unknown
  • Bio: abnormal hormone during fetal development
  • Psycho: parent rearing practices
30
Q

Define anorgasmia

A
  • female orgasmic disorder
31
Q

What is IELT

A
  • Intravaginal ejaculatory latency
  • lasts 5-6mins

premature: <1min 90% of time

32
Q

Dyspareunia

A

genital pain related to intercourse

33
Q

Vaginismus

A

involuntary contraction of pelvic muscles

34
Q

Nymphomania: ___ :: whanson@ualberta.ca: ___

A

Nympho -> women

Satyriasis -> men

35
Q

Difference between primary and secondary premature ejaculation

A

Primary: long time, usually conditioning
Secondary: used to have control, now don’t. trauma to sympathetic nervous system, or body part