Chapter 13 - Sexual and Gender Identity Disorders Flashcards
Categories of Sexual disorders in DSM5
1) Paraphilic disorders - sexual “deviance”
2) Sexual dysfunctions - sexual “malfunctioning”
3) Gender dysphoria - transgender
Key criteria for all sexual disorders
- emotional discress
- impairment (esp interpersonal)
- harm to others
Examples of impact of cultural norms on diagnoses
- homosexuality and masturbation
- both now widely accepted
Criteria for paraphilic disorders
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)
Associated features of paraphilia
- acting, hobbies, collections, dimension of distress experience
- highly comorbid: anxiety, mood, substance
- interpersonal difficulties
- sometimes sex dysfunctions
- personality disorder
- multiple paraphilias
Course of paraphilia
- chronic, begins in childhood/adolescence (puberty)
- fluctuates w stress
- declines w age
Paraphilia in men/women
- almost exclusive w men
- except S&M
Types of paraphilias - “variations” (consenting)
1) Fetishes
- media vs form
- form = object, usually related to human body
2) Transvestic fetishes
- aroused by dressing
3) S&M
- ritual
T or F: rape is a mental disorder
- false. Sick vs bad
- crime
- may be named paraphilic coercive disorder
Types of paraphilias - “offenses” (non consenting)
1) Voyerisum
2) Exhibitionism - most common arrested
3) Frotteurism - rubbing
4) Pedophilia
T or F: child molestation is same as pedophilia
- 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
Conditioning views of paraphilia
Classical: fetish - masturbate holding something, become conditioned
Operant: orgasm while activities is positively reinforcing
Etiology of paraphilia
- 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
Draw diagram of paraphilia
see word doc
Treatment of paraphilia
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