Chapter 13: Sexual and Gender Identity Disorders

Question 1

What is the sexual response cycle?

Answer 1

• sequence of changes that occur in the body with increased sexual arousal, orgasm, and the return to an unaroused state

Question 2

What is the Kaplan model of sexual response?

Answer 2

• desire,
  excitement, and orgasm
• important contribution of Kaplan’s work was the distinction of desire as primarily a psychological component to the sexual response

Question 3

What are 3 potential phases of dysfunction?

Answer 3

• desire
• arousal
• orgasm

→ subtypes: lifelong, acquired, generalized, situational

Question 4

What is male hypoactive sexual desire disorder?

Answer 4

• persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity
• symptoms must be distressing and present for a minimum of 6 months

Question 5

What is female sexual interest/arousal disorder?

Answer 5

• amalgamate interest and arousal into one disorder

→ based on findings from several studies indicating that the processes of desire and arousal overlap for
many women

Question 6

What is male erectile disorder?

Answer 6

• persistent or recurrent inability to reach or sustain an erection “until completion of the sexual activity”
• resultant distress

Question 7

What is female orgasmic disorder?

Answer 7

• “anorgasmia”
• persistent or recurrent
  delay in, or absence of, orgasm, following normal excitement, causing marked distress or interpersonal difficulty
• pretty much the same with male orgasmic disorder

Question 8

What is genito-pelvic pain/penetration disorder?

Answer 8

• used to be “dyspareunia” and “vaginismus”

- amalgamated due to difficulty to reliably differentiate between the two measures of pain and pelvic muscle tension

Question 9

What is the DSM-V diagnosis for genito-pelvic pain/penetration disorder?

Answer 9

• persistent or recurrent difficulties with one or more of the following:
  → vaginal penetration during intercourse;
  → marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts;
  → marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration;
  → and marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration
• present for at least 6 months and cause distress

Question 10

What is sexual performance anxiety?

Answer 10

• response of individuals who worry that their performance will not live up to the expectations of their partners when expected to perform sexually

Question 11

What are common psychological interventions in sexual dysfunctions?

Answer 11

• communication and exploration
• sensate focus (a form of desensitization)
• physical treatments (which include medication, surgical interventions, and physical implants)

Question 12

What are the 3 aspects of the development of gender identity?

Answer 12

• sexual orientation
• gender role
• gender identity

Question 13

What is gender dysphoria?

Answer 13

• individual feels like the opposite gender trapped in their present gender
• most common in children and males

Question 14

What are theories about the etiology of gender dysphoria?

Answer 14

• genetically influenced hormonal disturbances or exposure during fetal development to inappropriate hormones
• differences in cell clusters in hypothalamus
• psychodynamic/behavioural theories of human behaviour emphasize the importance of early childhood experiences and the family environment

Question 15

What are paraphilias?

Answer 15

Sexual activities that involve: 
1 - non-human
objects
2 - non-consenting adults
3 - suffering or causing humiliation
4 - children

Question 16

What are fetishistic disorders?

Answer 16

• sexual behaviours in which the presence of nonliving objects is usually required or strongly preferred for sexual excitement
  → underwear, shoes, leather, rubber, furs, etc.

Question 17

What is partialism?

Answer 17

• sexual fixation on/excessive attraction to specific parts of the body

Question 18

What is sadism?

Answer 18

• paraphilia deriving sexual pleasure from inflicting pain or humiliating others

→ sexual variant with consenting partners
→ sexual offense with non-consenting partners

Question 19

What is autoerotic asphyxia?

Answer 19

• “asphyxiophilia”, “hypoxyphilia”
• deliberate induction of unconsciousness by oxygen deprivation
  → produced by chest compression, strangulation, enclosing the head in a plastic bag, or various other techniques

Question 20

What is sexual masochism?

Answer 20

• sexual gratification obtained through experiencing pain and humiliation at the hands of one’s partner

Question 21

What is voyeurism?

Answer 21

• obtainment of sexual arousal by compulsively and secretly watching another person undressing, bathing, engaging in sex, or being naked

Question 22

What is exhibitionism?

Answer 22

• obtainment of sexual gratification by exposing one’s genitals to involuntary observers

Question 23

What is frotteurism?

Answer 23

• obtainment of sexual gratification by rubbing one’s genitals against or fondling the body parts of a non-consenting person

Question 24

What is pedophilia?

Answer 24

• adult obtainment of sexual gratification by engaging in sexual activities with children

Question 25

What is the behavioural theory of paraphilia?

Answer 25

• arousal is clasically conditioned to a previous neural stimulus

Question 26

What is the social learning theory of paraphilia?

Answer 26

• children whose parents engaged in aggressive, sexual behaviours with them learned to engage in impulsive, aggressive, sexualized acts toward others

Question 27

What is the cognitive theory of paraphilia?

Answer 27

• distorted cognitions and assumptions about sexuality underlie deviant sexual behaviour

Question 28

What is the phallometric assessment and monitoring technique?

Answer 28

• basically measuring arousal of member while showing pictures that are arousing or not arousing

Question 29

What medications are used to treat paraphilias?

Answer 29

• antiandrogen drugs (e.g. depo-Provera)

- SSRIs

Question 30

What cognitive interventions are used to treat paraphilias?

Answer 30

• aversion therapy
• desensitization
  → reduce anxiety about engaging in normal sexual activities with adults
• empathy training

Question 31

What is klismaphilia?

Answer 31

• obtainment of sexual arousal through enemas

Question 32

What are the class of nonconsenting disorders?

Answer 32

• exhibitionistic disorder
• voyeuristic disorder
• frotteuristic disorder
• pedophilic disorder

Question 33

What is the recidivism rate of nonconsenting disorders?

Answer 33

• very high recidivism,

→ highest being exhibitionists

Question 34

What are the 3 subtypes of sexual assault as defined by Canadian law?

Answer 34

• sexual assault
  → assault of a sexual nature that violates the sexual integrity of the victim
  → does not depend solely on contact with any specific part of the human anatomy but rather the act of a sexual nature that violates the sexual integrity of the victim
• sexual assault with a weapon/threats
  → carries, uses or threatens to use a weapon or an imitation of a weapon
  → threatens to cause bodily harm to a person other than the complainant
• aggravated sexual assault
  → wounds, maims, disfigures or endangers the life of the complainant

Question 35

What are the 3 distinct sexual arousal patterns seen in rapists?

Answer 35

• blastophilia
  → preference toward non-consenting and resisting but not necessarily physically suffering victims
• sadism
  → preference toward the suffering or humiliation of others
• antisociality
  → marked sexual indifference to the interests and desires of others
• NOTE: unless rapists meet criteria for sadism or personality disorder they will not be given DSM-V diagnosis

Question 36

What is courtship disorder theory?

Answer 36

• theory of sexual offending advanced by Kurt Freund
• holds that sexual offending is a product of a person’s sexual behaviour becoming fixed at one of four phases of human sexual interaction

1 → looking for and appraising a sexual partner (voyeurism)
2 → posturing and displaying onself to potential partner
(exhibitionism)
3 → tactile interaction with partner (frotteurism)
4 → sexual intercourse (rape)

Question 37

What is the feminist theory of sexual offending?

Answer 37

• primarily focuses on male-on-female sexual assault
• male privilege causes expectation that all women must find him desirable and when that doesn’t occur they lash out in a violent way

Question 38

What are comprehensive theories of sexual offending?

Answer 38

- acknowledge 
→ childhood experiences
→ deficiencies in social skills
→ sociocultural factors
→ and transitory states of offenders

Question 39

What is the treatment for sexual offenders?

Answer 39

• medical interventions aim to reduce sexual drive, increase control
• use of SSRIs seem to give sense of control over urges
• behaviour therapy aimed at elimination through aversion therapy
• comprehensive programs to help overcome tendency to deny/minimize their offending