Chapter 13 Sexual Disorders Flashcards
How does sexual disorder vary across cultures
- norms of sexual behavior are most influenced by culture, history, and society on how we define what is sexually deviant
-generally, women are more suppressed in sexual expression than men
-the old belief that masturbation could lead to sexual dysfunctions, homosexuality, and madness/insanity
Who is Alfred Kinsey
first large-scale sexual behaviors sexual across the country, uncovered homosexuality is more common than assumed, women don’t frequently orgasm during intercourse
Who is William Masters and Virginia Johnson
lab of sexual info, found normal sexual response cycle for men and women, women can have more than one orgasm
What is the sexual response cycle?
Appetitive phase—> arousal phase—–> orgasm phase—–> resolution phase
What is the appetitive phase
fantasy, thoughts, cognition
What is the arousal phase
stimulation
What is the orgasm phase
release
What is the resolution phase
recovery, no sexual dysfunction in the phase
How does aging affect sexual dysfunctions
sexual activity declines with age, women report less sexual activity, 50% have at least one sex problem, greater risk for illness that affext sex, partner gap, majority report high satisfaction, little decline in sexual desire
What is a sexual dysfunction
disturbances in normal sexual function, normal sexual response cycle,
-must be recurrent/persistent,
-distress or disrupted functioning,
-negative on sexual relationships
-can be lifelong or situational
What is vasocongestion
engorgement of blood vessels in the penis/labia
What is myotonia
muscular tension
What are sexual interest arousal disorders
arousal phase dysfunction, fantasies don’t exist or don’t lead to arousal
What are some examples of sexual interest arousal disorder
Hypoactive sexual desire, sexual aversion disorder, female sexual arousal disorder, erectile disorder, (hypersexual disorder(sexual addiction) not in DSM)
What is hypoactive sexual desire disorder
significant lack of interest in sexual activity, one of the most common problems in couples sex therapy, could be reflection of relationship dysfunction
What is sexual aversion disorder
lack of interest but also fear of sex; rape/trauma could be cause
What is female sexual arousal disorder
unable to get aroused/stimulated, even if the desire exists
What is erectile disorder
absence/blockage of sexual arousal —> complete or partial lack of erection or the undesirable loss of erection once its attained(impotence)
What are some examples of orgasmic disorders
females orgasmic disorder, delayed ejaculation, early ejaculation, gential pelvic pain/penetration disorder
What is female orgasmic disorder
delay or absence of orgasm in female even though desire/stimulation/arousal are adequate
early psychiatry: didn’t believe in clitoral orgasm, only in vaginal, based on cultural prohibitions regarding female self stimulation
treatment: Masturbation
What is delayed ejaculation
usually reported by men during intercourse, cause may be substance/alcohol abuse
What is early ejaculation
attaining early ejaculation before during or shortly after penetration during intercourse
treatment; start stop, squeeze
What is genital pelvic pain/penetration disorder
women who are victims of sexual traumas may develop these symptoms or have strong religious conflicts about sexuality, many have unidentified physiological factors
dyspaurenia
vaginismus
Treatment: gradual dilation of vaginal muscles
What is dyspaurenia
more in women, pain during intercourse
What is vaginsmus
muscles contract to prevent penetration
What is DSM on homosexuality
homosexuality(DSM1), sexual orientation disturbance replaced homosexuality(DSM2), ego dystonic homosexuality referring to someone who is homo but resents it(DSM 3), all terms dropped in 1986
What is the controversy on conversion
homosexuality is not a disease to be cured
What is Gender dysphoria(was gender identity)
conflict an adult’s anatomical sex + sex identification as male/female; not same as a sexual orientation; strong sense of gender incongruence from young age
-2years f conflict, more in biological males, presumed to have origins in early childhood life
-rare diagnosis
What are paraphilic disorders
deviation in what one is attracted to; atttraction to unusual sources of sexual gratification, person has acted on or is severely distressed by recurrent urges/fantasies involving non human objects, nonconsenting others, suffering/humilation
-mutiple, 6 month duration for diagnosis, must be distressed
-common in males
DSM 5 proposed changes: distinction between paraphilias(no stress or harm to others)+paraphillic disorders
What are some examples of paraphilic disorders
nonhuman objects, nonconsenting others, pain/humilation
What is non human objects disorder
fetishistic disorder(excessive ex. foot fetish), Transvestic disorder: sexual cross dressing; almost all heterosexual men, not drag queens
What is a nonconsenting person disorder
exhibitionistic disorder, voyeuristic, frotteuristic, pedophebephillic
What is exhibitionistic disorder
exposing one’s genitals; repeated exposure to unwilling observers, almost always men, remorse on exhibitionist is common
What id voyeuristic disorder
peeping
What is frotteuristic disorder
sexual pleasure though rubbing gentials or touching a nonconsenting person, often in a crowded situation; could be an alternative source of gratification for a man who lacks the source
What is a pedophebephellic disorder
relapse rate is high, children rarely report victimization, but can show up in bed wetting
What is Pain humiliation
sweden doesn’t have this anymore in DSM
sexual sadism and sexual masochism
What is sexual sadism
physical/emotional cruelty
What is sexual masochism disorder
sexual arousal from receiving pain/humiliation; gratifying theme is complete helplessness; pain must occupy a central role in sexual arousal; dominant/submissive role play common, while considered deviant it is not psychotic
What is atypical paraphilias
corprophilia, urophilia, kilsmaphilia, necrophilia(dead people sex), zoophilia(animals), telephone scatologia(making obscene phone calls/text), gerontonsexuality
What is sexual aggression(rape)
not in DSM, significant societal issue, often planned, sexual gratification from nonconsenting partner
statutory rape, date rapem rape trauma syndrome
What is statutory rape
sexual intercourse with a child younger than age of consent
What is date rape
raping on a date, majority of rapes
What are some rapist traits
create situations in which sexual encounters may occur, interpret friendliness as provocation/protest as insincerity, manipulate with alcohol/other drugs, neglect/severe abuse, sex earlier/more sexual partners than non rapists
What is rape trauma syndrome
consistent with PTSD symptoms
acute phase: disorganization
long term phase: reorganization
What is some rapist typology
power rapist, anger rapist, sadistic rapist
What is the sexual dysfunction etiology for bio
levels of testosterone/estrogen; side effects from medication, alcohol, physical illness
What are the psychological etiology
historical factors, current issue/concerns; unconsciouse conflict, performance anxiety/spectator role,
What is the spectator role
person removes psychologically removes themselves from sex and instead is evaluating experince
What is the etiology for social
strict religious enviroment, traumatic sexual experiences, relationship issues
What is the sociocultural
gender, age, culture scripts, educational level, gender role expectations, sexual orientation
What is the treatments for bio
hormone replacement, implants, injections, mechanical devices, oral medications(viagra, levitra, cialis)
What is the psych treatments
-educations(open/candid discussion of sexuality and dispel any misconceptions); anxiety reduction techniques to counter performance anxiety/spectator role
-structured exercises(sensate focus: couples take turns touching each other and communicate what feels goof/bad)
-communication training to talk about sexual wishes clearly
adjunctive psych treatments to address unresolved relationship issues
What is gender dysphoria etiology
multiple variables
-bio: neurohormonal factors
-psychodynamic: unable to solve Oedipus complex
-behavioral: childhood experiences based on operant conditioning and social learning
What is the gender dysphoria treatments
Psycho treatments, hormone treatments, sex reassignment surgery
What is Paraphilia etiology
Bio: unclear
Psycho: unconscious childhood conflicts
Social: early conditioning experiences
What is paraphilia treatment
extinquish inappropriate sexual behaviors—> reinforce sexually appropriate behaviors—> social skill training
What is the rapist etiology
sociocultural: media portrayals of violent sex impact societal values concerning violence and women
-rape is high in environments that encourage violence
What is rape treatments
no effective treatments
high relapse
imprisonment is not treatment, only punishment
surgical castration
chemical treatments
Incest
sexual relations between people too closely related to marry legally
-taboo
-most reported: father/daughter
-most frequent: brother/sister
-rare: mother/son
