chapter 13: sexual dysfunctions, gender, & paraphilic disorders Flashcards
sexual dysfunction
- clinically significant impairment on a person’s ability to respond sexually or to experience sexual pleasure
gender dysphoria
- feelings of distress due to gender identity
- ex not identifying with sex assigned at birth
difference between gender and sex
- gender: social construct, socio-cultural aspects
- sex: biological aspects (anatomy, hormones, chromosomes, etc)
paraphilic disorders vs paraphilia
- paraphilia: intense and persistant atypical sexual interests, cant be diagnosed unless it causes harm to others/person experiences distress/impairment
- paraphilic disorder: must have paraphilia, but to an extreme
sexual response cycle general definition
- changes that occur in the body during sexual arousal, orgasm, and return to unaroused state
four stages of sexual response cycle
- excitement
- plateau
- orgasm
- resolution
excitement stage of sexual response cycle
genital tissues swell/fill w blood, erection/engorged clit/vaginal lubrication/testes and nipple engorged/muscle tension/increased heart rate/rapid and shallow breathing
plateau stage of sexual response cycle
- additional swelling of penis/vulvar/vaginal tissues
- elevated testes
- clit retracts under hood
orgasm stage of sexual response cycle
- rhythmic, muscular contractions in genital region occurs at about eight second intervals
- penile orgasm has two stages: 1. seminal fluid collects at the urethral bulb at base of penis 2. contractions lead to expulsion of ejaculate
- uterus and vaginas: uterus muscles surrounding vagina contract during orgasm
- blood pressure and heart rate peak
resolution stage of sexual response cycle
- gradual return to pre arousal state
- refractory period: unresponsive to further sexual stimulation
dsm5 sexual dysfunctions categories
- sexual desire and arousal disorders
- orgasmic disorders
- genito-pelvic pain/penetration disorder
if the disorder is fairly recent in onset it is referred to as ______ sexual dysfunction whereas if it is persistent for an extended period of time it is _______ sexual dysfunction
Acquired, lifelong
if the disorder is only present in one situation (ie one partner/just masturbation) it is referred to as ______ sexual dysfunction whereas if it is present in all situations even non sexual (ie dr appointments) it is _______ sexual dysfunction
situational, generalized
t or f: the most frequent sexual dysfunction regardless of sex/gender is desire and arousal issues
false, true for women but for men it is erectile disorder and premature ejaculation
hypoactive sexual desire disorder
- persistently/recurrently deficient (absent) sexual/erotic thoughts/fantasies and desire for sexual activity
- min 6 months
- distressing
erectile disorder
- difficulties obtaining an erection during sexual activity, maintaining erection until completion, and/or decreased erectile rigidity
- min 6 months
- distressing
- can be impacted by: smoking, heart disease, and age
female orgasmic disorder
- marked delay/infrequency/absence of orgasm or reduced intensity of orgasmic sensations
- min 6 months
- distressing
orgasmic gap
- notable difference between women and men during penetrative sexual activity
- women report lower orgasm frequency
Delayed ejaculation
- marked delay/infrequency/absence of ejaculation in over 75% of sexual interactions
- min 6 months
- delay must not be desired and are distressed
premature ejaculation
- persistent/recurring pattern of ejaculation during penetrative sex within 1 min of penetration
- before person wishes, distressing
- min 6 months and occur in all or over 75% of sexual occasions
average intravaginal ejaculatory latency time
5-6 minutes
genito-pelvic pain/penetration disorder
- persistant/recurring difficulties w: vaginal penetration during intercourse, vulvovaginal/pelvic pain during vaginal intercourse/penetration attempts, fear/anxiety abt vulvovaginal/pelvic pain in anticipation of/during/from vaginal penetration, and/or tensing/tightening of pelvic floor muscles during vaginal penetration attempt
- min 6 months
- distress causing
vaginismus vs dyspareunia
- vaginismus: anxiety/fear causing difficulty, focus on tightening of pelvic muscles, more display avoidance behaviours
- dyspareunia: painful sexual intercourse
hypersexuality
- total sexual outlet (orgasms) of >7 per week
- 6 months min
- some research suggestion due to addiction, desire dysregulation
- loos of control over sexual urges, fantasies, behaviours
- often engage in sexual activity to regulate negative emotional states
what hormones are involved in sexual activity and desire
- estrogen
- androgen
- prolactin
fetishistic disorder
- sexual arousal from non-living things or highly specific body part that is not genitals
- significantly distressing
transvestic disorder/transvestism
- transvestism: cross dressing for sexual excitement
- transvestic disorder: cross dressing for over 6 months and causes significant distress
sexual sadism/masochism
sadism: inflict pain on others for arousal
masochism: enjoy experiencing pain (ex hypoxyphillia: oxy deprivation)
- diagnosis is given when urges are distressing or sadist inflict non-consensually
pedophellic disorder
- exclusive (only children) and non-exclusive (children and adults)
- must be over 16 and be at least 5 years older
- displayed preference for sexual behaviour with a child
- classic (prepubescent), hebophellic (pubescent), or pedohebphellic (both)
why is rape/sexual assault not always a sadistic disorder?
- they may not be motived by the arousal from physically/psychologically hurting someone
Etiology of sexual offending
- conditioning (courtship disorder theory)
- feminist theories (patriarchy)
- neurodevelopmental theories
- childhood/social development
main risk factors for sexual offending
- antisocial traits
- sexual deviance
- intimacy deficits
treatments for sexual disorders
- medication (anti-androgens)
- behaviour therapy (ineffective)
- comprehensive programs (risk/need/responsibility)
