chapter 15

Question 1

paraphillia

Answer 1

• can be exclusive or non exclusive
• any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling w phenotypically normal, physically mature, consenting human partners
• just bc you have paraphillia, doesnt mean you have a disorder

Question 2

paraphilic disorder

Answer 2

• paraphillia that casues distress/impairment to person or causes personal harm or risk of harm to others or self when acted upon

Question 3

diagnosing paraphillic disorders; what two things are taken into account

Answer 3

• A: qualitative nature of the paraphillia
• B: negative consequences of the paraphillia
• paraphillia must also be present for at least 6 months

Question 4

two main categories of paraphillic disorders

Answer 4

involving atypical activities and involving preference for atypical targets

Question 5

two main types of pharaphillic disorders under the category of atypical activities

Answer 5

• courtship disorders: disturbances in one or more areas of common courtship/partnered sexual activity (looking for partner, approaching partner w convo, nongenital touching, and/or sexual intercourse)
• aloglagnic disorders: involving pain and suffering

Question 6

voyuristsic disorder

Answer 6

• courtship atypical activity
• recurrant and intense sexual arousal from observing an unsuspecting person naked, undressing, or engaging in sex
• person has either acted on urges or they cause distress/impairment
• becomes disordered when it is preferred to partnered sex, interferes w daily life or involves crime
• mostly het men
• high comorbidity

Question 7

exhibitionist disorder

Answer 7

• courtship atypical activity
• recurrent and intense sexual arousal from exposure of one’s genitals to unsuspecting ppl
• person has either acted on urges or they cause distress/impairment
• excitement comes form the victim’s reaction (expect positive or neutral reaction or that they want to have sex)
• more common in men

Question 8

frotteuristic disorder

Answer 8

• courtship atypical activity
• frotter=french for rubbing/friction
• fantasizing abt or actually rubbing agaisnt or touching (toucherism) non consenting person for sexual gratification
• person has either acted on urges or they cause distress/impairment
• often in busy public areas and excused as accidental
• mostly men and highly comorbid

Question 9

telephone scatalogia

Answer 9

• other specified paraphillic disorder
• verbal exhibitionism
• arousal from making explicit phone calls (based on vicitms reaction)
• typically het men

Question 10

BDSM (define the different groups)

Answer 10

• bondage/discipline: restraints, painful stim (whips, hot wax, bites), humiliation, deprivation
• dominance/submission: ‘play’ scripts, master/top, slave/bottom or switch
  -sadomasochism: sexual ritual/scripts surrounding inflicting or receiving pain

Question 11

sexual sadism disorder

Answer 11

• aloglagnic disorder
• pleasure from inflicting pain or psychological suffering on another person (gains power or humiliating the person)
• recurrent and intense arousal through fantasies/urges/behaviours
• person has either acted on urges or they cause distress/impairment

Question 12

sexual masochism disorder

Answer 12

• pleasure from experiencing pain/humiliation/suffering
• person has either acted on urges or they cause distress/impairment

Question 13

pedophilloic disorder

Answer 13

• can be exclusive or non exclusive
• atypical target disorder
• recurrent and intense sexually arousing fantasies/urges of sexual activity with (a) child(ren) usually 13 or under
• person has either acted on urges or they cause distress/impairment

Question 14

3 types of pedos

Answer 14

• classic: prepubescent children
• hebephilic: pubescent children
• pedohebephillic: both

Question 15

what is the best measure in predicting revictivism in pedos

Answer 15

• penile photoplethysmography (measures changes in penile blood in response to stimuli)

Question 16

fetish vs fetishistic disorder

Answer 16

• fetish: urges/fantasies/behaviours with non living objects or specific body parts (that are not sexual by nature)
• disorder: persistent use/ dependence on object/body part as primary element of arousal, causing distress or impairment
• in extremes, the person can only get turned on if item is present/used
• common: feet/toes, worn items

Question 17

transvestism/transvestic disorder

Answer 17

• diagnosis: cross dressing or thoughts of are met with sexual excitement and emotional distress or impairment and distress

Question 18

what is it called when a person is sexually aroused to the clothes/garments worn when cross dressing

Answer 18

transvestic disorder with fetishism

Question 19

what is it called when a person is aroused when crossdressing from the thought of themselves as a woman

Answer 19

transvestic disorder with autogynephillia

Question 20

zoophilia, paraphillic infantilism

Answer 20

nonhuman animals (not particular), role play of self as an infant

Question 21

coprophillia and urophillia

Answer 21

feces, urine

Question 22

necrophillia and klismaphillia

Answer 22

dead people, enemas (douching)

Question 23

hypersexuality

Answer 23

excessive insatiable sex drive leading to continuous pursuit of sex despite negative consequences
- traditionally: nymphomania in women and satyriasis in men
- can be due to dysregulation of control, compulsivity, or addiction

Question 24

PGAD and priapism

Answer 24

PGAD: persistent genital arousal disorder, spontaneous persistent uncontrollable sensations of genital arousal not associated with feelings of arousal or desire (women)
priapism: persistent often painful erection

Question 25

reasons for paraphillia

Answer 25

- psychoanalytic theory: results from castration anx, fetishistic object replaces mom's nonexistent penis, all about masculinity/femininity - behavioural theory: social learning, classical conditioning where object is paired w arousal - neuro findings: pedos show deficits in brain activation associated w sexuality when viewing pics of adults and deficits in emo processing when viewing children, also decreased grey matter

Question 26

main risk factors for sexually abusing children

Answer 26

- sexual deviance, antisocial traits (associated w ASPD), intimacy deficits, or suffering from cognitive distortions (thinking errors)

Question 27

cognitive distortions

Answer 27

- things ppl say to themselves to excuse/justify/deny/minimize inappropriate, inappropriate behaviour

Question 28

malingering

Answer 28

- purposefully faking/exaggerating symptoms for personal gain

Question 29

assessment of paraphillic disorder

Answer 29

- first understand the nature of paraphilia and its impact on a patients - can incl psychometrics (intelligence test, personality, mental health) - can use phallometry (bloodflow) for pedos - volume is more sensitive to detecting arousal than circumference tests - lie detectors

Question 30

treatment for paraphillic disorders

Answer 30

- no evidence that it can be changed but the focus is on managing interests - main therapy treatment=CBT - other therapies: self esteem and social skills training (targets loneliness), mindfulness and emotion regulation, satiation therapy, orgasmic reconditioning, aversion therapy, community based support program - meds (if all else fails): antidepressants or if not effective in 4-6 weeks, small dose of anti androgen to reduce sex drive

Question 31

satiation therapy (treatment for paraphillic disorders)

Answer 31

masturbate first to appropriate fantasy then immediately after orgasm masturbate again but think of undesired fantasy (logic is bc its so soon after, decreased sex drive will be associated with bad fantasy)

Question 32

what is the treatment for paraphilic disorder called when the person is instructed to masturbate to paraphilic fantasy then switch to appropriate fantasy when about to orgasm (classical conditioning)

Answer 32

orgasmic reconditioning

Question 33

aversion therapy (treatment for paraphillic disorders)

Answer 33

link undesired fantasy with undesirable stimulus (ie bad smell/shock) to classically condition aversion to fantasy