chapter 15 Flashcards
paraphillia
- 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
paraphilic disorder
- paraphillia that casues distress/impairment to person or causes personal harm or risk of harm to others or self when acted upon
diagnosing paraphillic disorders; what two things are taken into account
- A: qualitative nature of the paraphillia
- B: negative consequences of the paraphillia
- paraphillia must also be present for at least 6 months
two main categories of paraphillic disorders
involving atypical activities and involving preference for atypical targets
two main types of pharaphillic disorders under the category of atypical activities
- 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
voyuristsic disorder
- 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
exhibitionist disorder
- 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
frotteuristic disorder
- 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
telephone scatalogia
- other specified paraphillic disorder
- verbal exhibitionism
- arousal from making explicit phone calls (based on vicitms reaction)
- typically het men
BDSM (define the different groups)
- 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
sexual sadism disorder
- 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
sexual masochism disorder
- pleasure from experiencing pain/humiliation/suffering
- person has either acted on urges or they cause distress/impairment
pedophilloic disorder
- 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
3 types of pedos
- classic: prepubescent children
- hebephilic: pubescent children
- pedohebephillic: both
what is the best measure in predicting revictivism in pedos
- penile photoplethysmography (measures changes in penile blood in response to stimuli)
fetish vs fetishistic disorder
- 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
transvestism/transvestic disorder
- diagnosis: cross dressing or thoughts of are met with sexual excitement and emotional distress or impairment and distress
what is it called when a person is sexually aroused to the clothes/garments worn when cross dressing
transvestic disorder with fetishism
what is it called when a person is aroused when crossdressing from the thought of themselves as a woman
transvestic disorder with autogynephillia
zoophilia, paraphillic infantilism
nonhuman animals (not particular), role play of self as an infant
coprophillia and urophillia
feces, urine
necrophillia and klismaphillia
dead people, enemas (douching)
hypersexuality
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
PGAD and priapism
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
reasons for paraphillia
- 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
main risk factors for sexually abusing children
- sexual deviance, antisocial traits (associated w ASPD), intimacy deficits, or suffering from cognitive distortions (thinking errors)
cognitive distortions
- things ppl say to themselves to excuse/justify/deny/minimize inappropriate, inappropriate behaviour
malingering
- purposefully faking/exaggerating symptoms for personal gain
assessment of paraphillic disorder
- 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
treatment for paraphillic disorders
- 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
satiation therapy (treatment for paraphillic disorders)
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)
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)
orgasmic reconditioning
aversion therapy (treatment for paraphillic disorders)
link undesired fantasy with undesirable stimulus (ie bad smell/shock) to classically condition aversion to fantasy
