CP: Chapter 12 Sexual Disorders Flashcards
cultural differences sex
some cultures view sexuality as an important part of wellbeing and pleasure, others view it as relevant only for procreation.
gender differences sex
women are more ashamed of flaws = interference with sexual satisfaction.
women: sexuality more closely tied to relationship status and social norms
sexual response cycle kaplan -> overview
desire phase -> excitement phase -> orgasm phase -> resolution phase
desire phase =
sexual interest associated with arousing fantasies or thoughts
excitement phase =
increased blood flow to genitalia
what happens to your body in the excitement phase
flow of blood into tissue to produce erection bij mannen
enlargement of breatst and changes in vagina (eg. lubrication) bij vrouwen
resolution phase =
relaxation and sense of wellbeing following an orgasm.
in men: refractory period, women can orgasm again.
how does kaplan not fit the data for women:
- desire and excitement phase may not be extinct for women
- kaplan definition of excitement may be too biological, biological and subjective excitement may be 2 separate things for women (even though they are the same for men)
hoe meten van biological excitement
vaginal plethysmograph (in vagina, measures blood flow) or penile plethysmograph (thin rubber tube that stretches as the penis enlargens)
hoe heet minder zin in seks bij vrouwen
sexual interest/arousal disorder in women
sexual interest/arousal disorder in women dsm
diminished, absent or reduced frequency of at least 3:
interest in sex
erotic thoughts/fantasies
initiation of sexual activity
sexual excitement/pleasure during 75% of the time
sexual interest by cues
genital or non genital sensations during 75% of encounters
hoe heet minder zin in seks bij mannen
male hypoactive sexual desire disorder
male hyposexual disorder =
sexual fantasies and desires are deficient or absent
erectile disorder =
on at least 75% of sexual occasions, one of these:
inability to attain erection
inability to maintain erection
marked decrease in erectile rigidity interferes with penetration oor pleasure
hoe heet het als een vrouw geen orgasme kan krijgen
female orgasmic disorder
female orgasmic disorder
on at least 75% of sexual occasions:
marked delay/infrequency or absence of orgasm
markeldy reduced sensitivity of orgasmic sensations
women are more likely to have orgasms as…
they age, and have closer relationships
womens problems with reaching an orgasm are distinct from problems with sexual arousal
oke
hoe heet het als mannen problemen hebben met orgasmen
delayed ejaculation disorder
delayed ejaculation disorder =
persistent difficulty in ejaculation (mainly during intercourse, not when masturbating)
-> delay, infrequency or absence of orgasm at at least 75% of sexual occasions
prevalentie delayed ejaculation disorder
less than 1% of men
early ejaculation disorder =
ejaculation that occurs too quickly, within 1 minute of penile insertion on at least 75% of the sexual occasions.
hoe helpen bij early ejaculation disorder
via psychoeducation: help set realistic expectations
sexual pain disorder =
genitopelvic pain/penetration disorder
persistent or recurrent difficulties with at least one:
vaginal penetration
vulvar, vaginal or pelvic pain during penetration
fear about pain or penetration
tensing of the pelvic floor muscles during penetration (vaginismus)
vaginismus =
involuntar ymuscle spasms of the outer third vagina so that intercourse is impossible
wat is er bij genitopelvic pain/penetration disorder wel nog
wel nog sexual arousal en oral orgasms
waarom geen mannen dsm 5 criteria bij sexual pain
omdat zij geen treatment zoeken
succesful sexual functioning: physical factors
good health, excersise, good nutrition
poor sexual functioning: physical factors
smoking
drinking
cardiovascular problems
low physiological arousal
neuro diseases
diabetes
ssri medication
antihypertensive medication
other drugs
psychosocial factors: good sex
good emotional health
attraction towards partner
positive attitude towards partner
positive sex attitude
poor sexual functioning psychological factors
depression or anxiety
focus on performance
too much routine
poor self esteem
uncomfortable environment
rigid attitude towards sex
negative thoughts about sex
social and sexual history factors; good sex
positive experiences with sex
good relationship with partner
sexual knowledge and skill
social and sexual history factors: poor sex
rape or abuse
relationship problems
long periods of abstinence
history of hurried sex
wat kun je doen tegen anxiety bij sex
gradual and systematic reduction of anxiety-provoking aspects: psychoeducation can do a lot to reduce anxiety
wat doen tegen attitude and thoughts
sensate focused exercises: use physical touch to get more intimate with partner
of communication training
wat to do for female orgasmic disorder
directed masturbation: examining nude body, touching, finding areas of pleasure with partner watching etc.
squeeze technique
for early ejaculation disorder, reduces arousal
wat is het lastige aan depressie
depressie zelf kan leiden tot poor sex, maar antidepressants juist ook
pde-5 inhibitors
relax smooth muscles, allowing blood to flow into penis, creating an erection during sexual stimulation
maar side effects = headache and indigestion
7 paraphilic disorders
fetishistic disorder
pedophilic disorder and incest
voyeuristic disorder
exhibitionistic disorder
frotteuristic disorder
sexual sadism disorder
sexual masochism disorder
fetishistic disorder=
at least 6 months: recurring and intense fantasies/urges/behaviour involving the use of nonliving objects or nongenital body parts
bv clothing in cross dressing, vibrator etc
hoe lang moeten alle paraphilic disorders zijn
at least 6 months!
pedophilic disorder
recurrent and intense arousing fantasies/urges/behaviour involving sexual contact with a prepubescent child.
either has acted on the urges or urges cause distress/interpersonal problems
person is at least 16, child is at least 5 years younger
voyeuristic disorder
recurrent and intense sexually arousing fantasies/urges/behaviour involving the observation of unsuspecting others who are naked, disrobing or have sex.
has acted on these urges in nonconsenting manner, or cause distress
exhibitionistic disorder
recurrent and intense sexually arousing fantasies/urges/behaviour about showing their genitals to unsuspecting strangers.
has acted on these urges to nonconsenting person or cause distress
frotteuristic disorder
recurrent and intense sexually arousing fantasies/urges/behaviour involving touching a non consenting person
has acted on or causes distress
sexual sadism disorder
recurrent and intense sexually arousing fantasies, urges or behaviour involving physical/psychological suffering of another person
has acted on urges or causes distress
sexual masochism disorder
recurrent and intense sexually arousing fantasies/urges/behaviour involving the act of being humiliated, beaten, bound or made to suffer.
causes distress or impairment
dus welke disorders horen bij ongewenst:
kijken - aanraken - showen
kijken = voyeuristic
aanraken = frotteuristic
showen = exhibitionistic
verschil sexual sadism en sexual masochism disorder
sexual sadism = suffering of someone else
sexual masochism = suffering of self
gender paraphilia
almost all are men
androgens in paraphilia?
niet perse anders dan ‘gezonde’ mannen
wat is wel een risicofactor voor paraphilia
childhood sexual abuse: 2/3 of paraphilic disorders zijn abused
triggers for paraphilia
alcohol, negative moods, loss of impulse control
risk factors for paraphilia
impulsiveness
bad emotion regulation
parenting
social skill deficits
hostility towards women
cognitive distortion
3 types of cognitive behaviour therapy for paraphilic disorders
aversion therapy - shock on the hand, or drug that produces nausea when looking at the thing that is the fetish
covert sensitization - imagine the situation in which they are aroused, and then imagine feeling sick or ashamed
counter distorted thinking - gedachtes tegengaan met rationaliteit
often these cbt methods are combined with…
social skills training, sexual impulse control strategies, empathy training, relapse prevention
wat voor biological treatments for paraphilia
drugs that lower testosterone -> ook mindere sex drive.
maar veel side effects
of antidepressants, maar geen goed bewijs voor
sexual desire disorders vrouw en man
female sexual interest/arousal disorder
male hypoactive sexual desire disorder
sexual arousal disorder vrouw en man
female orgasmic disorder
delayed ejaculation disorder
early ejaculation disorder
sexual pain disorder vrouw
genito-pelvic pain/penetration disorder
