CP: Lecture 8 Sexual Disorders Flashcards
percentage “had sex” bij: genitals touching, genitals oral contact, penile-anal intercourse, penile-vaginal intercourse respectievelijk…
15, 40, 80, 100%
% women never orgasm
18%
% women half of the time
17%
% women usually/always
65%
sexual behaviour =
produces arousal and increases the chance of orgasm
hoeveel % van de koppels heeft geen seks gehad in de afgelopen 4 weken
23%
hoeveel van de seks ends up in conception
0,1%
hoevaak mensen gemiddeld seks over 4 weken
3 keer
4 factors for why humans have sex
- physical reasons (minder stress, desirability, experience)
- goal attainment (resources, social status, revenge)
- emotional (love, commitment, expression)
- insecurity (self esteem boost, duty/pressure, mate guarding).
dutch approach to sexuality education
stepwise, dit is meer healthy dan in een keer all the way
verschil males en females participation in masturbation op 16
mannen: 80% en vrouwen 50%
equivalent to erectile response =
vulva lubrication
mannen kennen hun lichaam beter door…
plassen
masturberen
genitalia are on outside
genital response in males door…
vasocongestion
openen word doc en leren -> genitalia vrouw
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openen word doc en leren -> vrouw clitoris
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openen word doc en leren -> over urethral sponge etc
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factoren die gebeuren bij arousal vrouw
uterus verplaatst naar boven
vaginal lubrication
labia swell
clitoris enlargens
factoren die gebeuren bij orgasm vrouw
contractions uterus
rectal sphincter contracts
rhythmic contractions in orgasmic platform
leren -> anatomie man word doc
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wat is de genital response
vasocongestion -> leidt tot de biological prerequisits
biological prerequisits bij mannen
erection & rigidity
wat gebeurt er bij arousal man
omhoog (unstimulated - partially stimulated - full erection)
partial elevation of testes
wat gebeurt er bij orgasme man
urethral contractions -> force seminal fluid through the urethra
rectal sphincter contracts
internal sphincter of bladder closes
seminal vesicles contract
prostate gland contracts
biological prerequisites for a woman to enjoy pleasurable penetration
swelling and humidity/lubrication
waardoor komen de bio prerequisits
door vasocongestion
wat is de sexual cycle klein
desire - excitement - organsm - resolution
desire phase
sexual interest, with fantasies or thoughts
exitement phase
increased blood flow to the genitalia
orgasm phase
sexual pleasure peaks
resolution phase
relaxation and sense of well-being na orgasme
checken pic van verschillende cycles mannen en vrouwen
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kleine verschillen cycle mannen en vrouwen
bij mannen is desire langer en begint eerder, als de arousal nog low is.
bij vrouwen is deze desire fase korter bij vrouwen meer orgasme, soms ook resolution without orgasm
sex and eating
sex is not like eating
sexual desire can be compared to eating -> desire/craving
libido -> incentive motivation (rewards)
stimulus based system
fast, automatic, causation of behaviour can occur outside of control
goal based system
slow, intentional, goal directed, goals represented in the brain, involves full conscious control and insight
young welk systeem meer?
stimulus based
almost orgasm = welke systeem?
stimulus based
wat is belangrijk bij bv pedophilie
dat je systeem 2 aanpakt, dus goal based. want in systeem 1 is het meestal al te laat.
is sex an emotion?
eigenlijk wel, heeft:
physical arousal
subjective experience
behaviour
plaatje van sex = emotion bekijken system 1 en 2
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social exchange theory
rewards and costs.
people attempt to maximize their rewards while minimizing costs, that interaction with others is a series of exchanges, and that people who receive rewards feel obligated to reciprocate
equity matching hypothesis
argues that people are more likely to form and succeed in a committed relationship with someone who is equally socially desirable, typically in the form of physical attraction.
rubins charmed circle bekijken
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meeste sexual dysfunction in
middle east en zuidoost azie
6 soorten sexual problems
inhibition/excitation
acquired/lifelong
situational/generalized
male hypoactive sexual desire disorder
deficient/absent sexual fantasies and desires
erectile disorder
inability to get erection, maintain eraction or decrease in erectile rigidity in at least 75% of cases.
interferes with penetration or pleasure
welke male disorder komt het vaakste voor
erectile disorder
bij male hypoactive sexual desire disorder gaat het mis bij … phase
desire
bij erectile disorder gaat het mis bij … phase
excitement
female sexual interest/arousal disorder
deficits in sexual interest, biological arousal or subjective arousal.
at least 3 diminished:
interest in sex
erotic thought/fantasies
initiation of sexual activity and responsiveness to partners attempt
sexual excitement/pleasure during 75% of sexual encounters
sexual interest due to cues
genital or nongenital sensations
over welke phase gaat de female sexual interest/arousal disorder
desire and excitement
no distress is no diagnosis voorbeeld
For many women, enjoying a sense of emotional closeness to
their partner is more important than achieving an orgasm
early ejaculation disorder
tendency to ejaculate within 1 minute of penile insertion on at least 75% of sexual occasions
female orgasmic disorder
On at least 75% of sexual occasions:
* Marked delay, infrequency, or absence of orgasm, or
* Markedly reduced intensity of orgasmic sensation
(dus absence of minder intense orgasme)
Genitopelvic Pain/Penetration Disorder
difficulties with at least one:
o Inability to have vaginal penetration
o Vulvar, vaginal or pelvic pain
o Marked fear or anxiety about pain or penetration
o Marked tensing of the pelvic floor muscles
dus inability, pijn, anxiety about pain
prevalence pain female
50% female participants experience pain during coïtus, of whom 50% do not see it as a problem
subjective exitement may or may not reflect biological excitement for women.
overeenkomst bij mannen is 0,66, bij vrouwen 0,29
biopsychosocial perspective bekijken docs
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4 types of treatment for sexual dysfunctions
Psychoeducation
Couples therapy
Cognitive interventions
Sensate focus
treatment for female orgasmic disorder
directed masturbation
genito-pelvic pain/penetration disorder treatment
practice inserting smaller dildos, steeds groter
premature ejaculation treatment
medication
SSRIs
squeeze technique (alleen twee vingers net onder de penis, apply pressure. should inhibit ejaculation)
erectile disorder treatment
viagra
paraphilic disorders
Recurrent sexual attraction to unusual objects or sexual activities
paraphilic disorders should only be diagnosed when…
there is marked distress/impairment
behaviours are done with nonconsenting persons
fetishistic disorder
at least 6 months
recurrent and intense sexually arousing fantasies, urges or behaviours involving the use of nonliving/nongenital objects
causes distress
not limited to clothing, devices such as vibrator
pedophilic disorder
at least 6 months
recurrent andintense fantasies/urges/behaviour involving sexual contact with a prepubescent child (tot 12 ongeveer)
has acted on these urges or causes distress
person is at least 16, at least 5 years older than child
fetishistic disorder kort
inanimate object or nongenital body part
transvestic disorder
cross-dressing (van gender switchen qua kleding)
voyeuristic disorder
watching unsuspecting others undress or have sex
exhibitionistic disorder
exposing genitals to unwilling stranger
frotteuristic disorder
sexual touching of an unsuspecting person
sexual sadism disorder
inflicting pain
sexual masochism disorder
receiving pain
inanimate object/nongenital body part
fetishistic disorder
cross-dressing
transvestic disorder
watching unsuspecting others undress or have sex
voyeuristic disorder
exposing genitals to unwilling strangers
exhibitionistic disorder
sexual touching of an unsuspecting person
frotteuristic disorder
inflicting pain
sexual sadism disorder
receiving pain
sexual masochism disorder
nog een keer alle paraphilic disorders
fetishistic
transvestic
pedophilic
voyeuristic
exhibitionistic
frotteuristic
sexual sadism
sexual masochism
research paraphilic disorders is often focused on…
men charged with sexual offenses
enhance motivation for treatment
Focus on benefits for change and consequences of continued engagement in illegal sexual behaviors
biological treatments
hormonal agents to reduce androgens
cognitive behavioural therapy
aversion therapy
counter distorted thinking
combined with social skills, sexual impulse control strategies, empathy training, relapse prevention
