erectile disorder et al. Flashcards

1
Q

What does the DSM-5-TR describe sexual dysfunctions as?

A

A clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure

This definition is found on page 477 of the DSM-5-TR.

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2
Q

What must be ruled out before diagnosing a sexual dysfunction?

A

Nonsexual mental disorder, serious relationship disturbance, other stressor, or effects of a drug or medical condition

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3
Q

What specifiers are provided for most sexual dysfunction diagnoses?

A

Onset, extent, and severity

The exception is genito-pelvic pain/penetration disorder, which has specifiers only for onset and severity.

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4
Q

What are the symptoms required for a diagnosis of Erectile Disorder?

A

At least one of three symptoms on 75 to 100% of occasions:
* Marked difficulty obtaining an erection
* Marked difficulty maintaining an erection
* Marked decrease in erectile rigidity

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5
Q

How long must symptoms of Erectile Disorder be present for a diagnosis?

A

At least six months

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6
Q

What indicates that an organic etiology can be ruled out in Erectile Disorder?

A

Spontaneous erections when not planning to engage in sexual activity, morning erections, or erections when masturbating or with a different partner

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7
Q

What behavioral techniques are used to treat Erectile Disorder?

A

Reducing performance anxiety and increasing sexual stimulation

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8
Q

What is sensate focus?

A

A method for reducing performance anxiety through a series of activities promoting intimacy

Developed by Masters and Johnson in 1970.

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9
Q

What drugs are commonly used to treat Erectile Disorder?

A

Sildenafil citrate (Viagra), tadalafil (Cialis), vardenafil (Levitra)

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10
Q

What characterizes Premature (Early) Ejaculation?

A

Ejaculation within approximately one minute of vaginal penetration before the person desires it

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11
Q

What are the symptoms of Premature Ejaculation required for diagnosis?

A

Symptoms must be present for six months or more, occur during 75 to 100% of occasions, and cause significant distress

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12
Q

What techniques are used to treat Premature Ejaculation?

A

Sensate focus, start-stop technique, pause-squeeze technique

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13
Q

How does serotonin relate to Premature Ejaculation?

A

A low level of serotonin contributes to this disorder; SSRIs can delay ejaculation

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14
Q

What are the symptoms of Genito-Pelvic Pain/Penetration Disorder?

A

Problems with:
* Vaginal penetration during intercourse
* Vulvovaginal or pelvic pain during intercourse
* Anxiety about vulvovaginal or pelvic pain
* Tensing of pelvic floor muscles

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15
Q

What is the required duration of symptoms for Genito-Pelvic Pain/Penetration Disorder?

A

Six months or longer

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16
Q

What interventions are used for Genito-Pelvic Pain/Penetration Disorder?

A

Relaxation training, sensate focus, topical anesthetic, vaginal dilators, Kegel exercises

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17
Q

What is required for a diagnosis of Female Orgasmic Disorder (FOD)?

A

Marked delay, infrequency, or absence of orgasm or markedly reduced intensity of orgasmic sensations on almost all occasions for at least 6 months

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18
Q

What is the most empirically supported treatment for Female Orgasmic Disorder?

A

Directed masturbation

19
Q

What other treatments may be included for Female Orgasmic Disorder?

A

Sex education, sensate focus, anxiety reduction techniques, mindfulness training, communication skills training

20
Q

What is Gender Dysphoria?

A

A marked incongruence between one’s assigned gender and one’s experienced or expressed gender.

21
Q

What are the requirements for diagnosing Gender Dysphoria in children?

A

At least six of eight symptoms lasting for at least six months and causing significant distress or impaired functioning.

22
Q

List some symptoms required for diagnosing Gender Dysphoria in children.

A
  • Strong desire to be the other gender
  • Strong preference for wearing clothes of the other gender
  • Strong preference for toys and activities typically used by the other gender
  • Strong preference for playmates of the other gender
  • Strong dislike of one’s sexual anatomy
23
Q

What are the requirements for diagnosing Gender Dysphoria in adolescents and adults?

A

At least two of six symptoms lasting for at least six months and causing significant distress or impaired functioning.

24
Q

List some symptoms required for diagnosing Gender Dysphoria in adolescents and adults.

A
  • Strong desire to be rid of primary and/or secondary sex characteristics
  • Strong desire to be the other gender
  • Strong desire to be treated as the other gender
  • Strong conviction that one has feelings and reactions characteristic of the other gender
25
Q

What is the Dutch protocol in the treatment of Gender Dysphoria?

A

It recommends ‘watchful waiting’ and support for children under 12, followed by social transition and puberty-blocking drugs at the first signs of puberty.

26
Q

What is the gender-affirmative model?

A

It assumes a child may be cognizant of their authentic identity and benefits from a social transition at any stage of development.

27
Q

What are the key assumptions of the gender-affirmative model?

A
  • Gender variations are not disorders
  • Gender presentations are diverse and vary across cultures
  • Gender is not always binary and may be fluid
  • A child’s psychological problems are often secondary to negative reactions
28
Q

What are the outcomes associated with gender confirmation surgery?

A

Decrease in gender dysphoria, improved self-satisfaction, and a low incidence of regret.

29
Q

True or False: Transgender male patients generally have more positive outcomes than transgender female patients after gender confirmation surgery.

A

True.

30
Q

What factors are linked to positive outcomes following gender confirmation surgery?

A
  • Careful diagnostic screening
  • Psychological stability
  • Adequate social support
  • Lack of surgical complications
31
Q

Define paraphilia.

A

Intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with consenting human partners.

32
Q

What is a paraphilic disorder?

A

A paraphilia that is currently causing distress or impairment to the individual or has entailed personal harm or risk of harm to others.

33
Q

What types of treatments are used for paraphilic disorders?

A

Cognitive-behavior therapy combined with group therapy, marital therapy, and/or pharmacotherapy.

34
Q

What cognitive strategies are used in the treatment of paraphilic disorders?

A
  • Cognitive restructuring
  • Empathy training
  • Skills training
35
Q

What is covert sensitization?

A

A form of aversive counterconditioning conducted in imagination to replace sexual arousal with fear.

36
Q

What is orgasmic reconditioning?

A

Instructing the person to switch fantasizing from a paraphilic object to a more appropriate one while masturbating.

37
Q

What drugs are used to treat severe forms of paraphilic disorders?

A
  • Gonadotropin-releasing hormones (e.g., Lupron)
  • Antiandrogens (e.g., Depo-Provera)
38
Q

What is Frotteuristic Disorder?

A

Recurrent and intense sexual arousal from touching or rubbing against a nonconsenting adult.

39
Q

What is Transvestic Disorder?

A

Cross-dressing for the purpose of sexual arousal.

40
Q

What is Pedophilic Disorder?

A

Recurrent and intense sexual arousal involving sexual activity with a child 13 years of age or younger.

41
Q

What is Fetishistic Disorder?

A

Recurrent and intense sexual arousal in response to a nonliving object or specific non-genital body part.

42
Q

What is Exhibitionistic Disorder?

A

Recurrent and intense sexual arousal from exposing one’s genitals to an unsuspecting person.

43
Q

What are the subtypes of Exhibitionistic Disorder?

A
  • Exposing genitals to prepubertal children
  • Exposing genitals to physically mature individuals
  • Exposing genitals to both prepubertal children and physically mature individuals