erectile disorder et al. Flashcards
What does the DSM-5-TR describe sexual dysfunctions as?
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.
What must be ruled out before diagnosing a sexual dysfunction?
Nonsexual mental disorder, serious relationship disturbance, other stressor, or effects of a drug or medical condition
What specifiers are provided for most sexual dysfunction diagnoses?
Onset, extent, and severity
The exception is genito-pelvic pain/penetration disorder, which has specifiers only for onset and severity.
What are the symptoms required for a diagnosis of Erectile Disorder?
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
How long must symptoms of Erectile Disorder be present for a diagnosis?
At least six months
What indicates that an organic etiology can be ruled out in Erectile Disorder?
Spontaneous erections when not planning to engage in sexual activity, morning erections, or erections when masturbating or with a different partner
What behavioral techniques are used to treat Erectile Disorder?
Reducing performance anxiety and increasing sexual stimulation
What is sensate focus?
A method for reducing performance anxiety through a series of activities promoting intimacy
Developed by Masters and Johnson in 1970.
What drugs are commonly used to treat Erectile Disorder?
Sildenafil citrate (Viagra), tadalafil (Cialis), vardenafil (Levitra)
What characterizes Premature (Early) Ejaculation?
Ejaculation within approximately one minute of vaginal penetration before the person desires it
What are the symptoms of Premature Ejaculation required for diagnosis?
Symptoms must be present for six months or more, occur during 75 to 100% of occasions, and cause significant distress
What techniques are used to treat Premature Ejaculation?
Sensate focus, start-stop technique, pause-squeeze technique
How does serotonin relate to Premature Ejaculation?
A low level of serotonin contributes to this disorder; SSRIs can delay ejaculation
What are the symptoms of Genito-Pelvic Pain/Penetration Disorder?
Problems with:
* Vaginal penetration during intercourse
* Vulvovaginal or pelvic pain during intercourse
* Anxiety about vulvovaginal or pelvic pain
* Tensing of pelvic floor muscles
What is the required duration of symptoms for Genito-Pelvic Pain/Penetration Disorder?
Six months or longer
What interventions are used for Genito-Pelvic Pain/Penetration Disorder?
Relaxation training, sensate focus, topical anesthetic, vaginal dilators, Kegel exercises
What is required for a diagnosis of Female Orgasmic Disorder (FOD)?
Marked delay, infrequency, or absence of orgasm or markedly reduced intensity of orgasmic sensations on almost all occasions for at least 6 months
What is the most empirically supported treatment for Female Orgasmic Disorder?
Directed masturbation
What other treatments may be included for Female Orgasmic Disorder?
Sex education, sensate focus, anxiety reduction techniques, mindfulness training, communication skills training
What is Gender Dysphoria?
A marked incongruence between one’s assigned gender and one’s experienced or expressed gender.
What are the requirements for diagnosing Gender Dysphoria in children?
At least six of eight symptoms lasting for at least six months and causing significant distress or impaired functioning.
List some symptoms required for diagnosing Gender Dysphoria in children.
- 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
What are the requirements for diagnosing Gender Dysphoria in adolescents and adults?
At least two of six symptoms lasting for at least six months and causing significant distress or impaired functioning.
List some symptoms required for diagnosing Gender Dysphoria in adolescents and adults.
- 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
What is the Dutch protocol in the treatment of Gender Dysphoria?
It recommends ‘watchful waiting’ and support for children under 12, followed by social transition and puberty-blocking drugs at the first signs of puberty.
What is the gender-affirmative model?
It assumes a child may be cognizant of their authentic identity and benefits from a social transition at any stage of development.
What are the key assumptions of the gender-affirmative model?
- 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
What are the outcomes associated with gender confirmation surgery?
Decrease in gender dysphoria, improved self-satisfaction, and a low incidence of regret.
True or False: Transgender male patients generally have more positive outcomes than transgender female patients after gender confirmation surgery.
True.
What factors are linked to positive outcomes following gender confirmation surgery?
- Careful diagnostic screening
- Psychological stability
- Adequate social support
- Lack of surgical complications
Define paraphilia.
Intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with consenting human partners.
What is a paraphilic disorder?
A paraphilia that is currently causing distress or impairment to the individual or has entailed personal harm or risk of harm to others.
What types of treatments are used for paraphilic disorders?
Cognitive-behavior therapy combined with group therapy, marital therapy, and/or pharmacotherapy.
What cognitive strategies are used in the treatment of paraphilic disorders?
- Cognitive restructuring
- Empathy training
- Skills training
What is covert sensitization?
A form of aversive counterconditioning conducted in imagination to replace sexual arousal with fear.
What is orgasmic reconditioning?
Instructing the person to switch fantasizing from a paraphilic object to a more appropriate one while masturbating.
What drugs are used to treat severe forms of paraphilic disorders?
- Gonadotropin-releasing hormones (e.g., Lupron)
- Antiandrogens (e.g., Depo-Provera)
What is Frotteuristic Disorder?
Recurrent and intense sexual arousal from touching or rubbing against a nonconsenting adult.
What is Transvestic Disorder?
Cross-dressing for the purpose of sexual arousal.
What is Pedophilic Disorder?
Recurrent and intense sexual arousal involving sexual activity with a child 13 years of age or younger.
What is Fetishistic Disorder?
Recurrent and intense sexual arousal in response to a nonliving object or specific non-genital body part.
What is Exhibitionistic Disorder?
Recurrent and intense sexual arousal from exposing one’s genitals to an unsuspecting person.
What are the subtypes of Exhibitionistic Disorder?
- Exposing genitals to prepubertal children
- Exposing genitals to physically mature individuals
- Exposing genitals to both prepubertal children and physically mature individuals
