EXAM 2 - Sexual Dysfunction, Paraphilias, and Gender Dysphoria Flashcards
The Sexual Response Cycle
Appetitive
Desire
Excitement
The main physiological change in males is penile erection
The main physiological change in females is vaginal swelling and lubrication
Orgasm
In males, ejaculation
In females, rhythmic contractions in pelvic area
Resolution
In males there is a refractory period
In females it varies, may be no refractory period
Sexual Dysfunction
Sexual Desire Disorders DSM-IV
Hypoactive Sexual Desire Disorder
Sexual Aversion Disorder
Sexual Arousal Disorders in DSM-5 Female Sexual Interest/Arousal Disorder Male Erectile Disorder (Impotence) Rule out an organic basis (rare) Nocturnal penile tumescence test during a sleep study Performance anxiety (most common cause)
Female Sexual Interest/Arousal Disorder: An Overview
Lack of or significantly reduced sexual interest/arousal
Typically manifesting in:
reduced sexual interest
reduced sexual activity
fewer sexual thoughts
reduced arousal to sexual cues
reduced pleasure or sensations during almost all sexual encounters
DSM 5 Criteria for Female Sexual Interest/Arousal Disorder
A. Lack of, or significantly reduced, sexual interest/arousal, as manifested by at least three of the following:
1. Absent/reduced interest in sexual activity.
2. Absenvreduced sexualierotic thoughts or fantasies.
3. Nofreduced initiation of sexual activity, and typically unreceptive to a partner’s attempts to initiate.
4. Absent’reduced sexual excitement/pleasure during sexual activity in almost all or all (approximately 76%-100%) sexual encounters (in identified situational contexts or, if generalized, in all contexts).
5. Absent’reduced sexual interest/arousal in response to any internal or external sexual/erotic cues (e.g., written, verbal, visual).
6. Absent/reduced genital or nongenital sensations during sexual activity in almost all or all (approxi-mately 76°A-1009’0 sexual encounters (in identified situational contexts or, if generalized, in all contexts).
B. The symptoms in Criterion A have persisted for a minimum duration of approximately S months. C. The symptoms in Criterion A cause clinically significant distress in the individual. D. The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance! medication or another medical condition. Specify type:
Lifelong type
Acquired type
Specify type: Generalized type Situational type
Male Hypoactive Sexual Desire Disorder: An Overview
Little or no interest in any type of sexual activity
Masturbation, sexual fantasies, and intercourse are rare
Accounts for half of all complaints at sexuality clinics
Affects 5% of men
DSM 5 Criteria for Male Hypoactive Sexual Desire Disorder
A. Persistently or recurrently deficient (or absent) sexual/ erotic thoughts or fantasies and desire for sexual activ-ity.The judgment of deficiency is made by the clinician, taking into account factors that affect sexual functioning, such as age and general and socio-cultural contexts of the person’s life.
B. The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months. C. The symptoms in Criterion A cause clinically significant distress in the individual.
D. The sexual dysfunction is not better explained by a non-sexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.
Specify whether:
Lifelong type
Acquired type
Specify whether: Generalized type Situational type
Erectile Disorder
Difficulty achieving or maintaining an erection
Sexual desire is usually intact
Most common problem for which men seek treatment
Prevalence increases with age
60% of men over 60 experience erectile dysfunction
Sexual Dysfunction - Orgasmic Disorders
Female Orgasmic Disorder (Anorgasmia)
Male Orgasmic Disorder (Premature or delayed ejaculation)
Female Orgasmic Disorder
Marked delay, absence or decreased intensity of orgasm in almost all sexual encounters
Not explained by relationship distress or other significant stressors
1 in 4 women has significant difficulty achieving orgasm
DSM 5 Criteria for Female Orgasmic Disorder
A. Presence of either of the following symptoms and experienced on almost all or all (approximately 75%-100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts):
1. Marked delay in, marked infrequency of, or absence of orgasm. 2. Markedly reduced intensity of orgasmic sensations.
B. The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months.
C. The symptoms in Criterion A cause clinically significant distress in the individual.
D. The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stress-ors and is not attributable to the effects of a substance/ medication or another medical condition. Specify type:
Lifelong type
Acquired type
Specify type: Generalized type Situational type
Specify: Never experienced an orgasm under any situation
Premature Ejaculation
Ejaculation occurring within ~1 minute of penetration and before it is desired
Most prevalent sexual dysfunction in adult males
Affects 21% of all adult males
Most common in younger, inexperienced males
Problem tends to decline with age
DSM 5 Criteria for Premature Ejaculation
A. A persistent or recurrent pattern of ejaculation occur-ring during partnered sexual activity within approxi-mately 1 minute following vaginal penetration and before the person wishes it. Note: Although the diag-nosis of premature (early) ejaculation may be applied to individuals engaged in nonvaginal sexual activities, specific duration criteria have not been established for these activities.
B. The symptom in Criterion A must have been present for at least 6 months and must be experienced on almost all or all (approximately 75%1)-100%) occasions of sexual activity (in identified situational contexts or, if general-ized, in all contexts).
C. The symptoms in Criterion A cause clinically significant distress in the individual.
D. The sexual dysfunction is not better explained by a non-sexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.
Specify type:
Lifelong type
Acquired type
Specify type:
Generalized type Situational type
