Exam 3 PSY 395 Flashcards
1
Q
What is a sexual dysfunction?
A
Disorders involving either a disruption of the sexual response cycle or pain during sex
2
Q
Describe the sexual response cycle
A
desire –> excitement/arousal –> organism –> resolution
3
Q
what is the name of the disorder where a man has a lack of interest in sexual activity and fantasy?
A
Male Hypoactive Sexual Desire Disorder
4
Q
what is the name of the disorder for females that have a lack of interest in sexual activity and fantasy?
A
Female Sexual Interest/ Arousal Disorder
5
Q
what are factors of Female Sexual Interest/Arousal Disorder and what are treatment plans for it?
A
Factors: insufficient engorgement/lubrication
Treatment: Couple’s therapy focused on communication
and Sensate Focus Techniques
6
Q
inability to achieve/maintain erection
A
Erectile Disorder (ED)
7
Q
treatment for Erectile Disorders?
A
medications, sensate focus techniques + Paradoxical Instruction
8
Q
Female Orgasmic Disorder
A
women with difficulty reaching orgasm and other contributing factors
9
Q
treatment for female orgasmic disorder?
A
education about female sexuality, self-stimulation instructions
10
Q
Delayed Ejaculation
A
- men with difficulty reaching orgasm
Treatment: similar to erectile dysfunction and female orgasmic disorder. May also include cues from masturbation into partnered sex
11
Q
Premature Ejaculation
A
man reaches orgasm before, on, or shortly after penetration
Treatment: special condoms, squeeze technique, start/stop technique
12
Q
sexual dysfunctions with pain - Genito-Pelvic Pain/Penetration Disorder
A
female specific condition involving at least 1 of the following:
- difficulty with penetration during intercourse
- tensing or tightening of pelvic floor muscles during attempted penetration
- anxiety about pain associated with penetration
- marked pain during attempts at vaginal penetration
13
Q
Treatment for Genito-Pelvic Pain/Penetration Disorder
A
- can be associated with injuries, medical conditions, and trauma
- behavioral treatment includes physical therapy and learning to control vaginal muscles and gradual exposure to penetration
14
Q
lifelong dysfunction
A
existed, without relief, since the person’s earliest sexual experiences
15
Q
acquired dysfunction
A
develops after at least one period of normal functioning
16
Q
generalized dysfunction
A
present in all sexual situations at the time of diagnosis
17
Q
situational dysfunction
A
occurs only in certain situations or with certain partners (ex. when under stress)
18
Q
what is the general risk for sexual dysfunction by gender?
A
Women are at higher risk for dysfunction in all except for climaxing too early
19
Q
Paraphilias
A
Recognized patterns of sexuality that deviate markedly from norms
- pattern or object becomes a central focus person’s arousal and gratification, and causes distress or impairment or causes this to someone else
20
Q
Fetishistic Disorder - Paraphilia
A
reliance on inanimate objects or on a body part for sexual gratification
21
Q
Transvestite Disorder - Paraphilia
A
sexual gratification through dressing in the clothes of another gender
22
Q
Exhibitionistic Disorder - Paraphilia
A
sexual gratification through display of one’s genitals to an involuntary observer
- having sex openly in a public space
23
Q
Voyeuristic Disorder - Paraphilia
A
sexual gratification through clandestine observation of other people’s sexual activities or sexual anatomy
- secretly watch someone undress
24
Q
Sexual Sadism Disorder - Paraphilia
A
sexual gratification through infliction of pain and/or humiliation on others
- forcing someone to have sex
25
Sexual Masochism Disorder - Paraphilia
sexual gratification through pain and/or humiliation inflicted on oneself
- being dominated (MF)
- Being tied up (F)
- being spanked or whipped
26
Frotteuristic Disorder - Paraphilia
sexual gratification through touching and rubbing against a non-consenting person
27
Pedophilic Disorder - Paraphilia
sexual gratification, on the part of the adult, through sexual contact with prepubescent children
- must have age separation of at least 5 years
- perpetrator must be at least 16 years old
- child must be under 13 years of age
28
Behavioral Treatment for Paraphilia's
stimulus satiation = exposure to paraphilia stimuli immediately after orgasm (only when not aroused)
orgasmic reconditioning = switch to normative sexual fantasies or material right before orgasm
covert sensitization = imagine worst possible scenario during arousal
29
Medication Treatment for Paraphilia's
- reduce androgen activity - Depo Provera, Androcur
- Telstar (triptorelin) - inhibits gonadotropin secretion
30
Gender Dysphoria
- marked incongruence between one's experienced/expressed gender and assigned gender
- dysphoria causes substantial distress
- desire to live as experienced gender
- categorized based on age (children vs adolescent and adult)
- less than .1% in adults
31
gender affirmative treatment
treatment making one's body more consistent with gender identity
- hormones, hormone blockers, facial surgery, breast removal/augmentation, electrolysis
32
typical requirements for gender affirming surgery (WPATH guidance document)
1. detailed mental health evaluation
- affirm long-standing diagnosis, rule out contraindications
- often including a duration of psychotherapy
2. hormonal therapy to initiate changes for 1 year
3. living full-time in experienced gender for 1 year
4. capacity for informed consent including age of majority
33
Outcomes of treatment
- 80% with gender dysphoria improve with biological treatments
- 70% satisfaction rate with gender affirming surgery (small amount regret)
- satisfaction increases as time spent living as experienced gender prior to surgery increases
- psychotherapy alone does not reduce gender dysphoria ( AKA conversion therapy)
34
what causes gender variation?
neuroscience = monozygotic twins are concordant for GD
examples of CNS differences + blood flow patterns, reaction to strong odors based on gender identity, area of hypothalamus (BTA)
35
causes of gender dysphoria
intersex conditions - biological disorder of sex development
- partial androgen insensitivity
- congenital androgen hyperplasia (too much testosterone produced by adrenal gland)
36
ethical implications of gender dysphoria in DSM 5 is controversial
- claim transgender and nonbinary people deviate from cultural norms
- treatment availability and insurance coverage is dependent on verification of gender dysphoria as diagnosis
- prevalence of mental health rates, suicide, change
37
schizophrenia
psychotic disorder in which deterioration of functioning is marked by severe symptoms related to
- deficits in cognition/language
- distorted perception
- abnormal mood
-bizarre behavior
38
delusions of persecution
disorder when a person has an unfounded belief that other intend to harm them (targeted, spied on, government tracking, stealing, etc)
39
delusions of reference
someone believes that neutral events have a personal significance or are directed at them (others are observing you, communicating with you, referenced in the media, movie/song has a message for you)
40
delusions of grandeur
false belief that a person is powerful, wealthy, famous, or other extraordinary traits
- magical skills, reading minds
-immune to injury or disease
- special connection to aliens
41
loose associations
ideas jump from one to another, leading the person further and further away from the original topic
42
poverty of speech
mental dysfunction that involves a decrease in the amount of speech a person produces
- take longer to talk
- use fewer words
43
neologisms
the use of new words and phrases, often formed by combining parts of two or more regular words the have little if any translation
- belly bad luck
- tie father
- littlehood
-goodship
44
clanging
the pairing of words that have no relation to one another beyond the fact that they rhyme or sound alike
- repeat rhyme words
-puns or overuse puns
45
word salad
words and phrases are combined in what appears to be a completely disorganized fashion
- purple elephant blanket tree sky yesterday walking pizza
46
selective attention
inability to confine extraneous data to the edge of consciousness
- focusing on one thing while ignoring everything else
47
hallucinations
perceptions that occur in the absence of any appropriate external stimuli
48
blunted affect
patient shows little emotion
49
flat affect
patient shows no emotion
50
avolition
lack of motivation and the inability to initiate or engage in goal directed behaviors
- disorganized
- difficulty starting/finishing tasks
- zoning out
51
catatonic features
pronounced negative symptoms
- no reposes to external stimuli
- marked lack of movement and posturing self against gravity
52
catatonic stupor
complete immobility, usually accompanied by mutism
53
waxy flexibility
if someone gets moved, they have a slight resistance to being moved and will remain in the new position with their muscles tense. they look like a wax figure
54
stereotypy
persistent repetition of an action
- hand flapping, body rocking, toe walking, etc
55
echopraxia
condition where a person involuntarily imitates another person's actions, facial expressions, or words
56
epidemiology of Schizophrenia
-1% lifetime prevalence
-.7% 1 month prevalence
- prevalence is double amount AAs
- 75% new cases occur in ages 16-25
57
predictors that give a worse prognosis for schizophrenia
slower decline, poor premorbid adjustment, absence of delusions of persecution and grandeur
58
brief psychotic episode
symptoms present < 1 month
59
schizophreniform disorder
symptoms present >1 month, <6 months
60
schizophrenia diagnosis time
symptoms present >6 months
61
neuroscience perspective of Schizophrenia
- schizophrenic-like conditions run in families
- adoptees are more like biological parents than adoptive
- brain imaging studies (small frontal/temporal lobe)
1. prenatal brain injury - virus during pregnancy
62
biochemical theories of schizophrenia
1. dopamine hypothesis
- associated with excess activity of the brain that uses dopamine as a neurotransmitter
- may be excessive number of dopamine receptors that behave abnormally
63
cognitive theories of schizophrenia
agree that biology sets the stage for the disorder which can lead to loose associations and deficits in selective attention
- dysfunctional interpretations =
unpredictable, strange experience -- attribution of meaning to experience -- simple delusion -- elaboration -- construction of delusional system
64
sociocultural theory of schizophrenia
stigma and social labeling, family dysfunction
- emotional over-involvement that is highly critical, disorganized communication that prevents family from having shared understanding
65
diathesis - stress model
-no solitary explanation can account for all the variance
- genetic or biological predisposition PLUS environmental/relational stressor(s) = schizophrenia
66
treatment for schizophrenia
1. psychopharmacology
- neuroleptics can happen as a result of taking psychotics for a long time - Parkinson's and tar dive diskinesia
- other antipsychotics can be more effective but cause weight gain or very low white blood cell count
2. social skills training, family interventions and vocational training can be helpful additions to medication
3. cognitive behavioral therapy
- learn patterns of symptoms, challenge hallucinations, techniques for dealing with unpleasant symptoms
4. community-based management
- short hospitalizations, day treatment programs, care in mental health centers,
67
personality disorder
enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture
- pervasive/inflexible
- onset in adolescence or early adulthood
- maladaptive and/or cause serious personal distress
68
Odd/Eccentric
Paranoid PD, Schizotypal PD, Schizoid PD
69
Dramatic/Emotional
Antisocial PD, Borderline PD, Histrionic PD, Narcissistic PD
70
Anxious/Fearful
Avoidant PD, Dependent PD, Obsessive-compulsive PD
71
Paranoid Personality Disorder
pervasive distrust and suspicious of others
- expects that others will seek harm, preoccupied with potential disloyalty of others, hesitant to confide in others
- Dwight
few friends
72
Schizotypal Personality Disorder
acute discomfort with reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior
- odd beliefs, magical thinking, unusual speech patterns, social anxiety, behavior and appearance is odd
- relatives are more likely to have schizophrenia
- Willy Wonka
73
Schizoid PD
severely restricted range of emotions that is notably associated with social detachment
- uninterested in social connections, seems detached, indifferent to praise/criticism
- Sheldon and Amy
74
Antisocial PD
a pervasive pattern of disregard for and violation of the rights of others
- behavioral problems as a kid
- lack of responsibility, irritable, aggressiveness
- reckless/impulsive behavior
- serious lack of empathy or remorse
- The Joker
75
Borderline PD
a pattern of instability of interpersonal relationships, image, and affects
- difficulty in establishing secure self-identity, rely on close friends
- distrust of others and fear of abandonment
- impulsive and self destructive behavior
76
histrionic PD
a pervasive pattern of excessive emotionality and attention seeking as indicated by
- center of attention
- self dramatization, theatrically, exaggerate emotions
- uses physical appearance to draw attention
- inappropriate sexually seductive/provacative
77
narcissistic personality disorder
a grandiose sense of grandiosity, self importance, lack of empathy
- need to be admired, entitled, arrogant
- self-centered
78
Avoidant PD
a pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation
- severely socially withdrawn, avoidant of social criticism/rejection, shows restraint with intimate relationships
- personally unappealing, socially inept
- more debilitating than social anxiety disorder
79
dependent personality disorder
excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation
80
obsessive-compulsive PD
excessive preoccupation with orderliness, perfectionism, and control that is maladaptive
- preoccupied with details, rules, lists, organization, or schedules,
- shows perfectionism that interfered with task completion
- excessively devoted to work/productivity over leisure
81
psychodynamic perspective of PDs
character disorders - disturbances in early relationships, cannot manage conflicts
focuses on insight into defenses and relational patterns
82
behavioral perspective of PDs
PD's result of learning, modeling
involves new learning, dialectical behavior therapy, mindfulness, emotion regulation, distress tolerance, interpersonal effectiveness
83
cognitive perspective of PDs
faulty schemas, altering schemas
84
Neuroscience perspective PDs
genes and personality
drug treatment, some PDs respond well to antipsychotics
85
competency to stand trial (CST)
- questions the defendant's mental state at the time of the trial
- ability to assist legal counsel at the time of the trial and understand charges against them
86
the insanity defense
-defendant admits to having committed the crime
- pleads not guilty due to mental disturbance
- claims he or she was not morally responsible at the time of the crime
- sanity here becomes a legal term
- questions their state at the time of the offense
87
the M-Naugthen Rule
having a mental illness is not equivalent to insanity
- means one could not appreciate "the nature or quality" of their actions as being against the law or did not know that they were wrong
88
Irresistible impulse test
legal doctrine that allows a defense to be found not guilty by reason of insanity if they can prove that a mental illness prevented them from controlling their actions
89
American Law Institute's Model Penal Code of 1962
person is not responsible if at time of conduct person lacks substantial capacity either to appreciate criminality of conduct of to conform conduct to requirements of law
90
civil commitment
individuals who have been admitted involuntarily to a psychiatric facility because others decided they were disturbed enough to require hospitalization
91
procedures for civil commitment
in NY state: 2 physicians agree that a person needs treatment and poses threat to self or others (60 days)
- right to trial, right to counsel
- clear and convincing evidence
92
standards for commitment
definition of dangerousness, determination of dangerousness
false positive - an unjustified commitment
false negative - a failure to commit a person when commitment is justified and necessary
- false positive cannot be easily detected, false neg can
93
the thank you proposition
person will be grateful later, assume positive result and no negative side effects
94
case against civil commitment
denial of liberty without committing a crime, perhaps more problematic when person is not actively psychotic
95
the right to receive treatment
must provide an individualized treatment program for each patient, skilled staff in sufficient numbers to administer such treatment, and a humane psychological and physical environment
96
the right to refuse treatment
issues surrounding competency and informed consent, cannot refuse "routine" treatment
97
APA, professional ethics code, two sections
general principles and enforceable standards
98
beneficence and nonmaleficence
do good and do not harm
99
fidelity and responsibility
be faithful to commitments and trustworthy
100
integrity
be accurate, honest and truthful
101
justice
fairness and equity
102
respect for people's rights and dignity
honor worth and right of all people
103
duty to warn/duty to protect
breach of confidentiality with client in order to protect someone potentially at risk
104
multiple relationship
occurs when a psychologist is in a professional role with a person and at the same time is in another role with the same person, at the same time is in a relationship closely associated with or related to the person with whom the psychologist has the professional relationship, or promises to enter into another relationship in the future with the person or a person closely associated with or related to the person
105
when are dual relationships unethical?
psychologists are required to avoid dual relationships that could compromise objectivity, competence or effectiveness, exploit/harm someone
- ethics code specifically mentions sexual relationships with clients, students, supervises, and research participants
