Exam 3 PSY 395 Flashcards
What is a sexual dysfunction?
Disorders involving either a disruption of the sexual response cycle or pain during sex
Describe the sexual response cycle
desire –> excitement/arousal –> organism –> resolution
what is the name of the disorder where a man has a lack of interest in sexual activity and fantasy?
Male Hypoactive Sexual Desire Disorder
what is the name of the disorder for females that have a lack of interest in sexual activity and fantasy?
Female Sexual Interest/ Arousal Disorder
what are factors of Female Sexual Interest/Arousal Disorder and what are treatment plans for it?
Factors: insufficient engorgement/lubrication
Treatment: Couple’s therapy focused on communication
and Sensate Focus Techniques
inability to achieve/maintain erection
Erectile Disorder (ED)
treatment for Erectile Disorders?
medications, sensate focus techniques + Paradoxical Instruction
Female Orgasmic Disorder
women with difficulty reaching orgasm and other contributing factors
treatment for female orgasmic disorder?
education about female sexuality, self-stimulation instructions
Delayed Ejaculation
- men with difficulty reaching orgasm
Treatment: similar to erectile dysfunction and female orgasmic disorder. May also include cues from masturbation into partnered sex
Premature Ejaculation
man reaches orgasm before, on, or shortly after penetration
Treatment: special condoms, squeeze technique, start/stop technique
sexual dysfunctions with pain - Genito-Pelvic Pain/Penetration Disorder
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
Treatment for Genito-Pelvic Pain/Penetration Disorder
- 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
lifelong dysfunction
existed, without relief, since the person’s earliest sexual experiences
acquired dysfunction
develops after at least one period of normal functioning
generalized dysfunction
present in all sexual situations at the time of diagnosis
situational dysfunction
occurs only in certain situations or with certain partners (ex. when under stress)
what is the general risk for sexual dysfunction by gender?
Women are at higher risk for dysfunction in all except for climaxing too early
Paraphilias
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
Fetishistic Disorder - Paraphilia
reliance on inanimate objects or on a body part for sexual gratification
Transvestite Disorder - Paraphilia
sexual gratification through dressing in the clothes of another gender
Exhibitionistic Disorder - Paraphilia
sexual gratification through display of one’s genitals to an involuntary observer
- having sex openly in a public space
Voyeuristic Disorder - Paraphilia
sexual gratification through clandestine observation of other people’s sexual activities or sexual anatomy
- secretly watch someone undress
Sexual Sadism Disorder - Paraphilia
sexual gratification through infliction of pain and/or humiliation on others
- forcing someone to have sex
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
Frotteuristic Disorder - Paraphilia
sexual gratification through touching and rubbing against a non-consenting person
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
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
Medication Treatment for Paraphilia’s
- reduce androgen activity - Depo Provera, Androcur
- Telstar (triptorelin) - inhibits gonadotropin secretion
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
gender affirmative treatment
treatment making one’s body more consistent with gender identity
- hormones, hormone blockers, facial surgery, breast removal/augmentation, electrolysis
typical requirements for gender affirming surgery (WPATH guidance document)
- detailed mental health evaluation
- affirm long-standing diagnosis, rule out contraindications
- often including a duration of psychotherapy - hormonal therapy to initiate changes for 1 year
- living full-time in experienced gender for 1 year
- capacity for informed consent including age of majority
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)
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)
causes of gender dysphoria
intersex conditions - biological disorder of sex development
- partial androgen insensitivity
- congenital androgen hyperplasia (too much testosterone produced by adrenal gland)
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
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
delusions of persecution
disorder when a person has an unfounded belief that other intend to harm them (targeted, spied on, government tracking, stealing, etc)
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)
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
loose associations
ideas jump from one to another, leading the person further and further away from the original topic
poverty of speech
mental dysfunction that involves a decrease in the amount of speech a person produces
- take longer to talk
- use fewer words