Final Exam New Material Flashcards
Gottman’s Four Horseman of the Apocalypse
- “predicts divorce” if the couple has lots of:
- criticism
- contempt
- defensiveness
- withdrawal
Gottman’s magic ratio in stable marriages
- 5 positive to 1 negative interaction
Tannen’s argument about communication between women and men
- women and men from different linguistic communities
- implies huge gender differences in communication and great difficulty in cross-gender communication
Sexual Disorder
- problem with a sexual response that causes a person mental distress
- aka sexual dysfunction
- can have lifelong disorder or acquired disorder
Desire Disorders (2)
- hypoactive sexual desire
- discrepancy of sexual desire
Hypoactive Sexual Desire (HSD)
- aka inhibited sexual desire, low sexual desire
- lack of interest in sexual activity, sharply reduced interest, or lack of responsive desire
- 10-15% of women, half as many men
- women over 65, 50%
DSM-5 new desire disorder
- Female sexual interest/arousal disorder
- merged female low sexual desire with female arousal disorder
- controversial (split up men and women, no category for those who are trans)
Responsive desire
- individual feels desire as sexual activity begins
Arousal Disorders (2)
- Female sexual arousal disorder (FSAD)
- Erectile Disorder (ED)
Female Sexual Arousal Disorder
- lack of response to sexual stimulation
- 10% of women, more in menopause (less lubrication)
- combination phys and psychological
Erectile Disorder (ED)
- inability to have OR maintain an erection
- ## lifelong vs acquired vs situational
Orgasmic Disorders (3)
- premature ejaculation
- delayed ejaculation
- female orgasmic disorder
Premature ejaculation/early/rapid ejaculation (PE)
- ejaculating “too soon”
- international society for sexual medicine declares less than 1 minute from intromission AND feeling out of control AND distress
Delayed Ejaculation
- man cannot have an orgasm even with high arousal and sufficient stimulation
- 10% of men (usually older)
- can cause very long intercourse (could be good or bad)
Female Orgasmic Disorder
- anorgasmia
- inability to orgasm
- “frigidity”
- lifelong vs acquired vs situational
- not really a disorder because so common (20% of women)
Pain Disorders (2)
- Dyspareunia
- Vaginismus
Dyspareunia
- Painful Intercourse
- can be diagnosed in men and women
Vaginismus
- Spastic contraction of the muscles surrounding the vaginal entrance
- outer 1/3 of vagina
Genito-pelvic pain disorder
- DSM-5 merged dyspareunia and vaginismus for females, often co-occurence
Causes of Sexual Disorders (3 categories)
- Organic (Physical) factors
- Psychological factors
- New View
Organic (Physical) causes of sexual disorders: Premature ejaculation
- psychological mostly
- prostatitis, m.s.
Organic (Physical) causes of sexual disorders: Delayed Ejaculation
- m.s.
- spinal cord injury
- prostate surgery
- psychological
Organic (Physical) causes of sexual disorders: dysparenia
- vaginal infection
- PID
- vaginal entrance disorder
- pelvic disorders
Organic (Physical) causes of sexual disorders: ED
- vascular pathology
- damage to lower spinal cord
- hypogonadism
- hyperprolactinemia
- stress/fatigue
- prostate surgery
- diabetes major cause ( can cause circulatory and nerve damage)
Organic (Physical) causes of sexual disorders: Drugs (Alcohol)
- three categories: short-term pharmacological effects, expectancy effects, and long-term chronic alcohol abuse
- short term pharm effects: alcohol is a depressant and sexual arousal is suppressed at high levels of alcohol intake
- expectancy effects: individuals expect alcohol to loosen them up and make them more social
- long-term chronic alcohol abuse: frequently have sexual disorders as a result of atrophied testes (lower T production)
Organic (Physical) causes of sexual disorders: Drugs (illicit/recreational- marijuana)
- marijuana associated with orgasmic disorder though some say it increases their sexual desire and pleasure
- effect of cannabinoids depends on gender (low doses increase desire, high doses sexual problems arise)
Organic (Physical) causes of sexual disorders: Drugs (illicit/recreational- cocaine)
cocaine: increase sexual desire, enhance sensuality, and delay orgasm
* chronic use associated with ED, low sexual desire, and orgasmic disorders
* injections most negative effects
Organic (Physical) causes of sexual disorders: Drugs (illicit/recreational- amphetamines)
- increased sexual desire and arousal
Organic (Physical) causes of sexual disorders: Drugs (illicit/recreational- methamphetamine)
- when high, people have tendency to engage in risky sexual behaviors
Organic (Physical) causes of sexual disorders: Drugs (illicit/recreational- opiates)
- morphine, heroin, methadone
- strong suppression effects on sexual desire and response
- heroin decreases T levels in males
Organic (Physical) causes of sexual disorders: Drugs (prescription)
- anti-hypertension drugs: erection problems
- antihistamines: reduce vaginal lubrication
- psychiatric schizophrenia drugs: delayed/dry orgasms in men
- tranquilizers & antidepressants: improve sexual responding but can also have arousal problems and delayed orgasm
Psychological causes of sexual disorders (5 main categories)
- immediate
- prior learning
- emotional factors
- combined cognitive and physiological
- relationship factors
Psychological causes of sexual disorders: Immediate (4)
- anxiety
- cognitive interference
- failure to communicate
- ineffective stimulation
spectatoring
- thinking about worries/insecurities about the sexual activity while partaking in the sexual activity
- judging oneself from outside their body
- men more worried about performance, women about appearance
Psychological causes of sexual disorders:: prior learning
- sexual abuse in childhood
- growing up in a sex-negative family
Psychological causes of sexual disorders: Emotional factors
- ex. disgust
Psychological causes of sexual disorders: relationship factors
- relationship conflict
- fear of intimacy (with anyone, not specific to partner)
Sexual Excitation/Inhibition model as it pertains to sexual disorders
- those with sexual disorders likely to be low on excitation and high on inhibition
New View of Women’s Sexual Problems
- Tiefer
- criticism of medicalization of problems, think it should focus more on society
- 4 main categories
New View of Women’s sexual problems: 4 main categories
- Sociocultural, political, or economic factors
- partner or relationship
- psychological factors
- medical factors
New View of Women’s sexual problems: sociocultural, political, or economic factors (4)
- lack of education
- perceived inability to meet cultural ideals
- conflict between culture of origin norms and dominant cultural norms regarding sexuality
- lack of interest b/c of family/work pressures
New View of Women’s sexual problems: partner or relationship (5)
- fear of partner due to abuse
- discrepancy in desire or preference
- ignorance/inhibition of sexual communication
- loss of sexual interest b/c of conflicts
- loss of arousal b/c of partner’s health
New View of Women’s sexual problems: psychological factors (3)
- past experiences
- attachment/rejection
- fear of pregnancy, STIs
New View of Women’s sexual problems: medical factors (4)
- medical conditions
- STI/STDs
- pregnancy
- side effects of medication
Types of Sex Therapies (4 main categories)
- Behavioral Therapy
- Cognitive-Behavioral Therapy
- Couple Therapy
- Drug Therapy
Behavioral Therapy for Sexual Disorders
- stems from learning theory; behaviorism
- if you learned something you can unlearn it
- believe the disorder is maintained by immediate causes
Masters & Johnson type of therapy
- basically behavioral therapy
- sensate focused exercises & sex education
- treated hetero and homo couples
Sensate focused exercises
- masters & johnson
- every disorder affects both partners
- both partners need to attend
- gradual advancement of sexual activity (systematic desensitization)
- assignments to do as a couple (ex. touching then sexual touching then insertion…)
Cognitive Behavioral therapy for sexual disorders
- behavioral therapy + cognitive restructuring (changing the way one thinks about something)
Couple therapy for sexual disorders
- treat relationship problems
- assess the couple’s sexual scripts
Sex Therapy Online
- more affordable, anonymous
- chatrooms and appointments online or over phone
- bad because no licensing of online sex therapists (can easily be a poser)
- mostly provide positive encouragement and information
Specific Treatments for Specific Problems: stop-start
- aka Squeeze
- used for treating premature ejaculation
- partner stimulates man’s penis to erection, and then stops, repeats
- teaches that one can be aroused without ejaculation
Specific Treatments for Specific Problems: masturbation
- used to help women with orgasmic disorder
Specific Treatments for Specific Problems: kegel exercises
- strengthen pubococcygeus muscles (PC)
- enhances blood flow; strengthens arousal
- prescribed for both men and women
Specific Treatments for Specific Problems: Bibliotherapy
- reading book by sex therapist
Viagra
- introduced 1998
- relaxes smooth muscle in corpora cavernose allowing blood flow into penis
- PDE5 inhibitor
Cialis
- like viagra, works for 24 hours instead of a couple hours
- argument that sex shouldn’t have to be so carefully planned out
- no negative effects on sperm production
- also inhibits PDE5
Erection drugs (4)
- Viagra
- Cialis
- Levitra
- Zydena
- all work by bloodflow (PDE5 inhibitors)
Drugs for women’s desire problems (2)
- lybrido/lybridos
- flibanserin (Addyi)
Lybrido/Lybridos
- Lybrido/Lybridos used for hypoactive sexual desire disorder (HSDD)
- Lybrido: testosterone + PDE5 inhibitor
- Lybridos (used for those on SSRIs): testosterone + buspirone (short-term 5-HT supression)
- not yet approved by the FDA
Flibanserin (Addyi)
- originally an ineffective antidepressant
- developed in Germany for women’s sex problems
- lowers serotonin, raises dopamine and norep
- FDA rejected in 2010, but purchased by Sprout Pharmaceuticals
- launched pink viagra campaign
- FDA approved in 2015
- not proved to work, not selling well
Androgel
- T that is sprayed on body
Aprostadil
- intracavernosal injection
- injected into penis or suppository or cream
- vasodilator
- from before viagra era
Suction device for ED
plexiglass tube + rubber band on unerect penis
- suck top of tube, keep rubber band on to keep blood flow there
- take off when done
Surgical Prothesis for ED
- last resort
- two tubes replacing corpora cavernosa, pump fluid from reservoir
- release fluid when done
- also silcone-like rod implantation (less costly, non-inflatable)
- 25% dissatisfied after surgery
Vaginitis
- infection of the vagina; not sexually transmitted
- prevented by thoroughly washing and drying vulva after shower
- never go immediately from anal intercourse to vaginal intercourse
Candida
- aka yeast infection; moniliasis
- usually present in the vagina but when aggravated by change in environment (e.g. pH) can over-flourish
- not sexually transmitted, but intercourse may aggravate it
- major symptom is thick, white curd-like discharge; extreme itching
- treatment OTC
- can be transmitted to baby during birth
- similar symptoms to bacterial vaginosis
Prostatitis
- inflammation of the prostate gland
- caused by E. coli, gonorrhea, or chlamydia
- treated with antibiotics
- frequent urination, fever, chills, pain
15-24 year olds account for what % of all new STD cases?
- 50%
% of sexually active adolescent girls have an STD
- 25%, HPV, chlamydia, and trich most common
Tell me everything you know about chlamydia
- most common bacterial STI
- symptoms close to gonorrhea but less painful
- males: mild pain when urinating 7-21 days after infection
- most cases asymptomatic
- if left untreated can lead to PID and infertility
- antibiotics: azithromycin, doxycyclin (resistant to penicillin)
Antibiotics to treat chlamydia (2)
- azithromycin, doxycyclin
- resistant to penicillin
HPV (everything except vaccine information)
- viral
- causes genital warts 3-8 months post-contraction; many infections wart-free
- high prevalence (43% of US women 14-59 yrs)
- high risk and low risk HPV
- high risk: strains 16&18, more likely to lead to cervical cancer
- low risk: strains 6 & 11, cause genital warts
- most infections go away on own within 2 yrs
- no test for HPV in males
- 70% of cervical cancers caused by types 16 & 18
HPV Vaccine info
- Guardisil/Cervarix
- 3 shots over 6 months ideally at age 11-12, but approved up to age 26
- approved for boys in 2009
- Guardisil 4 protects against strains 16,18, and two other wart-causing strains
- Guardisil 9 (2015) protects against 9 types
- additional 5 types account for 15% of cervical cancers
Herpes
- Herpes Simplex Virus (HSV)
- HSV-1: usually cold sores on mouth (less severe)
- HSV-2: usually genital herpes
- symptoms: blisters w/in 2-3 wks of infection
- no cure
- treatment: acyclovir, valacyclovir, famciclovir which shorten outbreaks and reduce reoccurrences
- increases risk of HIV infection, transmission to fetus during birth (c-section usually performed)
HIV & AIDS
- two main types in US: HIV-1 and HIV-2
- 1.2 mil diagnosed in US as of 2012, 660,000 have died
- worldwide 75 mil infected
- risk factors worldwide: heterosexual sex
- risk factors in US: homosexual sex
Main causes of HIV contraction for US men
- men who have sex with men
- injection drug use
Main causes of HIV contraction for US women
- heterosexual sex
- injection drug use
One reason why African Americans disproportionally infected with AIDS
- mutation in CCR5 gene creates resistance to HIV
- mutation selected for during black plague in Europe, many without mutation died off
- European & European Americans much more likely to carry mutated gene than AA
description of HIV on a cellular level
- retrovirus
- invades and destroys T-cells (CD4+)
- coreceptors CCR5 & CXCR4 allow HIV to enter T-Cells
Transmission of HIV (4)
- bodily fluids (semen, blood, unlikely saliva and unlikely vaginal cervical secretions)
- contaminated blood, transfusions
- contaminated hydrodermic needles
- during childbirth
Who is at higher risk of HIV infection when engaging in anal intercourse?
- the receptive person, semen carries HIV
Progression of HIV & AIDS: Stage 0
- initial infection
- develop antibodies (2-8 wks)
- asymptomatic
- T-cell count 1000/uL of blood
- can last for years (non-progressors)
Progression of HIV & AIDS: Stage 1
- T-cell count >500
- no symptoms or can have swollen lymph nodes and night sweats, flu-like symptoms
Progression of HIV & AIDS: Stage 2
- T-cell count 200-499