HC3: Sexual disorders and gender variations Flashcards
De 4 D’s
- Deviance
- Distress
- Dysfunction
- Danger
1 of 3 categories in DSM-5 referring to sexuality; sexual dysfunctions
Persistent inability to function normally in some area of the sexual response cycle
1 of 3 categories in DSM-5 referring to sexuality; paraphilic
Repeated and intense sexual urges or fantasies in response to objects or situations that society deems inappropriate, and they may behave inappropriate as well
1 of 3 categories in DSM-5 referring to sexuality; gender dysphoria
Persistently feel that they have been born to the wrong sex, identify with the other gender, and experience significant distress or impairment because of these feelings
Sexual Dysfunctions: betekenis en diagnostiseren
- Set of disorders in which people have difficulty responding sexually or experiencing sexual pleasure
- To be diagnosed problems must:
- Occur most of the time for at least 6 months
- Cause significant distress or impairment
- Not be due to another nonsexual psychiatric problem
The sexual response cycle
- Desire fase; sexual urges in response to sexual fantasies or enviromental ques.
- Arousal fase; psychological experience of sexual arousal, vasocongestion = increased blood flow to penis in males and pelvic area in females, and myotonia = muscular tension.
- Plateau fase; high but stable level before orgasm
- Orgasm fase; in males sense of inevitability of ejaculation, followed by ejaculation; in female, rhytmic contractions of the vagina en more irregular contractions of the uterus.
- Resolution fase; decreased arousel, deep relaxation possible.
Sexual disfunctions terminology
- Life long; Some people struggle with sexual dysfunction their whole lives
- Acquired (verworven); For others, normal sexual functioning preceded the disorder
- Global (gegeneraliseerd); In some cases, the dysfunction is present during all sexual situations
- Situational (situatief); In others it is tied to particular situations
Sexual dysfunctions/disorders; DSM-IV TR → DSM-5
DSM-IV TR
Sexual desire disorders
- Hypoactive sexual desire disorder
- Sexual aversion disorder
Sexual arousal disorders
- Female sexual arousal disorder
- Male erectile disorder
Orgasmic disorders
- Female orgasmic disorder
- Male orgasmic disorder
- Premature orgasmic disorder
Sexual pain disorders
- Dyspareunia
- Vaginismus
DSM-5 (DSM-5 R since november 2022)
Sexual desire disorders
- Male hypoactive sexual desire disorder
- Female sexual interest/arousal disorder
Sexual arousal disorder
- Erectile disorder
- Female sexual interest/arousal disorder
Orgasmic disorders
- Female orgasmic disorder
- Premature ejaculation
- Delayed ejaculation
Sexual pain disorder
- Genito-pelvic pain/penetration disorder
functioning. The term sexual dysfunction refers to ___.
Problems with the normal sexual response cycle
Jacob (21 years old) has a reduced interest in sex. The psychologist thinks he has a male hypoactive sexual desire disorder. Which statement is correct?
In order to diagnose Jacob, the lack of interest should be present for 6 months, during that time he has few fantasies or desires
Some men, like Jacob, report never having had much interest in sex, either with other people or privately, as in the viewing of erotic films, masturbation, or fantasy. According to the DSM 5 , these men are most likely diagnosed with ________ disorder.
lifelong male hypoactive sexual desire
Janel finds that she reaches the sexual excitement phase of the sexual response cycle but has difficulty moving past that stage. She is most likely experiencing ___
anorgasmia
Janel’s friend Claudia has vaginismus. Anytime something is inserted into the vagina (penis, finger, tampon or speculum) what happens?
The muscles spasm and will not allow anything inside
Janel’s friend Claudia has vaginismus (DSM IV TR). Which symptoms belong to the criteria of genito pelvic pain/penetration disorder.
a. Difficulty having vaginal penetration during intercourse
b. Significant vaginal or pelvic pain when trying to have intercourse or penetration
c. Significant fear that vaginal penetration will cause vaginal or pelvic pain
d. Significant tensing of the pelvic muscles during vaginal penetration
Checklist voor; Female orgasmic disorder
- Individual usually displays a significant delay, infrequency, or absence of orgasm, and/or is unable to achieve past orgasmic intensity
- Individual experiences significant distress
- Present for at least 6 months
Interplay of Biological, Psychological, and Social Factors in Sexuality.
- Biological factors
- Psychological factors
- Social factors
Paraphilic disorders
- Characterized by intense sexual urges, fantasies, or behaviors involving objects or situations outside the usual sexual norms
- May involve multiple paraphilia displays
- Relatively few people receive a formal diagnosis
- In general, a diagnosis is applied when paraphilias cause a person significant distress or impairment or when the satisfaction of the paraphilias places the person or other people at risk of harm
Types of paraphilias
Involve:
- The consent of others
- Nonconsenting others
- Contact with others
- Those that do not necessarily require contact with others
Checklist voor Paraphilic disorder
Paraphilic disorder
* For at least 6 months, individual experiences recurrent and intense sexually arousing fantasies, urges, or behaviors involving objects or situations outside the usual sexual norms
(nonhuman objects; nongenital body parts; the suffering or humiliation of oneself or one’s partner; or children or other nonconsenting persons)
* Individual experiences significant distress or impairment over the fantasies, urges, or behaviors
In some paraphilic disorders pedophilic disorder, exhibitionistic disorder, voyeuristic disorder, frotteuristic disorder, and sexual sadism disorder the performance of the paraphilic behaviors indicates a disorder, even in the absence of distress or impairment
Explanations and research voor paraphilic disorders
- Although theorists have proposed various explanations for paraphilias, there is little formal evidence to support them
- Definitions of these disorders are strongly influenced by the norms of the society in which they occur
Leertheorieën: klassieke conditionering voor oproepen gedrag.
Fetish doordat object een keer samenkwam met opwinding.
Crossdressing gebaseerd op afspraken/conventies in samenleving wat mannen/vrouwen dragen. Rok in Schotland voor mannen normaal.
Paraphilic disorders (5); Fetishistic disorder
Sexual arousal or gratification resulting from handling a fetish (or a specific part of the body other than the sexual organs)
Paraphilic disorders (5); Transvestic disorder ( transvestism , cross dressing)
Kleden als ander geslacht
Paraphilic disorders (5); Exhibitionistic disorder
Laten zien geslachtsdelen aan mensen die geen toestemming geven. Spanning om gepakt te worden, dus naaktstrand geen spanning.
Paraphilic disorders (5); Voyeuristic disorder
Kijken naar mensen die ontkleden/seks hebben (soms via camera).
Paraphilic disorders (5); Frotteuristic disorder
Schuren met geslachtsdeel terwijl ander het niet doorheeft.
Paraphilic disorders (5); Pedophilic disorder
Paraphilic disorders (5); Sexual masochism disorder
Plezier aan het beleven van pijn
Paraphilic disorders (5); Sexual sadism disorder
Sexual sadism disorder is characterized by taking sexual pleasure from humiliation, fear, or another form of mental harm to a person. Sadistic acts include restraint (such as ropes, chains, or handcuffs), imprisonment, biting, spanking, whipping, or beating
A diagnosis of fetishism involves…
Intense sexually arousing fantasies and urges involving non
animate objects, and this causes them personal distress or affects social and occupational functioning
For a diagnosis of sexual sadism disorder to be made:
Following criteria must be met in addition to sexual fantasies, urges, or behaviors involving inflicting pain and humiliation on the person’s sex partner.
The urges and behavior must cause the person significant distress or impairment in functioning or involve a non consenting partner.
DSM-5 definition of gender dysphoria
- Extreme incongruence, distress (partly due to prejudice/stigma) and impairment
- Controversial: expectation that gender dysphoria may be dropped in the future
Checklist: Gender dysphoria
- For 6 months or more, an individual’s gender related feelings and/or behaviors are at odds with those of his or her assigned gender, as indicated by two or more of the following symptoms:
- Gender related feelings and/or behaviors clearly contradict the individual’s primary or secondary sex characteristics
- Powerful wish to eliminate one’s sex characteristics
- Yearning for the sex characteristics of another gender
- Powerful wish to be a member of another gender
- Yearning to be treated as a member of another gender
- Firm belief that one’s feelings and reactions are those that characterize another gender
- Individual experiences significant distress or impairment
Gender variations: Treatment aspects
- Psychological: Build awareness of needs and feelings; reduce anxiety, depression, and anger; improve self image; develop coping skills
- Biological: Gender
change procedures| gender reassignment surgery | gender confirmation surgery | gender affirming surgery, hormone therapy (estrogen/ - Cognitive behavioral: Transgender education programs, support programs
Which statement is true when considering a diagnosis of gender dysphoria?
Mensen die genderincongruentie ervaren en die wel lijden onder stress en beperkingen, kunnen een diagnose rechtvaardigen.
Which disorder was replaced by gender dysphoria as a new
diagnostic category in the DSM 5?
Gender identity disorder
Necrofilie
kikken op dode mensen
Hypoactive sexual desire disorder
A persistent or recurrent absence of sexual fantasies and desire for sexual activity, causing marked personal distress or interpersonal difficulties.
