Human Sexuality Flashcards
abnormal sexual behavior definition:
- causes harm to other people
- causes persistent or recurrent distress
- causes impairment in important areas of fxn’ing
Normal sexual behavior definition
- brings pleasure to oneself and one’s partner involves stimulation of primary sex organs including coitus, devoid of inappropriate feelings of guilt or anxiety and is not compulsive.
- recreational sex is normal
stages of normal sexual response
- desire
- excitement
- plateau
- orgasm
- resolution
Sexual dysfxn =
disturbance in sexual response cycle or pain with intercourse
Abnormality in individual responsiveness:
- indiviudually defined
- usually related to other problems
- must distinguish from physical and psychological
sexual dysfxn can be:
- lifelong or acquired
- generalized or situational
- biological or intrapsychological/intrapersonal
Spectatoring
- stage fright in the bedroom
- person may self-impose performance anxiety
Desire Disorder definition
- desire for and fantasy about sexual activity are chronologically or recurrently deficient or absent
- judged on the basis of the pt’s age and other life circumstances that may affect sexual fxn’ing
Causes of Sexual Dysfxn
- medications, dz, injuries, and psych problems
- medical causes: endocrine, vascular, local genital dz, surgical/post-op problems
- meds: CV meds, psychotropics, hormones, opiates, GI meds, methantheline bromide, anticonvulsants
- psychological: lack of info, negative family/religious attitudes, sexual trauma, rape, incest, childbirth, infidelity, sexual dysfxn in partner, psychiatric illness, interpersonal issues
treatment for sexual dysfxn:
- meds: cyproheptadine, buproprion, yohimbine, amantadine, busprione, sildenafil (viagra)
- psych/behavioral interventions: psychoeducation, sensate focus, homework assignments
Types of Arousal/Erectile Disorders:
- Hypoactive sexual desire disorder
- Sexual Aversion Disorder
- Female Sexual Arousal Disorder
- Male erectile disorder
Arousal Disorder=
- no other Axis I disorder explains it better
- it is not directly caused by substance use (medication or drug of abuse) or by general medical condition
- causes marked distress or interpersonal problems
Hypoactive Sexual desire D/O =
- abnormally low interest in sexual activity
- usually results from other physiological problems
Sexual Aversion disorder =
- active dislike/avoidance of sexual activity
- may lead to anxiety/panic attacks
- often related to: negative parental or religious attitudes, sexual trauma, pattern of sexual pressuring, gender identity or confusion
Female Sexual arousal disorder
- persistent or recurrent inability to maintain physiological arousal ( lubrication) during sexual activity
- sexual desire remains
Male erectile disorder
- recurrent failure to attain/maintain an erection
- sexual desire remains
Orgasmic Disorders =
- Male/Female Orgasmic DIsorder
- premature ejaculation
Male/Female Orgasmic Disorder
- inability to achieve an orgasm
- situational or generalized
- 75% of women do not achieve orgasm
- 25% of men do not achieve orgasm
Premature Ejaculation
-male reaches orgasm with minimal sexual stimulation, often ejaculating earlier than he wants to (before, during or just after penetration)
Sexual Pain disorder
- not caused by a substance use or by general medical condition
- causes marked distress or interpersonal problems
- 2 types: dyspareunia and vaginismus
Dyspareunia
=persistent genital pain before, during or after intercourse in male or female pts
-much more common in women
Vaginismus =
persistent involuntary spasm of musculature of the outer third of the vagina that creates problems with intercourse
Paraphilia =
- attraction to deviant object
- individual is unable to feel sexual gratifications in the absence of their desired stimulus
- recurrent intense obsessions and compulsive behavior related to the desired target
- desire must persist for 6 mnths
- exclusively male disorder
Paraphilia Tx
- is generally ingrained behavior
- hormone and antidepressant meds
- behavioral and cognitive therapies
- group, couple or family therapy
Exhibitionism =
- derives sexual gratification from exposing genitals to un-suspecting strangers
- *shock is arousing
- 100% male
- may prefer this to sexual behavior
Fetishism =
- strong sexual attraction related to non-living object
- sexual activity may be directed toward fetish itself or fetish may be incorporated into sexual intercourse
- may look at, smell, rub or wear object to get sexually aroused
Partialism =
-attraction to a body part
Sadism/Masochism
- sadist= derives sexual gratification from inflicting pain/humiliation
- masochist= derives sexual gratification from being humiliated/injured
Transvestic fetishism =
- man derives sexual gratification from wearing women’s clothing
- must be heterosexual
- often begins in childhood and adolescents
Voyuerism =
- derives sexual gratification from watching nudity or sexual activities of un-suspecting victims
- *not porn
- usually sexually frustrated
Pedophilia =
uncontrollable urge to have sex with children
-persons with pedophilia must be at least 16 y/o and 5 yrs older than child
Types of Molesters
- situational molesters
- preference molesters
- child rapists
Must specify sexual attraction of pedophile
- sexually attracted to women
- sexually attracted to men
- sexually attracted to both
Must specify pedophile’s sexual attraction limitations
- limited to incest
- exclusive: only attracted to children
- nonexclusive: not just children
Tx of Pedophilia
- Biological Tx
- Behavioral tx
- cognitive tx
- group therapy
Biological tx in pedophilia
- lowering level of testosterone = chemical castration
- surgical castration (rare)
- hypothalamotomy
Behavioral tx in pedophilia
adversive tx
Cognitive tx in pedophila
- relapse precention
- tx depression and anger
Group therapy tx
- confront denial and rationalizations
- supportive context to discuss desires and conflicts
Gender Identity disorder
-aka transexualism
=discrepancy btwn assigned sex (biological) and gender role (cultural and societal): feeling that they were born the wrong sex
Gender identitiy disorder features:
- must be evident before age 4
- refusal to engage in gender appropriate behaviors
- strong and persistent cross gender identification: repeated desire to be or insistence are other sex; insistence of dressing in opposite sex’s clothing; strong/persistent preference for cross-sex role in make believe play
Prevalence of transsexualism
- 1 in 30,000 males
- 1 in 100,000 females
Biological factors for Transsexualism
- Abnormal fetal hormones
- vulnerability to high sensory level
Psychological Factors to transsexualism
- parental preferences for child of other sex
- parental unintentional reinforcement of cross-gender bias
Ways to help transsexualsm young child:
-help develop self esteem
-transsexualism in older child tx:
- deal with cross gender behavior and fantasy
- help manage low self esteem
- cope with peer rejection
transsexualism in adults tx:
- focus on the biopsychosocial causes
- provide support and coping strategies
