kjb jbn Flashcards
Gender Dysphoria
Gender dysphoria is characterized by a “type of gender identity in which the individual has the psychological sense of belonging to one gender while possessing the sexual organs of the other.” The disorder is only diagnosed if this condition “causes significant distress or disability.”
Gender dysphoria often begins in childhood,
and there are “different set of criteria for children vs. adolescents/adults.”
Paraphilic Disorders
Paraphilic disorders involve “recurrent sexual urges and sexually arousing fantasies involving nonhuman objects (such as articles of clothing), inappropriate or nonconsenting partners (e.g., children) situations producing humiliation or pain to oneself or one’s partner.” These urges, fantasies, or behaviors must cause “distress OR impairment OR entails harm, or risk of harm, to self or others” to constitute a disorder.
Distinction from Paraphilia
It’s important to note that one “can have a paraphilia without having a disorder.”
Exhibitionistic Disorder
Recurrent urges to expose genitals to unsuspecting strangers, primarily affecting men who report “unsatisfactory relationships with women.”
Fetishistic Disorder
Recurrent sexual urges involving “inanimate objects, such as an article of clothing (bras, panties, hosiery, boots, shoes, leather, silk) nongenital body part (e.g., feet) referred to as partialism.”
Cross Dressing (Transvestic Disorder):
Recurrent urges and fantasies involving cross-dressing for sexual arousal, typically in heterosexual men.
Voyeuristic Disorder:
Recurrent urges involving watching unsuspecting people who are undressed or engaging in sexual activity. Individuals may be “often lacking in sexual experiences and may harbour deep feelings of inferiority or inadequacy.”
Frotteuristic Disorder:
Recurrent urges involving bumping and rubbing against nonconsenting victims in crowded places, almost exclusively diagnosed in men.
Pedophilic Disorder:
Recurrent urges involving sexual activity with prepubescent children. Diagnosis requires the individual to be at least 16 years old and at least 5 years older than the child. “Diagnostic indicator is the extensive use of child pornography.” Notably, men with this disorder are often “law-abiding, respected citizens” and research suggests they “are more likely to have been sexually abused as children.” This disorder has severe “Effects of Child Sexual Abuse on Victims,” including “Psychological problems Eating disorders Premature sexual behaviour or promiscuity Drug abuse Suicide attempts P T S D.”
Sexual Masochism Disorder:
Recurrent urges related to sexual acts involving being humiliated or made to suffer.
Sexual Sadism Disorder
Recurrent urges involving inflicting humiliation or pain on sex partners. “Sadomasochism: sexual activities between consenting partners involving the attainment of gratification by means of inflicting and receiving pain and humiliation.”
Differential Diagnosis (OCD):
It’s important to differentiate paraphilic disorders from “Sexual OCD-SOCD,” where intrusive thoughts focused on sexuality cause fear, distress, and disgust, but do not necessarily involve acting on those thoughts.
Theoretical Perspectives:Psychodynamic: (paraphilic)
Views paraphilic disorders as defenses against “unresolved castration anxiety.” For example, “Exhibitisionist: shock from victims reinforces confidence in having a penis.”
Learning Perspectives (paraphilic)
Emphasizes “associations between sexual experiences and certain objects/ situations.”
Biological Perspectives: (paraphilic)
Suggest “higher-than-average sex drives in men with paraphilias” and potential “disturbances in brain networks involved in sexual arousal.” A “diathesis-stress model” involving early trauma and biological factors is likely.
Treatment
Many individuals may not seek treatment. Available options include “Psychoanalysis Cognitive-Behavioural therapy aversive conditioning Biomedical Therapies” such as “S S R I s” to reduce obsessional thoughts and “Antiandrogen drugs” to reduce testosterone levels.
Sexual Assault:
While “Not a disorder onto itself,” it can be associated with paraphilic disorders. It involves “Non-consensual bodily contact for sexual purpose.” “The central issue…is whether consent was freely given.” Notably, “30% of all women aged 15 and older – have been sexually assaulted at least once” and “the victim is acquainted with the assailant in 80% of sexual assault cases.” Theoretical perspectives suggest “desires to dominate women or express hatred toward them may be more prominent motives…than is sexual desire.”
Sexual Dysfunction Disorders:
Definition: These disorders involve “problems with sexual interest, arousal, or response” and are widespread, affecting “over 40% of women and 20–30% of men.”
Major Categories:Disorders involving problems with sexual interest or arousal:
Includes “Female sexual interest/arousal Disorder Male hypoactive sexual desire disorder Male erectile disorder.” Defining “abnormal” arousal is complex and influenced by “Lifestyle Sociocultural factors Relationship quality Age.”
Disorders involving problems with orgasmic response:
Includes “Female orgasmic disorders” (marked delay or absence of orgasm) and “Male orgasmic disorders” (“Delayed ejaculation” or “Premature ejaculation,” defined as occurring within about one minute of vaginal penetration).
Problems involving pain during sexual intercourse or penetration (in women):
“Genito-pelvic pain/penetration disorder” involves difficulty with penetration, pain, fear of pain, and pelvic floor muscle tension. Controversy exists as many cases may have undiagnosed medical causes.
Theoretical Perspectives:Biological Perspectives:
Involve factors like “testosterone…thyroid overactivity or underactivity diabetes medical conditions.”
Psychological perspectives:
Include “conditioned anxiety” (Learning Perspectives), and “irrational beliefs and attitudes performance anxiety” (Cognitive Perspectives).
