lecture 10 + ch9 Flashcards
objective indicators of sexual arousal
change in:
- genital blood flow
- skin conductance
- brain activity
subjective indicators of arousal
internal cognitive and emotional processes
outward behaviour
Human sexual response
4 phases characterized in terms of vasocongestion and myotonia:
- excitement
- plateau
- orgasm
- resolution
some versions of this concept add a 5th phase after excitement phase: desire phase
define sexual dysfunction disorders generally
recurrent and persistent disruption of any part of normal sexual response cycle
must exist for minimum 6 months and cause sig. distress/impairment
describe + give 2 examples of sexual interest/arousal disorders
little to no interest in sexual activity (real or imagined)
male hypoactive sexual desire disorder
female sexual interest/arousal disorder
describe + give 4 examples of orgasmic disorders
erectile disorder
female orgasmic disorder
delayed ejaculation disorder
premature ejaculation disorder
what % of the population have erectile disorder (ED)
10%
erectile disorder
distress and problem w achieving/maintaining an erection during sexual activity
female orgasmic disorder
persistent delay or inability to achieve orgasm OR reduced intensity of orgasmic sensations
what % have female orgasmic disorder
10-42%
what % have delayed ejaculation
<1%
what % have premature ejaculation
up to 30%
delayed ejaculation
over 6 months, show delay in or lack of ejaculation, causing distress 75-100% of the time
but what counts as delay? this is debated
premature ejaculation
ejaculation occurring within 1 min of sexual activity, causing distress (only 1-3% meet this criteria tho)
genito pelvic pain / penetration disorder
recurrent issues w:
- vaginal penetration during intercourse
-vulvovaginal or pelvic pain during intercourse
- fear/anxiety abt vulvovaginal/pelvic pain
- tensing of pelvic floor muscles during intercourse
describe the two types of pain experienced in genito pelvic pain/penetration disorder
dyspareunia
- pain during intercourse (initial insertion or upon thrusting)
vaginismus
- muscles of vaginal wall/pelvic floor spasm when vaginal penetration is attempted, paired w pain or fear of pain, and penetration is not possible.
biological causes of sexual dysfunction disorders
medical conditions and medications
not exercising/ not normal weight
not limiting alcohol/nicotine use
psychological causes of sexual dysfunction disorders
stressful situations
childhood abuse
performance anxiety
psychological conditions
prohibitive beliefs
sociocultural causes for sexual dysfunction disorders
relationship itself (like conflict w partner)
gender and cultural scripts
true or false: all treatment options for sexual dysfunction disorder involve psychoeducation
true
biological treatment for sexual dys disorders
hormone replacement, surgery, penile implants (last resort for E.D)
medications (typically for E.D like viagra, but also genito pelvic pain disorder using creams)
why are medications for sexual dys. disorders not always 100% effective?
they dont address psychosocial contributions, so its best to combine w psychotherapy
psychological treatment for sexual dys. disorders
education of sexual anatomy/function
anxiety reduction
changing bad thoughts n beliefs
communication training
structured behavioural exercises (graded tasks that gradually increase amnt of sexual interaction bw partners)
true or false: the DSM-5 CLEARLY distinguishes paraphilias and paraphilic disorders
true
paraphilia
sexual arousal or gratification depends on fantasies or behavior involving socially unacceptable objects, situations, or individuals
involves sexual interest in non-normative targets
paraphilic disorder
this is diagnosed once paraphilia causes significant distress OR harms others or self when acted on
fixation lasts for MORE THAN 6 MONTHS
what is more common, paraphilias or paraphilic disorders?
paraphilia is common, paraphilic disorders are rare
what gender is more likely to have paraphilia or paraphilic disorders?
male
can ppl w paraphilic disorders have multiple paraphilias or just one?
multiple
list the categories under paraphilic disorders
nonhuman objects
nonconsenting persons
pain or humiliation
other specified paraphilic disorders
what disorders fall under the nonhuman objects category
fetishistic disorder
transvestic disorder
fetishistic disorder
strong sexual attraction to/fantasies w inanimate objects OR specific focus on nongenital body parts (like a foot!!!!)
transvestic disorder
intense sexual arousal associated w fantasies/urges/behaviours involving cross dressing
what disorders fall under nonconsenting persons category
exhibitionistic
voyeuristic
frotteuristic
pedophilic
exhibitionistic disorder
urges/acts/fantasies w exposing ones genitals to unsuspecting stranger, often w intent of shocking them
voyeuristic disorder
urges/acts/fantasies w observing unsuspecting person who is naked or having sex
usually starts before age 15, but only diagnosed once 18
not interested in looking at their partner
not interested in interacting w victim
frotteuristic disorder
sexual urges/acts/fantasies w touching or rubbing against nonconsenting person
usually from the side or behind, w no eye or face to face contact
pedophilic disorder
getting sexual gratification thru urges/acts/fantasies w prepubescent / early pubescent kids
does not require an actual sexual act for diagnosis!!!!!
typically starts during adolescence + lasts for entire life
what disorders fall under pain or humiliation category
sexual sadism
sexual masochism
sexual sadism disorder
sexual arousal from inflicting physical or psychological suffering on others
may include pretend or actual infliction of pain
extreme forms involve mutilation or murder
activities do not always involve vaginal intercourse
sexual masochism disorder
sexual arousal from being humiliated, bound or made to suffer
seen in males in females, more common in males
criteria also asks if asphyxiation is present (suffocation/choking)
biological causes of paraphilic disorders
limbic system dysfunction, PFC dysfunction
psychological causes of paraphilic disorders
psychodynamic tradition (fear of castration)
learning (accidentally associate sexual arousal w something)
juvenile sex offenders more likely to have unusual sexual interests etc etc
impulsivity or impulse control issues
true or false: those w paraphilic disorders tend to not seek treatment on their own
true
who encourages/forces those with paraphilic disorders to get treatment?
courts
their partner
SOMETIMES the person w the disorder if they r distressed or afraid of acting on urges
medications to treat paraphilic disorders
SSRIs to reduce sexual drive
more effective for disorders w strong affective components but results r inconsistent , so not typically a great option for treatment
psychological treatment for paraphilic disorders
behavioural approach:
- weakening/eliminating inappropriate behaviour thru extinction or aversive conditioning
- strengthening sexually appropriate behaviour
- develop social skills
cognitive behavioural:
- focus on how person interprets thoughts/emotions in relation to others
relapse prevention
gender dysphoria
distress or impairment in functioning due to marked incongruence bw ones experienced or expressed gender and ones assigned gender
can b seen in any age group
prevalence rate of gender dysphoria
.002-.014% (so small wtf)
causes of gender dysphoria
not much research bc its rare, but possibly:
prenatal exposure to androgens
brain structure (like fibre pathways and cortical thickness)
have there been any treatments that show an effect on gender identity or sexual orientation?
nope, none!
what are some treatments those w gender dysphoria use to help them feel less dysphoric
hormone therapy to reduce distress + improve quality of life
gender affirming surgery (ex; change genitals)
- outcomes usually positive but some have issues w sexual arousal/psychological issues
- not recommended prior to young adulthood
