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ABNORMAL PSYCHOLOGY > Lecture 4b - Sexual disorders > Flashcards

Lecture 4b - Sexual disorders Flashcards

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1
Q

Categories of sexual dysfunctions

A
  1. Sexual interest, desire and arousal
  2. Orgasmic disorder
  3. Sexual pain
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2
Q

Interest/arousal disorder in women - Criteria

A
  1. Diminished, absent, or reduced frequency of at least 3 of the following for 6 months or more:
    +interest in sexual activity
    +sexual/erotic thoughts or fantasies
    +Initiation of sexual activity and responsiveness to partner’s attempts to initiate
    +Sexual excitement/pleasure during 75% sexual encounters
    +Sexual interest/arousal elicited by any internal or external erotic cues
    +Genital or nongenital sensations during 75% sexual encounters.
  2. Causes marked distress or interpersonal problems.
  3. Not due to a medical illness, another psychological disorder (except another sexual dysfunction or the effects of a drug)
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3
Q

Criteria for Hypoactive sexual desire disorder in Men

A
  1. sexual fantasies and desires, deficient or absent
  2. causes marked distress or interpersonal problems
  3. Not due to a medical illness, another psychological disorder (except another sexual dysfunction) or the effects of a drug.
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4
Q

Criteria for Male Erectile disorder

A

On at least 75% of sexual occasions:
+Inability to attain an erection
+Inability to maintain an erection for completion of sexual activity
+Marked decrease in erectile rigidity interferes with penetration or pleasures
+Not due to a medical illness, another psychological disorder (except another sexual dysfunction) or the effects of a drug.

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5
Q

Kinds of Orgasmic disorders

A
  1. Female orgasmic disorder
  2. Early ejaculation disorder
  3. Delayed ejaculation disorder
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6
Q

What is Female orgasmic disorder?

A

Absence of orgasm after sexual excitement

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7
Q

What is early ejaculation disorder?

A

Ejaculation that occurs too quickly

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8
Q

What is delayed ejaculation disorder?

A

Persistent difficulty ejaculating

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9
Q

Criteria for Female Orgasmic disorder

A

On at least 75% of sexual occasions:
+Marked delay, infrequency or absence of orgasm
+Markedly reduced intensity of orgasmic sensation
+Causes marked distress or interpersonal problems
+Not due to a medical illness, another psychological disorder (except another sexual dysfunction) or the effects of a drug

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10
Q

Criteria for delayed Ejaculation

A

+ Marked delay, infrequency or absence of orgasm on at least 75% of sexual occasions.
+Causes marked distress or interpersonal problems
+Not due to a medical illness, another psychological disorder (except another sexual dysfunction) or the effects of a drug

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11
Q

What are the main sexual pain disorders?

A
  1. Genitopelvic pain / penetration disorder

2. Vaginismus and Dyspareunia

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12
Q

Criteria for Genitopelvic pain/ penetration disorder

A

+ Persistent or recurrent pain during intercourse
+Diagnosable in both men and women (rare in men)
+ R/O Medical cause (e.g. infection), lack of vaginal lubrication or menopausal problems.
+Most women experience sexual arousal and orgasms from manual or oral stimulation that does not involve penetration.
+ 10-30% prevalence rates

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13
Q

Criteria for Genitopelvic pain / penetration disorder

A

+ Inability to have vaginal intercourse/penetration
+Marked vulvar, vaginal or pelvic pain during vaginal penetration or intercourse attempts.
+Marked fear or anxiety about pain or penetration
+ Marked tensing of the pelvic floor muscles during attempted vaginal penetration
+Causes clinically significant distress or interpersonal problems
+ Not due to another psychological disorder, a medical condition, or the effects of a drug.

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14
Q

Etiology of sexual dysfunction

A

Masters & Johnson (1970) two-tier model:

  1. Immediate causes
    +Performance fears
    +Adoption of spectator role
2. Distal (historical) causes
\+Sociocultural
\+Biological causes
\+Sexual traumas
\+Homosexual inclinations
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15
Q

Distal and Immediate Causes of Human Sexual inadequacies

A 
Distal
\+Guilt about sexuality from religious and other cultural influences
\+ Rape or sexual abuse
\+ Homosexual preferences
\+Lack of knowledge about sexuality
\+Excessive alcohol intake
\+Physiological problems
\+Sociocultural factors

Immediate
+Spectators role and fears about performance

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16
Q

Predictors of successful sexual functioning

A 
Psychological factors
\+Good emotional health
\+Attraction toward partner
\+Positive attitude towards partner
\+Positive sexual attitude

Physical factors
+Good physical health
+Regular appropriate exercise
+Good nutrition

Social and Sexual history factors
+Positive sexual experiences in past
+Good relationship with partner
+Sexual knowledge and skills

17
Q

Predictors of poor sexual functioning

A 
Psychological factors
\+Depression or anxiety disorders
\+Focus on performance
\+Too much routine
\+Poor self-esteem
\+Uncomfortable environment for sex
\+Rigid, narrow attitude toward sex
\+Negative thoughts about sex
Physical factors
\+Heavy drinking
\+Cardiovascular problems
\+Diabetes
\+Neurological diseases
\+Low physiological arousal
\+SSRI medications
\+ Antihypertensive medication
\+Other drugs
Social and Sexual history factors
\+ Rape or sexual abuse
\+Relationship problems such as anger or poor communication
\+Long periods of abstinence
\+History of hurried sex
18
Q

Biological factors of sexual dysfunctions

A 
\+Diseases of vascular system
\+Diseases of the nervous system
\+Low levels of testosterone or estrogen
\+Heavy alcohol consumption before sex
\+History of chronic alcoholism
\+Heavy cigarette smoking
\+Medications - Antihypertensives and SSRIs
19
Q

Psychosocial factors of sexual dysfunctions

A

+Rape
+Early childhood sexual abuse
+ Relationship problems - anger, hostility, poor communication, underlying anxiety about relationship security
+Psychological disorders - Major depression, anxiety, or panic disorder
+ Low physiological arousal
+Stress and exhaustion
+Negative cognitions

20
Q

Treatments of sexual dysfunction

A

+Anxiety reduction
+directed masturbation
+Procedures to change thoughts and attitudes - sensory awareness procedures and rational emotive therapy
+Sexual skills and communication training
+Couples therapy
+Medications and physical treatments - Squeeze technique for early ejaculation - PDE-5 inhibitors for erectile dysfunction (Viagra, Cialis and Levitra)

21
Q

What are Paraphilias?

A

Recurrent sexual attraction to unusual objects or sexual activities

+For at least 6 months
+ Deviation (para) in what the person is attracted to (Philia)
+ Should only be diagnosed when they cause marked distress or are done with nonconsenting persons.

22
Q

What are the categories of Paraphilias?

A
  1. Sexual attraction to an inanimate objects

2. Sexual attractions based on children

23
Q

What are the different types of Paraphilias?

A
  1. Fetishistic disorder
  2. Transvestic disorder
  3. Pedohebephilic disorder
  4. Voyeuristic disorder
  5. Exhibitionistic disorder
  6. Frotteuristic disorder
  7. Sexual sadism disorder
  8. Sexual masochism disorder
24
Q

What is a Fetishistic disorder?

A

+For at least 6 months, recurrent and intense sexually arousing fantasies, urges or behaviors involving the use of nonliving objects or nongenital body parts.

+The sexually arousing objects are not limited to articles used in cross-dressing or to devies designed to provide tactile genital stimulations, such as a vibrator.

25
Q

Prevalence of Fetishistic disorder

A

+Occurs most often in men
+Object often necessary for sexual arousal
+Attraction to object irresistible and involuntary
+Fetishes often co-occur with other paraphilias.

26
Q

Pedohebephilic Disorder

A

Pedos = child
hebe= pubscence
philia=attraction

+Sexually arousing urges, fantasies or behaviours involving sexual contact with a prepubertal or pubescent child
+Ofender at least 16 years old and 5 years older than victim
+child pornography is widely used
+Person has acted on urges or the urges and fantasies cause marked distress or interpersonal problems.
+Victims usually known to pedophile
+Most pedophilia does not involve violence other than the sexual activity

27
Q

What is incest?

A

+Subtype of pedohebephilic disorder
+Most common brother and sister
+ Less common but more pathological - father and daughter
+Incest taboo almost culturally universal
+genetically adaptive
+Offspring of father-daughter or brother and sister have a greater likelihood of inheriting pairs of recessive genes with possible negative biological effects.

28
Q

What is Voyeuristic disorder?

A

+Sexually arousing fantasies, urges, or behaviors while observing other who are unclothed or engaging in sexual activity
+Almost always men
+Excitement comes from knowing the victim is unaware of the voyeur; element of risk important
+Seldom results in physical contact
+Orgasm achieved by masturbation
+Victims unaware that they are being watched

29
Q

Diagnostic criteria of voyeuristic disorder?

A

+For at least 6 months, recurrent and intense sexually arousing fantasies, urges, or behaviors involving the observation of unsuspecting others who are naked, disrobing, or engaged in sexual activity

+Person has acted on these urges with a nonconsenting person, or the urges and fantasies cause marked distress or interpersonal problems

30
Q

What is Exhibitionistic disorder?

A

+Intense desire to obtain sexual gratification by exposing one’s genitals to unwilling strangers
+Victims can be children
+Seldom results in physical contact
+Usually involves desire to shock or alarm victim
+ Often comorbid with voyeuristic and frotteuristic disorders

31
Q

Diagnostic criteria for Exhibitionistic disorder?

A

+For at least 6 months, recurrent, intense, and sexually arousing fantasies, urges, or behaviors involving showing one’s genitals to an unsuspecting person

+Person has acted on these urges to a nonconsenting person, or the urges and fantasies cause clinically significant distress or interpersonal problems

32
Q

What is Frotteuristic disorder?

A

+Sexually oriented touching of a
nonconsenting person

+The individual rubs his genitals against a women’s body or fondles her breast or genitals

+Often occurs in crowded subway or other public place

33
Q

What is sexual sadism and sexual masochism disorders?

A

• Intense and recurrent desire to obtain or increase sexual gratification by inflicting pain or psychological suffering on another person
• Must cause clinically significant distress or the person has acted on these
urges with a nonconsenting person.
• Intense and recurrent desire to obtain or increase sexual gratification through receiving pain or humiliation
• Must cause marked distress or impairment in functioning

34
Q

What is Asphyxiophilia?

A

+Sexual arousal by oxygen deprivation

+Can result in death or serious brain damage

35
Q

What is the Etiology of the Paraphilias?

A

Neurobiological factors
• Male hormones or androgens
+Almost all individuals with paraphilias are men
+Do not have unusual levels of testosterone

Clasical conditioning
+Research has not supported orgasm conditioning hypothesis

Operant conditioning
+Poor social skills or reinforcement of unconventionally

+History of childhood physical and sexual abuse

+Alcohol and negative affect are common triggers

+Cognitive distortions

36
Q

Treatment for Paraphilias

A

+ Incarceration and ordered treatment are common

+Often difficult to interpret outcome from treatment studies

Studies vary greatly
Many lack control groups
Dropout rates high

37
Q

Treatment of Paraphilias

A 
Enhance motivation
• Denial and minimization of problem often present
• Some blame the victim
\+Lack of motivation for treatment
  \+Drop out of treatment
Cognitive behavioral treatment
• Aversion therapy
• Covert sensitization
• Counter distorted thinking
• Often combined with social skills and empathy training
Biological treatments
• Castration used in past
• Medications
Hormonal agents to reduce androgens
Depo 
SSRIs

ABNORMAL PSYCHOLOGY (7 decks)

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