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Psychiatry > Module 3 > Flashcards

Module 3 Flashcards

1
Q
  • born in May 6, 1856 in Freiburg, Czechoslovakia
    at 4, moved to Vienna
  • after med school, specialized in Neurology in Paris Jean-Martin Charcot
  • taught in hypnosis by Leibault and Bernheim
  • back in Vienna, began clinical work with hysterical patients
  • 1887 - 1897 development of psychoanalysis
  • Died in 1939 in London
A

SIGMUND FREUD

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2
Q
  • anything that comes to mind initially or immediately
A

Free Association

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3
Q

Transference vs Countertransference

A

Transference: patient to therapist; people of the past that reminds you of the person in front of you

Countertransference: therapist to patient; the therapist sees a person from his or her past on the patient

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4
Q
  • process by which patient’s recollection of circumstances at the time symptoms appeared has led those same symptoms to disappear
A

talking cure

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5
Q
  • eruption of repressed thought / feeling when one word is substituted for another reveals an unacceptable unconscious wish
  • evidence of role of unconscious in everyday life
A

Parapraxes

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6
Q
  • vocational choice, selection of romantic partners, dreams, symptoms of psychiatric disorders - have meaning
  • shaped by unconscious forces in dynamic relationship with one another, not randomly selected
A

Psychic determinism

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7
Q
  • developmental successes / failures - central to evolution of adult characters and influential in pathogenesis of adult psychiatric disorder
  • factors include traumas, subtle and repetitive forms of interaction between children and parents, children and siblings
A

Past is Prologue

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8
Q

Topographical Model of the Mind

A

Conscious
Preconscious
Unconcious

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9
Q

Structural Theory of the Mind

A
  1. Id - me only; present since birth
  2. Ego - me and others; arises only 2-3 months after birth
  3. Superego
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10
Q

Structural Theory of the Mind: Ego

A
  1. Conscious and Preconscious functions
    - Logical and abstract thinking and verbal expression
  2. Unconscious domain - Defense Mechanisms
  3. Executive organ of the psyche - controls motility, perception; contact with reality; the delay and modulation of drive expression
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11
Q

Process: Primary Process ( wishing, fantasizing: the desire to create something that would satisfy some strong need going inside you at the time) momentarily pleasurable experiences
Reflex Action
Development: Innate; Biological Component
Principle: Pleasure principle
Conflict: Irrational (if it feels good do it)

A

Id

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12
Q

Process:
Secondary Process (thinking) - in charge of all our higher mental process: Thinking, reasoning, problem solving, judgement, perception, learning
Non reflexive behavior: voluntary movement and coordination, anything we chose to do
Sense of identity and environment
Use of manipulation of Ego Defense Mechanisms

Development: Develops between birth and 2 weeks
Principle: Reality principle
Conflict: Rational (job is to try to maintain stability)

A

Ego

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13
Q

Process: Socialization (end product of socialization)
Development: Entirely learned; demands perfection; social/moral component
Principle: Morality Principle
Conflict: Irrational (demands perfection)

A

Super Ego

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14
Q 
FREUD’S DEVELOPMENTAL STAGES
Age: 0-18 months
Definition: centered in oral zone
Description: Oral sensations –> thirst, hunger, touch by
nipple
Oral tension –> oral gratification
ORAL TRIAD: wish to EAT, SLEEP, RELAX
Objectives: to establish trusting dependence on nursing and sustaining objects
A

ORAL STAGE

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15
Q

Oral Stage: Pathologic and Character Traits

A

Pathologic Traits (adult fixation): excessive oral gratification/deprivation

  • optimism, narcissism, pessimism,
  • dependence, demandingness

Character Traits: capacities to give and receive from others
w/o excessive dependence, capacity to rely on others with
sense of trust

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16
Q

Age: 1-3 years
 Definition: maturation of sphincter control
Description: passivity => activity
anal control and toilet training => increase in ambivalence;
struggle of independence
Objectives: to achieve autonomy and independence without shame/self-doubt from loss of control

A

Anal Stage

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17
Q

Anal Stage: Pathologic and Character Traits

A

Pathologic Traits: orderliness, stubbornness, frugality,
ambivalence, messiness, rage, defiance
Character Traits: personal autonomy, independence and
initiative w/o guilt, lack of ambivalence, capacity for willing
cooperation

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18
Q

Age: 3-5 years
Definition: sexual interest; stimulation/excitement of genitals
Description: penis – organ of interest; unconscious fantasies
of sexual involvement with opposite sex parent
Objectives: to integrate residues of previous stages into
genital-sexual orientation

A

Phallic Stage

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19
Q

Phallic Stage: Pathologic and Character Traits

A

Pathologic Traits:

  • castration anxiety for males
  • penis envy for females
  • patterns of identity

Character Traits:
- sense of sexual identity, regulation of
drive impulses
- superego as source of regulation
- based on identification with parental figures

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20
Q

Age: 5-6 until 11-13 years
Definition: inactivity of sexual drive
Description: homosexual affliations, sublimation into
learning, play activities, exploring environment, skills
development
Objectives: to further integrate oedipal identities; consolidate sex role identity

A

Latency Stage

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21
Q

Latency Stage: Pathologic and Character Traits

A

Pathologic Traits: lack of control, failure to sublimate
energies in learning; excess in skill development, premature closing of personality development

Character Traits: establish decisive pattern of adaptive
functioning, capacity for mastery of objects with a sense of
initiative without sense of inferiority

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22
Q

Age: 11-18 years
Definition: intensification of drives
Description: reopening of conflicts of previous stages,
regression in personality organization
Objectives:
- to separate from dependence/attachment to parents
- to establish mature, non-incestuous object relations, to
achieve mature sense of personal identity, to integrate adult
roles/function

A

Genital Stage

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23
Q

Genital Stage: Pathologic and Character Traits

A

Pathologic Traits: previous unsuccessful resolution/fixation
=> defect of adult personality

Character Traits: capacity for full and satisfying genital
potency, self-integration, self-identity

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24
Q

Ages: 0-1
Focus of Libido: Mouth, Tongue, Lips
Major Development: Weaning off of breast feeding or formula
Adult Fixation Example: Overeating, smoking

A

Oral

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25
Q

Ages: 1-3
Focus of Libido: Anus
Major Development: Toilet training
Adult Fixation Example: Orderliness, Messiness

A

Anal

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26
Q

Ages: 3-6
Focus of Libido: Genitals
Major Development: Resolving Oedipus/Electra Complex
Adult Fixation Example: Deviancy; Sexual Dysfunction

A

Phallic

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27
Q

Ages: 6-12
Focus of Libido: None
Major Development: Developing Defense Mechanisms
Adult Fixation Example: None

A

Latency

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28
Q

Ages: 12+
Focus of Libido: Genitals
Major Development: Reaching Full Sexual Maturity
Adult Fixation Example: If all stages were successfully completed then the person should be sexually matured and mentally healthy

A

Genital

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29
Q
  • born in June 15, 1902 in Germany
  • parents separated before he was born
  • grew up with mother and stepfather
  • schooled in Montessori method of education
  • immigrated to US in 1933
  • Died in 1994
A

Erik Erikson

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30
Q
  • did anthropological work with Indians
  • “Childhood and Society” published in 1950
  • believed that human personality is determined by both childhood and adult experiences
  • formulated theory of human development covering entire span of life cycle : infancy -> old age
A

Erik Erikson

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31
Q

o Psychosocial theory of development
o Crucial steps in person’s relation with social world
o Based on interplay with biology and society

A

“Childhood and Society”

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32
Q
  • development occurs in sequential, clearly defined stages
  • each stage must be satisfactorily resolved for development to proceed smoothly
  • if not, subsequent stages will reflect failure in the form of physical, cognitive, social, or emotional maladjustment
A

Epigenetic Principle

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33
Q

Age: 0-1 year
Corresponding Freudian Stage: Oral
Dominant Zone: Oral Zone = mode of being statisfied
Internal Crises: mistrust if needs are not met;
oral crises – must control infant’s urge to
bite
Resolution: basic trust strong, child maintains hopeful
attitude and develops confidence
Pathologic Outcome: mistrust, depressive, dysthymic,
paranoid, delusional, substance-dependent

A

Trust vs Mistrust

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34
Q

Age: 1-3 years
Corresponding Freudian Stage: Anal
Dominant Zone: Anal Zone = mode of holding on and letting go
Internal Crises:
shame - child is overtly self-conscious through negative exposure and punishment

Resolution: outer control; firmness of caretaker =>
autonomy
Pathologic Outcome: self-doubt, compulsive doubting,
inflexibility, overly compulsive, perfectionist, delinquent

A

Autonomy vs Shame and Doubt

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35
Q

Age: 3-5 years
Corresponding Freudian Stage: Phallic
Dominant Zone: Phallic Zone = mode of competition and aggression
Internal Crises: desire to mimic adults; guilt over goals are contemplated

Resolution: Initiative - tasks for activity’s sake (motor,
intellectual); social role identification
Pathologic Outcome: generalized anxiety disorder (GAD) ,
phobia, sexual inhibitions, conversion disorder,
psychosomatic disease

A

Initiative vs Guilt

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36
Q

Age: 6-11 years
Corresponding Freudian Stage: Latency
Dominant Zone: None
Internal Crises: sense of idequacy, inferiority

Resolution: able to master and complete task, pleasure of
work completion and pride
Pathologic Outcome: severe work inhibition, inadequacy
feeling, increased drive for money, power and work

A

Industry vs Inferiority

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37
Q

Age: 11- late adolescence
Corresponding Freudian Stage: Genital
Dominant Zone: None
Internal Crises: struggle to develop ego, identity role
confusion, doubts about sexual/vocational identity

Resolution: solid identity – sense of inner solidarity with
idea/value of social group
Pathologic Outcome: conduct disorder, disruptive
behaviour, gender identity disorder and psychotic disorder

A

Identity vs Role Diffusion

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38
Q 
Age: 21-40 years
Corresponding Freudian Stage: None
Dominant Zone: None
Internal Crises: isolation – separation from others; view
that others are dangerous

Resolution: intimacy, self-abandonment, intense friendship,
lifelong attachment, mutuality of orgasm
Pathologic Outcome: lack of productivity, schizoid

A

Intimacy vs Isolation

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39
Q 
Age: 40-65 years
Corresponding Freudian Stage: None
Dominant Zone: None
Internal Crises: stagnation, self-concern, isolation and
absence of intimacy

Resolution: generativity – raising children and guiding new
generation; creativity
Pathologic Outcome: depression and substance use

A

Generativity vs Stagnation

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40
Q 
Age: >65 years
Corresponding Freudian Stage: None
Dominant Zone: None
Internal Crises: despair, loss of hope => disgust; fearful
of death

Resolution: integrity – sense of satisfaction (life is
productive and worthwhile); acceptance of one place in life cycle
Pathologic Outcome: anxiety disorder, psychosomatic
disorder, hypochondriasis, depression

A

Integrity vs Despair

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41
Q
  • Born in Switzerland – 1896
  • Doctorate in Biology 22 yo interested psychology
  • studied with Bleuler at Burgholtzli Psychiatric Hospital
  • Similarity with Freud: theoretical system for the development of cognitive abilities (intellectual and perceptual development)
  • Focus on how children and adolescents think and
    acquire knowledge
A

JEAN PIAGET

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42
Q
  • Study of the development of abstract thought on basis of an inherited or biological substrate
  • Intelligent functioning that makes growth of abstract thought possible
  • Progressive development of human knowledge
A

Genetic Epistemology

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43
Q
  • extension of biological adaptation that has a logical structure
A

intelligence

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44
Q
  • growth and development occur in stages, each of which is built on successful mastery of preceding stage
A

epigenesis

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45
Q

Jean Piaget: 3 Basic Components

A
  1. Schema (building blocks of knowledge)
  2. Adaptation processes that enable the transition from one stage to another (equilibrium,assimilation and accommodation)
  3. Stages of Development
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46
Q
  • basic building block of intelligent behavior – a way of organizing knowledge
  • as “units” of knowledge, each relating to one aspect of the world, including objects, actions and abstract (i.e. theoretical) concepts.
A

Schema

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47
Q

True or False

Piaget believed that newborn babies have a small number of innate schemas - even before they have had much opportunity to experience the world. These neonatal schemas are the cognitive structures underlying innate reflexes. These reflexes are genetically programmed into us.

A

True

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48
Q

process of learning and knowing that occurs in a predictable manner

A

COGNITIVE ORGANIZATION

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49
Q
  • ability of person to adjust to and interact with environment
  • result of 2 complementary processes : ASSIMILATION, ACCOMMODATION
A

adaptation

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50
Q
  • taking in of new experiences through one’s own system of knowledge
  • fitting external reality to the existing cognitive structure
  • reality is assimilated
A

assimilation

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51
Q
  • adjustment of one’s system of knowledge to the reality demands of environment
  • occurs when a child adjusts his/her schema to
    new information
  • At the lowest psychological level, accommodation refers to the gradual adaptation of the reflexes to new stimulus
    conditions (conditioning or stimulus generalization)
  • At higher levels it refers to the coordination of thought patterns to one another and to external reality
A

Accommodation

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52
Q
  • using an existing schema to deal with a new object or situation.
  • process of incorporating new information into a pre-existing schema.
A

assimilation

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53
Q
  • the force which moves development along
  • occurs when a child’s schemas can deal with most new information through assimilation
  • an unpleasant state of disequilibrium occurs when new information cannot be fitted into existing schemas (assimilation).
A

EQUILIBRATION

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54
Q
  • an interiorized action which modifies the object of knowledge the essence of knowledge
  • consists of joining objects in a class, to construct a classification
  • it is a set of actions modifying the object, and enabling the knower to get at the structures of the transformation
  • it is a reversible action
  • it is never isolated
A

OPERATION

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55
Q
  • specific cognitive structures with a behavioral pattern
  • Exist in infants as perceptual-motor behavior patterns (e.g. Sucking, grasping reflex, seeing)
  • All species inherit the ability to organize, what is organized is different for different species (Ex. Birds organize flying, human babies organize crawling)
A

Schemata

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56
Q

Factors for Cognitive Development

A
  1. Biological maturation
  2. Experience with the physical environment
  3. Experience with the social environment
  4. Equilibration
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57
Q

STAGES OF COGNITIVE DEVELOPMENT

A
  1. SENSORIMOTOR STAGE (0-2yrs)
  2. PREOPERATIONAL THOUGHT (2-7yrs)
  3. CONCRETE OPERATIONS (7-11yrs)
  4. FORMAL OPERATIONS (11- end of adolescence)
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58
Q
  • Child’s construction of mental schemata is totally

dependent on perceptions and bodily movements

A

Sensorimotor Stage (0 – 2 years) (Object permanence)

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59
Q
  • Use of inborn motor and sensory reflexes (sucking, grasping, looking) to interact and accommodate to external world
A

Sensorimotor Stage: 0 - 2 months

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60
Q

Primary circular reaction - happens when by chance the infant experiences a new consequence of a motor act and tries to repeat the act

  • coordinates activities of body with five senses;
  • reality subjective; displays curiosity
A

Sensorimotor Stage: 2 - 5 months

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61
Q

Secondary circular reaction - seeks new stimuli in environment, anticipate consequences of behavior and act to change environment; intentional behavior begins

A

Sensorimotor Stage: 5 - 9 months

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62
Q

Signs of object permanence, concept that objects exist apart from itself, plays peekaboo, imitates novel behaviors

A

Sensorimotor Stage: 9 months - 1 year

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63
Q

Tertiary circular reaction - seeks new experiences, produces novel behaviors

A

Sensorimotor Stage: 1 - 1½ years

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64
Q

Symbolic thought - uses symbolic representations of events and objects; signs of reasoning; attains object permanence

A

Sensorimotor Stage: 1½ - 2 years

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65
Q
  • 2 - 7 years
  • Use of symbols & language more extensive
  • Intuition more than reasoning
  • No sense of cause and effect
  • Things represented by function
  • Immanent justice-punishment for bad deeds inevitable
    Ex. if a child breaks 1 plate, walang difference when he/she breaks 10 plates; ang point, nakabasag parin sila
A

Preoperational Thought

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66
Q

(Preoperational Thought)

- “me” as center of universe

A

Egocentric thought

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67
Q

(Preoperational Thought)
- type of magical thinking, events occurring together are thought to cause one another
Ex. thunder causes lightning, feeling nila kulog ang
nagcause ng kidlat kasi malakas yung kulog; lucky
underwear pag may exam

A

Phenomenalistic casuality

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68
Q

(Preoperational Thought)
- tendency to endow physical events and objects with lifelike attributes (feelings, intentions)
- Ex. iniisip ng bata yung mga laruan niya din buhay
kaya pinapakain at kinakausap niya

A

Animistic thinking

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69
Q

(Preoperational Thought)
- can represent something (object, event, concept) with signifier
- ex. Drawing (yung bahay ang drawing lang niya bilog pero
para sakanya, bahay yun with family kasi yun lang ang kaya niya i-draw at that age)

A

Semiotic function

70
Q
  • 7 - 11 years
  • Operational thought - operates on concrete, real world ; deals with information outside the child; sees things from other’s perspective
  • Limited logical thought processes
  • Syllogistic reasoning -> logical conclusion formed from 2 premises
  • Can reason, follow rules, regulate themselves, develop moral sense and code of values
  • concept of CONSERVATION, REVERSIBILITY and CONCEPTS OF QUANTITY
  • Task is to organize and order occurrences in real world
A

Concrete Operations (7-11 years)

71
Q

(Concrete Operations)

  • ability to recognize that shape and form of objects may change while maintaining other characteristics that enable them to be recognized as same; ex. clay
A

Conservation

72
Q

(Concrete Operations)

  • capacity to understand relation between things, to understand that one thing can turn into another and back again ex. Ice and water
A

Reversibility

73
Q

(Concrete Operations)

  • one of Piaget’s most important cognitive developmental theories
  • measures of substance, length, number, liquids, and area
A

Ability to understand concepts of quantity

74
Q
  • 11 years - late adolescence
  • Operates in formal, highly logical, systematic, and symbolic manner
  • Use of language complex
  • Abstract thinking – interest in philosophy, religion, ethics, politics (Ex. relationship of wrist watch and clock
    concrete sense: parehas sila may numbers; Formal: orasan sila)
  • Prone to self-conscious behavior
  • May return to egocentric thought but higher level
  • Task is to deal with future and its possibilities
A

Formal Operations

75
Q

Hypothetico-deductive thinking - make a proposition/hypothesis and test it with reality

Deductive reasoning - going from general to particular
Deductive > inductive reasoning

A

Formal Operations

76
Q

(Formal Operations)

  • belief that others are preoccupied with the adolescent’s appearance and behavior, when in fact, the adolescent is preoccupied with these things
    Ex. Can change events by thought alone
A

Adolescent egocentrism

77
Q
  • British psychoanalyst

- Mother child attachment was an essential medium of human interaction

A

JOHN BOWLBY (1907-1990)

78
Q
  • emotional tone between children and their caregivers

- evidenced by an infant’s seeking and clinging to the caregiver

A

Attachment

79
Q
  • mother’s feelings for her infant
A

Bonding

80
Q
  • Glendale Ohio 1913
  • Received many academic awards
  • Died in 1999
  • Innovative methodology tested Bowlby’s theory
  • Help expand the theory and new directions
  • Attachment figure as a secure base
  • Strange Situation
A

Mary Salter Ainsworth

81
Q

Outcome of the Strange Situation

A

Secure Attachment
Anxious-ambivalent insecure attachment
Anxious-avoidant insecure attachment

82
Q
  • Proposed theory to describe how young children acquire a sense of identity separate from mothers
  • Theory of Separation-individuation
A

MARGARET MAHLER (1897 – 1985)

83
Q

Theory of Separation – Individuation

A
  1. Normal Autistic Phase

2. Normal Symbiotic Phase

84
Q
  • Birth to 2 months
  • Periods of sleep outweigh periods of arousal
  • Major task of phase is to achieve homeostatic
    equilibrium with the environment
    - Ex. ang baby pag iniwan mo magisa, pagbalik mo,
    ganun padin siya kasi ang nangyayari sa kanya, puro
    internal like autistic (different from Anti-Social and
    Schizo)
A

Normal autistic phase

85
Q
  • 2 – 5 months
  • Dim awareness of caretaker, but infant still functions as
    though he or she and caretaker were in state of
    undifferentiation or fusion
  • Social smile characteristic (2 – 4 months)

Ex. may concept na ng others si baby pero etong
‘others’ na to nakadikit sa kanya, so pag gutom siya,
nararamdaman ng care giver na gutom yung baby at
pupunta siya sa baby so feeling ng baby, iisa lang sila

A

Normal symbiotic phase

86
Q

Separation – Individuation Proper (Subphases)

A

First: differentiation
Second: practicing
Third: rapprochement
Fourth: consolidation and object constancy

87
Q
  • 5 - 10 months
  • Process of hatching from autistic shell (i.e., developing more alert sensorium that reflects cognitive and neurological maturation)
  • Progressive neurological development and increased alertness draw infant’s attention away from self to outer world
A

First subphase: Differentiation

88
Q
  • Physical and psychological distinctiveness from mother is gradually appreciated
  • Beginning of comparative scanning (i.e, comparing what is and what is not mother)
  • Characteristic anxiety: stranger anxiety which involves curiosity and fear (most prevalent around 8 months)
A

First subphase: Differentiation

89
Q
  • 10 - 18 months
    Beginning of this phase marked by upright locomotion (child has new perspective and mood of elation)
  • Mother used as home base
  • Characteristic anxiety: separation anxiety
  • Ability to move autonomously increases children’s exploration of the outer world
A

Second subphase: Practicing

90
Q
  • 18 - 24 months
  • Toddler - more aware of physical separateness (helplessness, dependence)
  • Child tries to bridge gap between self and mother - concretely seen as bringing objects to mother
  • Need for independence alternates with need for closeness
A

Third subphase: Rapprochement

91
Q
  • Mother’s efforts to help toddler often not perceived as helpful, temper tantrums are typical
  • Characteristic event: rapprochement crisis
  • wanting to be soothed by mother and yet not being able to accept her help
A

Third subphase: Rapprochement

92
Q

Symbol of rapprochement: child standing on threshold of door not knowing which way to turn in helpless frustration

Resolution of crisis occurs as child’s skills improve and child is able to get gratification from doing things

A

Third subphase: Rapprochement

93
Q
  • 2 – 5 years
  • Child better able to cope with mother’s absence and to engage substitutes
  • Child can begin to feel comfortable with mother’s absences by knowing she will return
A

Fourth subphase: Consolidation and Object Constancy

94
Q
  • Gradual internalization of image of mother as reliable and stable
  • Through increasing verbal skills and better sense of time, child can tolerate delay and endure separations
A

Fourth subphase: Consolidation and Object Constancy

95
Q

Phases

A
  1. Hatching – 5 – 9 months
    infant is alert to events, objects and persons and so begins to“hatch” from the symbiotic orbit with his or her cargiver
  2. Practicing – 9 – 16 months
    child’s developing motor skills permit far-ranging exploration of the environment. The affective tone of the practicing toddler is one of pleasure, energy and narcissism as the child revels in his or her motor autonomy, although the child occasionally returns to the caregiver for reassurance, encouragement and “re-dueling”
  3. Reapproachment – 15 months
    o Beginning
    o Crisis
    o Solution
96
Q

(1) ..perception of being male of female, and all those thoughts, feeling, behaviors, connected with sexual gratification and reproduction, including the attraction of one person to another.
(2) involves feelings of desire, behavior that brings pleasure to oneself and one’s partner… Devoid of guilt or anxiety… and not compulsive.
(3) Determined by anatomy, physiology, psychology, culture,
relationship with others, and developmental experience

A

Human Sexuality

97
Q

Physiological Aspects of Human Sexuality

A
  • Influenced by hormonal changes during pregnancy/ genetic predisposition
  • Sexual Dysfunction:
    libido diminution
    erectile dysfunction
98
Q

Social Aspects of Human Sexuality

A
  • Governed by rules of behavior and status quo
  • Influenced by social norms and vice versa
  • Example: gender identity
99
Q

Psychological Aspects of Human Sexuality

A
  1. Sexual Identity
    - Gender Identity; Orientation; Intention
  2. Sexual Function
    Sexual Desire; Sexual Arousal; Orgasm
  3. Sexual Satisfaction
100
Q
  • Sense of self as masculine or feminine
  • Gender in which a person identifies
  • Gender that other people attribute to the individual on the basis of gender role
  • Is affected by a variety of social structures
A

Gender Identity

101
Q

Gender Identity and Sexual Identity

A
  • In majority it is congruent
  • Human beings are cisgendered based on their biological sex
  • Gender is social and sex is biological

Remember:
Gender Identity: presentation
Sex Identity: biological (XX and XY; Penis and Vagina)

102
Q
  • How you present yourself adapt to the role in the society
  • Usually related to and derived from gender identity
  • Includes all disclosures of a person as having the status of a man or a woman
A

Gender Role

103
Q
  • Psychological
  • Describes the direction of an individual’s
    sexuality
  • Also known as Sexual Preference
    Markers:
    a. Self-labelling - boy or girl
    b. Actual sexual behavior – hkatikasan o kahinhinan
    c. Sexual Fantasy – what do you want during sex?
    d. Erotic arousal pattern – for males: physical preference; for females: attitude/characteristics/amoy
  • “dynamic and multi-variable process”
A

Sexual Orientation

104
Q

Sexual Orientation and Mental Illness

A
  • Psychiatric disorders were seen as more prevalent among homosexually active people
    Depression/ anxiety; Suicide; Substance abuse (alcohol/ smoking)
  • Sense of alienation predisposes them to mental illness
105
Q

What a person wants to do to his/ her partner during the sexual behavior and what is done to him or her

A

Sexual Intention

106
Q
  • Interest that a person experiences
    Drive – biological aspects
    Motive – psychological aspects
    Wish – social aspects
A

Sexual Desire

107
Q

The emotion of sexual excitement based on pelvic vasocongestion and autonomic arousal

A

Sexual Arousal

108
Q

Stimulated by high levels of arousal that results to brief, intense pleasure and release of pelvic congestion

A

Orgasm

109
Q

Private judgment that sexual behavior is pleasurable

A

Sexual Satisfaction

110
Q
  • Sexual response is a true psychophysiological experience
  • There is….
    Arousal
    Experience of tension
    Orgasm
A

Normal Sexual Behavior

111
Q

Four phase response cycle in relation to stimulation

A

Phase 1: Desire
Phase 2: Excitement
Phase 3: Orgasm
Phase 4: Resolution

112
Q
  • Motivation, drives, and personality towards the love object
  • Sexual fantasies and desire to have sexual activity
A

Phase 1: Desire

113
Q
  • Subjective sense of pleasure from
  • Psychological stimulation (fantasy, presence of the love object)
  • Physiological stimulation (Stroking or kissing)
  • Combination of both
A

Phase 2: Excitement

114
Q

Phase 2: Excitement (Male)

A
  • Lasts several minutes to several hours
  • Penile tumescence (increase in diameter/ length)
  • Tightening and lifting of the scrotal sac and elevation of the testes; 50% increase in the size of the testes
  • 2-3 drops of mucoid fluid that contain viable sperm are secreted at the height of excitement
  • Increase in heartbeat and respiration rates
  • Heightened excitement lasts 30 secs to several minutes
115
Q

Phase 2: Excitement (Female)

A
  • Lasts several minutes to several hours
  • Vaginal lubrication, nipple erection
  • Clitoral enlargement, thickening of the labia minora
  • Increase in breast size (25%)
  • vaginal color change to dark purple; vaginal transudate appears 10-30 secs after arousal
  • Labia minora changes color to bright and deep red
  • Increase in the heartbeat and respiration rates
  • Heightened excitement lasts 30 secs to several hours
116
Q
  • Peaking of sexual pleasure with subsequent release of sexual tension and rhythmic contraction of the perineal muscles and the pelvic organs
A

Phase 3: Orgasm

117
Q

Phase 3: Orgasm (Male)

A
  • 3-15 seconds
  • Forceful emission of semen (ejaculation) (12-20 inches at age 18, decreasing with age to seepage at 70)
  • 4-5 rhythmic spasms of the prostrate, seminal vesicles, vas, and urethra
  • Loss of voluntary muscle control (facial grimacing; carpopedal spasm)
  • BP up to 40-100 mm systolic, 20-50 mm diastolic
  • HR up to 180 beats per minute
  • Respiration up to 40 respirations a minute
118
Q

Phase 3: Orgasm (Female)

A
  • 3-15 seconds
  • Breasts may become tremulous
  • Uterine contractions throughout orgasm
  • Contractions of the lower third of the vagina
  • Loss of voluntary muscle control (carpopedal spasm; facial grimacing)
  • Hyperventilation and tachycardia
119
Q
  • Disgorgement of blood from the genitalia (detumescence)
  • With subjective feelings of well-being, general relaxation and muscle relaxation
  • If it does not occur, may take 2-6 hours associated with irritability and discomfort
  • Women do not have a refractory period
A

Phase 4: Resolution

120
Q
  • Nearly all men and three fourths of all women masturbate sometime during their lives
  • Moral taboos have generated myths that masturbation causes mental illness or a decrease in sexual potency
A

Masturbation

121
Q
  • Form of release from excessive sexual tension
  • is probably a universal and inevitable aspect of psychosexual development, and in most cases…
  • ADAPTIVE
  • Becomes pathologic if it becomes a compulsion
A

Masturbation

122
Q
  • An alternative lifestyle
  • A variant of human sexuality
    Definition:
  • A person’s overt behavior, sexual orientation, and a sense of personal or social identity.
    Lesbian or gay men
    Same sex or male female
A

Homosexuality

123
Q
  • 11 years through end of adolescence
  • Struggle to develop ego identity
  • Danger of role confusion, doubts about sexual and vocational identity
A

STAGE 5: Identity vs. Role Diffusion

124
Q
  • is defined as any activity that involved going out with someone of the opposite sex whether in a group or as a couple
    Group date
    Single date
A

Date

125
Q

Proportions ever Dated

A
  • Most Filipino youth aged 15-24 years have dated
  • 60% or 3 out of 5 have experienced going out on a date
  • 49% of the teenagers claimed to have gone out on a date
  • Dating either in groups or alone with someone of the opposite sex occurs quite early 10-13 years for only a few youth
  • By the age 15 the propensity to date picks up
  • At 16, more than a third of boys and 2 out of 5 girls date
126
Q

GROUP DATES OR SINGLE DATES

A
  • 3 out of five-group date
  • Girls more likely to start with group date
  • Boys immediately launched into a single date
127
Q

TIMING OF THE FIRST DATE

A
  • First date can trigger a series of events that might change the subsequent life of a person
  • During teens, boys date twice as much as girls
  • Age 15, 1/5 of the girls have dated while only 1/10 in boys have dated
128
Q

FIRST SINGLE DATE PARTNER

A
  • Irrespective of gender, the partner was a classmate or officemate introduced by a friend or a neighbor
- At the time of the first date:
46% already a boyfriend/girlfriend
28% friend
16% admirer or crush
10% acquaintance
129
Q

DATING WITH A STEADY PARTNER

A
  • Boys revealed that their partners became their girlfriends after only 3 months
  • Girls report the same after 6 months
  • Favorite dating places: movie houses, restaurants, parks and shopping malls
130
Q

CHAPERONES

A

Traditional role: ensure that no untoward incident happens during a date

Nowadays: chosen to assuage and persuade the parents or partner to agree to the date and leaves the couple during the actual date

131
Q

BEHAVIOR DURING first DATES

A

36% Kissed
3% sexual intercourse
*17 % of the girls confided intercourse happened without their consent

132
Q

IN THE SUBSEQUENT DATES

A

the number of those engaging in very intimate behaviors (petting and intercourse) increased dramatically from 15-28%

133
Q
  • The urban youth have their first crushes at 14
  • Admiring the opposite sex at 15
  • Group date at 16
  • Single dates with BF and GF at 17-18
A

Dating and related events

134
Q

Differentials in dating behavior

A
  • Those who have had exposure to urban life were prone to date about a quarter more than those who have always remained in the rural setting.
  • Having lived in a dorm, studied in a private school and living away from parents increase tendency to date
135
Q

Determinants of dating behavior

A
  • Live away from parents
  • Older age
  • Lived in the city
  • Attends private school
  • Fathers are college graduates
  • Less strict parents
  • Unstable marriage of parents
136
Q
  • one pays for sexual favors usually with a prostitute
    Prevalence:
    1 in 14 single men
    1 in 8 married men
A

COMMERCIAL EXPERIENCE

137
Q
  • Sexual intercourse with acquaintance or friend

- Most common first sexual experience of boys

A

CASUAL SEX

138
Q
  • Sexual experience before a union is formed

- Experienced more equally between males and females

A

COMMITTED SEX

139
Q

INITIAL EXPERIENCE WITH SEX

A
  • Occurs at 18 years old
  • 18% of today’s youth engage in premarital sex
  • Most popular venue for sexual encounters is the HOME
  • Majority of the youth did not use contraception because they did not expect to have sex at that time
  • In those who practiced contraception, withdrawal and condom were the most commonly used
140
Q

Conclusion

A
  • 49% have gone out on a date
  • dating occurs as early as 10 yrs old
  • girls more likely to group date first
  • first date can trigger events that may change the person’s life
  • Initial experience with premarital sex occurs at age 18
  • Most common first sexual experience with boys is casual sex
141
Q

Conclusion 2

A
  • Majority of the youth did not use contraception because they did not expect to have sex and despite acceptance of such practices, virginity is still a highly regarded virtue
  • SEXUALITY is at it’s peak in adolescence as expressed in dating behavior and premarital sex
142
Q
  • is currently classified as a non-psychiatric disorder. Still, divergent beliefs and values about it still prevail.

-Not a disorder
In 1973, was eliminated as a diagnostic category by the APA
In 1980, was removed from the DSM

A

Homosexuality

143
Q
  • An alternative lifestyle; A variant of human sexuality

- A person’s overt behavior, sexual orientation, and a sense of personal or social identity. (Lesbian or gay men)

A

Homosexuality

144
Q

a negative attitude toward or fear of homosexuality or homosexuals

A

Homophobia

145
Q
  • the belief that a heterosexual relationship is preferable to all others;
  • implies discrimination against those practicing other forms of sexuality.
A

Heteroxism

146
Q

Prevalence

A

Kinsey, 1948
10 % of men
5 % of women
37% had a homosexual experience

1988 - 2-3% in men

1989 - Less than 1% of both sexes are exclusively homosexual

1993
1%
2% lifetime homosexual experience

147
Q

Prevalence: Onset (Homosexuality)

A

— Males: Before puberty
50% have genital experience with a male partner
- Exploratory, shared with a peer
- Lack a strong affective component

— Females: middle to late adolescence or young adulthood

— More lesbians than gay men engaged in heterosexual experience
56% of lesbians
19% of gay men

148
Q

Early life situations that can result in male homosexuality:

A
  1. A strong fixation on the mother
  2. Lack of effective fathering
  3. Inhibition of masculine development by the parents
  4. Losses when competing with brothers and sisters
149
Q

Homosexuality: New concepts of psychoanalytic factors

A

Gay men have same-sex fantasies at 3-5 years old
father or father surrogate
- greater secretiveness than other boys, self-isolation and excessive emotionality
- Feminine traits - identification with the mother or mother surrogate

Similar psychodynamics in women.
- The little girl does not give up her original fixation on the mother as a love object and continues to seek it in adulthood.

150
Q

Homosexuality: Genetic and biological components

A

Lower levels of circulatory androgens

Prenatal androgens - organization of the central nervous system

  • Effective presence- sexual orientation toward females
  • Deficiency – sexual orientation toward males
151
Q

Homosexuality: Genetic and biological components 2

A
  • Higher incidence of homosexual concordance among monozygotic twins than among dizygotic twins
  • Chromosome studies have been unable to differentiate homosexuals from heterosexuals
  • familial distribution
152
Q

Homosexuality: Sexual behavior patterns

A

Similar to heterosexual behavior patterns

Relationship patterns:

  • Common household, monogamous or primary relationship for decades
  • Or fleeting sexual contacts
  • Male-male relationships appear to be less stable
  • Diminished promiscuity after AIDS
  • Subject to social and legal discrimination
153
Q

Homosexuality: Psychopathology

A
  • Parallels that found in heterosexuals
  • Higher suicide rate
  • Adjustment disorder or depressive disorder
  • ICD 11- ego-dystonic sexual orientation: a person’s desire to change gender identity or sexual preference that is not in doubt…because of associated psychological and behavioral disorders.
154
Q
  • “a process by which an individual acknowledges his or her sexual orientation in the face of societal stigma and with successful resolution accepts himself or herself”
  • Acceptance of his or her sexual orientation
  • Integration of this orientation into all spheres (social, vocational, and familial)
A

Coming out

155
Q
  • Degree of disclosure about sexual orientation to the external world
  • Difficulty is a common cause of relationship problems
  • May contribute to poor self-esteem and poor functioning
A

Coming out

156
Q

Homosexuality: What causes it?

A

Conservative: Multiple causes including: poor parenting, sexual molestation during childhood, perhaps demon possession. Addiction traps them in the lifestyle.

Liberal: Genetically predetermined perhaps with some unknown environmental factor in early childhood which “turns on” the gene or genes.

157
Q

Homosexuality: At what age does it become obvious in an individual?

A

Conservative: Teenage years, after puberty, when it is chosen.

Liberal: Homosexual orientation can be reliably predicted in pre-school children.

158
Q

Homosexuality: Is it sinful?

A

Conservative: Yes. Some consider it more serious than many other sins. It endangers the family and thus social stability.

Liberal: Neither heterosexuality, bisexuality, or homosexuality are inherently sinful. It is free of sin if it is safe, consensual and, perhaps, within a committed relationship.

159
Q

Homosexuality: Is it natural and normal?

A

Conservative: It is an unnatural, abnormal, deviant, and disordered behavior.

Liberal: It is normal and natural, for a minority of humans.

160
Q

Homosexuality: What should a homosexual do?

A

Conservative: Choose to remain celibate, or attempt to change their orientation to heterosexual.

Liberal: Choose either celibacy or monogamy with a same-sex partner. Changing sexual orientation is not possible in all, or essentially all, cases.

161
Q

Homosexuality: God’s attitude towards the homosexual and towards homosexuality

A

Conservative: He loves the sinner, but hates homosexuality, which is always sinful, irrespective of the nature of the relationship.

Liberal: Loves the person. Various beliefs: May approve of the activity if it is based on love and commitment. May approve if it is safe and consensual.

162
Q

Homosexuality: Is it changeable?

A

Conservative: Yes, through counseling and prayer. But it requires effort because it is so addictive.

Liberal: No. Sexual orientation is always or almost always fixed and cannot be changed in adulthood.

163
Q

Homosexuality: Is reparative therapy effective?

A

Conservative: Yes; it is an effective method to changing homosexuals into heterosexuals.

Liberal: It is a useless, ineffective, and potentially dangerous therapy that can trigger suicide.

164
Q

Homosexuality: What happens to children raised by gays or lesbian parents?

A

Conservative: A large percentage will become homosexuals. Those who don’t will be disturbed by the presence of homosexuality in the home.

Liberal: The vast majority of their children will be heterosexual – apparently more accepting and less judgmental than average.

165
Q

Homosexuality: Should churches recognize committed same-sex relationships?

A

Conservative: No. Gay relationships are an abomination, hated by God.

Liberal: Perhaps. Some feel that all loving, committed adult relationships should be recognized and supported by religious groups.

166
Q

Homosexuality: Should same-sex couples given benefits now given to opposite-sex married couples?

A

Conservative: No. Same sex marriages or civil unions threaten regular families and thus the stability of society.

Liberal: Yes. Official recognition of their relationship and government benefits are a fundamental civil right.

167
Q

Homosexuality: Should sexually active gays be eligible for ordination as clergy?

A

Conservative: No. It would be a major lowering of standards. It would condone seriously sinful behavior.

Liberal: Yes. One’s orientation has no bearing on the ability to be a priest, minister, rabbi, or pastor.

168
Q

(Daniel Stern)

A bodily self based on physiological needs

A

Emergent self (birth to 2 months)

169
Q

(Daniel Stern)

Associated with greater interpersonal relatedness

A

Core sense of self (appears between 2 and 6 months)

170
Q

(Daniel Stern)

A major advance involving the matching of intrapsychic states between mother and infant

A

Sense of subjective self (appears between 7 and 9 months)

171
Q

(Daniel Stern)

  • Coincides with the ability to think symbolically and communicate verbally
A

Verbal or categorical sense of self (appears between 15 and 18 months)

172
Q

(Daniel Stern)

The historical view of the self encountered when patients present their life stories in treatment

A

Narrative sense of self (appears between ages 3-5)

Psychiatry (6 decks)

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