Paraphilias and Sexual Disorders Flashcards
exposure of one’s genitals to an unsuspecting stranger. Onset <18yo
NO DIFFERENCE IN IQ, VOCATION, EDUCATION LEVELS.
Etiology? Problems with assertiveness, relationship difficulties/rejection, power, hostility towards women
exhibitionistic
the act of observing an unsuspecting person bake, disrobing or engaging in sex. Fantasize about the person but do not seek sex. Onset <15yo
voyeuristic
touching and rubbing against a nonconsenting person and fantasizes that he is in a relationship with them. Age 15-25yo
frotteuristic
psychological and physical suffering of the victim is sexually exciting. Onset of fantasies in early age and progress to acts by adulthood
sexual sadism
the use of non living objects. The objects were often somehow significant in childhood or adolescence.
fetishistic disorder
cross-dressing heterosexual male, arousal is from the act of cross-dressing, not the actual clothing items. Different from gender identity disorder
transcestic fetishistic
co-morbid symptoms of sex offender population
intimacy deficits, hyper-sexuality, emotional ID with children, deviant arousal, psychopathy, antisocial personality
recurrent intesne sexually arousing fantasies/urges/behaivour involving sexual activity with prepubescent child/children.
Must be at least age 16 yo and at least 5 yrs older than the child
Specifically excludes an individual in late teens involved in an ongoing sexual relaitonhsip with a 12 or 13 yo
pedophilia
subtypes of pedophilia
limited to incest, sexually attracted to males, females or both, or non-exclusive or exclusive pedophilia
etiologies of pedophilia
Maladaptive extreme attraction to youthfulness
Masturbatory conditioning: initial sexual experiecnes as a child is reinforced by using these memory during orgasm
Learned behaviours
Biological and genetic predispositions
Neurodevelopmental abnormalities (low IQ, childhood head injuries, higher left handedness)
Attachment problems (particularly sexually abused boys who also had neglect, lacked parental supervision and witnessed serious intra-familial violence
Pathogen exposure while in-utero?
T/F all child molesters are pedophiles
false.
Molestation can be due to any of: hypersexuality, inaccessible preferred partners, social incompetence, intimacy deficits, having more emotional affinity for children than adults, general antisocial tendencies, temporary disinhibition due to substances, psychopathy.
Child molesters more likely to have pedophilia when they are:
- Male victims
- Unrelated victims
- More than one child victim
- Victim is aged 11 or younger
T/F paraphilic arousal is the same as paraphilia
false.
Paraphilic arousal → paraphilia (intense persistent) → paraphilic disorder (paraphilia lasting at least 6 months and causes distress to person or harm to others)
*paraphilic arousal IS NOT a paraphilia!
Paraphilic sexual arousal is not unsual! More common in men, those who have been sexually unfaithful, pornography users, those who masturbate at least once weekly, those who subjectively rate themselves as low general health
- 62% of men in community reported some arousal to at least one paraphilic stimulus/
Sexual Dysfunction
Definition: sexual dysfunction for at leas__months in ___% of occasions and causes clinically significant distress
Sexual Dysfunction
Definition: sexual dysfunction for at least 6 months in 75% of occasions and causes clinically significant distress
4 phases of the sex arousal cycle
- desire
- arousal
- orgasm
- resolution
normal physiology of arousal for males and females
Normal physiology
Females: breast engorgemnet, sex flush, clitoris pull back, vascular changes to vagina
Male: erection, scrotal sack tights and lifts, sex flush begins
Female sexual interest/arousal disorder
management of erectile disorder
PDE-5 inhibitors, androgens, vacuum erectile devices, constriction rings
definition of premature ejactulation
ejaculating within 1 minute
Symptoms: persistent or recurrent difficulties with at least one of:
- Vaginal penetration during intercourse
- Marked pain with intercourse of penetration
- Marked fear/anxiety about pain in anticipation of, during or as a result of penetration
- Marked tensing or tightening of pelvic floor during attempted penetration
Genito-Pelvic Pain/Penetration Disorder
Management of genito-pelvic pain disorder
Relevant factors: difficulties in partner (healthy issues, mental health), relationship issues (communication, sexual preference), individual issues (body issues, abuse Hx), psych comorbidity/stressors, culture/religious issues, medical issues
Rule out other mental disorders leading to sexual dysfunction, substance/medication use leading to sexual dysfunction
- Antihypertensives, antipsychotics, antidepressants, hormones, drugs of abuse
-
Sexual dysfunction due to relationship distress, partner violence, life stressor
*
Human Sexuality
Adolescence: males tend to respond to ____ stimuli, while females respond to ___ ___. Same sex experimentation is common
First coitus: average age is ___, 40% of individuals who had sex prior to 13-14 yo was involuntary/unwanted
- Males: anxiety about __
- Females: anxiety about __ ___
Human Sexuality
Adolescence: males tend to respond to visual stimuli, while females respond to romantic stories. Same sex experimentation is common
First coitus: average age is 16, 40% of individuals who had sex prior to 13-14 yo was involuntary/unwanted
Males: anxiety about performance
Females: anxiety about losing virginity
how does human sexuality generally change in late middle age for men and women
Male: longer period to reach orgasm, longer refractory period, more stimulation for erection, sexual confidence?
Female: menopausal hormone changes, sexual confidence
