Paraphilic d/o

Question 1

Frotteuristic

Answer 1

sexual arousal from touching or rubbing against non-consenting person

Question 2

Voyeuristic

Answer 2

sexual arousal from observing an unsuspecting nude or disrobing individual (often w/ binoculars)

Question 3

Exhibitionistic

Answer 3

sexual arousal from exposure of one’s genitals to unsuspecting person

Question 4

Sexual masochism

Answer 4

sexual arousal from the act of being humiliated, beaten, bound of made to suffer

Question 5

Sexual sadism

Answer 5

sexual arousal from the physical or psychological suffering of another person

Question 6

Fetishistic

Answer 6

sexual arousal from either the use of non-living objects (shoes or pantyhose) or non-genital parts

Question 7

Transvestic

Answer 7

sexual arousal from cross-dressing (wearing women’s clothes such as underwear)

this does NOT mean they are homosexual

Question 8

Pedophilic

Answer 8

sexual fantasies/urges/behaviors involving sexual acts with prepubescent children

Question 9

Poor prognostic factors of paraphilic d/o

Answer 9

multiple paraphilias, early age of onset, comorbid substance use, high freq of behavior, referral by law enforcement agencies

Question 10

Good prognostic factors of paraphilic d/o

Answer 10

having only 1 paraphilia, self-referral for tx, sense of guilt associated w/ the behavior, hx of otherwise normal sexual activity in addition to paraphilia

Question 11

Treatment of paraphilic d/o

Answer 11

Difficult to treat
Long acting gonadotropin-releasing hormones (GnRH), SSRIs and naltrexone used to DEC sex drive and fantasies
CBT, group therapy and insight-oriented therapy

Question 12

3 MC types of paraphilia

Answer 12

pedophilia, voyeurism and exhibitionism

Question 13

Duration required for paraphilias

Answer 13

6 mo

Question 14

Epidemiology of paraphilic d/o

Answer 14

Rare

Almost exclusively in in men except sadism, masochism and pedophilia cam occur in women

Question 15

Sexual dysfunction DSM-5 criteria

Answer 15

d/o causes clinically significant distress

dysfunction not better explained by a non-sexual mental disorder, as a consequence of severe relationship distress or other stressors and not attributable to effects of substance/medication or medical condition

Question 16

Effect of dopamine on libido

Answer 16

enhances

Question 17

Effect of serotonin on sexual function

Answer 17

inhibits

Question 18

Male hypoactive sexual desire d/o

Answer 18

absence or deficiency of sexual thoughts, desire or fantasies for >6 mo

Question 19

Female sexual interest/arousal desire d/o

Answer 19

absence or reduced sexual interest, thoughts/fantasies, initiation of sex, sexual excitement/pleasure, sexual arousal, and/or genital/non-genital sensations during sex for >6 mo

Question 20

Erectile d/o

Answer 20

marked difficulty obtaining or maintaining erection or dec in erectile rigidity for >6 mo

Question 21

Premature ejaculation

Answer 21

recurrent pattern of ejaculation during sex within 1 min and before individual wishes it for >6 mo

Question 22

Female orgasmic d/o

Answer 22

marked delay in/infrequency/absence/reduced intensity of orgasm for for >6 mo

Question 23

Prevalence of premature ejaculation

Answer 23

30% of men report concerns

Question 24

Prevalence of female orgasmic d/o

Answer 24

10-42%

Question 25

Delayed ejaculation

Answer 25

marked delay in/infrequency/absence of ejaculation for >6mo Prev <1%

Question 26

MC sexual dysfunctions in men

Answer 26

erectile disorder and premature ejaculation

Question 27

MC sexual dysfunctions in women

Answer 27

female sexual interest/arousal d/o and female orgasmic d/o

Question 28

Genito-pelvic pain/penetration d/o

Answer 28

persistent or recurrent difficulties in one of the following during intercourse or penetration for >6 mo: vag penetration marked vulvovaginal pain or pelvic pain marked anticipatory fear or anxiety about vulvovag or pelvic pain marked tensing of pelvic floor muscles during penetration

Question 29

Treatment of sexual d/o

Answer 29

Sex therapy- good if no other psychopath involved CBT Hypnosis- good if anxiety is present Group therapy Analytically oriented psychotherapy- focuses on what may be contributing to d/o Pharm Mechanical therapies

Question 30

Pharmacologic tx for erectile d/o

Answer 30

Sildenafil (phosphodiesterase-5 inhibitors) Alprostadil acts locally

Question 31

Pharmacologic tx for premature ejaculation

Answer 31

SSRI and TCAs prolong time to orgasm

Question 32

Pharmacologic tx for male hypoactive sexual desire d/o/female sexual interest/arousal d/o

Answer 32

Testosterone for men w/ low levels (low doses can also be used in women) Low-dose vaginal estrogen replacement for vag dryness/atrophy in post-menopausal women

Question 33

Effect of alcohol on sexual desire

Answer 33

Alcohol and marijuana enhance sexual desire by suppressing inhibitors LT alcohol use will decrease sexual desire

Question 34

Effect of cocaine and amphetamines on libido

Answer 34

enhance libido by stimulation dopamine receptors

Question 35

Effect of narcotics on libido

Answer 35

inhibit

Question 36

Gender dysphoria treatment

Answer 36

therapy, family involvement for younger patient, surgical sex reassignment after living 1 year in the desired gender role and after 1 year of continuous hormone therapy