Paraphilic d/o Flashcards

1
Q

Frotteuristic

A

sexual arousal from touching or rubbing against non-consenting person

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2
Q

Voyeuristic

A

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

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3
Q

Exhibitionistic

A

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

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4
Q

Sexual masochism

A

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

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5
Q

Sexual sadism

A

sexual arousal from the physical or psychological suffering of another person

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6
Q

Fetishistic

A

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

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7
Q

Transvestic

A

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

this does NOT mean they are homosexual

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8
Q

Pedophilic

A

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

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9
Q

Poor prognostic factors of paraphilic d/o

A

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

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10
Q

Good prognostic factors of paraphilic d/o

A

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

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11
Q

Treatment of paraphilic d/o

A

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

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12
Q

3 MC types of paraphilia

A

pedophilia, voyeurism and exhibitionism

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13
Q

Duration required for paraphilias

A

6 mo

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14
Q

Epidemiology of paraphilic d/o

A

Rare

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

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15
Q

Sexual dysfunction DSM-5 criteria

A

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

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16
Q

Effect of dopamine on libido

A

enhances

17
Q

Effect of serotonin on sexual function

A

inhibits

18
Q

Male hypoactive sexual desire d/o

A

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

19
Q

Female sexual interest/arousal desire d/o

A

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

20
Q

Erectile d/o

A

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

21
Q

Premature ejaculation

A

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

22
Q

Female orgasmic d/o

A

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

23
Q

Prevalence of premature ejaculation

A

30% of men report concerns

24
Q

Prevalence of female orgasmic d/o

A

10-42%

25
Q

Delayed ejaculation

A

marked delay in/infrequency/absence of ejaculation for >6mo

Prev <1%

26
Q

MC sexual dysfunctions in men

A

erectile disorder and premature ejaculation

27
Q

MC sexual dysfunctions in women

A

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

28
Q

Genito-pelvic pain/penetration d/o

A

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

29
Q

Treatment of sexual d/o

A

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

30
Q

Pharmacologic tx for erectile d/o

A

Sildenafil (phosphodiesterase-5 inhibitors)

Alprostadil acts locally

31
Q

Pharmacologic tx for premature ejaculation

A

SSRI and TCAs prolong time to orgasm

32
Q

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

A

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

33
Q

Effect of alcohol on sexual desire

A

Alcohol and marijuana enhance sexual desire by suppressing inhibitors

LT alcohol use will decrease sexual desire

34
Q

Effect of cocaine and amphetamines on libido

A

enhance libido by stimulation dopamine receptors

35
Q

Effect of narcotics on libido

A

inhibit

36
Q

Gender dysphoria treatment

A

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