PSY2003 W10 Sexual Disorders (L)

Question 1

What are some limites to research in sexual behaiour?

Answer 1

Sexual behaviours are hard to measure: private subject

Question 2

How does measurements and behavour link in sexual bheaviour?

Answer 2

Multiple axes of measurements – “sexual behaviours” convers a very wide range of specific behaviour

Question 3

What changes / makes it hard to generalise sexual behaviours?

Answer 3

Diverse across individuals, culutre and time (inter-individual variation)

Question 4

Where does our main understanding of enural basis of sexual behaviour come from?

Answer 4

animals, rodents

Question 5

How is sexual behaviour’s measured ?

Answer 5

Multiple axes of measurments - sexual behaviours convers a very wide range of specific behaviours. Diverse across individuals, cultures adn time. Varies within individuals (intra-individual varaition) e.g. age and dev, circumstances adn life events.

Our understanding of the neural basis comes from animal models specifcally rodents

Question 6

What neural mechanisms underlies sexual behaviours?

Answer 6

Hypothalamus: region critical for observable copulatory behaviours of rodans.

Question 7

IS the MPAO commanding the motor plan or producing the motivatoinal state to copulate?

Answer 7

Motivational state, in keeping with general hypothalamic function

Question 8

What regions seems critical in female?

Hypothalamus

Answer 8

In females, the ventromedial nucleus appears critical for the display of female copulatory behaviour (e.g. lordosis). Electrical stimulation of the VMN facilitates lordosis In response to a male

Question 9

What regions seems critical in male?

Hypothalamus

Answer 9

In males, the medial preoptic area of the hypothalamus seems critical for male copulatory behaviour (e.g. mounting, intromission, ejaculation).
Lesions of the MPAO abolish such behaviours in males (and in females where some are also observed). Stimulation of the MPAO elicits these behaviours.

Question 10

Is sexual behaviour that simple?

Answer 10

No it is more complicated. The importance of complex sensory input, other cortical and subcortical systems conveying contextual, reward-related and motivational information, is also important (even in rodents).

Question 11

Do mice court each other?

Answer 11

Mice sing to each other as part of courtship a chemical in the tears of juvenile mice deters female mice from copulation.

Question 12

Are animal models transferable?

Answer 12

Human sexual behaviour is more complex and multidimensional. The male and female binary has utility when we are thinking comparatively (humans as animals) about sexual behaviour. But as other reductionist approaches to very complex things, generalisability and ecological validity is limited/questionable

Question 13

What are some early foundaitonal studies of human sexual behaviour?

Alfred Kinsey - The Kinsey reports

Answer 13

Taxonomy of human sexual behaviour based on 1000s of interviews. Studies types/frequency of certain behaviours in the population. Shocking / provocative at the time. Remain widely cited in academic literature. Some statistical and sampling issues

Question 14

What is a additionally early foundational study of human sexual behaviour?

William Master adn Virginia Johnson (Masters and Johnson)

Answer 14

Detailed study of human sexual behaviour and sexual disorders in 50s/60s. Measured aspects of sexual intercourse and masturbation in a laboratory setting. Established the highly influential 4-stage model for human sexual behaviour known as the Sexual Response Cycle (Desire, Plateau, Orgasm, Resolution). Remain widely cited in academic literature. Model has been criticised and revised, but remains influential

Question 15

What are some more recent work on human sexual behaviour?

Answer 15

More recent work has refined the terminology, identified additional variability in ‘normal’ cycles, and attempted to determine the neuroanatomical correlates of components of the cycle.
3 major components linked to distinct brain systems: wanting, liking, and learning
Numerous fMRI studies of sexual function: methodological limitations include the lab setting itself, and head movement!

Question 16

What is sexual identity?

Answer 16

captures aspects of both gender identity and sexual orientation (Roselli et al. and others use this term)

Question 17

How does interference with sexual differentation affects behaviour in animal models?

Answer 17

In animal models interference with sexual differentiation (e.g. by perinatal sex hormone exposure, castration/ovarectomy or lesioning of hypothalamic nuclei) can lead to displays of sexual behaviours typically associated with the opposite chromosomal sex, and to same-sex preferences

Question 18

What is the fraternal birth order effect?

FBOE

Answer 18

Some evidence that fraternal birth order is associated with male homosexuality. The more brothers a biological male has, the more likely they are to identify as homosexual. 15-29% of homosexual men may owe their sexual orientation to this effect. Robust across different cultures. Older sisters or younger brothers/sisters have no effect on sexual orientation. Effect remains if older brothers raised in different households but does not occur in the case of older step-brothers or adopted brothers ==> this implies the effect relates to maternal factors: maternal immunization hypothesis

Limites: seemed to have exagerated a small effect size

Question 19

What are hormonal factors of sexual orientation?

Answer 19

Some limited evidence that perinatal hormone exposure in humans can modulate same-sex / opposite sex preferences

Question 20

What are some neuroanatomical factors of sexual orientation?

Answer 20

Evidence also suggests that specific hypothalamic nuclei may play a role in sexual preferences, and that there are differences in the sizes of these nuclei between homosexual/heterosexual males/females

Question 21

What are some genetic factors of sexual orientation?

Answer 21

Some evidence from family/twin studies for a moderate genetic influence on sexual orientation: up to 40% of variance in sexual orientation of males, and up to 20% of variance in sexual orientation of females, may have a genetic basis.
A more recent study used Genome Wide Association and found several specific genetic markers associated with sexual orientation, but determined that none were predictive of sexual orientation – essentially, the genetic component of sexual orientation is multidimensional and complex

Question 22

What is an issue with sex based research?

Answer 22

gender bias: selection of something you might investigate because they matter, usually male problem

Question 23

How is dysfunction found?

Answer 23

Devision from statistical norms
Deviation from social norms
Distress
Deficit in normal function

Question 24

How is sexual dysfunction related to a deviation from social norms?

Answer 24

Deviation from social norms: Powerful influence on social judgement, but socially normal isn’t always adaptive/functional. Subjective perception of norms often differ from actual norms. Culutral and historical variation. Political influences. Circularity (norms can create pathology as well as define it)

Question 25

How is sexual dysfunction related to a deviation from statistical norms?

Answer 25

somewhat arbitrary, in terms of usefulness of classification, relies on extensive adn accurate data which is hard to obtain cross-culutral granularity. Ultimately remains subjective.

Question 26

How is sexual dysfunction related to a distress?

Answer 26

A focus on emotional adn psychological wellbeing. Persistence or frequency of distress may be important. Requires awareness and acknowledgement that soem inividuals may not expeirence distress. Social norms and the protection of others (including laws)

Question 27

How is sexual dysfunction related to a deficit in normal function?

Answer 27

Focus on social, interpersonal, occupational functioning. e.G. interference in ability to develop and maintain a loving relationship. But some maladaptive respnses may have reasonable basis (impacts of sexual abuse) need to avoid unhelpful pathologising. Can cut across individual life choices. Can ignore individual experience/impact, interacts with social norm.

Question 28

What is sexual dysfunction?

Answer 28

Relates to problems with experiencing the human sexual response cycle

Question 29

What is paraphilic disorders?

Answer 29

Relates to “inappropriate” activation of the human sexual response cycle

Question 30

What is gender dysphoria?

Answer 30

Unhappiness due to perceived gender differing from assigned gender

Question 31

How are types of sucal dysfunction categorised?

Answer 31

Types of sexual dysfunction are categorised according to phases of the human sexual response cycle.
For diagnosis, there must be an impact on:
-Subjective distress
-Functioning (e.g. relationships)
Symptoms must also be persistent or recurrent

Question 32

What are some risk factors fo sexual dysfunction?

Answer 32

Gender related, certain health condition, sexual abuse

Question 33

What are some causes of sexual dysfunction?

Answer 33

May be psychological and or biological can be hard to determine

Question 34

What are some treatments for sexual dysfunction?

Answer 34

Symptom focused, psychotherapy (individual/couple), biological (drug or devices)

Question 35

What are paraphilic disorders?

DSM-V

Answer 35

Any intense and persistent sexual interest, other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal physically mature, consenting human partners.

To qualify as a paraphilic disorder, satisfaction must entail either distress/harm to the individual, or to another person

Question 36

What are some paraphilic disorders?

Answer 36

fetishistic disorder
transvestic disorder
exhibitionistic disorder
frotteuristic disorder (touching)
pedophilic disorder
voyeuristic disorder
sexual masochism disorder
sexual sadism disorder

Question 37

Which paraphilic disorders are not typically direct at another person?

Answer 37

fetishistic disorder
transvestic disorder

Question 38

What paraphilic disorders are directed at a non-consenting person?

Answer 38

exhibitionistic disorder
frotteuristic disorder (touching)
pedophilic disorder
voyeuristic disorder

Question 39

What paraphilic disorders involve expereincing or inflicting suffering?

Answer 39

sexual masochism disorder
sexual sadism disorder

Question 40

What is gender dysphoria?

Answer 40

Previously termed gender identity disorder. A dispartity between an indivdual’s assigned gender sex and their perceived gender that causes distress or impairment.

Question 41

What must be for a diagnosis of gender dysphoria?

Answer 41

1. Marked and persistent cross-gender identification
2. Significant distress or impairment (of function, e.g. relationships, occupation, etc)
3. A lack of a physical intersex condition (both sets of genitalia)

Question 42

What are treatments for gender dysphoria?

Answer 42

Behavioural techniques
Cognitive therapies
Hormonal or drug treatments

Psychological treatments (behavioural and cognitive) - some success but clients often resistant (understandably)
Gender reassignment surgery – often leads to satisfactory outcomes but may not alleviate other psychological co-morbidities

Question 43

What are causes of gender dysphoria?

Answer 43

Very little understood about this – possibly psychodynamic, but also cognitive or biological factors may play a role.

Evidence for differences in brain structures is mixed (see earlier discussion re: male: female brain differences). But, there is evidence from twin studies for heritability, though no single gene has been found

Question 44

What risk factors to gender dysphoria?

Answer 44

Being male and hypersexuality.
Some evidence to indicate that paternal relationship (for males) and childhood abuse (for females) may be factors. Little support for notion that parental attitudes or behaviours play a role. Biological factors may include in-utero hormone exposure

Question 45

What are risk factors for pedophilic disorder?

Answer 45

Past sexual abuse
Attachment problems
Psychiatric comorbidity
Substance abuse

Question 46

How is gender dysphoria diagnosed?

Answer 46

Can be diagnosed in children, though most will not have a diagnosable condition subsequently as adults. Incidence estimates vary, from relatively rare (0.01% of males, even rarer in females). Often co-morbid with anxiety and depression: the unhappiness aspect is part of the name of the disorder. However BMA recently cited evidence that 1% of population may experience some level of gender incongruency.

Question 47

What is the psychobiological model that accounts for gender dysphoria?

Answer 47

Based on a review of a wide range of evidence, the authors suggest “GD has neurobiological basis, but it is closely associated with the individuals’ interaction with the external world, their self-perception and the feedback received in return. ”

They introduce the concept of “brain gender”, with gender identity development passing through 4 stages….