Psych Paraphilic/Sexual Dysfnx Flashcards
Patient will present as → a 23-year-old male who goes to city park during the summer months in an overcoat. He enjoys walking around the park exposing his genitals to strangers. He then runs away so as to avoid getting caught.
Exhibitionistic Disorder
Tx for ED
Phosphodiesterase Inhibitors
(Sildenafil, Vardenafil, Avanafil, Tadalafil)
Intraurethral/Intracavernosal Prostaglandins
Exhibitionistic Disorder
Exhibitionistic Disorder: “Flasher” - “Put on a show”
→ Disease Presentation:
He enjoys walking around the park exposing his genitals to strangers. He then runs away so as to avoid getting caught.
→ DSM-5:
Shows genitals to unsuspected persons
Arousal from the exposure
6 months
Not in full remission until 5 years
→ Treatment:
CBT
SSRIs
Patient will present as → a 33-year-old woman with a chief complaint of trouble having intercourse. She is completely disinterested in sex and she is not receptive to her partner’s attempts to initiate foreplay. She reports that when they do have sex she never achieves orgasm. This is affecting her current relationship with her boyfriend.
Female Sexual Interest/Arousal Disorder:
Female Sexual Interest/Arousal Disorder:
→ DSM-5:
Inability to achieve sexual arousal causing distress and problematic interpersonal relationships
NOT caused by any other reasoning
6 Months
→ Treatment:
Therapy
OFF-LABEL: Sildenafil/Tadalafil or Testosterone
Patient will present as → a female brings her 29-year-old boyfriend to a couples therapist because she is uncomfortable with his behavior. She found him clutching her feet during intercourse, and noticed that he insists on being able to see her feet while they engage in sexual acts.
Fetishistic DO
Fetishistic Disorder
→ DSM-5:
Sexual arousal by specific objects
6 Months
Body parts/objects
→ Treatment:
CBT
SSRI (help with impulses)
Patient will present as → a 53-year-old male complaining of a lack of desire for sex with his wife causing him marked distress for the past year. His wife has been very hurt by his lack of response to her advances and he reports that this is having a significant strain on their relationship. Prior to this, he was interested in sex and he and his wife would have intercourse 1-2x per month. He is very active and continues to compete in triathlons. He has no significant past medical history.
Male Hypoactive Sexual Desire Disorder:
Male Hypoactive Sexual Desire Disorder:
Male Hypoactive Sexual Desire Disorder:
→ DSM-5:
Lack or absence of sexual fantasies or desire for sexual activity
Causes distress in relationships
6 months
→ Treatment:
1st line: CBT
Testosterone Supplements: Short-term
Patient will present as → a 33-year-old male gymnastics teacher insists that all his students take a shower after class. He supervises the children showering and becomes sexually aroused.
Pedophilic DO
Pedophilic Disorder:
→ Disease Presentation:
He supervises the children showering and becomes sexually aroused.
→ DSM-5:
Aroused by PREPUBESCENT CHILDREN (13 years or younger)
6 months
→ Treatment:
Behavioral therapy
SSRI
Antiandrogens
Depo Shot
Patient will present as → a 23-year-old male who concerned that his behavior has resulted in his inability to maintain a relationship. He reveals that he requires his partners to strangle him and humiliate him in order for him to achieve and maintain an erection.
Sexual Masochism DO
Sexual Masochism Disorder
Sexual Masochism Disorder:
→ Disease Presentation:
He reveals that he requires his partners to strangle him and humiliate him in order for him to achieve and maintain an erection.
→ DSM-5:
Arousal from being threatened or hurt during sexual activities: humiliated, bound, beated, etc.
→ Treatment:
CBT
SSRI
Antiandrogens
a 20-year-old male college student was reported by others for spying through the windows of his fellow female dormmates.
Voyeuristic Disorder
Voyeuristic Disorder:
Voyeuristic Disorder:
→ Disease Presentation:
a 20-year-old male college student was reported by others for spying through the windows of his fellow female dorm mates.
→ DSM-5:
Observing unsuspected persons naked/performing sexual acts
Person >18
6 months
→ Treatment:
Psychoanalytic, Group therapy, Shock aversion
Pornography
Antipsychotics/antidepressants
