Psychosexual Disorders Flashcards
What is the prevalence of sexual dysfunction?
National Health and Social Life Survey Prevalence Rates for Sexual Dysfunction:
- 43% for women
- 31% for men
Lewis, R. W. (2010)
- 30-40% for women
- 20-30% for men
Rates increase with age
What is Sexual Dysfunction?
Sexual dysfunctions are characterized by disturbances in sexual desire and in the psychophysiological changes associated with the sexual response cycle in men and women (DSM-IV-TR).
What are the 4 stages of human sexual response cycle?
The human sexual response cycle has traditionally been viewed as being comprised of four stages which are (1) Desire (2) Arousal (3) Orgasm and (4) Resolution (American Psychiatric Association, 2000).
Sexual dysfunction can happen in any of these stages, however research has focused on the first three stages.
What did a study by Masters and Johnson find?
- Only tested men in early days
- Assumed can be generalized to
women but not the case
Classification according to which part of the sexual response cycle is disrupted - desire
hypoactive sexual desire disorder (low sexual desire level than norm) - arousal
sexual arousal disorder (trouble with arousal) - orgasm
sexual orgasm disorder (trouble getting an orgasm) - resolution
wrong
What is the alternate sexual response cycle?
- Have to have willingness for desire
(have to be in the mood)- Spontaneous innate desire, all
of a sudden have desire
without anything triggering it,
rare
- Spontaneous innate desire, all
- Usually turned on by stimuli
- Then have to process it
(psychologically and mentally) - Then get arousal, first thing is mind
if innate then can be body - Arousal incr desire
- Can get sexual satisfaction with or
without orgasm - Sexual satisfaction also incr desire
- Non sexual rewards (emotional
intimacy, sense of physical well-
being) also incr desire - Desire is complicated diff triggers etc
- Desire starts it but need expectations and motivation to have it
What are some Female Sexual Disorders?
- Sexual Desire Disorders
Hypoactive Sexual Desire Disorder
Sexual Aversion Disorder - Sexual Pain Disorders
Dyspareunia
Vaginismus - Sexual Arousal Disorder
- Orgasmic Disorder
What are some Male Sexual Disorders?
- Premature Ejaculation
- Prolonged Ejaculation
- Erectile Dysfunction
- Orgasmic Disorder
- Hypoactive Sexual Desire Disorder
What are other Sexual Disorder?
- Sexual Dysfunction due to a general medical condition
- Substance Induced Sexual Dysfunction
- Sexual Dysfunction (NOS)
What are some characteristics of Sexual Dysfunctions?
Lifelong
- Has been happening since sexual
maturation.
or
Acquired
- Sudden onset of sexual dysfunction
after a period of normal sexual
functioning.
Generalized
- Sexual dysfunction happens in all
contexts.
or
Situational
- Sexual dysfunction is context
specific.
What are the predisposing factors of stress in the context of sexual dysfunction?
- Constitutional factors (biology)
- Prior Life Experience (problematic attachment, poor parenting during childhood, sexual and physical abuse)
What are the precipitating factors of stress in the context of sexual dysfunction?
An element that causes or contributes to the occurrence of a disorder or problem (mental or physical)
What are the maintaining factors of stress in the context of sexual dysfunction?
Internal Stress
- Stress arising from within the relationship
- sexual prob being maintained by new stress caused within the couple
What are the contextual factors of stress in the context of sexual dysfunction?
External Stress- Stress originating outside of the close relationship
- Acute Stress- Short-term activation
of the stress response
- Chronic Stress- Long-term stress
that one has no control over (ex:GAD)
What is the negative feedback loop?
Have stress factor that causes sexual problem then sexual prob causes stress that causes more sex probs (more worried about performance= less likely to perform better)
What did McCabe find about performance anxiety?
Found that performance anxiety has a (primary) role in the development and maintenance of a broad range of sexual dysfunctions in both men and women.
What is performance anxiety?
A very common sexual problem in which men and women acquire anxiety when it comes time to engage in sexual activity.
- Partner wants to have sex and make excuses cause is anxious, avoiding it reinforces the problem= bigger prob
What is Hypoactive Sexual Desire Disorder (HSDD)?
Deficiency (or absence) of sexual fantasies/
thoughts, and/or desire for or receptivity to sexual activity, which causes personal distress.
Synonyms include sexual aversion, inhibited sexual desire, sexualapathy, and sexual anorexia.
HSDD is the most frequent sexual problem among women.
In its extreme form, the person not only lacks sexual desire but may find sex to be repulsive, revolting, and distasteful.
Phobic or panic responses may be present in extreme cases.
What is
Sexual Aversion Disorder?
Phobic aversion to and avoidance of sexual contact with a sexual partner, which causes personal distress.
What is Dyspareunia?
Genital pain associated with sexual intercourse.
What is Vaginismus?
The involuntary spasm of the musculature of the outer third of the vagina that interferes with vaginal penetration, which causes personal distress.
What is Sexual Arousal Disorder?
Inability to attain or maintain sufficient sexual excitement, causing personal distress, which may be expressed as a lack of subjective excitement, or genital (lubrication/swelling) or other somatic responses.
What is Orgasmic Disorder?
Difficulty, delay in, or absence of attaining orgasm following sufficient sexual stimulation and arousal, which causes personal distress.
What are the Female Sexual Dysfunction Prevalence?
The National Health and Social Life Survey (NHSLS), a population-based survey of sexual behaviour in men and women aged 18 to 59, results showed that
- 33.4% of women had persistent complaints of low sexual desire
- 20% of women reported difficulty becoming lubricated
- 14.4% of women have experienced pain during sex
- 24% of women reported a lack of orgasm
- Approximately 10% of women reported early climax
What are the risk factors for Female Sexual Dysfunction?
- neurologic disease
- stroke
- spinal cord injury
- parkinsonism
- genital atrophy
- genital surgery
- endocrinopathies
- diabetes
- hyperprolactinemia
- liver and/or renal failure
- peripheral vascular disease
- sexual abuse
- psychological factors like life stressors
- interpersonal, relationship disorders
- medications
What is a main point for male and females that lead to sexual problems?
A lot of sexual probs are due to lack of education
What did Colson, et al. find about Stress and Hypoactive Sexual Desire Disorder?
- Found that in the 63% of subjects
with jobs, sexual desire was
reported to decrease during
periods of work-related stress,
especially in women (72.3% vs.
55.5% in men). - At such times, men indicated that
erectile problems were more
frequent (76% vs. 22% in other
periods), while 63% of women said
that they would like more foreplay.
What did Traeen, et al. find about Stress and Hypoactive Sexual Desire Disorder?
found that the most frequently reported causes of distressing reduced sexual desire among women was stress (40%).
What did Yoon, et al. find about Stress and Hypoactive Sexual Desire Disorder?
- Investigated whether prolonged
stress interferes with sexual
behaviour and changed biological
and physiologic mechanisms. - Found that female rats in the stress
condition showed significantly
reduced sexual receptivity to their
male partners and more aggressive
irritable behaviour. - needs to be in a certain time of the
month to be receptive but with
stress will not be receptive
What is Sexual Arousal Disorder?
- When a woman becomes aroused,
the blood vessels in her genitals
dilate. - There is increased blood flow in the
vaginal walls, resulting in fluid
passing through them. This is the
main source of lubrication,
whichmakes the vagina wet. - Her external genitalia become
engorged due to the increased
blood supply and it is these
changes taken together that make
up the what is known as the
lubrication-swelling response,
which is designed to facilitate the
entry of the penis into the vagina. - A woman with sexual arousal
disorder either does not have these
physical responses or does not
maintain them during sexual
activity.
What did a study from Kuilea, Vigevenoa, & Laanb find on Stress and Sexual Arousal Disorder?
- Found that women in the acute
stress condition responded with
lower levels of genital and
subjective sexual arousal to an
erotic stimulus than women in the
control condition. - In addition, women with high
levels of chronic stress responded
with lower levels of genital sexual
arousal to an erotic stimulus than
women with low levels of chronic
stress.
What did a study from Dunn, Croft, & Hackett find on Stress and Female Sexual Disorder?
Found that in women, the predominant association with arousal, orgasmic, and enjoyment problems was marital difficulties (stressor).
What is the prevalence of Male Sexual Dysfunction?
- The most prevalent male sexual
dysfunctions are Premature
Ejaculation (PE) and Erectile
Dysfunction (ED). - The global prevalence of PE is
around 30% across age groups and
different cultures (Montorsi, 2005) - Prevalence for ED was found to be
around 40% (Quek et al. 2008)
What is Erectile Dysfunction?
Erectile Dysfunction (ED) is a male sexual dysfunction that is characterized by the inability to obtain/and or maintain penile erection sufficient for satisfactory sexual performance
What did a study from Sugimori et al. find on Anxiety and Erectile Dysfunction?
- examined anxiety and depression
in Japanese men with ED - both anxiety and depression contribute
- effects even greater when one has both
What are the Erectile Dysfunction Risk Factors?
Psychological stress
- Anxiety
- Depression
Metabolic
- Diabetes
- Heart diseases
- Hypertension
- GI disorders
Lifestyle
- Obesity
- smoking
What are the disorders Erectile Dysfunction can be a predictor of?
ED may be a precursor for many other disorders
- Diabetes
- Hypertension
- Obesity
ED is increasingly being recognized as the single greatest risk factor for PE
What is Premature Ejaculation?
DSM IV criteria for PE is characterized by:
- Reduced intravaginal ejaculatory
latency time (IELT)
- Diminished control over ejaculation
- Decreased satisfaction with sexual
intercourse
The condition also needs to be:
- Persistent or recurrent
- Cause “marked distress or
interpersonal difficulty”
- Not be due to the use of a
substance
What are the limitations of Premature Ejaculation?
- Difficult to determine what is
“normal” ejaculatory latency - Perception of what is “normal”
ejaculatory latency varies across
cultures
What is the Physiology of Premature Ejaculation?
- Increased heart rate during sexual
arousal
-Also a noticeable acceleration in
heart rate before premature
ejaculation - Shorter latency to maximum penile
tumescence - Alteration in male sexual response
What is the relationship between Stress and Premature Ejaculation?
- Men with PE and their partners
reported to be “extremely” or “quite
a bit” distressed compared to non-
PE groups (43.9% vs. 1.4% for men;
30.2% vs. 1.0% partners) - Difficulty relaxing in sexual
situations (30.7% vs. 7.7%) - Anxiety, depression, and
psychological distress (24.4% vs.
12.9% for anxiety)
What did a study by Quek et al. find in Stress and Premature Ejaculation?
examined a number of different factors relevant to PE
- Medical
- Social
- Psychological
Anxiety contributed the most
What did a study by Symonds et al. find in Stress and Premature Ejaculation?
- found strong associations between
sexual confidence and anxiety, with
PE - When men with PE are engaged in
sexual activity, they reported that:- They were preoccupied with
ejaculatory control - Experienced anxiety during sex
- They were preoccupied with
