Psychosexual Dysfunction And Paraphilia

Question 1

Diagnosis of Paraphilia (DSM IV)

Answer 1

At least 6 months, includes: fetishism, transvestic fetishism, voyerism, exhibitionism, paedophilia, frotturism

Question 2

Added criterion B of Paraphilia (DSM V)

Answer 2

Causes stress and impairment, causes risk and harm to self and others, requires intervention

Question 3

Aetiology of Paraphilia

Answer 3

Early experiences, dysfunctional beliefs, behavioural explanations (classical conditioning, modelling, social learning hypothesis)

Question 4

Paedophilia

Answer 4

Recurrent sexual urges towards prepubescent child

Question 5

Therapy goals for paedophilia

Answer 5

Modify patterns of arousal, modify cognitions and social responses, improve social interactions, reduce sex drive and trigger behaviours

Question 6

Aversion therapy for paedophilia

Answer 6

Slides paired with shock/unpleasant events

Question 7

Marshall and laws (2003) aversion therapy:

Answer 7

Can improve control of arousal, but no evidence of maintenance

Question 8

CBT for paedophilia

Answer 8

Target cognitions and behaviours that increase risk of offending, teach recognition of risky behaviours, Relapse intervention programme

Question 9

Kenworthy et al (2004)- CBT for paedophilia

Answer 9

Review of 9 RCTs, 500+ male offenders, CBT may reduce reoffending but may contribute to rearrest up to 10 years later.

Question 10

Relapse intervention programme

Answer 10

Identify high lapses, identify lapses, develop avoidance and coping strategies

Question 11

Marques et al (2005) Relapse intervention programme

Answer 11

No differences between programme and control group prisoners in 8 year follow up.

Question 12

What is Paraphilia?

Answer 12

Atypical variations in sexual behaviours, urges and fantasies

Question 13

Sexual dysfunction

Answer 13

Impairment in sexual desire or gratification

Question 14

DSM General criteria for sexual dysfunction

Answer 14

Caused by marked distress or interpersonal difficulty

Question 15

DSM 5 (2013) criteria for sexual dysfunction disorder

Answer 15

Lifelong, at least 6 months, desire and arousal occur together, gender-specific, includes factors (religious, cultural)

Question 16

Hypoactive sexual desire disorder

Answer 16

Little drive or interest in sex. In extremes, becomes sexual aversion disorder (avoidance of gentian contact)

Question 17

Psychological factors of hypo sexual desire disorder

Answer 17

Low relationship satisfaction, daily hassle, conflicts and resentment, reduced affectionate behaviours

Question 18

Treatment for hyposexual desire disorder

Answer 18

No drugs, so psychological treatment focuses on: education, communication skills, cognitive restructuring of beliefs, sexual fantasy training

Question 19

The Sexual arousal disorders are:

Answer 19

Male erectile disorder and female sexual arousal disorder

Question 20

Male sexual erectile disorder criteria

Answer 20

Distraction of negative thoughts reinforces by loss of erection

Question 21

Treatment for male erectile disorder

Answer 21

Medical erection promoters (viagra, injection muscle relaxants, penile implants) viagra is 70% successful in promoting erections but not for enhancing libido

Question 22

Female sexual arousal disorder

Answer 22

Basson et al (2000): lack of physical response of lubrication and swelling. Added physical distress after panel of 19 experts from 5 countries

Question 23

Hypothesised causes of female sexual arousal disorder

Answer 23

Early sexual trauma, moralisation, disgust with patients, sexual repertoire, decrease in oestrogen, SSRIs.

Question 24

Treatment of female sexual arousal disorder

Answer 24

Meston and Bradford (2007) almost no trials; vaginal lube masks and treats symptoms. Education, retraining, sensory-focus training

Question 25

Three types of orgasmic disorder

Answer 25

Premature ejaculation, male orgasmic disorder, female orgasmic disorder

Question 26

Premature ejaculation characteristics

Answer 26

Persistent and recurrent pre-orgasm on minimal contact, usually within 15 seconds

Question 27

Treatment for premature ejaculation

Answer 27

Pause and squeeze techniques, antidepressants (SSRI’s) can prolong ejaculation

Question 28

Male orgasmic disorder is

Answer 28

Inability to ejaculate during intercourse

Question 29

Treatment for male orgasmic disorder

Answer 29

Avoid orgasm and ejaculation during sex

Question 30

Female orgasmic disorder

Answer 30

Persistently absent orgasm, almost always situational (specific to penetration)

Question 31

Aetiology of female orgasmic disorder

Answer 31

Fear, inexperience, guilt of no orgasm

Question 32

Treatment for female orgasmic disorder

Answer 32

Education, directed masturbation without partner then with

Question 33

Sexual pain disorders focus

Answer 33

Muscle tension during intercourse

Question 34

Treatment for sexual pain disorders

Answer 34

Train the vaginal muscles, relaxation etc