Sexual Flashcards
The 2 forms of sexual problems are
a) sexual dysfunction - disturbances in ability to respond sexually or experience sexual pleasure
b) paraphilia - desire to cause distress, or impairment to self or others, may involve humiliation, objects, non-consent
contrast the 19th century view of sexual activity vs now
was thought that excessive activity/self stimulation lead to exhaustion of sexual energy = erectile dysfunction.
NOW - inhibition of sexual expression - negative connotations, prude etc.,
What has influenced the change in perception of sex
Technology has normalised exposure to explicit imagery
Knowledge of STI’s spread awareness
STI are ________ in AU, HIV rates are____________
rising, stable
Cultures often adopt one of 2 attitudes towards sex_________
Sex= pleasure,
sex=procreation
The INCORRECT statement regarding WOMEN is;
a) think less about sexual behaviours
b) have fear + anx about sex
c) have greater sex drive when not in a relationship
d) sexuality closely linked with male’s satisfaction
C - have a smaller drive when single
Which is INCORRECT regarding men;
a) men use more sex toys
b) men use internet apps more to find a partner
c) report more thoughts about sex + engaging in sex
d) men look at pornography more
A - women use toys
What is a criticism of the DSM description of sexual disorders
does not pay attention to relational components of human sexuality in describing sexual dysfunction. Important bc for WOMEN sexual dysfunction issues tend to relate closely to relationship issues for women.
Men seek sex for___________, whereas women seek_________ in sex
men - sexual attraction + physical gratification
women - relationship closeness
What are the 4 different stages of the sexual response cycle
1) desire phase - refers to sexual desire i.e. fantasies, sexual thoughts
2) excitement phase - blood flow to genitals
men - erection women - enlargement of breasts + lubrication
3) orgasm phase - sexual pleasure peaks.
men - ejac women - walls contract
4) resolution phase - relaxation + wellbeing after orgasm.
men - have a REFRACTORY period duration of which VARIES
women - usually able to respond several times to excitement = multiple orgasms possible
What are the criticisms of Kinsey’s sexual response cycle?
Some women report co-occurence of desire + excitement phase. Others report desire AFTER physical arousal
Vaginal plethysmography measures_________ whereas a penile plethysmograph measures__________
physiological arousal via amount of blood flow to the vagina BUT has little correlation with desire/excitement.
Male arousal via penile circumference.
Sexuality provides us with____________
closeness, connection, shared pleasure
The 3 categories of sexual dysfunction are_________
a) sexual desire, arousal, interest
b) orgasmic disorders
c) sexual pain
The INCORRECT statement is;
a) dysfunction should occur for 6+ months
b) dysfunction must be associated with physical illness or psychiatric disorder
c) sexual concerns arising from relationship distress do not qualify for sexual dysfunction
d) diagnosis is made based on the stage of sex cycle
B - sexual dysfunction CANNOT be associated with relational issues i.e. inability to orgasm because partner is abusive does not count as disorder
In women, arousal, desire, and interest problems are called________whereas in men, they are called________.
Women - Female sexual interest/arousal disorder
Men - Male Hypoactive sexual desire disorder
Orgasmic disorders for men and women are called ___________
Female orgasmic disorder
Erectile disorder
Sexual pain in women is called_________, whereas in men it is called_________
Women - genitopelvic pain / peentration disorder
Men - premature /delayed ejaculation
Female sexual, interest and arousal disorder likely involves
Persistent defects in desire/interest/bioloical arousal. Frequent in menopausal women DESPITE still getting lubricated, no longer aroused. MORE common in women
DSM criteria for female interest + arousal disorder is
LOW subjectivity (arousal), HIGH biological stimulation
Male hypoactive sexual desire DIFFERS from erectyle dysfunction in that
a) lack of sexual fantasies/ urges
b) failure to attain OR maintain erection through sexual activity
Which is CORRECT;
a) cultural influences are not important in sexual dysfunction
b) hypoactive sexual desire and arousal more common in UK than US
c) male and female hypoactive sexual desire+ arousal is due to low sex drive
d) erectile dysfunction prevalence generally 20%
a - ARE important
b - MORE IN US
c - not necessarily, just bc don’t want sex doesn’t = disorder
d - CORRECT
Criteria for erectile dysfunction _____________
persists for 75-100% of time in 6+ months
difficulty attaining/maintaining for completion of sex
decrease in rigidity
Female sexual desire/arousal disorder have 3+ of_________
reduced interest in sexual activity; reduced erotic thoughts; reduced initiation of sexual activity / unreceptive to advances; absent excitement/ pleasure in 75-100% of encounter; reduced biological sensarions during sexual activity 75-100% of time.
Describe the features of FEMALE orgasmic disorder
persistent absence OR educed intensity of orgasm
after sexual excitement.
Women have different arousal thresholds = need different amounts of clitoral stimulation + some report they need emotional closeness BUT no difference in arousal levels while viewing erotic stimuli in women with/out orgasmic disorder
DSM - criteria for female orgasmic disorder
- if suffer 75-100% sexual encounters
- experience delay, infrequency or absence of orgasm,
- marked reduced INTENSITY of orgasm
What is defined as premature ejaculation? how is it diagnosed
Less than one minute after insertion. DSM - if on 75-100% of occasions have ejac early.
The LEAST common sexual dysfunction disorder is_______ involving_______
Delayed ejaculation, <1%; persisting difficulty in ejaculating
DSM for delayed ejaculation disorder
75-100% of encounters experience marked delay/absence in ejaculation
Vaginismus is
involuntary muscle spams of the outer third of the vagina making intercourse impossible
Genito-pelvic/penetration disorder is
persistent or recurrent pain during intercourse, mostly FEMALE oriented.
The INCORRECT statement is
a) sexual pain must not be due to medical/desire issue or /menopause
b) women are able to get aroused from erotic pictures of penetration
c) women are able to get aroused from oral and manual stimulation
d) there may be a psychological component to the aetiology
B - get aroused from pictures of oral stimulation but NOT aroused from pictures of penetration –> psych element not just physical
DSM criteria for genito-pelvic pain /penetration disorder in women is
PERSISTENT difficulty with 1+ of;
a) Inability to have vaginal/penetration during intercourse
b) Marked vulvar, vaginal or pelvic pain during vaginal penetration or intercourse
attempts
c) fear/anx about pain or penetration
d)tensing of the pelvic floor muscles during attempted vaginal penetration
Master and Johnson’s 1970 theory of sexual dysfunction has 2 distinct causes _________
Immediate + distal. Overall conceptualise as a complex multifactorial process.
The 2 immediate causes of sexual dysfunction according to Master & Johnson are_________and come from________
Fear about performance, adoption of a spectator role (observing rather than participating in sex);
come from historical experience (DISTAL) i.e. sociocultural influences, biological causes, sexual abuse
Some psychological factors contributing to poor sexual function are___________
Anx + mdd (2x likely to have SD issues)
Panic disorder (physiological arousal i.e. HR brings on panic attack)
focus on performance
too much routine
poor self esteem
Rigid narrow or negative attitude towards sex
Physical factors predicting poor sexual performance
smoking, heavy drinking, medications, cardiovascular disease, diabetes
social factors for poor sex function___________
history of abuse, relationship problems, poor communication, long periods of abstinence, history of hurried sex
Which is INCORRECT regarding biological factors in SD;
a) diabetes, multiple sclerosis heavy smoking diminish functioning
b) high levels of hormones causes by anabolic steroids/ supplements enhance performance
c) SSRI’s linked with delayed orgasm, decreased libido and lubrication
d) Gentio-pelvic pain may have a neurobiological basis
B - steroids + supplements reduce function
How does sexual abuse affect later function
reduced desire, arousal, premature ejaculation
how does blame contribute to sexual dysfunction
if think badly of self, will decrease sexual performance. Among men who were given internal explanation for low arousal, corresponded with low physiol arousal.
List some treatments for sexual dysfunction
- Therapist works on relationship issues i.e. communication to improve intercourse
- helps restore closeness, empathy
- physical / pharmacological interventions secondary option but may be necessary bc SD is complex, May be offered alone or alongside therapy
Anxiety reduction and psycho-education applies to SD by __________
1) first using EDUCATION about body + fear (may watch a video)
2) systematic desensitization to try and reduce problems i.e. for penetration disorder try 1 finger at a time
Therapist may suggest ____________for erectile dysfunction
Expand repertoire to other activities + remove the pressure of penetration
How can attitudes and thoughts be changed about SD_______
- Sensate-focus exercises - focus of current feelings rather than worry about performance
- challenge self-demanding thoughts that underlie SD
Communication training involves
Encouraging partners to communicate their likes and dislikes to each other, helps to expose partners to anxiety provoking conversations.
What is the recommended treatment for female orgasmic disorder / low sexual arousal/desire disorder
direct masturbation - examines own body, touch it and enjoy it, then partner comes in later and mimics it.
60-90% effective
The 2 types of medications recommended for SD are
Antidepressants, PDE-5 inhibitors;
Antidepressants may reduce maladaptive psychological factors + premature ejaculation BUT some types may reduce sex drive
The INCORRECT answer is;
a) Sidenafil, Tadalafil, Vardenafil are types of PDE-5
b) PDE-5 acts on smooth muscle and allows blood flow ONLY during sexual stimulation
c) Erectile dysfunction often comorbid with diabetes
d) Erectile dysfunction often comorbid with indigestion + headaches
C - comorbid with cardiovascular disease SO may be dangerous for this population
Para means__________ whereas philia refers to___________. Paraphilia must be present for ______months
deviation; what a person is attracted to;
6+
Fetish disorder, Voyeuristic dis’d, Frotteuristic, Masochism refer to _____ type of attraction, respectively
inanimate object / non-genital body partD;
Watching other people have sex
sex with an UNSUSPECTING person
receiving pain
What are some of the issues regarding paraphilia classification by the DSM
Disorder implies distress + dysfunction BUT if both partners are consenting, does not have to be a ‘disorder’.
- transvestic disorder’ again, may or may not be disordered based on if person feels shame + guilt about their practice
Which is INCORRECT regarding SD research;
a) Most paraphilia clients are straight males
b) Paraphilia often starts with Fetish, voyeuristic and
exhibitionism
c) all paraphilias often have similar age of onset
d) paraphilia often co-morbid with mood + anx + SUD disorders
C - wrong.
-Fetish, voyeuristic and
exhibitionist-ADOLESCENCE
-Sadism + masochism= early adulthood
Fetishistic disorder is different from an attraction if
The object is EXCLUSIVELY required for arousal // strongly preferred = sexual reliance on this object for 6+ months, inv distress/impairment,
Which is INCORRECT regarding paediphillia;
a) offender has to be 16+ AND victim 5+ years YOUNGER
b) Manipulation + grooming frequent, insertion sometimes attempted
c) National Crime Authority of Australia defines ‘paedophiles’ as adults with a sexual preference for children
d) ‘child’ refers to anyone below the age
of consent
e) penile plethysmograph can help predict reoffending
C - WRONG. Refers to someone who has a PREFERENCE and then ACTS on this preference. Desire alone is not enough.
For diagnosis purposes, desire must be present, frequent, and cause distress to individual
Incest refers to; a) a first line blood relative b) a second line blood relative c) close relative for whom marriage is forbidden d) parental relations
C
The most common incestial relationships are
Siblings, followed by father daughter
Do men committing incest differ from paedophillic men?
Yes, incest more likely to abuse girl POST puberty, other will abuse prepubescent
DSM criteria for paedophilic disorder is________
for at least six months, they experience recurrent and
intense, sexually arousing fantasies, urges/ behaviours involving sexual contact with a
prepubescent child. Person will have ACTED on this and it has caused them DISTRESS. Person is >16yo, and child >5 years younger
In voyeuristic disorder, FALSE statement is;
a) fantasies about looking at unsuspecting others classifies a diagnosis
b) someone undressing for them, is NOT arousing
c) risk of getting caught elevates arousal
d) for some, this is their only act of sexual activity
A - not enough diagnosis. Needs to occur 6+ months, cause distress. Need to ACT ON THESE DESIRES with watching an unsuspecting person
Which is INCORRECT regarding exhibiitonism disorder
a) many masturbate during the incident
b) occurs in the same place + time of the day
c) offender experiences headaches, palpitations and
derealisation
d) 1/200 get arrested
D - 1/150 gets arrested
The DIFFERENCE between voyeuristic and Frotteusrtic disorder is that
Frottersitic enjoys PHYSICALLY TOUCHING victim, rubbing self on others
between masochism and sadism, the most common is
Masochism, being subjected to pain/humiliation.
Sadism is not freq diagnosed bc of stigma = used in FORENSIC settings. Diagnosis requires person to act on this with NON-CONSENTING partner
hyposyphilla refers to
attraction to strangling
_____ type of substance abuse associated with sadism
Alcohol
Some aetiological factors for paraphilia are
high androgens (sex hormones)
history of sexual abuse
impulsivity (to act on urges), may relate to SUD, i.e. alcohol reduces inhibitions even more
negative mood
lack of empathy, hostile attitudes to victim
Low IQ, academia, criminal activity freq,
Most paraphillic disorders are often treated voluntarily
T/F
False - court ordered
What are the challenges therapist faces in treating paraphilia clients and how are these overcome
client minimises the harm they inflict
blame the victim
assert that they have control over actions
high drop out rate
TRIES TO motivate client CONTROL urges, highlight
legal + other consequence of the behaviour
CBT for paraphilia involves
Aversion therapy: men coached to pair paraphilic fantasies with aversive stimuli i.e. small electric shock
Covert sanitation - man imagines situations he finds arousing + at the same time imagines feeling sick/ ashamed for feeling this way
OVERALL therapist tries to change distorted thinking i.e. ‘she was too young to remember’ –> younger = more damage
The main biological interventions for paraphilia
castration - removal of testes
hormonal treatment
SSRI’s
What is the ethical concern associated with biological interventions of paraphilia
ethical concerns such as - indefinite
hormonal agents = reduce androgens. They are LIMITED = infertility, liver problems, osteoporosis, diabetes
Post-sentence preventive detention order serves to ________ and is present in ALL states of Au (T/F)
allows a person post-sentence to be detained indefinitely in prison to ensure adequate protection of the community for serious sexual offences; FALSE
diagnosis of paraphilia can lead to placement in a psychiatric facility T/F
True
The Australian National Child Offender Register
(ANCOR) requires offenders to notify police of their
address, places they frequent,car registration + other info
