Sexual d/o's

Question 1

What constitutes a sexual disorder?

Answer 1

Characterized by a clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure. Can have >1 at a time.

Question 2

What factors should you consider before diagnosing a sexual disorder?

Answer 2

• Determine if there is a case of inadequate sexual stimulation
• Partner factors, relationship factors, individual vulnerability factors, cultural/religious factors, medical factors
  -Another mental disorder: ie depression
  Determine if life-long, acquired, generalized or situational

Question 3

What are paraphilias?

Answer 3

Unusual expressions of sexuality that are consider aberrant or even illegal. Any intense/persistent interest other than w/genital stimulation or preparatory activity.
Must be present for at least 6 months

Question 4

What are essential features of sexual dysfunction?

Answer 4

They are r/t disorders of normal sexual functioning.
Inability to respond to sexual stimulation or the experience of pain during the sexual act.

Question 5

What factors impact sexual drive?

Answer 5

Biological drive
adequate self-esteem
the ability to accept oneself as a sexual person
availability of appropriate partner
good relationship in nonsexual areas with partner

Question 6

What are 8 primary sexual disorders?

Answer 6

1. Delayed ejaculation (delay/absence at least 75-100% of time for at least 6 months)
2. Erectile d/o: 75-100% for at least 6 months
3. Premature/early ejac: 75-100 for 6 mo
4. Female orgasmic d/o: marked delay or infrequency/absence of orgasm or marked intensity of orgasmic sensations 75-100% x 6 mo
5. Male hypoactive sex desire: persistent deficient/absent thoughts, fantasies or desire x6mo
6. Desire discrepancy: lower desire than partner.
7. Female sex interest/arousal d/o
8. Genito-pelvic pain/penetration d/o (not dx if severe relationship distress, IPV)

Question 7

Common causes of sex d/o include…

Answer 7

General medical conditions: GU surgery, parkinson’s and other neuro d/o’s, hypothyroid, DM
Meds/drugs: AD’s antihypertensives, ETOH, amphetamines, opiates, anxiolytics, hypnotics, lithium, anticholinergis
Haldol - issues with ejac
Risperdone, clozapine, trazodone - priaprism

Question 8

Voyerism

Answer 8

A recurrent intense sex arousal from observing an unsuspecting person who is naked in the process of disrobing or engaging in sex

Question 9

Masochism

Answer 9

Individual who takes pleasure in EXPERIENCING physical/emotional pain and rely on this for sexual gratification. The individual who suffers from this is a masochist

Question 10

Sadism

Answer 10

A person who enjoys and achieves sex gratification by the INFLICTION of pain on another person

Question 11

Exhibitionism

Answer 11

Act of obtaining sex gratification from exposing oneself in a public or semi-public context

Question 12

Fethishism

Answer 12

Someone with a sexual interest in an object or in a part of the body other than sexual organs

Question 13

Pedophilia

Answer 13

Psychiatric d/o where an adult or older adolescent experiences a primary or exclusive sex attraction for prepubescent kids.

Question 14

Frotteurism

Answer 14

Recurrent sex arousal from touching/rubbing against a nonconsenting person as manifested by fantasies, urges, or behaviors

Question 15

Transvestic d/o

Answer 15

sex arousal from cross dressing (would be fetishism if aroused by fabrics/materials or garments)
with autogynephilia if sexually aroused by thoughts or images of self as opposite sex