Sexual Disorders Flashcards
What are the 4 phases in sexual response cycle?
- Appetitive
- Excitement
- Orgasm
- Resolution
Describe the appetitive cycle in the sexual response cycle
Desire - external and internal cues
Describe the excitement cycle in the sexual response cycle
Arousal - physical and psychological signs of arousal
Describe the orgasm cycle in the sexual response cycle
Ejaculation of seminal fluids and contractions of inner third of vagina
Describe the resolution cycle in the sexual response cycle
Decrease in arousal followed by refractory “resting” period
List Sexual Dysfunction Disorders?
- Sexual interest/desire disorders
- Sexual pain disorders
- Orgasmic disorders
- Substance induced sexual dysfunction
How long should a Sexual Dysfunction Disorder be present?
6 months an must lead to marked distress by the individual
List the 3 Sexual Interest/Desire Disorders
- Male hyperactive sexual desire disorder
- Female sexual interest/arousal disorder
- Male Erectile Disorder
What is Male hyperactive sexual desire disorder?
Persistent or absent desire for sex
What is Female sexual/arousal disorder?
Reduced or absent sexual interest/arousal
What is Male erectile disorder?
Impotence - failure to gain or maintain erection
What are the 4 Orgasmic Disorders?
- Female Orgasmic Disorder
- Male Orgasmic Disorder
- Delayed Ejaculation
- Premature Ejaculation
What is Female Orgasmic Disorder?
Absence of orgasm
What is Male Orgasmic Disorder?
Problems with ejaculation during sex
What is Delayed Ejaculation Disorder?
Delay or inability to ejaculate
What is Premature Ejaculation Disorder?
Inability to inhibit ejaculation (most common disorder in men)
What is the Sexual Pain Disorder?
Genito - Pelvic Pain/Penetration Disorder
What is Genito - Pelvic Pain/Penetration Disorder?
- Dyspareunia: Pain during or after sexual intercourse
- Vaginismus: Involuntary spasms of outer third of vagina such that intercourse is not possible
What is the Physical aetiology of Sexual Disfunction Disorders?
Aging, alcohol, medications, injuries, medical condition (hypertension, diabetes, kidney failure), nuerological disorders, inflammations, hormonal problems (Reduced testosterone in 30/40s, hypothyroidism/hypogonadism, Reduced estrogen in menopause)
What is the Psychoanalytic aetiology of Sexual Disfunction Disorders?
Unresolved unconscious conflict
What is the Behavioural aetiology of Sexual Disfunction Disorders?
Sexual feelings paired with anxiety that blocks sexual responses
What is Masters and Johnson aetiology of Sexual Disfunction Disorders?
- Fear of performance anxiety
- Adoption of a spectator ie not in the moment due to religion, sexual trauma, physicological causes and social cultural factors
What is the Cognitive aetiology of Sexual Disfunction Disorders?
Thoughts produce anxiety
What are other aetiology of Sexual Disfunction Disorders?
- Lack of knowledge
- Unaware of likes and dislikes of partner
- Poor communication
- Fear of contracting STD
What is the format for Sexual Dysfunction Treatment?
- Mutual responsibility/Couples therapy
How is Sexual Dysfunction assessed?
- Sexual history
- medical examinations
- exclusion of other mental disorders
What are treatments for Sexual Dysfunction?
- sex education
- Directed mastubation
- Skills and communication training
- Change in attitudes and cognitions
- Anxiety reduction techniques (sensation focus and non demand pleasuring)
- Shifts in routine
- Marital therapy
- Medical and physical procedures
What is Gender Dysphoria Disorder?
Gender Identity Disorder: mismatch in understanding of gender identity and biological sex match
What are DSM-V criteria for Gender Dysphoria Disorder?
In children:
A. Mismatch in expressed gender for at least 6 months and 6 of:
1. Strong desire to be other gender
2. Desire to cross dress
3. Preference for cross gender roles in fantasy play
4. Preference for toys, games, activities sterotypically for the other gender
5. Preference for playmates of the other gender
6. Rejection of their genders toys
7. Dislike of sexual anatomy
8. Desire for primary/secondary sex characteristic for experienced gender
B. Significant clinical distress and impairment
What is the Modelling and operant conditioning aetiology for Gender Dysphoria Disorder?
Reinforced cross dressing
What is the Biological aetiology for Gender Dysphoria Disorder?
Hormaonal and chromosomal abnormality: Pseudohermaphroditism (Genetically male but no penis, but increase in hormones as a teenager produces penis and adaption to male gender easy indicating preprogrammed to be male)
What is the treatment for Gender Dysphoria Disorder?
Sex reassignment surgery:
- Must live in gender for 2 years
- Hormone treatment
- Surgery
What are Paraphilic Disorders?
Any intense and persistent sexual interest other than genital stimulation with a phenogenically normal, physically mature, consenting human partner that causes distress or social impairment for the person or causes harm to or threatens other people
How long must Paraphilic symptoms be present?
6 months
What age is onset of Paraphilic Disorders?
7 to 38 (average 16)
What 4 things must be present for Paraphilic diagnosis?
- Must lead to cinical distress or impairment
- Are compulsory
- Produce sexual dysfunction
- Requires participation of non consenting person
What is Voyeristic Disorder?
Observing and unsuspecting person that is naked or in the process of disrobing or engaging in sex. No arousal without spying
What is Exhibitionist Disorder?
Indecent exposure with the intent to shock the observer
What Frotteuristic Disorder?
Sexual aroused by touching or rubbing genitals against a non-consenting person
What is sexual Sodism Disorder?
Arousing fantasies, urges or behaviour that involve that psychological or physical suffering of a victim. Fantasies involve asserting dominance (control and power)
What is Sexual Masochism Disorder?
Arousing fantasies, urges, impulses involving being humiliated, beaten, bound or made to suffer. More common in male 20:1
What is Pedophilic Disorder?
Persistently engaging in sexual activities with children.
What is Fetishistic Disorder?
Association of sexual arousal with nonliving objects eg underwear, shoes, rubber, leather
What is Transvestic Disorder?
Cross dressing for sexual arousal
What is the Biological aeitology for Paraphilic Disorders?
- Hormones: High levels of sex hormones
- Brain damage: Possible temporal lobe damage
- Kluver-Bucy syndrome: Monkeys with temporal lobe damage behave oddly but not present in temporal lobe epilepsy
What is the Behavioural aeitology for Paraphilic Disorders?
- Classical conditioning - orgasm to stimuli
- Modelling
- Reinforcement
What are courtship disorders?
Difficulty identifying partner
What are intimacy deficits?
Failure to achieve intimacy with adults
What are Lovemaps?
Mental pictures representing a persons ideal sexual relationship learned in childhood and adolescence
Could sexual, physical and emotional abuse as a child impact paraphilic Disorders?
Yes - limits ability to form intimate adult relationships
What are treatments for Paraphilic Disorders?
Aversion Therapy
Drug Treatment
CBT - Education, social skills, relapse prevention procedures
What drugs are used in Paraphilic Disorders?
- Cypoterone, acetate, triptorelin to reduce testosterone
- Anti depressants and anti anxiety medications
