Sexual Disorders Flashcards

1
Q

What are the 4 aspects of Masters and Johnsons sexual response cycle?

A

1) Sexual Excitement
2) Plateau
3) Orgasm
4) Resolution-things slow down,male is refractory for a period of time (From 30 mins to 24 hours)

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2
Q

What are the 3 aspects of Helen Singer Kaplan’s sexual response cycle?

A

1) Desire
2) Excitement
3) Orgasm
Adding desire is important as a successful sexual interaction includes desire

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3
Q

What does one need in order to be diagnosed with a sexual disorder?

A

-Must include recurrent problems over 6 months and CLEAR distress or interpersonal difficulty. Diagnosis is not made without this. People who do not experience sexual activity as distressing and who do not cause harm to others are not diagnosed. Must not be explainable by other disorders, substance abuse, general medical conditions (a lot are associated with medical conditions).

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4
Q

What is the time distinction in sexual disorders?

A

Has the dysfunction been lifelong or acquired (through trauma, bad relationship, medical etc)

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5
Q

What is the contextual distinction in sexual disorders?

A

Generalized sex dysfunction versus situational

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6
Q

What are the sexual arousal and desire phase disorders?

A
  • Male hypoactive sexual disorder
  • Female sexual interest disorder
  • Erectile disorder
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7
Q

What do male hypoactive sexual disorder and female sexual disorder have in common?

A

Both have to do with getting started. Man describes having less interest in sex than other males.

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8
Q

What percentage of men have an erectile disorder (and what is the trend?)

A

40% of males at 40, 50% of males at 50, 60% at 60. Goes up by 10% every 10 years. If you are 70 and have never had problems, you’re doing well

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9
Q

What are the orgasmic phase disorders?

A
  • Delayed Ejaculation
  • Female Orgasmic disorder
  • Premature Orgasm
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10
Q

What is female orgasmic disorder and is it common?

A

Inability to achieve orgasm. Not unusual as you get older

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11
Q

What is premature orgasm and is it common?

A

30s of penetration, 10 thrusts. Common in men, not an unusual issue. Usually one of the main problems men present with

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12
Q

Does hypersexuality exist? Is it a problem?

A

We are unsure, as we don’t know how to define it. Not a disorder in DSM5. Research was weak, as was criteria. However, it can be a big problem (multiple partners, prostitutes, phone sex etc)

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13
Q

What is Genito-Pelvic Pain/Penetration disorder?

A

Persistent, recurrent difficulties with one or more of the following:

  • Vaginal penetration during intercourse
  • Marked pain during intercourse and penetration attempts (core feature of dyspareunia)
  • Marked fear or anxiety about the pain
  • Marked tensing or tightening of pelvic floor during penetration (core feature of vaginismus)
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14
Q

Which gender has genito-pelvic pain more often?

A

Females. For men, it’s usually due to an infection

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15
Q

What is dyspareunia?

A

Marked pain and difficulty with vaginal penetration/. 18-22% of women experience this.

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16
Q

What types of disorders is treatment normally sought for?

A

Erectile disorder, female orgasmic disorder, premature orgasm

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17
Q

Have sexual desire problems become more or less frequent in both genders?

A

More

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18
Q

What is a common factor that affects sexual functioning?

A

Age

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19
Q

What are the biological factors related to in sex dysfunctions?

A

Hormone problems

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20
Q

What type of biological dysfunction is erectile dysfunction related to?

A

Vascular dysfunction (possibly an early indicator of cardiovascular dysfunction)

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21
Q

What hormone causes sex disorders in men?

A

Testosterone

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22
Q

How does oxytocin play into sex dysfunctions?

A

Drug that increases sexual pleasure and favours emotional bonds. Included in “love”. Less oxytocin, means a lack of interest.

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23
Q

What types of drugs can affect sexual desire?

A

Tobacco, alcohol, marijuana. Tobacco is hard on the heart, alcohol affects the CNS

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24
Q

How do SSRI’s affect sexual functioning?

A

Can cause delayed ejaculation and orgasmic dysfunction. Plays a HUGE role in sexual dysfunction

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25
Q

What other types of disorders can cause erectile dysfunction in men?

A

Neurological disorders (need medical consultation to diagnose sex disorders)

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26
Q

What types of things can interfere with vaginal swelling and lubrication?

A

Neurological disorders, pelvic disease, hormonal dysfunction

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27
Q

How do social factors play into sex dysfunctions?

A

Sex education shapes how we view sex. Women in recent decades report fewer orgasmic problems. Women with orgasmic disorders are less likely to talk about it. Sex is the most regulated form of behaviour in humans

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28
Q

Why is North America described as hypersexual, and what is funny about this?

A

Our consumption of porn is substantial. Yet people are still shy about sex and complain about not getting enough information (on sex and how to love)

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29
Q

How can childhood socialization play into sex disorders?

A

Baby boys can get erections in the womb-shows that hormones act fast. Children will explore themselves and others. Parents should guide kids through this, help them understand boundaries, and also give information.

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30
Q

What are some of the psychological factors that play into sex disorders?

A
  • Performance Anxiety
  • Relationship factors
  • Assertiveness problems, lack of social skills, discomfort about sex
  • Previous harmful experiences
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31
Q

What is performance anxiety?

A

One of the most important aspects. Concern that person will not perform well. Become spectators of their own behaviour. Anxiety about how body will respond and discomfort with body

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32
Q

What are some relationship factors that play into sexual dysfunctions?

A

Bad relationships make bad sex. Reliable indicator of bad relationship

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33
Q

What is the PLISSIT model and the 4 phases?

A
A treatment model with 4 phases
Permission
Limited Information
Specific Suggestions
Intensive therapy
34
Q

What is permission?

A

Therapist gets the couples permission to discuss sex. Gives couple permission to feel comfort with the topic

35
Q

What is limited information?

A

Correcting misconceptions, giving more information. Provide people with general info for general understanding

36
Q

What is specific suggestions?

A

Give suggestions related to specific issues and assignments. Solutions are helpful, but are difficult to do (uncomfortable, problematic)

37
Q

What is intensive therapy?

A

Some people may need extensive treatment, especially if sex dysfunction is accompanied by sexual abuse, depression, and anxiety.

38
Q

How can both genders prevent sexual disorders?

A

Healthy communication, staying sexually active, smoking cessation, reduction of alcohol intake, regular exercise

39
Q

What is a sensate focus?

A

Behavioural approach that allows couple to reduce anxiety with sex interactions. Beginning can sometimes be as simple as holding hands, arm around, kissing. Program of desensitization to sexuality and anxiety

40
Q

How is Genito-Pelvic Pain typically treated?

A

Psychosocial approaches: Relaxation training, changes to sexual approaches, interventions targeting body image and relationship problems, medical intervention

41
Q

What are some biomedical treatments for erectile dysfunction?

A

Viagara, Cialis, etc. Injections of neurotransmitters, mechanical devices (pumps for blood, rings, inflatable tubes)

42
Q

What is the one problem with a mechanical device for erectile dysfunction?

A

Penis will stop functioning totally

43
Q

What are some treatment options for women (biomedical)

A

Focuses mainly on way to reduce pain, use of vaginal moisturizers and lubricants, etc.

44
Q

What are paraphilias?

A

Sexual arousal associated with atypical stimuli. Intense, persistent sexual interest other than in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners.

45
Q

Which gender are paraphilias more common in?

A

Men than women

46
Q

What are the typical symptoms of paraphilias?

A

Sexual fantasies are strong, long-standing, unusual, persistent. Fantasies do not involve reciprocal loving with an adult partner. Themes of aggression, revenge, hostility, dominance. Compulsions, lack of flexibility.

47
Q

What are the 3 categories that men with paraphilias can fall into?

A

1) Timid, submissive, socially inept
2) Aggressive, domineering, rigid, self-indulgent
3) Confused, disorganized, sometimes mentally ill or intellectually deficient.

48
Q

What are some of the major paraphilias?

A

-Fetishistic disorder
-Transvestic disorder (transvestic fetishism)
-Sexual sadism and masochism (autoerotic asphyxia)
-Exhibitionistic disorders
-Voyeuristic disorder
-Frotteuristic disorder
-Pedophilic disorder
(LAST 4 constitute criminal offences)

49
Q

Is fetishistic disorder problematic?

A

Not unless it causes some form of distress (transvestic and sadism and masochism included)

50
Q

What is exhibitionistic disorder?

A

Sexual excitement involves showing self to someone explicitly

51
Q

What is voyeuristic disorder?

A

Sexual arousal from watching explicit actions

52
Q

What is frotteuristic disorder?

A

Gratification from rubbing oneself against someone

53
Q

What is pedophilic disorder?

A

Attraction to children under the age of consent

54
Q

What is typical of pedophilic disorder?

A

Child victim usually knows the perpetrator. Most incidents occur in childs home or perpetrators home. Includes grooming. Most behave normally in everyday life

55
Q

What is the difference between a pedophile and a child molester?

A

Pedophilia: Consists in the experience of recurrent, intense, sexually arousing fantasies and urges involving sex with people 13 or younger.
Molesters: Typically have an adult partner. Also interact sexually with children and teens. Most frequent in hero males, most victims are girls, most common contact is genital fondling

56
Q

How do pedophiles feel about the child they’re coming after?

A

Sometimes they love the child. Don’t want to hurt them. Incestuous relationships take place between relatives

57
Q

How is pedophilia and child molestation passed on?

A

Passed on to their sons through trauma.

58
Q

What fraction of men who abuse their own children are also abusing other children sexually?

A

About half.

59
Q

What personality trait do many pedophiles have?

A

Many are passive, sensitive, and non-threatening. Believe that kids benefit from them, grooming. A few are domineering, controlling and aggressive, but are unsuccessful.

60
Q

What is sexual assault?

A

Involves any sexual act, from touching to penetration performed without consent

61
Q

What is rape?

A

Nonconsensual sexual penetration by force, threat, or when victim is incapable of consent. Victims usually know the perpetrator (exception is during war)

62
Q

What percentage of women have reported being sexually assaulted or raped?

A

Assaulted: 21%
Raped: 6%

63
Q

How high is the recidivism rate of rape?

A

High. Around 25% of rapists will commit another sexual assault after 5-10 years of living in the community

64
Q

What is rape motivated by?

A

Aggression and arousal linked to suffering of the victim. Dangerous rapists enjoy fear, humiliation, pain.

65
Q

Is treatment successful in a rapist?

A

No

66
Q

What is a rapist usually diagnosed with in the DSM-5?

A

ASPD (cluster B personality disorders), sadistic behaviours etc.

67
Q

What are the biological factors associated with paraphilias?

A

Poorly understood… may be hormonal (testosterone) and temporal lobe dysfunction

68
Q

What is Freud’s Cortship Theory with paraphilias (psychosocial) and the 4 phases?

A

Why some men develop paraphiias. How various, highly evolved organisms approach sex partners and mate. 4 parts:
1) Pretactile
2) Tactile
3) Sex
Fixations at each level result in paraphilias.

69
Q

What is the pretactile phase?

A

Talking, approaching, smiling, offers

70
Q

What is the tactile phase?

A

Embracing, kissing, mutual touching, intercourse

71
Q

What is the feminist theory of paraphilias?

A

Male physical violence relates to unequal power distribution. Men have an impaired notion of nurturing and caring. Men see women as property

72
Q

What is the integrative theory of paraphilias?

A

Men who involve themselves in sexual violence have a history of sexual abuse, inappropriate modelling of sex behaviours and values, low self-esteem, poor social competence, poor knowledge of sexuality, the distorted notion of how to approach women.

73
Q

What is aversion therapy?

A

Get a person to imagine feeling revolted by sexual acts. Value is limited, as one needs a powerful imagination

74
Q

How does CBT work with paraphilias?

A

Skills teaching, dealing with fantasies and belief systems, other mental disorders, self-esteem. More successful

75
Q

How does hormone therapy work with paraphilias?

A

Injections of luteinizing hormones to take out testosterone. Testicle removal works too. You can remove the sexual interest, but not the violence.

76
Q

What is Gender Identity Disorder characterized by?

A

Firm conviction that one is a member of the opposite sex. Arises in early childhood (around 6 years). Gender dysphoria is more common in children. Biological variables are consistent, but discordant with persons sense of self

77
Q

What are some of the many dimensions of gender?

A
Chromosomal
Gonadal
Prenatal Hormonal
Internal Organs
External Genital Characteristics
Gender Identity
78
Q

What is gender role?

A

Collection of characteristics that society defines as masculine or feminine.

79
Q

What percentage of boys and girls develop GID?

A

Rare disorder: 3% of boys, 1% of girls

80
Q

How is psychotherapy used in the treatment of GID?

A

Used to explore gender identity issues and psychological distress. Therapy involves a period of time where the individual lives in a gender role congruent to their identity. Hormonal treatment and sex reassignment require you to live as the other sex for awhile

81
Q

What are the Standards of Care?

A
  • Persistent and well-documented gender dysphoria
  • Capacity to make fully informed decisions and consent to treatment
  • Age of majority in given country
  • Any medical concerns must be well controlled
  • 12 continuous months of hormone therapy, and 12 months of living as their preferred gender (not necessary for receiving hormone therapy or non-genital surgeries)