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NMSP Exam 1 > Sexual Disorders and Paraphilias > Flashcards

Sexual Disorders and Paraphilias Flashcards

1
Q

Abnormal sexuality excludes what?

A

Stimulation of primary sex organs

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2
Q

High-risk factors in human sexual behavior

A
  • Substance use
  • Limited access to care
  • Poor health literacy
    • About STIs, STI symptoms, and prevention
  • Unassertive
  • Poor communication skills
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3
Q

High-risk human sexual behaviors

A
  • Unprotected
    • Intercourse
    • Oral sex
    • Anal sex
  • Multiple sex partners
  • High-risk partner
  • Sex trade work
  • Self or partner use of IV drugs
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4
Q

High-risk factors and behaviors lead to…

A
  • STI
  • Unwanted/unplanned pregnancy
  • Relationship complications
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5
Q

Sexual response cycle (4)

A
  1. Desire
  2. Excitement
  3. Orgasm
  4. Resolution
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6
Q

Components of phase 1 (desire) of the sexual response cycle

A
  1. Sexual drive
    • Biological
    • Genital sensations and thoughts about sex
  2. Motivation
    • Psychological
    • Willingness to offer your body for sex
  3. Wishful fulfillment
    • Social
    • Hoping for sex, expectations for sex
    • Can be culturally influenced
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7
Q

Components of phase 2 (excitement​) of the sexual response cycle

A

Arousal

  • Lasts several min to hours
  • Erection; vaginal lubrication
  • Nipples harden
  • Increased RR, HR (up to 180 bpm), and BP
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8
Q

Two physiological processes that occur during the excitement stage of the sexual response cycle

A
  1. Vasodilation/constriction
    • Engorgement of blood vessels of the genitals as a result of dilation of vessels
  2. Myotonia
    • Muscle contractions not only in the genitals but throughout the body
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9
Q

Components of phase 3 (orgasm​) of the sexual response cycle

A
  • Peak of sexual pleasure
  • Release of sexual tension and the rhythmic contraction of the perinatal muscles and pelvic reproductive organs
  • Orgasms typically last 3-25 seconds
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10
Q

Components of phase 4 (resolution​) of the sexual response cycle

A
  • Disengorgement of blood from genitalia
  • Body returns to resting state
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11
Q

If an orgasm occurred, what is the resolution phase like?

A
  • Rapid
    • ​Accompanied by a general sense of well-being
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12
Q

If orgasm did not occur, what is the resolution phase like?

A

Resolution may take up to 2-6 hours

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13
Q

Average resolution period in males

A

3-10 minutes, to 24 hours, to several days for a refractory period

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14
Q

Average resolution period in females

A

Need time for resolution

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15
Q

Do females have a refractory period in the sexual response cycle?

A

No

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16
Q

What is important when discussing sexual health with patients?

A

Education

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17
Q

Male hypoactive sexual desire disorder

  • Characteristics
  • Time criteria
A
  • Persistent or recurrently deficient (or absent) sexual fantasies and desire for sexual activity
  • 6 months
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18
Q

What must the clinician take into account when diagnosing a patient with male hypoactive sexual desire disorder?

A

Age and context of the persons life over 6 months

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19
Q

Female sexual interest/arousal disorder

  • Criteria
A

Lack of or significantly reduced sexual interest/arousal with at least 3 of the following for 6 months:

  • Absent or reduced interest in sexual activity
  • Absent or reduced sexual/erotic thoughts or fantasies
  • None or reduced initiation** of sexual activity, **unreceptive to partner’s attempts
  • Absent or reduced sexual pleasure (75-100% of encounters)
  • Absent or reduced sexual interest/arousal in response to any internal or external sexual/erotic cues
  • Absent or reduced genital or non-genital sensations during sexual activity in 75-100% of sexual encounters
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20
Q

Criteria for erectile disorder (ED)

A

At least one of the three following symptoms experienced on almost all or all occasions of sexual activity for 6 months:

  • Difficulty obtaining an erection
  • Difficulty maintaining an erection until completion of sexual activity
  • Marked decrease in erectile rigidity
21
Q

Risk factors for erectile disorder

A
  • HTN, DM
  • Smoking
  • CVD, PVD
  • Dyslipidemia
  • Peyronies disease, Priapism tx
  • Pelvic trauma/surgery
  • Renal failure and dialysis
  • Hypogonadism
  • Alcoholism
  • Antidepressant side effects
  • Poor sexual technique, lack of sexual knowledge
22
Q

Female orgasmic disorder

  • criteria
A

Persistent or recurrent delay in, or absence of, orgasm or reduced intensity (75-100%) following a normal sexual excitement phase, for 6 months

**Ensure adequate stimulation**

23
Q

Criteria for delayed ejaculation

A

Either of the following symptoms must be experienced on almost all or all occasions for 6 months:

  • Marked delay in ejaculation
  • Marked infrequency or absence of ejaculation
24
Q

Premature ejaculation

  • Criteria
A

Persistent or recurrent ejaculation with partnered sexual activity within approximately 1 minute following penetration and before the patient prefers it, for 6 months on almost all or all occasions

25
Q

Genito-pelvic pain penetration disorder

  • Criteria
A

Persistent or recurrent difficulties with one or more of the following for 6 months:

  • Vaginal penetration during intercourse
  • Marked vulvovaginal or pelvic pain during intercourse
  • Marked fear or anxiety about pain preceding, during, or as a result of vaginal penetration
  • Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration
26
Q

Psychological cycle of sexual dysfunction

A

Performance pressure ⇨ Fear of failure ⇨ anxiety that interferes with some phase of the sexual response ⇨ sexual dysfunction actually experienced

27
Q

Behavior therapies useful in sexual disorders

A
  • Sensate focus
  • Squeeze technique; start-stop method
  • Relaxation technique
  • Masturbation
28
Q

Define paraphilia

A

Any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypicaly normal, physically mature, conseting human partners for at least 6 months

29
Q

Legal (non-victimizing) types of paraphilias

A
  • Fetishism
  • Sexual masochism (injury to self)
  • Transvestic fetishism
  • [Mild] Sexual sadism (injury to others)
30
Q

Illegal (victimizing) types of paraphilias

A
  • Voyeurism
  • Exhibitionism
  • Pedophilia
  • Sexual sadism
31
Q

Legal (non-victimizing) paraphilias are often described as

A

Alternative sexual lifestyle

  • They have no severe co-morbid psychopathologies
  • Not likely to present for treatment
32
Q

What high comorbidity is associated with Illegal (victimizing) paraphilias

A

Antisocial personality disorder

33
Q

Sexual masochism disorder

A

Derives sexual pleasure from suffering (humiliation, beaten, bound)

  • Real acts, not simulation
34
Q

Hypoxyphilia aka autoerotic asphyxiation

A

Sexual arousal by oxygen deprivation obtained by means of:

  • chest compression
  • noose
  • ligature
  • plastic bag
  • mask
  • chemical (amyl nitrate)
35
Q

Most common motivation for hypoxyphilia

A

fantasy of bondage and pain

36
Q

Effects associated with hypoxyphilia

A
  • Dizziness
  • Lightheadedness
  • Increased intensity of orgasm
37
Q

Classic population associated with hypoxyphilia

A

Middle class, caucasian males < 30 y/o without history of mental illness

38
Q

Sexual sadism disorder

A

Sexual arousal from the physical or psychological suffering of another person

  • Partner may or may not have consented
39
Q

Define Exhibitionism

A

Exposure of genitals to unsuspecting strangers in public

  • victim is usually nonconsenting
40
Q

Intent of exhibitionism

A

Evoke shock or fear

41
Q

Fetishistic disorder

A

Sexual arousal from non-living objects or specific focus on non-genital body parts

Common examples: women’s shoes or panties; feet

42
Q

Frotteuristic disorder

A

Touching or rubbing against a non-consenting person

  • Implies rubbing genitals on another person
  • Typically males 15-25 y/o
43
Q

Transvestic disorder

A

Sexually arousing fantasies, urges or behaviors about cross-dressing

  • Not related to gender identity
44
Q

Voyeuristic disorder

A

Sexual arousal by watching an unsuspecting person who is naked, disrobing, or engaging in sexual activity

  • Perpetrator must be 18+; “peeping Tom”
45
Q

Define pedophilic disorder

A

Sexual fantasies, urges or activity with a prepubescent child (usually < 13 y/o)

46
Q

What is the criteria for the perpetrator in order to define pedophilic disorder

A

Must be 16+ and at least 5 years older than the child

47
Q

Exclusive pedophilic disorder

A

Sexual interest only in children

48
Q

Non-exclusive pedophilic disorder

A

Usually heterosexual and married with interest in and aroused by children

49
Q

Risk factors for the tendency of a convicted pedophile to reoffend

A
  • Male victims
  • Stranger victims
  • Prior sex offenses
  • Lack of a cohabitation history with adult partners

NMSP Exam 1 (6 decks)

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