Sexual Disorders and Paraphilias

Question 1

What is abnormal sexuality?

Answer 1

not a human sex partner

stimulates other than primary sex organs

compulsive and injurious to self or others

Question 2

Describe high risk factors

Answer 2

substance use

limited access to care

poor health literacy about STI, STI sx and prevention

unassertive

poor communication skills

young age

Question 3

Describe high-risk behaviors

Answer 3

unprotected genital, mouth-genital, anal sex

multiple sex partners

high-risk partner

sex trade work

self or partner use of IV drugs

Question 4

Describe undesired outcomes from high-risk factors–> behaviors–> outcomes

Answer 4

STI

unwanted pregnancy

relationship complications

poverty

Question 5

Describe sexual response cycle

Answer 5

Desire
Excitement
Orgasm
Resolution

Question 6

Describe desire of sexual response

Answer 6

sexual drive
-biological, genital sensations and thoughts about sex

motivation
-psychological, willingness to offer body for sex

wish fulfillment
-social, hoping or expectation for sex, can be culturally influenced

Question 7

Describe excitement stage of sexual response

Answer 7

AROUSAL:

lasts several minutes to hours

erection, vaginal lubrication, hardening of nipples

increased respiration, tachy up to 180 bpm, rise in BP

Question 8

What are the 2 basic physiological processes that occur during the excitement stage of sexual response?

Answer 8

vasodilation/constriction
-engorgement of blood vessels of genitals d/t dilation of blood vessels

mytonia
-muscle contractions in genitals and throughout body

Question 9

Describe orgasm stage of sexual response

Answer 9

peak of sexual pleasure

release of tension and rhythmic contraction of perinatal muscles and pelvic reproductive organs

3-25 seconds

Question 10

Describe resolution of sexual response

Answer 10

disgorgement of blood from genitalia

body returns to resting state

if orgasm occurred–> rapid resolution with general sense of well-being

if orgasm did not occur–> can take up to 2-6 hours for resolution

Question 11

What sexual response stage is erectile disorder associated with?

Answer 11

excitement/arousal

Question 12

What sexual response stage is delayed or premature ejaculation associated with?

Answer 12

orgasm

Question 13

What is the difference between male and female hypoactive sexual disorders?

Answer 13

male: with decreased desire
female: with decreased desire, excitement or arousal

Question 14

Define male hypoactive sexual desire disorder

Answer 14

absent or deficient sexual fantasies and desire for 6 MONTHS

Question 15

Define female sexual interest/arousal disorder

Answer 15

lack or significantly reduced interest/arousal (at least 3) for 6 MONTHS

interest in sexual activity
sexual/erotic thoughts
initiation or unresponsive
pleasure
arousal response
sensations during activity

Question 16

Define erectile disorder

Answer 16

at least one in 75-100% of sexual encounters for 6 months:

difficulty obtaining erection

” maintaining erection until completion

marked decreased in erectile rigidity

Question 17

Name some RF for ED

Answer 17

HTN or tmt
DM
smoking
CAD
peripheral vascular DO
blood lipid abn
priapism tmt
alcoholism
antidepressant meds
lack of sexual knowledge
poor technique
interpersonal problems

Question 18

Describe female orgasmic disorder

Answer 18

delay in or absence of orgasm (75-100% of encounters) for 6 months

Question 19

Describe delayed ejaculation

Answer 19

all occasions for 6 months:

marked delay in ejaculation, infrequency or absence

Question 20

Describe premature ejaculation

Answer 20

within 1 minute for 6 months, all encounters

Question 21

Describe genito-pelvic pain penetration disorder

Answer 21

persistent with 1+ for 6 months:

vaginal penetration

vulvovaginal or pelvic pain

fear or anxiety about pain

tensing or tightening of pelvic floor muscles during attempted penetration

Question 22

Define paraphilia

Answer 22

sexual interest in things other than genital stimulation or sex with genetically normal, physically mature people

at least 6 months

Question 23

Describe non-victimizing paraphilias

Answer 23

not likely to present for treatment

described as alternative sexual lifestyle

no severe co-morbid psychopathologies (no other psych issues)

Question 24

Examples of non-victimizing or legal paraphilias

Answer 24

fetishism
sexual masochism
transvestic fetishism
mild sexual sadism

Question 25

Examples of victimizing and illegal paraphilias

Answer 25

voyeurism
exhibitionism
pedophilia
sexual sadism

Question 26

Describe victimizing paraphilias

Answer 26

unlikely to seek treatment

tend to rationalize as defense mechanism

antisocial personality disorder frequent with this paraphilia

Question 27

Define sexual masochism disorder

Answer 27

sexual pleasure from suffering (humiliation, beaten, bound)

real acts, not simulations

Question 28

Define sexual sadism disorder

Answer 28

arousal from suffering of another person (physical or psychological)

may or may not have consented (possible victimizing)

Question 29

Describe Frotteuristic disorder

Answer 29

victimizing

touching or rubbing against non-consenting person in crowded area

male, 15-25

Question 30

Does transvestic disorder correlate with gender identity?

Answer 30

NO

when guy wants to wear women’s underwear or dress up–> derives sexual pleasure but doesn’t want to become that gender

Question 31

Define voyeuristic disorder

Answer 31

arousal by watching unsuspecting person naked, disrobe, engage in sexual activity

must be 18+ to diagnose

Question 32

Describe pedophilic disorder

Answer 32

sexual fantasies, urges, activity with child under 13 (prepubescent)

must be 16+ and over 5 years older than child to diagnose

exclusive–> only arousal from kids

non-exclusive–> usually heterosexual and married