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BSP extra (not included in other deck) > Sexual Disorders + Paraphilias > Flashcards

Sexual Disorders + Paraphilias Flashcards

1
Q

What are some high risk factors for human sexual behavior leading to abnormal sexuality?

A

substance use, limited access to care, poor health literacy (about STIs, STI syxs, prevention), unassertive, poor communication skills

*people vulnerable = anyone w/ trauma, children, various religious backgrounds, people with lower IQ/mental disabilities

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2
Q

What are some high risk factors for human sexual behavior leading to abnormal sexuality?

A

unprotected intercourse/mouth-to-genital contact/anal sex, multiple sex partners, sex trade work, self or partner use of IV drugs

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3
Q

What can high risk factors + high risk behavior lead to?

A

STI, unwanted pregnancy, relationship complications

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4
Q

What are the 4 phases of the sexual response cycle?

A
  1. Desire
  2. Excitement
  3. Orgasm
  4. Resolution
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5
Q

What are the components of the Desire phase?

A
  1. sexual drive - biological, genital sensations + thoughts about sex
  2. motivation- psychological, willingness to offer body for sex
  3. wish fulfillment- social, hoping for sex, expectations; can be culturally influenced
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6
Q

What are the components of the Excitement phase?

A

Arousal - lasts several mins to hours; erection; vaginal lubrication; nipples harden; increase resp, tachy, incr. BP

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7
Q

What are the two basic physiological processes that occur in the excitement phase?

A
  1. VD/constriction: engorgement of BVs of genitals as result of dilation of BVs
  2. Mytonia: muscle contractions in genitals + throughout body
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8
Q

What are the components of the Orgasm phase? how long does it last?

A

peak of sexual pleasure, release of sexual tension; rhythmic contraction of perinatal muscles + pelvic reproductive organs

3-25 seconds

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9
Q

What are the components of the Resolution phase?

A

disgorgement of blood from genitalia, body returns to its resting state

w/ orgasm–> RAPID resolution + sense of well-being
w/out organsm–> resolution may take up to 2-6 hrs

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10
Q

Gender differences in resolution?

A

males: average 3-10 mins 24 hrs, or several days for refractory period
females: no refractory period, usually need to time for resolution tho; can have multiple orgasms

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11
Q

What is important to do with patients having issues with sex?

A

EDUCATING patients is impt!!

Timing- teach pts about sexual response cycle so they know whats normal in themselves and their partner

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12
Q

What are the dysfunctions in desire called?

A

Female- Female sexual interest/arousal disorder

Male- Male hypoactive sexual desire disorder

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13
Q

Male hypoactive sexual desire disorder:

A
  • persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity
  • judgement made by clinician + acct for factors like age + context of persons life

** 6+ months ***

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14
Q

Female sexual interest/arousal disorder

A

Lack of or significantly reduced sexual interest/arousal w/ at LEAST 3 of:

  • absent/reduced interest in sexual activity
  • absent/reduced sexual/erotic thoughts or fantasies
  • none/reduced initiation of sexual activity, unreceptive to partner’s attempts to initiate
  • absent/reduced sexual pleasure (75-100% of time)
  • absent/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 (75-100% of time)

** 6+ months ***

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15
Q

Erectile Disorder (ED):

A

at least one of three following syx must be experience on ALMOST ALL or ALL occasions of sexual activity:

  • difficulty obtaining erection
  • difficulty maintaining erection until completion of sexual activity
  • marked decrease in erectile rigidity

** 6+ months ***

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16
Q

Risk factors for erectile dysfunction (just be familiar):

A 
Hypertension or treatment 
Pelvic trauma or surgery
Diabetes 
Renal failure and dialysis
Smoking 
Hypogonadism
Coronary artery disease 
Alcoholism
Peripheral vascular disorders 
Antidepressant medication
Blood lipid Abnormalities 
Lack of sexual knowledge
Peyronie’s disease 
Poor sexual technique
Priapism treatment 
Interpersonal problem
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17
Q

What are the dysfunctions in excitement/arousal called?

A

Male- erectile disorder

female- female sexual interest/arousal disorder (same as desire)

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18
Q

What are the dysfunctions in orgasm called?

A

Male- delayed ejaculation, premature ejaculation

Female- female orgasmic disorder

19
Q

What are the dysfunctions in sexual pain called?

A

Female= genito-pelvic pain/penetration disorder

no male

20
Q

Female orgasmic disorder:

A

persistent or recurrent DELAY in, or ABSENCE of, orgasm or reduced intensity (75-100%) following a Normal sexual excitement phase

** 6+ months ***`

21
Q

Delayed ejaculation:

A

either of the following symptoms must be experienced on ALMOST ALL OR ALL occasions

  1. marked delay in ejaculation
  2. marked infrequency or absence of ejaculation

** 6+ months ***`

22
Q

Premature ejaculation:

A

persistent or recurrent ejaculation w/ partnered sexual activity within approximately 1 MINUTE following penetration + before pt prefers it; ALMOST ALL or ALL occasions of sexual activity

** 6+ months ***`

23
Q

Genito-Pelvic Pain penetration disorder:

A

PERSISTENT or recurrent difficulties w/ 1 or more of the following:

  1. vaginal penetration during intercourse
  2. marked vulvovaginal or pelvic pain during penetration on intercourse
  3. marked fear or anxiety about pain preceding, during, or as a result of vaginal penetration
  4. marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration

** 6+ months ***`

24
Q

Psychologically what may cause the vicious cycle of sexual dysfunction? What could help it?

A

fear of failure and performance pressure

Treatment: focus on cognitive intervention!!

25
Q

What is the general approach to treating sexual dysfunction?

A
  1. Evaluate + treat underlying medical conditions (comorbidities)
  2. consider medication side effects
  3. education, if needed
  4. behavior therapy, if needed
  5. refer to counseling, if relationship problems
26
Q

What is the sensate focus behavioral therapy?

A

No intercourse allowed for a time period, then systemically re-introduce sexual stimulation

helps with the anxiety surrounding sex

27
Q

What are other behavioral therapies besides the sensate focus that can help with sexual dysfunction?

A

squeeze technique; start stop method (premature ejac)

relaxation techniques (can include systemic desensitization)

Masturbation (increases knowledge + awareness of personal preferences)

28
Q

What is a paraphilia?

A

any intense and persistent sexual interest other
than sexual interest in genital stimulation or preparatory
fondling with phenotypically normal, physically mature,
consenting human partners
** 6+ months ***`
An overall term describing several individual disorders

29
Q

What are the legal/non-victimizing types of paraphilias?

A

fetishism, sexual masochism, transvestic fetishism, sexual sadism (mild)

30
Q

What are the illegal/victimizing types of paraphilias?

A

Voyeurism, exhibitionism, pedophilia, sexual sadism (injury to others)

31
Q

Who most commonly has paraphilic disorders?

A
  • rare in US
  • early onset (<18)
  • male, 50% married
32
Q

Non-victimizing paraphalias vs. victimizing:

A

Non-victimizing: no severe comorbid psychopathologies, not likely presenting for treatment, “alternative sexual lifestyle”

Victimizing: unlikely to seek treatment; “rationalizing”= defense mechanism; high comorbidity w/ Antisocial Personality Disorder

33
Q

Sexual Masochism Disorder

A

Derives sexual pleasure from suffering (humiliation, beaten, bound)- real acts, not simulation

Asphyxiophlia or Hypoxphilia is part of this (sexual arousal by oxygen deprivation obtained by means of chest compression, noose, ligature, plastic bag, mask, or chemical)

34
Q

Why is Asphyxiophlia or Hypoxphilia dangerous?

A

risk of sudden death

used to increase intensity of orgasm; increase sexual pleasure by feeling in “mortal danger”

35
Q

Sexual Sadism Disorder:

A

sexual arousal from the physical or psychological suffering of another person

“partner” may or may not have consented

36
Q

Exhibitionism:

A

exposure of genitals to unsuspecting strangers in public

intent= evoke their shock or fear

-victim usually nonconsenting

males

37
Q

Fetishistic Disorder:

A

sexual arousal from NON-LIVING objects or specfici focus on NON-genital body parts (ex. womens panties, feet)

38
Q

Frotteuristic Disorder:

A

touching or rubbing against a non-consenting person w/ their genitals

male, usually 15-25 y/o

39
Q

Transvestic Disorder

A

sexually arousing fantasies, urges, or behaviors about/from cross-dressing

not related to gender identity

40
Q

Voyeuristic Disorder:

A

Sexual arousal by watching an unsuspecting person who is naked, disrobing, or engaging in sexual activity.
Must be 18+ y/o

BASICALLY JOE GOLDBERG. OR is it Love now? Stay tuned on this VOYage to season 3.

41
Q

Pedophilic Disorder

A

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

must be 16+ and at least 5 yrs older than child

exclusive = sexual interest only in children
non-exclusive =  usually heterosexual and married

EXTREMELY difficult to treat!

42
Q

What are some behavior therapies used paraphilias? are they successful

A

LOW SUCCESS RATE

  • aversive therapy (reduce pleasure)
  • desensitization (neutralize anxiety)
  • social skills training (form better interpersonal relationships)
  • orgasmic reconditioning (teach more approp mental imagery for sexual fantasies)
43
Q

Is it successful to use Rx to treat paraphilias?

A

no low success rate

BSP extra (not included in other deck) (4 decks)

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