Sexual Dysfunction Flashcards
Paraphilias
- Recurrent, intense arousing fantasies, urges, behaviors that involve
- non human objects
- suffering, humiliation
- non consenting ppl
Dx of Paraphilia
- must have acted on fantasy without distress
- many are reluctant to disclose behavior
Types of Paraphilias
- fetishism
- transvestic fetishism
- voeurism
- exhibitionism
- sadism
- masochism
- pedophilia
- frotteurism
Fetishism
- fantasies involving inanimate objects for sexual gratification
- masturbate while touching object
ex: hair, ears, underpants, shoes, prefume all associated with opposite sex
Cause for Fetishism
Classical conditioning and social learning: items become eroticized via association with sex
Transvestic Fetishism
- Fantasies cross-dressing as female
- caused by masturbation while wearing womens clothing during adolescence
- attracted by woman on the outside and the inside
- mostly hetero men
Voyeurism
- Peeping toms
- Fantasies observing unknowing others undressing, having sex
- men tuned on by nude women, privacy surrounding sexual activity increases curiosity, male feels inadequate
Exhibitionism
- flasher
- indecent exposure of genitals
- shock is arousing
Sadism
- fantasies inflicting psychological/physical pain
- themes of dominance, control, humiliation, bondage
- varying severity: transient sadist, severe sadist
Masochism
- sexual gratification from pain and degradation
- Causes: physical abuse in youth
- Autoerotic asphyxia
Causal factors of Paraphilias (Men)
- Males (most vul to paraphilias) are more dependent on visual imagery, physical stimulus.
- more vulnerable to form sexual associations with nonsexual stimuli
- occurs after puberty when sex drive is high
- behavior is reinforced by orgasm release
Gender Identity Disorder
- strong cross gender identification (desire to be opposite sex)
- gender dysphoria (persistent discomfort about bio sex)
Tx of gender Identity Disorder
- psychotherapy
- improve peer and parent relationships
- reduce cross-gender behavior
Transsexualism
- adults with desire to change sex
- adult version of GID
Homosexual Transsexual
men are feminine and are attracted to men
Autogeniphilia
attraction to thoughts, images, fantasies of self as a woman
Tx of Transsexualism
- surgical sex reassignment:
- hormone tx
- live as opposite sex for 1 year
Sexual Abuse
Sexual contact that involves coercion
- pedophilia
- incest
- rape
Consequences of childhood sex abuse
- PTSD
- sexual inappropriateness
- poor self esteem
- sexual aversion
- promiscuity
- borderline personality disorder
- somatization disorder
- dissociative identity disorder
Pedophilia
- fantasies of sexual activity with children
- fondling child’s genitals, penetration
- mostly hetero males
- think child benefits from behavior
Causal Factors for Rapists
- abuse
- violent home environment
- inconsistent caregiver
- rape & other paraphilias
- deficits in social communication
Pschotherapy Tx of sex offenders
- modify patterns of arousal
- modify cognitions and social skills
- change habits
- reduce sexual drive
- aversion therapy: paraphilic stim paired with aversive event
- cognitive restructuring
Bio Tx of Sex Offenders
- Hormone tx
- castration
Sexual Dysfunction
Impairment in desire or ability to achieve sexual gratification
4 phases of sexual response
- Desire: fantasies about/for sexual activity
- excitement (arousal): sexual pleasure and physiological changes that come with pleasure. I.e. erection, lubrication
- Orgasm: release of sexual tension and peak
- Resolution: relaxation and well-being
Hypoactive Sexual Desire Disorder
- little or no sexual drive or interest\
- psychologica factors
Sexual Aversion Disorder
Extreme aversion and avoidance of genital sexual contact
Causes for Sexual Desire Disorders
- depression/anxiety
- decline in testosterone
- SSRI
- low relationship satisfaction
Tx of Sexual Desire Disorders
- SSRI
- communication training
- cognitive restructuring
- sexual fantasy training
- sensate focus training
Male Erectile Disorder
- Sexual Arousal Disorder
- inability to achieve or maintain erection for sex
- originating from psychogenic and medical factors
- anxiety aout performance
Causes of Erectile Disorder
- negative thoughts
- cognitive distractions
- age
- meds
Tx of Erectile disorder
- Erection promoting meds
- injections of muscle relaxers
- vaccum pump
Female Sexual Arousal Disorder
- Absence arousal and unresponsiveness to stimulation
- no swelling, lubrication of vagina
- intercourse uncomfortable, orgasm impossible
Tx of Female Sexual Arousal Disorder
- psychotherapy and sex therapy
- vaginal lubricants
Premature Ejaculation
- orgasmic disorder
- recurrent onset of orgasm and ejaculation with minimal stimulation
- before or shortly after penetration
- loss of control
Tx of Premature Ejaculation
- Antidepressants
- pause-and-squeeze
Male Orgasmic Disorder
- Inability to ejaculate during intercourse
Female Orgasmic Disorder
- women who are excitable but have delay or abscence of orgasm
Tx of Female Orgasmic Disorder
- education
- masturbation exercises
Vaginismus
- involuntary muscle spasms on outer vagina perventing intercourse
- comorbid with sexual arousal disorder
- conditioned fears associated with traum experience
Tx of Vaginismus
- ban intercourse
- train muscles
- gradual self insertion
- relaxation exercises
Dispareunia
- persistent, recurrent genital pain associated with intercourse
- more common in women
- caused by infection, inflammation, vaginal atrophy, vaginal tearing, insufficient arousal
Tx of Dyspareunia
- cognitive behavioral therapy
- vaginal insertion exercises
