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Abnormal Psychology 3018 > Sexual Dysfunction > Flashcards

Sexual Dysfunction Flashcards

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1
Q

Sexuality can sometimes be restricted to societal expectations. Why is this wrong?

A

Because in terms of sexuality, there is no such thing as ‘normal’ or ‘average’ and with or without a partner, we are all sexual beings.

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2
Q

Just as we need to sleep and eat…

A

… having sex or reproducing is a legitimate aspect of our wellbeing.

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3
Q

‘Sexual health’ is a state of what four elements that relate to sexuality?

A

Sexual health is a state of physical, emotional, mental and social wellbeing relating to sexuality.

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4
Q

How does the World Health Organisation understand ‘Sexual dysfunction’?

A

Sexual dysfunction is ‘the various ways in which an individual is unable to participate in a sexual relationship as he/she would wish’.

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5
Q

What is sexuality?

A
  • Intimacy (loving and being loved; expressing mutual care).
  • Loving relationships.
  • Any type of sexual activity.
  • Physical appearance.
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6
Q

As sexuality is complex and multifaceted, it is not about how frequently you have sex… what is it about?

A

It is about the emotional and physical needs that you have.

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7
Q

What does ‘one sexual dysfunction’ mean?

A

A sexual dysfunction is about being unable to participate in a sexual relationship/activity to the level that you desire (to the point that it is distressing).

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8
Q

Across an international study, how many women vs. men reported having a sexual dysfunction?

A

1/2 of women.

1/3 of men.

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9
Q

In an Australian study, how many women (in a heterosexual relationship) reported having had at least one sexual difficulty? And then at a 12 month follow-up, how many reported have one new sexual difficulty?

A

One difficulty: 2/3

One new difficulty: 1/3.

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10
Q

The statistics on sexual dysfunctions are high, but could they actually be higher than what the data captures?

A

Yes, people typically underreport these kinds of issues.

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11
Q

What are some of the limitations on research of sexual dysfunctions?

A

First of all, it is very hard to get people to participate, and typically these studies have small sample sizes.
Need to be very specific about the age group being studied, as the issues are age-related.
Need to know if the study was population-based vs. clinical or self-report vs. clinical interview.
Are the clinicians asking the ‘right’ questions, understanding the concepts?

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12
Q

In a clinical interview about someone’s sexual status/experiences what is the difference between an ‘open’ question and a ‘closed’ question?

A

Closed question: ‘are you sexually active?’

Open question: ‘how satisfied are you with your sexual life?’

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13
Q

What is Kaplan’s triphasic (3-stage) model of sexual response?

A

The model focuses on genital response.

  1. ‘Desire’ - the muscle tension, breathing, butterflies in stomach, changes in heart rate, preparing for sexual activity.
  2. ‘Excitement’ - bodily changes intensify, engorged vagina and uterus, clitoris is sensitive, penis has erection.
  3. ‘Orgasm’ - contractions, spasms of uterus/vagina walls, male ejaculation, testicles contract into the scrotum.
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14
Q

What is wrong with Kaplan’s triphasic model of sexual response?

A

It is a very simplistic and linear model. It excludes other parts of intimacy, like emotional intimacy, relationship satisfaction.

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15
Q

Basson re-conceptualised the model of the female sexual response. Compared to a linear model, what kind of model is it and what does it entail?

A

It is a circular model. It begins with ‘Spontaneous Sexual Drive’ which can lead to seeking out ‘Sexual Stimuli’ or being receptive to ‘Sexual Arousal’.
The circular model is:
‘Sexual Stimuli’ –> ‘Sexual Arousal’ –> ‘Arousal and Sexual Desire’ –> ‘Emotional and Physical Satisfaction’ –> ‘Emotional Intimacy’ –> (back to the beginning).

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16
Q

What elements do Basson’s model of female sexual response acknowledge that other non-linear models don’t?

A

It acknowledges how emotional intimacy, sexual stimuli, and relationship satisfaction can all affect the female sexual response.

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17
Q

We know that the mechanics and functioning of the male genitals are really important for their identity/masculinity. What part of the sexual experience is (generally) most important for women?

A

The intimate aspect, the loving aspect.

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18
Q

Earlier it was believed that for women, ‘desire’ needed to come before ‘arousal’. Is that the case?

A

No, ‘arousal’ can happen first and then ‘desire’ can come afterwards.

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19
Q

What are the 5 definitions of Sexual Dysfunction, as written in the DSM-5’s criteria?

A
  • A clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure.
  • A minimum duration of 6 months.
  • Symptoms must cause significant distress.
  • Experienced on ALMOST all or ALL occasions of sexual activity (75 - 100%).
  • Important to consider cultural values and age.
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20
Q

In the DSM-5, what are the 3 specifiers/sub-types of sexual dysfunction?

A
  1. Nature of the onset: lifelong vs. acquired.
  2. Context: generalised vs. situational.
  3. Severity: mild vs. moderate vs. severe (based on level of distress).
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21
Q

In the ‘Nature of Onset’ specifier/subtype of the DSM-5 definition of sexual dysfunction, what are the two different types and what do they entail?

A

They are:

  • Lifelong (present from the very first sexual experience).
  • Acquired (had a period of normalcy and then an issue developed).
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22
Q

How many women have NEVER experienced an orgasm?

A

10%

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23
Q

In the ‘Context’ specifier/subtype of the DSM-5 definition of sexual dysfunction, what are the two different types and what do they entail?

A

They are:

  • Generalised (e.g., does not experience sexual arousal in any context).
  • Specific (e.g., experiences sexual arousal in one context but not the other).
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24
Q

In the ‘severity’ specifier/subtype in the DSM-5 definition of sexual dysfunction, they look at how severe the distress is. What is the one exception to the ‘distress’ specifier?

A

Premature ejaculation. If the man ejaculates (after penetration has begun) -
60 seconds: mild.
30 seconds: moderate.
15 seconds: severe.

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25
Q

The DSM-4 classified the different sexual functions based on Kaplan’s (linear) stages of sexual response. What were the four? And were they gender specific?

A
  1. Desire.
  2. Arousal.
  3. Orgasm.
  4. Pain.
    No, they were not gender specific.
26
Q

The DSM-5 has gender specific dysfunctions that relate to the four categories of desire, arousal, orgasm and pain. What are the MALE sexual dysfunctions specific to desire, arousal or orgasm?

A

Desire - ‘Male hypoactive sexual desire disorder’.
Arousal - ‘Erectile disorder’.
Orgasm - ‘Delayed ejaculation’ and ‘Premature ejaculation’.

27
Q

The DSM-5 has gender specific dysfunctions that relate to the four categories of desire, arousal, orgasm and pain. What are the FEMALE sexual dysfunctions specific to desire, arousal, orgasm or pain?

A

Desire & Arousal - ‘Female sexual interest/arousal disorder’.
Orgasm - ‘Female orgasmic disorder’.
Pain - ‘Genito-pelvic pain/penetration disorder’.

28
Q

What is the difference between someone who is asexual and someone who has a sexual desire disorder?

A

The person who is asexual is not distressed by their lack of desire and therefore cannot be diagnosed. Someone with a desire disorder ARE distressed by their lack of desire.

29
Q

What two definitions explain what a ‘Sexual Desire Disorder’ is?

A
  • Persistent disinterest in sexual activity.

- The person is distressed by their lack of interest.

30
Q

What is the prevalence of sexual desire disorders? And what is the prevalence in men vs. women?

A

Overall prevalence: 7-33%.
Men: 8%.
Women: 55%.

31
Q

Which is the most common FEMALE sexual dysfunction?

A

A sexual desire disorder.

32
Q

What is one way that the presentation of a sexual desire disorder may differ in between men and women?

A

Women tend to have a lack of desire AND a lack of arousal.

Men tend to have a lack of desire but can still have arousal (physical response is normal).

33
Q

What is the sexual desire/arousal disorder for women? Describe it in two points.

A

Female Sexual Interest/Arousal Disorder:

  • Interest/desire: a lack of, or significantly reduced, sexual interest in sexual activity and fantasising.
  • Arousal: difficulty attaining or maintaining adequate lubrication until completion of the sexual act.
34
Q

What is the sexual arousal disorder in men? Explain it.

A 
Erectile Dysfunction (ED):
- Marked difficulty in obtaining OR maintaining an erection (until completion) of sexual activity, OR marked decrease in erectile rigidity.
35
Q

What is the prevalence of Erectile Dysfunction?

A 
About 50%, increases with age:
50 y/old: 50%.
60 y/old: 60%.
70 y/old: 70%.
80 y/old: 80%.
36
Q

What are the differences between Psychogenic Erectile Dysfunction vs. Organic Erectile Dysfunction?

A

Psychogenic:

  • sudden onset.
  • situational.
  • still have morning erections.
  • erection when masturbating.
  • partner specific?
  • often present in younger patients.

Organic:

  • gradual onset/deterioration.
  • always.
  • decrease in morning erection.
  • no erection when masturbating.
  • may be due to injury, trauma, disease, medication, or drug/alcohol use.
37
Q

What are the two sexual ORGASM dysfunctions for men? Please explain.

A
  • Delayed ejaculation: maintains erection but with marked delay (or inability) to ejaculate (without wanting the delay). Experienced almost every time and will try to ejaculate for 20-25 minutes.
    (The least common male sexual complaint, around 4%).
  • Premature ejaculation: ejaculation with only minimal stimulation (around 8%).
38
Q

What is the female sexual ORGASM dysfunction? Please explain.

A
  • Female Orgasmic Disorder:
    Marked delay/infrequency/absence of orgasm OR reduced intensity of orgasm.
    It must be distressing, and can be situational.
39
Q

Why is the female orgasm understood to be a learned response (that can improve with experience) as opposed to an automatic response?

A

Because women don’t know their anatomy as well as men and sometimes don’t know how to feel pleasure. They can learn how to properly stimulate themselves and eventually achieve orgasm.

40
Q

What is the prevalence of Female Orgasmic Disorder?

A

Around 51%.

41
Q

What is the female sexual pain disorder? Please explain.

A
  • Genito-Pelvic Pain/Penetration Disorder:
    Persistent/recurrent difficulties with -
  • Vaginal penetration during intercourse.
  • Fear or anxiety about pain.
  • Tensing or tightening or the pelvic floor muscles.
42
Q

What often happens that exacerbates Genito-Pelvic Pain/Penetration Disorder?

A

If a woman experienced pain during sex, they might anticipate pain again and automatically tighten their muscles in fear. This creates more pain for the future sexual encounter.

43
Q

What is the ‘cycle of pain’ in Genito-Pelvic Pain/Penetration Disorder?

A

The body anticipates pain, fear/anxiety –>
The body automatically tightens vaginal muscles –>
Tightness makes sex painful, penetration may be impossible –>
Pain reinforces/intensifies –>
Body reacts by ‘bracing’ –>
Avoidance of intimacy –>
(back to the start).

44
Q

What are the four groups of causes behind Sexual Dysfunctions?

A
  • Biological/Physical factors.
  • Psychosocial factors.
  • Environmental factors.
  • Interpersonal factors.
45
Q

List some Biological/Physical causes of Sexual Dysfunction.

A

Ageing, illness, disability, medications, substance use/abuse.

46
Q

List some Psychosocial causes of Sexual Dysfunction.

A

Cultural/religious beliefs, self-acceptance (identity/orientation), body image, depression/anxiety, life stressors, past experiences, inexperience, perfectionism/performance anxiety.

47
Q

List some Interpersonal causes of Sexual Dysfunction.

A

Attraction to partner, partner performance and technique, excessive goal orientation, relationship quality and conflict, routinisation/changes in role, lack of partner.

48
Q

List some Environmental causes of Sexual Dysfunction.

A

Lack of privacy, lack of time, physical discomfort.

49
Q

What are the four medical treatments for Male Erectile Dysfunction?

A
  • Pharmacotherapy: viagra (highly effective).
  • Penile injections: inject muscle relaxing drug into erection chamber 30-45 minutes before sex.
  • Vacuum devices.
  • Penile prosthesis (inflatable): invasive surgery, remove the testes and put a machine in the scrotum. When squeezed can induce an erection.
50
Q

When treating MALE sexual dysfunction it is often found that if there is no change they will just give up. What needs to have less focus on, and what needs more focus?

A

Less focus: on restoring erection-dependant sexual practice.

More focus: on promoting sexual intimacy despite functional challenges.

51
Q

What are some aspects of ‘relational intimacy’ that can enhance the sexual experience?

A
  • self-disclosure.
  • emotional connection.
  • shared interests.
  • shared values.
  • shared dreams.
52
Q

What are some aspects of ‘erection-independent sex’ that can enhance the sexual experience?

A
  • sensual massaging.
  • genital caressing.
  • mutual masturbation.
  • outercourse.
  • deep kissing.
  • sex toys.
  • oral sex.
53
Q

What are some aspects of ‘physical affection’ that can enhance the sexual experience?

A
  • holding hands.
  • hugging.
  • physical touch.
  • kissing.
  • cuddling.
54
Q

What are some medical treatments for FEMALE sexual dysfunction?

A
  • Hormonal therapy (estrogen).

- Addyi (‘pink pill’, not effective for many and many side-effects).

55
Q

What are some non-medical/pharmacological treatments for female sexual dysfunction?

A
  • Kegel exercise and vaginal weights (strengthen the vaginal muscles).
  • Vaginal lubricants.
  • Vaginal moisturisers (insert a small tablet/pellet into the vagina 3 times a week to naturally restore lubrication in the vagina and vulva.
56
Q

What is a non-medical treat for female Genito-pelvic pain/penetration disorder?

A

Vaginal dilator: a plastic/rubber tube that is used to stretch the vagina.

57
Q

What is a non-medical treat for female sexual arousal disorder?

A

Female vacuum therapy: creates a gentle pulsating suction over the clitoris to increase the blood flow.

58
Q

What is the MOST important thing when targeting sexual difficulties between people? What does it help with?

A

COMMUNICATION! Helps with understanding:

  • likes/dislikes.
  • comforts/insecurities.
  • how to communicate verbally and behaviourally during sex.
  • the underlying relationship issues that may impact sex.
59
Q

In the treatment of Sexual Dysfunction, what are two SENSATE FOCUS exercises?

A

Exercise 1: general body pleasuring (focus on sensation of touching partner).
Exercise 2: introducing genital body pleasuring in the absence of intercourse.

60
Q

What are the goals of the SENSATE FOCUS exercises?

A
  • non-goal-orientated physical intimacy (minimise performance pressure/anxiety and reduce spectatoring).
  • enhance communication between partners about sensual and sexual experiences.
  • effective in treating female desire, arousal and orgasmic dysfunctions and erectile disorders.

Abnormal Psychology 3018 (29 decks)

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