Sexual Dysfunction, paraphilic Disorders & gender dysphoria Flashcards
Normal human sexual response cycle:
Phase 1: sexual desire = fantasies about sexual activity and the related desire for it
Phase 2: sexual excitement = subjective sense of sexual arousal and pleasure and the accompanying physiological changes
Phase 3: orgasm = peaking and climax of sexual pleasure and release of sexual tension
Phase 4: resolution = consists of a sense in general relaxation, well-being and muscular relaxation
Sexual Arousal, Interest & Desire (excitement) disorders:
male hypoactive sexual desire d/o
female sexual interest / arousal d/o
erectile disorder
ejaculation & orgasmic disorders:
female orgasmic disorder
premature ejaculation
delayed ejaculation
sexual pain disorders
gentio-pelvic pain / penetration disorder
etiology of sexual dysfunction?
childhood sexual/emotional abuse
sexual trauma/rape
body image / self esteem problems
treatment of sexual dysfunction
short term therapy (focus on here and now of couple interactions)
sensate focus (pay increase attention to own senses)
Preferential Sexual Interests?
Paraphilias?
Paraphilic Disorder?
Preferential Sexual Interest = sexual preferences (not intense or persistent)
Paraphilias = an intense & persistent sexual interest other than genital stimulation or fondling with normal consenting partners
Paraphilic Disorder = paraphilia that is causing distress and impairment or whose satisfaction causes personal harm or risk of harm.
paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder
unusual or bizarre imagery, acts or objects to induce sexual excitement
paraphilia
most paraphilias occur in men and are of unknown etiology
paraphilia
Overview of Paraphilic Classification
Paraphilias:
I. Anomalous ACTIVITY preference:
a. courtship disorders (distorted components of courtship behavior)
1. voyeuristic
2. exhibitionistic
3. frotteuristic
b. algolagnic (pain & suffering)
4. sexual masochism
5. sexual sadism
II. Anomalous TARGET preferences:
a. human directed:
6. pedophilic
b. other directed:
7. fetishistic
8. transvestic
- Anomalous ACTIVITY preferences:
a. courtship disorders (distorted components of courtship behavior)
Courtship disorders = voyeuristic, exhibitionistic & frotteuristic
- anomalous activity preferences:
b. algolagnic (pain & suffering)
4. sexual masochism
5. sexual sadism
algolagnic (pain & suffering):
- sexual masochism
- sexual sadism
II. Anomalous TARGET preferences:
human directed:
human directed:
6. pedophilic
II. Anomalous TARGET preferences:
b. other directed:
other directed:
- fetishistic
- transvestic
Voyeurism
sexual excitement in watching unsuspecitng people who are nude, undressing or having sex
TRUE OR FALSE:
Voyeurism:
1. almost always male
- victims are usually strangers
- may fantasize about having sex with a victim but almot never actually pursues this
TRUE
exposure of genitals to a non-consenting stranger (or has fantasized about this)
Exhibitionistic
Exhibitionistic d/o
A. 6 months, recurrent sexual arousal from exposure of one’s genitals to an unsuspecting person (manifested in fantasies, urges or behaviors)
B. individual has acted on these urges w/ a non-consenting persons or the urges/fantasies cause impairment
Voyeuristic d/o
A. 6 months recurrent sexual arousal from observing an unsuspecting person who is naked, getting naked or having sex (manifested in fantasies, urges or behaviors)
B. individual has acted on these urges w/ a non-consenting persons or the urges/fantasies cause impairment
C. person is at least 18 yrs or older
exhibitionistic d/o: may masturbate while exposing himself
tends to occur in mid twenties- shy, married hetereosexual males
TRUE
gratification by touching or rubbing against a non-consenting person
often occurs in busy/crowded places
Frotteurism
Frotteuristic d/o
A. 6 months recurrent arousal from touching or rubbing against a non-consenting person (manifested in fantasies, urges or behaviors)
B. individual has acted on these urges w/ a non-consenting persons or the urges/fantasies cause impairment
desire to be made to suffer
Sexual Masochism
Sexual Masochism d/o
Sexual Masochism d/o
A. 6 months recurrent arousal from the act of being humiliated, beaten, bound or made to suffer (manifested in fantasies, urges or behaviors)
B. the urges, fantasies, behaviors casuse impairment
sexual masochism is the only paraphilia in which any noticeable number of women participate - 5% are female
it usually begins in childhood or adolescence and is chronic
TRUE
the desire to make others suffer
sexual sadism
Sexual Sadism d/o
Sexual Sadism d/o
A. 6 months recurrent arousal from the physical or psychological suffering of another person (manifested in fantasies, urges or behaviors)
B. individual has acted on these urges w/ a non-consenting persons or the urges/fantasies cause impairment
involves sexual activity with a child (generally under age 13)
usually sexually abused as a child
develop strategies for gaining access to and trust of children
it is a chronic disorder with frequent relapses
Pedophilia
Pedophilic d/o
Pedophilic d/o
A. 6 months recurrent arousing fantasies, urges or behaviors involving sexual activity with a prepubescent chil or children (generally 13 years or younger)
B. individual has acted on these urges or the urges/fantasies cause impairment
C. individual is at least 16 years or older & at least 5 yrs older than the child
intense desire to use or fantasize about using non-living objects to achieve sexual gratification
Fetishism
most fetishes are women’s underwear, shoe’s or other clothing
TRUE
Fetishistic d/o
Fetishistic d/o
A. 6 months recurrent arousal from the use of nonliving objects or specific focus on nongenital body parts (manifested in fantasies, urges or behaviors)
B. the urges/fantasies cause impairment
C. fetish objects are not limited to articles of clothing used in cross dressing or for genital stimulation (vibrator)
heterosexual males who dress in women’s clothing to achieve a sexual response: arousal from crossdressing
Transvestic d/o
Transvestic d/o
Transvestic d/o
A. 6 months recurrent arousal from crossdressing (manifested in fantasies, urges or behaviors)
B. the urges/fantasies cause impairment
Transvestic d/o:
a. with fetishism
b. with autogynephilia
Transvestic d/o with fetishism:
if sexual aroused by fabrics, materials or garments
Transvestic d/o with autogynephilia:
if sexually aroused by thoughts or images of self as female
Tranvestic D/o (with fetishism or autogynephilia)
VS
Transsexual (gender Dysphoria)
transvestic: heterosexual males, cross dressing for sexual pleausure & doesn’t wish to change gender
Transsexual (gender dysphoria):
commonly male with female gender identity, cross dressing is done only to be congruent with gender identity; male wants to be female and wishes to get rid of genitals
Zoophilia
other specified paraphilic disorder
(sexual feelings on animals)
Necrophilia
other specified paraphilic disorder
(sex with corpse)
Telephone scatalogia
other specified paraphilic disorder
(obscene phone calls)
Coprophilia
other specified paraphilic disorder
(feces)
Klismaphilia
other specified paraphilic disorder
(enemas)
Urophilia
other specified paraphilic disorder
(urine)
Gender Dysphoria, in children d/o
Gender Dysphoria, in children d/o
A. Incongruence btwn one’s own gender and assigned gender for 6 months and 6 (or more) Sx:
I. Desire to be other gender
II. (boys) preference for cross dressing (girls) wearing masculine clothing
III. preference for cross gender roles in fantasy play
IV. preference for toys, games or activities stereotypical of other gender
V. playmate of the other gender
VI. (boys) rejection of rough play (girls) rejection of feminine toys/games
VII. dislike of sexual anatomy
VIII. desire for sex charateristics of desired gender
Gender Dysphoria, in adults d/o
Gender Dysphoria, in adults d/o
A. Incongruence btwn one’s own gender and assigned gender for 6 months and 2 (or more) Sx:
I. Incongruence betwn gender and sex
II. Desire to rid of sex characteristics
III. Desire for the sex characteristics of the other gender
IV. Desire to be of the other gender
V. Desire to be treated as the other gender
VI. Conviction that one acts/feels typical fo other gender
*specify if:
posttransition (full-time living in desired gender)
cross-sex hormone treatment
gender reassignment surgery
involves a strong feeling of incongruence betwen gender at birth and gender identity
occurs in both women and men
Gender Dysphoria
gender dysphoria:
begins in childhood
manifest in adolescence or adulthood by dressing like other gender
suicide attempts and substance abuse are common
no agreed upon cause
if it persists into adolescence, it is chornic
true
DURATION of Sexual Dysfunction, paraphilic disorders and gender dysphoria
6 MONTHS
gender dysphoria refers to a broad class of phenomena characterized by:
biological sex, social gender or both
gender dysphoria was previously called?
transsexualism and gender identity disorder
individuals with gender dysphoria can be sexually attracted to: MALES, FEMALES OR NEITHER
TRUE
gender dysphoria in children incldues a marked incongruence btwn one’s gender and one’s assigned gender of at least:
(duration & sx)
6 months duration and 6 sx
what is the recommended treatment for gender dysphoria?
group therapy
CBT
Sexual identity therapy (SIT)
what is the prevalence rate for all sexual disorders?
men = 31%
women = 43%
what 4 factors play a role in the etiology of sexual dysfunction disorders?
drugs
medical conditions
psychosocial/culture
biopsychosocial
rewarding sexual activity requires adequate functioning of which 3 organs?
hormonal
cardiovascular
neurological
viagra can be used to help which sexual dysfunction disorder?
viagra = Erectile Dysfunction
sexual dysfunction CBTexercizes involves?
diagnostic and therapeutic values
what factors impact the likelihood of developing a paraphilic disorder?
low IQ
lower white matter in brain
childhood sexual abuse
what is the symptom duration for paraphilic disorders?
6 months
the term paraphilia can be defined as?
any intense or persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with normal, mature consenting human partners
and
any sexual interest greater than or equal to normophilic sexual interests
what should a therapist focus on when working with paraphilic disorders?
treating the mental, social and sociocultural dynamics that lead to the development of paraphilia
only men can develop paraphilic d/o?
FALSE
(women and men can develop paraphilic d/o
