Sexual Dysfunctions, Gender Dysphoria, and Paraphilic Disorders Flashcards
1
Q
Rule-outs before diagnosing sexual dysfunction
A
- Nonsexual mental disorder
- Serious life stressor
- Medical conditions or medications
2
Q
Sexual dysfunction specifiers
A
- Onset (lifelong v. acquired)
- Extent (generalized v. situational)
- Severity
Does not apply to Genito-Pelvic Pain/Penetration Disorder
3
Q
Types of sexual dysfunctions
A
- Erectile Disorder
- Premature Ejaculation
- Genito-Pelvic Pain/Penetration Disorder
- Female Orgasmic Disorder
4
Q
Erectile Disorder criteria
A
- 1+ symptoms during 75-100% of sexual activities
- Duration > 6 months
5
Q
Ruling out organic etiology for Erectile Disorder
A
- Random erections
- Morning erections
- Erections when masturbating or w/ different sexual partner
6
Q
Erectile Disorder treatment
A
- Behavioral techniques
- Medication to increase blood flow to penis (Viagra, Cialis)
7
Q
Erectile Disorder behavioral techniques
A
- Reducing performance anxiety (“sensate focus”)
- Increasing sexual stimulation
8
Q
Sensate focus
A
- Non-sexual touching
- Sexual touching
- Sex
9
Q
Premature Ejaculation criteria
A
- Ejaculation w/in 1 minute or before desired
- Duration > 6 months
- 75-100% of sexual activities
10
Q
Premature Ejaculation treatment
A
- Sensate focus
- Start-stop or pause-squeeze techniques to control ejaculation
- Medications to increase serotonin and delay ejaculation (Paroxetine)
11
Q
Genito-Pelvic Pain/Penetration Disorder criteria
A
- 1+ symptoms (vaginal penetration, pain during sex, anxiety related to pain, tensing of pelvic floor muscles during penetration)
- Duration > 6 months
12
Q
Genito-Pelvic Pain/Penetration Disorder etiology
A
1.Sexual or physical abuse
2. Vaginal infections
13
Q
Genito-Pelvic Pain/Penetration Disorder treatment
A
- Relaxation training
- Sensate focus
- Topical anesthetic
- Vaginal dilators
- Kegels
14
Q
Female Orgasmic Disorder critieria
A
- Delayed/infrequent/absent OR less intense
- All or almost all sexual activities
- Duration > 6 months
15
Q
Female Orgasmic Disorder treatment
A
- First line = directed masturbation (especially for lifelong course)
- Other cognitive-behavioral techniques
- Sex education
- Sensate focus
- Anxiety reduction techniques
- Mindfulness training
- Communication skills training
16
Q
Gender Dysphoria criteria (children)
A
- Incongruence between assigned and experienced gender
- 6+ of 8 symptoms
- Duration > 6 months
- Distress or impairment
17
Q
Gender Dysphoria criteria (adolescents and adults)
A
- Incongruence between assigned and experienced gender
- 2+ of 6 symptoms
- Duration > 6 months
- Distress or impairment
18
Q
Gender Dysphoria treatment models
A
- Gender-affirmative model*
- Dutch protocol
19
Q
Dutch protocol
A
Assumes gender dysphoria persists into adolescence for small group
- < 12 yo = “watchful waiting”
- 12 yo = social transition, puberty blockers
- 16 yo = hormones
- 18 yo = surgery
20
Q
Gender-affirming model
A
- Gender dysphoria valid at any age
- Gender variations = NOT disorders
- Gender presentation = diverse, cultural
- Gender can be fluid = NOT binary
- Psychological problems due to negative reactions to person rather than simply dysphoria
- Social transition > puberty blockers, hormones, surgery
21
Q
Common gender-affirming surgery outcomes
A
- Less dysphoria
- Improved self-satisfaction
- Low regret
- Males > females
- Positive = screening, mental stability, social support, fewer surgical complications
22
Q
Paraphilia
A
- Intense, persistent sexual interest
- Atypical
- Distress or impairment
23
Q
Paraphilia treatment
A
- CBT + group therapy, marital therapy, medication*
- Cognitive
- Behavioral
- Medication
24
Q
Cognitive treatment for Paraphilia
A
- Cognitive restructuring
- Empathy and skills training
25
Behavioral treatment for Paraphilia
1. Covert sensitization
2. Orgasmic reconditioning
26
Covert sensitization
1. Imaginal
2. Replace arousal with undesirable response
27
Orgasmic reconditioning
1. Imaginal
2. Replace paraphilic with normative fantasy
28
Medications for Paraphilia
Reduce sexual desire but have side effects and high risk for relapse
1. Gonadotropic-releasing hormines (Lupron)
2. Antiandrogens that block testosterone production (Depo-Provera)
29
Five types of paraphilic disorders
1. Frotteuristic Disorder
2. Transvestic Disorder
3. Pedophilic Disorder
4. Fetishistic Disorder
5. Exhibitionistic Disorder
30
Frotteuristic Disorder criteria
1. Rubbing against non-consenting adults
2. Duration > 6 months
3. Acting on urges OR distress/impairment
31
Transvestic Disorder criteria
1. Cross-dressing for arousal
2. Duration > 6 months
3. Distress/impairment
32
Transvestic Disorder and sexual orientation
1. Most males identify as heterosexual
2. May engage in sexual activity with men (especially while cross-dressed)
33
Pedophilic Disorder criteria
1. Sexual activity with children < 13 yo
2. Acting on urges or distress/impairment
3. Must be > 16 yo
4. Must be 5+ years older than child
34
Fetishistic Disorder criteria
1. Nonliving object or non-genital body part
2. Duration > 6 months
3. Distress/impairment
35
Exhibitionistic Disorder criteria
1. Exposing genitals to unsuspecting person
2. Acting on urges OR distress/impairment
3. Disclosed or denied despite evidence
36
Three subtypes of Exhibitionistic Disorder
1. Exposure to prepubertal children
2. Exposure to physically mature people
3. Both
