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Never-Ending Road to Licensure > Sexual Dysfunctions, Gender Dysphoria, and Paraphilic Disorders > Flashcards

Sexual Dysfunctions, Gender Dysphoria, and Paraphilic Disorders Flashcards

1
Q

Rule-outs before diagnosing sexual dysfunction

A
  1. Nonsexual mental disorder
  2. Serious life stressor
  3. Medical conditions or medications
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2
Q

Sexual dysfunction specifiers

A
  1. Onset (lifelong v. acquired)
  2. Extent (generalized v. situational)
  3. Severity

Does not apply to Genito-Pelvic Pain/Penetration Disorder

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3
Q

Types of sexual dysfunctions

A
  1. Erectile Disorder
  2. Premature Ejaculation
  3. Genito-Pelvic Pain/Penetration Disorder
  4. Female Orgasmic Disorder
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4
Q

Erectile Disorder criteria

A
  1. 1+ symptoms during 75-100% of sexual activities
  2. Duration > 6 months
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5
Q

Ruling out organic etiology for Erectile Disorder

A
  1. Random erections
  2. Morning erections
  3. Erections when masturbating or w/ different sexual partner
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6
Q

Erectile Disorder treatment

A
  1. Behavioral techniques
  2. Medication to increase blood flow to penis (Viagra, Cialis)
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7
Q

Erectile Disorder behavioral techniques

A
  1. Reducing performance anxiety (“sensate focus”)
  2. Increasing sexual stimulation
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8
Q

Sensate focus

A
  1. Non-sexual touching
  2. Sexual touching
  3. Sex
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9
Q

Premature Ejaculation criteria

A
  1. Ejaculation w/in 1 minute or before desired
  2. Duration > 6 months
  3. 75-100% of sexual activities
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10
Q

Premature Ejaculation treatment

A
  1. Sensate focus
  2. Start-stop or pause-squeeze techniques to control ejaculation
  3. Medications to increase serotonin and delay ejaculation (Paroxetine)
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11
Q

Genito-Pelvic Pain/Penetration Disorder criteria

A
  1. 1+ symptoms (vaginal penetration, pain during sex, anxiety related to pain, tensing of pelvic floor muscles during penetration)
  2. Duration > 6 months
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12
Q

Genito-Pelvic Pain/Penetration Disorder etiology

A

1.Sexual or physical abuse
2. Vaginal infections

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13
Q

Genito-Pelvic Pain/Penetration Disorder treatment

A
  1. Relaxation training
  2. Sensate focus
  3. Topical anesthetic
  4. Vaginal dilators
  5. Kegels
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14
Q

Female Orgasmic Disorder critieria

A
  1. Delayed/infrequent/absent OR less intense
  2. All or almost all sexual activities
  3. Duration > 6 months
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15
Q

Female Orgasmic Disorder treatment

A
  1. First line = directed masturbation (especially for lifelong course)
  2. Other cognitive-behavioral techniques
  3. Sex education
  4. Sensate focus
  5. Anxiety reduction techniques
  6. Mindfulness training
  7. Communication skills training
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16
Q

Gender Dysphoria criteria (children)

A
  1. Incongruence between assigned and experienced gender
  2. 6+ of 8 symptoms
  3. Duration > 6 months
  4. Distress or impairment
17
Q

Gender Dysphoria criteria (adolescents and adults)

A
  1. Incongruence between assigned and experienced gender
  2. 2+ of 6 symptoms
  3. Duration > 6 months
  4. Distress or impairment
18
Q

Gender Dysphoria treatment models

A
  1. Gender-affirmative model*
  2. Dutch protocol
19
Q

Dutch protocol

A

Assumes gender dysphoria persists into adolescence for small group

  1. < 12 yo = “watchful waiting”
  2. 12 yo = social transition, puberty blockers
  3. 16 yo = hormones
  4. 18 yo = surgery
20
Q

Gender-affirming model

A
  1. Gender dysphoria valid at any age
  2. Gender variations = NOT disorders
  3. Gender presentation = diverse, cultural
  4. Gender can be fluid = NOT binary
  5. Psychological problems due to negative reactions to person rather than simply dysphoria
  6. Social transition > puberty blockers, hormones, surgery
21
Q

Common gender-affirming surgery outcomes

A
  1. Less dysphoria
  2. Improved self-satisfaction
  3. Low regret
  4. Males > females
  5. Positive = screening, mental stability, social support, fewer surgical complications
22
Q

Paraphilia

A
  1. Intense, persistent sexual interest
  2. Atypical
  3. Distress or impairment
23
Q

Paraphilia treatment

A
  1. CBT + group therapy, marital therapy, medication*
  2. Cognitive
  3. Behavioral
  4. Medication
24
Q

Cognitive treatment for Paraphilia

A
  1. Cognitive restructuring
  2. Empathy and skills training
25
Q

Behavioral treatment for Paraphilia

A
  1. Covert sensitization
  2. Orgasmic reconditioning
26
Q

Covert sensitization

A
  1. Imaginal
  2. Replace arousal with undesirable response
27
Q

Orgasmic reconditioning

A
  1. Imaginal
  2. Replace paraphilic with normative fantasy
28
Q

Medications for Paraphilia

A

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
Q

Five types of paraphilic disorders

A
  1. Frotteuristic Disorder
  2. Transvestic Disorder
  3. Pedophilic Disorder
  4. Fetishistic Disorder
  5. Exhibitionistic Disorder
30
Q

Frotteuristic Disorder criteria

A
  1. Rubbing against non-consenting adults
  2. Duration > 6 months
  3. Acting on urges OR distress/impairment
31
Q

Transvestic Disorder criteria

A
  1. Cross-dressing for arousal
  2. Duration > 6 months
  3. Distress/impairment
32
Q

Transvestic Disorder and sexual orientation

A
  1. Most males identify as heterosexual
  2. May engage in sexual activity with men (especially while cross-dressed)
33
Q

Pedophilic Disorder criteria

A
  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
Q

Fetishistic Disorder criteria

A
  1. Nonliving object or non-genital body part
  2. Duration > 6 months
  3. Distress/impairment
35
Q

Exhibitionistic Disorder criteria

A
  1. Exposing genitals to unsuspecting person
  2. Acting on urges OR distress/impairment
  3. Disclosed or denied despite evidence
36
Q

Three subtypes of Exhibitionistic Disorder

A
  1. Exposure to prepubertal children
  2. Exposure to physically mature people
  3. Both

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