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Psychosocial Conditions > Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria > Flashcards

Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria Flashcards

1
Q

Name the sexual dysfunctions

A
  • Delayed ejaculation
  • Erectile Disorder
  • Female Orgasmic Disorder
  • Female Sexual Interest/Arousal Disorder
  • Genito-Pelvic Pain/Penetration Disorder
  • Male Hypoactive Sexual Desire Disorder
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2
Q

What is required for all Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria?

A

All require that the individual experience distress associated with other symptoms

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3
Q

How are sexual dysfunctions defined?

A

Problems associated with sexual intercourse, often (but not always) with a biological basis, that cause to psychological distress

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4
Q

How are paraphilic disorders defined?

A

Sexual arousal associated with atypical/unacceptable stimuli or behaviors

The individuals experience intense sexual arousal to atypical objects, situations, fantasies, or individuals

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5
Q

How is gender dysphoria defined?

A

Biological and genetic gender is inconsistent with his or her perceived gender

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6
Q

What are the implications for function for Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria?

A
  • Self-esteem, self-concept
  • Physical and psychological distress
  • Sexual and social occupations with partner or spouse
  • Affect social interactions
  • Affect family relationship
  • Confusion with roles
  • In some cases, high risks with legal responsibility
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7
Q

What is the diagnostic criteria for Delayed Ejaculation?

A
  • One or both on most occasions when intercourse is attempted: Significant delay in ejaculation and/or Absence of ejaculation
  • At least six months
  • Symptoms are distressing to the individual
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8
Q

What is the etiology of Delayed Ejaculation?

A
  • Physiological/ physical factors- illness, injury, drug side effects, and lifestyle
  • Psychological factors- distress, anxiety, depression, relationship distress
  • Combined
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9
Q

What is the prognosis for Delayed Ejaculation?

A

Usually good, particularly with treatment

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10
Q

What is diagnostic criteria for Erectile Disorder?

A

One or more on most occasions when intercourse is attempted:

  • Difficulty obtaining an erection
  • Difficulty maintaining an erection
  • Decrease in erectile rigidity

Symptoms have persisted at least six months

Symptoms cause distress

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11
Q

What is the etiology for Erectile Disorder?

A
  • Diseases like hypertension, diabetes, and cardiovascular disease
  • Lifestyle factors like obesity, and infectious processes
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12
Q

What is the prognosis for Erectile Disorder?

A

Treatable, particularly if the underlying physiological cause can be identified and reversed

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13
Q

What treatment is used for Erectile Disorder?

A

Symptomatic treatment of erectile dysfunction is possible using medication

May not be acceptable to all individuals

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14
Q

What is the diagnostic criteria for Female Orgasmic Disorder?

A

One or more during most intercourse:

  • Delay, infrequency or absence of orgasm
  • Reduced intensity of orgasm

Symptoms have persisted for at least six months

Symptoms cause distress

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15
Q

What is the etiology for Female Orgasmic Disorder?

A
  • Inadequate tone in the perivaginal muscles
  • Anxiety
  • Illness
  • Neurological conditions
  • Medications
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16
Q

What is the prognosis for Female Orgasmic Disorder?

A

Good if a psychological issue is resolved

If a medical issue, prognosis depends on course of medical condition

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17
Q

What treatments are used for Female Orgasmic Disorder?

A

Psychoanalytic psychotherapy

Cognitive-behavioral therapy

Medical attention to underlying physical problem

18
Q

What is the diagnostic criteria for Female Sexual Arousal Disorder?

A

Reduced sexual interest or arousal including:

  • Reduced interest in sex
  • Lack of initiation of sex and generally unreceptive response to partner’s interest
  • Reduced sexual excitement, pleasure, sensation, most of the time (consistent with life stage, and sociocultural considerations)

Symptoms have persisted for at least six months

Symptoms cause distress

19
Q

What is the etiology for Female Sexual Arousal Disorder?

A

A complex interaction among physical (infection, neurological condition) and psychological (anxiety, stress) factors

20
Q

What is the prognosis for Female Sexual Arousal Disorder?

A

With appropriate treatment, the majority of individuals improve significantly

21
Q

What treatment is used for Female Sexual Arousal Disorder?

A
  • Psychological treatments like cognitive behavioral therapy
  • Communication skills training
  • Sex education and couple therapy
  • Hormone therapy
22
Q

What is the diagnostic criteria for Genito-Pelvic Pain/Penetration Disorder?

A

Recurrent difficulties with:

  • Vaginal penetration during sex
  • Pain during vaginal intercourse
  • Anxiety about pelvic pain
  • Tensing of the pelvic floor in anticipation of pain

Symptoms persist for at least six months

Symptoms cause distress

23
Q

What is the etiology of Genito-Pelvic Pain/Penetration Disorder?

A

Psychological: Anxiety (anticipation of pain), stress, and tension

Physical: Abdominal abnormalities

Mixed: Childbirth- inadequate healing following childbirth; anxiety about resuming sexual relations

24
Q

What is the prognosis for Genito-Pelvic Pain/Penetration Disorder?

A

Varied depending on etiology

25
Q

What treatment is used for Genito-Pelvic Pain/Penetration Disorder?

A

Treatment of any underlying medical conditions

Behavioral interventions

Estrogen for peri- or post-menopausal women

26
Q

What is the diagnostic criteria for Male Hypoactive Sexual Desire Disorder?

A

Reduced sexual thoughts or fantasies and desire for sexual activity (consistent with life stage, and sociocultural considerations)

Symptoms persist for at least six months

Symptoms cause distress

27
Q

What is the etiology for Male Hypoactive Sexual Desire Disorder?

A

Almost always psychological in nature

Anxiety about sex or sexual performance

Trauma

Unusual arousal pattern

28
Q

What is the prognosis for Male Hypoactive Sexual Desire Disorder?

A

Good with psychotherapy

29
Q

What treatments are used for Male Hypoactive Sexual Desire Disorder?

A

Psychotherapy

Couples therapy

30
Q

What is the etiology of Paraphilic disorders?

A

Not well understood, but several hypotheses:

  • Dysfunction in hormonal balance
  • Genetic abnormalities
  • Neuropsychiatric deficits
31
Q

What is the prognosis for Paraphilic disorders?

A

Poor

Chronic, stable, rarely worsen or improve

32
Q

What are the implications for function for Paraphilic Disorders?

A
  • Dysfunctional sexual and social occupation
  • Difficulty with relationship
  • May also affect work, self-care
  • Carry high risk of legal difficulties
33
Q

What treatments are used for Paraphilic Disorders?

A

Pharmacologic treatments like serotonin and testosterone

Cognitive-behavioral therapy

But limited evidence about efficacy of treatments

34
Q

What is the diagnostic criteria for Gender Dysphoria?

A

Incongruence between self-perceived gender and assigned gender, for at least six months, with at least two of:

  • Incongruence between experienced gender and sex characteristics
  • Desire to be rid of sex characteristics because of this incongruence
  • Wish to have the sex characteristics of the other gender
  • Wish to be and to be treated as the other gender
  • Has romantic and sexual feelings or reactions of the other gender

Symptoms are associated with distress

35
Q

What is the etiology of Gender Dysphoria?

A

Not well understood, but almost certainly biological- complicated genetic and hormonal events

36
Q

What is the prognosis for Gender Dysphoria?

A

Variable

Depends on the degree of support in his/her social network

Individual must decide what course of action to take, gender reassignment being the most extreme but in some cases, offering the best outcome

37
Q

What are the implications for function for Gender Dysphoria?

A
  • Affects most performance areas due to psychological distress, particularly social occupation
  • Self-esteem, self-identity, role
  • May affect academic for school-aged individuals
  • May affect emotional regulation, cognition
38
Q

What treatments are used for Gender Dysphoria?

A

Psychotherapy

Gender reassignment with accompanying therapy to assist in adaptation to new gender

39
Q

What are the implications for OT for Sexual Dysfunctions?

A
  • Address issues of self-concept, self-esteem, social interaction
  • Identify performance areas that are strengths and assist to enact them
  • Provide opportunities for emotional expression through non-verbal mechanisms (e.g. creative arts)
  • For paraphilias, redirect to socially acceptable occupations
  • For gender dysphoria, assist in adjustment to new gender role
  • None of these is well-documented in the OT literature
40
Q

What are the cultural and lifespan considerations for Sexual related Disorders?

A
  • Cultural differences in gender roles and acceptable sexual expression
  • Cultural differences in willingness to seek help
  • Level of acceptance and support network
  • Gender dysphoria often emerges in childhood or adolescence: Potential for victimization, bullying, social isolation

Psychosocial Conditions (9 decks)

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