sexual [WA6,]

Question 1

Which sexual dysfunction is possibly a fitting classification if someone has no sexual fantasies or desires for more than six months?

Answer 1

male hypoactive sexual desire disorder

Question 2

Which of the following statements about ejaculation disorders is correct?

• The number of men who indicate that they suffer from premature (early) ejaculation is higher than the number of men who indicate that they suffer from delayed ejaculation.
• The number of men who indicate that they suffer from premature (early) ejaculation is smaller than the number of men who indicate that they suffer from delayed ejaculation.
• The number of men who indicate that they suffer from premature (early) ejaculation is about the same as the number of men who indicate that they suffer from delayed ejaculation.

Answer 2

• The number of men who indicate that they suffer from premature (early) ejaculation is higher than the number of men who indicate that they suffer from delayed ejaculation.

Question 3

Which mental disorders increase the risk of sexual dysfunctions?

• Schizophrenia.
• Personality disorders.
• Major depressive disorder and anxiety disorders.

Answer 3

Major depressive disorder and anxiety disorders.

Question 4

According to the DSM-5, the diagnostic classification of paraphilic disorder only applies if the corresponding behaviors, fantasies, and desires last for at least

• twelve months.
• six months.
• three months

Answer 4

• six months.

Question 5

Henk has been taking the train to work every day for years. Since eight months Henk has noticed that he gets very aroused when he is standing close to women. The past few weeks he has pushed his genitals against a woman at moments when it was very crowded in the train. This aroused him very much. Which paraphilic disorder does Henk possibly have?

Answer 5

Frotteuristic disorder.

Question 6

Which of the following statements regarding the etiology of paraphilic disorders is correct?

• The etiology of paraphilic disorders is difficult to investigate, because people generally prefer not to talk about it.
• A connection was expected between paraphilic disorders and childhood abuse. However, this connection has not been found.
• A lack of empathy among men causes them to develop a paraphilic disorder in which the woman does not consent to the sexual contact.

Answer 6

• The etiology of paraphilic disorders is difficult to investigate, because people generally prefer not to talk about it.

Question 7

clinical case:
Anne was a 26-year-old, attractive woman who sought treatment after beginning her first “steady” sexual relationship. She reported that she and her partner, Colin, enjoyed their sexual life together. Nonetheless, Colin had begun to express concerns because she had been unable to achieve an orgasm. She sought therapy independently to talk about this concern. In therapy, she described that she had not really enjoyed sexual activities with her former partners and that she had rarely masturbated. Anne disclosed to the therapist that her brother had raped her when she was 12 years old, an event that she had not been able to disclose to anyone in the past. The therapist provided directed masturbation exercises (described as we review treatments) for Anne to begin to explore and enjoy her body independently, and in sessions, they discussed her abuse history and her feelings about sexuality. With the use of a vibrator, Anne began to enjoy orgasms. As her comfort with her body and sexuality increased, Anne also learned to discuss her sexual preferences more openly with Colin.

Answer 7

female orgasmic disorder

Question 8

list Kaplan’s 4 phases of the sexual response cycle

Answer 8

1. desire
2. excitation
3. orgasm
4. resolution

Question 9

Describe the major challenges to the validity of the Kaplan sexual response cycle phases as applied to women.

Answer 9

Desire does not consistently precede the excitement phase for women, and although Kaplan relied on biological changes to define the excitement phase, biological changes do not closely mirror subjective arousal for women.

o Assumes desire precedes excitation
–> may not be distinct stages
o Definition of excitement – overly biological (not subjective)
–> Vaginal plethysmograph – measure women’s physio arousal, blood flow

Question 10

clinical case:
Robert, a very bright 25-year-old graduate student in physics at a leading university, sought treatment for what he called “sexual diffidence” toward his fiancée. He said he loved his fiancée very much and felt compatible with her in every conceivable way except in bed. There, try as he might, and with understanding from his fiancée, he found himself uninterested in initiating or responding to sex. He and his fiancée had attributed these problems to the aca- demic pressures he had faced for the past 2 years, but a discussion with the therapist revealed that Robert had had little interest in sex—either with men or with women—for as far back as he could remember, even when work pressures were not present. He asserted that he found his fiancée very attractive, but as with other women he had known, he did not feel passion for her.
He had masturbated very rarely in adolescence and did not begin dating until late in college, though he had had many female acquaintances. His general approach to life, including sex, was analytical and intellectual, and he described his problems in a very unemotional and detached way to the therapist. He freely admitted that he would not have contacted a therapist at all were it not for the quietly stated wishes of his fiancée, who worried that his lack of interest in sex would interfere with their future relationship.After a few individual sessions, the therapist asked the young man to invite his fiancée to a therapy session, which the client readily agreed to do. During a joint session, the couple appeared to be in love and looking forward to a life together, despite the woman’s concern about Robert’s lack of sexual interest.

Answer 10

male hypoactive sexual desire disorder.

Question 11

clinical case:
Bill, age 42, and Mary, his girlfriend of 18 months, sought treatment due to concerns about premature ejaculation. Both were divorced with children, and they stayed together every other weekend. Bill had a history of hypertension, hyperlipidemia, and low total tes- tosterone levels. Bill’s symptom, though, began well before these medical issues—he reported that he had never been able to main- tain an erection for more than a minute after insertion.

Answer 11

premature ejaculation

Question 12

t or f?
A person who experiences a brief problem with sexual arousal, orgasm, or desire is likely to meet the criteria for a sexual dysfunction.

Answer 12

F (unless the problem is recurrent and leads to distress or impairment, it cannot be diagnosed)

Question 13

t or f?

People with one sexual dysfunction tend to have other comorbid sexual dysfunctions.

Answer 13

true

Question 14

t or f?

Relationships are usually unsatisfying when one person has a symptom of sexual dysfunction.

Answer 14

false

Question 15

In the international survey conducted by Laumann and colleagues, which sexual dysfunction symptom did women most commonly report?

Answer 15

lack of interest (or female hypoactive sexual desire/arousal disorder)

Question 16

In the international survey conducted by Laumann and colleagues, which sexual dysfunction symptom did men most commonly report?

Answer 16

premature ejaculation

Question 17

define the spectator role

Answer 17

person immersed in how they are looking and performing during sex, as opposed to being present

Question 18

how large are the effects of depression + anxiety on sexual dissatisfaction?

Answer 18

Depression is associated with a threefold increase in risk of sexual dissatisfaction and anxiety with a twofold increase.

Question 19

describe the sensate focus technique

Answer 19

no intercourse, only touching, one giving, one receiving, communication

Question 20

which is the most effective treatment for female orgasmic disorder?

Answer 20

directed masturbation

Question 21

which is the most effective treatment for premature ejaculation?

Answer 21

SSRIs (dapoxetine)

Question 22

t or f?

Sex therapists may recommend that a woman who does not achieve orgasm practice masturbation without her partner present.

Answer 22

true

Question 23

clinical case:
Matt feels aroused only when he is able to cause pain to someone as part of engaging in sex. Most of the time, he indulges in these activities at a sadomasochism club. He has not been able to sustain a relationship with any of the women he has met in clubs. He is deeply distressed by his inability to enjoy other forms of sexuality.

Answer 23

sadism

Question 24

clinical case:
Barry is a 40-year-old single man who has never had a sustained dating relationship or sexual partnership. Several times a week, Barry parks his car at the beach, masturbates, and then finds a way to lure a woman to his car, usually by asking for directions. He is unable to have an orgasm unless the woman notices his erection. He has been arrested three times for this behavior.

Answer 24

exhibitionistic disorder

Question 25

clinical case:
Joe is able to obtain sexual arousal only by rubbing his body against strangers. He has worked out a set of rituals to engage in this behavior; he knows which bus routes and times will be most crowded, chooses a bus that tends to have many women, and times his attacks so that he can leave the bus at a stop along with many other people.

Answer 25

frotteuristic disorder

Question 26

describe the major problem with the research literature on causes of paraphilic disorders

Answer 26

Small samples comprised of sexual offenders
lack of well- validated diagnostic interviews, and few studies;

• most people dont want to talk about it
• majority of research sample is those who have been arrested

Question 27

what types of factors may contribute to the loss of control over sexual urges for those with paraphilic disorders?

Answer 27

• alcohol use
• negative emotions
• impulsivity
• poor emotion regulation

Question 28

The most commonly used biological treatments to reduce sexual desire and paraphilic behaviors are:

a. surgical castration
b. hormonal agents and antidepressants
c. anti-anxiety medications
d. none of the above

Answer 28

b. hormonal agents and antidepressants

Question 29

Name four cognitive-behavioral strategies used in the treatment of paraphilic disorders.

Answer 29

Covert sensitization, 
cognitive interventions to address maladaptive beliefs, 
social skills training, 
sexual impulse control training, 
therapy focused on early abuse, 
empathy training, 
relapse prevention
- aversion therapy

Question 30

Describe the evidence base for the psychological and biological treatments of paraphilic disorders.

Answer 30

The largest RCT for CBT showed little effect on repeat offending; hormone agents reduce sexual desire to deviant objects; no RCT is avail- able for SSRIs; available trials typically focus on sexual offenders and little long-term data is available.

Question 31

which is the most effective treatment for erectile dysfunction?

Answer 31

PDE-5 inhibitors