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Psych Exam 2 (A,S,L) > Sexuality And Sexual Disorders (Lauren 🌭) > Flashcards

Sexuality And Sexual Disorders (Lauren 🌭) Flashcards

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1
Q

Are sexual dysfunctions and sexual paraphilias the same thing?

A

No

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2
Q

Are you a mature adult

A

Then act like one

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3
Q

What are the 4 phases of the human sexual response?

A

Desire

Arousal/Excitement

Orgasm

Resolution

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4
Q

Men usually have _____ orgasm(s) before going to resolution

A

1

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5
Q

Do women always have 1 orgasm before they go to resolution?

A

No, may have 0 or may be multiple

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6
Q

What is responsible for so many people’s sex drive going straight to sexual stimuli these days

A

Porn

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7
Q

If you have a 28yo female patient express that she is having marital problems because her husband is unhappy that they only “hanky panky” once a month, even though she is satisfied, what should your next questions be?

A

Do you think this is abnormal for ~you~?

Have they ~talked~ about their different desires?

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8
Q

What features of sexual dysfunction would make you think that it has an ORGANIC etiology?

A

Generalized (not just one part of the sex cycle but all of it)

Gradual onset

Rapid onset when associated with mediation

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9
Q

What features of a sexual dysfunction would make you suspect that it is of a PSYCHOGENIC etiology?

A

Situational- specific situations just don’t do it for them

Rapid onset

Sexual phobia and aversion

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10
Q

What are some possible psychological causes for sexual dysfunction?

A

Performance anxiety (Spectatoring)

Inadequate communication with partner

Sexual myths and ignorance

**Intrapsychic issues: fear, guilt, TRAUMA

**Relationship issues: trust, power, control anger that crosses over into bedroom

**Sociocultural values: attitude, religious beliefs

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11
Q

What is spectatoring ?

A

Watching your own performance (on a camera? In the mirror? I dont know)

Anyways it can add to the performance anxiety one feels when you’re “doing squat thrusts in the cucumber patch”

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12
Q

What are some of the ways you can have “sexual dysfucntion”?

A

No erection/ lubrication

Initial erection/lube is lost

Premature ejaculation

Retarded ejaculation/femal orgasm dysfunction

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13
Q

How long must symptoms be present in order to diagnose a sexual dysfunction?

(This includes male hypoactive sexual desire disorder, femal sexual interest disorder, erectile disorder, premature ejaculation, female orgasmic disorder, and genito-pelvic pain disroder)

A

6 months

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14
Q

Couples typically have different levels of desire. This is (normal/abnormal)

A

Normal

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15
Q

True or false:

there are many variations of “normal”

A

True.

HE SAID THIS A LOT. BE CAREFUL WITH YOUR LANGUAGE

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16
Q

What kind of things might be going on in someone’s life that may cause them to have lower desire for ”doodle bopping?”

A

Too busy with family, career, friends, hobby

Relationship issues: anger, control, fear, abuse

Childhood abuse issues

Medical illness

DEPRESSION***

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17
Q

What kind of diseases/drugs can cause lower desire for “jamming the clam?”

A

Depression

SSRI side effect**

Vascular/neuro disease

Heavy alcohol consumption

Anxiety

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18
Q

What are the DSM5 criteria for males hypoactive sexual desire disorder?

A
  1. Absence/deficiency of sexual thoughts, desire, or fantasies for more than 6 months
  2. Sx cause marked distress/impairment
  3. Not result of other disease/drug (SSRI, depression, alcohol, etc)
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19
Q

How do you treat male hypoactive sexual desire disorder?

A

Psychosocial therapy

Bupropion

Testosterone

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20
Q

What are the DSM5 criteria for Female Sexual Interest/Arousal Disorder?

A
  1. Absence/deficiency of sexual thoughts, interest, fantasies, initiation of sex, sexual excitement/pleasure, sexual arousal, and/our genital/non-genital sensations during sex for >6 months
  2. Symptoms cause marked distress/impairment
  3. Not result of other dieease or drug

If there is interest, there is lack of adequate lubrication (arousal) to permit vaginal sex

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21
Q

What kinds of things other than Female Sexual Interest/Arousal disorder can cause a woman to produce inadequate lubrication for taking ol’ One Eye to the optometrist?

A

Medical conditions (atrophic vaginitis, infections, estrogen deficiency)

Medication side effects

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22
Q

What are the treatment options for Female Sexual Interest/Arousal disorder?

A

Artificial lubricants

Local estrogen

Flibanserin (serotonin, dopamine, and NE modulator)

Psychosocial therapy

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23
Q

What are the DSM5 criteria for Erectile Disorder?

A
  1. Marked difficulty obtaining or maintaining an erection or marked decrease of erectile rigidity for >6 months
  2. Sx cause marked distress/impairment
  3. Not result of other disease or drug
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24
Q

What are some organic factors that may contribute to erectile dysfunction?

A

Medication side effects

Diabetes

Post surgery (prostatectomy)

Hormonal problems

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25
Q

What are some psychological factors that may contribute to erectile dysfunction?

A

Anxiety/performance anxiety

Relationship issues: anger, control etc

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26
Q

What are the treatment options for erectile disorder?

A

Psychosocial therapy

Medications (PDE5 inhibitors)

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27
Q

What are the DSM5 criteria for premature ejaculation?

A
  1. Recurrent pattern of ejaculation during sex within one minute AND before the individual wishes. >6 months
  2. Cause marked distress/impairment
  3. Not result of other disease or drug
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28
Q

If a man always ejacualtes 30 seconds into “pickling the prime meridian,” and he and his wife are both extremely happy with their sex life, can you diagnose him with premature ejactulation?

A

No, both partners are happy and it’s not causing any marked distress/impairment

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29
Q

What is the etiology of premature ejaculation?

A

Early conditioning**

Anxiety

Lack of awareness of subtle penile sensations, especially sensations just prior to orgasmic threshold

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30
Q

What are the treatment options for premature ejaculation?

A

Self-treatment like distraction (thinkgin about baseball), squeezing, stopping etc

Low dose SSRIs**

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31
Q

What is the average normal duration of “gland to gland combat?”

A

5-7 minutes

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32
Q

What are the DSM5 criteria for Female Orgasmic Disorder?

A
  1. Marked delay, in frequency, absence, or reduced intensity of orgasm >6 months
  2. Causes marked distress/impairment
  3. Not a result of other disease of drug
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33
Q

What kinds of questions do you need to ask your patient who you think has Female Orgasmic Disroder?

A

Is it primary (Lifelong) or secondary (Acquired)?

Is it situational or generalized? With masturbation vs with partner. Is there both mental and physical stimuli ?

34
Q

What are the treatment option for female orgasmic disorder?

A

Patient Education

Psychosocial Interventions

Meds: Echinacea or Sildenafil

35
Q

What are the DSM5 criteria for Genito-Pelvic Pain/Penetration Disorder?

A
  1. Persistent/recurrent difficulties in one of the following for >6 months:
    - vaginal penetration during intercourse
    - marked vulvovaginal or pelvic pain during intercourse
    - marked anticipatory fear or anxiety about the pain
    - marked tensing or tightening of pelvic floor muscles during attempted vaginal penetration
36
Q

What are some of the components that can contribute to Genito-Pelvic Pain/Penetration disorder?

A

Past abuse

Strong negative conditioning

Anxiety component

Sexual component

37
Q

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

A

Trauma therapy (ex: EMDR)

38
Q

What are the Psychosocal Therpaies you can use for sexual dysfucntions?

A

Sex Therapy

CBT

39
Q

How does Sex Therapy treat sexual dysfunction disorders?

A

Treats the couple

Identify and discuss problems

Suggests Sexual exercises at home

40
Q

What are some sexual exercises at home you can do if you have a sexual dysfucntion disorder

A

Gradual heightening of sensory awareness

Progressively increase level of sexual contact

41
Q

Does Sex Therapy take many years to fix a sexual dysfunction disorder?

A

No, it is usually a short term thing. “Cognitive stuff doesn’t take long”

42
Q

How does Cognitive Behaviroal Therapy help sexual dysfucntion disroders?

A

Approaches the disorder as a learned maladddaptive behavior (that needs to be ~unlearned~)

Cognitive restructuring

Partner communication training

Systematic desensitization

Muscle relaxation

Assertiveness training

43
Q

What is the DSM5 definition of paraphilias?

A

Deviations for what are considered normal sexual interests and behaviors.

Recurrent, intense, sexually arousing fantasies, urges or behaviors involving either:

  1. Nonhuman objects
  2. The suffering/humiliation of self or partner
  3. Children or non-consenting persons

Occurs over at least 6 months

Causes significant distress to self/others or impairment in social, occupational, or other important areas of functioning

44
Q

If someone thinks about fantasies involving children, but never acts on it and it doesn’t cause distress or impairment, is it a priobelm?

A

No

45
Q

Paraphilias are usually a means to release _______ _______ and ________

A

Sexual energy

Frustration

46
Q

What are paraphilias often associated with?

A

Concealment

Guilt/shame

Financial and legal problems

47
Q

Do people with paraphilias cooperate well with treatment?

A

No, they are resistant to change

48
Q

What kind of technology did Dr. Stoehr say is problematic for paraphiliacs?

A

On-line material because it is unfiltered access 💻

💄🦶🏻👠🍆💦

49
Q

What is the Psychoanalytical (Freudian) theory regarding paraphilias?

A

They result from unsuccessful negotiating in normal developmental phases of courtship.

Urges are repressed and the re-expressed in paraphilas

50
Q

What does the Classical Conditioning theory say regarding paraphilias?

A

They are classically conditioned to associate the object with sexual arousal, and then they get subsequent negative reinforcement due to normal sex being unpleasant for them.

(Men only)

51
Q

Do women become classically conditioned to be sexually aroused by shoes, leather, underwear, etc?

A

No. Women dont usually become conditioned to ~objects~

52
Q

What is exhibitionism?

A

Flashing 🧥

Indecent exposure

53
Q

What are the DSM5 criteria for exhibitionism?

A
  1. Recurrent, intense, sexually arousngin fantasies, sexual urges or behaviors that involve exposing their genitals to unsuspecting strangers
  2. “Impairment”
54
Q

Why do Exhibitionists have so much fun flashing their “21st Digit” to strangers?

A

It evokes shock and fear in the victim, which they derive pleasure from.

The excitement increases with the risk of being discovered

55
Q

What sexual paraphilia is this:

  1. Recurrent intense sexually arousing fantasies, sexual urges, or behaviors involving the act of observing an unsuspecting person who is naked, in the process of disrobing or engaging in sexual activity
  2. “Impairment”
A

Voyeurism

56
Q

If you had to paint a picture of the type of person most likely to engage in voyeurism, what would that person look like?

A

Unmarried male in 20’s or 30’s

57
Q

What is a wonderful luxury available to voyeurs that allows them to explore their fantasies without victimizing anyone else?

A

Voyeur webpages/cam sites of “dressing rooms” etc but the people in the videos know that the cameras are there and are just pretending that they dont

58
Q

What paraphilia involves rubbing against and touching a non-consenting person?

A

Frotteurism

🚌🛩🚉

59
Q

What types of settings does frotteurism usually take place?

A

In crowded situations, they will attempt to rub their genitals against another person

60
Q

Are these things considered frotteurism:

Accidental touching

Inappropriate grabbing

Copping a feel

A

Yes. These are not innocent. They are total violations of someone’s personal space.

61
Q

What are the DSM5 criteria for fetishism?

A
  1. Recurrent, intense sexually arousing fantasies, urges, or behaviors involving non living objects or non-genital body part
  2. “Impairment”
  3. Patient do not limit the fetish objects to articles of female clothing used in cross dressing or to devices designated for the purpose of tactile genital stimulation
62
Q

What do fetishists ~do~ with the object/body part they are attracted to?

A

It is invariably used for masturbation

👙🦵🏽🦶🏻👠👡👝🧳🧥💅🏻👒

63
Q

What is the common name for “Transvestic Fetishism?”

A

Cross Dressing

64
Q

If you had to describe the kind of person most likely to engage in transvestic fetishism/cross dressing, what would they look like?

A

Heterosexual**

Married men

65
Q

Do Gender Dysphoria and Drag Queens fall under the category of Transvestic Fetishism (crossdressing)?

A

NO!!!!

66
Q

If you get off to being humiliated, beaten, bound, or made to suffer, you are a (masochist/sadist)

A

Masochist

(Masochist: Me)

⛓🔪🏓🤺💩

67
Q

What kind of fun activities may be arousing to someone who is a masochist?

A

Restraint⛓

Bondage

Paddling🏏

Beating 🤼‍♀️

Verbal abuse 🗣

Getting peed on 🚿

Getting pooped on 💩

Forced cross-dressing👠

Infantilism 🍼

Hypoxyphilia (occluding carotids)

68
Q

If someone is a masochist, can they also be a sadist?

A

Yes, that is called **sadomasochism*

69
Q

Why do paraphilias ruin “normal” sex for people?

A

Because it is ~learned behavior~ aka ~classical conditioning~ and that person only wants that form of sex now

70
Q

What are the DSM5 criteria for sadism?

A
  1. Recurrent, intense, sexually arousing fantasies, urges, or behaviors involving act in which psychological or physical suffering of the victim is sexually exciting
  2. The person has acted on these urges with a NON CONSENTING person, or the sexual urges and fantasies cause marked distress or interpersonal difficulty
  3. “Impairment”
71
Q

At what age do sadistic fantasies often begin, vs when sadisitic activities begin

A

Fantasies in childhood

Activities in early adulthood

72
Q

What personality disorder may be associated with Sadism?

A

ASPD

73
Q

What are the DSM5 criteria for pedophilia?

A
  1. Recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child (13 yrs or younger)*
  2. The patient must be age 16 or older and at least 5 years older than the child involved
  3. “Impairment”
74
Q

How might pedophiles try to rationalize their behavior?

A

They are providing “educational value”

The child derives sexual pleasure, so it’s not abuse

The child is sexually provocative, and he/she wanted this

🤢

75
Q

Coerced intercourse is also known as:

A

RAPE

76
Q

What age and gender are most victims of pedophilia?

A

Girls between 8 and 11

77
Q

What is meant by the victim to perpetrator cycle when it comes to pedophiles?

A

Victims of child sex abuse grow up and replace their feelings of ‘defeat’ with ‘triumph.’ (“Now I can control someone else”)

It artificially props up their self esteem

78
Q

Is all child sexual abuse committed by people who meet the DSM5 criteria for pedophilia?

A

No, there are sex offenders who do not ~prefer~ children, the opportunity just presented itself

79
Q

What factors have a poor prognosis for the course of all paraphilias?

A

Multiple paraphilias

Early age of onset

Comorbid substance abuse**

High frequency of behavior (or it’s their only form of sex)

They are getting psychiatric help due to referral by law enforcement (not by their own volition)

80
Q

What are some factors that have a good prognosis for the course of all paraphilias?

A

Only one paraphilia

Self-referral for treatment

Sense of Guilt over their behavior****

History of otherwise normal sexual behavior

81
Q

What kinds of psychotherapy are available for the treatment of paraphilias?>

A

CBT- addresses rationalizations and distorted thinking

Social skills training- intimacy development (learn how to get aroused without the shoe, foot, etc), communication, sex ed

12-step programs

Group therapy- address denial, healthy remorse, relapse prevention, call each other out on their BS

Individual psychotherapy

82
Q

What kinds of medications can be added to psychotherapy for the treatment of paraphilias?

A

SSRIs for mild cases

Antiandrogens/Chemical castrations (victim based paraphilias)

Mood stabilizers (Valproic acid) and antipsychotics for aggressive behaviors

Psych Exam 2 (A,S,L) (3 decks)

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