Week 3 - Stress and Sexual Diversity

Question 1

What is motivational interviewing?

Answer 1

• Where a health professional helps patients to identify and change behaviours that may be putting their health at risk
• Aims to elicit patient’s own arguments for change
• Increases internal motivation: shift towards being more ready/willing/able to change

Question 2

What are the 5 key principles of motivational interviewing?

Answer 2

• Express empathy
• Avoid argument
• Support self-efficacy
• Roll with resistance
• Develop discrepancy

Question 3

What are some positive and negative effects of stress?

Answer 3

• A medium amount of stress can help us to perform better
• Negative effects:
• – Effects on health
• – Memory problems
• – Irritability
• – Loss of sex drive
• – Moodiness
• – Sense of loneliness and isolation
• – Etc.

Question 4

What is a stressor?

Answer 4

Stressor = stressful life events

• E.g. marriage, divorce, death of partner, Christmas, moving house
• Different things may be stressful for different people at different times

Question 5

What is the transactional model of stress?

Answer 5

• Stress is a result of how people appraise events and their ability to cope with them
• Demands (stressors), resources (e.g. personality, coping skills) and appraisals are all considered and weighed up before the stress response is caused
• The stress response occurs when someone places the demands as greater than the resources they have available

Question 6

What are appraisals?

Answer 6

• Primary appraisal:
• – Is this event a threat?
• – How bad could it be?
• – Benign, challenging, threatening
• Secondary appraisal:
• – Do I have the resources or skills to cope?
• Reappraisal:
• – Reconsider the situation once have tried to cope with it (may decide it’s more or less stressful than thought)

Question 7

What are the 2 important factors that moderate the impact of stress?

Answer 7

• Control
• – If we feel that we have no control over an event then we are more likely to be stressed by it
• Social support
• – An important coping resource
• – Less likely to be stressed if you have good social support

Question 8

What are the different ways that stress can negatively impact on health?

Answer 8

• Physiological responses cause physical damage, especially when intense or prolonged
• – Primarily to cardiovascular system which can result in a heart attack
• Effects on the immune system can increase vulnerability to infection
• – E.g. frequent colds
• – For short/medium term stress the immune system is upregulated (prepares to repair damage and resist infection, prepares to fight off pathogens)
• – So when you relax, more likely to get ill
• – For longer term stress the immune system is depressed
• Coping efforts: increase in unhealthy behaviour
• – E.g. smoking, drinking, eating unhealthy snacks
• – Don’t address the course of the problem
• Negative impact on mental health (e.g. anxiety, depression) affecting coping and illness behaviour
• – Thinking is more rigid and extreme under stress
• – Prone to cognitive distortions (e.g. overgeneralisation, catastrophising, personalisation)

Question 9

What are some strategies for coping with stress?

Answer 9

• Cognitive strategies
• – E.g. cognitive restructuring, hypothesis testing
• Behavioural strategies
• – Skills training
• – E.g. assertiveness, time-management
• Emotional strategies
• – Counselling, emotional disclosure, social support
• Physical strategies
• – Relaxation training
• – Biofeedback
• – Exercise
• Non-cognitive strategies
• – Drugs

Question 10

What is the NATSAL survey?

Answer 10

National survey of sexual attitudes and lifestyles

• Been conducted on 3 occasions in Britain (1990-1991, 1999-2001, 2010-2012)
• NATSAL 3 included a representative sample of 15162 men and women aged 16-74
• People were asked questions about their sexual behaviour by an interviewer in their own homes, using a standard set of questions on a computer screen

Question 11

What is the sexual response cycle?

Answer 11

• Desire
• Arousal
• Orgasm

Question 12

What sexual dysfunction may arise if sexual desire/interest is affected?

Answer 12

Lack or loss of sexual desire

Question 13

What sexual dysfunction may arise if sexual arousal is affected?

Answer 13

• Men: erectile disorder

- Women: Sexual arousal disorder =

Question 14

What sexual dysfunction may arise if orgasm is affected?

Answer 14

• Men:
• – Rapid ejaculation
• – Inhibited orgasm
• Women:
• – Orgasmic dysfunction

Question 15

What are some other sexual dysfunctions?

Answer 15

• Sexual aversion and lack of sexual enjoyment
• Dyspareunia
• In women: vaginismus

Question 16

What are some precipitating factors that may lead to sexual dysfunction?

Answer 16

• Physical
• Psychological
• Life events
• Partners problems

Question 17

What are some perpetuating factors that may lead to sexual dysfunction?

Answer 17

Self:
- Loss of confidence
- Spectating
- Guilt and shame
- Anger and frustration
Partner:
- Breakdown communication
- Pressure to perform
- Criticism and hostility
- Guilt and self blame

Question 18

What are some predisposing factors that may lead to sexual dysfunction?

Answer 18

• False beliefs and concepts
• Unrealistic expectations
• Poor communication skills
• Physical vulnerability
• Early sexual trauma

Question 19

What are the main components of psychosexual therapy?

Answer 19

• Educative counselling – individual/couple
• Modification of attitudes/beliefs
• Facilitation of communication/assertiveness
• Specific directions for sexual behaviour
• – Sensate focus
• – Dilator therapy
• – Stop-start

Question 20

What are some physical treatments that can be offered for sexual dysfunction?

Answer 20

Male:
- Oral therapy
--- E.g. Viagra, testosterone
- Local therapy
--- E.g. EMLA cream
- Self injection therapy
- Mechanical therapy
--- E.g. pumps, rings
- Surgery
--- E.g. penile implant
Female:
- Testosterone
- Lubricants
- Oestrogen
- Clitoral therapy device
- Zestra gel