Term
| SEXUAL DISORDERS AND GENDER IDENTITY DISORDER |
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Definition
-sexual dysfunctions (problems with sexual responses)
-paraphilias (repeated and intense sexual urges or fantasies in response to objects or situations that society deems inappropriate)
-gender identity disorder(sex-related pattern in which people persistently feel that they have been born to the wrong sex and identify with the other gender) |
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Term
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Definition
- disorder marked by a persistent inability to function normally in some area of the human sexual response cycle
-distressing, lead to sexual frustration, guilt, loss of self-esteem, interpersonal problems…
-sexual response cycle has four phases: desire, excitement, orgasm, resolution –SD affects one or more of first three phases |
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Term
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Definition
| hypoactive, sexual aversion... |
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Term
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Definition
| - phase of sexual response cycle consisting of an urge to have sex, sexual fantasies, and sexual attraction to others (hypoactive sexual desire disorder and sexual aversion disorder affect this phase) |
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Term
hypoactive sexual desire disorder
(desire disorder) |
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Definition
- disorder marked by a lack of interest in sex and hence a low level of sexual activity (but when do have sex responses are normal and may enjoy it)
-found in 16% of men, 33% women
-many experience desire and arousal but choose not to engage in sexual relations- but this is NOT the disorder |
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Term
| DSM-IV checklist: hypoactive sexual desire disorder |
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Definition
1- persistent or recurrent deficiency of sexual fantasies and desire for sexual activity
2- significant distress or interpersonal difficulty
^ ‘deficient’ not clearly defined… (age, number of years married, education, social class and others all affect frequency of sex) – on the basis of one survey, hypoactive desire would be desiring sex less frequently than once every two weeks |
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Term
sexual aversion disorder
(desire disorder) |
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Definition
- disorder characterized by an aversion to and avoidance of genital sexual interplay (distinctly unpleasant or repulsive)
-some repelled by particular aspect of sex (actual penetration), others experience general aversion
-seems quite rare in men and more common in women |
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Term
| DSM-IV checklist: sexual aversion disorder |
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Definition
1-persistent or recurrent extreme aversion to, and avoidance or, almost all genital contact with a sexual partner
2- significant distress or interpersonal difficulty |
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Term
| -sex drive is caused by combo of ... |
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Definition
-sex drive is determined by combo of biological, psychological, and sociocultural factors
– most cases caused by psychological or sociocultural but any of them can decrease drive |
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Term
Biological Causes
(desire) |
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Definition
-hormone abnormalities: high level of prolactin, low level of testosterone, and either high or low level of estrogen (high level/low drive linked with some birth control pills or low level in postmenopausal women or those who’ve just given birth)
-long term physical illness can lower drive: direct result, or indirect (because of stress, pain, or depression brought on by illness)
-pain medications, certain psychotropic drugs, many illegal drugs (cocaine, marijuana, amphetamines, heroin), low levels of alcohol may raise drive (lowers inhibitions) yet high levels may reduce it |
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Term
Psychological Cause
(desire) |
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Definition
-increase in anxiety, depression, or anger (in both men and women): those with HSD and SA have particular attitudes, fears, or memories that contribute to dysfunction (sex is immoral or dangerous)
-fear losing control of sexual urges
-fear of pregnancy
-disorders may contribute (depression, OCD…) |
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Term
Sociocultural Causes
(desire) |
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Definition
-situational pressures (divorce, death in family, job stress, infertility difficulties, having a baby)
-problems in relationship (unhappy, lost affection, feel powerless/dominated by partner, unskilled or unenthusiastic partner, differ in needs for closeness)
-cultural standards: some men adopt double standard and can’t feel desire for a woman they love and respect, middle-aged and older men and women lose interest as self-image/attraction diminishes
-molestation or assault: fears, memories, attitudes, flashbacks of assault during sexual activity (SA very common) |
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Term
| PYSCH WATCH: lifetime patterns of sexual behavior |
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Definition
| teenagers, early adulthood, mid-adulthood, old age ... |
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Term
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Definition
-90% of boys masturbate by end of adolescence once or twice a week, 50% of girls once a month;
-20% have hetero intercourse by 15, 80% by 19 (younger than past generations) usually only in one relationship at a time but over time many have at least 2 partners;
-extended periods without sex common (half of active girls once a month or less, and boys 6 months without);
-condom usage has increased (almost half) but less than 1/3rd report using consistently and appropriately |
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Term
early adulthood (18-24)
(psychwatch) |
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Definition
-80% unmarried young adults in a year;
-1/3rd two-three times a month and other 1/3rd two-three times a week;
-masturbation still common (60% males 1/3rd at least once a week, 36% females 1/10th at least once a week) |
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Term
mid-adulthood (25-59)
(psychwatch) |
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Definition
-relationships last longer and more monogamous;
-90% in given year;
-half of unmarried men have 2+ partners in a year compared to ¼ women;
-60% men three times a week and 60% women 1-2 times a week;
-still masturbation (1/2 men at least monthly, and ½ women) |
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Term
old age (over 60)
(psychwatch) |
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Definition
-more and more stop having intercourse- 10% in 40s, 15% in 50s, 30% in 60s, 45% in 70s – health failure, death/illness of partner;
-women seem to lose interest before men (1/2 in 60s compared to fewer than 10% males);
-those who remain active- 60s average 4 times a month, 70s 2-3 times a month;
-70% men and 50% women continue to have fantasies;
-½ men and ¼ women continue masturbation |
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Term
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Definition
| sexual arousal, erectile ... |
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Term
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Definition
- phase in sexual response cycle marked by changes in the pelvic region, general physical arousal, and increases in heart rate, muscle tension, blood pressure, and rate of breathing (female sexual arousal disorder (frigidity) and male erectile disorder (impotent) affect this phase)
-in men: blood pools in pelvis and leads to erection
-in women: swelling of clitoris and labia, lubrication of vagina |
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Term
Female Sexual Arousal Disorder
(excitement disorder) |
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Definition
- female dysfunction marked by a persistent inability to attain sexual excitement, including adequate lubrication or genital swelling, during sexual activity
-many also experience orgasmic disorder or other sexual dysfunction (rarely diagnosed alone)- orgasmic disorder very commonly accompanies
-more than 10% experience |
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Term
| DSM-IV checklist: female sexual arousal disorder |
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Definition
1- persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, adequate lubrication or swelling response of sexual excitement
2- significant distress or interpersonal difficulty |
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Term
Male Erectile Disorder
(excitement disorder) |
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Definition
- dysfunction in which a man repeatedly fails to attain or maintain an erection during sexual activity
-10% experience, most men over age of 50 (largely due to ailments or diseases); 7% men under 30 and 50% over 60; half of adult men experience erectile difficulty during intercourse at least some of the time
-interaction of biological, psychological, and sociocultural processes… |
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Term
| DSM-IV checklist: male erectile disorder |
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Definition
1-persistent or recurrent inability to attain, or to maintain until completion of sexual activity, an adequate erection
2-significant distress or interpersonal difficulty |
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Term
Biological Causes
(erectile disorder) |
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Definition
-hormonal imbalances (same as before)
-more commonly vascular problems (blood vessels)- any condition that reduces blood flow to penis (heart disease, clogging of arteries)
-damage to nervous system as result of diabetes, spinal cord injuries, MS, kidney failure, treatment of dialysis
-certain medications, substance abuse (alcohol, smoking)
-medical procedures for diagnosing: nocturnal penile tumescent (NPT)- erection during sleep – are measured determining whether physical factors are responsible; erections during REM sleep (2-5 REMs a night and perhaps 2-3 hours of penile erections)- abnormal or absent NPTs usually indicated physical basis of disorder; measured by fastening snap gauge band around penis before bed and check it in the morning- broken band indicates erection during the night – device today connects to computer and gets precise measurements (RigiScan- two bands around penis, if computer says bands have expanded throughout night erections experienced)
-Viagra and other drugs given |
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Term
Psychological Causes
(erectile disorder) |
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Definition
-90% of depressed men experience to some degree
-Masters and Johnson explanation: performance anxiety- fear of performing inadequately and related tension experienced during sex- and spectator role- state of mind that some people experience during sex focusing on their sexual performance to such an extent that their performance and enjoyment are reduced – once a man begins to experience erectile problems he becomes fearful and worrisome and distanced from activity becoming the judge and spectator (no matter the initial cause) |
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Term
Sociocultural Causes
(erectile disorder) |
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Definition
-losing jobs, financial stress, marital stress more likely to develop
-relationship patterns: wife provides too little stimulation (because with age he requires more intense, direct, lengthy) OR couple believes that only intercourse can give wife orgasm (increases pressure on man) |
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Term
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Definition
| premature ejaculation, male and female orgasmic ... |
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Term
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Definition
| - phase of sexual response cycle during which an individual’s sexual pleasure peaks and sexual tension is released as muscles in the pelvic region contract rhythmically (man ejaculates, women’s vaginal wall contracts (outer third)) (rapid/premature ejaculation, male orgasmic disorder, female orgasmic disorder affect this phase) |
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Term
Rapid or Premature Ejaculation
(orgasm disorder) |
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Definition
- dysfunction in which a man reaches orgasm and ejaculates before, on, or shortly after penetration and before he wishes to
-30% experience at some time; many young and old men experience
-typical duration of intercourse has increased in our society in turn increasing distress of men who suffer
-psychological causes mostly researched- sexually inexperienced men who have simply not learned to slow down and control; related to anxiety, hurried masturbatory experiences in adolescence- only some support
-biological factors may play role- genetic predisposition, certain serotonin receptors are overactive and others underactive, greater sensitivity/nerve conduction in penis |
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Term
| DSM-IV checklist: rapid/premature ejaculation |
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Definition
1-persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it
2-significant distress or interpersonal difficulty |
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Term
Male Orgasmic Disorder
(orgasm disorder) |
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Definition
- male dysfunction characterized by repeated inability to reach orgasm or long delays in reaching orgasm after normal sexual excitement
-8% males
-low testosterone, certain neurological diseases, some head and spinal injuries can interfere; drugs that slow sympathetic nervous system (alcohol, some high blood pressure meds, certain psychotropic- serotonin-enhancing antidepressants in at least 30% men)
-psychological- performance anxiety and spectator role (cognitive-behavioral factors); past masturbation habits (absence of certain stimuli- made associations); develop out of hypoactive sexual desire |
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Term
| DSM-IV checklist: male orgasmic disorder |
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Definition
1-persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity
2- significant distress or interpersonal difficulty |
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Term
Female Orgasmic Disorder
(orgasmic disorder) |
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Definition
- dysfunction in which a woman rarely has an orgasm or repeatedly experiences a very delayed one
-24% women to some degree; 1/3rd post-menopausal women, more common in single women; 10% women have never had an orgasm and 9% rarely experience while 50% women fairly regularly experience in intercourse- those who are more sexually assertive and more comfortable with masturbation more regularly have orgasms
-typically linked to female sexual arousal disorder (so studied and treated together) |
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Term
| DSM-IV checklist: female orgasmic disorder |
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Definition
1- persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity
2-significant distress or interpersonal difficulty |
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Term
Biological Causes
(female orgasmic disorder) |
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Definition
-diabetes (damage to nervous system- arousal, lubrication, orgasm), MS and other neurological diseases
- drugs and medications (same as men)
- (often postmenopausal) changes in skin sensitivity and structure of clitoris, vaginal walls, or labia |
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Term
Psychological Causes
(female orgasmic disorder) |
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Definition
-depression, memories of childhood traumas and relationships (unhappy childhood- loss of parent…)
-memories of dependable father, positive relationship with mother, affection between parents, mothers’ positive personality, and mother’s expression of positive emotions are all predictors of orgasm |
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Term
Sociocultural Causes
(female orgasmic disorder) |
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Definition
-society’s message that women should repress and deny their sexuality (less permissive attitudes and behavior)
-sexually restrictive history: strict religious upbringing, punished for childhood, masturbation, no preparation for oncoming menstruation, restricted from dating, told that ‘nice girls don’t’… -but just as common among women who function well in sexual encounters and rate stays the same as more positive sexual messages increased
-stressful events or relationships may help produce fears, memories, and attitudes that often accompany these dysfunctions (those who were molested or raped as adults)
-certain qualities in women’s intimate relationships: reaching orgasm tied to how much emotional involvement during first intercourse and how long relationship lasted, pleasure women obtained during experience, current attraction to partner’s body, and marital happiness and erotic fantasies during sex |
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Term
| Figure 11-4:sex in casual relationships |
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Definition
| women from US, Russia, Japan on average rated it unacceptable while men rated it fairly acceptable |
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Term
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Definition
| -enormous physical discomfort when sexual activity is attempted |
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Term
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Definition
- condition marked by involuntary contractions of the muscles around the outer third of the vagina preventing entry of the penis
-20% women occasionally experience pain and vaginismus occurs in 1% of women
-cognitive-behavioral- it’s usually learned fear response set off by woman’s expectation that intercourse will be painful and damaging (set off by anxiety, ignorance, exaggerated stories, trauma from unskilled lover who forces penis in, trauma of sexual abuse or rape)
-infection of vagina or urinary tract, herpes, menopause- pain can only be overcome if seek treatment for these conditions
-many who have vaginismus have other sexual dysfunctions; some greatly enjoy sex, have strong sex drive, and reach orgasm via clit- they just fear penetration |
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Term
| DSM-IV checklist: vaginismus |
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Definition
1-recurrent or persistent involuntary spasm of the muscles of the outer third of the vagina that interferes with sexual intercourse
2-significant distress or interpersonal difficulty |
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Term
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Definition
- disorder in which a person experiences severe pain in the genitals during sexual activity
-14% women (8% all or most of the time), 3% men- most enjoy sex and get aroused but find sex lives limited by pain
-in women: usually physical cause- injury during birth, scar left by episiotomy (cut made to enlarge vaginal entrance for baby), collision of penis with hymen, infections of vagina, wiry pubic hair that rubs against labia, pelvic diseases, tumors, cysts, allergic reactions
-psychological factors (heightened anxiety, or overattentiveness to one’s body) may contribute, but are rarely sole cause |
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Term
| DSM-IV checklist: dysparenia |
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Definition
1-recurrent or persistent genital pain associated with sexual intercourse in either male or female
2- significant distress or interpersonal difficulty |
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Term
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Definition
| -produce near-unconscious yet responsive state eliminating clear thinking, reducing inhibitions, impairing memory; usually slip tasteless, odorless drugs into drinks- but now how drug-detecting coasters (turns dark blue if any alcohol is spilled on them) |
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Term
| TREATMENTS FOR SEXUAL DYSFUNCTIONS |
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Definition
-for first half of 20th century long-term psychodynamic approach was most popular (clinicians assumed cause was from failure to progress properly through stages) but was typically unsuccessful
-then relaxation training and systematic desensitization (successful in cases that included misinformation, negative attitudes, and lack of effective technique)
-William and Masters- published Human Sexual Inadequacy and had a sex therapy program (includes various interventions) |
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Term
| What Are the General Features of Sex Therapy? |
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Definition
| -modern therapy is short-term (15-20 sessions) and instructive; centers on specific sexual problems rather than personality issues; principles and techniques: ... |
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Term
| 1- assessment and conceptualization of the problem: |
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Definition
| medical exam and sex history interview (past life events, current factors contributing to dysfunction); sometimes requires psychologist, urologist, neurologist |
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Term
| 2- mutual responsibility: |
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Definition
| both partners share the problem (regardless of who has dysfunction) therefore both get therapy (more successful then) |
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Term
| 3- education about sexuality: |
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Definition
| many know little about physiology and techniques (books, videos, websites) |
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Term
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Definition
| examine and change beliefs that are preventing arousal and pleasure (can result from past traumatic events, family attitudes, or cultural ideas) |
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Term
| 5- elimination of performance anxiety and the spectator role: |
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Definition
| teach sensate focus (nondemand pleasuring)- series of sensual tasks (‘petting’ exercises) in which partners focus on sexual pleasure by exploring and caressing each other’s body without demands to have intercourse or reach orgasm – first told to refrain from intercourse and to limit sexual activity to kissing, hugging, and sensual massage to nongenital parts of body and over time learn how to give greater sexual pleasure and build back up to intercourse |
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Term
| 6- increasing sexual and general communication skills: |
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Definition
| apply sensate-focus skills and try new techniques/positions, give instructions in nonthreatening informative manner, and general communication skills |
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Term
| 7- changing destructive lifestyles and marital interactions: |
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Definition
| encouraged to change lifestyle or other steps to improve destructive situation (distance selves from interfering in-laws, change jobs) |
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Term
| 8- addressing physical and medical factors: |
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Definition
| try to medically address disease, injury, medication, or substance abuse problems (lowering dosage… etc) |
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Term
| What Techniques Are Applied to Particular Dysfunctions |
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Definition
-most difficult to treat because of the many factors that feed into them- so therapists try a combination of techniques…
-apparently helpful techniques
-dysfunction resulting from assault or molestation- remember, talk about, think about the assault until memories no longer produce fear or tension, or instructed to have a mock dialogue with molestor/assaulter (to express rage and powerlessness)
... |
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Term
affectual awareness
(hypoactive treatments) |
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Definition
| - visualize sexual scenes in order to discover any feelings of anxiety, vulnerability, or other negative emotions |
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Term
self-instruction training
(hypoactive tx) |
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Definition
| - learn to replace negative statements during sex with coping statements (‘I can allow myself to enjoy sex, it doesn’t mean I’ll lose control’) |
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Term
behavioral approaches to increase sex drive
(hypoactive tx) |
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Definition
| - keep a desire diary (record sexual thoughts and feelings, read books and watch films with erotic content, fantasize about sex) |
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Term
| Erectile Disorder treatments |
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Definition
-treatments focus on reducing a man’s performance anxiety, increasing his stimulation using behavioral, cognitive, and relationship interventions
-before medications- ‘second-line’ treatments used (when meds are ineffective or too risky), gel suppositories, injections into penis, vacuum erection device (hollow cylinder placed over penis, use hand pump to pump air out of cylinder drawing blood into penis) |
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Term
tease technique
(erectile tx) |
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Definition
| - during sensate-focus exercises, partner caresses until erection and then stops until he loses it (reduces pressure for man to perform and teaches that erections occur naturally in response to stimulation as long as no one focuses on performance), encouraged to use oral and/or manual stimulation to bring woman to orgasm (again reducing performance pressure) |
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Term
biological approaches
(erectile tx) |
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Definition
| Viagra- increases blood flow to penis within one hour of digestion making it easier to get an erection during sexual activity, safe medication except for those with heart and cardiovascular diseases; also Cialis and Levitra – collectively these drugs are most common treatment, restore erections in 75% of men |
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Term
| Male Orgasmic Disorder treatments |
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Definition
-techniques that reduce performance anxiety and increase stimulation
-may be instructed to masturbate to orgasm in presence of his partner or to just short of orgasm before inserting for intercourse
-when physical factors (neurological damage or injury) given drug to increase arousal of sympathetic nervous system |
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Term
| Rapid Ejaculation treatments |
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Definition
-behavioral procedures: stop-start procedure (stimulated until highly aroused, then pause until arousal subsides, then resume and repeat several times before ejaculation; eventually stop-start with insertion)- after a few months many enjoy prolonged intercourse without pauses
-SSRIs (serotonin enhancing antidepressants)- because they often reduce arousal or orgasm (serotonin receptors in brain may function abnormally) |
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Term
| Female Arousal and Orgasmic Disorders treatments |
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Definition
-cognitive-behavioral techniques, self-exploration, enhancement of body awareness, directed masturbation training (especially useful for those women who have never had an orgasm; biological treatments have been tried but not consistently helpful
-lack of orgasm does not necessarily sexual dysfunction, provided the woman enjoys intercourse and can reach orgasm during caressing (by partner or self)- because of this some believe wisest treatment is simply to educate women (informing them that they’re normal) |
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Term
directed masturbation training
(female arousal and orgasmic tx) |
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Definition
| - sex therapy approach that teaches women with female arousal or orgasmic disorders how to masturbate effectively and eventually to reach orgasm during sexual interactions; includes diagrams and reading material, private self-stimulation, erotic material and fantasies, orgasm triggers (holding her breath, thrusting pelvis), sensate focus with partner, sexual positioning producing stimulation of clit during intercourse- highly effective (over 90% learned to orgasm during masturbation, 80% while partners caressing them, 30% during intercourse) |
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Term
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Definition
-first, woman practices tightening and relaxing vaginal muscles until she gains more voluntary control over them; second, gradual exposure treatment (beginning with increasingly large dilators then working up to a penis- most are successful
-medical interventions sometimes also applied- Botox to vaginal muscles to reduce spasms |
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Term
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Definition
-when cause is known, pain management procedures and sex therapy techniques (learning positions that avoid pressure on injured area), medical interventions (topical creams to surgery) but must be combined with other techniques to overcome years of anxiety and lack of arousal
-most cases best treated with a team of professionals (gyno, physical therapist, sex therapist, or other professionals) |
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Term
| Current Trends in Sex Therapy |
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Definition
-not only married couples but also those who are just living together
-also dysfunctions resulting from depression, mania, schizophrenia, and certain personality disorders
-no longer screen out those with severe marital discord, elderly, medically ill, physically handicapped, homosexual, or those with no long-term sexual partner
-paying more attention to hypersexuality or sexual addiction
-concern for sharp increase in drugs and other medical interventions- therapists may start increasingly choosing biological interventions rather than integrating with psychological and sociocultural (narrow approaches can’t fully address the complex issue) |
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Term
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Definition
-disorders characterized by recurrent and intense sexual urges, fantasies, or behaviors involving nonhuman objects, children, nonconsenting adults, or experiences of suffering or humiliation
- many can only become aroused when specific stimulus is present, fantasized about, or acted out, others need stimulus only during times of stress or under special circumstances
-some with one kind paraphilia display others as well; few receive formal diagnosis but large internet/pornography market leads clinicians to suspect that patterns may be common
-little formal evidence to support them
-psychological and sociocultural treatments have been available the longest, but today also biological (antiadrogen drugs- lower production of testosterone reducing sex drive- but may interrupt normal sexual feelings as well(only applied when dangerous); also SSRIs hoping they’ll reduce the compulsion-like sexual behaviors just like others- but also lower arousal) |
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Term
| DSM-IV checklist: paraphilias |
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Definition
1-over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving certain inappropriate stimuli or situations (nonhuman objects, suffering or humiliation of oneself or one’s partner, or children or other nonconsenting persons)
2-significant distress or impairment over the fantasies, urges, or behaviors (in some paraphilias- pedophilia, exhibitionism, voyeurism, frotteurism, and sexual sadism- the performance of paraphilic behaviors indicates a disorder even in the absence of distress or impairment) |
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Term
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Definition
- paraphilia consisting of recurrent and intense sexual urges, fantasies, or behaviors that involve the use of a nonliving object, often to the exclusion of all other stimuli
far more common in men that women
-begins in adolescence
-anything can be a fetish (boots, underwear, shoes); objects may be touched, smelled, worn, or some other way during masturbation or intercourse |
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Term
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Definition
fetishes acquired through classical conditioning;
-sometimes treat with aversion therapy (electric shock);
-masturbatory satiation- behaviorally treatment in which a client masturbates for a very long period of time while fantasizing in detail about paraphilia object, the procedure is expected to produce a feeling of boredom that in turn becomes linked to objects;
-orgasmic reorientation- procedure for treating certain paraphilias by teaching clients to respond to new, more appropriate sources of sexual stimulation |
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Term
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Definition
- paraphilia consisting of repeated and intense sexual urges, fantasies, or behaviors that involve dressing in clothes of the opposite sex; also known as transvestism or cross-dressing
-almost all are heterosexual; often cross dress in private, small percent goes out to bars/clubs; some wear only one item (panties) others fully dress up
-begins in childhood/adolescence; seems to follow principles of operant conditioning
-often confused with gender identity disorder |
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Term
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Definition
- paraphilia in which persons have repeated sexually arousing urges or fantasies about exposing their genitals to another person and may act upon these urges (but rarely attempts to initiate sexual activity)
-mostly to provoke shock or surprise; urge grows stronger if person has free time or under stress
-in one study, 4.3% men have performed exhibitionist behavior, yet 1/3 – ½ of women report being exposed to
-begins before 18 and most common in males; typically immature in dealings with opposite sex and have difficulty with interpersonal relationships; 30% married, 30% divorced or separated- sexual relations with partners usually unsatisfactory; doubts about masculinity; seem to have strong bond with possessive mother
-aversion therapy, masturbatory satiation, possibly combined with orgasmic reorientation, social skills training, or CBT |
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Term
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Definition
- paraphilia in which a person has repeated and intense sexual desires to observe unsuspecting people in secret as they undress or to spy on couples having intercourse and may act upon these desires (doesn’t seek out sexual relations with the person)
-person being spied on’s vulnerability and humiliation if they ever found out are part of the enjoyment and risk of being caught
-may be part of normal sexual relations (if partner consents); clinical disorder marked by repeated invasion of other people’s privacy
-behaviorists claim that can be traced back to a chance and secret observation of sexually arousing scene (not motivated to gain power over others) |
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Term
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Definition
- paraphilia consisting of repeated and intense sexual urges, fantasies, or behaviors that involve touching and rubbing against a nonconsenting person
-usually committed in a crowded place; almost always male; fantasize that he has a caring relationship with victim
-may rub genitals against victim’s thighs or buttocks or fondle her genital area or breasts
-begins in teenage years or earlier often after observing an act of frottage; usually gradually decreases and often disappears at about 25 |
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Term
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Definition
- paraphilia in which a person has repeated and intense sexual urges or fantasies about watching, touching, or engaging in sexual acts with prepubescent children and may carry out these urges or fantasies
-children usually 13 years or younger, some satisfied child porn, children can be girls or boys but evidence suggests that 2/3rds are girls; some only attracted to children, some to adults as well |
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Term
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Definition
-usually develop during adolescence- some abused as children, many neglected, excessively punished, deprived of close relationships
- often married and have sexual difficulties or other frustrations that lead them to want to be masters in some area; often immature- social and sexual skills undeveloped, thoughts of normal sexual relationships provoke anxiety
-distorted thinking (it’s okay if they agree)- even some joined pedophile organizations that advocate abolishing the age of consent laws
- some also display at least one psychological disorder
-may be related to biochemical or brain structure abnormality
-most imprisoned or forced into treatment; now registration and community notification laws
-aversion therapy, masturbatory satiation, orgasmic reorientation, CBT (relapse-prevention training- identify triggers and lead avoidance and coping strategies), antiandrogen drugs |
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Term
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Definition
- paraphilia characterized by repeated and intense sexual urges, fantasies, or behaviors that involve being humiliated, beaten, bound, or otherwise made to suffer
-only those distressed/impaired by these fantasies get diagnosis
-hypoxyphilia¬- strangling or smothering themselves; sometimes reports autoerotic asphyxia- accidentally induced fatal lack of oxygen by hanging, suffocating, or strangling themselves while masturbating
-most begin in childhood, but usually doesn’t act out urges until later (early adulthood) and continues for many years- more and more dangerous acts over time and during times of stress
-classical conditioning |
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Term
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Definition
- paraphilia characterized by repeated and intense sexual urges, fantasies, or behaviors that involve inflicting suffering on others
-derived from Marquis de Sade who tortured others in order to satisfy his sexual desires
-imagine they have total control over their victim who is terrified by the sadistic act; many carry out with consenting partners but some (rapists, sexual murderers) exhibit sexual sadism
-fantasies may first appear in childhood, the acts develop by early adulthood, long-term pattern; acts sometimes stay at the same level of cruelty but often become more severe
-classical conditioning- while inflicting pain (perhaps unintentionally) on animal or person a teenager may feel intense emotions and sexual arousal- association is made; may result from modeling- observing others inflicting pain and achieving sexual satisfaction (internet, magazines, books, videos)
-psychodynamic and cognitive theorists suggest that people inflict pain to achieve sense of power or control necessitated perhaps by underlying feelings of sexual inadequacy- sense of power in turn increases feelings of sexual arousal
-aversion therapy- not clear if it’s helpful; relapse-prevention training- may be helpful |
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-definitions of paraphilias are strongly influenced by norms of society in which they occur
-clinicians argue that except when people are hurt by them, many should not be considered disorders; homosexuality used to be considered a disorder |
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- disorder in which a person persistently feels extremely uncomfortable about his or her assigned sex and strongly wishes to be a member of the opposite
-many have transgender experiences and come to terms with their gender inconsistencies, but others experience gender dysphoria- unhappiness with their current gender- and often seek treatment
-many would like to get rid of their primary and secondary sex characteristics and acquire those of the other sex; many experience anxiety or depression and contemplate suicide; some manifest personality disorder |
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| DSM-IV checklist: gender identity disorder |
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Definition
1- strong and persistent cross-gender identification (for example- a stated desire to be the other sex, frequent passing as the other sex, desire to live or be treated as the other sex, or the conviction that one has the typical feelings and reactions of the other sex)
2- persistent discomfort with one’s sex or a sense of inappropriateness in the gender role of that sex (for example preoccupation with getting rid of primary and secondary sex characteristics or belief that one was born the wrong sex
3- significant distress or impairment
-DSM categorization recently controversial- many think transgender experiences reflect alternative (not pathological) ways of experiencing one’s gender identity, others say it is a disorder because it produces unhappiness (just like other medical conditions) but shouldn’t be psychologically categorized |
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-M:F - 2:1
-sometimes emerges in children and disappears by adolescence or adulthood but in some cases it develops into GID
-1.5% boys want to be girls, 3.5% girls wish to be boys, yet less than 1% manifest GID- why many strongly recommend against any physical treatment for this pattern until 16 years |
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| Explanations of Gender Identity Disorder |
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Definition
-limited and generally weak support
-biological (genetic or prenatal) factors- sometimes runs in families; brain size abnormalities (bed nucleus of stria terminalis- only half as large in those who changed their sex from male to female- normally women’s are smaller- not sure of function but regulates sexual behavior in rats) |
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| Treatments for Gender Identity Disorder |
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Definition
| -in order to assess and treat, have to identify types… |
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| Types of Gender Dysphoria Clients |
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| 1- female to male gender dysphoria |
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Definition
-born female but appear/behave in masculine manner from early on (often 3 years or younger)- play rough games, prefer company of boys, hate girly clothes, state that they wish to be male;
-in adolescence- disgusted by physical changes and sexually attracted to females but lesbian relationships aren’t satisfactory |
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| 2- male to female gender dysphoria: androphilic type |
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Definition
-born male but appear/behave in feminine manner;
-children- gentle, avoid rough play, hate boy clothing;
-adolescence- sexually attracted to males and often come out as gay (androphilic=attracted to males) but by adulthood the gay relationships don’t satisfy and want to be with men who are attracted to them as women |
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| 3- male to female gender dysphoria: autogynephilic type |
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Definition
-not attracted to males but to themselves being females (autogynephilic=attracted to oneself as a female), similar to transvestic fetishism;
-children- act masculine, enjoy dressing up in female clothing, and after puberty become aroused when dressed up;
-adolescence- attracted to females but have fantasies of becoming a female which becomes stronger during adulthood |
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| Treatment for Gender Identity Disorder |
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Definition
-many receive psychotherapy
-a large number further seek treatment biologically- hormone treatments (estrogen to males, testosterone to women); if hormones not enough then…
(sex-change surgery) |
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Term
sex-change surgery
(treatment for GID) |
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Definition
- surgical procedure that changes a person’s sex organs, features, and in turn sexual identity; also known as sexual reassignment surgery
-preceded by two years of hormone therapy; men- amputation of penis and creation of vagina, face-changing plastic surgery; women- bilateral mastectomy and hysterectomy, creating penis (phalloplasty- silicone prosthesis) |
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-1 of 30,000 men and 1 of 100,000 women seek the surgery; in US more thatn 6,000 – and appears to be on the increase
-some clinicians think humane solution, others think drastic nonsolution to complex disorder
-most satisfied with outcome- improvements in self-satisfaction and interpersonal interactions, but often lacking in sexual functioning – poor outcomes about 8%, female to male show most favorable outcomes and those with autogynephilic type show most unfavorable and those with pretreatment psychological disorder (ex:personality disorder) more likely to regret and more likely to attempt suicide |
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-affected by physical and psychosocial factors
-sleep deprivation: for 100+ hours- hallucinations, paranoia, bizarre behavior; 200+ hours- experience microsleep (naps lasting 2-3 seconds) |
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| people come into lab and sleep hooked up to various recording devices |
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- eyes move rapidly about 25% of time person is asleep, body is immobilized, blood flow to brain increases, brain-wave activity almost identical to when awake
- 80% of those awaken during REM reported that they were dreaming |
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Definition
-dysomnias (insomnia, hypersomnia, breathing-realted sleep disorders, narolepsy, circadian rhythm sleep disorder)- disturbances in the amount, quality, or timing of sleep
-parasomnias (nightmare disorder, sleep terror disorder, sleepwalking disorder)- abnormal events that occur during sleep |
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Definition
| insomnia (great difficulty falling or maintaining sleep); more than 20% of population in any given year; feel constantly awake, very sleepy during the day and difficulty functioning; may be caused by anxiety, depression, medical ailments, pain, medication effects |
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Term
| sleep disorders among the elderly |
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Definition
-insomnia more common than in younger people- 50% over 65 experience some measure of insomnia; elderly may be particularly prone due to medial ailments, pain, medications, depression and anxiety, and some normal physical changes (body rhythms, spend less time in deep sleep, sleep more interrupted, longer to get back to sleep)
-breathing-related sleep disorder- respiratory problem in which people are periodically deprived of oxygen to the brain so frequently wake up; sleep apnea (most common form)- 10% of elderly population and less common in younger age groups; usually those who are overweight and heavy snorers stop breathing for up to 30 seconds- hundreds of episodes may occur in one night |
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| sleep disorders throughout the lifespan |
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Definition
...
-breathing-related and insomnia both found in younger populations (just not as common) |
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| - heightened need for sleep and excessive sleepiness; |
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Definition
| - repeated sudden bouts of REM sleep during waking hours (afflicts 135,000 in US)- often triggered by strong emotions |
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| circadian rhythm sleep disorder |
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Definition
| - excessive sleepiness or insomnia as result of mismatch between own sleep-wake patterns and sleep-wake schedules of others- often falling asleep and waking up late- result from night-shift work, repeated episodes of jet lag |
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Definition
| - most common of parasomnias; nightmares become frequent and cause great distress leading individual to seek treatment |
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| - awaken suddenly during first third of night screaming in extreme fear and agitation- state of panic, often incoherent, high heart rate; most often in children and disappear by adolescence |
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- usually children; leave beds and walk around without being conscious of episode and not remembering later; occur in first third of night; those who are awakened are confused, if allowed to keep sleepwalking eventually return to bed; usually manage to avoid obstacles, climb stairs, perform complex activities all in a seemingly emotionless state (accidents to happen though)
-5% children and 40% of those have occasional sleepwalking episodes- usually disappears by 15 |
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