P lifetime p lifetime dsm 5 reliability of

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Prevalence: 17-19% lifetime. Prevalence: 17-19% lifetime. DSM-5: Reliability of differentiating between dyspareunia DSM-5: Reliability of differentiating between dyspareunia and vaginismus was difficult and unreliable; merged the two and vaginismus was difficult and unreliable; merged the two under genital-pelvic pain/penetration disorder. under genital-pelvic pain/penetration disorder. Orgasmic Disorders Orgasmic Disorders
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Etiology and Treatment of Sexual Etiology and Treatment of Sexual Dysfunctions Dysfunctions Biological factors and treatment Sex hormones – testosterone therapy for men and women now used. Insufficient blood flow in genitals – Vaginal (Kegel) exercises and masturbation to increase flow for women. Vascular surgery to increase blood flow, injections of vasodialating drugs into penis; and Viagra which increases vascular response by blocking the enzyme that breaks down the substance that expands arteries and relaxes the smooth muscle.
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Psychological factors and behavioral therapy Predisposing factors: Negative parental attitudes, strict religious upbringing, and trauma associated with molestation, rape, and incest. Current factors can include relationship stress, performance anxiety, self-focus, lack of accurate information about sexuality and sexual behavior/techniques, and guilt. Treatment usually includes education, anxiety reduction, structured behavioral exercises (i.e., graded progressive steps – non-genital fondling, genital fondling, intercourse, and lastly, orgasm) and communication training. Specific techniques for specific disorders: Masturbation for female orgasmic dysfunction, start-stop and squeeze techniques for early (premature) ejaculation, relaxation and successively larger dilators for vaginismus. Evaluation of behavior therapy: Questions about high success rate; relapse a concern – 75% had relapses.
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Formerly gender identity disorder -- controversy over whether these are true disorders and should be treated. DSM-5 emphasizes gender incongruence rather than cross- gender identification Type and severity is inferred from the number and type of indicators and from severity (distress) measures Considered to be a multi-category concept rather than a dichotomy (i.e., cross-gender identification, aversion toward one’s gender) Gender Dysphoria Gender Dysphoria
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Biological factors are major determinants Animal studies support role of sex hormones – excess or deficiency in hormones such as testosterone. Differences in areas (size of brain clusters in regions) of the hypothalamus Psychodynamic perspective: Unresolved Oedipal complex, unsuccessful separation and individuation results from inability to resolve conflict. Behavioral perspective: Parental encouragement of feminine behavior, lack of autonomy, overprotective/attentive mother, and lack of male model or playmates, peer ostracism .
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