Human Sexuality and Paraphilias FCs Flashcards

Terms Definitions
What is sexual identity defined as?
Consistent, enduring sense of one's own sexuality and of repeated sexual feelings, thoughts and/or behaviors.
What is gender identity?
Subjective feeling of either being male or female.
What is the sexual response cycle?
What are 3 common psychological causes of sexual disorders?
Interpersonal problems with sexual partner

Guilt about sexual activity

Fears (pregnancy, rejection, oss of control)
What are sexual disorders NOT caused by?
Substance abuse or a general medical condition.
What are three categories of sexual disorders?
1) Sexual dysfunctions - involve either disturbance of sexual arousal or disturbance of psychophysiological performance.

2)Paraphilias - involve culturally inappropriate or dangerous patterns of sexual arousal.

3)Gender identity disorders - involve dissatisfaction with one's biological gender and a desire to become a member of the opposite gender.
4 major categories of sexual dysfunction?
1) Sexual desire disorders
2) Sexual arousal disorders
3) Orgasmic disorders
4) Sexual pain disorders
2 disorders of sexual desire?
1) Hypoactive sexual desire disorder (20% of population, women>men)
2) Sexual aversion disorder
What must be taken into account before hypoactive sexual desire disorder is diagnosed?
Context of a person's life
What is sexual aversion disorder?
Avoidance of genital contact with sexual partner - possibly former victim of sexual abuse.
What are the sexual arousal disorders?
1) Male erectile disorder (Primary or secondary(10-20%))

2) Female sexual arousal disorder (33% of women)- inability to maintain lubrication until completion of sex act.
Difference btwn primary and secondary impotence?
Primary - man has never been able to acheive erection sufficient for vaginal insertion.

Secondary - Successfully acheived erection in past but cannot now.
What are the orgasmic disorders?
1) Female orgasmic disorder (30% of women)- delay/absence of orgasm but normal excitement stage.

2) Male orgasmic disorder

3) Premature ejaculation (35% of all male sexual disorders)
What are the sexual pain disorders?
1) Dyspareunia - women>men; often associated with vaginismus; should not be dx'ed when better accounted for by Axis I disorder.

2) Vaginismus (increased incidence with higher socioeconomic class and strict religious upbringing)- spasms/contracture of vaginal muscles.
What are post coital headaches?
Headache occuring immediately after intercourse.
What is orgasmic anhedonia?
No physical sensation of orgasm even though ejaculation may have occured.
What is 75% of male impotence caused by?
Physical disorder:
Cardiovascular dz
Renal disorders
Liver disease
Traumatic spinal cord injury
Abuse of alcohol/drugs
Psychotropic meds
Prostate surgery
Pelvic irradiation
Important when determining if psychological cause is responsible for impotence?
If spontaneous erections occur when man does not plan to have intercourse.
What must male orgasmic disorder be differentiated from?
Retrograde ejaculation
Important factor in ejaculatory delay or failure?
Age - older men may not ejaculate at every sexual encounter.
Important methods for treating sexual disorders?
1) Dual sex therapy (focuses on unit, short term)
2) Behavior therapy
3) Hypnosis
4) Group therapy
5) Testosterone
6) Masturbation
7) Squeeze technique
8) Gradual desensitization (dyspareunia)
9)Vaginal dilation
10) SSRI - Prem. Ejac
3 drugs approved for erectile dysfunction?
Sildenafil - works quickly
Vardenafil - last up to 1day
Tadalafil - lasts up to 3days

enhance effect of nitric oxide --> relaxes smooth muscle in penis -> increased blood flow
SEs of erectile dysfunction drugs?
Upset stomach
Muscle aches
What is Alprostadil?
Impotence drug placed directly into penis to increase penile blood flow. Inconvinient.
Surgical tx's for erectile dysfunction?
Penile prosthesis
Vacuum pump device
What are paraphilias?
A disturance in the object or expression of sexual gratification.

Last >6months and interfere with daily functioning.

Men>women;some only in men
What is exhibitionism?
Exposing self to others.
What is fetishism?
Using inanimate objects(shoe).
What is frotteurism?
rubbing against non-consenting persons.
What is pedophilia?
Preferring prepubertal children.
What is sexual masochism?
Enjoying pain and humiliation.
What is sexual sadism?
Inflicting pain on others.
What is Transvestic fetishism?
What is voyeurism?
Window peeping
Paraphilia NOS: What is coprophilia?
Paraphilia NOS: What is hypoxyphilia?
Desire to acheive altered state of consciousness secondary to hypoxia.
Paraphilia NOS: What is Infantilism?
Acting as though one is an infant.
Paraphilia NOS: What is klismania?
Paraphilia NOS: What is Necrophilia?
Dead persons.
Paraphilia NOS: What is oralism?
Focusing on oral-genita contact to exclusion of intercourse.
Paraphilia NOS: What is partialism?
Focusing on one part of the body to exclusion of all else.
Paraphilia NOS: What is telephone scatologia?
obscene telephone calls.
Paraphilia NOS: What is Urophilia?
Paraphilia NOS: What is zoophilia?
animal contacts.
Poor prognostic factors for paraphilias?
Early age of onset
Co-morbid substance abuse
Frequent paraphilic behavior
Referral by law enforcement agency.
Good prognostic factors for paraphilias?
Self- referral for treatment.
Associated guilt
Hx of normal sexual behavior
3 aspects of sexual deviation?
1) behavior doesn't conform to generally accepted views of what constitutes normal sexual activity.

2) Behavior may cause harm to antoher person involved

3) Behavior may result in subjective distress.
Most common paraphilia?
Parphilias most common in?
Treatments for paraphilias?
1) Insight oriented psychotherapy
2) Behavior therapy
3) Antiandrogens (Depoprovera, Leuprolide)
Gender identity disorder occurs more often in?
Associated with increased incidence of depression, anxiety, suicide.
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