|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?||
Traumatic spinal cord injury
Abuse of alcohol/drugs
|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?||
|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
4) Group therapy
7) Squeeze technique
8) Gradual desensitization (dyspareunia)
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?||
|What is Alprostadil?||
Impotence drug placed directly into penis to increase penile blood flow. Inconvinient.
|Surgical tx's for erectile dysfunction?||
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?||
|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?||
|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?||
|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.
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.