Psych disorders exam 3

Class poll on sex-related disorders

• How do we define normal?

• Main point → have to ask many other clarifying questions, and identity what we define as normal

Main difference between men and women (sex related disorders)

• Frequency of masturbation 

Other U.S. gender differences

• Males are more permissive regarding premarital sex, but gap shrinking 

• Frequency of sex, number of partners, slightly greater in males

• Females are more likely to report passion and romance important for sexuality 

• Females are more likely to have self-conscious and negative schema about sex

Sex spectrum

• Homosexual used to be in DSM

• Not a binary thing

• Have to also think about gender identities 

• At what point is there a disorder

Sex

• Biological characteristics to delineate male and female

• Genitalia

• Sex chromosomes

• Internal organs

• Also on a spectrum → ex: intersex: born with characteristics that are not male nor female

Gender

• Constructs, not as biological

• Gender identity: make sense of own gender

• Gender expression: how you convey to the world (cultural restraints)

• Sexual orientation: what gender you are attracted to

Gender dysphoria

• Controversial: and should it be a “disorder”? A DSM-5 change from gender identity disorder 

• Biological sex does not match gender identity and distress is the focus 

• Independent of sexual orientation 

• In what duration and severity should these lead to labels and transitions? No easy answers

• Higher risk for mood disorders and suicide 

Stages of sexual response

• Desire

• Arousal

• Plateau

• Orgasm

• Revolution

• Sometimes shortened to desire, arousal, orgasm

Sexual dysfunction

• Something is going wrong in one of the phases of the sexual response

Treatment of sexual dysfunction 

• Education

• Increased communication

• Sensate focus (non demand pleasuring)

  • Dysfunction involves performance anxiety

  • Performance plummets

  • Pleasure/be pleasured without demand of needing an orgasm

• CBT for performance anxiety

  • Ex: negative schemas about sex, shame, insecurities

• Self-pleasuring → exploring own body

• Possible medication

  • Erectile dysfunction drugs (psych disorder related)

  • Prescribed a lot so we have to ask if we have to change norms, does this change performance anxiety

Paraphilic Disorders 

• Definition: arousal to something deemed inappropriate, causing distress

• Fetishistic disorder

  • Attraction to (typically object) that is problematic

• Voyeuristic and exhibitionistic disorder 

  • V → someone looking at someone against their will

  • E → actual exposure of yourself to someone against their will

• Transvestic disorder 

  • Sexual gratification from clothing

• Sexual sadism and masochism disorder

  • S → infliction of pain

  • M → receiving the pain

• Frotteuristic disorder

  • Sexual gratification from rubbing up against someone who is unsuspecting and not consensual

• Sadistic rape

  • Violence and infliction of harm is whole point of sexual gratification

• Pedophilic disorder and incest

  • P → attraction to prepubescent children (attraction itself, do not always act on it)

  • I → attraction to someone to whom you are in a familial relationship with

Causes of paraphilic disorders

• Genetics? still unclear 

• Difficulty forming “normal” relationships 

  • Deficits in typical sexual experiences

  • Relationship difficulties in childhood or adolescence

• Early experiences may lead to sexual associations by chance > then reinforced through masturbation

• Often have very high sex drive

  • Suppressing unwanted fantasies may paradoxically increase them

Treatment of paraphilic disorders

• Covert sensitization 

  • Creating aversive stimuli

    • Negative effects of object and fantasy

    • Ex: mild electric schools - very controversial

• Orgasmic reconditioning

  • Insert a more positive and sexual stimulus

    • Last second → switch to a more positive stimulus

    • Will be gradually conditioned

• Coping and relapse prevention (most important) as there is a high rate of relapse

• Keep in mind → high comorbidity with mood, anxiety, and substance related disorders

Modern technology role in sex related disorders

• Ex: chat-roulette → placed randomly with a stranger on video chat 

  • A lot of exhibitionist

• Larger problems now than what it used to be due to access of technology