Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria

Flashcards covering sexual dysfunctions, paraphilic disorders, and gender dysphoria based on lecture notes.

What is sexual dysfunction defined as in the transcript?

Finding difficulty to function adequately while having sex, such as failing to become aroused or achieve orgasm.

What is paraphilic disorder (sexual deviation) defined as in the transcript?

Finding sexual arousal in the context of inappropriate objects or individuals.

What is Gender Dysphoria defined as in the transcript?

A marked incongruence between one’s assigned sex and the gender one experiences or identifies with.

According to research cited in the text (Oliver & Hyde, 1993; Peplau, 2003; Petersen & Hyde, 2010), what gender difference is commonly found in masturbatory behavior?

A much higher percentage of men than women report that they masturbate or self-stimulate to orgasm.

What traditional view accounts for gender differences in masturbatory behavior?

Women have been taught to associate sex with romance and emotional intimacy, whereas men are more interested in physical gratification.

In the study by Oswalt & Wyatt (2013), which group of men had the fewest sexual partners?

Heterosexual men had fewer partners than gay men, bisexual men, and men who described themselves as unsure.

In the study by Oswalt & Wyatt (2013), which group of women had more partners than women with other sexual orientations?

Women who identified as bisexual.

According to cross-cultural surveys worldwide (Bancroft, 1989; Broude & Greene, 1980), in what proportion of societies is premarital sex accepted?

In about half of more than 100 societies surveyed worldwide.

What was conversion therapy designed to do?

An attempt to convert a person’s sexual orientation from same-sex sexual to heterosexual.

In twin studies by Bailey and colleagues (1991), what percentage of identical twins raised in the same house did not share the same sexual orientation?

Approximately 50%.

According to Balthazart (2020), what early biological mechanisms mediate sexual orientation?

Early actions of sex steroids, direct actions of sex-specific genes, and epigenetic mechanisms.

What are the five stages of the human sexual response cycle based on Kaplan (1979)?

Desire, Arousal, Plateau, Orgasm, and Resolution.

What occurs during the Desire stage of Kaplan's human sexual response cycle?

Sexual urges occur.

What occurs during the Arousal stage of Kaplan's human sexual response cycle?

Physiological signs of arousal occur.

How is the Plateau stage defined in Kaplan's human sexual response cycle?

Brief period before orgasm.

What occurs during the Orgasm stage of Kaplan's human sexual response cycle?

Ejaculation in males while contractions in females.

What occurs during the Resolution stage of Kaplan's human sexual response cycle?

Decrease in arousal, especially in men.

Which three stages of Kaplan's sexual response cycle are associated with specific sexual dysfunctions?

Desire, arousal, and orgasm.

How does Male Hypoactive Sexual Desire Disorder manifest?

Exhibits an apparent lack of interest in sexual activity or fantasy.

What is Criterion A for Male Hypoactive Sexual Desire Disorder?

Persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity.

What is the minimum symptom duration required for Criterion B of Male Hypoactive Sexual Desire Disorder?

Approximately six (6) months.

What does the Lifelong specifier indicate for sexual dysfunctions?

The disturbance has been present since the individual became sexually active.

What does the Acquired specifier indicate for sexual dysfunctions?

The disturbance began after a period of relatively normal sexual function.

What does the Generalized specifier indicate for sexual dysfunctions?

Not limited to certain types of stimulation, situations, or partners.

What does the Situational specifier indicate for sexual dysfunctions?

Only occurs with certain types of stimulation, situations, or partners.

What are the three severity levels used to specify sexual dysfunctions?

Mild, Moderate, and Severe.

What is problematic in Sexual Arousal Disorders?

Achieving or maintaining adequate penile erection or sexual excitement and vaginal lubrication.

What primary difficulty characterizes Erectile Disorder?

Difficulties obtaining and maintaining an erection.

What recurring inability characterizes Female Sexual Interest/Arousal Disorder?

Recurring inability to achieve or maintain adequate lubrication.

What frequency threshold is required for symptoms under Criterion A of Erectile Disorder?

Almost all or all (approximately 75%–100%) occasions of sexual activity.

What three symptoms are listed under Criterion A for Erectile Disorder?

1. Marked difficulty in obtaining an erection during sexual activity. 2. Marked difficulty in maintaining an erection until completion. 3. Marked decrease in erectile rigidity.

How many manifestations must be met under Criterion A for Female Sexual Interest/Arousal Disorder?

At least three of the six listed symptoms.

What are three manifestations of Criterion A for Female Sexual Interest/Arousal Disorder?

Absent/reduced interest in sexual activity, absent/reduced sexual/erotic thoughts or fantasies, and no/reduced initiation of sexual activity.

How are Orgasmic Disorders broadly defined?

Characterized by orgasms occurring too quickly or not at all.

What is Delayed Ejaculation?

A condition in men who reach orgasm only with great difficulty or not at all.

What alternative term is used for Female Orgasmic Disorder in the text?

Inhibited orgasm (female).

What is Retrograde Ejaculation?

A condition in which ejaculatory fluids travel backward rather than forward, caused by certain drugs or coexisting medical conditions.

How is Premature Ejaculation defined in DSM-5 regarding time following penetration?

Ejaculation occurring within approximately 1 minute following vaginal penetration.

What are the two Criterion A symptoms for Delayed Ejaculation?

1. Marked delay in ejaculation. 2. Marked infrequency or absence of ejaculation.

What is Criterion A for Premature Ejaculation?

A persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately 1 minute following vaginal penetration and before the individual wishes it.

What minimum duration must symptoms be present to diagnose Premature Ejaculation?

At least six (6) months.

What defines Mild severity for Premature Ejaculation?

Ejaculation occurring within approximately 30 seconds to 1 minute of vaginal penetration.

What defines Moderate severity for Premature Ejaculation?

Ejaculation occurring within approximately 15–30 seconds of vaginal penetration.

What defines Severe severity for Premature Ejaculation?

Ejaculation occurring before sexual activity, at the start of sexual activity, or within approximately 15 seconds of vaginal penetration.

What are the two symptoms listed under Criterion A for Female Orgasmic Disorder?

1. Marked delay in, marked infrequency of, or absence of orgasm. 2. Markedly reduced intensity of orgasmic sensations.

What specific 'Specify if' sub-clause exists for Female Orgasmic Disorder?

Never experienced an orgasm in any situation.

What is Vulvodynia?

A chronic pain condition affecting the external genital area, often accompanied by sensations of burning or stinging.

How is Vulvodynia classified in the DSM-5?

As a genito-pelvic pain/penetration disorder.

What is Vaginismus?

Involuntary spasms of the pelvic muscles in the outer third of the vagina when intercourse is attempted.

What sensations do women report during attempted intercourse with vaginismus according to Beck (1993)?

Sensations of ripping, burning, or tearing during attempted intercourse.

What four persistent/recurrent difficulties are listed in Criterion A of Genito-Pelvic Pain/Penetration Disorder?

1. Vaginal penetration during intercourse. 2. Marked vulvovaginal or pelvic pain. 3. Marked fear or anxiety about pain. 4. Marked tensing or tightening of pelvic floor muscles.

According to Wiegel, Wincze, & Barlow (2002), what are the three major aspects of assessing sexual behavior?

Interviews, medical evaluation, and psychophysiological assessment.

How long does the clinical assessment interview typically last?

Approximately 2 hours.

What device is used to measure penile erection directly in males?

A penile strain gauge developed by Barlow, Becker, Leitenberg, & Agras (1970).

What device is used to measure vaginal sexual arousal in females?

A vaginal photoplethysmograph developed by James Geer and associates (1974).

How does the vaginal photoplethysmograph measure sexual arousal?

It measures reflected light from vaginal walls, which decreases as blood flow to the vaginal walls increases during arousal.

What biological conditions can directly cause sexual dysfunction such as erectile dysfunction?

Neurological diseases, diabetes, kidney disease, and vascular disease (arterial insufficiency and venous leakage).

What prescription medication types can interfere with sexual desire and arousal?

Antihypertensives and antidepressants.

Which substances of abuse can interfere with sexual desire and arousal?

Alcohol, cocaine, and heroin.

What is erotophobia?

Negative cognitive sets learned early in life regarding sex.

What are the primary goals of psychosocial treatment for sexual dysfunctions?

To facilitate communication, improve sexual education, and eliminate anxiety.

For what percentage of patients are medical treatments like Viagra effective and satisfying?

About one-third of patients who try them.

What new drug is mentioned as a potential treatment for hypoactive sexual desire in women?

Flibanserin.

When does the DSM-5 consider a paraphilia to be a disorder?

When it is associated with distress and impairment or harm or the threat of harm to others.

What comorbid conditions frequently co-occur with paraphilic disorders?

Mood, anxiety, and substance abuse disorders.

What is Frotteuristic Disorder?

A disorder where a person rubs their genitals against a nonconsenting person (typically in crowded spaces) to achieve sexual stimulation to the point of ejaculation.

What is Voyeuristic Disorder?

The practice of observing an unsuspecting individual undressing or naked to become sexually aroused.

What is Exhibitionistic Disorder?

Achieving sexual arousal and gratification by exposing genitals to unsuspecting strangers.

What is Fetishistic Disorder?

A disorder characterized by sexual attraction to nonliving objects or specific sources of tactile stimulation.

What two nonliving objects are noted as popular choices in Fetishistic Disorder?

Women’s undergarments and shoes.

What two classes of objects or activities are associated with fetishistic arousal?

(1) An inanimate object, or (2) a source of specific tactile stimulation, such as rubber or shiny black plastic.

What is Transvestic Disorder?

Sexual arousal strongly associated with the act of (or fantasies of) dressing in clothes of the opposite sex (cross-dressing).

What specifier is added to Transvestic Disorder if arousal focuses primarily on the clothing itself?

With fetishism.

What is Autogynephilia?

A specifier for transvestism describing sexual arousal associated with thoughts or images of oneself as a woman.

What is Sexual Sadism?

Achieving sexual arousal associated with inflicting pain or humiliation on another person.

What is Sexual Masochism?

Achieving sexual arousal associated with suffering pain or humiliation.

Why is Sadistic Rape not classified as a paraphilic disorder in most instances?

Most rapists do not have paraphilic sexual arousal patterns; instead, they often meet criteria for antisocial personality disorder.

What is Pedophilia?

Sexual attraction to children (or young adolescents generally aged 13 years or younger).

What form does pedophilia take if the victim is a relative?

Incest.

How do child molesters commonly rationalize their behavior?

As loving the child or teaching the child useful lessons about sexuality.

How did Rachman and Hodgson (1968) demonstrate that neutral objects can elicit sexual arousal?

By repeatedly presenting a neutral object (such as a boot) while the individual was sexually aroused.

What is identified as one of the most powerful engines for developing unwanted sexual arousal?

Early sexual fantasies that are repeatedly reinforced through masturbation.

What is Covert Sensitization?

A psychological treatment procedure where patients associate sexually arousing images in their imagination with harmful or dangerous consequences.

What is Orgasmic Reconditioning?

A procedure where patients masturbate to usual fantasies but substitute more desirable ones just before ejaculation.

What is Cyproterone Acetate?

An antiandrogen drug ('chemical castration') that eliminates sexual desire and fantasy by dramatically reducing testosterone levels.

What is Medroxyprogesterone (Depo-Provera)?

A hormonal agent that reduces testosterone levels used in treating paraphilic disorders.

What happens when antiandrogen drugs like cyproterone acetate are removed?

Fantasies and arousal return as soon as the drug is removed.

What defines Gender Dysphoria in the text?

A condition present if a person's assigned sex at birth is not consistent with their sense of identity or experienced gender, causing significant distress.

How is Gender Dysphoria distinguished from Transvestic Fetishism?

Transvestic fetishism's primary purpose is sexual gratification, while in gender dysphoria the goal is to live life consistent with one's experienced gender.

What are Disorders of Sex Development (DSD)?

Formerly known as intersexuality or hermaphroditism, conditions where individuals are born with ambiguous genitalia associated with physical or hormonal abnormalities.

What non-biological contributing factors during early socialization are linked to Gender Dysphoria?

Excessive attention and physical contact by the mother, and a lack of male playmates during early socialization.

What surgical/hormonal process promotes secondary sex characteristics in trans women?

Hormone administration to promote gynecomastia (breast growth) and other secondary sex characteristics, along with electrolysis for facial hair.

How is an artificial penis constructed in gender-affirming surgery for trans men?

Through plastic surgery using sections of skin and muscle from elsewhere in the body, such as the thigh.

What are the three potential management approaches for gender nonconformity in children?

1. Lessening gender dysphoria and cross-gender behaviors. 2. Watchful waiting. 3. Actively affirming and encouraging cross-gender identification.

What is the function of puberty-blocking medication in adolescents with gender dysphoria?

It allows the adolescent time to continue exploring gender identity issues without the added stress of beginning puberty in an inconsistent gender.

What standard medical interventions are performed soon after birth for individuals with Disorders of Sex Development (DSD)?

Surgery and hormonal replacement therapy to match sexual anatomy as closely as possible to assigned gender.

According to Balthazart (2020), what early hormonal factors mediate sexual orientation?

Sex steroids.

What device for measuring female arousal was developed by James Geer and associates (1974)?

Vaginal photoplethysmograph.

What duration defines Moderate severity in Premature Ejaculation?

Ejaculation occurring within approximately 15–30 seconds of vaginal penetration.

What device for measuring male erection was developed by Barlow, Becker, Leitenberg, & Agras (1970)?

Penile strain gauge.