Psychopathology Ch 12: Sexual Disorders

sexual dysfunctions

problems with sexual responses in some area (desire, excitement, orgasm, and unlikely but resolution)

paraphilic disorders

repeated and intense sexual urges or fantasies in response to objects or situations that society deems inappropriate; may behave inappropriately

sexual response cycle

desire, excitement, orgasm, resolution

Male hypoactive sexual desire disorder:

a male dysfunction marked by a persistent reduction or lack of interest in sex and hence a low level of sexual activity.

desire phase

urge to have sex, sexual fantasies, and sexual attraction to others

female sexual interest/arousal disorder:

A female dysfunction marked by a persistent reduction or lack of interest in sex and low sexual activity, as well as, in some cases, limited excitement and few sexual sensations during sexual activity.

biological causes of low sexual desire

• Irregular hormonal levels

  • Prolactin: High level

  • Testosterone: Low level

• Birth control, psychotropic medications, alcohol (SSRI), and illegal drugs

• Long-term physical illness

psychological causes of low desire

• Anxiety, depression, anger

• Attitudes, fears, or memories

• Depression, OCD

sociocultural causes of low desire

• Situational pressures

• Unhappy or problematic relationship

• Cultural standards; double standard

• Sexual molestation or assault trauma

excitement phase

marked by changes in the pelvic region, general physical arousal, and increases in heart rate, muscle tension, blood pressure, and rate of breathing. 

• in men: erection

• in women: swelling of clitoris and labia and vaginal lubrication

erectile disorder

16% of male population worldwide; individual finds it very hard to obtain or maintain an erection

biological causes of erectile disorder

Hormonal imbalance, vascular problems, nervous system damage from disease, medication, substance abuse.

psychological causes of erectile disorder

Severe depression, performance anxiety, spectator role.

sociocultural causes

Financial strain, job loss, relationship stress.

orgasm phase

the sexual response cycle occurs when the person’s sexual pleasure peaks.

premature ejaculation

individual usually ejaculates within 1 minute of sex, earlier than he wants to. this disorder is impacted by youth, inexperience, infrequent sex, and can be learned by rushes masturbation

female orgasmic disorder

individual usually displays a significant delay, infrequency, or absence of orgasm, and is unable to achieve past orgasmic intensity. Prevalence: Ten to fifteen percent report never having had orgasm; 9 percent rarely have orgasm

delayed ejaculation

individual usually displays a significant delay, infrequency, or absence of ejaculation during sex. May affect men of any age; 1 to 10 percent worldwide. Impacted by low testosterone level, certain neurological diseases, and head or spinal cord injuries.

biological causes of sexual dysfunctions in women

• Neurological diseases

• Drugs and medications (SSRIs)

• Menopausal changes

psychological causes of sexual dysfunctions in women

• depression

• childhood trauma and relationships

sociocultural causes of sexual dysfunctions in women

society’s sexual restrictive role of women

genito-pelvic pain/penetration disorders

individual experiences: difficulty having vaginal penetration, significant pain or fear when trying to, or significant tensing of pelvic muscles during sex. it is a conditioned response to pain/fear.

general features of sex therapy

• Assessment of the problem

• Addressing physical and medical factors

• Addressing relationship problems

• Mutual responsibility

• Education about sexuality

• Elimination of performance anxiety and the spectator role

• Increasing communication

biological interventions

• Hormone treatments

• Erectile dysfunction meds like Viagra

psychological techniques

• Stop/start technique

• Sensate focus

• Directed masturbation

• Behavioral exposure (pain)

paraphilic disorders

Characterized by intense sexual urges, fantasies, or behaviors involving objects or situations outside the usual sexual norms. Much more common in men than women. little evidence to support explainations, and no treatments proven effective.

fetishistic disorder

Recurrent intense sexual urges or fantasies involving use of a nonliving object or nongenital body part, often to the exclusion of all other stimuli, accompanied by clinically significant distress or impairment.

transvestic disorder

• Fantasies, urges, or behaviors involving dressing in clothes not usually associated with their gender to achieve sexual arousal

• Typically heterosexual male who began cross-dressing in childhood or adolescence

• Does not involve transgender feelings or behaviors

exhibitionistic disorder

• Characterized by arousal from the exposure of genitals in a public setting

• Typically, person seeks to surprise, shock, or sexually arouse the victim

voyeuristic disorder

Characterized by repeated and intense sexual urges to observe people as they undress or to spy on couples having intercourse

• Risk of discovery often adds to the excitement

• Usually masturbates while watching or while fantasizing about watching

Frotteuristic disorder

Characterized by recurrent and intense fantasies, urges, or behaviors involving touching and rubbing against a nonconsenting person

• Almost always men, the person fantasizes during the act that they have a caring relationship with the targeted individual.

Pedophilic disorder

Characterized by repeated and intense sexual urges or fantasies about watching, touching, or engaging in sexual acts with children, and either acts on these urges or experiences clinically significant distress or impairment. This disorder emerges during adolescence.

treatment for pedophilic disorder

Cognitive-behavioral treatment involves relapse-prevention training, modeled after programs used for substance dependence

Sexual masochism disorder

Characterized by fantasies, urges, or behaviors involving the act or the thought of being humiliated, beaten, bound, or otherwise made to suffer, accompanied by clinically significant distress or impairment

Sexual sadism disorder

Characterized by repeated, intense sexual arousal from fantasies, urges, or behaviors involving thought or act of psychological or physical suffering of an individual

Cognitive-behavioral theory of sexual sadism disorder

Classical conditioning and modeling (via Internet sex sites, sexual videos, magazines, and books)