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SUSS PSY 203 ABNORMAL PSYCHOLOGY STUDY UNIT 2 (Part 2 of 2) (SCHIZOPHRENIA…
SUSS PSY 203 ABNORMAL PSYCHOLOGY STUDY UNIT 2 (Part 2 of 2)
SEXUAL DYSFUNCTIONS, PARAPHILIC DISORDERS, AND GENDER DYSPHORIA
Normal Sexuality
Normal Gender differences.
Normal Cultural differences.
Gender differences
Expectations
Females tend to desire more demonstrations of love and intimacy during
sex compared to males who focus more on the arousal aspects of sex.
Arousal
Males tend to become sexually aroused by a narrower range of stimuli than females; specifically, females show arousal to both male and female imagery.
Attitude
Males also show a more permissive attitude regarding premarital sex than females
Sexual self-schema
females tend to report the experience of passionate and romantic feelings as an integral part of their sexuality
however, a substantial number of females hold an embarrassed, conservative, or self-conscious schema that can conflict with more positive aspects of sexual attitudes. Males do not report such negative core beliefs.
Masturbatory behaviour
A greater percentage of males than females engage in masturbatory behaviour. Among those who do masturbate, the frequency is three times greater for males than females.
Masturbation is the largest gender difference in sexuality and is unrelated to later sexual functioning.
Cultural differences
Premarital sex is accepted in some societies but not others.
Subcultural differences are also apparent in Western countries.
Thus, what is normal sexual behaviour in one culture is not necessarily normal in another, even among cultures in the same country, and the range of sexual expression must be considered in diagnosing the presence of a disorder
Paraphilia
Paraphilias refer to
unusual sexual attractions
to inappropriate people, such as children, or to objects. As with sexual dysfunctions, it is unusual for an individual to have just one paraphilic pattern of sexual arousal, and it is not uncommon for individuals with paraphilia to suffer from comorbid mood, anxiety, or substance abuse disorders.
Types
Exhibitionism
Exhibitionism refers to sexual arousal and gratification by
exposing one’s genitals to unsuspecting strangers
. The thrilling element of risk is an important part of exhibitionism.
Transvestic fetishism
In transvestic fetishism, sexual
arousal is strongly associated with
the act
of dressing in clothes of the opposite sex, or
cross-dressing
.
Voyeurism
Voyeurism is the practice of
observing an unsuspecting
individual
undressing or naked in order to become aroused
Sexual sadism
and
masochism
are associated with either inflicting pain or humiliation (i.e., sadism) or suffering pain and humiliation (i.e., masochism).
Frotteurism
Frotteurism involves an
attraction to rubbing up against non-consenting
partners in order to achieve gratification, such as on a crowded bus.
Pedophilia/incest
Persons with pedophilia are sexually attracted to children or very young adolescents, whereas attraction to family members who are children is called incest. In both cases, the pattern of arousal may include male and/or female children. Victims of pedophilia tend to be young children, and victims of incest tend to be young girls who are beginning to mature physically.
Fetishism
In fetishism, a person is sexually
attracted to nonliving/inanimate
objects. Fetishistic arousal is associated with:
an inanimate object
a source of specific tactile stimulation (i.e. rubber)
partialism or arousal related to a part of the body (i.e. feet)
Treatments
Psycho-social treatments
This mode of treatment for decreasing unwanted sexual arousal are behavioural, and
focus on changing associations
and contexts from arousing to neutral with regard to unusual or inappropriate sexual objects
Drug treatments
The most popular drug used to treat individuals with paraphilic disorders is an antiandrogen called cyproterone acetate. This “chemical castration”
drug eliminates sexual desire and fantasy by reducing testosterone levels dramatically
, but fantasies and arousal return as soon as the drug is removed.
A second drug is a medroxyprogesterone, a hormonal agent that reduces testosterone. - These drugs may be useful for dangerous sexual offenders who do not respond to alternative treatments or to temporarily suppress sexual arousal in patients who require it, but it is
not always successful.
Psychophysiological procedures
The assessment of paraphilia often involves psychophysiological procedures to
determine patterns
of normal and deviant sexual arousal.
Important variables to evaluate include:
presence of deviant arousal
level of the desired arousal to adults
social skills
ability to form relationships.
Paraphilia in Women.
Paraphilia is rarely seen in women and was thought to be totally absent in women, except for sadomasochistic tendencies.
However, in recent years, several cases of paedophilia, exhibitionism, and sadomasochism have been reported in women.
Current estimates are that 5% to 10% of all sexual offenders are women.
Cause
Causes of paraphilia are complex and include the following dimensions:
Deviant patterns of sexual arousal often occur in the context of other
sexual and social problems
.
For example, undesired sexual arousal may be associated with deficiencies in levels of desired arousal with adults.
People with paraphilias may
lack the social skills
needed for meeting and dating persons of the opposite sex,
Persons with paraphilias display
strong sexual drives
that may produce obsessive-compulsive-like behaviour.
Acts of
suppressing
such thoughts and urges may paradoxically
result in their greater frequency and urgency
, leading the person to act on them in a vicious cycle.
Early sexual experiences
and fantasies seem to play a large etiological role.
For example, association of arousal and fantasies over unusual or inappropriate objects may be reinforced via an association with sexual pleasure via masturbation.
Gender Dysphoria
Overview
Gender dysphoria is dissatisfaction with one’s biological sex and t
he sense that one is really the opposite gender
. It must be distinguished from transvestic fetishism. In the case of gender dysphoria, the primary goal is not sexual gratification but rather the desire to live in a manner consistent with that of the other gender.
Gender dysphoria can also occur among individuals with Disorders of Sex Development (DSD), formerly known as inter-sexuality or hermaphroditism who are born with ambiguous genitalia associated with documented hormonal or other physical abnormalities.
Finally, gender dysphoria must be distinguished from the same-sex arousal patterns. Such an individual does not feel like a woman trapped in a man’s body or have any desire to be a woman, or vice versa.
Sex reassignment
To qualify for surgery at a reputable clinic, individuals must live in the desired gender for 1 to 2 years so that they can be sure they want to change sex. They also must be stable psychologically, financially, and socially.
In transwomen, hormones are administered to promote gynecomastia (the growth of breasts) and the development of other secondary sex characteristics. Facial hair is typically removed through electrolysis. If the individual is satisfied with the events of the trial period, the genitals are removed and a vagina is constructed.
For transmen, an artificial penis is typically constructed through plastic surgery, using sections of skin and muscle from elsewhere in the body, such as the thigh. Breasts are surgically removed. Genital surgery is more difficult and complex in natal females.
SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS
Statistics
Etiology
Various Sub-types
Treatments
Clinical Description
Overview
Schizophrenia is characterised by a broad spectrum of cognitive and emotional
dysfunctions
that include
hallucinations and delusions, disorganised speech
and behaviour, and inappropriate emotions.
Symptoms
Negative Symptoms
Negative symptoms of schizophrenia indicate the
absence or insufficiency of normal behaviour
and include emotional or social withdrawal, apathy, and poverty of thought or speech.
Anhedonia
refers to a
lack of pleasure or indifference
to activities that would normally be considered pleasurable including eating, social interactions, and sexual relations. Link how before schizophrenia, he likes it but now he dont
Affective flattening, or flat affect
, occurs in about two-thirds of persons with schizophrenia and refers to an
absence of normally expected emotional responses.
Alogia
refers to the relative
absence/lack of speech
Sometimes alogia takes the form of delayed comments or slow responses to questions.
Talking with individuals who manifest this symptom can be extremely frustrating,
One word answers for example
Avolition or apathy
refers to the
inability to initiate and persist in activities
.
People with this symptom show little interest in performing even the most basic day-to-day functions
Disorganised Symptoms
Disorganised symptoms of schizophrenia include rambling speech, erratic behaviour, and inappropriate affect.
Disorganised speech
refers to several often frustrating forms of
communication problems in persons with schizophrenia.
Persons with schizophrenia often show
inappropriate affect
and
disorganised behaviour.
Such problems include catatonia, which involves motor dysfunctions that range from wild agitation to immobility.
Tangentiality
a person totally does not answer the question.
Loose association/derailmet
Is that ideas in a statment are loosely link.
Positive Symptom
Positive symptoms of schizophrenia refer to
active manifestations of abnormal behaviour
or an excess or distortion of normal behaviour.
Examples include:
Delusion
Hallucination
Delusion
A delusion refers to a belief that would be seen by most members of society as a misrepresentation of reality; often referred to as a
disorder of thought content.
Delusions of grandeur
or the belief that one is particularly famous or important
Delusions of persecution
refer to a belief that other people are out to get or harm the person.
Types
Bizarre
Non Bizarre
Treating delusions
Do not engage in the delusions (E,g. pretend taht you can hear the voice that is talking to the clinet)
Do not dismiss it (e.g. you're just hearing things)
Do Explore the feelings of client has in response to the delusions (e.g. fear anger, etc)
Delusion of erotomania
Hallucination
Hallucinations refer to the
experience of sensory events without any input from the surrounding
environment.
Hallucinations can involve any of the senses, though auditory hallucinations (i.e., hearing things that are not there) are most common in persons with schizophrenia.
NEURODEVELOPMENTAL DISORDERS
NEUROCOGNITIVE DISORDERS