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SEXUAL DYSFUNCTIONS - Coggle Diagram
SEXUAL DYSFUNCTIONS
paraphillic disorders
voyeuristic disorder
recurrent, intense, sexually arousing fantasies, urges, or behaviors involving the observation of
unsuspecting
people who are undressing or couples engaging in sexual activity
often co-occurs w/ exhibitionism (mastrubating)
most common paraphilic disorder
feeling shy and inadequate in relations with the opposite sex, avoiding rejection, compensatory feelings of power and secret domination
comorbidity: psych problems, less satisfaction w/ life, higher rates of masturbation, greater use of pornography, greater ease of sexual arousability
exhibitionistic disorder
recurrent, intense, urges to expose genitals to others (usually strangers) in inappropriate circumstances without their consent
element of shock is arousing
comorbidity: same thing as voyeurism
criminal offense; 'indecent exposure'
frotteuristic disorder
sexual excitement at rubbing one's genitals against, or touching, the body of a nonconsenting person
diagnosed if frotteuristic acts occur, whether or not the frotteurer themself is bothered by their urges
sexual masochism disorder
experience of sexual stimulation and gratification from the experience of pain and degradation in relation to a lover (recurrent, intense urges to be humiliated, beaten, bound, or otherwise made to suffer)
*autoerotic asphyxia = self-strangulation (accidental deaths, much more common in men
sexual sadism disorder
recurrent, intense sexually arousing urges that involve inflicting psychological or physical pain on another individual (dominance, control, humiliation)
majority occurs in consensual relationships without any evident harm
diagnosed when these sadistic acts are nonconsensual, serious, and sometimes fatal or when the sadistic experience is marked by distress or interpersonal difficulties
comorbidity: naricissism, shizoid, or antisocial disorders (especially nonemphatic, so likely to act on these urges)
fetishistic disorder
recurrent, intense urges to use some inanimate object or part of the body not typically found erotic to obtain sexual gratification
some individuals are extremely ashamed and can't ask their parters, so they become extremely distressed
classical conditioning, social learning (women's underwear, fishnets), involves individual differences in conditionability
transvestic disorder
heterosexual men who experience recurrent, intense urges that involve cross-dressing as a female
diagnosis only when they experience significant distress or impairment (so, not drag)
*autogynephilia = paraphilic sexual arousal by the thought or fantasy of being a woman
strongly predicts gender dysphoria
comorbidity: same as voyeurism and such; but not dangerous, most are harmless
!if they cause harm/suffering to the individual or to others, it is a disorder, if not, then it is a
paraphilia
almost all males: male vulnerability linked to their greater dependence on visual sexual imagery (classical conditioning / social learning); but involving individual differences
treatments: CBT (impulse-control, problem-solving), SSRIs, antiandrogen therapy (decreasing testosterone)
gender dysphoria
persistent distress resulting from a perceived mismatch between one's assigned gender at birth and their gender identity
gender dysphoria in children
at least 6 months
cross-dressing, cross-gender roles, and rejection of the other, dislike of sexual anatomy...
gender dysphoria in adolescents and adults
a desire to get rid of one's sexual characteristics, desire to be the other gender, and to be treated as that...
at least 6 months
74-84% of children do not experience dysphoria later in life (should there be a children disorder then? 'tight' society, or clinically significant distress in children?)
stigmatization is not universal -- ex: Samoa
comorbidity: mood, anxiety disorders, suicidal thoughts, NSSI
treatments: in adulthood take medical steps to transform their bodies (crucial period ages 10-13)
male dysfunctions
male hypoactive sexual desire disorder
low levels of sexual thoughts, desires, or fantasies for at least 6 months
men in the oldest cohort are more likely to suffer than those in the youngest cohort
predictors: daily alcohol use, stress, unmarried status, poor health, depression, relationship stress...
situational or acquired, rather than lifelong
treatments: testosterone injections (for those w/ low testosterone), psychological
erectile disorder
inability to obtain / maintain an erection sufficient for intercourse
originates from psychological (/+medical) factors
function of anxiety about performance, but cognitive distractions of it are more important (negative thoughts, internal, stable, and causal attributions for negative sexual events)
symptom of SSRIs, aging, vascular disease, diabetes, smoking, obesity, alcohol abuse, multiple sclerosis, priapism...
lifelong (never; rare) & situational/acquired (at least one successful)
more common in the older cohort
treatments: Viagra, Levitra, Cialis, injections of muscle-relaxing drugs, penile implants (in extreme cases)
premature ejaculation
persistent and recurrent onset of orgasm and ejaculation w/ minimal sexual stimulation (15 seconds / 15 thrusts)
decreased sexual and relationship satisfaction, embarassment, avoidance, self-distracting
treatments: behavioral (pause-and-squeeze), antidepressants (work as long as they are taken)
delayed ejaculation disorder
persistent inability to ejaculate during intercourse (rare); can achieve orgasm by other means of stimulation (manual/oral)
can be related to multiple sclerosis or medications (SSRIs especially -- even to an unpleasant extent)
treatments: Viagra, couples therapy (emphasis on reduction of performance anxiety
female dysfunctions
female sexual interest/arousal disorder
low desire + low arousal
depression, anxiety, testosterone level, antidepressants, oral contraceptives//low relationship satisfaction, daily hassles, disagreements, conflicts, low levels of feelings, history of unwanted sexual experiences
treatments: testosterone (only when levels are low), bupropion, flibanserin (Addyi), Viagra and such are not so successful for women, psychological (education, communication, cognitive restructuring, sensate focus training...)
genito-pelvic pain/penetration disorder
persistent physical pain during sexual intercourse associated w/ psychological distress for at least 6 months
combined vaginismus and dyspareunia (genital pain and muscle tension + fear and anxiety related to the pain or sexual activity)
organic more than psych factors: chronic infections or inflammations, vaginal atrophy, scars from vaginal tearing, or insufficency of sexual arousal
treatments: CBT (education, correcting maladaptive cognitions, graduated vaginal dilation, muscle relaxation), surgical removal of vulvar vestibule
female orgasmic disorder
sexually excitable, otherwise enjoy sexual activity, but show recurrent delay or absence of orgasm following a normal sexual arousal phase, and are distressed by this
lifelong orgasmic disorder = lifelong erectile disorder
uncertainty whether her partner finds her sexually attractive -- leads to anxiety and tension -- interferes w/ sexual enjoyment / sexual guilt / antidepressants / genital anatotmy
treatment: CBT (effective even for lifelong, situational may be harder to treat because it is often associated w/ relationship problems that may be also hard to treat)