Sexual Dysfunction
Persistent inability to function normally in some area of the sexual response cycle
Desire Phase
The phase of the sexual response cycle consisting of:
- an urge to have sex
- sexual fantasies
- sexual attraction
Male Hypoactive Sexual Desire Disorder
- male dysfunction
- a persistent reduction or lack of interest in sex & hence a low level of sexual activity
Female Sexual Interest/Arousal Disorder
- female dysfunction
- persistent reduction or lack of interest in sex & low level of sexual activity
- in some cases, limited excitement & few sexual sensations during sexual activity
Biological Causes of Low Sexual Desire
Hormones:
- high prolactin
- low testosterone
- high estrogen (BCP)/low estrogen (menopause)
Neurotransmitters:
- high seretonin
- high dopamine
Medications:
- pain meds
- psychotropic/illegal drugs
- high levels of alcohol
Psychological Causes of Low Sexual Desire
Mental Illness:
- high anxiety
- high depression
- high anger
- OCD
Fears, Attitudes, memories where sex = bad
Sociocultural Causes of Low Sexual Desire
Situational Pressure:
- divorce
- death
- job stress
- infertility issues
- having a baby
Relationship Problems:
- unhappy
- loss of attraction
- unskilled/unenthusiastic lover
Cultural:
- double standard for women
- equating sexual attractiveness w/ yout
Excitement Phase
The phase of the sexual response cycle marked by:
- changes in the pelvic region
- generally physical arousal
- increases in heart rate
- muscle tension
- blood pressure
- rate of breathing
Erectile Disorder
A dysfunction in which a man repeatedly fails to attain or maintain an erection during sexual activity
Biological Causes of Erectile Disorder
Vascular Problems:
- problems w/ the body's blood vessels
- heart disease
- clogged arteries
Nervous System Problems:
- damage to spine/nerves
- diabetes
NPT:
- nocturnal penile tumescence
- erection during sleep, normally during REM sleep
Psychological Causes of Erectile Disorder
Mental Illness:
- high anxiety
- high depression
- high anger
- OCD
Fears, Attitudes, memories where sex = bad
Performance anxiety
Spectator role
Performance Anxiety
The fear of performing inadequately & a related tension experienced during sex
Spectator Role
A state of mind that some people experience during sex, focusing on their sexual performance to such an extent that their performance & enjoyment are reduced
Sociocultural Causes of Erectile Disorder
Situational Pressure:
- divorce
- death
- job/financial stress
- infertility issues
- having a baby
Relationship Problems:
- unhappy
- loss of attraction
- unskilled/unenthusiastic lover
Cultural:
- double standard for women
- equating sexual attractivene
Treatments for Erectile Disorder
Goals:
- reducing a man's performance anxiety
- increasing his stimulation
Tease technique:
- sensate-focus exercise
- partner caresses a man until he achieves an erection, then stops until it disappears
Medication:
- sildenafil (Viagra)
- tadalafil (Cial
Orgasm Phase
The phase of the sexual response cycle during which a person's sexual pleasure peaks & sexual tension is released as muscles in the pelvic region contract rhythmically
Premature Ejactulation
- A.K.A. early/rapid ejaculation
- male dysfunction
- persistently reaches orgams & ejaculates w/in 1 minute of beginning sexual activity w/ a partner
- before he wishes to
Treatments for Premature Ejaculation
Behavioral techniques:
- Stop-start method
Medication:
- SSRIs
Delayed Ejactulation
- male dysfunction
- persistent inability to ejaculate or very delayed ejaculations during sexual activity w/ a partner
Treatments for Delayed Ejaculation
Goals:
- reduce performance anxiety
- increase stimulation
Behavioral techniques:
- masturbate just short of orgasm before inserting penis for intercourse/ejaculation
Medical treatment
- mainly for use in cases of neurological damage/injury
Female Orgasmic Disorder
- female dysfunction
- persistently fails to reach orgasm, has very low intensity orgasms, or has very delayed orgasms
Biological Causes of Female Orgasmic Disorder
Nervous System:
- diabetes damage
- MS
Medications
Postmenopausal changes
Psychological Causes of Female Orgasmic Disorder
Mental Illness:
- high anxiety
- high depression
- high anger
- OCD
Fears, Attitudes, memories where sex = bad
Memories of childhood traumas & relationships
Sociocultural Causes of Female Orgasmic Disorder
Repression/denial of sexuality:
- overly strict religious upbringing
- punished for childhood masturbation
- no preparation for menstruation
- restricted dating as teens
- "nice girls don't"
Stressful events:
- past trauma
- relationships
Treatments for Female Orgasmic Disorder
Directed masturbation training:
- sex therapy approach
- teaches women who suffer from arousal/orgasmic problems how to masturbate effectively
- eventually able to reach orgasm during sexual intercourse
Genito-Pelvic Pain/Penetration Disorder
A sexual dysfunction characterized by significant physical discomfort during intercourse
Treatments for Genito-Pelvic Pain/Penetration Disorder
Behavioral techniques:
- kegel exercises
- inserting increasingly larger dilators inside the vagina to overcome fear of penetration
- specific intercourse positions to avoid putting pressure on injured area
Modern Sex Therapy
1. Assessing & conceptualizing the problem
2. Mutual responsibility
3. Education about sexuality
4. Emotion identification
5. Attitude change
6. Elimination of performance anxiety & the spectator role
7. Increasing sexual & general communication skills
8.
Treatments for Disorders of Desire
Affectual awareness:
- patients visualize sexual scenes in order to discover any feelings of anxiety, vulnerability, & other negative emotions
Self-instruction training:
- cognitive instruction to change negative reactions to sex
Paraphilias
Patterns in which a person has recurring & intense sexual urges, fantasies, or behaviors involving:
- nonhuman objects
- children
- nonconsenting adults
- experiences of suffering
- experiences of humiliation
Paraphilic Disorder
A disorder in which a person's paraphilia:
- causes great distress
- interferes w/ social or occupational activities
- places the person or others @ risk of harm--either currently or in the past
Fetishistic Disorder
- a paraphilic disorder
- the use of a nonliving object or nongenital part, often to the exclusion of all other stimuli
- clinically significant distress/impairment
Masturbatory Satiation
- a behavioral treatment in which a client masturbates for a long period of time while fantasizing in detail about a paraphilic object
- the procedure is expected to produce a feeling of boredom that becomes linked to the object
Orgasmic Reorientation
A procedure for treating certain paraphilias by teaching clients to respond to new, more appropriate sources of sexual stimulation
Transvestic Disorder
- A.K.A transvestism/cross-dressing
- a paraphilic disorder
- involves dressing in clothes of the opposite sex
- clinically significant distress/impairment
Exhibitionistic Disorder
- a paraphilic disorder
- involves exposing their genitals to others
- act on these urges w/ nonconsenting individuals
- clinically significant distress/impairment
Voyeuristic Disorder
- a paraphilic disorder
- involves observing unsuspecting people in secret as they undress or to spy on couples having intercourse
- acts on these urges w/ nonconsenting people
- clinically significant distress/impairment
Frotteuristic Disorder
- a paraphilic disorder
- involves touching/rubbing against nonconsenting persons
- acts on these urges w/ nonconsenting persons
- clinically significant distress/impairment
Pedophilic Disorder
- a paraphilic disorder
- involves watching, touching, or engaging in sexual acts w/ children
- acts on these urges
- clinically significant distress/impairment
Sexual Masochiosm Disorder
- a paraphilic disorder
- involve being humiliated, beaten, bound, or otherwise made to suffer
- clinically significant distress/impairment
Sexual Sadism Disorder
- a paraphilic disorder
- involve inflicting suffering on others
- acts on these urges w/ nonconsenting adults
- clinically significant distress/impairment
Psychosis
A state in which a person loses contact w/ reality in key ways
Schizophrenia
- psychotic disorder
- personal, social, & occupational functioning deteriorates as a result of:
- unusual perceptions
- odd thoughts
- disturbed emotions
- motor abnormalities
- previously functioned well
Positive Symptoms of Schizophrenia
Delusions:
- a strange or false belief firmly held despite evidence to the contrary
Disorganized thinking/speech:
- formal thought disorders--a disturbance in the production & organization of thought
- loose associations (A.K.A derailment)--a common think
Negative Symptoms of Schizophrenia
Poverty of speech (A.K.A alogia):
- a decrease in speech or speech content
Blunted & flat affect:
- a marked lack of apparent emotion
Loss of volition:
- apathy
- inability to start or complete a course of action
Social withdrawal
Progression of Schizophrenia
Prodromal phase:
- symptoms are not yet obvious, but the person is beginning to deteriorate
Active phase:
- symptoms become apparent
Residual phase:
- person returns to a prodromal-like level of functioning
Diagnosing Schizophrenia
Type I:
- thought to be dominated by positive symptoms
- seem to have been better adjusted prior to the disorder
- linked more closely to biochemical abnormalities
Type II:
- thought to be dominated by negative symptoms
- structural abnormalities in the b
Downward Drift
Mental illness causes one to have a downward shift in social class
Dopamine Hypothesis
The theory that schizophrenia results from excessive activity of the neurotransmitter dopamine
Treatments for Schizophrenia
Institutional care:
- Milieu therapy--institutions can help patients recover by creating a climate that promotes self-respect, responsible behavior, & meaningful activity
Antipsychotic drugs:
- drugs that help correct grossly confused/distorted thinking
P
Personality Disorder
An enduring, rigid pattern of inner experience & outward behavior that repeatedly impairs:
- a person's sense of self
- emotional experiences
- goals
- capacity for empathy
- capacity for intimacy
Odd" Personality Disorders
Consists of paranoid, schizoid, schizotypal personality disorders
Paranoid Personality Disorder
A pattern of distrust & suspiciousness of others
Schizoid Personality Disorder
Persistent avoidance of social relationships & little expression of emotions
Schizotypal Personality Disorder
- extreme discomfort in close relationships
- very odd patterns of thinking & perceiving
- behavioral eccentricities
Dramatic" Personality Disorders
Consists of antisocial, borderline, histrionic, and narcissistic personality disorders
Antisocial Personality Disorder
A general pattern of disregard for & violation of other people's rights
Borderline Personality Disorder
Repeated instability in:
- interpersonal relationships
- self-image
- mood
- impulsive behavior
Treatments for Borderline Personality Disorder
Dialectical Behavior Therapy (DBT):
- developed by Marsha Linehan
- combination of contemporary psychoanalytic & humanistic approaches
- similar to CBT
Histrionic Personality Disorder
- A.K.A hysterical personality disorder
- a pattern of excessive emotionality & attention seeking
Narcissistic Personality Disorder
A broad pattern of:
- grandiosity
- need for admiration
- lack of empathy
Anxious" Personality Disorders
Consists of avoidant, dependent, and obsessive-compulsive personality disorder
Avoidant Personality Disorder
Consistent:
- discomfort & restraint in social situations
- overwhelming feelings of inadequacy
- extreme sensitivity to negative evaluations
Dependent Personality Disorder
A pattern of:
- clinging & obedience
- fear of separation
- ongoing need to be taken care of
Obsessive-Compulsive Personality Disorder
An intense focus on:
- orderliness
- perfectionism
- control
that the person loses:
- flexibility
- openness
- efficiency
Conduct Disorder
- a childhood disorder
- repeatedly violates:
- the basic rights of others
- displays aggression
- characterized by symptoms such as:
- physical cruelty to people or animals
- the deliberate destruction of other people's property
- the commission of vario
Oppositional Defiant Disorder
- a childhood disorder
- repeatedly argumentative & defiant, angry & irritable, & in some cases, vindictive
Attention-Deficit/Hyperactivity Disorder (ADHD)
The inability to:
- focus attention
- overactive & impulsive behavior
- both
Autism Spectrum Disorder
- extreme unresponsiveness to others
- severe communication deficits
- highly repetitive & rigid behaviors/interests/activities
Mental Deficiency
- A.K.A. intellectual disability or "mental retardation"
- intellectual functioning & adaptive behavior that are well below average
Delirium
A rapidly developing, acute disturbance in attention & orientation that makes it very difficult to concentrate & think in a clear & organized manner
Dementia
A progressive loss of cognitive function, marked by memory problems & confused thinking
Alzheimer's Disease
- form of dementia
- the most common type of neurocognitive disorder
- usually occurring after the age of 65, marked most prominently by memory impairment
Insanity
Mental illness of such a severe nature that a person:
- cannot distinguish fantasy from reality
- cannot conduct their affairs due to psychosis
- subject to uncontrollable impulsive behavior
M'Naghten Rule
A legal test for insanity that hold people to be insane at the time they committed a crime if:
- because of a mental disorder
- they did not know the nature of the act
- they did not know right from wrong
Civil Commitment
A legal process by which a person can be forced to undergo mental health treatment
Two-Physician Certificates
Emergency commitment:
- states give clinicians the right to certify that certain patients need temporary commitment & medication
- require certification from two PHYSICIANS (not necessarily psychiatrists)
- normally lasts three (3) days