Lecture 8: Sexual Dysfunction Flashcards
What is Sexual dysfunction?
is a persistent or reoccurring
- lack of sexual desire
- difficulty becoming sexually aroused
- ability to reach orgasm
-pain
What might be some reasons why people are hesitant to seek help?
- they don’t want to talk about it
- don’t want to see a doctor
- may hide issues from partner
- feel shame/guilt
What are the biological approaches/reasons for sexual dysfunction?
-Neurological disorders (MS)
-Spinal cord injuries
- Vascular issues (lg network of blood vessels)
What are the psychological approaches/reasons for sexual dysfunction?
- Personal experiences that leave long-lasting implications
- Mood disorders - depression
What are the social reasons influencing sexual dysfunction?
- Religious beliefs, ethnicity, and culture all affect how we think about sex
What is an example of how culture impacts the interpretation of symptoms and diagnosis of sexual dysfunction?
Dhat syndrome from India
- semen is vital to body functionality
- when an individual is concerned/ worried about losing semen from ejaculation
- symptoms of anxiety, depression, weakness, fatigue, sleeplessness, palpitations and headaches
- treatment is usually medication with CBT
What criteria are required for a diagnosis of sexual dysfunction?
- Must have occurred for 6 months or more
- must occur 75 to 100% of the time
- Must cause person significant distress
Sexual dysfunctions can be classified in four ways.
Lifelong = something always present since being sexually active
Acquired = did not have before, but you have it now for some reason.
Generalized = whatever the problem is, it happens constantly with every partner, by yourself, and generalized across all contexts.
Situational = you only have the problem with partners, or with certain partners and not others.
What are some of the sexual desire-related disorders?
for both male and female
*affects both men and women but is higher in women
- Male Hypoactive Disorder
- Female sexual interest/arousal disorder
◦Absence of sexual thoughts or fantasies
◦(Some) can still become physiologically aroused and orgasm when adequately stimulated
◦Still appreciate physical closeness/intimacy, but no interest in genital stimulation
* married women were twice as
likely to experience this
compared to single women
* overall higher in married
couples
◦You share life stresses when you married
True or False:
There is no clear consensus among clinicians about how to define “low sexual desire”
True!
◦No standard level/ threshold of sexual desire
◦Always have individual differences
- problem becomes apparent when there is a discrepancy between partners
◦Men are generally more interested in sex
◦Gay and lesbian couples may have fewer discrepancies
What changes occurred in the DSM for female hypoactive disorder and female arousal disorder?
- both were combined as female sexual interest/arousal disorder
- based on how sexual responses overlap for many women
Sexual Arousal Related Disorders
in males
Male Erectile Disorder
* Persistent difficulty in achieving or maintaining an erection sufficient to allow completion of sexual activity
* In most cases, the failure is limited to sexual activity with partners or with some partners and not others
◦Usually situational (partnered activity typically the problematic situation)
* Some men can attain erections but not sustain them
* Incidence increases with age
* medical problems are associated
◦Cardiovascular disease- can lead to problems with erection because of blood flow
◦Diabetes- can damage the blood vessels and nerves
Younger individuals- more likely psychological reasons
What are some of the reasons why performance anxiety can become a consistent issue?
- the male will usually fear it occurring again
- becomes stuck in a feedback loop
- Embarrassment or shame
‣ Pressure on men to perform/ always want to have sex
- Men as initiators
- Need to be confident always
- Creates performance anxiety (anxiety concerning one’s ability to perform behaviours, esp behaviours that people may evaluate)
◦Canʼt stop thinking about your previous bad experience
◦Happens again, perhaps because of the way that you think about it
◦Self-fulfilling prophesy
Which model looks at sexual response from a biological POV?
a)Master’s and Jhonson’s
b) Kaplan’s model
c)Basson’s model
a) Master’s and Jhonson’s
Based on the DSM-5, changes to female hypoactive desire disorder and female arousal disorder to merging female sexual interest and arousal disorder - what model can better explain this change? (potential short answer question)
*Master’s and Jhonson’s models saw a sexual response from a biological POV. Does not consider desire.
*Kaplan’s model is linear and views desire as coming before arousal.
ANSWER: *Basson’s intimacy model seems to be more in alignment with this new change to the DSM-5 because, for females in particular, arousal can occur first before desire. Whereas for men, it’s a linear progression; desire comes first, the arousal.
Study (1986): Does anxiety always interfere with sexual performance?
(short answer question) - explain what happened and the results.
Researchers attempted to stimulate performance anxiety in sexually functional male volunteers who were shown an explicit sexual film under one of three conditions:
1 = Contingent threat
- mimics performance anxiety
- hard to recreate - they would shock participants if they did not reach a certain arousal
2 = Noncontingent threat
- generalized anxiety
- shock was not dependent on arousal and can happen at anytime
3 = control group = no shock given, just watched erotic film
Results: Researchers hypothesized that the contingent threat group would have the lowest level of arousal, but in fact, they actually had the highest level of arousal. This was done with healthy males.
*In males with sexual dysfunction
- showed reduced levels of sexual arousal to threat conditions
- their attention would be so focused on negative outcomes that they could not process erotic cues from film
- fears of sexual function have distorted the basic natural response that they broke out in a cold sweat
◦Canʼt forget how to have an erection
◦ It is an automatic response!!
What are the 5 key factors of a model of erectile dysfunction in men?
- Negative vs Positive effect
◦Men who often experience problems with erections go into situations with negative affect
◦Men who donʼt experience issues went in with a positive affect
‣ Expectations of the situation have a significant influence on the erection - Underreported sexual arousal/diminished self-control
◦Males who experience dysfunction UNDER reported sexual arousal
‣ Both groups had similar physiological arousal numbers
‣ Men underreported subjective arousal
3.Dysfunctional group felt they had lack of control
- they tend to attribute issues to diff factors
- healthy men will blame EXTERNAL facotrs
- problematic men will blame INTERNAL factors
- Distraced-related performance stimuli
- if the distraction is related to performance (shock) - Role of Anxiety
- anxiety will INHIBIT arousal in men who have dysfunction
- may facilitate arousal in healthy men
What are two types of disorders regarding female sexual arousal disorder that is suggested by Basson (2004)?
- Combined-arousal disorder
- no subjective arousal/experience = no genital response - Subjective arousal disorder
- aware that genitals response physically to stimulation = no subjective arousal is felt
* both physical and mental factors responsible
*Physical
◦Diabetes- nerve damage
◦Loss of estrogen- lower arousal
◦Skin may be less sensitive to touch than other women
*Psychological
◦Relationship issue
◦Past trauma
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Which of the following are orgasmic disorders?
a) Female orgasm disorder
b) Premature ejaculation
c) Delayed ejaculation
e) All of the above
f) a) only
e) All of the above!
Female Orgasmic Disorder
- unable to reach orgasm or have difficulty reaching orgasm after adequate sexual stimulation
True or False?
A woman who reaches orgasm through masturbation rather than through intercourse has Female orgasmic Disorder.
False! They do not
