Lecture 11 - Sexual Disorders

Question 1

Masters and Johnson famously defined the sexual response into four stages

Answer 1

Excitement
Plateau
Orgasm
Resolution

Question 2

What are the 8 sexual dysfunction diagnosis?

Answer 2

Female sexual interest/arousal disorder
Male hypoactive sexual desire disorder
Erectile disorder
Female orgasmic disorder
Delayed ejaculation
Premature (early) ejaculation
Genito-pelvic pain/penetration disorders

Question 3

What’s a big difference between women and men when it comes to sexual dysfunctions?

Answer 3

For women, abnormal sexual interest and arousal usually co- occur, but for men these are divided into several different disorders

Question 4

DSM 5 includes four main specifiers for all sexual dysfunctions?

Answer 4

ONset: lifelong or acquired
Context: Generalized or situational

Question 5

Which sexual disorder is similar to somatic symptom disorder?

Answer 5

Genito-pelvic pain/penetration disorders

Question 6

What are causal factors of sexual disorders related to desire?

Answer 6

SSRI use, depression, dysfunctional attitudes towards sexuality, guilt/shame, relationship problems, sometimes hormonal dysregulation

Question 7

what is the causal factors of sexual disorders related to arousal?

Answer 7

Imbalance between PNS and SNS activity

Question 8

What are causal factors of sexual disorders related to organismic disorder?

Answer 8

Lack of sexual knowledge/experience, ineffective technique, poor communication, conditioned response to very specific masturbatory technique or pornography viewing

Question 9

What are causal factors of sexual disorders related to premature ejaculation?

Answer 9

o Conditioned response to rapid ejaculation, physiological predisposition to sensitivity

Question 10

what is instrumental pathway communication?

Answer 10

by talking about what you want, you are more likely to get what you want

Question 11

what is expressive pathway communication?

Answer 11

by talking about what you want, the intimacy in the couple increases dramatically

Question 12

What are medical treatments for sexual dysfunction disorders?

Answer 12

• Traditional and pharmacological aphrodisiacs
• Phosphodiesterase inhibitors (Viagra, Cialis)
• Flibanserin for female sexual interest/arousal disorder, affects serotonin, dopamine, and norepinephrine
• Penile implants (most popular treatment until Viagra)

Question 13

What is sensate focus?

Answer 13

o Re-directs attention from specific sexual targets towards pleasure, enjoyment, intimacy
o A moratorium on intercourse, while the couple performs a series of steps with the aim of desensitization to anxiety or fears surrounding sexuality

Question 14

What is gender dysphoria?

Answer 14

Intense unhappiness with natal (biological) sex

Dysphoria (distress or unhappiness) is the clinical problem, not the incongruence itself

Question 15

What is the plus side for having gender dysphoria in the DSM

Answer 15

Diagnosis allows insurance coverage for medical treatment (hormones, surgery)

Question 16

What is the minus side for having gender dysphoria in the DSM

Answer 16

Diagnosis can be stigmatizing and there was little consultation with the trans community DSM-5

Question 17

What’s the difference between GD and BDD?

Answer 17

o In BDD, patient believes some part of the body is wrong or ugly, but it does not relate to their gender
o Also, surgery almost never leads to subjective improvement in BDD

Question 18

What are the 8 paraphilic disorders?

Answer 18

Voyeurism, Exhibitionism, Frotteurism, Sexual masochism, sexual sadism, pedophilia, transvestic fetishism, fetishism