SM_122b: Sexual Disorders

Question 1

____ is disorders of gender identity

Answer 1

Gender dysphoria is disorders of gender identity

Question 2

____ are disorders of sexual interest or behavior

Answer 2

Paraphilic disorders are disorders of sexual interest or behavior

Question 3

____ are disorders of sexual response

Answer 3

Sexual dysfunctions are disorders of sexual response

Question 4

Sexual behavior is a disorder when ____, ____, ____, ____, and ____

Answer 4

Sexual behavior is a disorder when

• Interferes w/ adult mutual sexual relationships
• Creates risk or harm for self or others
• Has difficulty controlling the behavior
• Distresses the individual
• Creates impairment in other areas of life

Question 5

Describe DSM-5 criteria for paraphilic disorders

Answer 5

Paraphilic disorders DSM-5 criteria

• Paraphilia: recurrent, intense sexually arousing fantasies, urges, or behaviors other than in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners (non-normophilic) lasting ≥ 6 months
• Problematic: cause clinically significant distress or impairment in social, occupational, or other important areas of functioning or has entailed personal harm / risk of harm to others

Question 6

Sexual behavior is problematic when ____

Answer 6

Sexual behavior is problematic when it causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or has entailed personal harm / risk of harm to others

Question 7

Describe characteristics of paraphilic disorders

Answer 7

Paraphilic disorders characteristics

• Much more common in men
• Usually more than one paraphilia
• Chronic
• Resistant to change
• Onset usually before age 18
• Associated with bipolar disorder, ADHD, anxiety, and substance use disorders

(may overlap with hyperseuxality or sexual offenses)

Question 8

Describe hypersexuality

Answer 8

Hypersexuality

Over a period of ≥ 6 months, recurrent and intense seuxal fantasies, urges, and behavior in assoication with ≥ 4 of the following:

• Great deal of time is consumed by sexual fantasies and urges and by planning for and engaging in sexual behavior
• Repetitively engaging in sexual fantasies, urges, and behavior in response to dysphoric mood states
• Repetitively engaging in sexual fantasies, urges, and behavior in response to stressful life events
• Repetitive but unsuccessful efforts to control or significantly reduce the fantasies, urges, and behavior
• Repetitively engaging in sexual behavior while disregarding the risk for physical or emotional harm to self or others

Question 9

Describe the etiology of paraphilias and hypersexuality

Answer 9

Paraphilias / hypersexuality etiology

• Exposure to paraphilic behavior
• Split-off sexuality
• Tension reduction or self-soothing
• Problems in mature sexuality
• Problems with masculine identity
• Compulsivity, impulsivity, or other mental health conditions
• Offenders: hostility, abuse, inadequacy, disinhibition, opportunity, or power

Question 10

Best question to ask about sexual issues is: ____

Answer 10

Best question to ask about sexual issues is: do you have any sexual concerns?

Question 11

Describe gender differences in sexual response

Answer 11

Gender differences in sexual response

• Men: quicker, more genitally focused, automatic, fixated
• Women: slower, less genitally focused, learned, fluid, more contextual

Question 12

Describe the sexual response cycle

Answer 12

Sexual response cycle

• Masters & Johnson: excitement, plateau, orgasm, resolution
• Kaplan: desire, arousal, orgasm, pain

Question 13

Etiological factors in sexual dysfunction include ____, ____, ____, ____, and ____

Answer 13

Etiological factors in sexual dysfunction include age, illness, medication, immediate psychological, and remote psychological

• Immediate: intrapsychic (anxiety), intepersonal (miscommunication)
• Remote: intrapsychic (fear of sex), interpersonal (resentment)

Question 14

Describe the development of sexual dysfunctions

Answer 14

Development of sexual dysfunctions

• Predisposing factors: physical (medial condition), psychological (anxiety regarding sex, relationship strain)
• Triggering factors: physical (new med, menopause, illness), psychological (new relationship, one bad experience)
• Exacerbating factors: physical (pain response), psychological (anxiety, partner’s negative response)
• Maintaining factors: physical (conditioned physical response), psychological (performance anxiety, avoidance)

Question 15

Describe DSM-5 diagnosis of sexual dysfunctions

Answer 15

Sex dysfunctions DSM-5 diagnosis

• Sexual desire disorders, sexual arousal disorders, orgasmic disorders, and sexual pain disorders
• Substance / medication-induced sexual dysfunction
• Does not receive diagnosis if resulting from meds
• Specify whether lifelong or acquired, generalized or situational, or mild / moderate / severe

Question 16

Describe etiology for sexual dysfunction disorders

Answer 16

Sexual dysfunction disorders etiology

• Physical: medical conditions, medication, constitutional, pain, trauma
• Pyschological: anxiety, depression, relationship strain, negative beliefs, over-control, bad sex, other sexual dysfunction