Chapter 12

Question 1

Trigger Warning:

Answer 1

In this chapter, we cover sexual disorders and as such we will be discussing sex and sexuality in depth. Some of those topics will involve trauma, rape, or other potentially triggering information. Please practice self care during this lecture and feel free to take a break as needed.

Question 2

define trigger as in “trigger warning”

Answer 2

Trigger: def – something that triggers a panic attack. Not something that offends you/ upsets you
Do not want to use this word incorrectly

Question 3

Men vs Women for sexual

Answer 3

Men are more likely to:
Meet diagnostic criteria for paraphilic disorder
Endorse engaging in masturbation and using pornography

Women are more likely to report sexual dysfunction

Question 4

Gender differences over time

Answer 4

Gender differences in sexuality have decreased over time

Question 5

gender differences and cultures

Answer 5

Reported gender differences in sexual behavior may reflect respondents’ attempts to match cultural expectations

Question 6

The Sexual Response Cycle

Answer 6

*Desire phase
Sexual interest associated with arousing fantasies or thoughts
*Excitement phase
Increased blood flow to the genitalia
*Orgasm phase
Sexual pleasure peaks
*Resolution phase
Relaxation and sense of well-being following an orgasm 
Oxytocin kicks in

Question 7

DSM-5 Sexual Dysfunctions: Three main types

Answer 7

Sexual desire, arousal, and interest disorders

Orgasmic disorders (difficulty achieving orgasm)

Sexual pain disorders

Question 8

Sexual desire, arousal, and interest disorders

Answer 8

women:Sexual interest/arousal disorder

In men: Male hyposexual disorder and erectile disorder

Question 9

Orgasmic disorders (difficulty achieving orgasm)

Answer 9

In women: Female orgasmic disorder

In men: Premature ejaculation and delayed ejaculation

Question 10

Sexual pain disorders

Answer 10

Sexual pain disorders
In women: Genito-pelvic pain/penetration disorder
(Men may not admit to having these issues)

Question 11

Disorders Involving Sexual Interest, Desire, and Arousal

Answer 11

Female sexual interest/arousal disorder

Male hypoactive sexual desire disorder

Male erectile disorder
Failure to attain or maintain an erection

Question 12

Female sexual interest/arousal disorder

Answer 12

Persistent deficits in sexual interest (fantasies or urges), biological arousal, or subjective arousal

Question 13

Male hypoactive sexual desire disorder

Answer 13

Deficient or absent of sexual fantasies and urges

a Sexual desire, arousal, and interest disorder

Question 14

DSM-5 Criteria:Female Sexual Interest/Arousal Disorder (1 of 2)

Answer 14

• Diminished, absent, or reduced frequency of at least three of the following:
• Interest in sexual activity
• Erotic thoughts or fantasies
• Initiation of sexual activity and responsiveness to partner’s attempts to initiate
• Sexual excitement/pleasure during 75% of sexual encounters
• Sexual interest/arousal elicited by any internal or external erotic cues
• Genital or nongenital sensations during 75% of sexual encounters

Question 15

Erectile Disorder

Answer 15

On at least 75% of sexual occasions, one of the following occurs:
Inability to attain an erection
Inability to maintain an erection for completion of sexual activity
Marked decrease in erectile rigidity interferes with penetration or pleasure

(men: Sexual desire, arousal, and interest disorder)

Question 16

Orgasmic Disorders

Answer 16

Female orgasmic disorder

Early ejaculation disorder

Delayed ejaculation disorder

Question 17

Female orgasmic disorder

Answer 17

Persistent absence or reduced intensity of orgasm after sexual arousal

Question 18

Early ejaculation disorder

Answer 18

Ejaculation that occurs too quickly

an Orgasmic disorder

Question 19

Delayed ejaculation disorder

Answer 19

Persistent difficulty in ejaculating
Least common, reported by less than 1% of men

(an Orgasmic disorder)

Question 20

DSM-5 Criteria: Female Orgasmic Disorder

Answer 20

On at least 75% of sexual occasions:
Marked delay, infrequency, or absence of orgasm, or
Markedly reduced intensity of orgasmic sensation
(Do not want to base this off of one experience)

Question 21

Premature Ejaculation

DSM

Answer 21

Premature Ejaculation
Tendency to ejaculate during partnered sexual activity within 1 minute of penile insertion on at least 75% of sexual occasions

Question 22

Delayed Ejaculation

DSM

Answer 22

Delayed Ejaculation

Marked delay, infrequency, or absence of orgasm on at least 75% of sexual occasions

Question 23

Genito-pelvic pain/penetration disorder

Answer 23

-a Sexual Pain Disorder

Persistent or recurrent pain during intercourse
Diagnosable in both men and women
Very few men seek treatment
R/O medical cause (e.g., infection), lack of vaginal lubrication, or postmenopausal changes
Many can experience sexual arousal and orgasms from manual or oral stimulation that does not involve penetration

Persistent or recurrent difficulties with at least one of the following:
Inability to have vaginal penetration during intercourse
Marked vulvar, vaginal or pelvic pain during vaginal penetration or intercourse attempts
Marked fear or anxiety about pain or penetration
Marked tensing of the pelvic floor muscles during attempted vaginal penetration

Question 24

Masters & Johnson (1970) two-tier model:

Answer 24

Masters & Johnson (1970) two-tier model:
*Immediate causes (takes place during performance)
Fears about performance
Adoption of spectator role

*Distal (historical) causes
Sociocultural influences
Biological causes
Sexual traumas

(Etiology of Sexual Dysfunction)

Question 25

Psychosocial Factors

Answer 25

History of rape, sexual abuse, absence of positive sexual experiences Relationship problems E.g., anxiety, anger, embarrassment, poor communication Depression and anxiety Low physiological arousal A psycholigist wouldn’t really treat this Stress and exhaustion ``` Negative cognitions Self-blame What the cognitive theorest really go at Social and cultural learning Whether to get treatment or nah ```

Question 26

Treatments of Sexual Dysfunctions

Answer 26

*Psychoeducation *Couples therapy Training in nonsexual COMMUNICATION skills Focus on nonsexual issues Focus on communication and restoration of intimacy Not really of the sexual kind (focusing on emotions between the couple) *Cognitive interventions Challenge self-demanding, perfectionistic thoughts *Sensate focus Re-establish intimacy by engaging in contact through touch

Question 27

Treatments for Female orgasmic disorder | Specific Female Sexual Dysfunctions

Answer 27

- a Specific Female Sexual Dysfunctions Female orgasmic disorder Directed masturbation 60–90% of that subgroup achieving orgasm post-treatment

Question 28

Treatments for Genito-pelvic pain/penetration disorder

Answer 28

- a Specific Female Sexual Dysfunctions Genito-pelvic pain/penetration disorder Trained in relaxation Practice inserting smaller and then larger dilators into vagina

Question 29

Treatments for Premature ejaculation

Answer 29

-Specific Male Sexual Dysfunctions Premature ejaculation SSRI (e.g., dapoxetine) taken 1 hour before sex Squeeze technique Partner is trained to squeeze the penis in the area where the head and shaft meet to rapidly reduce arousal Withdraw penis as needed during intercourse to reduce arousal Psychotherapy to regain confidence after experiences of these symptoms

Question 30

Treatments for Erectile Disorder

Answer 30

-Specific Male Sexual Dysfunctions Medication (e.g., Viagra) Works on physical side of things: blood pressure 83% able to successfully have intercourse

Question 31

Paraphilic Disorders -catagories

Answer 31

Recurrent sexual attraction to unusual objects or sexual activities lasting at least 6 months Should only be diagnosed when: There is marked distress or impairment Behaviors are done with nonconsenting persons Divided categories based on source of arousal: Sexual attractions based on inanimate objects Sexual attractions based on children Accurate prevalence statistics are not available

Question 32

Fetishistic Disorder

Answer 32

Reliance on an inanimate object or a nongenital part of the body for sexual arousal Recurrent and intense sexual urges toward these fetishes Presence of the fetish is strongly preferred or even necessary for sexual arousal Compulsive attraction to the object The attraction is experienced as involuntary and irresistible

Question 33

DSM-5 Criteria: Fetishistic Disorder

Answer 33

For at least 6 months, recurrent and intense sexually arousing fantasies, urges, or Behaviors involving the use of nonliving objects or nongenital body parts Causes significant distress or impairment in functioning The sexually arousing objects are not limited to articles of clothing used in cross-dressing or to devices designed to provide tactile genital stimulation, such as a vibrator

Question 34

Pedophilic Disorder

Answer 34

Diagnosed only when adults act on their sexual urges toward children, or when the urges cause distress Victims usually known to pedophile Most pedophilia does not involve violence other than the sexual act Pedophiles show more arousal to sexual stimuli involving children than to stimuli involving adults Pedophilic disorder, incest subtype Sexual relations between close relatives for whom marriage is forbidden (e.g., brother and sister)

Question 35

DSM-5 Criteria: Pedophilic Disorder

Answer 35

For at least 6 months, recurrent and intense, sexually arousing fantasies, urges, or Behaviors involving sexual contact with a prepubescent child Person has acted on these urges or the urges and fantasies cause marked distress or interpersonal problems Person is at least 16 years old and 5 years older than the child

Question 36

Voyeuristic Disorder

Answer 36

Intense and recurrent desire to obtain sexual gratification by watching: Unsuspecting others in a state of undress Having sexual relations May not find it particularly exciting to watch someone undress for his benefit The element of risk, and the threat of discovery, is important

Question 37

Voyeuristic Disorder and gender

Answer 37

Common in men

Question 38

DSM-5 Criteria: Voyeuristic Disorder

Answer 38

IDK

Question 39

Exhibitionistic Disorder

Answer 39

Exposing one’s genitals to an unwilling stranger Seldom an attempt to have other contact with the stranger Usually involves desire to shock or embarrass the observer Many exhibitionists masturbate during the exposure

Question 40

DSM-5 Criteria: Exhibitionistic Disorder

Answer 40

For at least 6 months, recurrent, intense, and sexually arousing fantasies, urges, or Behaviors involving showing one’s genitals to an unsuspecting person Person has acted on these urges to a nonconsenting person, or the urges and fantasies cause clinically significant distress or interpersonal problems

Question 41

Frotteuristic Disorder

Answer 41

Sexually oriented touching of a unsuspecting person Rubbing genitals against a person’s body or fondling a person’s genitals Often occurs in crowded places (To a nonconsenting person)

Question 42

DSM-5 Criteria: Frotteuristic Disorder

Answer 42

For at least 6 months, recurrent and intense and sexually arousing fantasies, urges, or Behaviors involving touching or rubbing against a nonconsenting person Person has acted on these urges with a nonconsenting person, or the urges and fantasies cause clinically significant distress or problems

Question 43

Sexual Sadism and Masochism Disorders

Answer 43

Sexual sadism disorder Sexual masochism disorder Being subjected to pain or humiliation Most sadists establish relationships with masochists to derive mutual sexual gratification Debate over inclusion in DSM-5: These disorders have become more common Typically do not cause impairment or distress

Question 44

Sexual Sadism

Answer 44

*Inflicting pain or psychological suffering (such as humiliation) on another For at least 6 months, recurrent, intense, and sexually arousing fantasies, urges, or Behaviors involving the physical or psychological suffering of another person Causes clinically significant distress or impairment in functioning or the person has acted on these urges with a nonconsenting person

Question 45

Sexual masochism disorder DSM-5 Criteria:

Answer 45

For at least 6 months, recurrent, intense, and sexually arousing fantasies, urges, or Behaviors involving the act of being humiliated, beaten, bound, or made to suffer Causes marked distress or impairment in functioning (Not really looking at the nonconsenting person (because the person giving pain, and cant force someone to do that))

Question 46

Etiology of the Paraphilic Disorders

Answer 46

*Neurobiological factors Almost all individuals with paraphilias are men They do not have unusual levels of testosterone or other androgens *Childhood sexual abuse 40-66% of adult sexual offenders reported a history of sexual abuse * Psychological Factors - Loss of control over Behavior - Heightened impulsivity and poor emotion regulation - Slightly lower IQ and higher rates of neurocognitive problems - More minor physical anomalies related to prenatal development

Question 47

Treatment for the Paraphilic Disorders

Answer 47

Very little is known about the effectiveness of treatments Research often focuses on men charged with sexual offenses Very little long-term data is available Unethical to withhold treatment Lack of control groups (No double blind studies) Enhance motivation for treatment Bolster hope for control over urges Focus on benefits for change and consequences of continued engagement in illegal sexual Behaviors Cognitive Behavioral treatment Aversion therapy Pair paraphilic fantasies with aversive stimuli Counter distorted thinking Often combined with social skills, sexual impulse control strategies, empathy training, and relapse prevention ``` Biological treatments Castration used in past Medications (supplement to psychological treatment) Hormonal agents to reduce androgens SSRIs ```

Question 48

Treatment for the Paraphilic Disorders : Biological treatments

Answer 48

*Biological treatments Castration used in past *Medications (supplement to psychological treatment) Hormonal agents to reduce androgens SSRIs

Question 49

Community Prevention

Answer 49

Balance between protecting the public and protecting the civil liberties of sexual offenders E.g., laws concerning the public’s “right to know” when a sex offender is released Megan’s law Unconstitutional to detain a person based on potential for future crimes: Supreme Court ruled that a person at high risk for a sex crime can be detained if the risk is related to a psychological disorder diminishing the person’s ability to control sexual Behavior Receipt of this diagnosis can lead to placement in a psychiatric facility after a prison term is completed

Question 50

Which of the following brain mechanisms have been implicated in anorexia? a. ) With puberty, the dramatic increase in female hormones damages centers that control eating in the thalamus and pituitary. b. ) Excessive exercise depletes the brain of neurotransmitters utilized by areas that regulate hunger or satiation. c. ) Stress-released hormones reduce the sensitivity of receptors that detect blood-sugar levels and release hormones that induce hunger. d. ) Starvation releases natural pain-reducing opioids producing a high, which reinforces not eating.

Answer 50

d.) Starvation releases natural pain-reducing opioids producing a high, which reinforces not eating.

Question 51

Efforts to treat bulimia nervosa using antidepressant drugs have been complicated by a. ) low federal funding for such studies b. )frequent side effects c. ) treatment refusal d. ) all of the above

Answer 51

c.) treatment refusal

Question 52

5. Research suggests that gender differences in sexuality are a) consistent across cultures. b) vary greatly by culture. c) vary slightly by culture. d) more of a result of culture than biology.

Answer 52

a) consistent across cultures.

Question 53

7. Which of the following is NOT a subcategory of paraphilia in the DSM-5? a) fetishistic disorder b) sexual arousal disorder c) transvestic disorder d) exhibitionistic disorder

Answer 53

b) sexual arousal disorder

Question 54

9. According to the Centers for Disease Control and Prevention, __________ percent of women will be diagnosed with a sexually transmitted illness by the age of 19. a) 10 b) 25 c) 40 d) 60

Answer 54

b) 25

Question 55

11. Which age group has the highest number of new HIV cases being diagnosed each year? a) 15-19 b) 20-24 c) 25-29 d) 30-34

Answer 55

b) 20-24

Question 56

17. A person who feels deep within themselves, usually from early childhood, that they are of the opposite gender is given the diagnosis of a) gender distortion disorder. b) gender identity disorder. c) sexual distortion disorder. d) all of the above are possible diagnostic labels.

Answer 56

b) gender identity disorder.

Question 57

dyspareunia

Answer 57

Persistent or recurrent genital pain that occurs just before, during, or after intercourse.

Question 58

31. Jane is finding that her interest in sex has diminished greatly. She not only avoids having sexual contact with her husband, but has even stopped fantasizing and masturbating. Jane would likely be diagnosed as having which of the following DSM-5 disorders? a) female orgasm disorder b) female sexual arousal disorder c) hypoactive sexual desire disorder d) none of the above

Answer 58

c) hypoactive sexual desire disorder

Question 59

``` 44. Which of the following is a current or proximal cause of sexual dysfunctions, according to Masters and Johnson? a) psychosexual trauma b) fear of performance c) excessive intake of alcohol d) homosexual inclinations ```

Answer 59

b) fear of performance

Question 60

50. Masters and Johnson found that many individuals who have sexual dysfunction a) were college-educated. b) had low socioeconomic status. c) had negative views of sexuality. d) were encouraged to express their sexuality at a young age.

Answer 60

c) had negative views of sexuality.

Question 61

55. For women with sexual dysfunctions in the context of marital relationship distress, which of the following has been found to improve many aspects of sexual functioning? a) SSRI medications b) behavioral marital couple's therapy c) anti-anxiety medications d) psychoanalysis

Answer 61

b) behavioral marital couple's therapy

Question 62

82. Megan's Law involves a) notification of members of a community when a convicted sex offender is released and moving into that neighborhood. b) additional compensation for victims' families following sex crimes. c) more rigid conviction standards for sex offenders. d) mandates intensive therapy for sex offenders following their first offense.

Answer 62

a) notification of members of a community when a convicted sex offender is released and moving into that neighborhood.

Question 63

107. True or false? A diagnosis of Pedophilic Disorder requires that an individual have persistent urges to behave sexually with pre-pubescent children, not necessarily to have acted on them.

Answer 63

TRUE

Question 64

108. Which of these diagnoses does not include a criterion that specifies the victim be non-consenting? a. Pedophilic Disorder b. Voyeuristic Disorder c. Exhibitionistic Disorder d. Frotteuristic Disorder

Answer 64

a. Pedophilic Disorder