erectile disorder et al.

Question 1

What does the DSM-5-TR describe sexual dysfunctions as?

Answer 1

A clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure

This definition is found on page 477 of the DSM-5-TR.

Question 2

What must be ruled out before diagnosing a sexual dysfunction?

Answer 2

Nonsexual mental disorder, serious relationship disturbance, other stressor, or effects of a drug or medical condition

Question 3

What specifiers are provided for most sexual dysfunction diagnoses?

Answer 3

Onset, extent, and severity

The exception is genito-pelvic pain/penetration disorder, which has specifiers only for onset and severity.

Question 4

What are the symptoms required for a diagnosis of Erectile Disorder?

Answer 4

At least one of three symptoms on 75 to 100% of occasions:
* Marked difficulty obtaining an erection
* Marked difficulty maintaining an erection
* Marked decrease in erectile rigidity

Question 5

How long must symptoms of Erectile Disorder be present for a diagnosis?

Answer 5

At least six months

Question 6

What indicates that an organic etiology can be ruled out in Erectile Disorder?

Answer 6

Spontaneous erections when not planning to engage in sexual activity, morning erections, or erections when masturbating or with a different partner

Question 7

What behavioral techniques are used to treat Erectile Disorder?

Answer 7

Reducing performance anxiety and increasing sexual stimulation

Question 8

What is sensate focus?

Answer 8

A method for reducing performance anxiety through a series of activities promoting intimacy

Developed by Masters and Johnson in 1970.

Question 9

What drugs are commonly used to treat Erectile Disorder?

Answer 9

Sildenafil citrate (Viagra), tadalafil (Cialis), vardenafil (Levitra)

Question 10

What characterizes Premature (Early) Ejaculation?

Answer 10

Ejaculation within approximately one minute of vaginal penetration before the person desires it

Question 11

What are the symptoms of Premature Ejaculation required for diagnosis?

Answer 11

Symptoms must be present for six months or more, occur during 75 to 100% of occasions, and cause significant distress

Question 12

What techniques are used to treat Premature Ejaculation?

Answer 12

Sensate focus, start-stop technique, pause-squeeze technique

Question 13

How does serotonin relate to Premature Ejaculation?

Answer 13

A low level of serotonin contributes to this disorder; SSRIs can delay ejaculation

Question 14

What are the symptoms of Genito-Pelvic Pain/Penetration Disorder?

Answer 14

Problems with:
* Vaginal penetration during intercourse
* Vulvovaginal or pelvic pain during intercourse
* Anxiety about vulvovaginal or pelvic pain
* Tensing of pelvic floor muscles

Question 15

What is the required duration of symptoms for Genito-Pelvic Pain/Penetration Disorder?

Answer 15

Six months or longer

Question 16

What interventions are used for Genito-Pelvic Pain/Penetration Disorder?

Answer 16

Relaxation training, sensate focus, topical anesthetic, vaginal dilators, Kegel exercises

Question 17

What is required for a diagnosis of Female Orgasmic Disorder (FOD)?

Answer 17

Marked delay, infrequency, or absence of orgasm or markedly reduced intensity of orgasmic sensations on almost all occasions for at least 6 months

Question 18

What is the most empirically supported treatment for Female Orgasmic Disorder?

Answer 18

Directed masturbation

Question 19

What other treatments may be included for Female Orgasmic Disorder?

Answer 19

Sex education, sensate focus, anxiety reduction techniques, mindfulness training, communication skills training

Question 20

What is Gender Dysphoria?

Answer 20

A marked incongruence between one’s assigned gender and one’s experienced or expressed gender.

Question 21

What are the requirements for diagnosing Gender Dysphoria in children?

Answer 21

At least six of eight symptoms lasting for at least six months and causing significant distress or impaired functioning.

Question 22

List some symptoms required for diagnosing Gender Dysphoria in children.

Answer 22

• Strong desire to be the other gender
• Strong preference for wearing clothes of the other gender
• Strong preference for toys and activities typically used by the other gender
• Strong preference for playmates of the other gender
• Strong dislike of one’s sexual anatomy

Question 23

What are the requirements for diagnosing Gender Dysphoria in adolescents and adults?

Answer 23

At least two of six symptoms lasting for at least six months and causing significant distress or impaired functioning.

Question 24

List some symptoms required for diagnosing Gender Dysphoria in adolescents and adults.

Answer 24

• Strong desire to be rid of primary and/or secondary sex characteristics
• Strong desire to be the other gender
• Strong desire to be treated as the other gender
• Strong conviction that one has feelings and reactions characteristic of the other gender

Question 25

What is the Dutch protocol in the treatment of Gender Dysphoria?

Answer 25

It recommends 'watchful waiting' and support for children under 12, followed by social transition and puberty-blocking drugs at the first signs of puberty.

Question 26

What is the gender-affirmative model?

Answer 26

It assumes a child may be cognizant of their authentic identity and benefits from a social transition at any stage of development.

Question 27

What are the key assumptions of the gender-affirmative model?

Answer 27

* Gender variations are not disorders * Gender presentations are diverse and vary across cultures * Gender is not always binary and may be fluid * A child’s psychological problems are often secondary to negative reactions

Question 28

What are the outcomes associated with gender confirmation surgery?

Answer 28

Decrease in gender dysphoria, improved self-satisfaction, and a low incidence of regret.

Question 29

True or False: Transgender male patients generally have more positive outcomes than transgender female patients after gender confirmation surgery.

Answer 29

True.

Question 30

What factors are linked to positive outcomes following gender confirmation surgery?

Answer 30

* Careful diagnostic screening * Psychological stability * Adequate social support * Lack of surgical complications

Question 31

Define paraphilia.

Answer 31

Intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with consenting human partners.

Question 32

What is a paraphilic disorder?

Answer 32

A paraphilia that is currently causing distress or impairment to the individual or has entailed personal harm or risk of harm to others.

Question 33

What types of treatments are used for paraphilic disorders?

Answer 33

Cognitive-behavior therapy combined with group therapy, marital therapy, and/or pharmacotherapy.

Question 34

What cognitive strategies are used in the treatment of paraphilic disorders?

Answer 34

* Cognitive restructuring * Empathy training * Skills training

Question 35

What is covert sensitization?

Answer 35

A form of aversive counterconditioning conducted in imagination to replace sexual arousal with fear.

Question 36

What is orgasmic reconditioning?

Answer 36

Instructing the person to switch fantasizing from a paraphilic object to a more appropriate one while masturbating.

Question 37

What drugs are used to treat severe forms of paraphilic disorders?

Answer 37

* Gonadotropin-releasing hormones (e.g., Lupron) * Antiandrogens (e.g., Depo-Provera)

Question 38

What is Frotteuristic Disorder?

Answer 38

Recurrent and intense sexual arousal from touching or rubbing against a nonconsenting adult.

Question 39

What is Transvestic Disorder?

Answer 39

Cross-dressing for the purpose of sexual arousal.

Question 40

What is Pedophilic Disorder?

Answer 40

Recurrent and intense sexual arousal involving sexual activity with a child 13 years of age or younger.

Question 41

What is Fetishistic Disorder?

Answer 41

Recurrent and intense sexual arousal in response to a nonliving object or specific non-genital body part.

Question 42

What is Exhibitionistic Disorder?

Answer 42

Recurrent and intense sexual arousal from exposing one’s genitals to an unsuspecting person.

Question 43

What are the subtypes of Exhibitionistic Disorder?

Answer 43

* Exposing genitals to prepubertal children * Exposing genitals to physically mature individuals * Exposing genitals to both prepubertal children and physically mature individuals