Abnormal Psychology Exam 4 Module 10

Voyeuristic Disorder, Frotteuristic Disorder, Pedophilic Disorder,

Observing unsuspecting others Rubbing against a non-consenting person Acted on or urges cause distress Sexual gratifaction from physical/sexual contact with children (13 or younger) At least 16yo and at least 5 yo older than child Acted on urges or causes distress Obsessive and Predatory Pedophiles -Lack empathy -Don't believe that it is causing harm -Believe acceptance will increase - NAMBLA -Attracted to specific age range Girls are more likely to be victims (Murray 2000) 44% prefer only girls 33% prefer only boys 23% choose both girls and boys Related factors: arrested psychological development Childish emotional needs low self-esteem poor social relations alcoholism exaggeration of the social male role (Murray, 2000) Victim of childhood sexual abuse for 35% (Keegan, 2001) Reasons why they do it (Pollack & Hashmall, 1991): They didn't fight, lacked sexual outlets Intoxication Victim-initiation High recidivism rates

There is no clear evidence to support any particular causal theory for gender dysphoria, however, which of the following is NOT considered a cause? a Prenatal hormone influence. b Prenatal or postnatal development. c Hereditable component. d Environmental influences.

d - Environmental influences.

All EXCEPT which of the following are interventions for the paraphilias? a Covert sensitization b Olfactory aversive therapy c Masturbatory retraining d Sensate focus

d - Sensate focus

The defining symptom of _____ is the persistent or recurrent inability to attain an adequate erection for sexual activity or to maintain the erection until the activity is completed.

erectile disorder

A woman's persistent or recurrent deficiency in the desire for sexual activity that causes significant distress is called _________.

female sexual arousal interest/arousal disorder

Erectile Disorder

is persistent or recurrent difficulty in attaining an adequate erection for sexual activity or in maintaining the erection until the activity is completed.

Treatment of PE Techniques for Women

- Stop-Start Technique - Squeeze Technique - SSRIs Masturbation Kegel Exercises Vaginal Dilators Botox

What fraction of women experience low sexual interest and what percentage of females report arousal problems, respectively? Masters and Johnson found that several subjects had seductive mothers with whom they shared a bed, while other subjects had negative experiences with prostitutes. What do these examples highlight as a possible causal factor of sexual dysfunction? What is the current state of treatment approaches for low sexual interest?

1/3; 20% Social learning histories Intervention is difficult for low or absent sexual desire, and the treatments available show modest improvements with short term benefits.

Human sexual response: stages and models (Masters & Johnson; Kaplan)

2 physiological processes Vasocongestion: Increased blood flow to and swelling of localized tissues and organs Myotonia: A neuromuscular disorder characterized by the slow relaxation of the muscles after a voluntary contraction. Stages: Excitement: The excitement phase begins with whatever is sexually stimulating and arousing for the particular person. Blood rushes into the genitals (vasocongestion), causing penile erection in males and vaginal lubrication and clitoral swelling in females. Plateau: If the stimulation continues, excitement builds quickly to a point called the plateau phase, in which the sexual arousal is maintained and intensified. If stimulation is terminated or ceases to be effective at this point, the person will not experience orgasm but will enter a prolonged period of gradually decreasing sexual tensions. Orgasm: The orgasmic phase, the shortest period of the cycle, consists of those few seconds when the bodily changes resulting from stimulation reach their maximum intensity. Orgasm involves muscular contractions of the pelvic area. In males, it consists of a stage of ejaculatory inevitability, after which the second stage, ejaculation of semen, cannot be controlled. Women do not report a corresponding point of inevitability before their orgasms, which include clusters of contractions that are intense and close together. Resolution During the resolution phase, sexual tensions decrease as the person returns to the unstimulated state. Women are capable of having another orgasm if effective stimulation is resumed. For men, however, there is the refractory period, when rearousal and orgasm are impossible. The duration of the refractory period varies widely, from minutes to hours, and is influenced by many factors including the male's age and novelty of the sexual practice.

Although the actual incidence of pedophilia in the population is not known, proven cases of sexual abuse appear to have declined by more than _____. _____ concerns sexual arousal involving the humiliation or physical or psychological suffering to others. Both masochistic and sadistic fantasies are likely to have been  present in _____. Which of the following interventions is MOST effective in treating gender dysphoria?

50% Sexual sadism disorder childhood Sex reassignment surgery

Symptoms, Etiology, and Treatments for: Female Sexual Interest/Arousal Disorder

A woman's persistent or recurrent deficiency in the desire for sexual activity, and in normal sexual fantasies or thoughts, that causes significant distress

Which of the following is NOT a required component of the male hypoactive sexual desire disorder?

An inability to achieve orgasm

Assessing and Treating Paraphilias:

Assessment Most dont seek treatment Problems with self-report and observation Penile plethysmography Treatments - Combination most effective Medications Individual - Behavioral most effective Education

Etiology: Psychological

Behavioral Theories Classical and Operant Conditioning -Associations between objects/actions and sexual pleasure -Behaviors become positively reinforced

Etiology: Biological Theories:

Brain structure and chemistry difference Alterations in the development of the brain and hormonal systems Head injury before age 13 Cognitive and memory deficits Lower intelligence Differences in brain structure volume Dysfunctions in the frontal areas of the brain -Regulating impulsive and aggressive behavior and in testosterone levels

Therapies for Sexual Disorders: Cognitive behavior Therapy: Bibliotherapy:

Cognitive restructuring -negative thought patterns Increasing sexual knowledge

Paraphilic Disorders

DSM recognizes 8: Develop before puberty More common in men

_____ involves an inability to reach orgasm or an extra amount of time in reaching orgasm that follows a normal phase of sexual excitement.

Delayed ejaculation

Causes of Sexual Dysfunction: Interpersonal Factors

Disturbances in relationship: -communication problems -Anger -Intimacy problems -sexual scripts -sexual skills -cultural differences

Causes of Sexual Dysfunction: Combined Cognitive and Physical Factors

Function well when: Experience arousal Interpret it as sexual arousal

Gender Dysphoria: diagnosis, controversy, contributors, treatments

Gender-related feelings at odds with assigned gender Discomfort Wish to eliminate sex characteristics WIsh to be a member of another gender Distress 6mo or more Contributors: Prenatal hormones and brain development Genetics Bed of nucleus of the stria terminalis Treatments: Body alteration programs Cosmetic surgery Hormonal treatments Gender affirming surgery -Require 6-12 months psychotherapy -Real life test

Genito-Pelvic Pain/Penetration Disorder

Genito-pelvic pain/penetration disorder involves pain, or the fearful anticipation of pain, during intercourse or vaginal penetration. The DSM-5 disorder replaces two sexual pain disorders in the DSM-IV—dyspareunia (painful intercourse) and vaginismus. The pain may occur during intercourse or persist afterward and is not caused by lack of lubrication, a general medical condition, the effects of a substance, or another mental disorder. Involuntary contraction of the perineal muscles surrounding the outer vagina, in response to attempts to penetrate the vagina, is sometimes involved. It may be triggered by actual or anticipated penetration by a penis, finger, speculum, or tampon. In sexual interactions, the contracted muscles prevent intercourse and may sometimes prevent normal gynecological examination as well.

Causes of Sexual Dysfunction: Biology

Hormone levels Testosterone Prolactin Estrogen Neurotransmitters Serotonin and Dopamine Drugs Vascular problems Chronic illness

Delayed Ejaculation

Like its female counterpart, __________ __________ involves an inability to reach orgasm or a delay in reaching orgasm that follows a normal phase of sexual excitement. The absence or delay of ejaculation is recurrent and persistent (lasting at least 6 months) and results in marked distress.

Premature Ejaculation

Males diagnosed with premature ejaculation show almost the opposite symptoms from delayed ejaculation. Instead, orgasm and ejaculation occur with minimal sexual stimulation, within approximately a minute of vaginal penetration or before the person wishes it in the case of nonvaginal sexual activities. Ejaculation may occur before penetration is achieved or shortly thereafter. The pattern must be recurrent and persistent and associated with significant distress.

Causes of Sexual Dysfunction: Psychological

Performance anxiety: fear of failure 1. anxiety and sexual arousal are incombatible states 2 Cogitive interference Thoughts that distract from sexual experience -Spectatoring - judging own performance 3. Psychological disorders 4. Prior learning -past experiences -upbringing

refractory period

Period following orgasm in males during which further sexual arousal and orgasm are not possible

Sexual masochism Disorder, Sexual Sadism Disorder

Preference for obtaining sexual gratification by experiencing pain inflicted on oneself / The person with sexual masochism disorder obtains intense sexual arousal through fantasies, urges, or behaviors involving the act of being bound, beaten, humiliated, or otherwise forced to suffer. Preference for obtaining sexual gratification by inflicting pain on one's partner / Sexual sadism disorder involves intense sexual arousal and fantasies, persisting for 6 months, about causing physical or psychological suffering to others.

Sexual Disorders

Problem in sexual response cycle Difficulty responding sexually or experiencing sexual pleasure Requirements for all diagnoses -Persistent and recurrent (6mo or more) -Distress or interpersonal difficulty -Not better accounted for by other condition

Varieties of gender: Cisgender, Transgender, etc. Gender Identity: Cisgender Transgender Gender fluid, non binary, genderqueer, etc.

Sense of ourself as either male or female

The Paraphillias:

Sexual attraction to unusual objects or activities -Endures for at least 6 months -Causes significant distress or impariment/victimization Prevalence unknown Controversial diagnosis

Fetishistic Disorder Transvestic Disorder, Exhibitionistic Disorder,

Sexual fantasies, urges, or behaviors involving use of nonliving objects or nongenital body parts Dressing in clothes of opposite sex to for sexual gratification Clothes not arousing, dressing up is Exposure of genitals to unsuspecting others

Therapies for Sexual Disorders: Behavior therapy:

Systematic desensitization Masters and Johnson: Eliminate goal-oriented performance and cognitive interference -sensate focus exercises -education

Sex vs. Gender; Gender Identity Sexual funtioning Sex Gender Gender Identity Sexual orientation

What happens in the body during sexual activity Intercourse Biological category Psychologica/cultural Individuals' perception of themselves as male or female Direction of sexual attraction

Female Orgasmic Disorder

Women with female orgasmic disorder may experience normal sexual desire and excitement phases, but they also experience a recurrent absence or delay of orgasm, either in specific sexual circumstances (situational type) or in all sexual activities (generalized type), persisting at least 6 months and causing significant distress. The diagnostic process requires careful consideration of factors such as age, sexual history, and whether the sexual stimulation received is adequate in focus, duration, and intensity for orgasm. The female capacity for orgasm tends to increase with sexual knowledge and experience; once acquired, the ability is rarely lost. Therefore, most cases of female orgasmic disorder may be lifelong rather than acquired (American Psychiatric Association, 2000).

Although chromosomal sex is determined at the time of conception, gender identity develops in early childhood by the age of 3, suggesting that causal factors for gender dysphoria point to all EXCEPT which of the following? a Environmental influences b Prenatal hormone influence c Prenatal or postnatal development d Hereditable component _____ appears to be among the only effective treatments for chronic gender dysphoria in adults? a Masturbatory training b Systematic desensitization c Sex reassignment surgery d Antidepressant medication

a - Environmental influences c - Sex reassignment surgery

Pedophiles use all EXCEPT which of the following to excuse their behavior? a The child provoked the sexual activity. b The sexual activity was consensual between the child and the perpetrator c The sexual activity was educational for the child. d The sexual activity was pleasurable for the child.

b - The sexual activity was consensual between the child and the perpetrator

The biggest advance in _____ treatments has been the development of oral medications that relax a valve in the penis to allow increased blood flow. _____ can occur in specific sexual circumstances, called situational type, or in all sexual activities, which is called generalized type. _____ is the least common male sexual complaint that occurs during the plateau phase. ____ are more commonly diagnosed with paraphilias than ____.

biological Female orgasmic disorder Delayed ejaculation Men; women

All EXCEPT which of the following are criteria for male hypoactive sexual desire disorder? a Symptoms have persisted for more than 6 months. b Symptoms cause significant distress. c An inability to achieve orgasm d Deficiency in, or absence of, sexual desire and erotic thoughts or fantasies

c - An inability to achieve orgasm

Roger, a 25-year-old man, occasionally wears dresses and skirts when he performs on stage for fun. Based on this information, Roger:

c - neither of the above.

Other Sexual Variations: Asphyxiophilia -

depriving self of oxygen

Male Hypoactive Sexual Desire Disorder

describes a condition of recurrent deficiency in (or absence of) sexual desire and erotic thoughts or fantasies, persisting at least 6 months and causing significant distress.

Which of the following is the CORRECT order of the human sexual response cycle as discussed by Masters and Johnson? Changes in the pelvic region, a general physical arousal, and increases in heart rate, muscle tension, blood pressure, and rate of breathing occur during which phase of the sexual response cycle?

excitement, plateau, orgasm, resolution excitement

Paraphilias:

related factors: dysfunctional family while growing up poor social skills distorted views of intimacy Try to suppress, but unable to Prime characteristic: replaces complex human sexual contact with undemanding sexuality of an inanimate object, scene, or single action Motivations: provides meaning and sense of self relieves depression and loneliness allows expression of rage

Therapies for Sexual Disorders: Couples therapy (Rosen, Leiblum & Spector, 1994)

sexual performance and anxiety reduction -sensate focus exercises education & cognitive intervention script assignment / modification -changing old patterns conflict resolution / relationship enhancement relapse prevention training

Sex therapy often includes teaching or encouraging clients to masturbate. This technique can be especially helpful for: The stop-start technique is used primarily to help:

women who do not have orgasms. men who have premature (early) ejaculations to learn to control their ejaculations.