Psych Quiz Chapter 6 and 10

assessing sexual behavior

1. Interviews, usually supported by numerous questionnaires because patients may provide more information on paper than in a verbal interview 2. A thorough medical evaluation, to rule out the variety of medical conditions that can contribute to sexual problems 3. A psychophysiological assessment, to directly measure the physiological aspects of sexual arousal

treatment for somatization disorder

40% of patients treated with CBT (versus 7% of a group receiving standard medical care) evidenced clinical improvement and these gains lasted at least a year in treatment, to limit these visits, a gatekeeper physician is assigned each patient to screen all physical complaints-Subsequent visits to specialists must be specifically authorized by this gatekeeper interacting with others are encouraged, along with additional procedures to promote healthy social and personal adjustment without relying on being "sick." Antidepressant drugs have shown some promise but are not the first choice for treatment because somatic or physical side effects such as nausea, agitation, or headaches are often frightening to these patients, making the drugs difficult to tolerate

paraphilia in women

5% to 10% of all sexual offenders are women

viagra

50% and 80% of a large number of men benefit from this treatment 30% of men may suffer severe headaches as a side effect, particularly at higher doses If men are particularly anxious about sex, results are not as good with the drug useful for dysfunction in postmenopausal women, but results were disappointing

gender nonconformity

A phenomenon in which pre-pubescent children do not identify with their biological sex, but instead identify strongly with the gender of the opposite sex and display varying degrees of behavior more characteristic of the opposite sex.

dissociative trance disorder (DTD)

Altered state of consciousness in which people firmly believe they are possessed by spirits; considered a disorder only where there is distress and dysfunction. Trance and possession are a common part of some traditional religious and cultural practices and are not considered abnormal in that context

hypoactive sexual desire disorder

Apparent lack of interest in sexual activity or fantasy that would not be expected considering the person's age and life situation. common presenting complaint of women; men present more often with erectile dysfunction 22% of women and 5% of men suffer from hypoactive sexual disorder individuals experience little sexual arousal, leading to a new label of "sexual interest/arousal disorder"

covert sensitization

Cognitive-behavioral intervention to reduce unwanted behaviors by having clients imagine the extremely aversive consequences of the behaviors and establish negative rather than positive associations with them. patients associate sexually arousing images in their imagination with some reasons why the behavior is harmful or dangerous During six or eight sessions, the therapist narrates such scenes dramatically, and the patient is then instructed to imagine them daily until all arousal disappears

retrograde ejaculation

Condition in which ejaculatory fluids travel backward into the bladder, usually as a result of certain drugs or a medical condition. This is not considered a DSM-IV-TR male orgasmic disorder.

malingering

Deliberate faking of a physical or psychological disorder motivated by gain.

incest

Deviant sexual attraction (pedophilia) directed toward a family member; often the attraction of a father toward a daughter who is maturing physically. victims of incest tend to be girls beginning to mature physically incestuous males are, in general, more aroused by adult women than are males with pedophilia, who tend to focus exclusively on children. incestuous relations may have more to do with availability and interpersonal issues ongoing in the family

dissociative disorder

Disorder in which individuals feel detached from themselves or their surroundings and reality, experience, and identity may disintegrate.

dissociative fugue

Dissociative disorder featuring sudden, unexpected travel away from home, along with an inability to recall the past, sometimes with assumption of a new identity. seldom appear before adolescence and usually occur in adulthood Fugue states usually end rather abruptly, and the individual returns home, recalling most, if not all, of what happened

dissociative amnesia

Dissociative disorder featuring the inability to recall personal information, usually of a stressful or traumatic nature. common during war therapeutic resolution of the distressing situations and increasing the strength of personal coping mechanisms recalling what happened during the amnesic or fugue states, often with the help of friends or family who know what happened, so that patients can confront the information and integrate it into their conscious experience

depersonalization disorder

Dissociative disorder in which feelings of depersonalization are so severe they dominate the client's life and prevent normal functioning. 0.8% of the population Mean age of onset was 16 years, chronic. substantially impaired. Anxiety, mood, and personality disorders also easily distracted and were slow to perceive and process new information deficits in perception and emotion regulation dysregulation in the hypothalamic- pituitary-adrenocortical (HPA) axis

sexual aversion disorder

Extreme and persistent dislike of sexual contact or similar activities. problem might be panic disorder treating the panic disorder may be a necessary first step

diagnosing/identifying hypochondriasis

First, a physician must rule out a physical cause for the somatic complaints before referring the patient to a mental health professional. Second, the mental health professional must determine the nature of the somatic complaints to know whether they are associated with a specific somatoform disorder or are part of some other psychopathological syndrome, such as a panic attack. Third, the clinician must be acutely aware of the specific culture or subculture of the patient, which often requires consultation with experts in cross-cultural presentations of psychopathology.

dissociative identity disorder (DID)

Formerly known as multiple personality disorder; a disorder in which as many as 100 personalities or fragments of personalities coexist within one body and mind. average number is closer to 15 the patient and asks for treatment is usually a "host" identity Usually, the switch is instantaneous

koro

In Singapore, a condition of mass hysteria or group delusion in which people believe their genitals are retracting into their bodies.

inhibited orgasm

Inability to achieve orgasm despite adequate sexual desire and arousal; commonly seen in women but relatively rare in men.

erotophobia

Learned negative reaction to or attitude about sexual activity, perhaps developed as a result of a negative or even traumatic event, such as rape.

orgasmic reconditioning

Learning procedure to help clients strengthen appropriate patterns of sexual arousal by pairing appropriate stimuli with the pleasurable sensations of masturbation. patients should be able to begin the desired fantasy earlier in the masturbatory process and still retain their arousalprovide the patient with coping skills to prevent slips or relapses.

fetishism

Long-term, recurring, intense sexually arousing urges, fantasies, or behavior involving the use of nonliving, unusual objects, which cause distress or impairment in life functioning. (1) an inanimate object or (2) a source of specific tactile stimulation, such as rubber, particularly clothing made out of rubber A third source of attraction (sometimes called partialism) is a part of the body, such as the foot, buttocks, or hair, but this attraction is no longer technically classified as a fetish because distinguishing it from more normal patterns of arousal is often difficult.Freud theorized that this is a displacement of sexual desire to safe objet

generalized amnesia

Loss of memory of all personal information, including identity.

pedophilia lecture

Many pedophiles were themselves sexually abused as children. These people attempt to restore their own feelings of control by reenacting their own victimization Some persons with pedophilia are attracted only to children; other are attracted to adults as well develop their disorder during adolescence alcoholism contributes mostly men, average age 40 Usually no physical coercion takes place, but this is by no means a hard and fixed rule. legal burden and responsibility is always on an adult offender. immaturity, or some kind of arrested psychological development, is often the primary cause unable to establish adult heterosexual relationships and turn to children as substitutes Stimuli satiation used with all kinds of sexual deviants. In this procedure, the client masturbates to orgasm while fantasizing aloud into a tape recorder about a sexually appropriate object or pictures. Two minutes after ejaculation, he switches to fantasizing in detail about inappropriate objects while masturbating and continues to elaborate on the pedophiliac fantasy for another 45 minutes. However, if he becomes aroused again during this time, he switches his attention back to the normal stimuli and ejaculates again while focused on normal sex. Therefore, he focuses on deviant stimuli only while he is not aroused and is not feeling any physical pleasure during masturbation of his nonerect penis. Orgasmic Reconditioning. In this treatment, the client arouses himself with inappropriate stimuli. Then, just before orgasm, he begins fantasizing about appropriate stimuli and comes to orgasm thinking about socially acceptable sexual objects. relapse-prevention training. This approach helps clients to identify the problematic situations that typically trigger their pedophilic fantasies and actions (such as depressed mood or disorted thinking), and to develop strategies to avoid or cope more effectively with these situations. Aversive Conditioning is used to treat offenders. In this treatment, the client arouses themselves with inappropriate stimuli during which time suddenly a highly noxious and unpleasant odor is introduced into the client's sensory space. The drugs the offenders are given serve to lower their testosterone levels.

localized or selective amnesia

Memory loss limited to specific times and events, particularly traumatic events.

factitious disorder

Nonexistent physical or psychological disorder deliberately faked for no apparent gain except possibly sympathy and attention.

amok

One of several running disorders seen in non-Western cultures—as in "running amok"—in which individuals enter a trancelike state and may commit violent acts. Later, they will have amnesia about the episode.

transvestic fetishism

Paraphilia in which individuals, usually males, are sexually aroused or receive gratification by wearing clothing of the opposite sex. not unusual for males who are strongly inclined to dress in female clothes to compensate by associating with so-called macho organizations wives of many men who cross-dress have accepted their husbands' behavior and can be quite supportive if it is a private matter between them transvestic fetishism is indistinguishable from other fetishes in most respects

sexual masochism

Paraphilia in which sexual arousal is associated with experiencing pain or humiliation.

sexual sadism

Paraphilia in which sexual arousal is associated with inflicting pain or humiliation.

voyeurism

Paraphilia in which sexual arousal is derived from observing unsuspecting individuals undressing or naked.

frotteurism

Paraphilia in which the person gains sexual gratification by rubbing against unwilling victims in crowds from which they cannot escape.

pedophilia

Paraphilia involving strong sexual attraction toward children. may be attracted to male children, female children, or both 12% of men and 17% of women reported being touched inappropriately by adults when they were children Approximately 90% of abusers are male, and 10% are female brutal antisocial and aggressive opportunistic acts being charged with a child pornography offense is one of the best diagnostic indications of pedophilia most child molesters are not physically abusive. Rarely is a child physically forced or injured. From the molester's perspective, no harm is done because there is no physical force or threats. Child molesters often rationalize their behavior as "loving" the child or teaching the child useful lessons about sexuality. The child molester almost never considers the psychological damage the victim suffers, yet these interactions often destroy the child's trust and ability to share intimacy.

somatoform disorders

Pathological concern of individuals with the appearance or functioning of their bodies, usually in the absence of any identifiable medical condition.

conversion disorder

Physical malfunctioning, such as blindness or paralysis, suggesting neurological impairment but with no organic pathology to account for it. anxiety resulting from unconscious conflicts somehow was "converted" into physical symptoms to find expression physical malfunctioning, such as paralysis, blindness, or difficulty speaking (aphonia), without any physical or organic pathology marked stress preceding a conversion symptom occurred in 52% to 93% of the studied patients ruling out medical causes for the symptoms is crucial to making a diagnosis of conversion primarily in women typically develop during adolescence or slightly thereafter often in males at times of extreme stress

statistics for hypochondriasis

Prevalence of hypochondriasis in the general population is estimated to be from 1% to 5% Although historically considered one of the "hysterical" disorders unique to women, the sex ratio is actually closer to 50:50 thought for a long time that hypochondriasis was more prevalent in elderly populations, but this does not seem to be true Hypochondriasis may emerge at any time of life, with the peak age periods found in adolescence, middle age (40s and 50s), and after age 60

gender identity disorder

Psychological dissatisfaction with biological gender, a disturbance in the sense of identity as a male or female. The primary goal is not sexual arousal but rather to live the life of the opposite gender. primary goal is not sexual gratification but rather the desire to live life openly in a manner consistent with that of the other gender no demonstrated physical abnormalities social tolerance for them is relatively low in Western cultures estimated that genetics contributed about 62% to creating a vulnerability to experience gender identity disorder in their twin sample slightly higher levels of testosterone or estrogen at certain critical periods of development might masculinize a female fetus or feminize a male fetus gender identity firms up between 18 months and 3 years of age individuals must live in the opposite-sex role for 1 to 2 years so that they can be sure they want to change sex-must be stable psychologically, financially, and socially.

female sexual arousal disorder

Recurrent inability in some women to attain or maintain adequate lubrication and sexual excitement swelling responses until completion of sexual activity. frequent sexual urges and fantasies and a strong desire to have sex Women who are unable to achieve vaginal lubrication, however, may be able to compensate by using a commercial lubricant prevalence of 14% of females experiencing an arousal disorder

male orgasmic disorder

Recurring delay in or absence of orgasm in some men following a normal sexual excitement phase, relative to age and current stimulation. Also known as inhibited orgasm (male). approximately 8% of men report having delayed orgasms or none during sexual interactions possible that in many cases some men reach climax through alternative forms of stimulation

female orgasmic disorder

Recurring delay or absence of orgasm in some women following a normal sexual excitement phase, relative to their prior experience and current stimulation. Also known as inhibited orgasm (female). 25% of women report significant difficulty reaching orgasm unmarried women were 1.5 times more likely than married women to experience orgasm disorder it is necessary to determine that the women "never or almost never" reach orgasm

premature ejaculation

Recurring ejaculation before the person wishes it, with minimal sexual stimulation. 21% of all men met criteria for premature ejaculation, making it the most common male sexual dysfunction

sexual pain disorders (dyspareunia)

Recurring genital pain in either males or females before, during, or after sexual intercourse. diagnosed only if no medical reasons for pain can be found Dyspareunia is rarely seen in clinics, with estimates of those affected ranging from 1% to 5% of men, 10% to 15% of women

male erectile disorder

Recurring inability in some men to attain or maintain adequate penile erection until completion of sexual activity. frequent sexual urges and fantasies and a strong desire to have sex man typically feels more impaired by his problem than a woman does by hers Inability to achieve and maintain an erection makes intercourse difficult or impossible full erections are possible during masturbation and partial erections occur during attempted intercourse, but with insufficient rigidity to allow penetration

vaginismus

Recurring involuntary muscle spasms in the outer third of the vagina that interfere with sexual intercourse. 6% of women

heterosexual behavior

Sexual activity with members of the opposite gender.

homosexual behavior

Sexual activity with members of the same gender.

sexual dysfunction

Sexual disorder in which the client finds it difficult to function adequately while having sex. three stages of the sexual response cycle—desire, arousal, and orgasm—are each associated with specific sexual dysfunctions Lifelong refers to a chronic condition that is present during a person's entire sexual life; acquired refers to a disorder that begins after sexual activity has been relatively normal. In addition, disorders can either be generalized, occurring every time the individual attempts sex, or they can be situational, occurring with some partners or at certain times but not with other partners or at other times. Finally, sexual dysfunctions are further specified as (1) due to psychological factors or (2) due to psychological factors combined with a general medical condition. The latter specification occurs when there is a demonstrable vascular, hormonal, or associated physical condition known to contribute to the sexual dysfunction.

paraphilias

Sexual disorders and deviations in which sexual arousal occurs almost exclusively in the context of inappropriate objects or individuals. not uncommon for individuals with paraphilia to also suffer from comorbid mood, anxiety, and substance abuse disorders It is not unusual for individuals with paraphilia to rationalize their behavior by engaging in some other practices that they consider to be morally correct or uplifting at the same time.

exhibitionism

Sexual gratification attained by exposing genitals to unsuspecting strangers. Exhibitionism is often associated with lower levels of education, but not always. the behavior must occur repeatedly and be compulsive or out of control. thrilling element of risk is an important part

alters

Shorthand term for alter egos, the different personalities or identities in dissociative identity disorder.

derealization

Situation in which the individual loses a sense of the reality of the external world.

undifferentiated somatoform disorder

So-matization disorder with fewer than eight symptoms but still causing distress and impaired functioning. People with only a few medically unexplained physical symptoms may experience sufficient distress and impairment of functioning

body dysmorphic disorder (BDD)

Somatoform disorder featuring a disruptive preoccupation with some imagined defect in appearance ("imagined ugliness"). average number of body areas of concern to these individuals was five to seven Many people with this disorder become fixated on mirrors- check if anything has changed suicidal ideation, suicide attempts, and suicide itself are typical consequences individuals with BDD whose beliefs are so firmly held that they could be called delusional should receive a second diagnosis of delusional disorder, somatic type-dsm drops this because bdd treatment works the same either way lifelong course 70% of college students report at least some dissatisfaction with their bodies, with 4% to 28% of these appearing to meet all the criteria for the disorder about 1% to 2% of individuals in community samples and from 2% to 13% of student samples equally in men and women onset ranges from early adolescence through the 20s, peaking at the age of 16-17 marriage is more rare Social and cultural determinants of beauty and body image largely define what is "deformed."

pain disorder

Somatoform disorder featuring true pain but for which psychological factors play an important role in onset, severity, or maintenance. clear physical reasons for pain, at least initially, but psychological factors play a major role in maintaining it difficult to separate the cases in which the causes were judged to be primarily psychological from the ones in which the causes are primarily physical Several studies suggest that this is a fairly common condition, with 5% to 12% of the population meeting criteria for pain disorder whatever its cause, pain has a strong psychological component If medical treatments for existing physical conditions are in place and pain remains, or if the pain seems clearly related to psychological factors, psychological interventions are appropriate

somatization disorder

Somatoform disorder involving extreme and long-lasting focus on multiple physical symptoms for which no medical cause is evident. 1859, Pierre Briquet, a French physician, described patients who came to see him with seemingly endless lists of somatic complaints for which he could find no medical basis concerned with the symptoms themselves, not with what they might mean

hypochondriasis

Somatoform disorder involving severe anxiety over belief in having a disease process without any evident physical cause. hypochondriasis shares many features with the anxiety and mood disorders, particularly panic disorder Almost any physical sensation may become the basis for concern for individuals with hypochondriasis reassurances from numerous doctors that all is well and the individual is healthy have, at best, only a short-term effect focus on a long-term process of illness and disease "better safe than sorry" approach to dealing with even minor physical symptoms by getting them checked out as soon as possible concept of health as being symptom free

sex reassignment surgery

Surgical procedures to alter a person's physical anatomy to conform to that person's psychological gender identity.

causes of paraphilia

Undesired kinds of arousal may be associated with deficiencies in levels of "desired" arousal with consensual adults inability to develop adequate social relations with the appropriate people for sexual relationships seems to be associated with a developing of inappropriate sexual outlets Many pedophiles also report being abused themselves as children, which turns out to be a strong predictor of later sexual abuse by the victim Before a pedophile or sadist ever acts on his behavior, he may fantasize about it thousands of times while masturbating. activity this consuming may be related to the obsessional processes of obsessive-compulsive disorder weak inhibitory control across these paraphilic disorders, which may indicate a weak biologically based behavioral inhibition system (BIS) in the brain

statistics for somatization disorder

adolescence is the typical age of onset tend to be women, unmarried, and from lower socioeconomic groups Suicidal attempts that appear to be manipulative gestures rather than true death efforts are frequent overuse and misuse the health-care system, with medical bills as much as 9 times more than the average patient chronic, often continuing into old age fairly common, and fairly uniform, throughout the world sex ratio is approximately 2:1 female to male

causes of DID

being horribly, often unspeakably, abused as a child. natural tendency to escape or "dissociate" from the unremitting negative affect associated with severe abuse attributed to a chaotic, nonsupportive family environment consistent with our diathesis-stress model in that only with the appropriate vulnerabilities (the diathesis) will someone react to stress with pathological dissociation "developmental window" of vulnerability to the abuse that leads to DID closes at approximately 9 years of age autohypnotic model, people who are suggestible may be able to use dissociation as a defense against extreme trauma

transsexualism

believe they belong to the opposite sex gender is a mistake, genitals look ugly to them cross dress to feel relaxed many are homosexual because they identify as a woman

treatment of conversion disorder

conversion disorder has much in common with somatization disorder, many of the treatment principles are similar reduce any reinforcing or supportive consequences of the conversion symptoms-therapist must collaborate with both the patient and the family to eliminate such self-defeating behaviors

treatment of sexual dysfunction

education is the best treatment-Ignorance of the most basic aspects of the sexual response cycle and intercourse often leads to long-lasting dysfunctions Human Sexual Inadequacy-male and a female therapist to facilitate communication between the dysfunctional partners, two week period, providing basic education about sexual functioning, altering deep-seated myths, and increasing communication, eliminate psychologically based performance anxiety sensate focus and nondemand pleasuring Lifelong female orgasmic disorder may be treated with explicit training in masturbatory procedures squeeze technique, in which the penis is stimulated, usually by the partner, to nearly full erection. At this point, the partner firmly squeezes the penis near the top where the head of the penis joins the shaft, which quickly reduces arousal. These steps are repeated until (for heterosexual partners) eventually the penis is briefly inserted in the vagina without thrusting. If arousal occurs too quickly, the penis is withdrawn and the squeeze technique is employed again. In this way, the man develops a sense of control over arousal and ejaculation increasingly larger dilators at the woman's pace

treating paraphilia

even the individual presenting with the problem is not fully aware of what caused arousal assess each patient not only for the presence of deviant arousal but also for levels of appropriate arousal to adults, for social skills, and for the ability to form relationships Most individuals with paraphilic arousal patterns need a great deal of attention to family functioning or other interpersonal systems in which they operate antiandrogen called cyproterone acetate-"chemical castration" drug eliminates sexual desire and fantasy by reducing testosterone levels dramatically, but fantasies and arousal return as soon as the drug is removed medroxyprogesterone -Medication that helps stimulate respiration and is used in treatment of obstructive sleep apnea.

gender differences

higher percentage of men than women report that they masturbate incidence of casual sex, attitudes toward casual premarital sex, and pornography use, with men expressing more permissive attitudes and behaviors than women no gender differences are currently apparent in attitudes about homosexuality (generally acceptable), the experience of sexual satisfaction (important for both), or attitudes toward masturbation (generally accepting) moderate gender differences were evident in attitudes toward premarital intercourse when the couple was engaged or in a committed relationship (with men more approving than women) and in attitudes toward extramarital sex (1) men show more sexual desire and arousal than women; (2) women emphasize committed relationships as a context for sex more than men; (3) men's sexual self-concept, unlike women's, is characterized partly by power, independence, and aggression; and (4) women's sexual beliefs are more "plastic" in that they are more easily shaped by cultural, social, and situational factors.

causes of somatization disorder

history of family illness or injury during childhood runs in families and may have a heritable basis seem to reflect the impulsive characteristic of short-term gain at the expense of long-term problems gender socialization accounts almost entirely for the profound differences in the expression of the same biological vulnerability among men and women

causes of hypochondriasis

hypochondriasis is basically a disorder of cognition or perception with strong emotional contributions similar to those implicated in the anxiety disorders hypochondriasis runs in families and that there is a modest genetic contribution Hyperresponsivity might combine with a tendency to view negative life events as unpredictable and uncontrollable and, therefore, to be guarded against at all times learned from family members to focus their anxiety on specific physical conditions and illness develop in the context of a stressful life event disproportionate incidence of disease in their family when they were children-strong memories of illness that could easily become the focus of anxiety learned that an ill person often gets a lot of attention-"sick person" who receives increased attention for being ill and is able to avoid work or other responsibilities is described as adopting a "sick role."

connection between somatoform and dissociative disorders

hysterical came to refer more generally to physical symptoms without known organic cause or to dramatic or "histrionic" behavior thought to be characteristic of women. one general heading, "hysterical neurosis"

retarded ejaculation

in which ejaculation is delayed; thus, the patient is unable to reach orgasm with his partner, although he is able to ejaculate during masturbation.

causes of conversion disorder

individual experiences a traumatic event— in Freud's view, an unacceptable, unconscious conflict because the conflict and the resulting anxiety are unacceptable, the person represses the conflict, making it unconscious. anxiety continues to increase and threatens to emerge into consciousness, and the person "converts" it into physical symptoms (primary gain)- freud disproved because patients do show distress individual receives greatly increased attention and sympathy from loved ones and may also be allowed to avoid a difficult situation or task (secondary gain) less educated, lower socioeconomic groups where knowledge about disease and medical illness is not well developed strong connectivity between the conversion symptom and parts of the brain regulating emotion, such as the amygdala

sadistic rape

many rapists meet criteria for antisocial personality disorder and may engage in a variety of antisocial and aggressive acts marked lack of empathy and disregard for inflicting pain on others certain rapists do fit definitions of paraphilia closely and could probably better be described as sadists

development of sexual orientation

more common among identical twins than among fraternal twins or natural siblings

causes and treatments of bdd

no information on whether it runs in families underlying unconscious conflict would be too anxiety provoking to admit into consciousness, so the person displaces it onto a body part BDD does not tend to co-occur with the other somatoform disorders co-occur with BDD and is found among other family members is obsessive-compulsive disorder (OCD) drugs that block the reuptake of serotonin, such as clomipramine (Anafranil) and fluvoxamine (Luvox), provide relief to at least some people exposure and response prevention, the type of cognitive-behavioral therapy effective with OCD, has also been successful with BDD patients do not benefit from surgery and may return for additional surgery or, on occasion, file malpractice lawsuits-distress either did not change or increased after surgery

medical treatment for sexual dysfunction

oral medication, injection of vasoactive substances directly into the penis, surgery, and vacuum device therapy Some urologists teach patients to inject vasodilating drugs such as papaverine or prostaglandin directly into the penis when they want to have sexual intercourse. These drugs dilate the blood vessels, allowing blood to flow to the penis and thereby producing an erection within 15 minutes that can last from 1 to 4 hours testosterone has little effect soft capsule that contains papaverine can be inserted directly into the urethra, but this is somewhat painful, is less effective than injections, and remains awkward and artificial enough to preclude wide acceptance topical application of papaverine externally to women's genitalia produced vasocongestion and arousal in postmenopausal woman Insertion of penile prostheses or implants has been a surgical option for almost 100 years; only recently are they good enough to approximate normal sexual functioning-useful for men who must have a cancerous prostate removed, because this surgery often causes erectile dysfunction, although newer "nerve-sparing" surgeries lessen the effect to some extent vacuum device therapy , which works by creating a vacuum in a cylinder placed over the penis

treatment of DID

patient must confront and relive the early trauma and gain control over the horrible events Hypnosis is often used to access unconscious memories and bring various alters into awareness

faking DID

patients with DID acted more like simulators concerning other identities, about which they profess no memory (interidentity amnesia), suggesting the possibility of faking memories are different from one alter to the next. symptoms of DID could mostly be accounted for by therapists who inadvertently suggested the existence of alters to suggestible individuals DID patients had 4.5 times the average number of changes in optical functioning in their alter identities than control patients who simulated alter personalities

transvestism lecture

put on and wear their fetishes usually male cross dressing begins in childhood, mostly in private some like to go out to be admired they know they are men- don't to be women self centered, hostile personality limited ability for intimacy

DID statistics

ratio of females to males is as high as 9:1 average alters=15 onset is almost always in childhood, often as young as 4 years of age, although it is usually approximately 7 years after the appearance of symptoms before the disorder is identified prevalence of 1.5%

treatment of hypochondriasis

reassurance and education seems to be effective in some cases Mental health professionals may well be able to offer reassurance in a more effective and sensitive manner, devote sufficient time to all concerns the patient may have, and attend to the "meaning" of the symptoms taking the time to explain in some detail the nature of the patient's disorder in an educational framework was associated with a significant reduction in hypochondriacal fears and beliefs and a decrease in health-care usage CBT focused on identifying and challenging illness-related misinterpretations of physical sensations and on showing patients how to create "symptoms" by focusing attention on certain body areas (antidepressants) are useful for anxiety and depression

antisocial personality disorder (ASPD)

vandalism, persistent lying, theft, irresponsibility with finances and at work, and outright physical aggression little anxiety or guilt ASPD occurs primarily in males and somatization disorder in females

causes of sexual dysfunction

wide assortment of sexual problems Neurological diseases and other conditions that affect the nervous system may directly interfere with sexual functioning by reducing sensitivity in the genital area, and they are a common cause of erectile dysfunction in males Vascular disease is a major cause of sexual dysfunction Chronic illness can also indirectly affect sexual functioning. cause of sexual dysfunction is prescription medication- SSRIs, drugs for high blood pressure, cocaine, alcohol anxiety does not necessarily decrease sexual arousal and performance One component is arousal, another is cognitive processes, and the third is negative affect When confronted with the possibility of having sexual relations, individuals who are dysfunctional tend to expect the worst and find the situation to be relatively negative and unpleasant decreased arousal during performance demand, experience negative affect, are not distracted by nonsexual stimuli, and do not have an accurate sense of how aroused they are substantial impact of early traumatic sexual events on later sexual functioning, particularly in women marked deterioration in close interpersonal relationships Poor sexual skills might also lead to frequent sexual failure and, ultimately, lack of desire.

prevalence of DID lecture

• First reports late-1950s • 1970-only about 100 people were diagnosed • mid1970s-200 • 1980-300 • 1980s- DID in DSM III • thousands of cases now • 1% of pop has DID • believe more about authenticity of diagnosis now, why people are coming forward to get help • not culture bound

explanations of DID lecture

• Psychodynamic: DID as an example of repression in the extreme- defense mechanism, use when they have experienced something traumatic or stressful- repress it to help cope o DID represents this repression in extreme form o result of excessive childhood abuse or traumatic childhood experience • Self-hypnosis- abuse of self hypnosis since around age 4-5

treatment of DID lecture

• Recognizing the disorder is the most important first step • Plain psychotherapy is the first treatment- psychodynamic, sometimes cognitive • Hypnotherapy- most important part of treatment is recovering the memories- they have repressed awful memories • Drugs- sodium amorbital • Integration into one personality or cooperation within the personalities is the goal

sub personalities lectures

• Relate to each other in various ways- some say its like brothers and sisters • 3 forms of relationships • Mutually amnesia- no awareness of other subpersonalities • Mutually cognizant- all aware of each other, may hear each other talk, some are on good terms, some are not on good terms • One-way amnesiac- (most common form)- some personalities are aware of others and some are not aware • The personalities that are aware are co-conscious subpersonalities o Observing quietly a personality that is out at the time o Sometimes communicate with current personality with auditory hallucinations o Write down automatic messages from other personalities o Christine Beauchamp- one of the earliest known cases of DID- three distinct subpersonalities: the saint (religious and even tempered), the woman (mean tempered, not religious), and the devil (mischievous)- saint was the primary personality and did not know about the other personalities- • Devil knew about the woman and saint in different ways- knew thoughts and actions of the saint, but only knew the actions of the woman • Number of personalities is higher- women=15, men=8 (average) • Some people report more than 100 subpersonalities • Subpersonalities will emerge in groups of 2-3 at a time • Become aware of subpersonalities through therapy- come in for something different and discover subpersonalities • Primary personality is usually drab and life is shoved into other personalities • Eve had three personalities- Eve White- primary personality, drab, colorless, Eve Black- carefree, uninhibited, mischievous, Jane- mature, intelligent, serious o Eventually merged into one personality- Evelyn o 20 years later- Chris Sizemore identified herself as the real Eve- had 22 personalities, 9 emerged after hearing about the 3, now has one personality • have their own name, race, age, etc.- each personality looks different • different abilities- play an instrument, drive, speak a different language- don't share these abilities • some personalities display different physiological aspects- different blood pressures, menstrual cycles • Putnam measured evoked potentials- had DID patients present 4 personalities and evoked potentials on each of them- the evoked potentials for each personality for each person were very different o Had normal people create 4 personalities for themselves- when he evoked potentials on the control group and they were not as different

validity of DID lecture

• Some people wonder if DID is iatrogenic- brought on by the therapist- therapist evokes or encourages the patients to show these subpersonalities • Some cases when the person isn't really suffering from DID- could be acting because they are getting something out of it- therapist is more interested in them because they do this • The vast majority with this diagnosis actually have it

DID lecture

• Two or more distinct personalities- alters or subpersonalities • Unique set of behaviors, thoughts, emotions for each personalities • Each subpersonality acts as the conscious • One personality often acts as the host- most often expressed and has the conscious- this personality can change • Transition from personalities can be abrupt or violent but can also be controlled • Sometimes associated with a tragic event • First reported 4 centuries ago • Not as rare as we once thought • About 5% have DID in psych wards • 1% in the community (comparable to schizo) • first diagnosed in early adulthood, symptoms usually begin much earlier (before 5) and are associated with episodes of childhood abuse • women more often than men (3-9 times) due to more abuse • personalities will come out to deal with a certain issue