Behavior- Sexual Pathology

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Greeks/Romans

Back 1

liberal sexuality reflective of their upper class value structure

Front 2

Victorian

Back 2

conservative sexually
reflective of middle-class backlash to previous promiscuous age

Front 3

quality of sex life

Back 3

important to consider when deciding on medical interventions and treatments

impacts patient compliance

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coronary artery disease

Back 4

clogged peripheral arteries decrease blood flow to genitals

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hypertension

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affect vasculature and especially erection in males

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diabetes

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injury to vasculature impedes erection and periph blood flow

Front 7

fibromyalgia

Back 7

chronic pain, can inhibit sexual motivation

Front 8

Neurological disorders affecting sex

Back 8

dementia, multiple sclerosis, ALS, Parkinson's, Huntington's, epilepsy (comfort in sex effected)

Front 9

Anxiety

Back 9

no anxiety=dec performance
a little bit of anxiety=increases performance
way too much anxiety=dec performance

'circular relationship'

Front 10

psychiatric illness

Back 10

anxiety, depression, bipolar, mult personality disorder (cant relax in sex), schizophrenia

lots of antipsych drugs affect sexual performance

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Physical disfigurements

Back 11

can affect BOTH partners

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immune disorders

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AIDS/HIV
arthritis, Lupus, Chronic Fatigue syn, cancer, etc

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Urological diseases

Back 13

renal failure, cystitis, incontinence

Prostatitis- has a direct effect

Front 14

Peyronie's Disease

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scarring/blockage of erectile tissue or vasculature causes partial/no erections in isolated tissue. results in a bent or crooked penis during erection

Bill Clinton

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Gynecological conditions

Back 15

atypical bleeding
endometriosis
genital warts/HPV

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menopause

Back 16

increased vaginal dryness
necessary to use lube

Front 17

Vaginitis

Back 17

infections of vagina
inflammation and pain

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Surgery

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Direct- ie prostate surgeries
Indirect- affect self image

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Alcohol

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double edge sword, delecate balance

Reduces inhibitions
Reduces responsivity

Front 20

Psychological Interventions

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can give unintended consequences from a change in a system

ie-treating depression makes someone go from hypo to hypersexual

affects relationships

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Antipsychotics

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Hyperprolactineia- too much prolactin, vag dryness, affects sexual functioning

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Antidepressents

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erectile dysfunction, delay orgas, diminish interest

can help premature ejaculators

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stimulants
CNS depressents

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affect sexual drive/activity

Front 24

Diuretics

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decrease blood pressure
impacts quality of erection
can cause generic drying in women

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psychosocial interventions

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psychotherapy
marital/couples therapy

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physical therapy

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pain-->inhibits sexual activity

reduce pain--->inc sex

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Pain disorders

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dyspareunia
vaginismus

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anorgasmia

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primary or secondary

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Paraphilia

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sexual arousal from/by an inappropriate object or individual

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Fetish

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sexual arousal by an object b/c of powerful association

ie- keys or shoes

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Partialism

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sexual arousal associated with a body part that is not normally sexual

ie- ear lobe, arch of foot

NOT same as a fetish

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Transvestites

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sexual arousal from wearing clothing of opposite gender

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Paraphilias

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sexual arousal from/by inappropriate OBJECT

Not necessarily a problem unless getting in way of life or law

It is a disorder when it inverferes with daily function

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Nymphomania

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random/habitual/addictive type of sex

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Don Juanism

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individual views themself as a fantastic lover and pursues many people

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"Did I agree to this" type of disorders

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refers to people or other objects that dont give consent

zoophilia, pedophilia, necrophilia

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pedophilia

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often associated with prepubescent children

very hard to treat. Recidivism is extremely high

a few social groups find this accceptable

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Froutteurism

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sexual arousal from bumping genitalia against someone. or surreptitiously taking hold of a sexual body part

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Voyeurism

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sexual arousal by watching other people in sexually explicit situation

usually relatively harmless

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Exhibitionism

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sexual arousal from flashing people and seeing their reactions

arousal is from seeing another person's shock/response

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Scatalogia

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sexual arousal from obscene phone calls

they invision that you enjoy this even though they dont know who you are

protest, defense, anger only encourages them

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Urophilia

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sexual arousal from urinating or being urinated on

'water sports' 'golden showers'

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Coprophilia

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sexual arousal from defecation eith on someone or by someone

Front 44

Klizmaphilia

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sexual arousal from enemas

illustrated in the movie 'The Road to Wellville'

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Sadomasochism

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sexual arousal from giving or receiving pain

generally practiced at lower levels in our society

Dominatrix- women in black leather that discipline/beat men

mild forms are common

Front 46

Sadomasochism

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sexual arousal from giving or receiving pain

often the massochist is an educated white male (?)

usually a cue/signal for stopping

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Paraphilia progression

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people that engage in paraphilias usually dont engage in more serious sexual aggression

HOWEVER, sexual violent criminals may have engaged in sexual paraphilias in the past

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Masters and Johnson

Back 48

analyzed numerous sexual disorders

stated that disorders have a physical, psychological, and/or social component

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Apply Biopsychosocial Model to sexual illness

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states that disorders have a physical, psychological, and/or social component

ie- erectile dysfunction can have a phys, psych, and social aspect

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Treatment

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1. Rule out physiological problems first
-may be underlying or indirect
2. Take a thorough medical/social history
3. Understand the environment. may be relationship problems

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Masters and Johnson

Back 51

suggested trying to treat relationship issues if they exist by extensive therapy

if no strong physical evidence for dysfunction, proceed to behavioral treatment strategy

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Behavioral Treatment Strategy

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*a good relationship is impt for these
1. Sensate focus- put intercouse on back burner, take away performance/demand anxiety
2. Start/Stop Technique- apply stimulation to achieve erection, let it go down, repeat. reduces anxiety about getting an erection

Front 53

Start/Stop Technique

Back 53

used for erectile dysfunction and premature ejaculators

Reconditioning: reduces perfomance anxiety by exposure and fine tuning ability to recognize sensations

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Premature Ejaculation

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less than 2 minutes of active thrusting before ejaculation

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Vaginismus

Back 55

pain disorder
outer 1/3 of vaginal muscles contract, preventing penetration

either from pain/trauma or attitude inhib relaxation

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Systematic Desensitization

Back 56

effective treatment of Vaginisums. desensitize her reflex response.
start with small cylinder and move up to size of penis