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126 Cards in this Set
- Front
- Back
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What factors must be considered when considering 'normal' sexual behaviour?
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- time & place
- gender - culture |
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What are two examples of a change is western view involving of normal sexual behaviour in men?
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masturbation and homsexuality
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What gender differences are found in attitudes towards casual & premarital sex?
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men report more permissive attitudes toward casual sex, in particular premarital and extramarital sex
woman more often emphasise the committed relationship as a context for sex |
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What gender differences are found in patterns of arousal?
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men have more specific patterns of arousal - only aroused by female sexual stimuli (heterosexual)
woman tend to be aroused by both male and female sexual stimuli woman are more likely to change their sexual orientation over time than men |
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What gender differences are found in sexual self-concept?
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men think about their sexuality in terms of power and aggression
woman think about their sexuality in terms of experiencing passionate or romantic feelings |
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What gender differences are found in the reporting of sexual disorders?
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men report experiencing more sexual dysfunction as they age they are less likely to do anything about it compared to woman
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What are three proposed reasons for gender differences in sexuality?
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1. social/cultural prohibition? - re: female sexuality
2. biological differences? - men wanting more partners 3. investment in parenting? woman |
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What is an example of cultural differences in sexual behaviour?
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tribe in papua new guinea belief boys don't produce semen naturally so adolescent boys feed 7 year old their semen
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What are three main difficulties in defining what is 'normal' sexual behaviour?
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- self report measures used in research bias results
- methodological bias of clinicians - no control group |
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What criteria must be met in order diagnose a sexual disorder?
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associated with significant impairment or involves non-consenting individuals
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Describe three types of dysfunctions and disorders in the DSM-IV-TR?
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1. Sexual dysfunctions - difficulty functioning adequately while having sex
2. Gender Identity Disorder - psychological dissatisfaction with one's biological sex 3. Paraphilias - arousal primarily in the context of inappropriate objects or individuals |
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Which two types of dysfunctions and disorders in the DSM-IV-TR are being retained and which one is being changed?
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Sexual dysfunctions and paraphilias are being retained
Gender Identity Disorder is being reclassified |
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What are the four phases of the sexual response cycle?
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1. Desire phase
2. Excitement phase 3. Orgasm phase 4. Resolution phase |
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Which two researchers formed the sexual response cycle?
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Masters & Johnson (1966) and Kaplan (1974)
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Describe the 'desire' phase in the sexual response cycle?
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sexual interest or desire, often associated with sexually arousing fantasies or thoughts
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Describe the 'excitement' phase in the sexual response cycle?
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experience of pleasure and increased blood flow to genitalia
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Describe the gender differences in the 'excitement' phase of the sexual response cycle.
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Increased blood flow produces and erection in men, and enlarged breasts and changes in the vagina, including lubrication, for woman.
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Describe the 'Orgasm' phase in the sexual response cycle?
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Sexual pleasure peaks, men ejaculate, and the outer walls of the woman's vagina contract. Both sexes experience muscle tension.
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Describe the 'Resolution' phase in the sexual response cycle?
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Relaxation and sense of well being.
Men have a refractory period during which further erection is not possible. Woman are often able to respond again immediately and can have multiple orgasms. |
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Which two phases of the sexual response cycle are not clearly distinguished in woman?
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desire and excitement
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What two reasons evidence a crossover in the desire and excitement phases for woman in the sexual response cycle?
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1. 30% of woman experience desire in response to physiological arousal
2. low correlation between subjective desire and biological measures of arousal using vaginal plethysmograph. |
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The name of the device used to measure woman's physiological arousal, particularly blood flow.
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vaginal plethysmograph
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Which two types of excitement should be considered separately for woman?
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biological and subjective excitement
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Which three stages of the sexual response cycle do disorders occur in?
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desire, excitement & orgasm
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In what context do sexual dysfunctions occur in?
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intimate personal relationships
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What are the proposed three categories for sexual dysfunctions in the DSM-5?
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1. those involving sexual desire, arousal and interest
2. orgasmic disorders 3. sexual pain disorders |
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Four broad criteria for all sexual dysfunctions?
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1. Persistent & Recurrent
2. Cause clinically significant distress 3. Not due to a medical condition/other psychological illness 4. Present during masturbation, and both heterosexual & homosexual activity |
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What are the four desire and arousal disorders in the DSM-IV-TR?
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1. Hypoactive sexual desire disorder
2. Female sexual arousal disorder 3. Erectile disorder 4. Sexual aversion disorder |
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What changes are proposed in the DSM-5 for the four desire & sexual arousal disorder currently in DSM-IV-TR?
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1. Hypoactive sexual desire disorder change to be specific to men only
2. Female arousal disorder renamed Sexual interest/desire disorder in woman 3. Erectile disorder stays the same 4. Sexual aversion disorder being removed as it becomes part of number 2 |
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Prevalence of symptoms of sexual dysfunctions in past 12 months reported by Klasser et al.
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43% woman
30% men |
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What do many people who report a problem in one stage of the cycle report?
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problems in another phase
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A sexual problem with one partner can lead to what in their partner?
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sexual problems in the partner
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What sexual disorder is characterised by persistent deficits in sexual interest (sexual fantasies or urges), biological arousal, or subjective arousal?
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Sexual interest/arousal disorder in woman
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What sexual disorder is characterised by deficient or absent sexual fantasies and urges?
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Hypoactive sexual desire disorder in men
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What sexual disorder is characterised by the failure to attain or maintain an erection through completion of sexual activity?
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erectile dysfunction
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What is important to rule out when diagnosing sexual interest, desire, and arousal disorders?
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biological explanations for the symptoms
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What % of people who seek treatment for sexual dysfunction report low sexual desire?
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more than 50%
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How many times more likely are postmenopausal woman to report low sexual desire than woman in their 20's?
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2 to 4 times
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How does image impact on erectile dysfunction?
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Erectile dysfunction increases with age
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What rates of occasional symptoms of erectile dysfunction are reported?
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13 to 28% depending on the country
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What percentage of men report erectile dysfunction in their 70's?
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15%
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What percentage of men report occasional erectile dysfunction?
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70%
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What do woman who seek treatment for sexual arousal disorder also report problems with?
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desire
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What DSM-IV-TR criteria for sexual dysfunctions are too vague?
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duration of the disorder
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What duration is specified of sexual dysfunctions in the DSM-5?
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persistence for 6 months or more
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Diminished, absent or reduced frequency 3 of what 6 criteria are required for 6 months or more in Sexual Interes/Arousal Disorder?
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1. Interest in sexual activity
2. Sexual thoughts or fantasies 3. Initiation of sexual activity and responsiveness to partner's attempts to initiate 4. Sexual excitement/pleasure during 75% of sexual encounters 5. Sexual interest/arousal elicited by any internal or external erotic cues 6. Genital or non genital sensations during 75% of sexual encounters |
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What is the DSM-5 criteria for Hypoactive Sexual Desire Disorder?
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Persistently deficient or absent sexual fantasies and desires, as judged by the clinician.
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What two criteria are required in the DSM-5 criteria for Erectile Dysfunction Disorder to persist on at least 75% of sexual occasions for more than 6 months?
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1. Inability to attain or maintain an erection for completion of sexual activity, or
2. Marked decrease in erectile rigidity interferes with penetration or pleasure. |
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What is important to rule out when diagnosing sexual interest, desire and arousal disorders?
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a biological explanation for the symptoms
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Is low desire more commonly reported by men or woman?
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woman
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Is hypoactive sexual desire reported more by men in America, Britain, or Germany?
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America
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What are the three criteria for sexual aversion disorder in the DSM-IV-TR?
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1. Persistent or recurrent extreme aversion to, and avoidance of, all (or, almost all) genital sexual contact with a sexual partner
2. Causes marked distress or interpersonal difficulty 3. Not better accounted for by another Axis 1 disorder (except another sexual disorder) |
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Does sexual aversion disorder occur more in males or females?
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females
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In what category of disorders in the DSM-5 is sexual aversion disorder being moved to?
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Anxiety Disorders
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What are the three main reasons for the reassignment of sexual aversion disorder to anxiety disorders in the DSM-5?
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1. Fear response associated with physical sensations of sex
2. 25% of patients also meet the criteria for panic disorder 3. Sexual acts/fantasises may trigger traumatic images/memories |
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What are the three orgasmic disorders in the DSM-IV-TR and what are they being renamed in the DSM-5?
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1. Female orgasmic disorder - no change in the DSM-5
2. Male orgasmic disorder - Delayed ejaculation 3. Premature ejaculation - Early ejaculation |
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What change to the duration of sexual dysfunctions in being made in the DSM-5?
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including persistence of disorder for 6 months or more
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What percentage of men report erectile dysfunction symptoms lasting for one month in any given year? what percentage report these symptoms for more than 6 months?
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6% for one month, less than 1% for 6 months
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What percentage of woman report loss of desire for one month in any given year? what percentage report these symptoms for more than 6 months?
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40% for one month, 10% for 6 months
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What is the criteria for female orgasmic disorder required in at least 75% of sexual occasions for 6 months in the DSM-5?
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Marked delay, infrequency, or absence of orgasm, or markedly reduced intensity of orgasmic sensation.
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What is the most common sexual problem for which females seek help?
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Female Orgasmic Disorder
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What percentage of woman reliably experience orgasm during sex?
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20%
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What percentage of woman experience significant difficulty reaching orgasm during sex?
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25%
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What proportion of woman report that they have faked an orgasm?
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two thirds
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What is the proposed criteria in the DSM-5 for Early Ejaculation?
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the tendency to ejaculate during partnered sexual activity with 1 minute of sexual activity on at least 75% of sexual occasions for 6 months.
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What is the most common sexual disorder to which men seek treatment?
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Early Ejaculation
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Prevalence of Early ejaculation.
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20 to 30%
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When is Early Ejaculation most common?
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in young, sexually inexperienced males
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What is the proposed criteria in the DSM-5 for Delayed Ejaculation?
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Marked delay, infrequency, or absence of orgasm on at least 75% of sexual occasions for 6 months.
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What percentage of men report having delayed or no orgasm during sexual intercourse?
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8%
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Which is the more common pattern in delayed ejaculation retarded(delayed) ejaculation or no ejaculation?
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retarded ejaculation
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What is the term used to describe the condition where the semen fluid travels backwards into the bladder rather than forwards upon orgasm?
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Retrograde ejaculation
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What are the common causes of retrograde ejaculation?
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drugs or medical condition
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What are the two sexual pain disorders currently in the DSM-IV-TR?
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Dyspareunia & Vaginismus
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Dyspareunia & Vaginismus being combined to form which condition in the DSM-5?
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Genito-pelvic pain/penetration disorder
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What is the first step in making a diagnosis for genito-pelvic pain/penetration disorder?
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to ensure pain is not caused by a medical condition such as infection
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Persistent and recurrent for at least 6 months are one of which four criteria proposed in the DSM-5 for Genito-Pelvic Pain/Penetration Disorder?
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1/ Inability to have vaginal intercourse/penetration
2. Marked vulvovaginal or pelvic pain during vaginal penetration or intercourse attempts 3. Marked fear or anxiety about pain or penetration 4. Marked tensing of the pelvic floor muscles during attempted vaginal penetration |
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How do most woman with genito-pelvic pain/penetration disorder achieve orgasms?
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Through manual or oral stimulation that does not involve penetration
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Do woman with genit-pelvic pain/penetration disorder feel more aroused when watching erotic films of oral sex or sex involving intercourse?
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oral sex
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Prevalence of pain during intercourse for all woman over the lifetime.
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10 to 30%
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The persistent or recurrent pain during sexual intercourse is which disorder in the DSM-IV-TR?
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Dyspareunia
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Involuntary muscle spasms of the outer third of the vagina to a degree that makes intercourse impossible is which disorder in the DMS-IV-TR?
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Vaginismus
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What is a common symptom in both Dyspareunia and Vaginismus?
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muscle tension
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When is pain experienced in genito-pelvic pain/penetration disorder?
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during penetration or intercourse
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What does erectile engorgement depend on?
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adequate blood flow
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What are the 4 main biological contributions to sexual dysfunction?
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1. Organic problems
2. Prescription medication 3. Illicit drugs 4. Alcohol 5. Smoking |
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What are the two proximal (immediate) causes of sexual dysfunction suggested by Masters & Johnson (1970) in their two-tier model?
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Spectator role and performance anxiety
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Being an observer rather than a participant in the sexual experience is known as the what?
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spectator role
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What effect can SSRI's have on sexual function?
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delayed orgasm, decreased libido, and diminished lubrication.
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What is a common caused of erectile dysfunction in older men?
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vascular conditions
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What percentage of men with diabetes have erectile dysfunction?
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28%
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What effect for antihypertensives have on sexual function?
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diminish blood flow required for biological arousal
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Do illicit drugs alcohol increase biological or psychological arousal?
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psychological. use over time interferes with biological arousal
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Describe the differences in aetiology of sexual dysfunction according to Barlow Model with regards sexual functioning?
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Functional response to sexual cues is positive, dysfunctional sexual response is negative affect
Functional sexual response to focus on erotic areas, dysfunctional sexual response is to focus on public consequences of not performing or other non-erotic issues Functional approach the sexual experience, where dysfunctional avoid the sexual experience |
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Sexual abuse suffered during childhood is associated with what problems in sexual functioning as adults?
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Diminished desire and arousal, and early ejaculation in men
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How many times more likely is it for male victims of childhood sexual abuse to suffer early ejaculation as an adult?
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2 times more likely
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What do many people with sexual problems lack?
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knowledge and skill about their sexuality
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What effect can relationships problems have on sexual functioning?
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reduce desire and pleasure
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How many times more likely are people with depression to have a sexual dysfunction?
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2 times more likely
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Which type of anxiety disorder increases the risk of have a sexual dysfunction?
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panic disorder
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Low general physiological arousal can interfere with what step of the sexual response cycle?
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arousal
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People who blame themselves for decreased sexual performance are more likely to develop what?
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recurrent sexual problems
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What is the name of the tool used to measure penile circumference?
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penile plethmyograph
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People who blame themselves when their body doesn't perform will experience what?
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diminished subsequent arousal
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What intrusive thoughts do woman often suffer during sex?
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worry about attractiveness, particularly weight and appearance
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What do men often worry about during sex?
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their erection
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Engaging in sexual behaviour appears to vary by cultural group and can inhibit sexual desire due to what overriding emotion?
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guilt
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Woman in Ireland and Turkey experience what sexual dysfunction more than woman in Australia and America?
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Pain during sex due to cultural and religious guilt
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A marked deterioration in close interpersonal relationship can cause what?
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sexual dysfunction
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What are the six main types of treatment options for sexual dysfunction?
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1. Anxiety reduction
2. Directed Masturbation 3. Changing attitudes and thoughts 4. Skills and communication training 5. Couples therapy 6. Medications and physical treatments |
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What are three treatment approaches to reducing anxiety associated with sexual Dysfunction?
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1. Systematic desensitisation and skills training
2. Psychoeducation 3. Removing the focus on penile insertion |
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Are men or woman more likely to be prescribed directed masturbation to treat sexual dysfunction?
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woman
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Describe the 4 step process for directed masturbation?
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1. Woman examines her body and genitals, and identifies various areas
2. Touches body and genitals to find areas that produce pleasure 3. Increases intensity of masturbation using fantasy, and a vibrator (if required) to reach orgasm 4. Her partner is introduced to watch her masturbate, then do for her what she has been doing to herself, and then having intercourse in a way that allows him to stimulate her genitals manually or with a vibrator |
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Directed masturbation is helpful in treating which two types of sexual disorders?
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Female Orgasmic Disorder and disorders of desire
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What type of intervention is employed to assist in changing attitudes and thoughts about sex?
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Cognitive approaches
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Sexual dysfunctions are often embedded in a what?
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distressed relationship
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What is an important consideration when considering treating a sexual problem with medication?
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that many sexual problems are inherently interpersonal
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What is the squeeze technique used to treat?
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early ejaculation
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What short-acting SSRI has been approved in several European countries for the treatment of Early Ejaculation?
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Dapoxetine (Priligy)
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What effect does viagra have on the body?
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relaxes smooth muscles allowing blood to flow to the penis
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Which neurotransmitter is inhibited by viagra?
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Phosphodiesterase type 5 (PDE-5)
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What are three medical treatments for Erectile Dysfunction?
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1. Medication such as viagra
2. Injection of vasoactive substance into the penis 3. Surgery |
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How far in advance are PDE-5 inhibitors taken before sex? and how long do their effects last for?
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1 hours before, and about 4 hours
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What does PDE-5 represent?
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Phosphodiesterase type 5
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What are common side effects of PDE-5 inhibitors?
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headaches and indigestion,
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Who are PDE-5 inhibitors dangerous for?
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men with cardiovascular disease
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