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61 Cards in this Set
- Front
- Back
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Dissociative Amnesia
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inability to recall important personal info, usually of a traumatic or stressful nature that is too extensive to be explained by ordinary forgetfulness.
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Dissociative Fugue:
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sudden, unexpected travel away from home or place of work, accompanied by an inability to recall ones past and confusion about personal identity or assumption of new identity
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Dissociative Disorders
Essential feature: |
disruption in the usually integrated functions of consciousness, memory, identity, perception
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Dissociative Identity Disorder: (formely multiple personality disorder)-
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prescence of two or more distinct identities or personality states that recurrently take control of individuals behavior accompanied by an inability to recall important info that is too extensive to be explained by ordinary forgetfulness
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Depersonalization disorder:
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persistent/recurrent feelings of being detached from ones mental processes/body that is accompanied by intact reality testing
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Sexual Dysfunction:
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disturbance in sexual desire and psychopathological changes that characterize sexual response cycle and cause marked distress and interpersonal difficulty
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Hypoactive sexual desire disorder:
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deficiency/absence of sexual fantasies and desire for sexual activity
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Sexual Aversion Disorder
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• Avoidance of genital contact with a sexual partner
• Have anxiety, fear, disgust when confronted by sexual opportunity |
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Female sexual arousal disorder:
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o Recurrent inability to attaqin or maintain until completion of sexual activity ( ie lubrication
o Usually accompanied by female sexual desire or orgasmic disorder |
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Male Erectile disorder:
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o Recurrent inability to attain maintain until completion an adequate erection
o Some have issues obtaining one at all, others lose it after attaining it, usually okay for masturbation o Associated with sexual anxiety, fear of failure, concerns about sexual performance |
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Female orgasmic disorder:
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Delay or absence of orgasm following sexual excitement phase
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Male orgasmic disorder:
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Persistent delay, absence of orgasm following excitement phase.
Tend to be aroused at beginning of encounter but thrusting gradually becomes a chore rather than pleasure |
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Premature ejaculation
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•Recurrent onset of orgasm and ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it
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Dyspareunia:
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Genital pain associated with intercourse
Intensity is mild to sharp pain |
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Vaginismus:
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• Recurrent/persistent involuntary contraction of perineal muscles surrounding the outer third of the vagina with penetration
Can cause mild to severe pain |
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Sexual dysfunction due to general med condition
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• Significant sexual dysfunction judged to be due exclusively to direct physiological effects of a general med condition
Can involve pain with intercourse, hypoactive sexual arousal, other forms of sexual dysfunction |
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Substance-induced sexual dysfunction
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• Can involve impaired desire, impaired arousal, impaired orgasm, sexual pain
Due to direct physiological effects of substance |
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Paraphilias:
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recurrent, intense sexual urges, fantasies or behaviors that involve unusual objects, activities or situations
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Exhibitionism:
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Exposure of ones gentials to a stranger
Tend to masturbate while exposing themselves Tends to be a “turnoff” and not lead to any other activity with the person Occurs before 18 |
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Fetishism:
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Use of nonliving objects
Womens underwear, bras, stockings, shoes, boots Tend to masturbate while holding these objects Item is preferred for sexual excitement |
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Frotteurism:
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Touching and rubbing against a nonconsenting person
Tends to occur in crowded places (easily escape arrest) Touches boobs, butt, rubs up against them with gentialia and fantasizes about a relationship with that person |
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Pedophilia
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Sexually activity with a prepubescent child (13 or younger)
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Sexual macochism
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Act of being humiliated, beaten, bound or otherwise made to suffer
Fantasies involve being raped while being held bound Desire to use bondage, blind fold, restraint, cutting, electrical shocks, humiliating them by calling them names etc |
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Infantilism:
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wanting to be treated like an infant
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Sexual sadism:
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Person receives sexual excitement from psychological/physical suffering of victim
Involve having control over victim who is terrified by the act Can involve restraint, blindfolding, paddling, spanking, torture |
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Transvestic fetishism
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Occurs in heterosexual males
Aroused by dressing as female and want to have sex w/female |
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Voyeurism
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Act of observing unsuspecting ppl who are having sex
Is for sexual excitement Tend to have fantasy with person observed |
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Gender identity disorders:
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strong, persistent crossgender identification AND accompanied by persistent discomfort with one’s assigned sex (persons perception as male/female
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Hypoactive sexual desire disorder
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low activity in terms of sexual desire
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Primary Desire
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no interest in sexual activity
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Secondary Desire
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there had been a period of normal sexual interest but no longer interested
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Sexual aversion disorder-
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lack of interest, they find it to be aversive to engage in sex (anxiety provoking)
Can develop in response to rape |
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Female sexual arousal disorder
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lubication that is not occuring which can hinder sexual activity. Psyhcological issue that is preventing the phyisological response (same as above)
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Sexual pain disorders
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Do not fit in with response cycle b/c ideally we are not experiencing pain during sexual activity
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“Spectator role”
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Learned anxiety
Constantly worried about performance (ie that someone else is critiquing them on their performance) |
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Spectator Role
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Religious/sociocultural taboos on sexual feelings-may be guilt
Marriage problems ETOH overuse-if there is use, it can impair ability to get erection Early psychosexual trauma |
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Masters and Johnson
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Gurus of sex therapy
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“Sensate Focusing”-
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working w/ couple and prescribe there be intimate touching but no intercourse for those who are uncomfortable with sex
No intercourse (not for trauma patients) |
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Surrogate partner controversy
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Client comes in and has issues when it comes to sex, no person they are in relationship with. They hired ppl to be surrogate “gf/bf” to practice the sensate focusing. They were charged with “pimping” due to it basically being prostitution
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Start-stop” Technique (premature ejaculation)
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teaching man to become more familiar with sensation of ejaculation. Man taught to stop moving when he feels like he will and then resume when excitation level goes down
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“Squeeze Technique” (premature ejaculation)
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squeeze head of penis to stop ejaculation
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“Paradoxical Instruction”
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man is supposed to try not to have an erection and wife is supposed to do everything she can to get him to have one (man ends up getting one) ie b/c the man is thinking too much about getting one and not being able to get one, so you have him do this
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Vaccum device for erectile dysfunction
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draws blood into the penis-can be used with ppl who have spinal cord paralysis but who still have sexual desire
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Orgasmic dysfunction in women
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Education on female sexual anatomy
Self-exploration exercises - vibrator, erotic pictures, etc. (within bounds of what client feels comfortable with) |
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Difficulty with treating pharaphallias
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treatment is hard to overcome as it is a pleasurable response. Very difficult to treat
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Fetishism from conditioning process
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sexual arousal can only occur with the fetish experience/object
(If man can only become sexually aroused by wife wearing shoes) Early sexual experiences + unconventional stimulus (ie child sitting in moms closet masturbating, now child associates shoes with sexual arousal) Particularly masturbation Object/activity then discriminative stimulus for arousal |
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Masochism could be due to:
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From child only receiving love/attention after parents punish him?-ie. child is spanked and then given love after b/c they feel bad
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Transvesticism name change
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“Femme” personality-some variation of their name i.e. steven,/stephanie
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Stimulus Satiation
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gradual exposure to object of excitation
Masturbates looking at acceptable stimulus until ejaculation, (playboy) Verbally describing his fantasies which are tape recorded (have to make sure he isnt imagining the girl in boots or something related to shoes) Then 2 minutes after ejaculation, he masturbates to deviant stimulus (masturbates then to picture of the shoes-physiologically impossible for him to become aroused that quickly to the shoes after he just ejaculated) And continues for 55 minutes to deviant stimulus (playboy) Unless he becomes aroused At which point he switches back to the acceptable stimulus Repeated 3 times a week for 1 month Working up hierarchy of deviant stimuli |
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Covert Sensitization=
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have client imagine they are engaging in deviant activity, asked what is happening then therapist brings in worst case scenario ie ask client what is worst case (ie boss comes to drop paperwork off and sees him doing it)
Deviant fantasy until arousal Then imagining the worst scenario |
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Covert Sensitization
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Deviant fantasy until arousal
Then imagining the worst scenario |
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Shame Aversion Therapy (not ethical)
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Rehearses paraphiliac behavior in front of therapist and wife
They observe and comment (making derogatory remarks) Used only when other techniques have failed |
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DID Etiology
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Arising From Abuse in Childhood?
DID considered to be a strategy used by children to distance themselves from abuse Imagine happening to someone else. 89% report onset before age 12 Caution Retrospective surveys of patients or their therapists (only data we have) No prospective studies of abused children Many children are abused, but only some develop multiple identities... |
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DID etiology (culture)
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Arising From Culture?
More cases of MPD reported from 1981-1986 than in the preceding 2 centuries (basically b/c the book sybil came out so ppl became more aware of it) Highest in U.S. It’s a popular diagnosis. Ppl in canada had 500x the national avg of this. Problem was they found they all went to the same doctor. All went in for separate things but ended up developing multiple personalities due to the diagnosis. -this is a rare diagnosis |
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DID etiology (Personality Characteristic – Hypnotizability?)
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Compared to general/psychiatric population:
Easier to hypnotize More suggestible Power of suggestion: convert severe but common disorders into more interesting “multiple personalities”-so every time they come out of hypnosis they have a new personality suddenly |
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DID etiology (Undiagnosed Epilepsy?)
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Psychomotor seizures and amnesia for event
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Behavioral markers of DID
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These have been offered by proponents (Franklin 1990; Loewenstein 1991; Putnam 1989, 118-123; Ross 1989, 232) as important diagnostic indicators. What do you think the sensitivity and specificity of these are?
Glancing around the therapist's office Frequently blinking one's eyes Changing posture or voice's pitch or volume Rolling the eyes upward Laughing or showing anger Suddenly covering the mouth Allowing the hair to fall over one's face Developing a headache Scratching an itch Touching the face or the chair in which one sits Changing hairstyles between sessions Wearing a particular color of clothing or item of jewelry |
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Treatment of DID
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Psychodynamic Perspective
“Working through” Expose trauma |
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Behavioral Treatment (reinforcement) DID
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Reinforcement – positive (something gained) and negative (something negative taken away Ie. anxiety, shyness)
“Expert diagnosis” “Strategic enactments”-the husband starts to challenge her on things she is doing and she flips into the baby personality to avoid conflict with husband) |
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Behavioral Treatment (nonreinforcement) DID
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Family ignores other personalities (mom is always mom not baby, teddy bear, queen etc-talk to mom same way, expect her to have same responsibilities ie. cooking, cleaning etc)
Force person to take responsibility for actions of other personalities |
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Behavioral Treatment (case report)
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Case report resulted in less frequent behaviors of other personalities
Other personality was assertive Dominant personality given assertiveness training-if teach them to give skills to dominant personality, there is not a need to give into the other personalities Other personality disappeared |
