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51 Cards in this Set

  • Front
  • Back

Edwin Cole's most common confessed sexual sins?






sexual fantasies

when does sexuality begin to unfold?

during preschool & scholastic yrs

What is Reenactment Behavior

when children begin to exhibit externalized behavior. reenacting what they have experienced or seen

Acting in and Acting out

Acting in: Internalized typical in females

Acting out: externalized typical in males

Acting In Presents As:




eating disorders

inhibited sexual desires

self mutilation

Acting Out Presents As:

Sexual Perpetration

impulse control disorder

antisocial personality disorder



What is a Love Map?

it is not present @ birth, it differentiates within a few yrs. it is a developmental representation or template in your mind/brain and is dependent on input through the senses. Once formed extremely resistant to change

Kinsey's scale of sexual orientation

Sequence of Sexual Addiction

Initiation Phase

Establishment Phase

De-escalation/escalation phase

acute phase

chronic phase

Sexual addiction causes impaired thinking.

sex is his life w/o he will die

he is sensitized to see sexual signals everywhere

he sees sex objects and others; objectifies people

he views himself unfit for love; contacts are devoid of intimacy

Sexual Compulsivity

The inability to control one's sexual behavior (loss of control) preoccupation and rituals predominately precede compulsive acting out

Treatment of Sexual Addiction

questions need to be asked about behaviors that have been engaged in addictively. need history of substance use, over 50% have problems w/alcohol & other drugs

accurate initial assessment must be followed by sensitive monitoring of symptomatic status throughout the course of treatment.

Dimensions of Sexual Health & 12 step support

nurturing, sensuality,sense of self, relationship sexuality, partner sexuality, non-genital sexuality, spiritual sexuality


any betting or wagering, for self or others, whether for money or not, no matter how slight or insignificant, where the outcome is uncertain depends on chance or skill.

Compulsive Gamblers

written hot checks

3-6 mo behind in bills

owes relatives, friends, banks, bookies, loan sharks

sells things of self and family

has secret checking accounts

cashed in insurance policies or maxed out cards

debt may be as high as 100k


Pathological Gambling

persistent & recurrent maladaptive gambling behavior.

1. preoccupied w/ reliving past gambling experiences

2. needs to gamble w/increasing amounts of money

3.has repeated unsuccessful efforts to control, cut back/stop gambling

4.restless or irritable w/trying to cut down or stop

5.used as an escape

6. tries to break even the after loosing chasing one's losses.


8.committed illegal acts

9. lost relationships, jobs, education opportunities

10. relies on others for money

Difference between compulsive gambling and substance abuse

hidden addiction

cant overdose/no saturation point

financial problems require immediate attention in treatment

can function @ employment site

cannot be tested

no ingestion of chemicals

fewer resources for gamblers and family

%of disease different

prevention message not as easily accepted

Similarities between gambling and substance abuse

denial 1st drink/win remembered

use of rituals depression/mood swings

preoccupation rush like that of coke

inability to stop progressive disease

dysfunctional families


immediate gratification

chasing the first win/high

low self-esteem/high ego

Pathological gambling characteristics

1.gambler cant stop when winning


3.absorbs & precludes all other interests


4. seeks & enjoys pleasure/pain thrill release of endorphin

5. tolerance little at first then more then affordable

6. always optimistic beyond reach of objection/argument

Stages of Compulsive Gambling





features of compulsive gambling

distorted thinking

extravagant generosity

workaholic traits

chase behavior

the bail out

Clomipramine (anafranil)

used in mood state theory to treat gambling; blocks the re-uptake of norepinephrine and serotonin which serves to increase mood.

Fluvoxamine (luvox)

SSRI medication reduced 17 subjects compulsive gambling 7 got complete abstinence

Other Drugs used in gambling treatment


valproate(depokote)-interacts w/gaba

lithium (eskalith) decreases norepinephine and increases serotonin

Gambling Treatment Issues

1.individuals attempt to take control of therapy

2.plan for relapse

3.avoid discussing gambling

4.stay structured/goal oriented

5.missed appointments and last minute cancellations

6.look for cross addictions and replacement behavior

7. anticipate depression, anxiety and critical remarks about treatment

8.keep gamblers significant family members involved in treatment

-dont waste time trying to convince them about the odds of winning they know and dont care.

Women Gamblers

1/3 of pathological gamblers are women

more prone to depression less concerned about impressing ppl. play alone less competitive games and rely on more luck rather than skill. become dependent on gambling faster than males.

Action Gamblers

Controlling,domineering and manipulative. usually men. see themselves as friendly, sociable, gregarious, and generous. start gambling at an early age (teens) prefers skill games, card games, poker craps, dice, horse and dog races and sports betting

Escape Compulsive Gamblers

low self esteem

become liers


4 stages- winning-losing-desperation-hopeless

no "winning" stage for escape gamblers but they have winning episodes

play luck

start later in life

Eating Disorder Models

Biochemical Model-endorphin addiction

Psychodynamic model-phobic avoidance disorder

Cognitive/behavioral model-false beliefs/dysfunctional behavior

Family Systems Model-faulty communication

Sexual abuse and eating disorders

experienced incest

family meals verbal and physical torture by parent

fearful during meal time

stress triggers and reenactment behavior

ptsd and dissociative disorders

Course of Anorexia Nervosa

Phase 1- early weight loss-brings praise from relatives and friends

Phase 2-advanced weight loss-brings about the need to continue to lose weight, ppl begin to voice concern

phase 3- burn out or depletion-endorphins no longer exists (reward) dysphoria, irritability, agitation, jumpy, sleep disturbances, inability to concentrate


phobic avoidance disorder

physiological aspects of anorexia (experimental starvation research)

1. depression


3.mood lability

4. indecisiveness

5.obsessive thinking

6. difficulty concentrating

Medical Symptomatology of Anorexia

-fatigue; weight loss

brittle nails; loss of libido

constipation; loss of menses

thinning hair; dry skin; lanugo

slowed heart rate; swollen joints

hypothermia; reduced breast size

lowered blood pressure; disruption of ovulation

diminished vaginal secretions; decreased estrogen production

Emotional Eating

marked by periods of binge eating, grazing, and/or eating when one is not hungry in order to soothe feelings


uncontrolled eating followed by guilt and shame about the eating episode.

The emotional eater

may or may not be obese; not all overweight people are emotional eaters

issues with emotional eating

1. weight becomes focus of life

2.feeling tormented by eating habits

3.putting off living one's life until thin

4. social w/d and isolation increases

5. professional failures attributed to weight

6. intense fear of rejection related to weight

7. dreams about being happier when thin

8.low self esteem and it's based on weight control and eating

The Funnel Effect

pleasurable or activities that were previously enjoyable, are progressively less acceptable for the anoretic; she denies herself the pleasure of food and this generalizes or spreads to many other aspects of life.

The Gamblers Fallacy (monte carlo fallacy)

the mistaken belief that , if something happens more frequently than normal during some period, it will happen less frequently in the future or that if something happens less frequently than normal during some period it will happen more frequently in the future

Anorexia treatment phases

1. baseline- about 5 days-assessment; patient adjusts to facility & treatment contract is created

2. Weight gain- measured @ the same time each day

3. Maintenance- 7-10 days contract is renegotiated to reward maintenance; discharge planning

4. Follow on-out patient programs

Psychological profile of a woman with anorexia


-denial of her condition

-ambiguity about sexuality

-great fear of bodily changes

-feelings of self doubt ex: intelligence/appearance

-rigid/obessional thinking point that eating restricts other activities

Initial Assessment of Anorexia

weight history

use of exercise

laboratory values

foods that are avoided

frequency of binge or purge behaviors

methods of purging

medical/psychological co-occurring disorder

previous 1-6 wk intake;food & fluids

The Refeeding Syndrome

potentially fatal condition, must be prevented early in the refeeding phase by working closely with registered dietitian to avoid a too aggressive increase in caloric intake.

Anorexia-Restrictive Type

during the current episode of anorexia nervosa, the person has not regularly engaged in binge eating or purging behavior

binge eating/purging type

during the current episode of anorexia the person regularly engages in binge and purging behavior

Bulimia Nervosa

reccurent episodes of binge eating: eating in a discrete period of time and lack of control over eating during episode

occur on avg twice a week for 3 months

purging type

engages regularly in self induced vomiting or misuse of laxatives, diuretics, or enemas

non purging type

uses other inappropriate compensatory behaviors such as; fasting, excessive exercise, but does not regularly engage in self induced vomiting or misuse of laxatives, diuretics, or enemas

Reflex Peripheral Edema

a state that is exacerbated during laxative w/d constipation also is problematic during w/d from laxatives

Cognitive behavioral therapy for bulima nervosa

stage 1: self monitoring, weekly weighing,