DSM's 3 major types of sexual disorders

1. Gender Identity Disorders

-sense of self as of the male or female sex = gender

-anatomy and gender not in concert

-transsexualism

2. Paraphilias

-sexual attraction to an unusual object or activity

3. Sexual dysfunctions

-sexual performance or arousal difficulties

 

Gender Identity Disorder

= a strong and persistent cross-gender identification

-not just a desire for any perceived cultural advantage of being the other sex

-not a result of an intersex condition (hermaphrodite)

-diagnosis involves 2 criteria that differ by age

A. desire to be the opposite sex

B. discomfort with his or her sex

 

Paraphilias

= sexual attraction is to unusual objects or sexual activities that are unusual in nature.

Fetishism and Transvestic fetishism

Pedophiles

Voyeurism

Exhibitionists

Frotteurism

Sexual sadism

Sexual masochism

Etiology of the Paraphilias

Psychodynamic theorists

view paraphilias as defensive, guarding the ego from dealing with repressed fears and representing fixations at pregenital stages of psychosexual development.

Behaviorists

 

Therapies for the Paraphilias

LEGAL

Involuntary commitment to mental hospitals

Imprisonment

Court-ordered into treatment

"Megan’s law"

BEHAVIORAL

Aversion therapy

Satiation

0rgasmic reorientation

Social skills training

Alternative behavior competition

Cognitive procedures

MEDICAL

Castration

Drugs to lower testosterone

SEXUAL DYSFUNCTIONS

 

= range of sexual problems that are considered to represent inhibitions in the normal sexual response cycle.

-persistent and recurrent, and cause marked distress or interpersonal problems

Human Sexual Response Cycle

(1) appetitive (sexual desire),

(2) excitement (sexual pleasure and accompanying physiologic changes such as tumescence),

(3) orgasm (the peak of sexual pleasure),

(4) resolution (relaxation following orgasm).

 

Sexual Dysfunctions

APPETITIVE/DESIRE

Hypoactive sexual desire disorder,

Sexual aversion disorder

AROUSAL/EXCITEMENT

Female sexual arousal disorder

Male erectile disorder.

ORGASM

Female orgasmic disorder (inhibited orgasm)

Male orgasmic disorder (inhibited orgasm)

Premature ejaculation

PAIN

Dyspareunia

Vaginismus

 

General Theories of Sexual Dysfunctions

Masters and Johnson

CURRENT FACTORS

-the adoption of a spectator role

-fears of performance

HISTORICAL FACTORS

-religious orthodoxy,

-psychosexual trauma,

-homosexual inclinations,

-inadequate counseling,

-excessive intake of alcohol,

-biological causes,

-sociocultural factors.

Other theorists

-partner/ marital conflict

-the meaning of a sexual problem for a person (including secondary gain),

-lack of knowledge or skill,

-poor communication between partners,

-fear of acquiring sexually transmitted diseases.

Behavioral Therapies for Sexual Dysfunctions

Masters and Johnson's pioneering treatment work

- intensive two week program

-FIRST a ban on sexual activity and a discussion of the couple's sexual value system.

-SECOND sensate focus, or pleasurable touching without intercourse, begins, and couples are encouraged to communicate their desires to their partner.

-THIRD specific instructions for approaching intercourse are given, according to particular dysfunctions.

Behavioral Therapies for Sexual Dysfunctions Continued

Other techniques used by sex therapists:

(hormones, anti-anxiety, anti-depressant, implants, vacuum pump ,Viagra)