Title 15 AbPsy - Sexual Dysfunctions.pdf ✅

15 – Sexual Dysfunctions and Gender Dysphoria ABPSY | 2024 - 2025 | NOT FOR SALE OUTLINE 1. Overview of Sexual Dysfunctions 2. Delayed Ejaculation 3. Erectile Disorder 4. Female Orgasmic Disorder 5. Female Sexual Interest/Arousal Disorder 6. Genito-Pelvic Pain/Penetration Disorder 7. Male Hypoactive Sexual Desire Disorder 8. Premature (Early) Ejaculation 9. Gender Dysphoria OVERVIEW OF SEXUAL DYSFUNCTIONS DEFINING SEXUAL DYSFUNCTIONS Sexual Dysfunctions – characterized by a clinically significant disturbance in a person's ability to respond sexually or to experience sexual pleasure ● May occur in both heterosexual and homosexual relationships ● Lifelong: chronic condition that is present during a person’s entire sexual life ● Acquired: disorder that begins after sexual activity has been relatively normal ● Generalized: occurring every time the individual attempts sex ● Situational: occurring with some partners or at certain times but not with other partners or at other times Human Sexual Response Cycle TYPES OF DYSFUNCTIONS Sexual Desire Disorders Characterized by little or no interest in sex that is causing significant distress in the individual or couple Male hypoactive sexual desire disorder Female sexual interest/arousal disorder Sexual Arousal Disorders Erectile disorder Female sexual interest/arousal disorder Orgasm Disorders Orgasm occurs at an inappropriate time or it does not occur Delayed ejaculation Premature (early) ejaculation Female orgasmic disorder Sexual Pain Disorders Genito-pelvic pain/penetration disorder DELAYED EJACULATION DISORDER DEFINING DELAYED EJACULATION DISORDER Delayed Ejaculation Disorder – inability to achieve an orgasm despite adequate sexual desire and arousal ● They achieve orgasm only with great difficulty or not at all ● Male orgasmic disorder ● Men seldom seek treatment for this condition ● Some men reach climax through alternative forms of stimulation ● Retrograde Ejaculation: ejaculatory fluids travel backward into the bladder rather than forward ● Begins with early sexual experiences and continues throughout life ● Common in severe forms of MDD DIAGNOSTIC CRITERIA A. Either of the following symptoms must be experienced on almost all or all occasions (approximately 75%-100%) of partnered sexual activity (in identified situational contexts or, if generalized, in all contexts), and without the individual desiring delay: 1. Marked delay in ejaculation. 2. Marked infrequency or absence of ejaculation B. The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months. C. The symptoms in Criterion A cause clinically significant distress in the individual. D. Sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a 1 | @studywithky
substance/medication or another medical condition. CAUSES / RISK FACTORS Genetic and Physiological Risks ● Age-related loss of the fast-conducting peripheral sensory nerves ● Age-related decreased sex steroid secretion ● Commonly in men older than 50 years ● Less coital activity, higher levels of relationship distress, sexual dissatisfaction, lower subjective arousal, anxiety about their sexual performance, and general health issues than sexually functional men Environmental Risks ● Associated with highly frequent masturbation ● Use of masturbation techniques not easily duplicated by a partner ● Marked disparities between sexual fantasies during masturbation and the reality of sex with a partner ERECTILE DYSFUNCTION DISORDER DEFINING ERECTILE DYSFUNCTION DISORDER Erectile Dysfunction Disorder – repeated failure to obtain or maintain erections during partnered sexual activities ● Many may have low self-esteem, low self-confidence, and a decreased sense of masculinity, and may experience depressed affect ● Many males with erectile dysfunction have frequent sexual urges and fantasies and a strong desire to have sex at any time ● Problems tend to accompany aging ● Prevalence of erectile dysfunction is startlingly high and increases with age ● Strongly associated with feelings of guilt, self-blame, sense of failure, anger, and concern about disappointing one’s partner ● Decreased sexual satisfaction and reduced sexual desire ● Comorbid with other sexual disorders, anxiety and depressive disorders DIAGNOSTIC CRITERIA A. At least one of the three following symptoms must be experienced on almost all or all (approximately 75%-100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts): 1. Marked difficulty in obtaining an erection during sexual activity. 2. Marked difficulty in maintaining an erection until the completion of sexual activity. 3. Marked decrease in erectile rigidity B. The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months. C. The symptoms in Criterion A cause clinically significant distress in the individual. D. Sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition. CAUSES / RISK FACTORS Temperamental Risks ● Neurotic personality traits may be associated with erectile problems in college students ● Submissive personality traits may be associated with erectile problems in men age 40 years and older ● Alexithymia: deficits in cognitive processing of emotions FEMALE ORGASMIC DISORDER DEFINING FEMALE ORGASMIC DISORDER Female Orgasmic Disorder – inability to achieve an orgasm despite adequate sexual desire and arousal in women ● Most common complaint among women who seek therapy for sexual problems ● Unmarried women were 1.5 times more likely than married women to experience orgasm disorder ● Approximately 80% do not achieve orgasm with every sexual encounter ● A woman's first experience of orgasm can occur any time from the prepubertal period to well into adulthood ● Greater difficulty communicating about sexual issues ● High levels of sexual satisfaction despite rarely or never experiencing orgasm DIAGNOSTIC CRITERIA A. Presence of either of the following symptoms and experienced on almost all or all (approximately 75%-100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts): 1. Marked delay in, marked infrequency of, or absence of orgasm. 2. Markedly reduced intensity of orgasmic sensations B. The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months. 2 | @studywithky