Term
| what % of men and women have some form of sexual dysfunction? |
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Definition
| 43% of women and 31% of men |
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Term
| when did the current understanding of the human sexual response start? |
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Definition
| in the 1960s w/masters and johnson. |
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Term
| what is the 4 step masters and johnson model for sexual function? |
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Definition
| 1) excitement/arousal. 2) plateau. 3) orgasm - physical/autonomic release [males: ejaculation/females: pelvic contractions]. 4) resolution [period of time before sexual arousal can occur again]. |
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Term
| can antidepressants dampen the sexual response? |
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Definition
| yes, particularly the SSRIs (20-40%). in males: delayed ejaculation/in females: anorgasmia. |
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Term
| what NT has the most negative effect on sexual function? |
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Definition
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Term
| what is the effect of DA, ACh and NE on sexual function? |
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Definition
| DA: increases sexual desire. ACh: enhances vaginal lubrication/erectile function. NE: can speed up ejaculation (may be a negative effect). |
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Term
| what psychiatric conditions can cause sexual disorders? |
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Definition
| depression, anxiety, OCD, and schizophrenia |
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Term
| can there simply be a decreased desire for sexual activity in some pts? |
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Definition
| yes, this can happen in 40% of females & 30% of males |
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Term
| what is sexual aversion disorder? |
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Definition
| extreme avoidance of any kind of sexual contact. this is often comorbid in pts w/panic disorder and who may have had an active sexual life at one point in the past. |
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Term
| how do disorders of arousal present in men and women pts? |
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Definition
| women may not be able to achieve lubrication (can lead to dyspareunia). men may not be able to achieve erection (may be chronic or situational). |
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Term
| what is female orgasmic disorder? (*possible exam question*) |
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Definition
| *the most common sexual complaint women have* w/a lifetime prevalence of 35%. some women are totally anorgasmic, others are variable and w/others it may depend on vaginal vs clitoral stimulation. this can also be due to medication. |
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Term
| what is male orgasmic disorder? |
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Definition
| the pt reaches full erection but can't achieve orgasm. this is sometimes confused w/retrograde ejaculation (goes to bladder due to antipsychotic medication or otherwise). |
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Term
| what is premature ejaculation? |
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Definition
| ejaculation which occurs w/minimal stimulation before/after vaginal penetration - usually before 10 thrusts or 2 min. this is the most common sexual dysfunction in the male and may become chronic w/psychological involvement and development of ED. |
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Term
| what is dyspareunia usually due to in women? |
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Definition
| usually: lack of vaginal lubrication. vaginismus can also cause dyspareunia, which is a very painful spasm of pelvic musculature when anything comes in contact with the vulva or vaginal outlet (even a tampon). this may be primary or secondary to another condition. |
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Term
| how would a hypoactive sexual disorder in an avoidant pt be treated? would this also be tx for sexual aversion disorder? |
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Definition
| in a gentle, non-threatening, progressive way starting w/stimulation distal to the genitals and moving that direction (sensate focus). this would also be tx for sexual aversion disorder. |
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Term
| how would a woman w/orgasmic disorder be treated? |
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Definition
| encourage them to masturbate |
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Term
| what are kegel exercises? |
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Definition
| voluntary pelvic exercises |
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Term
| how can premature ejaculation be treated? |
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Definition
| the squeeze technique: when male senses that ejaculation is imminent – withdraws and the woman squeezes the distal end of the penis with a finger behind the corona and the thumb on the frenulum. SSRIs can also be used (delay ejaculation). |
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Term
| how is vaginismus treated? |
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Definition
| desensitization starting w/a small object |
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Term
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Definition
| a disturbance in what the object of sexual gratification is or how sexual gratification is expressed (aka sexual perversions/deviations). these pts tend to be compulsive w/their sexual relationships which often exist outside societal rules/standards. for ex: normally sexual feelings and aggressive feelings are fused, but there’s a paraphilia where they become separate. |
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Term
| what are some examples of paraphilias? |
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Definition
| exhibitionism, pedophilia, vouyerism, fetishes, transvestite, sexual masochism, frotteurism, necrophilia, and coprophilia |
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Term
| what is an exhibitionist? |
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Definition
| a pt (usually male) w/a recurring urge to expose their genitals to a stranger or someone (usually female) who is unsuspecting. they become sexually aroused and may masturbate+orgasm in doing this. the point where the victim says "gross" is sexually stimulating to these pts. these pts don't want physical contact, they want the distance and the more frightened or disgusted victim gets, the better. these pts do have a sense of impotency - can't be intimate. |
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Term
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Definition
| this pt gets sexual excitement by observing others having sex or getting undressed. the distance is also important to these pts. |
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Term
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Definition
| a pt who wants to have physical contact w/o the other person's awareness - sought in crowded areas, but still intended to be anonymous. |
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Term
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Definition
| when sexual feelings become directed more toward an object (like lingerie, boots, etc) than a person. often associated w/childhood associations w/mother or other females. |
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Term
| what is a transvestite fetishism? |
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Definition
| urges by a heterosexual male to dress in women’s clothing to achieve sexual arousal. this isn't homosexual, often the pt will be a very heterosexual macho man. |
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Term
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Definition
| when the choice of sexual object is a child (usually pre-pubescent) and usually manual/oral contact is as far as it goes physically. 95% of pedophiliacs are heterosexual, 50% are drunk at the time of incident, many are previous victims of another pedophiliac, and usually there is already a relationship between that pt and the child. these pts usually have a low self-esteem - which is fed by a relationship w/a child. this is a dangerous disorder b/c the children involved are psychologically traumatized and the pt is a predator. tx: inpatient and perhaps chemical castration (methoxyprogesterone - lowers testosterone). |
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Term
| what is sexual masochism? |
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Definition
| these pts have recurring sexual dreams and fantasies where they’re verbally humiliated, beaten or made to suffer. this can be damaging and dangerous b/c the pt only becomes aroused if they are being abused. |
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Term
| is rape a response to sexual excitement? |
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Definition
| no, it is a response to a need to control and damage |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| sex w/urination or defecation |
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