Paraphilic Disorders
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Hypersexuality in Neurological Disorders
HYPERSEXUALITY IN NEUROLOGICAL DISORDERS NATALIE AHMAD MAHMOUD TAYIM A thesis submitted to the Institute of Neurology in fulfilment of the requirements for the degree of Doctor of Philosophy (PhD) University College London January 2019 Declaration of originality I, Natalie Ahmad Mahmoud Tayim, confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis. _________________________________ Natalie Ahmad Mahmoud Tayim ii Abstract The issue of hypersexuality in neurological disorders is grossly underreported. More research has been done into sexual dysfunction (outside of hypersexuality) in neurological disorders such as erectile dysfunction and hyposexuality (loss of libido). Furthermore, in Parkinson’s disease research, most mention of hypersexuality has been in conjunction with other impulse control disorders and has therefore not been examined in depth on its own. Although in recent years hypersexuality has become more recognized as an issue in research, there is still very limited information regarding its manifestations, impact, and correlates. It is therefore important to explore this area in detail in order to broaden understanding associated with this sensitive issue. Perhaps in doing so, barriers will be broken and the issue will become more easily discussed and, eventually, more systematically assessed and better managed. This thesis aims to serve as an exploratory paper examining prevalence, clinical phenomenology, impact, and potential feasible psychological interventions for hypersexuality in patients with neurological disorders and their carers. The thesis is divided into three main studies: 1. Study I: systematic review assessing prevalence, clinical phenomenology, successful treatment modalities, implicated factors contributing to the development, and assessment tools for hypersexuality in specific neurological disorders. -
Sexual Disorders and Gender Identity Disorder
CHAPTER :13 Sexual Disorders and Gender Identity Disorder TOPIC OVERVIEW Sexual Dysfunctions Disorders of Desire Disorders of Excitement Disorders of Orgasm Disorders of Sexual Pain Treatments for Sexual Dysfunctions What are the General Features of Sex Therapy? What Techniques Are Applied to Particular Dysfunctions? What Are the Current Trends in Sex Therapy? Paraphilias Fetishism Transvestic Fetishism Exhibitionism Voyeurism Frotteurism Pedophilia Sexual Masochism Sexual Sadism A Word of Caution Gender Identity Disorder Putting It Together: A Private Topic Draws Public Attention 177 178 CHAPTER 13 LECTURE OUTLINE I. SEXUAL DISORDERS AND GENDER-IDENTITY DISORDER A. Sexual behavior is a major focus of both our private thoughts and public discussions B. Experts recognize two general categories of sexual disorders: 1. Sexual dysfunctions—problems with sexual responses 2. Paraphilias—repeated and intense sexual urges and fantasies to socially inappropri- ate objects or situations C. In addition to the sexual disorders, DSM includes a diagnosis called gender identity dis- order, a sex-related pattern in which people feel that they have been assigned to the wrong sex D. Relatively little is known about racial and other cultural differences in sexuality 1. Sex therapists and sex researchers have only recently begun to attend systematically to the importance of culture and race II. SEXUAL DYSFUNCTIONS A. Sexual dysfunctions are disorders in which people cannot respond normally in key areas of sexual functioning 1. As many as 31 percent of men and 43 percent of women in the United States suffer from such a dysfunction during their lives 2. Sexual dysfunctions typically are very distressing and often lead to sexual frustra- tion, guilt, loss of self-esteem, and interpersonal problems 3. -
Penile Measurements in Normal Adult Jordanians and in Patients with Erectile Dysfunction
International Journal of Impotence Research (2005) 17, 191–195 & 2005 Nature Publishing Group All rights reserved 0955-9930/05 $30.00 www.nature.com/ijir Penile measurements in normal adult Jordanians and in patients with erectile dysfunction Z Awwad1*, M Abu-Hijleh2, S Basri2, N Shegam3, M Murshidi1 and K Ajlouni3 1Department of Urology, Jordan University Hospital, Amman, Jordan; 2Jordan Center for the Treatment of Erectile Dysfunction, Amman, Jordan; and 3National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan The purpose of this work was to determine penile size in adult normal (group one, 271) and impotent (group two, 109) Jordanian patients. Heights of the patients, the flaccid and fully stretched penile lengths were measured in centimeters in both groups. Midshaft circumference in the flaccid state was recorded in group one. Penile length in the fully erect penis was measured in group two. In group one mean midshaft circumference was 8.9871.4, mean flaccid length was mean 9.371.9, and mean stretched length was 13.572.3. In group two, mean flaccid length was 7.771.3, and mean stretched length was 11.671.4. The mean of fully erect penile length after trimex injection was 11.871.5. In group 1 there was no correlation between height and flaccid length or stretched length, but there was a significant correlation between height and midpoint circumference, flaccid and stretched lengths, and between stretched lengths and midpoint circumference. In group 2 there was no correlation between height and flaccid, stretched, or fully erect lengths. On the other hand, there was a significant correlation between the flaccid, stretched and fully erect lengths. -
Sexual Dysfunction and Related Factors in Pregnancy
Banaei et al. Systematic Reviews (2019) 8:161 https://doi.org/10.1186/s13643-019-1079-4 PROTOCOL Open Access Sexual dysfunction and related factors in pregnancy and postpartum: a systematic review and meta-analysis protocol Mojdeh Banaei1, Maryam Azizi2, Azam Moridi3, Sareh Dashti4, Asiyeh Pormehr Yabandeh3 and Nasibeh Roozbeh3* Abstract Background: Sexual dysfunction refers to a chain of psychiatric, individual, and couple’s experiences that manifests itself as a dysfunction in sexual desire, sexual arousal, orgasm, and pain during intercourse. The aim of this systematic review will be to assess the sexual dysfunction and determine the relevant factors to sexual dysfunction during pregnancy and postpartum. Methods and analysis: All observational studies, including descriptive, descriptive-analytic, case-control, and cohort studies published between 1990 and 2019, will be included in the study. Review articles, case studies, case reports, letter to editors, pilot studies, and editorial will be excluded from the study. The search will be conducted in the Cochrane Central Register, MEDLINE, Google Scholar, EMBASE, ProQuest, Scopus, WOS, and CINAHL databases. Eligible studies should assess at least one of the sexual dysfunction symptoms in pregnant women orinthefirstyearpostpartum.Quality assessment of studies will be performed by two authors independently based on the NOS checklist. This checklist is designed to assess the quality of observational studies. Data will be analyzed using Stata software ver. 11. Considering that the index investigated in the present study will be the level of sexual disorder, standard error will be calculated for each study using binomial distribution. The heterogeneity level will be investigated using Cochran’sQstatisticandI2 index in a chi-square test at a significance level of 1.1. -
Erectile Dysfunction and Premature Ejaculation
GUIDELINES ON MALE SEXUAL DYSFUNCTION: Erectile Dysfunction and Premature Ejaculation (Text update April 2014) K. Hatzimouratidis (chair), I. Eardley, F. Giuliano, D. Hatzichristou, I. Moncada, A. Salonia, Y. Vardi, E. Wespes Eur Urol 2006 May;49(5):806-15 Eur Urol 2010 May;57(5):804-14 Eur Urol 2012 Sep;62(3):543-52 ERECTILE DYSFUNCTION Definition, epidemiology and risk factors Erectile dysfunction (ED) is the persistent inability to attain and maintain an erection sufficient to permit satisfactory sex- ual performance. Although ED is a benign disorder, it affects physical and psychosocial health and has a significant impact on the quality of life (QoL) of sufferers and their partners. There is increasing evidence that ED can be an early mani- festation of coronary artery and peripheral vascular disease; thus, ED should not be regarded only as a QoL issue but also as a potential warning sign of cardiovascular disease includ- ing lack of exercise, obesity, smoking, hypercholesterolaemia, and the metabolic syndrome. The risk of ED may be reduced by modifying these risk factors, particularly taking exercise or losing weight. Another risk factor for ED is radical prostatec- tomy (RP) in any form (open, laparoscopic, or robotic) because of the risk of cavernosal nerve injury, poor oxygenation of the corpora cavernosa, and vascular insufficiency. 130 Male Sexual Dysfunction Diagnosis and work-up Basic work-up The basic work-up (minimal diagnostic evaluation) outlined in Fig. 1 must be performed in every patient with ED. Due to the potential cardiac risks associated with sexual activity, the three Princeton Consensus Conference stratified patients with ED wanting to initiate, or resume, sexual activity into three risk categories. -
Background Note on Human Rights Violations Against Intersex People Table of Contents 1 Introduction
Background Note on Human Rights Violations against Intersex People Table of Contents 1 Introduction .................................................................................................................. 2 2 Understanding intersex ................................................................................................... 2 2.1 Situating the rights of intersex people......................................................................... 4 2.2 Promoting the rights of intersex people....................................................................... 7 3 Forced and coercive medical interventions......................................................................... 8 4 Violence and infanticide ............................................................................................... 20 5 Stigma and discrimination in healthcare .......................................................................... 22 6 Legal recognition, including registration at birth ............................................................... 26 7 Discrimination and stigmatization .................................................................................. 29 8 Access to justice and remedies ....................................................................................... 32 9 Addressing root causes of human rights violations ............................................................ 35 10 Conclusions and way forward..................................................................................... 37 10.1 Conclusions -
The DSM Diagnostic Criteria for Paraphilia Not Otherwise Specified
Arch Sex Behav DOI 10.1007/s10508-009-9552-0 ORIGINAL PAPER The DSM Diagnostic Criteria for Paraphilia Not Otherwise Specified Martin P. Kafka Ó American Psychiatric Association 2009 Abstract The category of ‘‘Not Otherwise Specified’’ (NOS) Introduction for DSM-based psychiatric diagnosis has typically retained diag- noses whose rarity, empirical criterion validation or symptomatic Prior to an informed discussion of the residual category for expression has been insufficient to be codified. This article re- paraphilic disorders, Paraphilia Not Otherwise Specified (PA- views the literature on Telephone Scatologia, Necrophilia, Zoo- NOS), it is important to briefly review the diagnostic criteria philia, Urophilia, Coprophilia, and Partialism. Based on extant for a categorical diagnosis of paraphilic disorders as well as the data, no changes are suggested except for the status of Partialism. types of conditions reserved for the NOS designation. Partialism, sexual arousal characterized by ‘‘an exclusive focus The diagnostic criteria for paraphilic disorders have been mod- on part of the body,’’ had historically been subsumed as a type of ified during the publication of the Diagnostic and Statistical Man- Fetishism until the advent of DSM-III-R. The rationale for con- uals of the American Psychiatric Association. In the latest edition, sidering the removal of Partialism from Paraphilia NOS and its DSM-IV-TR (American Psychiatric Association, 2000), a para- reintegration as a specifier for Fetishism is discussed here and in a philic disorder must meet two essential criteria. The essential companion review on the DSM diagnostic criteria for fetishism features of a Paraphilia are recurrent, intense sexually arousing (Kafka, 2009). -
Use of DSM Paraphilia Diagnoses in Sexually Violent Predator Commitment Cases
SPECIAL ARTICLE Use of DSM Paraphilia Diagnoses in Sexually Violent Predator Commitment Cases Michael B. First, MD, and Robert L. Halon, PhD There is legitimate concern in the psychiatric community about the constitutionality of sexually violent predator (SVP) commitment statutes. Such constitutionality depends on the requirement that a sexual offender have a mental abnormality that makes him commit violent predatory sex offenses and reflects almost exclusively a concern for public safety, with little regard for notions of clinical sensibility or diagnostic accuracy. However, given that mental health experts’ diagnostic opinions are, and will continue to be, important to the triers of fact in regard to the application of the SVP statutes, we describe valid means of making a DSM-IV-TR paraphilic diagnosis. We also provide a three-step approach for the judicious application of the diagnosis in the context of SVP commitment evaluations that emphasizes the importance of not making a paraphilia diagnosis based solely on the sexual offenses themselves. Finally, we discuss the appropriate use of a paraphilia NOS diagnosis in SVP cases. J Am Acad Psychiatry Law 36:443–54, 2008 In 1990, the state of Washington passed the first Despite several challenges to the constitutionality sexually violent predator (SVP) involuntary commit- of SVP statutes, the U.S. Supreme Court in two sep- ment statute, which was designed to allow for the arate rulings (Kansas v. Hendricks3 and Kansas v. civil commitment of sex offenders to mental hospi- Crane4) upheld the constitutionality of the Kansas tals after they complete mandatory prison sentences. State Sexually Violent Predator laws, essentially mak- According to the Washington SVP statute, the of- ing similar laws with analogous proof requirements fender must be found to be “a person who has been constitutional in all states. -
Zoophilia and Hypersexuality in an Adult Male with Schizophrenia A
Neurology, Psychiatry and Brain Research 34 (2019) 41–43 Contents lists available at ScienceDirect Neurology, Psychiatry and Brain Research journal homepage: www.elsevier.com/locate/npbr Zoophilia and hypersexuality in an adult male with schizophrenia: A case report T Sujita Kumar Kar, Sankalp Dixit King George’s Medical University, Lucknow, India ARTICLE INFO ABSTRACT Keywords: Background: Paraphilias can be seen in the context of schizophrenia. Among the paraphilias, zoophilia is less Paraphilia commonly reported. Paraphilias are often associated with hypersexuality and psychiatric comorbidities. Zoophilia Paraphilias like zoophilia may result in development of sexually transmitted diseases. Schizophrenia Method: After obtaining informed consent, details of history were obtained. Mental status of the patient was Sexually transmitted diseases done at regular intervals. General physical examination, appropriate blood investigations and neuroimaging were done. Result: We have described here the case of an adult male suffering from schizophrenia with co-morbid alcohol and cannabis use disorder with hypersexuality, who had zoophilia and developed hepatitis B infection. Conclusion: Paraphilias like zoophilia can lead to development of sexually transmitted disease in patients with schizophrenia. 1. Introduction of paraphilia. Earlier reports suggest the prevalence of zoophilia to be significantly higher among psychiatric inpatients than those in medical Schizophrenia is a severe mental disorder. Altered sexual behaviour inpatients (Alvarez & Freinhar, 1991). Presence of comorbid paraphilia may be seen more frequently in patients with schizophrenia. Zoophilia in schizophrenia is associated with increased rate of suicides as well as (Bestiality) is a form of sexual perversion (paraphilia), which involves longer duration of hospitalization (Marsh et al., 2010). This case report sexual fantasies and acts with animals. -
Delayed Ejaculation & Anorgasmia
Delayed ejaculation & anorgasmia EMMANUELE A. JANNINI Chair of Endocrinology & Sexual Medicine Tor Vergata University of Rome, Italy It Soc Androl & Sex Med – President-elect Taxonomy of ejaculatory disorders Epidemiology of ejaculatory disorders 25 a) timing 20 – PREMATURE EJACULATION 15 – DELAYED EJACULATION 10 Percentage 5 b) modality 0 E N IA R PE DE IO M AS ‐ RETROGRADE EJACULATION LAT G U R O JAC ‐ ANEJACULATION (impotentia ejaculationis) E AN AN Taxonomy of ejaculatory disorders • EMISSION PHASE DISORDERS: – Retrograde ejaculation • EJACULATION PHASE DISORDERS: – Premature ejaculation – Deficient ejaculation: • Delayed ejaculation • Anejaculation • ORGASM DISORDERS: – Anorgasmia – Postorgasmic illness syndrome Standard Operating Procedures (SOP) in Diagnosis and Treatment of Delayed Ejaculation/Anejaculation ISSM Standards Committee Meeting June 23-25, 2010 Hotel Agneshof Nürnberg, Germany Pierre Assalian Canada Emmanuele A. Jannini Italy Chris G McMahon (Chairman) Australia David Rowland USA Marcel Waldinger (Chairman) The Netherlands DELAYED EJACULATION Delayed ejaculation • Much less frequent than PE • A rare reason for medical help seeking • Underdiagnosed • Undertreated Is DE a disease? • girls are happy… …where is the problem? …but girls are not happy… Why so poor science? • Low prevalence • Few studies • Classically considered A new psychogenic in nature • Classically treated with behavioral therapies challenge • Definition(s) lacking • Etiologies largely unknown for • Pathogenesis obscure • Lack of awareness and Sexual acknowledgements -
The Brain, Erectile Dysfunction, and Sexual Violence John D
Dignity: A Journal on Sexual Exploitation and Violence Volume 2 Article 6 Issue 3 Freedom from Sexploitation July 2017 The Public eH alth Harms of Pornography: The Brain, Erectile Dysfunction, and Sexual Violence John D. Foubert Oklahoma State University, [email protected] Follow this and additional works at: https://digitalcommons.uri.edu/dignity Part of the Civic and Community Engagement Commons, Clinical and Medical Social Work Commons, Cognition and Perception Commons, Cognitive Behavioral Therapy Commons, Community-Based Learning Commons, Community Health Commons, Community Health and Preventive Medicine Commons, Developmental Psychology Commons, Domestic and Intimate Partner Violence Commons, Family, Life Course, and Society Commons, Family Practice Nursing Commons, Health Psychology Commons, Marriage and Family Therapy and Counseling Commons, Medical Humanities Commons, Personality and Social Contexts Commons, Politics and Social Change Commons, Psychoanalysis and Psychotherapy Commons, Public Health and Community Nursing Commons, Public Health Education and Promotion Commons, Social Psychology Commons, Social Work Commons, Sociology of Culture Commons, and the Substance Abuse and Addiction Commons Recommended Citation Foubert, John D. (2017) "The ubP lic Health Harms of Pornography: The rB ain, Erectile Dysfunction, and Sexual Violence," Dignity: A Journal on Sexual Exploitation and Violence: Vol. 2: Iss. 3, Article 6. DOI: 10.23860/dignity.2017.02.03.06 Available at: https://digitalcommons.uri.edu/dignity/vol2/iss3/6https://digitalcommons.uri.edu/dignity/vol2/iss3/6 This Freedom from Sexploitation: An Agenda is brought to you for free and open access by DigitalCommons@URI. It has been accepted for inclusion in Dignity: A Journal on Sexual Exploitation and Violence by an authorized editor of DigitalCommons@URI. -
Post-Orgasmic Illness Syndrome: a Closer Look
Indonesian Andrology and Biomedical Journal Vol. 1 No. 2 December 2020 Post-orgasmic Illness Syndrome: A Closer Look William1,2, Cennikon Pakpahan2,3, Raditya Ibrahim2 1 Department of Medical Biology, Faculty of Medicine and Health Sciences, Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia 2 Andrology Specialist Program, Department of Medical Biology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo Hospital, Surabaya, Indonesia 3 Ferina Hospital – Center for Reproductive Medicine, Surabaya, Indonesia Received date: Sep 19, 2020; Revised date: Oct 6, 2020; Accepted date: Oct 7, 2020 ABSTRACT Background: Post-orgasmic illness syndrome (POIS) is a rare condition in which someone experiences flu- like symptoms, such as feverish, myalgia, fatigue, irritabilty and/or allergic manifestation after having an orgasm. POIS can occur either after intercourse or masturbation, starting seconds to hours after having an orgasm, and can be lasted to 2 - 7 days. The prevalence and incidence of POIS itself are not certainly known. Reviews: Waldinger and colleagues were the first to report cases of POIS and later in establishing the diagnosis, they proposed 5 preliminary diagnostic criteria, also known as Waldinger's Preliminary Diagnostic Criteria (WPDC). Symptoms can vary from somatic to psychological complaints. The mechanism underlying this disease are not clear. Immune modulated mechanism is one of the hypothesis that is widely believed to be the cause of this syndrome apart from opioid withdrawal and disordered cytokine or neuroendocrine responses. POIS treatment is also not standardized. Treatments includeintra lymphatic hyposensitization of autologous semen, non-steroid anti-inflamation drugs (NSAIDs), steroids such as Prednisone, antihistamines, benzodiazepines, hormones (hCG and Testosterone), alpha-blockers, and other adjuvant medications.