Tutorial Letter 202/1/2016 Abnormal Behaviour and Mental Health
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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. -
Effects of Expressive Writing on Sexual Dysfunction, Depression, and PTSD in Women with a History of Childhood Sexual Abuse: Results from a Randomized Clinical Trial
2177 ORIGINAL RESEARCH—PSYCHOLOGY Effects of Expressive Writing on Sexual Dysfunction, Depression, and PTSD in Women with a History of Childhood Sexual Abuse: Results from a Randomized Clinical Trial Cindy M. Meston, PhD, Tierney A. Lorenz, MA, and Kyle R. Stephenson, MA Department of Psychology, University of Texas at Austin, Austin, TX, USA DOI: 10.1111/jsm.12247 ABSTRACT Introduction. Women with a history of childhood sexual abuse (CSA) have high rates of depression, posttraumatic stress disorder, and sexual problems in adulthood. Aim. We tested an expressive writing-based intervention for its effects on psychopathology, sexual function, satisfaction, and distress in women who have a history of CSA. Methods. Seventy women with CSA histories completed five 30-minute sessions of expressive writing, either with a trauma focus or a sexual schema focus. Main Outcome Measures. Validated self-report measures of psychopathology and sexual function were conducted at posttreatment: 2 weeks, 1 month, and 6 months. Results. Women in both writing interventions exhibited improved symptoms of depression and posttraumatic stress disorder (PTSD). Women who were instructed to write about the impact of the abuse on their sexual schema were significantly more likely to recover from sexual dysfunction. Conclusions. Expressive writing may improve depressive and PTSD symptoms in women with CSA histories. Sexual schema-focused expressive writing in particular appears to improve sexual problems, especially for depressed women with CSA histories. Both treatments are accessible, cost-effective, and acceptable to patients. Meston CM, Lorenz TA, and Stephenson KR. Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: Results from a randomized clinical trial. -
Sexual Dysfunctions in Women
ANRV307-CP03-10 ARI 2 March 2007 13:46 Sexual Dysfunctions in Women Cindy M. Meston and Andrea Bradford Department of Psychology, University of Texas at Austin, Austin, Texas 78712; email: [email protected] Annu. Rev. Clin. Psychol. 2007. 3:233–56 Key Words First published online as a Review in women’s sexuality, orgasm, desire, arousal, sexual pain Advance on October 12, 2006 Access provided by University of Texas - Austin on 06/08/16. For personal use only. The Annual Review of Clinical Psychology is Abstract Annu. Rev. Clin. Psychol. 2007.3:233-256. Downloaded from www.annualreviews.org online at http://clinpsy.annualreviews.org In this article, we summarize the definition, etiology, assessment, and This article’s doi: treatment of sexual dysfunctions in women. Although the Diagnostic 10.1146/annurev.clinpsy.3.022806.091507 and Statistical Manual of Mental Disorders, fourth edition (DSM-IV- Copyright c 2007 by Annual Reviews. TR) is our guiding framework for classifying and defining women’s All rights reserved sexual dysfunctions, we draw special attention to recent discussion 1548-5943/07/0427-0233$20.00 in the literature criticizing the DSM-IV-TR diagnostic criteria and their underlying assumptions. Our review of clinical research on sexual dysfunction summarizes psychosocial and biomedical man- agement approaches, with a critical examination of the empirical support for commonly prescribed therapies and limitations of re- cent clinical trials. 233 ANRV307-CP03-10 ARI 2 March 2007 13:46 women with sexual problems that are not Contents clinically diagnosable, on the opposite end of the spectrum is the percentage of women in INTRODUCTION................ -
Hypoactive Sexual Desire Disorder in Females
Running head: FEMALE HYPOACTIVE SEXUAL DESIRE DISORDER 1 Female Hypoactive Sexual Desire Disorder A Summary Paper Presented to The Faculty of the Adler Graduate School ___________________ In Partial Fulfillment of the Requirements for the Degree of Master of Arts in Adlerian Counseling and Psychotherapy __________________ By: Mera Le Colling October 2011 FEMALE HYPOACTIVE SEXUAL DESIRE DISORDER 2 Abstract Hypoactive sexual desire disorder is the most prevalent sexual disorder in women, and one of the most challenging to overcome. This paper discusses the current definition for HSDD, the prevalence of HSDD in women, definitions of sexual health and sexual desire, sexual myths and HSDD, and criticisms around creating sexual norms and ideals related to HSDD. This paper will also discuss physical vs. psychological arousal in women, physical, psychological, and relational aspects of HSDD, male HSDD, an Adlerian perspective of HSDD, theories of desire, and proposed definitions of female HSDD including a proposed DSM-V revision of HSDD. Treatment options discussed include hormonal, antidepressant, herbal, CBT, and mindfulness. FEMALE HYPOACTIVE SEXUAL DESIRE DISORDER 3 Acknowledgments I would like to thank Professor Jere Truer for his guidance and encouragement in the selection of my master’s project. I would also like to thank Earl Heinrich for his ongoing assistance throughout my time at Adler Graduate School. Herb Laube, as both my master’s project reader and as my instructor in many classes, did much to mold my interest in psychology and human sexuality. I also wish to acknowledge the role my family played in my education, specifically Henrietta Truh and Lois Truh, my maternal grandmother and mother. -
Chapter 11 – Schizophrenia
Chapter 11 – Schizophrenia Schizophrenia Psychotic Disorder DSM: Must experience two or more of these symptoms (acute episode) for at least 1 month with disturbances for 6 months o Delusions o Hallucinations o Disorganized Speech o Disorganize or Catatonic Behavior o Negative Symptoms o Must also have decline in social or occupational functioning Acute Schizophrenic episode (“active” phase) o Generally positive symptoms o Patient continues to experience negative symptoms outside of active phase Symptoms o Major disturbances . Thought . Emotion . Behavior o Disordered thinking o Disturbances in movement and behavior o Positive Symptoms (Added behaviors) . Delusions Often persecutory delusions (CIA implanting thoughts in head) Can include grandiose delusions (Belief one is Jesus Christ) . Hallucinations Audible (Hearing things that are not there) – Often manifests as voices in head Visible (See things not there) Increased activity in Broca’s area during hallucinations o Negative Symptoms (Removed behaviors) . Avolition – Lack of interest . Alogia – Reduction in speech . Anhendonia – Cannot experience pleasure Includes anticipatory (pleasure derived from excitement of future event) Includes consummatory (pleasure derived from participating in an activity) . Flat Affect – Little emotion in face or voice . Asociality – Unable to form personal relationships o Disorganized Symptoms . Disorganized Speech Incoherence – Inability to organize and articulate ideas Loose associations – Goes off on tangents, difficulty in staying on one topic . Disorganized Behavior Odd behavior o Silliness, easily agitated, strange clothing choices o Other . Catatonia Motor abnormalities o Repetitive, complex gestures . Generally of fingers and hands o Excitable, wild flailing of limbs Catatonic immobility o Maintain odd positions for long periods of time Waxy Flexibility o Other people can move and pose the person’s limbs . -
Psychophysiological Sexual Arousal in Women with a History of Child Sexual Abuse
Journal of Sex & Marital Therapy ISSN: 0092-623X (Print) 1521-0715 (Online) Journal homepage: http://www.tandfonline.com/loi/usmt20 Psychophysiological Sexual Arousal in Women with a History of Child Sexual Abuse Alessandra H. Rellini & Cindy M. Meston To cite this article: Alessandra H. Rellini & Cindy M. Meston (2006) Psychophysiological Sexual Arousal in Women with a History of Child Sexual Abuse, Journal of Sex & Marital Therapy, 32:1, 5-22, DOI: 10.1080/00926230500229145 To link to this article: http://dx.doi.org/10.1080/00926230500229145 Published online: 22 Sep 2006. Submit your article to this journal Article views: 147 View related articles Citing articles: 29 View citing articles Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=usmt20 Download by: [University of Texas Libraries] Date: 08 June 2016, At: 11:17 Journal of Sex & Marital Therapy, 32:5–22, 2006 Copyright © Taylor & Francis Inc. ISSN: 0092-623X print DOI: 10.1080/00926230500229145 Psychophysiological Sexual Arousal in Women with a History of Child Sexual Abuse ALESSANDRA H. RELLINI and CINDY M. MESTON Department of Psychology, University of Texas at Austin, Austin, Texas, USA On the basis of literature that suggests that child sexual abuse (CSA) survivors with post traumatic stress disorder (PTSD) have higher baseline sympathetic nervous system (SNS) activity than healthy controls and research that suggests that the SNS plays a critical role in female physiological sexual arousal, we examined the impact of SNS activation through intense exercise on sexual arousal in women with CSA and PTSD. We measured physiological and sub- jective sexual arousal in women with CSA (n = 8), women with CSA and PTSD (n = 10), and healthy controls (n = 10) during exposure to nonerotic and erotic videos. -
Female Sexual Dysfunction Alessandra Graziottin
266 PELVIC FLOOR DYSFUNCTION AND EVIDENCE-BASED PHYSICAL THERAPY Female sexual dysfunction Alessandra Graziottin ASSESSMENT Last, but not least, new insights into the role of the hyperactivity of the pelvic fl oor in adolescence and, Women’s sexuality has only recently emerged as a possibly, infanthood, as predictors of vulnerability to central concern after years of neglect in the medical further sexual pain disorders (vaginismus and dyspa- world. The current challenge is to blend together the reunia) and to vulvar vestibulitis/vulvodynia open a biological, psychosexual and context-related compo- new preventive window for female sexual dysfunctions nents of women’s sexual response in a comprehensive (FSD) (Chiozza & Graziottin 2004, Graziottin 2005a, and meaningful scenario (Basson et al 2000, 2004). In Harlow et al 2001). Appropriate management of early this perspective, the role of pelvic fl oor function and hyperactivity of the pelvic fl oor could hopefully prevent dysfunction is of the highest importance (Alvarez & the urogenital and sexual comorbidities that affect so Rockwell 2002, Bourcier et al 2004, Graziottin 2001a, many young lives. 2005a). In this book, dedicated to physical therapy for the Levator ani’s tone, strength and performance is a pelvic fl oor, FSD is reviewed paying special attention to major contributor to vaginal receptivity, vaginal respon- the genital components of women’s sexual response in siveness, coital competence and pleasure (for both part- physiological and pathological conditions. However, ners), and for the orgasmic muscular response. Indirectly, the role of the biological and medical factors should pelvic fl oor disorders (PFD) may impair genital arousal always be considered in the appropriate psychosexual and, through a negative feedback, may affect the poten- and sociocultural context. -
DSM Sexual and Gender Identity Disorders
Sexual and Gender Identity Disorders This section contains the Sexual Dysfunctions, the Paraphilias, and the Gender Identity Disorders. The Sexual Dysfunctions are characterized by disturbance in sexual desire and in the psychophysiological changes that characterize the sexual response cycle and cause marked distress and interpersonal difficulty. The Sexual Dysfunctions include Sexual Desire Disorders (i.e., Hypoactive Sexual Desire Disorder, Sexual Aversion Disorder), Sexual Arousal Disorders (i.e., Female Sexual Arousal Disorder, Male Erectile Disorder), Orgasmic Disorders (i.e., Female Orgasmic Disorder, Male Orgasmic Disorder, Premature Ejaculation), Sexual Pain Disorders (i.e., Dyspareunia, Vaginismus), Sexual Dysfunction Due to a General Medical Condition, Substance- Induced Sexual Dysfunction, and Sexual Dysfunction Not Otherwise Specified. The Paraphilias are characterized by recurrent, intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, or situations and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The Paraphilias include Exhibitionism, Fetishism, Frotteurism, Pedophilia, Sexual Masochism, Sexual Sadism, Transvestic Fetishism, Voyeurism, and Paraphilia Not Otherwise Specified. Gender Identity Disorders are characterized by strong and persistent cross-gender identification accompanied by persistent discomfort with one's assigned sex. Gender identity refers to an individual's self-perception as male or female. The term gender dysphoria denotes strong and persistent feelings of discomfort with one's assigned sex, the desire to possess the body of the other sex, and the desire to be regarded by others as a member of the other sex. The terms gender identity and gender dysphoria should be distinguished from the term sexual orientation, which refers to erotic attraction to males, females, or both. -
How Changes in Depression and Anxiety Symptoms Correspond to Variations in Female Sexual Response in a Nonclinical Sample of Young Women: a Daily Diary Study
2915 ORIGINAL RESEARCH—PSYCHOLOGY How Changes in Depression and Anxiety Symptoms Correspond to Variations in Female Sexual Response in a Nonclinical Sample of Young Women: A Daily Diary Study David A. Kalmbach, PhD,*† Sheryl A. Kingsberg, PhD,‡ and Jeffrey A. Ciesla, PhD† *Sleep and Chronophysiology Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; †Department of Psychology, Kent State University, Kent, OH, USA; ‡Departments of Reproductive Biology and Psychiatry, Case Western Reserve University, Cleveland, OH, USA DOI: 10.1111/jsm.12692 ABSTRACT Introduction. A large body of literature supports the co-occurrence of depression, anxiety, and sexual dysfunction. However, the manner in which affective symptoms map onto specific female sexual response indices is not well understood. Aims. The present study aimed to examine changes in depression and anxiety symptoms and their correspondence to fluctuations in desire, subjective arousal, genital response, orgasmic function, and vaginal pain. Methods. The study used a 2-week daily diary approach to examine same-day and temporal relations between affective symptoms and sexual function. Main Outcome Measures. The unique relations between shared and disorder-specific symptoms of depression and anxiety (i.e., general distress, anhedonia, and anxious arousal) and female sexual response (i.e., desire, subjective arousal, vaginal lubrication, orgasmic function, and sexual pain) were examined, controlling for baseline levels of sexual distress, depression, and anxiety, as well as age effects and menstruation. Results. Analyses revealed that changes in depression and anxiety severity corresponded to same-day variations in sexual response. Specifically, anhedonia (depression-specific symptom) was related to poorer same-day sexual desire, whereas greater anxious arousal (anxiety-specific symptom) was independently related to simultaneous increases in subjective sexual arousal, vaginal lubrication, and sexual pain. -
To Consult Or Not to Consult? Investigating Barriers to Dysparenia Treatment-Seeking in Young Women
UNLV Theses, Dissertations, Professional Papers, and Capstones 5-2011 To consult or not to consult? Investigating barriers to dysparenia treatment-seeking in young women Robyn L. Donaldson University of Nevada, Las Vegas Follow this and additional works at: https://digitalscholarship.unlv.edu/thesesdissertations Part of the Female Urogenital Diseases and Pregnancy Complications Commons, Health Psychology Commons, and the Public Health Commons Repository Citation Donaldson, Robyn L., "To consult or not to consult? Investigating barriers to dysparenia treatment-seeking in young women" (2011). UNLV Theses, Dissertations, Professional Papers, and Capstones. 1001. http://dx.doi.org/10.34917/2344937 This Dissertation is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Dissertation in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/or on the work itself. This Dissertation has been accepted for inclusion in UNLV Theses, Dissertations, Professional Papers, and Capstones by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. TO CONSULT OR NOT TO CONSULT? INVESTIGATING BARRIERS TO DYSPARENIA TREATMENT-SEEKING IN YOUNG WOMEN by Robyn L. Donaldson Bachelor of Science College of Charleston, South Carolina 2002 Master of Arts University of Nevada, Las Vegas 2007 A dissertation submitted in partial fulfillment of the requirements for the Degree of Philosophy in Psychology Department of Psychology College of Liberal Arts Graduate College University of Nevada, Las Vegas May 2011 Copyright by Robyn L. -
The ICD-10 Classification of Mental and Behavioural Disorders
The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines World Health Organization -1- Preface In the early 1960s, the Mental Health Programme of the World Health Organization (WHO) became actively engaged in a programme aiming to improve the diagnosis and classification of mental disorders. At that time, WHO convened a series of meetings to review knowledge, actively involving representatives of different disciplines, various schools of thought in psychiatry, and all parts of the world in the programme. It stimulated and conducted research on criteria for classification and for reliability of diagnosis, and produced and promulgated procedures for joint rating of videotaped interviews and other useful research methods. Numerous proposals to improve the classification of mental disorders resulted from the extensive consultation process, and these were used in drafting the Eighth Revision of the International Classification of Diseases (ICD-8). A glossary defining each category of mental disorder in ICD-8 was also developed. The programme activities also resulted in the establishment of a network of individuals and centres who continued to work on issues related to the improvement of psychiatric classification (1, 2). The 1970s saw further growth of interest in improving psychiatric classification worldwide. Expansion of international contacts, the undertaking of several international collaborative studies, and the availability of new treatments all contributed to this trend. Several national psychiatric bodies encouraged the development of specific criteria for classification in order to improve diagnostic reliability. In particular, the American Psychiatric Association developed and promulgated its Third Revision of the Diagnostic and Statistical Manual, which incorporated operational criteria into its classification system. -
Sexual Arousal: Similarities and Differences Between Men and Women the Journal of Men’S Health & Gender, 1 (2-3): 215-223, 2004
Graziottin A. Sexual arousal: similarities and differences between men and women The Journal of Men’s Health & Gender, 1 (2-3): 215-223, 2004 DRAFT COPY – PERSONAL USE ONLY Sexual arousal: similarities and differences between men and women Alessandra Graziottin MD Centre of Gynaecology and Medical Sexology, Milan, Italy Abstract Sexual arousal encompasses activation of physiological systems that coordinate sexual function in both sexes and can be divided into central arousal, peripheral non-genital arousal, and genital arousal. Genital arousal leads to erection in men and to vaginal lubrication and clitoral/vulvar (vestibular bulb) congestion in women. Persisting biases in the understanding of the pathophysiology of sexual arousal are exemplified by the current differences in definitions. In men, sexual arousal disorders are identified with erectile disorders. In women, a more sophisticated set of definitions is described. It includes the subjective arousal disorder, the genital arousal disorder, the mixed arousal disorder, and the persistent sexual arousal disorder. Painful arousal, although not officially included in current nosology, should be considered. A preliminary critical consideration of similarities and differences in the definitions of arousal disorders, in the physiology of sexual arousal, in the causes of arousal disorders, and the influence of arousal disorders on satisfaction with the partner and happiness will be presented. In contrast to popular opinion, women’s arousal disorders influence their physical (OR= 7.04 (4.71-10.53) more than their emotional satisfaction (OR= 4.28 (2.96-6.20). Furthermore such disorders are reported to have a greater effect on women’s physical satisfaction (OR= 7.04 (4.71-10.53) than erectile dysfunction has on men’s physical satisfaction (OR= 4.38 (2.46-7.82).