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Ch16 Textbook Notes

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CHAPTER 16 SEXUAL DISORDERS sexual disorders fall into three distinct categoriessexual dysfunctions involve problems in experiencing sexual arousal or in carrying through with a sexual act to the point of sexual satisfactionparaphilias involve sexual activities that are focused on nonhuman objects children or nonconsenting adults or suffering or humiliationgender identity disorder involves the belief that one has been born with the body of the wrong genderSexual Dysfunctions occasional problems with sexual functioning are extremely commonLaumann Paik Rosen 1999 43 of women 31 of men reported occasional dysfunctionsThe Sexual Response CycleWilliam Masters Virginia Johnson in the 1950s and 1960s observed people engaging in a variety of sexual practices in a lab setting and recorded physiological changessexual desire phase urge to engage in any type of sexual activityarousal phase or excitement phasepsychological experience of arousal and pleasure and physiological changesvasocongestion is the filling of blood vessels and tissues with blood engorgementmyotonia is a muscular tensionplateau phaseexcitement remains at a high but stable levelduring both arousal and plateau phase person may feel tense all over flushed skin salivation increase nostrils flare heart pounds heavy breathing oblivious to external stimuli or eventsarousal and plateau phase are followed by orgasmin males involves rhythmic contractions of prostate seminal vesicles vas deferens entire length of penis urethra accompanied by semen ejaculationrefractory period follows ejaculation cant achieve full erection and another orgasm lasts for a few minutes to several hoursin females involves rhythmic contractions of the orgasmic platform irregular contractions of uterus no refractory periodresolution entire musculature of body relaxes state of deep relaxationsome differences in sexual responsessexual arousal in women often is more mental excitementgreater variability in female response patternto be diagnosed for a sexual dysfunction must be more than occasional and cause significant distress or interpersonal difficultDSMIVTR divides into four categories sexual desire disorder sexual arousal disorders orgasmic disorders sexual pain disordersSexual Desire Disordersindividuals level of sexual desire is how much heshe wants to have sexmanifested in sexual thought or fantasies interest in initiating or participating in sexual activities awareness of sexual cues from othersHelen Singer Kaplan one of the first to recognize sexual desire disorder as a separate problemHypoactive Sexual Desire Disorderhave little desire for sex causes them marked distress or interpersonal difficultyin most cases individual used to enjoy sex but has lost interest despite the presence of a willing and desirable partnerdiagnosis isnt given if individuals lack of desire results from transient circumstances eg too busy or fatigued from over worknot given if lack of desire is caused by other problems in sexual functioninggeneralized sexual desire disorder little desire for sexual activity most of hisher lifesituational sexual desire disorder lacks desire to have sex with partner but has sexual fantasies about othersLaumann et al 1999 22 women 5 men reported low sexual desiremore often connected to problems in relationships for womenSexual Aversion Disorderactively avoid sexual activitieswhen they do engage in sex may feel sickened or experience acute anxietyin women frequently tied to sexual assault experiencesSexual Arousal disorderdont experience the physiological changes that make up the excitement or arousal phase of sexual response cyclein females involves recurrent inability to attain or maintain the swelling lubrication responsemale erectile disorder involves recurrent inability to attain or maintain an erection until the completion of sexual activitylifelong form and acquired formLaumann et al 1999 20 of women report difficulties with lubrication or arousal49 of men have problems sufficient to warrant a diagnosisOrgasmic Disordersin women experience a recurrent delay or complete absence of orgasm after reaching the excitement phasediagnosis made only if unable to achieve orgasm despite receiving adequate stimulationLaumann et al 1999 25 women report difficulties reaching orgasm 33 among postmenopausal womenmost common form in males is premature ejaculation
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