Textbook Notes (368,125)
Canada (161,663)
Psychology (4,889)
Chapter

PSYCH 2075_Ch 18 Sexual Disorders and Sex Therapy_EC.docx

13 Pages
166 Views
Unlock Document

Department
Psychology
Course
Psychology 2075
Professor
William Fisher
Semester
Winter

Description
C H 18: S EXUAL D ISORDERS AND S EX T HERAPY • When a problem with sexual response causes significant psychological distress or interpersonal difficulty = sexual disorder • Sexual dysfunction • Long-term sexual difficulties can cause a great deal of psychological distress to individuals troubled by them, not to mention to their partners, and many of these people seek out treatment S EXUAL D ISORDERS • Sexual disorders: A problem with sexual response that causes a person mental distress • 4 categories: o desire disorder (hypoactive sexual desire, sexual aversion) o arousal disorder (erectile disorder, female sexual arousal disorder) o orgasmic disorder (rapid ejaculation, male orgasmic disorder, female orgasmic disorder) o sexual pain disorder (dyspareunia, vaginismus) • Can vary along two dimensions o Lifelong sexual disorder: a sexual disorder that has been present since the person began sexual functioning  Sometimes called primary sexual disorder o Acquired: A sexual disorder that develops after a period of normal functioning  Sometimes called a secondary sexual disorder o Generalized= occurring in all situations o Situational sexual disorder: a sexual disorder that a person has in some situations but not in others • Can occur with one partner (same or other gender), or in one situation but not another D ESIRE D ISORDERS Hypoactive Sexual Desire • Sexual desire or libido refers to an interest in sexual activity, leading the individual to seek out sexual activity or to be pleasurably receptive to it • Hypoactive sexual desire (HSD): a sexual disorder in which there is a lack of interest in sexual activity; also terms inhibited sexual desire or low sexual desire • Responsive desire: person begins to feel desire after sexual activity starts • Too little sexual desire = most common sexual issue reported by women • Discrepancy of sexual desire: a sexual problem in which the partners have considerably different levels of sexual desire Sexual Aversion Disorder • Person has a strong aversion involving anxiety, fear, or disgust to sexual interaction and actively avoids any kind of genital contact with a partner • Causes great difficulty in the person’s relationship • Common in persons who have panic disorders Emily Chan PSYCH 2075 | CH 18 Sexual Disorder and Sex Therapy | PagMarch 2011 A ROUSAL D ISORDERS Erectile Disorder • Erectile disorder: inability to have an erection or maintain one • Erectile dysfunction and inhibited sexual excitement (previously: impotence) • Can be lifelong/acquired, generalized/situational • The older men are, the more likely they are to experience erectile difficulties, with the incidence increasingly markedly between the ages 40 and 70 • Most common of the disorders among men who seek sex therapy, particularly since the introduction of Viagra • Psychological reactions: embarrassment, depression, worry (both to the man or their partner) Female Sexual Arousal Disorder • Female sexual arousal disorder (FSAD): A sexual disorder in which there is a lack of response to sexual stimulation • Involves a subjective, psychological component and a physiological element • Woman’s own subjective sense that she does not feel aroused and partly by difficulties with vaginal lubrication • Difficulties with lubrication o Particularly frequent among women during and after menopause and this is not a sexual disorder  estrogen levels decline, vaginal lubrication decreases O RGASMIC D ISORDERS Premature (Rapid) Ejaculation • Premature ejaculation (Rapid, PE): a sexual disorder in which the man ejaculates too soon and feels he cannot control when he ejaculates • Early ejaculation or rapid ejaculation • Different criteria o “prematurity” as the occurrence of orgasm less than 30 seconds after the penis has been inserted some say 2 minutes o 10 pelvic thrusts • Helen Singer Kaplan- key to defining rapid ejaculation is the absence of voluntary control of orgasm • If a man finds that he has become greatly concerned about his lack of ejaculatory control or that it is interfering with his ability to form intimate relationships, or if a couple agree that it is a problem in their relationship • Common problem in the general male population o 24% of Canadian men o Avg time to ejaculation after penetration: 8 minutes • PE was associated with lower sexual satisfaction for the men but not for their partners, and it was not associated with relationship satisfaction for either partner • May cause psychological problems o Because the ability to postpone ejaculation and “satisfy” a partner is so important in our concept of a man who is a competent lover, PE can cause a man to become anxious about his sexual competence o Partner may become frustrated because she or he is not having a satisfying sexual experience either Emily Chan PSYCH 2075 | CH 18 Sexual Disorder and Sex Therapy | Page 2 March 2011 • Thoughts they used to delay ejaculation  5 categories o Sex negative (unattractive tv personality) o Sex positive (visualizing a past episode of prolonged intercourse) o Non-sexual and negative (thinking of a sad event, unpaid debts) o Sex neutral (counting backwards from 100) o Sexually incongruous (thinking of your grandmother) o  recommends the sex-positive alternative = delays ejaculation and allows both partners to remain in the moment • Many clinicians encourage that the focus remain on sensations, and use of the stop/start technique Male Orgasmic Disorders • Male orgasmic disorder: a sexual disorder in which the male cannot have an orgasm, even though he has an erection and has had a great deal of sexual stimulation • Delayed or retarded ejaculation • Most common version: man is incapable of orgasm during intercourse but may be able to orgasm as a result of hand or mouth stimulation • Far less common than premature ejaculation • Negative reaction = see their partner’s inability to have an orgasm as a personal rejection • Some men adopt the practice of faking orgasm • Can create painful intercourse because intercourse goes on too long Female Orgasmic Disorder • Female orgasmic disorder: A sexual disorder in which the woman is unable to have an orgasm • Orgasmic dysfunction, anorgasmia, inhibited female orgasm, or “frigidity” • Can be lifelong/acquired, common is situational orgasmic disorder • Common: 21% of Canadian women report that they do not usually have an orgasm during intercourse • Younger women were more likely to report infrequent orgasms than were older women • Possibly due to an overly idealistic script S EXUAL P AIN D ISORDERS Painful Intercourse • Dyspareunia: painful intercourse • Can occur in both males and females • NHSLS: 14% of women, 3% men • In women, the pain may be felt in the vagina, around the vaginal entrance and clitoris, or deep in the pelvis • Pain may also differ in quality and in intensity o Some describe a burning sensation, a sharp pain, or an aching feeling • Most of these women also experience pain in non-sexual situations affecting the vulva  sports or inserting a tampon • Dyspareunia decreases one’s enjoyment of sexual experience, frequently causes problems with arousal and orgasm, and may even lead one to abstain from sexual activity Vaginismus Emily Chan PSYCH 2075 | CH 18 Sexual Disorder and Sex Therapy | Page 3 March 2011 • Vaginismus: a sexual disorder in which there is a spastic contraction of the muscles surrounding the entrance to the vagina, in some cases so severe that penetration is impossible • Involuntary constriction of the outer third of the vagina • Often associated with dyspareunia • Women diagnosed with vaginismus had greater muscle tension, lower muscle strength, and greater fear and avoidance of intercourse than did women with other forms of dyspareunia and control women • Not all women diagnosed with vaginismus had muscle spasms • Not common in the general population  women seek treatment if it makes intercourse impossible and they are interested in conceiving a child W HAT C AUSES S EXUAL D ISORDERS ? • Several categories of factors may be related to sexual disorders: physical factors (organic factors and drugs), individual psychological factors, and interpersonal factors • Factors interact with each other so that the causes of most disorders can best be understood from a biopsychosocial perspective • Biopsychosocial model: A general model that argues that physical, psychological, and social factors all contribute to sexual disorders P HYSICAL C AUSES • Organic factors: physical factors, such as disease or injury, that cause sexual disorder • Drugs Erectile Disorder (ED) • Major contributor to 50%+ cases of erectile disorder • Diseases associated with the heart and the circulatory system  erection depends on the circulatory system • Vascular pathology (problems in the blood vessels supplying the penis) can produce erection problems • Erection depends on having a great deal of blood flowing into the penis via the arteries, with simultaneous constricting of the veins so that the blood cannot flow out as rapidly as it is coming in = damage to either these arteries or veins may produce ED • Associated with Diabetes mellitus o 35% of men with diabetes have an ED • Hypogonadism – underfunctioning of the testes so that testosterone levels are very low • Hyperprolactinemia- excessive production of prolactin • Any disease or injury that damages the lower part of the spinal cord may cause ED  location of the erection reflex centre • Some kinds of prostate surgery may cause the condition Premature Ejaculation • More often caused by psychological than physical factors • Ma be due to malfunctioning of the ejaculatory reflexes  physiological hypersensitivity that results in faster ejaculation • Local infection – prostatitis, degeneration in the related parts of the nervous system, neural disorders (like MS) • Sociobiologists- “survival of the fastest” Emily Chan PSYCH 2075 | CH 18 Sexual Disorder and Sex Therapy | Page 4 March 2011 o Those who copulated and ejaculates rapidly would be more likely to survive and reproduce in that the female would be less likely to get away, and the male would be less likely to be attacked by other sexually aroused males while he was copulating o Average time from intromission to ejaculation among chimpanzees is rapid- 7 seconds o = due to genes Male Orgasmic Disorder • May be associated with a variety of medical or surgical conditions such as MS, spinal cord injury, and prostate surgery • Most commonly associated with psychological factors Female Orgasmic Disorder • May be caused by severe illness, general ill health, or extreme fatigue • Injury to the spinal cord • Most cases: psychological factors Painful Intercourse • Dyspareunia in women is often caused by organic factors, experience of sexual pain is influenced by psychological factors • Organic factors o 1. Disorders of the vaginal entrance o 2. Disorders of the vagina o 3. Pelvic Disorders • In men o Uncircumcised man, poor hygiene  bacteria can collect under the foreskin o Phimosis = foreskin cannot be pulled back o Allergic reaction to spermicidal creams or to the latex in condoms o Various prostate problems during intercourse, after intercourse, or on ejaculation Vaginismus • Painful intercrouse = conditions that cause that • More common caused by individual psychological factors or interpersonal factors D RUGS • Some drugs have side effects that cause sexual disorders • Drugs that treat high BP = erection problems, decrease sexual desire • Drugs may impair or improve sexual response (can increase/decrease desire, increase/decrease orgasm, improve/disprove premature ejaculation, erectile problems/difficulties, infertility Alcohol • Three categories of effects o 1. Short-term pharmacological effects o 2. Expectancy effects o 3. Long-term effects of chronic alcohol abuse • Alcoholics, in the later stages of alcoholism, frequently have sexual disorders  ED, orgasmic disorder, loss of desire • May be due to disturbances in sex hormone production because of atrophy of testes or liver damage + negative effect on interpersonal relationships Emily Chan PSYCH 2075 | CH 18 Sexual Disorder and Sex Therapy | Page 5 March 2011 • High levels of alcohol suppress sexual arousal  “whiskey dick” Illicit or Recreational Drugs • Marijuana o Claims to Increase sexual desire and makes sexual interactions more pleasurable o Potential negative effects: risky sexual desire o Associated with orgasmic disorder • Cocaine o Reported to be one of the drugs of choice for enhancing sexual experiences o Said to increase sexual desire, enhance sensuality, and delay orgasm o Chronic use = loss of sexual desire, orgasmic disorder, erectile disorders o Effects depend on the means of administration: inhaled, smoked, injected o Most negative effect = injection • Stimulant drugs (such as amphetamines) o Associated with increased sexual desire and better control of orgasm in some studies o Sometimes orgasm becomes difficult or impossible • Crystal methamphetamine (“ice”) o While high on it, people have tendency to engage in risky sexual behaviour o Can lead to paranoia, hallucinations, and violent behaviour • Opiate/ narcotics (e.g. morphine, heroin, and methadone) o Strong suppression effects on sexual desire and response o LT use of heroin in males leads to decreased testosterone levels Prescription Drugs • Psychiatric drugs – drugs used in the treatment of psychological disorders o Alter function of the CNS  affect sexual functioning o Tranquilizers and antidepressants often improve sexual responding as a result of improvement of the person’s mental state = may also be negative effects • Antidepressants (SSRIs) o Associated with desire, arousal, and delayed orgasm o Sometimes used to treat premature ejaculation because they delay orgasm • Antihypertensive drugs o Used to treat high BP = can cause erection problems in men • Drugs used to treat epilepsy appear to cause erection problems and decreased sexual desire P SYCHOLOGICAL C AUSES • Psychological sources of sexual disorders can be separated into predisposing factors and maintaining or ongoing causes • Predisposing factors: experiences that people have had in the past- for example, in childhood- that now affect their sexual response • Maintaining factors: various ongoing life circumstances, personal characteristics, and lovemaking patterns that inhibit sexual response Emily Chan PSYCH 2075 | CH 18 Sexual Disorder and Sex Therapy | Page 6 March 2011 Maintaining Psychological Causes • 8 factors are frequently maintaining psychological causes of sexual disorder o 1. Myths or misinformation  Sexual scripts that does not fully enhance sexual arousal and pleasure or to anxiety and worry o 2. Negative attitudes  Sexual activity, one’s own body, one’s partner’s body o 3. Anxieties such as fear of failure  Fear of failure, negative or traumatic experiences, o 4. Cognitive interference  Cognitive interference: negative thoughts that distract a person from focusing on the erotic experience  Most often relate to performance concerns, concerns related to external consequences, and emotional consequences, and body images  Men more likely to have thoughts related to performance, women to body image  Specta
More Less

Related notes for Psychology 2075

Log In


OR

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


OR

By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.


Submit