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This Concept Map, created with IHMC CmapTools, has information related to: Sexual Disorders, Sexual Disorders Paraphilias -recurrent, intense fantasies, urges, behs -mutual arousal not a goal PARAPHILIA NOS Telephone scatophilia Internet sexual activity Partialism-focus on non-sexual body part Acrotomophilia-focus on amputees Coprophilia-feces Urophilia-urine Kismaphilia-enemas Necrophilia Zoophilia Ephebophilia-teen attraction, Sexual Disorders Paraphilias -recurrent, intense fantasies, urges, behs -mutual arousal not a goal SEXUAL MASOCHISM -humiliation, abuse, etc. -not if SIMULATED suffering -not if unintentional -women often seek Tx ASPHYXIOPHILIA -strangulation for arousal, Sexual Disorders 2ndary ERECTILE DYSFCN SUBSTANCE-INDUCED -Antidepressants -Antipsychotics -Anti-HTNs -Alcohol, barbiturates, pot, coke, heroin -Anti-PD drugs -Digoxin, Sexual Disorders Sexual Dysfunctions Disorders of Desire HYPOACTIVE SEXUAL DESIRE -r/o sexual incompatibility, Axis I d/o -issues of intimacy, sexuality, control -social pressures -determination made by clinician SEXUAL AVERSION -lack of desire+active avoidance -rule out Axis I (depression) -Therapy (pref) or brief anxiolytics, Sexual Disorders Sexual Dysfunctions Sexual Pain Disorders DYSPAREUNIA -persistent, recurrent pain w/ coitus -mostly in WOMEN -often w/ vaginitis, endometriosis, or post-op conplications -but can have no medical reason Ex-psychoTx and sex Tx VAGINISMUS -involutary constriction of vag mm -MOST CURABLE of sex dysfcns -issues: infx, post-op, past sexual trauma, anxiety, r'ship problems Tx-use dilators, exercises, Tx, Sexual Disorders Gender Identity Disorders -strong, persistent ID w/ other gender -independent of sexual orientation -Tx-find balance b/w physical, psych -psychotherapy -can-> surgery (men>women) GENDER IDENTITY D/Os IN ADOLS/ADULTS, PEDOPHILIA -Sx for at least 6 mos -w/ prepubescent kids -pedophile at least 16yo -5yr older than victim -mostly male, FM possible -specify attraction Exclusivity Non-exclusive-pedophiles attracted to boys, but not to men -usually heterosexual Exclusive-boys and men If exclusive to adolescents: EPHEBOPHILIA-paraphilia NOS, Sexual Disorders Gender Identity Disorders -strong, persistent ID w/ other gender -independent of sexual orientation -Tx-find balance b/w physical, psych -psychotherapy -can-> surgery (men>women) GENDER IDENTITY D/Os IN CHILDREN, Sexual Disorders Paraphilias -recurrent, intense fantasies, urges, behs -mutual arousal not a goal Tx-usually chronic -inpt if risk to others -SSRIs may decrease urges -Individual/group psychoTx -CBT>psychodynamic -long-term F/U for relapse prevention, Sexual Disorders Paraphilias -recurrent, intense fantasies, urges, behs -mutual arousal not a goal FETISHISM -objects worn/used during masturbation -not "fetish" if designed for sexual arousal, Sexual Disorders Paraphilias -recurrent, intense fantasies, urges, behs -mutual arousal not a goal PEDOPHILIA -Sx for at least 6 mos -w/ prepubescent kids -pedophile at least 16yo -5yr older than victim -mostly male, FM possible -specify attraction, Sexual Disorders Paraphilias -recurrent, intense fantasies, urges, behs -mutual arousal not a goal VOYEURISM-usually MALE watches FM -watching unsuspecting individuals undress or having sex -if stalking for purpose of RAPE-NOS Dx, Sexual Disorders Paraphilias -recurrent, intense fantasies, urges, behs -mutual arousal not a goal SEXUAL DISORDER NOS, Sexual Disorders Sexual Dysfunctions Disorders of Orgasm -NL-generalized mm tension Women: ANORGASMIA, PREORGASMIA Men: DELAYED/INHIBITED EJACULATION PREMATURE EJACULATION -define pt's 'premature' -can result from conditioning Behavioral Tx-squeeze method, start-stop -Tx to explore feelings on intimacy, etc. -SSRIs?, Sexual Disorders 2ndary ERECTILE DYSFCN INHIBITED FM ORGASM -TCAs, -MAOIs -SSRIs -antipsychotics, Sexual Disorders Definitions Sex-defined on basis of genitals Gender-indiv status as male or female Gender Identity-the private experience of gender role Gender Role-public manifestation of gender Sexual orientation-object choice, fantasy, Sexual Disorders 2ndary ERECTILE DYSFCN GENERAL MEDICAL CONDITION -pretty much everything Organic and iatrogenic, Sexual Disorders Paraphilias -recurrent, intense fantasies, urges, behs -mutual arousal not a goal TRANSVESTIC FETISHISM -cross-dress for sexual arousal -heterosexual males -can involve gender dysphoria -not fetishistic if for entertainment, Sexual Disorders Paraphilias -recurrent, intense fantasies, urges, behs -mutual arousal not a goal S/Sx Fantasies, urges for ɲmos Not transitory/changeable Cannot be kept out of sexual consciousness Difficult to resist acting out May be hypersexual Could have legal problems, Sexual Disorders Sexual Dysfunctions Disorders of Arousal -NL-pelvic congestion, myotonia in M/FM FEMALE SEXUAL AROUSAL D/O -rarely Dx'ed -absence of adequate vag lubrication -for Dx -dyspareunia more likely MALE ERECTILE D/O -can't attain or maintain