SEXUAL VARIANTS, ABUSE AND DYSFUNCTIONS TOPIC 11 SEXUAL VARIANTS, ABUSE AND DYSFUNCTIONS

introduction Early medical and scientific approaches to sexual behavior were heavily influenced by religious doctrines and prevailing cultural values. Anything that varied from the purpose of sexual behavior which is biological reproduction was considered a form psychopathology and was usually subject to severe moral and legal sanctions.

SOCIOCULTURAL INFLUENCES ON SEXUAL PRACTISE AND STANDARDS Homosexuality and American Psychiatry Homosexuality as a sickness Homosexuality as a Nonpathological Variations

Sexual and gender variants Paraphilias People with paraphilia have recurrent intense sexually arousing fantasies, sexual urges or behaviors To meet DSM-IV-TR criteria, the patterns must last at least 6 months

Types of paraphilias Fetishism Transvestic fateshism Voyeurism Exhibitionism Sexual sadism Sexual masochism Pedophilia

GENDER IDENTITY Our sense of ourselves as being either male or female is known as gender identity

GENDER IDENTITY DISORDER IN CHILDHOOD Always reflects the child’s physical anatomy Must be distinguished from sex roles Boys with gender identity disorder show a marked preoccupation with traditionally feminine activities which is opposite for girls with gender identity disorder. Treatment Psychotherapy

Transsexualsm Also known as gender dysphoria. Most of them report that they were aware of these feelings very early in childhood. Treatment Change the person’s identity to match his or her anatomy or change anatomy to match the person’s gender identity

SEXUAL ABUSE Sexual contact that involves physical or psychological coercion or at least one individual who cannot reasonably consent to the contact. Childhood Sexual Abuse Pedophilia Incest Rape

SEXUAL ABUSE Treatment and Recidivism of Sex Offenders Psychotherapies Biological and Surgical Treatments

SEXUAL DYSFUNCTIONS Inhibitions of sexual desire and interference with the physiological responses leading to organism

CRITERIA FOR DIFFERENT SEXUAL DYSFUNCTIONS General criteria for all dysfunctions The disturbance causes marked distress or interpersonal difficulty The sexual dysfunction is not better accounted for by another Axis I disorder and is not due to direct effects of a substance or general medical conditions Specifiers include: Lifelong vs Acquired Types and Generalized vs Situational Types

CRITERIA FOR DIFFERENT SEXUAL DYSFUNCTIONS Specific criteria for different dysfunctions Sexual desire disorders Sexual Arousal Disorder Orgasmics Disorder Sexual Pain disorder

Dysfunctions of sexual desire Dysfunctions of sexual arousal Male erectile disorder Female sexual arousal disorder Orgasmic Disorder Premature Ejaculation Male Orgasmic Disorder (retarded ejaculation) Female Orgasmic Disorder (never experience orgasm) Dysfunctions involving sexual pain Vaginismus Dyspareunia