Chapter 12 Sexual Variants, Abuse, and Dysfunctions ABNORMAL PSYCHOLOGY, SIXTEENTH EDITION James N. Butcher/ Jill M. Hooley/ Susan Mineka Chapter 12 Sexual Variants, Abuse, and Dysfunctions © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Sociocultural Influences on Sexual Practices and Standards Important points! Some aspects of sexuality are universal; others are quite variable Sexual attitudes vary greatly across cultures and across time © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Sociocultural Influences on Sexual Practices and Standards Cases on upcoming slides exemplify variety of sexual standards © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Case 1: Degeneracy and Abstinence Theory Degeneracy theory (1750s) Semen loss cause men to lose masculine characteristics Abstinence theory (1830s) Masturbation threatened public health and caused insanity In the 1750s, degeneracy theory held that loss of semen caused men to lose masculine characteristics Masturbation and patronizing prostitutes were seen as problematic In the 1830s, abstinence theory held that masturbation threatened public health and caused insanity © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Case 2: Ritualized Homosexuality in Melanesia Ritualized homosexuality is practiced in some societies in Melanesia Male initiation rituals Young males exchange semen with each other Ingested semen protective against “female pollution” © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Case 3: Homosexuality and American Psychiatry Up to 1970, homosexuality widely regarded as sickness Current evidence shows that homosexuality is compatible with psychological normality Homosexuality is no longer listed as a disorder in the DSM-5 Significant status of homosexuality during last half-century © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Paraphilias Gender Dysphoria Causal factors Treatments Gender identity disorders © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

The Paraphilias Paraphilias Group of persistent sexual behavior patterns in which unusual objects, rituals, or situations are required to fulfill sexual satisfaction Can be diagnosed even if person does not experience distress or impairment This is rare among mental disorders © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Transvestic fetishism The Paraphilias Paraphilias Fetishism Transvestic fetishism Voyeurism Exhibitionism Sadism Masochism Pedophilia Frotteurism Paraphilias Fetishism (arousal by nonliving objects) Transvestic fetishism (arousal by cross-dressing) Voyeurism (“peeping Tom”) Exhibitionism (indecent exposure) Sadism (arousal by pain to others) Masochism (arousal by pain to self) © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Causal Factors and Treatments for Paraphilias Gender Multiple paraphilias Nearly all people with paraphilias are male People with paraphilias often have more than one paraphilia © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Causal Factors and Treatments for Paraphilias True or false? Other than sex offenders, most people with paraphilias do not seek treatment Other than sex offenders, most people with paraphilias do not seek treatment © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Gender Dysphoria Gender Dysphoria Discomfort with assigned gender or sex-relevant physical characteristics © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Girls – May lead to homosexuality but only small studies done Gender Dysphoria Common outcomes Boys – Homosexuality Girls – May lead to homosexuality but only small studies done © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Gender Dysphoria Transsexuals Adults with gender dysphoria who want to change their sex Autogynephilia Paraphilia characterized by man’s sexual arousal at thought of being a woman © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Gender Dysphoria Surgical sex reassignment typically effective Treatment Psychotherapy is usually not effective Surgical sex reassignment typically effective © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Sexual abuse Sexual Abuse Childhood sexual abuse Pedophilia Incest Rape Treatment and recidivism of offenders © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Childhood Sexual Abuse Children’s testimony and recovered memories of sexual abuse Short- and long-term negative consequences Prevalence Prevalence depends on definition but ranges from less than 5% to over 30% Short- and long-term negative consequences Controversies include children’s testimony and recovered memories of sexual abuse © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Pedophilia Pedophilia Adult has recurrent, intense sexual urges or fantasies about sexual activity with prepubescent child © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Pedophilia Almost all pedophiles are male Two-thirds of victims are female Almost all pedophiles are male; 2/3 of victims are female In recent years, many scandals involving priests have involved pedophilia © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Culturally prohibited sexual relations between family members Incest Incest Culturally prohibited sexual relations between family members © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Incest Virtually universal taboo across all human societies Prevalence and incidence Universal taboo Incidence unclear due to non-reporting Virtually universal taboo across all human societies Incidence is difficult to determine because it often goes unreported © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Sexual activity involving actual or threatened forcible coercion Rape Rape Sexual activity involving actual or threatened forcible coercion © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Definition used Prevalence Statistics Rape Depending on the definition used, prevalence figures run from 5% to 13% © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Figure 12.1: Age of Rape and Sexual Assault Victims © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Is rape motivated by sex or aggression? What do you think? Is rape motivated by sex or aggression? © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Rape Physical trauma Potential consequences Psychological trauma Post-traumatic stress disorder © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Can you fill in the blanks? Who Commits Rape? Can you fill in the blanks? ________ commit only a small fraction of all rapes Most rapes are committed by ________ 60% of all rapists are under ________ years of age Strangers commit only a small fraction of all rapes Most rapes are committed by someone known to the victim 60% of all rapists are under 25 © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Treatment and Recidivism of Sex Offenders Did you know? Sex offenders with deviant sexual preferences have high rates of recidivism Recidivism rates for rape and sexually deviant behavior decrease with age Sex offenders with deviant sexual preferences (e.g., those most attracted to children) have high rates of recidivism Recidivism rates for rape and sexually deviant behavior decrease with age © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Treatment and Recidivism of Sex Offenders Sex offenders’ therapy goals To modify patterns of sexual arousal To modify cognitions and social skills to allow more appropriate sexual interactions with adult partners To change habits and behavior that increase the chance of reoffending To reduce sexual drive © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Treatment and Recidivism of Sex Offenders Psychological therapies Aversion therapy Covert sensitization/assisted covert sensitization Cognitive restructuring Social-skills training © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Treatment and Recidivism of Sex Offenders Biological and surgical Hormone therapy and cognitive-behavioral combination Treatments Biological and surgical treatments may include: Antidepressant medications Castration (surgical or “chemical” via hormones) Many treatment programs use a combination of hormone therapy and cognitive-behavioral treatments © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Sexual Dysfunctions Sexual dysfunction Impairment in desire for sexual gratification and/or ability to achieve it © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Four human sexual response phases Sexual Dysfunctions Four human sexual response phases Desire phase Excitement phase Orgasm Resolution © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Male Sexual Dysfunctions Hypoactive sexual desire disorder Little or no sex drive or interest Erectile disorder May be based on anxiety about sexual performance or physiological dysfunction Early ejaculation disorder Persistent and recurrent orgasm and ejaculation with little sexual stimulation Delayed ejaculation disorder Inability to ejaculate during intercourse In hypoactive sexual desire disorder, a person shows little or no sex drive or interest Erectile disorder affects half the male population on at least a temporary basis © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Female Sexual Dysfunctions Female sexual interest/arousal disorder Low sexual desire and low sexual arousal Genito-pelvic pain/penetration disorder Genital pain during intercourse with muscle tension and fear and anxiety related to genital pain or penetrative sexual activity Female orgasmic disorder Persistent or recurrent delay in, or absence of, orgasm following normal sexual excitement phase Female sexual interest/arousal disorder new to DSM-5 but likely to be most common sexual dysfunction in females © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.

Unresolved Issues How harmful is childhood sexual abuse? Some researchers have questioned the conventional belief that it is very harmful Findings, methodology, and implications are controversial © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.