SOCW 6140 July 28 2014 Slide 1 The disorders in this syndrome cluster entail concerns that cause Distress impairment etc not better explained by mental or substance disorder Slide 2 4 Phases Appetite thoughts or fantasies desire for sexual activity excitement feelings of sexual arousal orgasm physiologically specific peak resolution sense of relaxation and well being afterglow Slide 3 Risk Factors partner factors relationship factors individual vulnerability factors cultural or religious factors medical factors Slide4 Sexual Concerns decreased sexual desire or arousal pain or discomfort during sex difficulty to orgasm use of non human objects for arousal non consenting adults children animals engaged in sexual activity Slide 5 Sex vs Gender biological sex the combination of genetic traits that results in the specialization of organism s genitals and related functions for specific reproductive roles gender an individual s culturally constructed self conception as being male or female intersex biologically containing both male and female body parts Slide 6 Gender related Definitions gender identity identified gender does not agree with biological sex organs Slide 7 Gender Dysphoria onset in childhood adolescence or adult must have stressor and impairment Slide 8 Development Disorders congenital adrenal hyperplasia autoimmune disease affects how sex organs develop and mature androgen sensitivity syndrome Female or mixed genitalia can develop on males due to cellular response Slide9 Sexual Orientation orientation is about attraction Slide 10 Sexual Disorders Male Hypoactive Sexual Desire Disorder functional interest is not there Female sexual arousal interest disorder inability or difficulty obtaining or maintaining adequate lubrication swelling response of sexual excitement erectile dysfunction not able to maintain or achieve an erection Slide 11 Orgasm Disorder female orgasmic disorder delayed or absent orgasm following normal excitement phase delayed ejaculation same as above premature ejaculation ejaculation with minimal stimulation before upon or shortly after penetration before desired time frame Slide12 Pain Disorders Genito Pelvic Pain Disorder dyspareunia Persistent genital pain before during and or after intercourse not due to a medical condition Slide13 Paraphilia any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal physiologically mature consenting human partners relate to courtship disorders pain and suffering disorders and target preference disorders Slide14 exhibitionism showing genitals fetishism attraction to objects frotteurism fantasies or acts of rubbing up against people sadism inflicting pain or suffering that can cause distress or impairment or non consenting Slide15 pedophilia must be 16 child must be 5 years younger exclusive or non exclusive depending on adult interests with child interest Slide16 voyeurism aroused by observing someone disrobe have sex get naked etc paraphilia NOS not specified by a paraphilia disorder does not meet criteria Alexia Case Alexia may need counseling to talk about her issues Her issues come from not trying to make them better She may have some depression and anxiety as do most people I Female Sexual Arousal Disorder II 799 9 III None reported referred by obgyn IV loss of sexual interest problem related to lifestyle IV GAF 72 80 current