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Sexual Disorders
Hard to determine, based on moral, legal and statistical/behavioral models
Sexual Dysfunction
Cannot respond normally in key areas of sexual functioning (Desire, Excitement, Orgasm)
DSM distinctions
Lifelong type vs acquired type generalized type vs situational type
Disorder of Desire
Problems with urge to have sex, sexual attraction, etc.
Hypoactive Sexual Desire Disorder
absent or low interest in sex
Sexual Aversion Disorder
Views sex as disgusting and animalistic
Female Sexual Arousal Disorder
Repeated inability to maintain lubrication or clitoral swelling during sexual activity ~ 10% of women
Male Erectile Dysfunction
Repeated inability to gain/maintain adequate erection during activity ~ 50% of men
Causes of Desire/Excitement Disorders
Premature (Early) Ejaculation Disorder
Male Orgasmic Disorder (delayed ejaculation disorder)
Inability or great delay in orgasm, biologically driven by hormones or damage to spinal cord
Female Orgasmic Disorder
Persistent delay or absence of orgasm following normal sexual excitement ~ 25% of women
Causes of Female Orgasmic Disorder
Usually hormonal, but could be psychological from molestation or rape
Vaginismus
Involuntary muscle contractions of outer 1/3 of vagina. Fear response from traumatic experience
Dyspareunia
Severe pain in genitals during sex, most often has a physical cause
Treatments for Sexual Pain Disorders
Hormone therapy/medication, educate, reduce anxiety, structured behavior exercises, increase sexual communication skills
Paraphilias
Unusual sexual fantasy urge/behavior that is inappropriate and recurrent. Involves nonhuman, non-consenting, children, humiliation, and must cause distress
Fetishism
Involves nonhuman nonliving object, can be almost anything (usually develops in adolescence)
Transvestic Fetishism
Cross-dressing for sexual arousal, mostly heterosexual males, follows operant conditioning
Exhibitionism
Arousal from exposing oneself in public. Sexual contact neither initiated nor desired. Almost exclusively male. Treatment is aversion therapy and masturbatory satiation.
Voyeruism
Sexual desire to observe people undressing, kissing, etc. Masturbate during observation (adds excitement)
Frotteurism
Fantasies/urges/behavior of touching strangers. Usually young males, wants a caring relationship.
Pedophilia
Sexual desires to a prepubescent child. Some were sexually abused/neglected as children, low IQs.
Sadism & Masochism
Sexual arousal in inflicting suffering, and/or sexual response to being humiliated, bound or made to suffer.
Gender Identity
Internal feeling of maleness or femaleness
Sexual Identity
Feeling of who you are attracted to
Transgender
born one sex, identifies as opposite
Gender Dysmorphia
Born one sex, identify as other, MUST CAUSE DISCOMFORT
Treatment for Gender Dysmorphia
Research is limited and weak, but psychotherapy, hormone therapy, sexual reassignment surgery
Addiction is characterized by
Compulsive behavior, continued use despite negative effects, changes the brain structure and function
Addiction is like other diseases
Preventable, treatable, changes biology, could last a lifetime if untreated, strong physiological component
Dopamine
Neurotransmitter involved in movement, motivation, addiction, reward. Less dopamine receptors = high vulnerability
Drug abuse effects on the brain
Prolonged use changes brain in fundamental and long-lasting ways, mental/motor skills lost
Environmental factors for drug addiction
Stress, early physical abuse, witnessing violence, peers who use drugs, drug availability
DSM characterizes substance related disorders under which axis?
Axis I
Substance use disorders
Abuse/dependence
Substance-induced disorders
Withdrawal/disorders
Substance Abuse
patter of use; significant impairment/dysfunction. Includes failed role obligation, use in hazardous situations, recurrent legal problems, continued use despite problems but doesn't meet criteria for dependency
Substance Dependence (addiction)
Maladaptive use and 3+ symptoms in 12 months: tolerance, withdrawal, increase in amount used over time, unsuccessful at controlling use, increased time recovering, gave up other social/occupational things, continue despite negative effects
Substance Induced Disorder
Have the symptoms and meet the criteria for another DSM diagnosis, but onset of symptoms developed during substance intoxication or withdrawal.
Substance Use changes in DSM-V
10 classes of substances to be addicted to and each has 3 disorders (use, intoxication, withdrawal)
10 Classes of substances to abuse
Alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, stimulants, tobacco, other
Traditional Treatments for addiction
abstinence programs, CBT, learn coping skills
Pathological gambling
impulse control disorder popularized by the World Series of Poker
Kleptomania
Impulse control disorder of stealing for the thrill of it
Pyromania
Impulse control disorder for the thrill of watching something burn
Intermittent Explosive Disorder
Impulse control disorder of (random) violent acts
Trichotillomania
Impulse control disorder of ripping out their own hair
Trichotillomania
Impulse control disorder of ripping out their own hair
Why do we need sleep?
No unified theory, but perhaps cellular construction/replenishment, neuronal rerouting, filing of memories, improve the immune system

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