PSYCH 2510: EXAM 3
172 Cards in this Set
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somatic
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bodily
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mind-body dualism
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17th century idea that the mind, or soul, is totally separate from the body
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actitious disorder
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also known as Munchausen syndrome
patients intentionally produce or feign physical symptoms
imposed on self or imposed on another
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malingering
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intentionally feigning illness to achieve some external gain, such as financial compensation or military discharge
not a mental illness or factitious disorder
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malingering vs. factitious disorder
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malingering is in order to get some gain, and factitious disorder is because the person wants to be a patient and play the sick role
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prevalence of factitious disorder
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more common in women than men
men have more severe cases
disorder usually begins in early adulthood
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factitious disorders are particularly common among people who...
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received extensive medical treatment for a medical problem as a child
carry a grudge against the medical profession
have worked as a nurse, lab tech, or medical aide
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causes of fictitious disorder
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precise causes not understood
some factors could include depression, unsupportive parents, and an extreme need for social support
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Munchausen syndrome by proxy
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form of factitious disorder that is caused by a caregiver who uses various techniques to induce symptoms in a child - giving them drugs, tampering with feeding tubes.
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conversion disorder
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characterized by medically unexplained physical symptoms that affect voluntary motor or sensory functioning
"functional neurological symptom disorder"
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la belle indifference
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A condition in which the person is unconcerned with symptoms caused by a conversion disorder
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somatic symptom disorder
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when people become disproportionately concerned, distressed, and disrupted by bodily symptoms
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how to recognize a somatic or conversion disorder
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a bodily ailment has an excessive and disproportionate impact on the person and has no apparent medical cause or is inconsistent with known medical diseases
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glove anesthesia
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conversion disorder symptom of numbness of the hand
real neurological damage is rarely as abrupt or evenly spread out
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atrophy
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waste away
muscles of people with conversion disorder do not atrophy, while real paralysis does
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factitious disorder versus conversion disorder
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those with conversion disorder do not consciously want or purposely produce their symptoms
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prevalence of conversion disorder
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usually begins in late childhood/young adulthood
women 2x more likely than men
typically appears suddenly, at times of extreme stress, and lasts a matter of weeks
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symptoms of conversion disorder versus somatic
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somatic symptoms last longer but are less dramatic than conversion symptoms
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somatization
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tendency to communicate distress through physical symptoms and to pursue medical help for these symptoms
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2 patterns of somatic symptom disorder: somatization pattern
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the individual experiences a large and varied number of bodily symptoms.
long lasting physical ailments with no physical basis.
pain symptoms, gastrointestinal symptoms, sexual symptoms, neurological symptoms
usually go from doctor to doctor and describe symptoms in exaggerated detai…
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2 patterns of somatic symptom disorder: predominant pain pattern
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he person's primary bodily problem is the experience of pain
fairly common
more common in women, begins at any age
often develops after an accident or during an illness
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hysterical disorders
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conversion and somatic disorders
leading explanations come from psychodynamic, behavioral, cognitive, and multicultural models
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illness anxiety disorder
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when people who are anxious about their health become preoccupied with the notion that they are seriously ill despite the absence of bodily symptoms
some may recognize excessiveness, many do not
up to 78% also have anxiety or depression
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psychological factors affecting other medical conditions
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when psychological factors adversely affect a person's general medical condition
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psychodynamic etiology: disorders with somatic symptoms
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psychological distress expressed as physical symptoms
primary and secondary gain
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people in psychodynamic etiology: disorders with somatic symptoms
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Freud: tried to explain hysterical symptoms, treated patients seriously unlike others, studied hypnosis, believed that hysterical disorders represented a conversion of underlying emotional conflicts into physical symptoms and concerns
Josef Breuer: successfully used hypnosis to treat…
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primary gain
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ex. a man who has fears about expressing anger may develop a conversion paralysis of the arm, thus preventing his feelings of rage from reaching consciousness
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secondary gain
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when a persons bodily symptoms further enable them to avoid unpleasant activities or to receive sympathy from others
ex. when a conversion paralysis allows a soldier to avoid combat duty or conversion blindness prevents the breakup of a relationship
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behavioral etiology: disorders with somatic symptoms
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physical symptoms of conversion and somatic symptom disorders bring rewards to sufferers
the rewards lead sufferers to display bodily symptoms more and more
people familiar with an illness will more readily adopt its physical symptoms
similar to secondary gains (psychodynamic theory) b…
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cognitive etiology: disorders with somatic symptoms
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these disorders are a way for people to communicate and express emotions that may be difficult to convey, through physical symptoms
purpose of conversion is not to defend against anxiety, but to communicate extreme feelings in a physical language
over-sensitivity to bodily cues
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environmental/sociocultural etiology: disorders with somatic symptoms
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somatic symptoms are the norm in many cultures
western bias against somatic complaints
stress, sexual abuse, family separation/loss, family conflict,/violence
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treatments: disorders with somatic symptoms
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psychodynamic:
difficulty engaging in psychotherapy, therapeutic alliance is key, insight, emphasis on repression
cognitive-behavioral:
exposure and response prevention, changing reward structures
biological:
medication, antidepressants (SSRIs) often for anxiety and depression
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"best practice" for somatic symptom disorders
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coordinating psychiatric care with medical care
any co-existing medical illness can be addressed, and demonstrates importance of caring for body and mind
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psychological factors affecting medical condition
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cause physical damage, unlike other somatic symptom disorders
ulcers, asthma, insomnia, chronic headaches, high blood pressure, coronary heart disease
causes may be biological, psychological, or sociocultural
psychological factors: coping, personality styles (Type A)
sociocultural fac…
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social readjustment rating scale studies
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assigns numerical values to the stresses that most people experience at some time in their lives
the more life change units (LCUs) that a stressor has, the more stressful it is
Holmes and Rahe invented it
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social readjustment rating scale findings
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LCU scores of sick people during the year before they fell ill were much higher than those of healthy people
if a person's life changes totaled more than 300 LCUs over the course of a year, he or she was particularly likely to develop serious health problems
greater life stress = greate…
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shortcoming of social readjustment rating scale
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it does not take into consideration the particular life stress reactions of specific populations
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immune system
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the body's network of activities and cells that identify and destroy antigens (foreign invaders)
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lymphocytes
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white blood cells that circulate through the lymph system and the bloodstream
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psychoneuroimmunology
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area of study in which researchers seek to uncover the links between psychosocial stress, the immune system, and health
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what does stress to the immune system?
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stress slows lymphocyte activity --> increases susceptibility to infections
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what does prolonged stress do to the immune system?
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norepinephrine and corticosteroids may both inhibit lymphocytes, slowing immune system functions
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helper t-cells
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group of lymphocytes that identify antigens and then multiply and trigger the production of other kinds of immune cells
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natural killer t-cells
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group of lymphocytes that seek out and destroy body cells that have already been affected by viruses, thus helping to stop the spread of a viral infection
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b-cells
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group of lymphocytes that produce antibodies (protein molecules that recognize and bind to antigens), mark them for destruction, and prevent them from causing infection
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excessive activity of norepinephrine leads to...
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slowdown of the immune system. stress causes an excessive release of norepinephrine
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behavioral medicine
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field combining psychological and physical interventions to treat or prevent medical problems
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types of behavioral medicine used to treat psychophysiological disorders
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relaxation training, biofeedback, meditation, cognitive interventions, support groups, psychotherapy
combination approaches (both psychological and medical) are often most useful
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anorexia nervosa
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condition marked by restriction of energy intake relative to body requirements, causing significantly low body weight
intense fear of gaining weight
significant perceptual and cognitive distortions
restricting and binge-eating/purging types
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physical and psychological features of anorexia nervosa
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physical: merabolic/electrolyte imbalances, amenorrhea (no periods), brittle hair/nails, dry skin, swelling, cardiovascular problems, kidney dysfunction, death
psychological: cognitive impairment, depression (80% co-morbidity), anxiety (75% co-morbidity), OCD, perfectionism
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anorexia nervosa mortality rate
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has highest mortality rate of any psychiatric disorder (10.5 times more likely)
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types of anorexia nervosa
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restricting-type: reducing weight by restricting intake of food
binge-eating/purging type: reducing weight by forcing themselves to vomit after meals or by abusing laxatives, and sometimes having eating binges
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when does anorexia nervosa usually begin?
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after a person who is slightly overweight or of normal weight has been on a diet
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anorexia nervosa statistics
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90-95% are female
can occur at any age, but peak age of onset is 14-20
0.5-4% of females in Western countries develop the disorder in their lifetime
2-6% die
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bulimia nervosa
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repeated binge eating episodes and compensatory behaviors to avoid weight gain
purging and non-purging types
must occur at least twice a week for 3 months
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binge
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takes place over a limited amount of time, often two hours, during which the person eats much more food than most people would eat during a similar time span
people with bulimia have 1-30 binge episodes per week
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compensatory behaviors
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trying to make up for all the food they have eaten
forcing self to vomit, misusing laxatives, fasting, excessive exercising
may provide temporary relief, but usually lead to an unhealthy cycle
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bulimia statistics
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90-95% are females
begins at ages 15-20
weight usually stays at normal range
5% of women develop bulimia
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physical and psychological features of bulimia
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death rate not as high as anorexia
decay of tooth enamel
damage to taste buds
gastrointestinal problems
menstrual irregularities
inflamed esophagus
depression, anxiety, substance abuse
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how to people feel after binging?
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tension
irritable, unreal, powerless
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bulimia vs. anorexia
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people with bulimia are usually more concerned about pleasing others, being attractive to others, and having intimate relationships. more sexually experienced/active
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purging type versus non-purging type
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purging type: vomiting, laxatives, etc.
non-purging type: exercise, fasting, etc
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binge-eating disorder
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recurrent episodes of binge eating
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body dissatisfaction
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when you evaluate your weight and shape negatively
73% of women, 56% of men
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binge-eating involves:
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eating, in a specified period of time, and amount of food that is larger than what most people would eat in that circumstance
feeling a lack of control over one's eating
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binge-eating disorder vs. bulimia
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people with binge-eating disorder do not perform compensatory behavior
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amount of people with binge-eating disorder who become overweight
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2/3
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epidemiology of eating disorders
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models, athletes at greater risk. highest rates of eating disorders in males
race and culture no longer considered a protective factor; rates becoming more similar for racial groups
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lifetime prevalence of eating disorder
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anorexia: women: 0.9%, men: 0.3%
bulimia: women: 1.5%, men: 0.5%
binge-eating: women: 3.5%, men: 2%
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psychodynamic factors: eating disorders
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Hilde Bruch: ineffective parenting --> ego deficiencies (poor sense of independence and control) and perceptual disturbances
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cognitive factors: eating disorders
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deficiencies from childhood contribute to a broad cognitive distortion (people with these disorders judge themselves based on their shape/weight, and their ability to control them
referred to as "core pathology"
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biological factors: eating disorders
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certain genes lead some people to be more susceptible to getting an eating disorder
relatives of someone with anorexia are 6x more likely to have it
70% of people with an identical twin who has anorexia also get it; 20% of fraternal twins
23% for identical twins with bulimia; 9% for fr…
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biological factors: eating disorders 2
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hypothalamus regulates many bodily functions
two separate areas of it help control eating:
lateral hypothalamus: side ares of hypothalamus, produces hunger when activated
ventromedial hypothalamus: bottom and middle of hypothalamus, reduces hunger when activated
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family factors: eating disorders
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Minuchin suggests that an enmeshed family pattern often leads to eating disorders
enmeshed family system: family members are overly involved in each others affairs and over concerned with the details of each others lives
can be clingy, fosters dependency
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treatment of eating disorders
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two goals: correct the dangerous eating pattern, address the broader psychological factors
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anorexia treatments
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goal is to gain the weight back quickly and return to health within weeks
life threatening situations may call for tube and intravenous feedings
cognitive-behavioral therapy included in most programs
inpatient or outpatient, supportive nursing care, nutritional counseling, weight gain…
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bulimia treatments
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often in eating disorder clinics
cognitive-behavioral therapy is particularly helpful as well as anti-depressants
eating behavior diaries
exposure and response prevention
clinic based, education, group therapy
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substance disorder stats
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about 15% of U.S. population will meet criteria for a substance use disorder over the course of their lifetimes
costs U.S. more than $600 billion per year
contributes to 25% of all deaths in U.S.
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substance
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preferred term for psychoactive drugs and alcohol
psychoactive: brain-affecting
legal (licit) or illegal (illicit)
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substance use
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low to moderate use of a substance that does not impair functioning
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substance intoxication
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acute effects of substance use; temporary
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substance use disorder
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a pattern of maladaptive behaviors and reactions brought about by repeated use of a substance
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physiological dependence
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presence of one or both of these physical symptoms:
tolerance: body's adaptation to substance, as indicated by need for more to achieve same effect or by obtaining less effect with the same amount
withdrawal: unpleasant and/or dangerous physical or psychological symptoms if use is decre…
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categories of substances: depressants
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depressants: slow or inhibit the central nervous system
alcohol, sedative-hypnotics, sedative drugs, opioids
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alcohol
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binge drinking episode: 5 or more drinks on a single occasion
all alcohol contains ethyl alcohol which absorbs into the blood through the lining of stomach and intestine
ethyl alcohol binds to GABA receptors, which helps GABA to shut down neurons, which relaxes the drinker
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Korsakoff's syndrome
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disease marked by extreme confusion, memory loss, and other neurological symptoms which can be caused by an alcohol-related deficiency of vitamin B
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sedative-hypnotic drugs
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produce feelings of relaxation and drowsiness
involve barbiturates and benzodiazepines
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opioids
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include heroin, morphine, and codeine
reduces physical and emotional pain
the drugs attach to brain receptors that usually receive endorphins (neurotransmitters that help relieve pain) and act similar to endorphins
opioids cause nausea, narrowing of pupils, constipation
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categories of substances: stimulants
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stimulants: increase central nervous system activity
caffeine, nicotine, cocaine, amphetamines
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cocaine
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most powerful natural stimulant
increases supplies of the neurotransmitter dopamine at key neurons in the brain
excessive amounts of dopamine travel to receiving neurons in the CNS and overstimulate them
cocaine also increases norepinephrine and serotonin
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caffeine
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worlds most widely used stimulant
80% of people in the world consume it everyday
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categories of substances: hallucinogens
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hallucinogens: produce altered states of perception and sensation, along with emotional and other experiences
LSD, psilocybin, mescaline
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hallucinogens
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there is no tolerance or withdrawal when a person stops taking them
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categories of substances: other
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marijuana, inhalants, steroids, PCP, ketamine
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polysubstance abuse
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consuming more than one drug at a time
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DSM-5 changes
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behavioral addictions added (gambling disorder)
internet use gaming disorder added under conditions for further study
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substance disorder epidemiology
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women: use associated with relationship issues and comorbidity with mental illness
men: more likely to be diagnosed with substance abuse disorders
influence of ethnicity and socioeconomic status
education level: illicit use lowest among college graduates (5.9%)
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disease model
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dominant approach to explaining and treating substance use disorders today
argues that substance dependence is like other medical diseases
has strengths and limitations
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psychological model
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views substance dependence as symptom of underlying problem
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delirium treatments
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terrifying visual hallucinations that begin within 3 days after they stop or reduce their drinking
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hyperthermia
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when the body's tempature rises and remains high
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etiology: substance abuse
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no single explanation has gained broad support
best explanation: a combination of factors
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sociocultural factors: substance abuse
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unemployment
low socioeconomic status
family and environmental variables
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behavioral factors: substance abuse
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drugs are reinforcing (operant conditioning)
drugs have conditioned cues (classical conditioning)
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cognitive factors: substance abuse
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expectancy theory (Bandura)
positive outcome expectancies: "this will make me feel great/better"
minimal negative expectancies: "nothing will go wrong"
poor self-efficacy beliefs: "i can't cope without it"
self medication
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biological factors: substance abuse
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high correlations among family members
identical twins: 54% chance, fraternal twins: 28% chance
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dopamine-2 (D2) receptor gene
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found in majority of people with substance use disorders, but in only 20% of people without the disorder
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reward system (pleasure pathway)
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VTA > nucleus accumbens > frontal cortex
neurotransmitter dopamine is a key in this pathway
hugs, words, music, etc. will activate the dopamine in the pathway, producing pleasure, and so will drugs
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reward-deficiency syndrome
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a person's reward center is not readily activated by the usual events in their lives, so they turn to drugs to stimulate this pleasure pathway (D2 may cause this)
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incentive-sensitization theory
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neurons in the center fire more readily when stimulated by the substances, contributing to future desires for them
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treatment of substance abuse
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substance abuse and dependence problems are very difficult to treat
intense, long-lasting approaches are usually preferred
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behavioral therapies: substance abuse
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contingency management: program that involves reinforcements and punishments to shape behavior
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cognitive-behavioral therapies: substance abuse
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relapse prevention therapy
motivational interviewing
5 stage model of behavioral change: precontemplation, contemplation, preparation, action, and maintenance
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biological therapies: substance abuse
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detoxification: medically supervised withdrawal
antagonist drugs: reduce cravings, make use less pleasurable or uncomfortable
drug maintenance therapy (antagonist substitution): safer but similar substance provided in monitored setting
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sociocultural therapies: substance abuse
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self-help and residential treatment programs
12 step approach: AA, NA
combines principles from many theoretical approaches with spiritual emphasis
group format encourages sharing and sense of community
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long term outcomes: substance abuse
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about half of people who seek treatment for a substance related disorder successfully control the program
many people experience severe problems for much of their lives
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sexual dysfunctions
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persistent problems with sexual interest, sexual response, or orgasm
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paraphilic disorders
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persistent sexual urges, fantasies, and behaviors that involve unusual situations, objects, or activities and cause distress or impairment
less common than the dysfunctions
almost exclusively male
some are illegal/legal some are consensual/non-consensual
to qualify as disorder: (for a…
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gender dysphoria
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strong and persistent cross-sex identification in which a person's biological sex and gender identity do not match. intense discomfort with one's biological sex and the desire to change sexes
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changing beliefs about masturbation
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from 1700s, considered damaging; in 1900s sometimes hospitalized
in 1994, Dr. Elders (surgeon general) was fired for suggesting masturbation be discussed in sex ed.
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changing beliefs about homosexuality
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DSM disorder until 1973
ego-dystonic homosexuality until 1987
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sexual response cycle
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desire
excitement
orgasm
resolution
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desire phase
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consists of an interest in or urge to have sex, sexual attraction to others, and sexual fantasies
disorders include male hypoactive sexual desire disorder and female sexual interest/arousal disorder
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male hypoactive sexual desire disorder
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men lack or have reduced interest in sex and engage in little sexual activity
18% of men worldwide
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emale sexual interest/arousal disorder
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women lack normal interest in sex and rarely initiate sexual activity
in addition, many women feel little excitement by sexual activity
38% of women worldwide
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biological causes of low sexual desire
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high level of prolactin in men and women, low level of testosterone in men, and high or low level of estrogen in women can all lead to low sex drive
also linked to excessive activity in serotonin and dopamine
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excitement phase
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marked by changes in the pelvic region, general physical arousal, and increases in heart rate, muscle tension, blood pressure, and rate of breathing
disorder: male erectile disorder
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erectile disorder
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men persistently fail to attain or maintain an erection during sexual activity
25% of male population
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biological causes of erectile disorder
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problem's with the body's blood vessels (vascular)
alcohol, smoking, medicines
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psychological causes of erectile disorder
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depression
performance anxiety
spectator role: so nervous he ends up watching himself and forgets to actually enjoy the sex because he is focusing only on getting an erection
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orgasm phase
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when a person's sexual pleasure peaks and sexual tension is released as the muscles in the pelvic region contract, or draw together, rhythmically
dysfunctions: early ejaculation and delayed ejaculation in men; female orgasmic disorder in women
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premature ejaculation
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when a man persistently reaches orgasm and ejaculates within 1 minute of beginning sexual activity with a partner and before he wishes to
30% of men worldwide
psychological (particularly behavioral) explanations have most support
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biological causes of premature ejaculation
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some men are born with a genetic predisposition to develop this dysfunction
the brains of men who ejaculate prematurely contain certain serotonin receptors that are overactive and others that are under-active
men with this dysfunction have greater sensitivity or nerve conduction in the…
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delayed ejaculation
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when a man persistently is unable to ejaculate or has very delayed ejaculations
around 10% of men worldwide
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biological causes of delayed ejaculation
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low testosterone
certain neurological diseases
some head or spinal cord injuries
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psychological causes of delayed ejaculation
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performance anxiety and the spectator role
past masturbation habits (if he usually masturbates by rubbing his penis on sheets or pillows, sexual intercourse may not give him that sensation)
male hypoactive sexual desire disorder: man engages in sex largely because of pressure from his p…
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female orgasmic disorder
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when women persistently fail to reach orgasm, have very low intensity orgasms, or have a very delayed orgasm
25% of women worldwide
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biological causes of female orgasmic disorder
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diabetes
multiple sclerosis
drugs and medication
changes in skin sensitivity and structure of the clitoris, vaginal walls, or labia
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psychological causes of female orgasmic disorder
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depression
memories of childhood traumas and relationships
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sociocultural causes of female orgasmic disorder
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society's message to women that they should repress and deny their sexuality
unusually stressful events or trauma
attraction and health of her relationship
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genito-pelvic pain/penetration disorder
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vaginismus
dyspareunia
occurs in men too, but much more in women
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vaginismus
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for some women, the muscles around the outer third of the vagina involuntarily contract, preventing entry of the penis
less than 1% of women
cognitive-behavioral research support
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dispareunia
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for other women, there is severe vaginal pain during sexual intercourse, without the contractions
14% of women, 3% of men
usually has a physical cause
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cognitive-behavioral causes of vaginismus
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usually a learned fear response, set off by a woman's expectation that intercourse will be painful and damaging
trauma caused by sexual abuse/rape
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biological causes of vaginismus
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infection of the vagina or urinary tract
a gynecological disease such as herpes simplex
menopause
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physical causes of dyspareunia
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injury during childbirth (16% of women have sexual pain for up to a year after childbirth)
penis colliding with parts of the hymen
vaginal infections
wiry pubic hair rubbing against the labia
pelvic diseases
tumors, cysts
allergies to douches, semen, or latex
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biological causes of sexual dysfunctions
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hormones
neurotransmitters
medical illness
medications
poor diet
aging
substance use
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psychological causes of sexual dysfunctions
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emotional conflicts (present, past, childhood) or trauma, stress, negative emotional states or psychiatric disorders
performance anxiety and spectatoring, attitudes, dears, situational pressures
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useful points about sexual dysfunctions
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severe desire/interest disorders: active disgust usually indicates emotional conflicts
male erectile disorder: absence of erections during sleep --> biological etiology
female orgasmic disorder: intercourse alone is not adequate stimulation
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general features of treatments of sexual dysfunctions
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assessment of the problem
mutual responsibility - working with the couple
education
exploration of emotions
attitude change
communication issues
marital interactions and lifestyle issues
physical or medical factors
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treatments of sexual dysfunctions: sensate focus
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non-demand pleasuring, or exercises to enhance sexual awareness
tease technique for erectile dysfunction
stop-start technique for premature ejaculation
directed masturbation for female orgasmic disorder
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treatments of sexual dysfunctions: medication
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anti-depressants
sildenafil (Viagra) increases blood flow to the penis
sharp increase in use of medications worries sex therapists because then therapists will increasingly choose medication over other techniques (using a narrow approach won't work)
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paraphilias
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patterns in which people repeatedly have intense sexual urges or fantasies or display sexual behaviors that involve objects or situations outside the usual sexual norms
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types of paraphilias
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fetishistic disorder
transvestic disorder
exhibitionistic disorder
voyeuristic disorder
frotteuristic disorder
pedophilic disorder
sexual masochism disorder
sexual sadism disorder
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fetishistic disorder
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recurrent features: intense sexual urges, sexually arousing fantasies, or behaviors that involve the use of a nonliving object or nongenital body part
far more common in men than women
begins in adolescence
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causes for fetishistic disorder
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psychodynamic: fetishes are defense mechanisms that help people avoid the anxiety produced by normal sexual contact
behavioral: fetishes are acquired through classical conditioning
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treatments for festishistic disorder
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behavioral approaches
aversion therapy: shock patients when they think of their sexual object
masturbatory satiation: masturbate to a sexually appropriate object, switch to masturbating to a fetish object, which will then bore you of the fetish object
orgasmic re-orientation: start mas…
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transvestic disorder
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feeling recurrent and intense sexual arousal from dressing in clothes of the opposite sex
typically homosexual males, begins in childhood/adolescence
cross dressing, but most involve distress and/or impairment
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exhibitionistic disorder
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recurrent and intense sexual arousal from exposing genitals to an unsuspecting individual
generally to shock or surprise rather than to illicit sex
generally starts before 18 years old
usually men
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voyeuristic disorder
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recurrent and intense sexual arousal from observing an unsuspecting individual who is naked, disrobing, or engaging in sexual activity
usually begins before age of 15, and persists
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frotteuristic disorder
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repeated and intense sexual arousal from touching or rubbing against a nonconsenting person
almost always male
usually starts in teenage years, usually decreases after the age of 25
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pedophilic disorder
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person experiences equal or greater sexual arousal from children than from physically mature people
classic type: attracted to prepubescent children
hebephilic type: attracted to early pubescent children
pedohebephilic type: attracted to both
2/3 of victims are girls (usually 13 or yo…
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sexual masochism disorder
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arousal by the act of being humiliated beaten bound, or otherwise made to suffer
hypoxyphilia: people strangle or smother themselves (or have others do it)
autoerotic asphyxia: when people accidentally induce a fatal lack of oxygen by hanging, suffocating or strangling themselves while …
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sexual sadism disorder
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intense sexual arousal by the physical or psychological suffering of another individual
fantasies begin in childhood, acts in early adulthood
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etiology of paraphilic disorderes
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etiology unknown
behavioral conditioning theories: both classical and operant
psychodynamic theories: defense mechanism, feelings of inadequacy
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treatments of paraphilic disorders
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biological
antiandrogen medicine: reduce testosterone
psychosocial
convert sensitization: imagine aversive stimulus (like consequences)
aversion therapies: viewing object and receiving punishment, or satiation until response decreases
orgasmic reorientation
sex ed, couples tre…
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gender dysphoria
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biological sex and gender identity do not match
discomfort and desire to change sex
very rare
AKA transsexualism
although transsexuals cross-dress, they usually do it to feel in harmony with their gender identity, not because it is sexually arousing
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biological causes of gender dysphoria
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suspected biological factors due to twin and family studies, temperament differences
possible brain anatomy differences, such as in the bed nucleus of stria terminalis (BST)
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psychological causes of gender dysphoria
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disturbed mother-son relationship
cross-gender behavior rewarded
significant parental psychopathology, family stress and frustration, and difficulty with effective limit setting
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treatments for gender dysphoria in children
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involves trying to re-adjust their gender identity to fit their biological sex
gender identity considered still fluid in childhood
some experts believe children should be helped to become more comfortable with biological sex
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treatments for gender dysphoria in adults
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can involve sex change/sex reassignment surgery to make biological sex confirm gender identity
mixed results regarding successful outcomes
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adult outcome of children with gender dysphoria
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gender dysphoria in children usually disappears by adolescense or adulthood, but in some cases it develops into adolescent and adult forms
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Study Guide: Exam 4