Chapter 13. Sexual Variants, Abuse, and Dysfunctions. Sexual Abuse. Sexual and Gender Variants

Transcription

1 Chapter 13 Sexual Variants, Abuse, and Dysfunctions This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission over any network; preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program. ISBN: Sexual Abuse Controversies surrounding child sexual abuse include Children s testimony Recovered memories of sexual abuse 2 Sexual and Gender Variants Pedophilia is diagnosed when an adult has recurrent, intense sexual urges or fantasies about sexual activity with a prepubescent child Culturally prohibited sexual relations between family members are known as incest 3 1

2 Rape Sexual activity that occurs under actual or threatened forcible coercion of one person by another Physical trauma inflicted Psychological trauma PTSD 4 Recidivism of Sex Offenders Recidivism rates for sex offenders are relatively low However, sex offenders with deviant sexual preferences (e.g., those most attracted to children) have high rates of recidivism 5 Treatment 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 6 2

3 Treatment Psychological Therapies: Aversion therapy Covert sensitization/assisted covert sensitization Satiation Cognitive restructuring Relapse prevention 7 Treatment Biological and surgical treatments may include Castration Chemical castration Many treatment programs use a combination of hormone therapy and cognitive-behavioral treatments 8 Sexual Dysfunctions Refers to impairment either in The desire for sexual gratification The ability to achieve it The human sexual response has four phases: Desire phase Excitement phase Orgasm Resolution 9 3

4 Sexual Response Cycle Masters and Johnson (1970) 10 Dysfunctions of Sexual Desire Hypoactive sexual desire disorder : a person shows little or no sex drive or interest Sexual aversion disorder : Person shows extreme aversion to, and avoidance of, all genital sexual contact with a partner Sexual desire disorder appears to be the most common female sexual dysfunction 11 Sexual Dysfunctions Characterized by a disturbance in the processes that characterize the sexual response cycle or by pain associated with sexual intercourse 12 4

5 Dysfunctions of Sexual Arousal Male erectile disorder Effects half the male population on at least a temporary basis May be based on Anxiety about sexual performance Physiological dysfunction Female sexual arousal disorder is in many ways the female counterpart of erectile disorder 13 Orgasmic Disorders Premature ejaculation: persistent and recurrent onset of ejaculation with minimal sexual stimulation Male orgasmic disorder: persistent inability to ejaculate during intercourse Female orgasmic disorder: Persistent or recurrent delay in or absence of orgasm following a normal sexual excitement phase14 Dysfunctions Involving Sexual Pain Vaginismus: An involuntary spasm of the muscles at the entrance of the vagina (not due to physical disorder) that prevents penetration and sexual intercourse Painful coitus, or dyspareunia, can occur in men but is far more common in women 15 5

6 Sexual Desire Disorders Deficiency or absence of sexual fantasies and desire for sexual activity The disturbance must cause marked distress or interpersonal difficulty Not due to a general medical condition Hypoactive Sexual Desire Disorder Sexual Aversion Disorder 16 Sexual Arousal Disorders Persistent or reoccurring inability to attain or maintain sexual activity. Female Sexual Arousal Disorder Male Erectile Disorder 17 Orgasmic Disorder Persistent or recurrent delay in, or absence of, orgasm following normal sexual excitement phase. Female Orgasmic Disorder Male Orgasmic Disorder Premature Ejaculation 18 6

7 Sexual Pain Disorder Pain during sexual intercourse. Dyspareunia (not due to a General Medical Condition) Vaginismus (not due to a General Medical Condition) 19 Sexual Dysfunction NOS NOS: Not Otherwise Specified This category includes sexual dysfunctions that do not meet criteria for any specific Sexual Dysfunction 20 Sexual and Gender Variants: The Paraphilias The paraphilias are a group of persistent sexual behavior patterns in which unusual objects, rituals, or situations are required to fulfill sexual satisfaction 21 7

8 The Paraphilias Fetishism Transvestic fetishism Voyeurism Exhibitionism Sadism Masochism 22 The Paraphilias Mostly male Have more than one paraphilia Usually do not seek treatment 23 Sexual Dysfunction NOS Paraphilias Exhibitionism Fetishism Frotteurism Pedophilia Sexual Masochism Sexual Sadism Transvestic Fetishism Voyeurism Paraphilia NOS 24 8

9 Gender Identity Disorders Two components must be present: Evidence of a strong and persistent cross-gender identification, (not merely a desire for any perceived cultural advantages of being the other sex). Persistent discomfort about one s assigned sex and sense of inappropriate in the gender role of that sex Significant distress or impairment in social, occupational, or other important areas of functioning Gender Identity Disorder NOS Sexual Disorder NOS 25 Therapy for Sexual Disorders Senate Focus: Masters and Johnson (1970) Technique used with couples to focus on their sensory experience during sexual activity. Cognitive Behavioral Therapy: Combines behavioral exercises (those suggested by Masters and Johnson,1970) with therapy techniques that emphasize thought patterns or cognitive factors Cognitive Restructuring: The therapist tries to change people s inappropriate negative thoughts Allyn & Bacon about copyright some aspect of 26 sexuality. Gender Identity Disorders Characterized by two components: Cross-gender identification Gender dysphoria persistent discomfort about one s biological sex or the sense that the gender role of that sex is inappropriate 27 9