Sexual Aversion PP7501: Adult Psychopathology
What is Sexual Aversion? The individual reports anxiety, fear, or disgust when confronted by sexual opportunity.
What is Sexual Aversion NOT? Loss of desire due to: Menopause / Menstruation Recovery from an illness or surgery Major stressor (Bereavement or job loss) Role change (Career change or birth of a child) Lack of time or privacy
DSM-IV Diagnostic Criteria A. Persistent or recurrent extreme aversion to, and avoidance of, all (or almost all) genital sexual contact with a sexual partner. B. The disturbance causes marked distress or interpersonal difficulty. C. The sexual dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction).
Other DSM-IV Information Types: Lifelong vs. Acquired Generalized vs. Situational Etiological factors can include: Due to Psychological Factors Due to Combined Factors
DSM-V Recommended for Removal Specific Phobia
Etiology Many causes Interpersonal Problems Trauma Events Religious or cultural teachings Emotional factors
Treatment Psychotherapy Behavioral Therapy such as desensitization Address symptoms (such as anxiety, OCD, or depression)
Special populations Specifics not well known More Prevalent in Women
Differential Diagnoses May occur w/ other Sexual Dysfunctions Other Axis 1 (with Sexual Dysfunction) Specific Phobia Aversion that is not marked with distress Do not confuse with: Hypoactive Sexual Desire Disorder Arousal Disorder Orgasmic Disorder
Any questions so far?
Anxiety & Sexual Functioning Study on sexual functioning of women with anxiety disorders (2000) Women with Panic and OCD had lower desire and frequency of contact than controls. HSDD and SAD were more frequently found in anxiety patients than controls.
Depressed Mood & Sexual Functioning Substantial correlations between clinical depression and HSDD Association between depressed mood and sexuality in couples (2007)
Women s Scores on SIS/SES Study on Sexual Inhibition/Sexual Excitation Scales (2008) Dual Control Model Women scored higher on sexual inhibition and lower on sexual excitation compared with men.
Sexual Anorexia Sexual Anorexia (1998) Sexual Addicts can be Sexual Adverse Binging/Purging Case Study
Case Study 30 year old white woman Married 5 years No history of sexual abuse Virgin at time of treatment Major Depressive Disorder treated with Nefazaodone Desired children
SAD & Desensitization More effective treatment of depression Two behavioral hierarchies created 8 sessions over 5 ½ months with progressive steps Positive Outcome
Case Study Female Victims of Human Trafficking 600,000 800,000 worldwide Host of symptoms Self-harm, stress-related symptoms, depression, dissociative disorders, impulsivity, PTSD, anxiety, trust issues, difficulty in relationships, guilt, self-blame, low self-esteem, hopelessness and helplessness, and SAD
Test Questions How does SAD differ from other forms of sexual dysfunction? What disorders are most commonly co-morbid with SAD?
Further Reading Handbook of Sexual Dysfunction (2005) International Journal of Sexual Health Sexual & Relationship Therapy Journal U.S. Dept. of Health &Human Services www.acf.hhs.gov/trafficking/
Questions?
References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author. American Psychiatric Association. (2010). DSM-5 Development: 302.79 Sexual Aversion Disorder [Webpage]. Retrieved September 27, 2010 from http://www.dsm5.org/proposedrevisions/pages/proposedrevision.aspx?rid=61 Carnes, P. (1998). The case for sexual anorexia: An interim report on 144 patients with sexual disorders. Sexual Addiction & Compulsivity, 5(4), 293. Retrieved from Academic Search Complete database. Carpenter, D., Janssen, E., Graham, C., Vorst, H., & Wicherts, J. (2008). Women's Scores on the Sexual Inhibition/Sexual Excitation Scales (SIS/SES): Gender Similarities and Differences. Journal of Sex Research, 45(1), 36. Retrieved from MasterFILE Premier database. Finch, S. (2001). Sexual aversion disorder treated with behavioural desensitization. Canadian Journal Of Psychiatry. Revue Canadienne De Psychiatrie, 46(6), 563-564. Retrieved from MEDLINE with Full Text database. Gale. (2003). Sexual aversion disorder [Webpage]. Retrieved September 27, 2010 from http://www.novelguide.com/a/discover/gemd_02/gemd_02_00350.html Minnen, A., & Kampman, M. (2000). The interaction between anxiety and sexual functioning: a controlled study of sexual functioning in women with anxiety disorders. Sexual & Relationship Therapy, 15(1), 47-57. Retrieved from CINAHL Plus with Full Text database. Schober, J. (2004). Sexual quality of life in an intersexual population: a needs assessment. BJU International, 93 Suppl 354-56. Retrieved from MEDLINE with Full Text database.