Ch11sexualdis2

Sexual Dysfunctions

Normal Sexual Desires and Sexual Disorders/Paraphilias

Normal Gender Development and Gender Identity Disorder

Sexual Dysfunctions

Human sexual response

Plateau

Orgasm

Male Female

Sexual Dysfunctions

Increase with age

Associate with one another

Associate with anxiety and depression

May link to medical, substance, and cultural factors

Common

Sexual Dysfunctions

Negative moodAnd expectancyabout gaining an erection

Focus onconsequencesof inability toperform

Increased physical arousal

Intense focus onconsequencesof inability toperform

Erectiledysfunction andavoidance of sex

Demands or expectations for sexual performance

Sexual Dysfunctions

Items from the Female Sexual Function Index

Over the past 4 weeks, how often did you feel sexual desire or interest?

5 = Almost always or always

4 = Most times (more than half the time)

3 = Sometimes (about half the time)

2 = A few times (less than half the time)

1 = Almost never or never

Sexual Dysfunctions

Good relationship quality

High partner motivation

Lack of comorbid disorders

Positive outcomes

Sexual Dysfunctions

Emotions

Cognitions

Behaviors

Normal

Regular arousal and desire to have typicalsexual behavior.

Thoughts about typical sexual behavior.

Engaging in typical sexual behavior.

Sexual Dysfunctions

Emotions

Cognitions

Behaviors

NormalMild

Mild physical arousal when thinking about unusualsexual behavior.

Thoughts about unusual sexual behavior.

Surfing Internet sites that cater to unusualsexual behavior.

Sexual Dysfunctions

Emotions

Cognitions

Behaviors

NormalMildModerate

Strong physical arousal when fantasizing aboutunusual sexual behavior.

Sexual fantasies that lead to urges toward highlyunusual sexual behaviors.

Spending substantial time on the Internet or inadult bookstores, especially regarding unusual sexual behavior.

Sexual Dysfunctions

Emotions

Cognitions

Behaviors

NormalMildModerateSexual Disorder – Less Severe

Intense physical arousal when fantasizing aboutor engaging in unusual sexual behavior.

Sexual fantasies about unusual sexual behavior that become central to a person’s life and create distress.

Inability to concentrate or have regular sexual relationships. Engaging in some unusual sexual behavior.

Sexual Dysfunctions

Emotions

Cognitions

Behaviors

NormalMildModerateSexual Disorder – Less SevereSexual Disorder – More Severe

Extreme physical arousal when fantasizing about or engaging in unusual sexual behavior.

Obsession-like sexual fantasies about unusual sexual behavior that cause great distress.

Engaging in or being arrested for highly unusual sexual behavior such as inappropriate contact with a child.

Sexual Dysfunctions

Child molestation 35%

Voyeurism 19%

Exhibitionism 13%

Fetishism 12%

Frotteurism 10%

Transvestic fetishism 6%

Sexual masochism and sadism 2%

Deviant sexual interest Prevalence

Sexual Dysfunctions

Frontal lobe

Cingulate gyrus

Hypothalamus

Amygdala

Hippocampus

Sexual Dysfunctions

Family variables

Learning experience

Cognitive distortions

Poor social skills

Offender has an unrelated victim (Yes = 1; No, related victims only = 0)

Sexual Dysfunctions

Items from the Screening Scale for Pedophilic Interests

Offender has male victim (Yes = 2; No, female victims only = 0)

Offender has more than one victim (Yes = 1; No, single victim only = 0)

Offender has a victim aged 11 or younger (Yes = 1; No, child victims were 12 or 13 years old = 0)

Sexual Dysfunctions

Masturbatory procedures

Cognitive therapy

Aversive techniques

Sexual Dysfunctions

78.6 – 95.6% respond positively to treatment

Sexual Dysfunctions

Ch11sexualdis2

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