Gender Identity Disorders - Abnormal Psychology - Lecture Slides, Slides of Abnormal Psychology

Download Gender Identity Disorders - Abnormal Psychology - Lecture Slides and more Slides Abnormal Psychology in PDF only on Docsity! Sexual and Gender Identity Disorders docsity.com Sexual and Gender Identity Disorders • Sexual Dysfunctions: Problems of inhibited sexual desire, arousal, and response. • Gender-Identity Disorders: Incongruity or conflict between one’s anatomical sex and one’s psychological feeling of being male or female. • Paraphilias: Sexual urges and fantasies about situations, objects, or people not part of the usual arousal pattern leading to reciprocal and affectional sexual activity. docsity.com {S8NP a}! J8y}0 UO ayeNUADUOD 0} ajqeuN jJasuNOA pul NOA yeu 2HeUIa|qGOId 05 alUOIEq JAA }! 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Courtesy Dr. Stephen Glickman docsity.com Theories of Homosexuality Is it a choice? • SDN-POA and the SNB in rats • INAH-3, hypothalamus, anterior commissure and thalamus in humans docsity.com Theories of Homosexuality Is it a choice? • Otoacoustic emissions are stronger in women than in men. • Otoacoustic emissions of lesbian and bisexual women fall midway between heterosexual men and women. • Relative finger lengths of lesbians are more similar to men than women. • Men with older brothers are more likely to be homosexual, possibly due to an immune response to androgens on the part of the mother. docsity.com Homosexual Women Heterosexual Women Homosexual Mon Heterosexual Men a Heterosexual men P-<0.025 0.980 , “4Heterosexual women po 991 0.980 &8§Homosexual women [1 0.975) aa Homosexual men 0.979 0.970 0.970 g 0.965 0.965 = 0.960 0.960 5 0.955 0.955 aq 0.950 0.950 “0.945 0.945 0.940 0.940 o.o00t it SS LTA SS eal 4’9 gogdex Finger Length Left hand Right hand ing Finger Length b No older brothers 1 older brother 0.970 >1 older brother 0.970 8 P<0.025 P<0.04 ns. 0.965 5 — ss — 8 0.960 a 0.955 NA z 0.950 oO = 0.945 S x 0.940 132 56 51 29 23 (7d bd 117d Be 40.000 Allmen Homosexual Heterosexual men men docsity.com Theories of Homosexuality Is it a choice? Simon LeVay compared INAH-3 in heterosexual and homosexual males. Courtesy Simon LeVay, Salk Institute docsity.com Aging and Sexual Activity • Physiologically based changes • Illnesses affect sexual activity • Medical procedures help minimize effects of organically-based problems. • AARP survey (1999): –Relationships more important than sex – Sexual activity affected by “partner gap” –Despite health-related declines in sexual activity, ~2/3 of men and women with sexual partners are satisfied with their sex lives docsity.com Aging and Sexual Activity • The Janus Report: – Little decline in sexual activity or ability to reach orgasm from middle age to >65 –Unchanged desire to continue relatively active sex life docsity.com Percentage of Men with Erectile Problems, Ages 60 and Older docsity.com Sexual Dysfunctions • Orgasmic Disorder: Inability to achieve orgasm after entering excitement phase and receiving adequate sexual stimulation (problem at the plateau phase). • Sexual Pain Disorder: Pain in the genital area before, during, or after sexual intercourse. docsity.com taste 10.2 DISORDERS CHART cS DYSFUNCTION Sexual Desire Disorders Aare —Problems during the appetitive phase —Hypoactive sexual desire disorder Absent or low sexual interest/desire —Sexual aversion disorder Avoidance offaversion to sexual intercourse AGE OF ONSET | COURSE Sexual Arousal Disorders —Problems of sexual pleasure or physiological changes involving sexual excitement —Male erectile disorder (ED) Inability to attair/maintain an erection sufficient for sexual intercourse and/or psychological arousal during sexual activity —Female sexual arousal disorder Inability to attain/maintain physiological response and/or psychological arousal during sexual activity Orgasmic Disorders Sexual Pain Disorders —Problems with the orgasm phase —Female/male orgasmic disorder Persistent delay or inability to achieve orgasm after reaching excitement phase —Premature ejaculation Ejaculation with minimal sexual stimulation before, during, or shortly after penetration —Dyspareunia Genital pain ina man or woman not primarily due to lack of lubrication in the vagina or vaginismus. —Vaginismus \nvoluntary spasm of the outer third of the vaginal wall that prevents or interferes with sexual intercourse PREVALENCE 20% of adult Usually noticed May be lifelong population; women in adulthood by or acquired; have higher rates a partner who treatment may (20-35%) than men complains help (15%) 10% of men report Can occur at Most can be ED; some 50% have age of sexual helped by experienced “transient” maturity but psychological conditions; 10-50% increases with or medical of women suffer from age, especially treatment arousal lubrication in men problems Premature ejaculation — Atage of sexual __In men, often estimates from maturity related to 30-50%; 3-10% of performance nonclinical population anxiety; in suffer from inhibited women, lack of male orgasm; 10% of foreplay is most ‘women have never frequent reason experienced an orgasm Dyspareunia is Can occur Most have relatively rare in men because of physical causes but more common medical problems and can be in women (17-19%); (such as injury treated vaginismus occurs in to the pelvis) or less than 1% of females traumatic event docsity.com Sexual Dysfunctions Sexual Desire Disorders • Hypoactive Sexual Desire Disorder: Little or no interest in sexual activities (actual or fantasized). – Prevalence: 20-35% of women, 15% of men – The most common complaint of couples seeking sex therapy – Associated with low testosterone levels • Sexual Aversion Disorder: Avoidance of and aversion to sexual intercourse. • Role of interpersonal problems in sexual desire disorders docsity.com Some Possible Physical Causes of Erectile Disorder and Dyspareunia docsity.com Sexual Dysfunctions Sexual Arousal Disorders • Male Erectile Disorder: Inability to attain or maintain an erection sufficient for sexual intercourse. –Primary erectile dysfunction – Secondary erectile dysfunction –30-70% may be due to physical conditions –Prevalence: Difficult to determine due to under reporting docsity.com Sexual Dysfunctions Sexual Arousal Disorders • Female Sexual Arousal Disorder: Inability to attain or maintain physiological response and/or psychological arousal during sexual activity. –May be lifelong or acquired –Often related to negative attitudes about sex or early sexual experiences –Prevalence: Estimates vary from 10-50% of female population docsity.com Sexual Dysfunctions Orgasmic Disorders • Premature Ejaculation: Ejaculation with minimal sexual stimulation before, during, or shortly after penetration. docsity.com Sexual Dysfunctions Sexual Pain Disorders • Dyspareunia: Recurrent or persistent pain in the genitals before, during, or after sexual intercourse. – Lack of lubrication –Vaginismus: Involuntary spasm of the outer third of the vaginal wall, preventing or interfering with sexual intercourse. –General medical condition – Substance-induced sexual dysfunction docsity.com Etiology of Sexual Dysfunctions • Biological factors: – Levels of testosterone (low) or estrogens (high) –Medications used to treat medical conditions – Illnesses and other physiological factors –Amount of blood flow into genital area docsity.com TABLE 10.5 TREATING ERECTILE DISORDERS: MEDICAL INTERVENT EFFECTS DRAWBACKS Taken as a pill. Some 70 to 80% of users achieve erections normal for their ages. Viagra enhances blood flow and retention by blocking an enzyme found primarily in the penis. The drug must be taken an hour before sex, and stimulation is needed for an erection. Possible headaches and diarrhea. A drop in blood pressure. Temporary blue- green-tinted vision. Corrects venous leak from a groin injury by repairing arteries to boost blood supply in the penis. Restores the ability to have a normal erection. Minimal problems when used appropriately with diagnosed condition. PRIMARY TREATMENT AGENT Oral medication Viagra (sildenafil) Surgery Vascular surgery Suppository Muse (alprotadil) e A tiny pellet is inserted into the penis by means of an applicator 5 to 10 minutes before sex. Erections can last an hour. Some 65% of users show some tumescence. Penile aching, minor urethral bleeding or spotting, dizziness, and leg- vein swelling. docsity.com Injection therapy Vasodilating Drug is injected directly into the base of the penis Pain, bleeding, and scar drugs, including 10 minutes to 2 hours before sex, depending on tissue formation. Erections Caverject the drug. The drug helps relax smooth-muscle may not readily subside. (alprotadil), tissues and creates an erection in up to 90% of Edex patients. Erection lasts about an hour. (alprostadil), and Invicorp (VIP and phentolamine) Devices Vacuum pump Canes negative air pressure ea the penis to Some difficulty in induce the flow of blood, which is then trapped ejaculation. Penis can by an elastic band encircling the shaft. Pump is become cool and appear used just before sex. Erection lasts until band is constricted in color. removed. Apparatus can be clumsy to use. Penile implants | Considered a court of last resort. A penile Destruction of spongy prosthesis is implanted in the penis, enabling men __ tissue inside the penis. to literally “pump themselves up” by pulling blood into it. docsity.com Psychological Factors and Behavioral Therapy • Predisposing or historical factors • Current factors • Therapy: – Education –Anxiety reduction – Structured behavioral exercises –Communication training – Specific nonmedical treatments for female orgasmic dysfunction, premature ejaculation, and vaginismus docsity.com Frequency of Symptoms in 55 Boys with Cross-Gender Preferences docsity.com Gender Identity Disorders • Transsexualism (“specified gender identity disorder”): Strong and persistent cross-gender identification and persistent discomfort with one’s anatomical sex, causing significant impairment in social, occupational, or other areas of functioning. – Prevalence: 1:100,000-30,000 for males; 1:400,000- 100,000 for females • Gender Identity Disorder Not-Otherwise-Specified: Disorders not classifiable as specific gender identity disorder docsity.com Etiology of Gender Identity Disorders • Etiology is unclear—probably an interaction of multiple variables. • Biological: Possibly neurohormonal factors • Psychodynamic: Unconscious childhood conflicts resulting from failure to deal successfully with separation-individuation phases of life, or inability to resolve Oedipus complex. • Behavioral: Childhood experiences based on operant conditioning and social learning docsity.com taste 10.6 DISORDERS CHART LLL aN CATEGORY SYMPTOMS PREVALENCE AGE OF ONSET pete ti Nonhuman Objects Nonconsenting Persons Fetishism Sexual attraction and fantasies involving nonliving objects such as female undergarments Primarily a male disorder; rare in women; exact figures unavailable Usually adolescence Causes are difficult to pinpoint; conditioning and learning seem likely Transvestic fetishism \ntense sexual arousal by cross- dressing Exhibitionism Urges, acts, or fantasies involving exposure of genitals to a stranger Exact figures difficult to obtain because cross- dressing often goes unreported and is acceptable in many societies Almost exclusively a male activity; exact figures lacking Begins as early as Puberty Begins in tee exhibitionist is most likely in 20s Cross-dressing is not usually associated with major psychiatric problems Most likely to have doubts about his masculinity; likes to shock; many have an erection during act; most masturbate after exposure Voyeurism Urges, acts, or fantasies of observing an unsuspecting person disrobing or engaging in sexual activity Difficult to determine; most are men Begins around age tends to be chronic Voyeurs tend to be young males; they may masturbate during or after the episode Frotteurism Urges, acts, or fantasies of touching or rubbing against a nonconsenting person Difficult to determine; most are men Begins in adolescence or earlier Usually decreases after age 25 Pedophilia Urges, acts, or fantasies involving sexual contact with a prepubescent child Primarily men; exact figures not available Must be at least 16; pedophiles tend to be in late 20s/30s Prefer children who are at least 5 years younger than they are and usually less than 13 years old; pedophiles often have poor social skills docsity.com Pain or Humiliation Sadism Sexually arousing urges, fantasies, or acts associated with inflicting physical or psychological suffering Masochism Sexual urges, fantasies, or acts associated with being humiliated, bound, or made to suffer Usually male; rates unknown, however, 22% of men and 12% of women in one study report some sexual arousal from sadistic stories difficult to obtain Begins in early childhood with sexual fantasies Males report first interests around 15 and women at 22 Fantasies begin in childhood; sadistic acts usually develop in adulthood and can stay at the same level of cruelty or, more rarely, increase to problematic proportions Not all suffering arouses; usually it must be produced in a specific way; classical conditioning strongly implicated as causal docsity.com Paraphilias Involving Nonhuman Objects • Fetishism: Extremely strong sexual attraction and fantasies involving inanimate objects, such as female undergarments. • Transvestic Fetishism: Intense sexual arousal obtained through cross-dressing (wearing clothes appropriate to the opposite gender); do not confuse with transsexualism. – If arousal is not present/has disappeared over time, more appropriate diagnosis is gender identity disorder. docsity.com Childhood Sexual Abuse • Victims of childhood sexual abuse: –~25% are younger than age 6; 25% are age 6-10; 50% are 11-13 –Relapse rate for pedophiles: 35% –Physical symptoms of victims: • Urinary tract infections, poor appetite, headaches docsity.com Childhood Sexual Abuse • Victims of childhood sexual abuse: –Psychological symptoms of victims: • Nightmares, difficulty sleeping, decline in school performance, acting-out behaviors, sexually focused behavior • Some exhibit posttraumatic stress disorder: flashbacks, diminished responsiveness to environment, hyperalertness, and jumpiness docsity.com Paraphilias Involving Pain or Humiliation • Sadism: Form of paraphilia in which sexually arousing urges, fantasies, or acts are associated with inflicting physical or psychological suffering on others. • Masochism: A paraphilia in which sexual urges, fantasies, or acts are associated with being humiliated, bound, or made to suffer. • Most sadomasochists engage in both submissive and dominant roles • Brain pathology and life experiences may underlie sadism docsity.com Etiology and Treatment of Paraphilias • Behavioral: – Learning theory stresses early conditioning experiences –Preparedness: Prepared to associate some stimuli with reinforcers, but not others – Treatment: Extinction or aversive conditioning (aversive behavior rehearsal); acquiring/strengthening appropriate behaviors; developing appropriate social skills docsity.com Sexual Aggression • Sexual Aggression: Actions, such as rape, incest, and any type of sexual activity performed against a person’s will through use of force, argument, pressure, alcohol or drugs, or authority. – Sexual Activity: Petting, oral-genital sex, anal intercourse, sexual intercourse. – Sexual Coercion: Any/all forms of sexual pressure (pleading, arguing, cajoling, force, or threat of force). docsity.com Rape • Rape: An act of intercourse accomplished through force or threat of force. • Statutory Rape: Sexual intercourse with a child younger than a certain age. • Date Rape: Majority of all rapes (8-25% of female college students report having “unwanted sexual intercourse”). docsity.com Etiology of Rape • Power Rapist: Compensate for feelings of personal/sexual inadequacy by trying to intimidate victims (55% of rapists). • Anger Rapist: Angry at women in general (40% of rapists). • Sadistic Rapist: Derives satisfaction from inflicting pain; may torture or mutilate victims (5% of rapists). docsity.com Etiology of Rape • Media portrayals of violent sex reflect/affect societal values concerning violence and women • “Cultural spillover” Theory: Rape is high in environments that encourage violence. docsity.com Incest • Incest: Sexual relations between people too closely related to marry legally. –Universally taboo in human societies – Incidence: 48,000-250,000 reported per year –Most frequently reported to law enforcement: Father with daughter/step-daughter –Most frequent: Brother-sister –Rare: Mother-son docsity.com