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65 Cards in this Set
- Front
- Back
What is sexual identity?
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One's biological sex
Chromosomes, gonads, genitalia, etc. |
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What is gender identity?
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SUBJECTIVE sense of "maleness" or "femaleness"
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What is gender role?
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BEHAVIOR that identifies one as "male" or "female"
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What is orientation?
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Whether an indiv. is attracted to same sex, opposite, or both
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What 4 behavioral dimensions does homosexuality subsume?
Which is most important? |
Sexual fantasy
Sexual activity Personal identity Social role Fantasy is most important Ex. person can have homo orientation w/o engaging in homo activity |
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How does concordance rate for homosexuality compare between twins, etc.?
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Monozygotic > dizygotic > adopted siblings
Some reports of concordance between mono twins, that were reared apart |
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What structure(s) is proposed as link between genotype & phenotype?
(when it comes to sexuality) |
Interstitial nuclei in the anterior hypothalamus (INAH)
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What are the four main influences on excitement?
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Psychological
Neural factors Vascular factors Endocrine/metabolic factors |
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What branch of the nervous system is responsible for sexual excitement?
(ie erection) |
Parasympathetic branch
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What endocrine/metabolic substances facilitate sexual excitement (2)?
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Testosterone
Dopamine |
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What endocrine/metabolic substance inhibits sexual excitement?
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Serotonin
Remember, SSRIs have adverse sexual effects |
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What branch of the nervous system is responsible for orgasm?
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Sympathetic branch
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Anti-cholinergic meds can have what sexual side effect(s)?
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May inhibit arousal
(impotence in men, impaired lubrication in women) |
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Anti-hypertensive meds can have what sexual side effect(s)?
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Inhibition of orgasm due to decreased sympathetic function
Beta-blockers can decrease arousal |
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Trazodone can have what sexual side effect(s)?
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Priapism
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Anti-psychotics can have what sexual side effect(s)?
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Decreased arousal (DA blockade, anti-cholinergism, inc. prolactin)
Alpha-blockade can cause anorgasmia |
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SSRIs can have what sexual side effect(s)?
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Inhibited arousal and orgasm
(due to increased serotonin levels) |
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Spironolactone, steroids, and estrogens can have what sexual side effect(s)?
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Decreased sexual desire and arousal
(via anti-androgenic effects) |
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Alcohol, opiates and cocaine can have what sexual side effect(s)?
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Interference w/ both arousal and orgasm
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What is hypoactive sexual desire disorder defined as?
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Deficiency/absence of BOTH sexual fantasies and desire
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What 2 main sexual dysfunctions is Hypoactive Sex Desire often assoc. w/?
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Impaired arousal
Impaired orgasm |
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What is the treatment for Hypoactive Sex Desire Disorder?
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Sex education
Individual or couple's therapy Courtship exercises |
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What is sexual aversion disorder defined as?
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Active aversion to genital sexual contact with the sexual partner
Libido IS present, but anxiety, fear or disgust interferes |
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What is the treatment for Sexual Aversion Disorder?
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Graded in vivo desensitization at careful pace
NOTE: similar to the treatment for Phobic Disorder |
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What is Female Sexual Arousal Disorder defined as?
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Recurrent inability to attain or maintain adequate lubrication-swelling response
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What other disorders does Female Sex Arousal Disorder often appear with (2)?
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Hypoactive Sex Arousal Disorder
Female Orgasmic Disorder |
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What medical conditions are common causes of Female Arousal Disorder (4)?
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Post-menopausal state (most common cause)
Atrophic vaginitis Diabetes mellitus Lactation |
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What is the treatment for Female Sex Arousal Disorder?
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Estrogen replacement therapy and topical lubricant
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What is the most common presenting complaint at sex therapy clinics?
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Male Erectile Disorder
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What is the prevalence of Male ED?
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Overall -- 3% - 9%
Ages 20-30 -- 7% Ages 40-70 -- 50% |
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What % of men with ED actually seek treatment?
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Only 10%
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What is the most common cause of male ED?
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Diabetes
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What artery provides the majority of blood supply to the penis?
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Pudendal artery
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What does psychological treatment for male ED entail (4)?
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Education
Couple's therapy Sensate focus exercises Graded, in vivo desensitization, leading to entry |
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What are Sensate Focus exercises?
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Ex. in which each partner pays increased attention to their own senses
(take turns progressing through stages of touching) |
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What are the injectable options for treating male ED pharmacologically (3)?
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Papaverine -- smooth muscle relaxant
Phenoxybenzamine -- alpha-adrenergic blocker Prostglandin E1 |
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What are the pill options for treating male ED pharmacologically (3)?
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Sildenafil -- Viagra
Vardenafil -- Levitra Tadalafil -- Cialis (NOTE: long acting [DOA up to 36 hrs.]) |
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What is primary anorgasmia?
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Never having achieved orgasm
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What is secondary anorgasmia?
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Only being anorgasmic in certain situations
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What % of the population is primary anorgasmic?
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5 - 10%
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What % of the population is secondary anorgasmic?
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Up to one third of the population
NOTE: response to treatment is 50% and variable |
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Why may anorgasmia appear before ED in general medical conditions?
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Sympathetic innervation of penis is more sensitive to insult
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What are NON-pharmacologic treatment options for male org. disorder (3)?
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Sensate focus exercises
Increased stimulation prior to coitus Anal stimulation |
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What are pharmacologic treatment options for male org. disorder (2)?
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Cyprohepatadine -- 5-HT antagonist
Yohimbine -- alpha-2 antagonist |
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Lifelong premature ejaculation is more common in what age group?
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Younger men (40%)
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Acquired prem. ejaculation is associated w/ what 2 other problems?
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Male ED
Performance anxiety |
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What is a non-pharmacologic treatment option for prem. ejaculation?
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Start/stop or squeeze technique
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What is dyspareunia?
Who experiences it? |
Genital pain associated with sexual intercourse
Almost always in women |
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What general medical conditions may cause dyspareunia (4)?
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Infections
Estrogen deficiency (decreased lubrication) Post-radiation therapy effects Vulvar vestibulitis |
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What are treatment options for dyspareunia (3)?
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Education
Relaxation exercises Exploratory masturbation |
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What is vaginismus?
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Persistent, INVOLUNTARY, contraction of perineal muscles
Occurs during, or in anticipation of vaginal penetration |
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What 3 psych. factors may play a role in vaginismus?
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Previous dyspareunia
Sexual abuse Childhood teachings about sex |
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What are treatment options for vaginismus (4)?
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Relaxation training
Gradual self-exploration Attempts at insertion (finger, dilator, etc.) Sensate focus exercises |
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What are paraphilias?
How long must they persist to qualify? |
Intense sexually arousing fantasies, urges
Involve either non-human objects, suffering/humiliation, non-consenting persons Must persist > 6 months |
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What is frotteurism?
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Touching or rubbing against a non-consenting person
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What is sexual masochism?
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RECEIVING humiliation or suffering
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What is sexual sadism?
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INFLICTING humiliation or suffering
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What is partialism?
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Exclusive focus on part of the body
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What is coprophilia?
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Inclusion of feces in sexual fantasy
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What is klismaphilia?
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Inclusion of enemas in sexual fantasy
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What group of people do paraphilias appear in?
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Almost exclusively in men
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What are treatment options for paraphilias?
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STOP the behavior
Remove external reinforcers Remove internal reinforcers (Behavioral and cognitive therapy, Anti-androgen meds) |
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What is gender identity disorder defined as?
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Strong and persistent cross-gender identification
The desire to be, or insistence that one is, of the other sex MUST also be evidence of discomfort about one's assigned sex (or, a sense of inappropriateness in gender role of assigned sex) |
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When does gender identity disorder typically begin?
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Between ages of 2 and 4
NOTE: most kids w/ GID do NOT remain that way as adults |
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When considering reassignment surgery, what must be ruled out (3)?
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Borderline personality disorder
Effeminate homosexual w/ adjustment disorder Transvestite w/ adjustment disorder NOTE: you can treat all of the above w/ psychotherapy |