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Chapter 11 Assignment

Sexual behavior is considered a psychological disorder if it causes what?

What are the four types of sexual aggressors and define each.

Define paraphilias.

What are the features of paraphilias?

According to the DSM 5 what are the 10 Paraphilic Disorders? Briefly define each.

What are the types of pedophilia and briefly define each.

What is the biological treatment for pedophilia?

Define Gender Dysphoria or Gender Identity Disorder.

What are the theories of Gender Identity Disorder?

Name the 10 Sexual dysfunction disorder for males and females.

Abnormal
Psychology
Clinical Perspectives on Psychological Disorders 5e
Richard P. Halgin
Susan Krauss Whitbourne
University of Massachusetts at Amherst
slides by Travis Langley
Henderson State University
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Chapter 11
Paraphilic Disorders, Sexual Dysfuntions,
and Gender Dysphoria
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What is Abnormal
Sexual Behavior?
Sexual behavior is considered a psychological disorder if it causes:
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harm to other people,
persistent or recurrent distress, or
impairment in important areas of functioning.
Some behaviors, such as child molestation, can clearly fit the first
criterion (causing harm to others) without necessarily causing
distress or impairing other functioning in the individual who does
these things.
It is important to consider context, as well as customs and mores
which change over time, when evaluating the normality of a given
sexual behavior.
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THEORIES
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EARLY LIFE EXPERIENCE
➢ Sexually and emotionally abused as
children
➢ Victim-to-abuser cycle
PERSONALITY TRAITS
➢ Antisocial personality traits
➢ Anger stemming from feelings of
inadequacy, introversion, cognitive rigidity
Many pedophiles were sexually and emotionally abused as
children, in which case they were once victims, then grew up to
become abusers. However, most abused children do not grow up
to become pedophiles.
There appears to be a strong antisocial element in the
personalities of child molesters, especially among those who prey
on unrelated children.
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Types of Sexual Aggressor in
General
â–ª Physiological
â–ª Cognitive
â–ª Affective
â–ª Developmentally-related
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Types of Sexual Aggressor
in General
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Another model applies to sexual aggressors, in general, but seems
particularly suited for examining pedophilia.
The physiological sexual aggressor experiences deviant sexual
arousal patterns.
The cognitive sexual aggressor plans his sexual aggression, which is
more likely acquaintance rape or incest, less impulsive and violent than
other kinds.
The affective sexual aggressor lacks affective control. His sexual
aggression is opportunistic, unplanned, and often violent.
The sexual aggressor with developmentally-related personality
problems has a long history of personality and adjustment difficulties,
family and interpersonal conflicts, and childhood victimization. They tend
to engage in violent sexual aggression and have the poorest treatment
prognosis.
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Paraphilic Disorders
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Paraphilias
â—¼ Disorders in which an individual has
recurrent, intense sexually arousing
fantasies, sexual urges, or behaviors
involving
â–ª nonhuman objects,
â–ª children or other nonconsenting persons, or
â–ª the suffering or humiliation of self or partner.
â—¼ Inability to experience sexual gratification
in the absence of the desired stimulus.
â—¼ Lasting at least six months.
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Features of Paraphilias
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Vary by paraphilia
Generally, ingrained behaviors
Biopsychosocial factors
Conditioning appears to be main cause
Difficult to treat
Rarely present for treatment unless legally bound
Treatment depends on the nature of the paraphilia
Most paraphilias emerge during adolescence, although there is usually a connection with
events or relationships in early childhood. Once established, they tend to be chronic.
Although biological factors play a role in some paraphilias, psychological factors seem to be
central; in most cases, one or more learning events have taken place in childhood involving a
conditioned response that results in a paraphilia.
Treatment depends on the nature of the paraphilia and may include a biological component
(such as medication), a psychological component (such as psychotherapy), and a
sociocultural component (such as group or family therapy).
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Paraphilic Disorders
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Voyeuristic
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Exhibitionist
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Frotteurism
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A person who becomes sexually aroused by rubbing against a
nonconsenting person, usually in a crowded place, may have a
sexual disorder called frotteurism. Frotteurism is a type of a
paraphilic interest or paraphilia.
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Sexual Masochism and
Sexual Sadism Disorders
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Some Sadomasochistic
Activities
â—¼ spanking
â—¼ cutting
â—¼ master-slave
â—¼ shocking
â—¼ bondage
â—¼ asphyxiation
â—¼ humiliation
â—¼ restraint
â—¼ pain infliction
â—¼ whipping
â—¼ verbal abuse
â—¼ toilet-related activities
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Pedophilia
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Pedophilia Types
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PEDOPHILIA
➢ 2/3 of all sexual assault victims are children &
adolescents
➢ Among children age 12-17, 14-year-olds are
the most common victims
➢ For children under 12, 4-year-olds are the
most commonly abused
➢ Nearly 2/3 of victims are female
➢ Vast majority of perpetrators are male
➢ About 1/3 of offenders are relatives of the
victimized children
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Pedophilia
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Hebephilia is the strong, persistent sexual interest by adults
in pubescent children who are in early adolescence, typically
ages 11–14. It differs from pedophilia (the primary or exclusive
sexual interest in prepubescent children), and
from ephebophilia (the primary sexual interest in later
adolescents, typically ages 15–19). While individuals with a
sexual preference for adults may have some sexual interest in
pubescent-aged individuals, researchers and clinical diagnoses
have proposed that hebephilia is characterized by a sexual
preference for pubescent rather than adult partners.
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Pedophilia
â—¼ Hebephilia is approximate in its age range because
the onset and completion of puberty vary. On average,
girls begin the process of puberty at age 10 or 11
while boys begin at age 11 or 12. Partly because
puberty varies, some definitions
of chronophilias (sexual preference for a specific
physiological appearance related to age) show overlap
between pedophilia, hebephilia and ephebophilia. For
example, the DSM-5 extends the prepubescent age to
13, the ICD-10 includes early pubertal age in its
definition of pedophilia, and some definitions of
ephebophilia include age 14.
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Pedophilia Treatment
BIOLOGICAL APPROACH
â—¼ IN DIAGNOSIS
➢ Penile plethysmograph
➢ Penile plethysmography (PPG) or phallometry is
measurement of bloodflow to the penis, typically
used as a proxy for measurement of sexual
arousal. … Corpora cavernosa nerve penile
plethysmographs measure changes in response to
inter-operative electric stimulation during surgery.
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Pedophilia Treatment
BIOLOGICAL APPROACH
â—¼ IN TREATMENT
➢ Lowering testosterone.
➢ Castration (rare).
➢ Hypothalamotomy.
These may help curb sex drive, but
inappropriateness of the choice of partner must
also be addressed.
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Pedophilia Treatment
â—¼ BEHAVIORAL TREATMENT
➢ Aversive therapy
➢ Ridicule
â—¼ COGNITIVE
➢ Relapse prevention
â—¼ GROUP THERAPY
➢ Confront denial and rationalizations
➢ Supportive context to discuss desires and
conflicts
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Fetishism
â—¼ Behavior is not fetishistic when involving
an object specifically designed for sexual
excitation (e.g., vibrator).
Fetishism:
A paraphilia in which the individual is
preoccupied with an object and depends
on this object rather than sexual intimacy
with a partner for achieving sexual
gratification.
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Fetishism
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Partialism
Partialism:
A paraphilia in which the
person is interested solely
in sexual gratification from
a specific body part, such
as feet.
Some experts regard
this as a kind of fetishism
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Continuum for NormalAbnormal Behavior
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Transvestic Disorder
Transvestic fetishism:
A paraphilia in which a man has an uncontrollable craving to dress in
women’s clothing in order to derive sexual gratification.
Homosexual men who make themselves up as women are not
transvestic fetishists because they are not dressing this way to
gain sexual satisfaction.
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OTHER PARAPHILIAS
Telephone scatologia
Making obscene calls
Necrophilia
Zoophilia
Coprophilia
Klismaphilia
Urophilia
Autagonistophilia
Somnophilia
Stigmatophilia
Autonepiophilia
Corpses
Animals
Feces
Enemas
Urine
Sex in front of others
Sleeping people
Skin piercing or tattoo
Wearing diapers
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Gender Identity Disorders
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Gender identity:
The individual’s self-perception as a
male or female
Gender identity disorder:
A condition in which there is a
discrepancy between an individual’s
gender identity and assigned
(biological) sex.
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GENDER IDENTITY
DISORDER
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Strong and persistent (but not delusional) belief that a
person is the wrong sex
Refusal to engage in culturally “gender-appropriate”
behaviors
Recurrent fantasies and cross-dressing
No sexual gratification from cross-dressing
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THEORIES OF GENDER
IDENTITY DISORDER
â—¼ BIOLOGICAL
✓Abnormal fetal hormone levels
✓Vulnerability to high sensory arousal
✓Sensitive to parents’ emotional expressions
â—¼ PSYCHOLOGICAL
✓Parental preferences for child of other sex
✓Parental unintentional reinforcement of
cross-gender behaviors
â—¼ SOCIAL – Cultural idealization of
stereotypical male and female “types”
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THEORIES OF GENDER
IDENTITY DISORDER
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Females exposed to increased androgens before birth are more
likely to display stereotypically male gender roles.
In rare cases, chromosomal abnormalities are found in which
male-to-female transsexuals have an extra X chromosome.
Boys with gender identity disorders are acutely sensitive to
various sensory stimuli and to their parents’ affect.
Psychological theories focus on factors such as the role of a
parent’s preference for a child of the other gender, the impact of
early attachment experiences, and parents’ unintentional
reinforcement of cross-gender behavior.
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THEORIES OF GENDER
IDENTITY DISORDER
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For some mothers, disappointment with the birth of yet another
boy may negatively influence her relationship with younger sons.
Birth order findings: Later-born boys have this more often, and
they’re likely to have more brothers than sisters.
Sociocultural theories consider various ways in which American
society idealizes men and women according to certain
stereotypical variables. Various factors influence the choice of
intervention, with the most extreme method involving sex
reassignment surgery.
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TREATMENT
â—¼ PSYCHOTHERAPY
â–ª Very young child
• Help develop self-esteem
â–ª Older child
• Deal with cross-gender behavior and fantasy,
low self-esteem, peer rejection
â–ª Adults
• Focus on the biopsychosocial causes, provide
support and coping strategies
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SEX REASSIGNMENT SURGERY
â—¼ Sought by a small number of those with
gender identity disorder.
â—¼ Factors in improved functioning postsurgery:
â–ª Female-to-male transition hold greater
satisfaction
â–ª Level of adjustment pre-surgery
â–ª Level of commitment to being other sex
â–ª Quality of surgery itself
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SEX REASSIGNMENT SURGERY
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Sexual Dysfunctions
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SEXUAL DYSFUNCTIONS
â—¼ Abnormality in individual sexual
responsiveness
â—¼ Individually defined
â—¼ Usually related to other problems
â—¼ Lifelong or acquired
â—¼ Generalized or situational
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Sexual Dysfunctions
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The National Health and Social Life Survey found sexual
dysfunction reported by 43% of women and 31% of men.
Sexual dysfunctions are usually related to other life problems:
relationship, past experiences, depression, physical illness,
substance abuse.
Clinicians must determine whether the dysfunction has a
psychological cause (such as depression or relationship
problems) or results from a combination of psychological and
physical factors.
Masters & Johnson (1966, 1970) identified four phases of the
sexual response cycle: arousal, plateau, orgasm, and
resolution. Sexual dysfunctions are associated with the arousal
and orgasm phases, and with initial sexual desire.
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THEORIES
Sexual dysfunctions may arise from
physical and/or psychological problems.
â—¼ Neurological, cardiovascular disorders
â—¼ Liver or kidney disease
â—¼ Hormonal abnormalities
â—¼ Problems with reproductive system
â—¼ Substance-induced
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TREATMENT
Treatment – Variety of physical, educative,
attitudinal, intrapsychic, and interpersonal
treatments
Treatment varies depending on the
cause, the specific problem, and
influencing factors.
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TREATMENT
Masters & Johnson
recommend sensate
focus:
The partners take turns
stimulating each other in
nonsexual but affectionate
ways at first, then
gradually progress over a
period of time toward
genital stimulation.
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Hypoactive Sexual Desire
Disorder
A sexual dysfunction in which the
individual has an abnormally low level of
interest in sexual activity.
Possible Causes:
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•
Psychological difficulties
Poor body image or self-esteem
Interpersonal hostility
Relationship power struggles
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Erectile Disorder
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Premature Ejaculation
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Delayed Ejaculation
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Substance/Medication- Induced Sexual
Dysfunction
â—¼ Substances officially designated by the American
Psychiatric Association as potential causes of
substance-induced sexual dysfunction include alcohol,
legal opioid (narcotic) medications and illegal opioid
drugs, cocaine, amphetamine
medications, methamphetamine, anti-anxiety
medications, sedative medications, and sleep-inducing
(hypnotic) medications. All other known (and
unknown) substances capable of triggering symptoms
of the disorder belong to a single catchall category
known as “other substances.”
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Sexual Interest Arousal Disorder
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Orgasmic Disorder
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Genito-Pelvic
Pain/Penetration Disorder
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Genito-Pelvic
Pain/Penetration Disorder
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Substance/Medication- Induced Sexual
Dysfunction
â—¼ Substances officially designated by the American
Psychiatric Association as potential causes of
substance-induced sexual dysfunction include alcohol,
legal opioid (narcotic) medications and illegal opioid
drugs, cocaine, amphetamine
medications, methamphetamine, anti-anxiety
medications, sedative medications, and sleep-inducing
(hypnotic) medications. All other known (and
unknown) substances capable of triggering symptoms
of the disorder belong to a single catchall category
known as “other substances.”
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Sexual Aversion Disorder
A sexual dysfunction characterized by an
active dislike and avoidance of genital
contact with a sexual partner.
4 Primary Causes:
1. Severely negatively parental sex attitudes
2. History of sexual trauma
3. Sexual pressuring by partner
4. Gender identity confusion
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The Biopsychosocial
Perspective
â—¼ Behavioral perspective appears to hold the
most promise in explaining sexual disorders.
â—¼ Behavioral treatments of sexual disorders can
be applied to the paraphilias and sexual
dysfunctions.
â—¼ Biological perspective is important, too,
especially with gender identity disorders and
the treatment of erectile dysfunction.
â—¼ Exploring personal history and relationship
difficulties is important.
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