Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key          1




Chapter 11 – Sexual...
Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key                          2



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Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key                                   ...
Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key                                   ...
Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key                                 5
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Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key                                  6...
Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key                           7




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Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key                         8




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Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key            9




Handout 64: Trans...
Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key                    10




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Abnormal sexual ident ans key ch11

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Abnormal sexual ident ans key ch11

  1. 1. Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key 1 Chapter 11 – Sexual Disorders and Gender Identity Disorder Slides, handouts, and answers keys created by Karen Clay Rhines, Ph.D. Handout 3: Sexual Dysfunctions Sexual dysfunctions are disorders in which people cannot respond normally in key areas of sexual functioning  As many as 31% of men and 43% of women in the U.S. suffer from such a dysfunction during their lives Sexual dysfunctions are typically very distressing, and often lead to sexual frustration, guilt, loss of self-esteem, and interpersonal problems Handout 4: Sexual Dysfunctions The human sexual response can be described as a cycle with four phases:  Desire  Excitement  Orgasm  Resolution Sexual dysfunctions affect one or more of the first three phases Handout 8: Disorders of Desire The desire phase of the sexual response cycle consists of an urge to have sex, sexual fantasies, and sexual attraction to others Two dysfunctions affect this phase:  Hypoactive sexual desire disorder  Sexual aversion disorder Handout 10: Disorders of Desire Hypoactive sexual desire disorder  Characterized by a lack of interest in sex and a low level of sexual activity  Physical responses may be normal  Prevalent in about 16% of men and 33% of women  DSM-IV-TR criteria refers to “deficient” sexual interest/activity but provides no definition of “deficient” • In reality, this criterion is difficult to define Handout 11: Disorders of Desire
  2. 2. Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key 2 Sexual aversion disorder  Characterized by a total aversion to (disgust of) sex • Sexual advances may sicken, repulse, or frighten  This disorder seems to be rare in men and more common in women Handout 13: Disorders of Desire Biological causes  A number of hormones interact to produce sexual desire and behavior • Abnormalities in their activity can lower sex drive • These hormones include prolactin, testosterone, and estrogen for both men and women  Sex drive can also be lowered by chronic illness, some medications, some psychotropic drugs, and a number of illegal drugs Handout 15: Disorders of Desire Sociocultural causes  Attitudes, fears, and psychological disorders that contribute to sexual desire disorders occur within a social context  Many sufferers of desire disorders are feeling situational pressures Examples: divorce, death, job stress, infertility, and/or relationship difficulties  Cultural standards can affect the development of these disorders  The trauma of sexual molestation or assault is also likely to produce sexual dysfunction Handout 16: Disorders of Excitement Excitement phase of the sexual response cycle  Marked by changes in the pelvic region, general physical arousal, and increases in heart rate, muscle tension, blood pressure, and rate of breathing • In men: erection of the penis • In women: clitoral swelling and vaginal lubrication Two dysfunctions affect this phase:  Female sexual arousal disorder (formerly “frigidity”)  Male erectile disorder (formerly “impotence”)
  3. 3. Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key 3 Handout 18: Disorders of Excitement Female sexual arousal disorder  Characterized by repeated inability to maintain proper lubrication or genital swelling during sexual activity  Many with this disorder also have desire or orgasmic disorders  It is estimated that more than 10% of women experience this disorder  Because this disorder is so often tied to an orgasmic disorder, researchers usually study the two together; causes of the two disorders will be discussed together Handout 19: Disorders of Excitement Male erectile disorder (ED)  Characterized by repeated inability to attain or maintain an adequate erection during sexual activity  An estimated 10% of men experience this disorder  According to surveys, half of all adult men have erectile difficulty during intercourse at least some of the time Handout 21: Disorders of Excitement Biological causes  The same hormonal imbalances that can cause hypoactive sexual desire can also produce ED  Most commonly, vascular problems are involved • ED can also be caused by damage to the nervous system from various diseases, disorders or injuries  The use of certain medications and substances may interfere with erections Handout 23: Disorders of Excitement Psychological factors  Any of the psychological causes of hypoactive sexual desire can also interfere with erectile function  For example, as many as 90% of men with severe depression experience some degree of ED  One well-supported cognitive explanation for ED emphasizes performance anxiety and the spectator role  Once a man begins to have erectile difficulties, he becomes fearful and worried during sexual encounters; instead of being a participant, he becomes a spectator and judge  This can create a vicious cycle of sexual dysfunction where the original cause of the erectile failure becomes less important that the fear of failure
  4. 4. Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key 4 Handout 27: Disorders of Orgasm Premature ejaculation  Characterized by persistent reaching of orgasm and ejaculation with little sexual stimulation  About 30% of men experience premature ejaculation at some time  Psychological, particularly behavioral, explanations of this disorder have received more research support than other theories  The dysfunction seems to be typical of young, sexually inexperienced men  It may also be related to anxiety, hurried masturbation experiences, or poor recognition of arousal Handout 28: Disorders of Orgasm Male orgasmic disorder  Characterized by a repeated inability to reach orgasm or by a very delayed orgasm after normal sexual excitement • Occurs in 8% of the male population  Biological causes include low testosterone, neurological disease, and head or spinal injury • Medications, including certain antidepressants (especially SSRIs) and drugs that slow down the CNS, can also affect ejaculation Handout 29: Disorders of Orgasm Male orgasmic disorder  A leading psychological cause appears to be performance anxiety and the spectator role, the cognitive factors involved in ED Handout 30: Disorders of Orgasm Female orgasmic disorder  Characterized by persistent delay in or absence of orgasm following normal sexual excitement  Almost 25% of women appear to have this problem  10% or more have never reached orgasm  An additional 10% reach orgasm only rarely  Women who are more sexually assertive and more comfortable with masturbation tend to have orgasms more regularly  Female orgasmic disorder is more common in single women than in married or cohabiting women
  5. 5. Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key 5 Handout 31: Disorders of Orgasm  Female orgasmic disorder  Most clinicians agree that orgasm during intercourse is not mandatory for normal sexual functioning  Early psychoanalytic theory used to consider lack of orgasm during intercourse to be pathological  Typically linked to female sexual arousal disorder • The two disorders tend to be studied and treated together Once again, biological, psychological, and sociocultural factors may combine to produce these disorders Handout 33: Disorders of Orgasm  Female orgasmic disorder Psychological causes The psychological causes of hypoactive sexual desire and sexual aversion may also lead to female arousal and orgasmic disorders Memories of childhood trauma and relationship distress may also be related Handout 34: Disorders of Orgasm  Female orgasmic disorder  Sociocultural causes For decades, the leading sociocultural theory of female sexual dysfunction was that it resulted from sexually restrictive cultural messages This theory has been challenged because: Sexually restrictive histories are equally common in women with and without disorder Cultural messages about female sexuality have been changing while the rate of female sexual dysfunction stays constant Handout 38: Disorders of Sexual Pain  Vaginismus  Characterized by involuntary contractions of the muscles of the outer third of the vagina Severe cases can prevent a couple from having intercourse Perhaps 20% of women occasionally have pain during intercourse, but fewer than 1% of all women have vaginismus
  6. 6. Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key 6 Handout 39: Disorders of Sexual Pain  Vaginismus Most clinicians agree with the cognitive-behavioral theory that vaginismus is a learned fear response  A variety of factors can set the stage for this fear, including anxiety and ignorance about intercourse, trauma caused by an unskilled partner, and childhood sexual abuse Some women experience painful intercourse because of infection or disease, leading to “rational” vaginismus Many women with vaginismus also have other sexual disorders Handout 40: Disorders of Sexual Pain Dyspareunia Characterized by severe pain in the genitals during sexual activity Affects about 14% of women and 3% of men Dyspareunia in women usually has a physical cause, most commonly from injury sustained in childbirth Although relationship problems or psychological trauma from abuse may contribute to dyspareunia, psychosocial factors alone are rarely responsible Handout 41: Treatments for Sexual Dysfunctions  The last 35 years have brought major changes in the treatment of sexual dysfunction  Early 20th century: psychodynamic therapy  Believed that sexual dysfunction was caused by failure to negotiate the stages of psychosexual development  Therapy focused on gaining insight and making broad personality changes; was generally unhelpful Handout 42: Treatments for Sexual Dysfunctions  1950s and 1960s: behavioral therapy  Attempted to reduce fear by applying relaxation training and systematic desensitization  Had moderate success, but failed to work in cases where the key problems were cognitive or psychoeducational
  7. 7. Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key 7 Handout 45: What Are the General Features of Sex Therapy?  Modern sex therapy includes:  Assessing and conceptualizing the problem  Assigning “mutual responsibility” for the problem  Education about sexuality  Attitude change  Elimination of performance anxiety and the spectator role  Increasing sexual and general communication skills  Changing destructive lifestyles and marital interactions  Addressing physical and medical factors Handout 48: What Techniques Are Applied to Particular Dysfunctions? Erectile disorder Treatments for ED focus on reducing a man’s performance anxiety and/or increasing his stimulation May include sensate-focus exercises such as the “tease technique” Biological approaches, used when the ED has biological causes, have gained great momentum with the recent approval of sildenafil (Viagra) Most other biological approaches have been around for decades and include gels, suppositories, penile injections, a vacuum erection device (VED), and penile implant surgery Handout 50: What Techniques Are Applied to Particular Dysfunctions?  Premature ejaculation  Premature ejaculation has been successfully treated for years by behavioral procedures such as the “stop-start” or “pause” technique  Some clinicians favor the use of fluoxetine (Prozac) and other serotonin-enhancing antidepressant drugs  Because these drugs often reduce sexual arousal or orgasm, they may be helpful in delaying premature ejaculation  Although some studies have reported positive findings, long-term outcome studies have yet to be conducted
  8. 8. Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key 8 Handout 52: What Techniques Are Applied to Particular Dysfunctions? Vaginismus Specific treatment for vaginismus takes two approaches: Practice tightening and releasing the muscles of the vagina to gain more voluntary control Overcome fear of intercourse through gradual behavioral exposure treatment Over 75% of women treated for vaginismus using these methods eventually reported pain-free intercourse Handout 57: Paraphilias According to the DSM-IV-TR, paraphilias should be diagnosed only when the urges, fantasies, or behaviors last at least 6 months For most paraphilias, the urges, fantasies, or behaviors must also cause great distress or impairment For certain paraphilias, however, performance of the behavior itself is indicative of a disorder Example: sexual contact with children Handout 60: Fetishism The key features of fetishism are recurrent intense sexual urges, sexually arousing fantasies, or behaviors that involve the use of a nonliving object The disorder usually begins in adolescence Almost anything can be a fetish Women’s underwear, shoes, and boots are especially common Handout 62: Fetishism Behaviorists propose that fetishes are learned through classical conditioning Fetishes are sometimes treated with aversion therapy, covert sensitization, or imaginal exposure Anotherbehavioral treatment is masturbatory satiation, in which clients masturbate to boredom while imagining the fetish object An additional behavioral treatment is orgasmic reorientation, a process which teaches individuals to respond to more appropriate sources of sexual stimulation
  9. 9. Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key 9 Handout 64: Transvestic Fetishism The typical person with transvestism is a heterosexual male who began cross- dressing in childhood or adolescence Transvestism is often confused with gender identity disorder (transsexualism), but the two are separate patterns The development of the disorder seems to follow the behavioral principles of operant conditioning Handout 65: Exhibitionism Characterized by arousal from the exposure of genitals in a public setting  Also known as “flashing”  Sexual contact is neither initiated nor desired Usually begins before age 18 and is most common in males Treatment generally includes aversion therapy and masturbatory satiation,  May be combined with orgasmic reorientation, social skills training, or psychodynamic therapy Handout 68: Frotteurism A person who develops frotteurism has fantasies, urges, or behaviors involving touching and rubbing against a nonconsenting person Almost always male, the person fantasizes during the act that he is having a caring relationship with the victim  Usually begins in the teenage years or earlier Acts generally decrease and disappear after age 25 Handout 69: Pedophilia Characterized by fantasies, urges, or behaviors involving sexual activity with a prepubescent child, usually 13 years of age or younger Some people are satisfied with child pornography Others are driven to watching, fondling, or engaging in intercourse with children Evidence suggests that two-thirds of victims are female
  10. 10. Comer, Fundamentals of Abnormal Psychology, 5e — Chapter 11: Student Handout Answer Key 10 Handout 76: A Word of Caution The definitions of paraphilias, like those of sexual dysfunctions, are strongly influenced by the norms of the particular society in which they occur Some clinicians argue that, except when people are hurt by them, paraphilic behaviors should not be considers disorders at all Handout 77: Gender Identity Disorder Gender identity disorder, or transsexualism, is one of the most fascinating disorders related to sexuality People with this disorder persistently feel that they have been assigned to the wrong biological sex • They would like to remove their secondary sex characteristics and acquire the characteristics of the opposite sex Handout 80: Gender Identity Disorder People with gender identity disorder usually feel uncomfortable wearing the clothes of their own sex and may cross-dress This is distinctly different than a transsexual fetish; there is no sexual arousal related to this disorder The disorder sometimes emerges in childhood and disappears with adolescence In some cases it develops into adult gender identity disorder

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