Human Sexuality

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nbennett
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83741
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Human Sexuality
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2011-05-08 23:06:29
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  1. Sexual Dysfunction
    A disturbance or disorder in desire, excitement, orgasm, or resolution of the sexual response cycle.
  2. Causes of Sexual Dysfunction
    • Sensory arousal combines with emotional arousal and conscious thought as our sensing, feeling, thinking brain triggers and directs the organs, glands, and tissues that regulate our sexual response
    • Levels of performance and satisfaction vary
    • Perception, gender role, and belief about aging factor into determining whether or not a problem is or is not a dysfunction
    • Gender role also affects ones sexual performance and response
    • Emotional factors and intimacy issues are the central issues in understanding sexual response
  3. Physical/Medical Causes of Sexual Dysfunction
    • Erectile Dysfunction
    • Cardiovascular Disease
    • Other diseases
    • Injuries and Surgery
    • Substance-Induced Sexual Dysfunction
    • Prescription Drug Interactions
    • Psychotropic Drugs
    • Cautions
  4. Erectile Dysfunction
    • A host of physical causes ranging from disease and injury to effects of drugs
    • Dysfunction in men is primarily related to flow and physical causes
    • Dysfunction in women are related to psychosocial issues such as intimacy
  5. Cardiovascular Disease
    • In a study of male aging nearly half of the subjects had experienced erectile difficulties
    • Men being treated for heart disease and high blood pressure were up to four times more likely to be completely impotent
    • These findings implicate vascular problems as the major culprit
    • Behaviors that increase the risk for cardiovascular disease can increase the likelihood of incurrig erectile disorders
  6. Other Diseases
    • Structural defects or changes such as congenital abnormality, scar tissues, fibroids, to sexually transmitted diseases
    • Deficiency disease such as insufficient hormonal production, malnutrition, vitamin deficiency and allergic reactions to spermicide
  7. Injuries and Surgery
    • Many cases of erectile dysfunction are attributed to accidents and injuries to the underside of the penis
    • Sex therapists suggest that such injuries to women can also damage nerves and blood vessels in the pelvic region associated with sexual response in women
    • Sexual dysfunction can also be traced to nerve and blood vessel damage associated with surgery
  8. Substance-Induced Sexual Dysfunction
    • Can affect any stage of the sexual response cycle
    • Psychotropic (mind-altering) and somatropic (body-altering) drugs may have side effects that produce sexual dysfunction
    • The effects of drug use are sometimes untentional or unexpected
  9. Diagnostic Criteria for Substance-Induced Sexual Dysfunction
    • The dysfunction causes marked distress or interpersonal difficulty
    • Depending on the substance, the condition may involve imparited desire, arousal, or orgasm, or sexual pain and is fully explained by the substance
    • The dysfunction is not better accounted for by a dysfunction that is not substance induced.
  10. Prescription Drug Interactions
    • The effects of prescribed and over-the-counter drugs are varied
    • Range is from vaginal dryness from antihistamines to erectile dysfunctino associated with certain forms of antihypertensive medication
    • Prozac has been shown to cause erectile disorder and anorgasmia
    • Anyone who takes these drugs should have a thorough understanding of their potential side effects
    • Combining medications can have a synergistic effect- the effects of two or more drugs creating a third, enhanced effect
  11. Psychotropic Drugs
    • Mind altering drugs have the potential to affect sexual response
    • Depressants
    • Stimulants
    • Hallucinogens
    • Marijuana
    • Narcotics
  12. Depressants
    • Tranquilizers, barbiturates, and alcohol are central nervous system depressants
    • They reduce, depress or slow down brain and nervous systme functioning
    • Barbiturates have a diffuse effect on the nervous system
    • Benzodiaepines (tranquilizers) target neural receptors
    • Valium- like drugs reduce anxiety and treat neuroses and have a more diffuse effect on depressing the nervous system
    • Alcohol is a strong nervous system depressant and creates a sedative/hypnotic effect
    • The measurement of blood alcohol content of blood in ciruclation is termed blood alcohol concentration
    • Physiological respsonse are compromised with increasing BAC's
    • Chronic drinkers often have a problem with erectile dysfunction
  13. Stimulates
    • Amphetamines, cocaine, etc.
    • Work by increasing or speeding up the nervous system functioning
    • Can increase sexual performance and interest by providing a boost of energy that users claim intensifies and prolongs their sexual response
    • Can interfere with the brain's ability to trigger orgasm
  14. Hallucinogens
    • Distort perception of reality and alter the user's perception of sensory stimuli
    • Enhance sexual touches, tastes, sights, sounds, and smells
    • The best known are LSD, MDMA, PCP
  15. Marijuana
    • Classified as a mild hallucinogen
    • The effects vary depending on the amount of THC
    • Users reported heightened sensitivity to visual and auditory stimuli and an increased craving for certain kinds of foods
    • The effects on sexual repsonse are variable
  16. Narcotics
    • Pain kills
    • Have no intended effects for sexual reponse
    • One of the side effects of heroin is a diminished interest in sex
  17. Cautions
    • Any illegal drug carries the potential for toxicity, overdose, and serious physical danger because illegal substances are not controlled
    • All categories of drug have the potential to cause sexual dysfunctino
  18. Two Main Types of Psychological Causes of Sexual Dysfunction
    • Prior Learning
    • Immediate Causes
  19. Psychological Causes of Sexual Dysfunction
    • Prior learning refers to our overall upbringing and the specific childhood messages we received concerning sexuality
    • The messages we receive during childhood contribute to healthy or unhealthy pscyhosexual development
    • Children raised in environment wehre nudity, masturbation, and childhood inquiry and discussion of sexuality were severly punished are significantly more likely to develop sexual problems than their peers raised in more tolerant environments.
    • Parents who are uneasy about sexuality and ignore it can sabotage healthy development
    • Negative gender role expectations can create anxiety, shame, guilt, and fear
  20. Four Immediate Causes of Sexual Dysfunction
    • Failure to engage in effective sexual behavior because of either ignorance or avoidance
    • Anxiety related to performance or fear of failure
    • Defenses
    • Communication Problems
    • Stress and Fatigue
  21. Failure to Engage in Effective Sexual Behavior because of Ignorance or Avoidance
    • Simple ignorance concerning effective lovemaking techniques
    • Anxiety related to current sexual functioning is often rooted in past failed sexual episodes and can foster anticipation of present and future failure
    • Becoming a critical observer, or spectator of your own sexual activity (spectatoring) is an intellectual defense against erotic feelings.
  22. Anxiety Related to Performance or Fear of Failure
    • Any anxiety interferes with performance
    • Anxiety related to sexual performance is usually a result of past episodes
    • Being asked to perform on demand can create resentment
    • Performance anxiety is not just a man's problem; women suffer too
    • The expectation-anxiety-performance-feedback loop perpetuates sexual problems
    • Anxiety creates physiological and psychological roadblocks that impair performance
  23. Defenses
    • Spectatoring is a perceptual and intelecutal defense against erotic feelings
    • One becomes an outside observer of their sexual encounter
    • Rather than being fully involved, spectatoring results in lack of enjoyment
  24. Communication Problems
    • Occurs when we have learned that sex and sexual needs are taboo
    • It is difficult to understand, articulate, and communicate about sex
    • We suppress our needs and problems, anger and resentment build
  25. Stress and Fatigue
    • Can precipitate dysfunction
    • Can cause the testorterone levels to drop for men
  26. APA Classifies Sexual Dysfunction As:
    • Lifelong
    • Acquired
    • Generalized
    • Situational
  27. Lifelong
    Present since the onset of sexual functioning
  28. Acquired
    Developed after a period of normal functioning
  29. Generalized
    Disorders that are not limited to certain situations/partners
  30. Situational
    Disorders limited to certain situations/partners
  31. APA Classification of Sexual Dysfunctions Based on Traditional Models of Sexual Response
    • Desire Phase
    • Excitement Phase
    • Orgasm Phase
    • Resolution Phase
  32. Desire Phase
    • Originates with fantasizing and thinking about engaging in sexual activities
    • Dysfunctions of this type are called sexual desire disorders
  33. Excitement Phase
    • Build-up of sexual excitement and tension; vasocongestion
    • Dysfunctions of this type are called sexual arousal disorders
  34. Orgasm Phase
    • Build up of sexual tension is released followed by feelings of satisfaction and satiation
    • Dysfunction s related to this phase are orgasmic disorders
  35. Resolution Phase
    • Characterized by a physiological return to the predesire stage
    • Sexual pain disorders may be present during intercourse or in the resolution phase
  36. Dysfunction Vs. Disinterest
    • Some people are more interested in sex than others
    • Little interest, low desire, and no fantasizing aren't dysfunction unless accompanied by three diagnostic criteria:
    • --Must be persistent and recurrent
    • --Cause marked distress of interpersonal difficulty
    • --Not be the result of another medical or physical condition
  37. Sexual Desire Disorders
    • Hypoactive Sexual Desire Disorder
    • Sexual Aversion Disorder
  38. Hypoactive Sexual Desire Disorder
    Characterized by very low levels (or complete absence of) sexual desire.
  39. Criteria to Diagnosis Hypoactive Sexual Desire Disorder
    • Persistent or recurrent deficiency or absence of sexual fantasy or desire for sexual activity
    • Marked psychological or interpersonal distress attributable to this disorder
    • No other psychological disorder, medical condition or direct physiological effects of a drug or medication
  40. Sexual Aversion Disorder
    • Characterized by disgust and active avoidance of any genital sexual contact with another person; individuals report anxiety, fear, disgust, or revulsion when confronted with sexual opportunity
    • --The aversion may be to a specific aspect of sexual contact
    • --This disorder results in extreme psychological distress, panic attacks, and other physical symptoms.
  41. Sexual Arousal Disorder
    • Problems related to the arousal phase of sexual response
    • These disorders differ from Sexual Desire Disorders in that sufferers desire to have sex but have problems becoming sufficiently aroused
    • Vasocongestion is impaired resulting in insufficient lubrication and engorgement, impaired penetration and painful intercourse
    • The condition often results in the avoidance of sexual intercourse and disturbances in sexual relationships
    • Male erectile disorder (impotence)
    • Men suffering from this disorder often have performance anxiety, avoid sexual intercourse and have problems in their sexual relationships.
  42. Two Types of Sexual Arousal Disorders
    • Female Sexual Arousal Disorder
    • Male Sexual Arousal Disorder
  43. Female Sexual Arousal Disorder
    Characterized by the persistent or recurrent inability to attain or maintain until the completion of sexual activity, sufficient vaginal lubrication and genital swelling
  44. Male Erectile Disorder
    The persistent or recurrent inability to attain or maintain an adequate erection for the completion of sexual activity
  45. Diagnostic Criteria for Sexual Arousal Disorder
    • Marked distress or interpersonal difficulty
    • No other coexisting psychological condition
    • No direct physiological effects of a substance or preexisting medical condition
  46. Orgasmic Disorders
    • Problems associated with the orgasm phase of sexual response
    • People who suffer from this disorder have sexual desire and can become aroused, but are unable to orgasm
    • There is much variability in definint a "typical" excitement stage and it is up to the clinician taking the women's sexual history, to determine whether or not her level of excitement would be typical enough to trigger orgasm
    • This disorder is more common in younger women
    • Situtional orgasmic problems are often related to stress and interpersonal problems
    • Most men with this condition cannot reach orgasm through intercourse alone but can climax through manual, oral, or other forms of stimulation by themselves or in combination with coitus
    • Men with male orgasmic disorder have a pattern of paraphiliac sex disorder and cannot orgasm without the object of desire
  47. Female Orgasmic Disorder
    • A persistent or recurrent delay in or absence of orgasm following a typical excitement phase
    • Tends to be lifelong rather than acquired since once women learn to be orgasmic they rarely lose this ability
  48. APA Criteria for Female Orgasmic Disorder
    • The absence of ograsm following a "normal" excitement pahse
    • Accompanying marked distress or interpersonal difficulty
    • Not the result of another medical or psychological condition or direct physiological effects of a substance
  49. Male Orgasmic Disorder
    The persistent or recurrent delay in or inability to reach orgasm following a normal excitement phase, formerly known as inhibitied male orgasm
  50. 3 APA Diagnostic Criteria for Male Orgasmic Disorder
    • Absence of orgasm following "normal" excitement phase
    • Marker distress or interpersonal difficulty
    • Not the result of a preexisting medical or psychological condition or physiological effects of a medication or other drug
  51. Premature Ejaculation
    • The persistent or recurrent onset of orgasm and ejaculation shortly after penetration or before the man wishes it.
    • This problem is much more common in younger men as the majority of men learn to delay orgasm with age.
  52. Sexual Pain Disorders
    Can occur before, during, or following sexual intercourse are not the result of insufficint excitement or poor technique.
  53. Dyspareunia
    • Genital pain associated with sexual intercourse
    • -APA diagnostice criteria must be met
  54. Vaginismus
    • The reucurrent or persistent involuntary contraction of the perineal muscles surrounding the outer third of the vagina during any form of penetration.
    • Is more commnon among young women
    • Is commonly discovered upon first gyncological exam
    • Can become a lifelong problem if left untreated.

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