Paraphilias and Sexual Behaviors

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Questions and Answers

According to historical records, which types of sexual contacts were viewed as unnatural by the early Christian church?

Consensual same-sex relationships

Marital sexual activities during menstruation

Extramarital heterosexual activities

Oral-genital, anal, homosexual, and animal sexual contacts (correct)

What is the primary characteristic of Exhibitionism?

The use of nonliving objects to attain sexual arousal

A fear of rejection by members of the opposite sex

Recurrent, intense sexual urges or fantasies involving exposure of one’s genitals to an unsuspecting stranger (correct)

The act of touching or rubbing against a non-consenting person

What is the primary characteristic of Fetishism?

The act of touching or rubbing against a non-consenting person

Recurrent, intense sexual urges or fantasies involving the exposure of one’s genitals to an unsuspecting stranger

A fear of rejection by members of the opposite sex

The use of nonliving objects or a highly specific focus on a body part to attain sexual arousal (correct)

What is the primary characteristic of Frotteurism?

Recurrent, intense sexual urges or fantasies involving touching or rubbing against a non-consenting person Signup and view all the answers

What is a common characteristic of people who exhibit Fetishism?

A fear of rejection by members of the opposite sex Signup and view all the answers

What is a common requirement for the diagnosis of Paraphilias?

A duration of at least 6 months Signup and view all the answers

What is the minimum age difference between the child and the molester in pedophilia?

5 years Signup and view all the answers

What is the duration of sexual urges, behaviors, or fantasies required for a diagnosis of pedophilia?

6 months Signup and view all the answers

What is the key characteristic of sexual masochism disorder?

Recurrent, intense sexual urges involving the act of being humiliated, beaten, bound, or otherwise made to suffer Signup and view all the answers

What is the term used in DSM-5 to describe pedophilia?

Pedophilic disorder Signup and view all the answers

What is a common symptom of sex addiction?

Chronic, obsessive sexual thoughts and fantasies Signup and view all the answers

What is the minimum age of the molester in pedophilia?

16 years Signup and view all the answers

What is the primary goal of inpatient treatment programs for sex addiction?

To help individuals regain control of their impulses and start healing Signup and view all the answers

What is an additional requirement for a diagnosis of sexual masochism disorder?

Psychosocial distress or interpersonal difficulty Signup and view all the answers

What is the focus of cognitive behavioral therapy in treating sex addiction?

Helping individuals identify triggers for sexual impulses and alter behaviors Signup and view all the answers

What is the primary difference between 12-step programs for sex addiction and other forms of treatment?

The group meetings with others addressing the same challenges Signup and view all the answers

What is a consequence of untreated sex addiction?

Negative personal or professional consequences Signup and view all the answers

What is the goal of pharmacotherapy in the context of sexual reassignment?

To inhibit or promote the expression of secondary sex characteristics in males and females Signup and view all the answers

What is unique about the recovery model of 12-step programs for sex addiction?

It follows the same recovery model as Alcoholics Anonymous Signup and view all the answers

What is the use of progestins in the context of sexual reassignment?

To inhibit the secretion of pituitary gonadotropins Signup and view all the answers

What is the purpose of gonadotropin-releasing hormone agonists?

To produce a hypogonadotropic-hypogonadal state Signup and view all the answers

What is the first choice of therapy for young women with hirsutism who do not want to become pregnant?

Oral contraceptives Signup and view all the answers

What is the use of estrogen derivatives in the context of sexual reassignment?

For replacement therapy in hypogonadism associated with a deficiency or absence of endogenous testosterone or estrogen Signup and view all the answers

What is the role of parental involvement in the context of sexual reassignment surgery?

To give approval and involvement in the decision-making process Signup and view all the answers

What might certain antidepressants help alleviate?

Urges Signup and view all the answers

Which sexual dysfunction is characterized by a persistent or recurrent extreme aversion to genital sexual contact?

Sexual aversion disorder Signup and view all the answers

What is the primary characteristic of hypoactive sexual disorder?

Persistent or recurrently deficient sexual or erotic thoughts Signup and view all the answers

What is the primary characteristic of female sexual arousal disorder according to the DSM-5?

Lack of, or significantly reduced, sexual interest/arousal Signup and view all the answers

What is the primary characteristic of male erectile disorder?

Recurrent inability to achieve an erection, or to maintain an adequate erection Signup and view all the answers

What happened to the diagnosis of sexual aversion disorder (SAD) in the development from DSM-IV-TR to DSM-5?

It was removed Signup and view all the answers

Study Notes

Historical View of Sexual Behavior

In early Christian church, oral-genital, anal, homosexual, and animal sexual contacts were seen as unnatural and greater transgressions than extramarital sexual activity
These behaviors were considered unnatural because they didn't lead to biological reproduction

Types of Paraphilias

Exhibitionism: recurrent, intense sexual urge to expose genitals to an unsuspecting stranger for at least 6 months
Fetishism: recurrent, intense sexual fantasy involving nonliving objects or specific body parts for at least 6 months
Frotteurism: recurrent, intense sexual urge to touch or rub against a non-consenting person for at least 6 months
Pedophilia: recurrent, intense sexual urge towards prepubescent child for at least 6 months
Sexual masochism: recurrent, intense sexual urge to be humiliated, beaten, bound, or made to suffer for at least 6 months

Sexual Reassignment Surgery

Controversy exists regarding whether adolescents should be allowed to pursue SRS
Early treatment may be beneficial in adolescents whose secondary sex characteristics have not yet developed fully

Pharmacologic Management

Progestins: inhibit secretion of pituitary gonadotropins
Gonadotropin-releasing hormone agonists: produce hypogonadotropic-hypogonadal state by down-regulating pituitary gland
Aldosterone antagonists: block androgen receptors
Antineoplastic, antiandrogens: used as first-line therapy for hirsutism
Oral contraceptives: inhibit ovarian androgen production and are probably the first choice for young women with hirsutism
Estrogen derivatives: used for replacement therapy in hypogonadism associated with estrogen deficiency
Androgens: used for replacement therapy in hypogonadism associated with testosterone deficiency

Symptoms of Sex Addiction

Chronic, obsessive sexual thoughts and fantasies
Compulsive relations with multiple partners, including strangers
Lying to cover up behaviors
Preoccupation with having sex, even when it interferes with daily life
Inability to stop or control behaviors
Putting oneself or others in danger due to sexual behavior
Feeling remorse or guilt after sex
Experiencing negative personal or professional consequences

Treatments for Sex Addiction

Inpatient treatment programs: remove individual from normal daily life for at least 30 days
12-step programs: follow same recovery model as Alcoholics Anonymous
Cognitive behavioral therapy: help individuals identify triggers for sexual impulses and alter behaviors

Types of Sexual Dysfunctions

Hypoactive sexual disorder: persistent or recurrently deficient sexual or erotic thoughts, fantasies, and desire for sexual activity
Sexual aversion disorder: persistent or recurrent extreme aversion to, and avoidance of, all (or almost all) genital sexual contact with a sexual partner (removed from DSM-5)
Female sexual arousal disorder: lack of, or significantly reduced, sexual interest/arousal
Male erectile disorder: recurrent inability to achieve an erection, maintain an adequate erection, and/or noticeable decrease in erectile rigidity during partnered sexual activity

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Description

Learn about the different types of paraphilias, including exhibitionism, and how they were viewed by the early Christian church. Understand the symptoms and characteristics of these behaviors.