6^th lecture - Clinical Practice of Behavioral Medicine

Human Sexuality

Normal Sexuality - difficult to define - what fits into your social and cultural mores and legal. Many try to define it and attempt to get others to abide by their standards.

Abnormal Sexuality - sexual behavior that is destructive to a person or people, cannot be directed toward a partner, excludes stimulation of the primary sex organs, is inappropriately associated with guilt and anxiety, or is compulsive.

In some cultures, sex outside marriage, masturbation, and various forms of sexual stimulation involving other than the primary sexual organs may fall within normal limits.

Psychosexual factors

Can't really be separated out since sexuality is of a complex nature that involves gender, culture, early learning, environmental factors, etc.

Sexual Identity - all begin as genetically female.

Gender Identity - By the age of 2 or 3 almost everyone has a since of being a male or female. Masculinity and femininity are also beginning to develop at this time and probably have a higher environmental component. Gender role is no longer stereotypically defined.

Sexual Orientation - Describes the object of a person's sexual impulses.

Sexual Behavior - As measured by Masters & Johnson (EPOR) or below as defined by the text.

Sexual Response Cycle

    Desire
    Excitement
    Orgasm
    Resolution

Master's & Johnson EPOR Model

    Excitement
    Plateau
    Orgasm
    Resolution

Love and Intimacy Issues

Sexual Dysfunctions

    Female Sexual Arousal
    Male Erectile Disorder
    Female Orgasmic Disorder
    Male Orgasmic Disorder
    Premature Ejaculation

Sexual Pain Disorders

Dyspareunia
Vaginismus
Prioprism

Sexual Disorders due to a General Medical Condition/Psychopharmacological

Paraphilias

    Unusual fantasies or sexual urges or behaviors that are recurrent and sexually arousing.  These activities generally focus on a person's humiliating himself or herself or a partner, on children or other nonconsenting people, or on nonhuman objects.  The urges and behaviors must occur for at least 6 months and must cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning."  Paraphilia can involve illegal activities; criminal sexual offenses belong to this category of disorder.

    A given person may have multiple paraphiliac disorders.

Exhibitionism
Fetishism
Frotteurism
Pedophilia
Sexual masochism
Sexual Sadism
Voyeurism
Transvestic Fetishism
Praphilia NOS

Sexual Addiction

    Refers to persons who compulsively seek out sexual experiences and whose behavior becomes impaired if they are unable to gratify their sexual impulses.  

Gender Identity Disorder

Two components:  evidence of a "strong and persistent cross-gender identification" and evidence of  "persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex."

Sex-Reassignment Surgery

Film (If Time) Will be in LRC = What Sex Am I?

Eating Disorders

Anorexia Nervosa
Definitions
 

Bulimia Nervosa
Definitions
 

Obesity
Definitions
 

Sleep Disorders
Sleep Hx Questionnaire

Impulse-Control Disorders

Intermittent Explosive Disorder

Kleptomania
Diagnostic Criteria

Pyromania
Diagnostic Criteria

Pathological Gambling
Diagnostic Criteria

Trichotillomania