Clinical psychology
Chapter 12
Sexual disorders
Sexual dysfunctions are defined by persistent disruptions in the ability to experience sexual arousal, desire, orgasm, or by pain associated with intercourse.
Paraphilias are defined by persistent and troubling attractions to unusual sexual activities or objects.
Definitions of what is normal or desirable in human sexual behavior vary with time and place.
Culture influences attitudes and beliefs about sexuality.
Gender and sexuality
Women tend to be more ashamed of any flaws in their appearance than do men, and this shame can interfere with sexual satisfaction.
For women, sexuality appears to be more closely tied to relationship, status, and social norms than for men.
Among women with sexual symptoms, more than half believe their symptoms are caused by relationship problems. Men are more likely to think about their sexuality in terms of power than are women.
There are many parallels in men’s and women’s sexuality.
- The primary motivation for having sex was sexual attraction and physical gratification.
The sexual response cycle
Four phases in the human sexual response cycle
- Desire phase
- Excitement phase
- Orgasm phase
- Resolution phase
Sexual dysfunctions
Sexuality usually occurs in the context of an intimate personal relationship.
Our sexuality shapes at least part of our self-concept.
When sexual problems emerge, they can wreak havoc on our self-esteem and relationships.
Clinical descriptions of sexual dysfunctions
The DSM-5 divides sexual dysfunctions into three categories:
- Involving sexual desire, arousal, and interest
- Orgasmic disorders
- Sexual pain disorders
Separate diagnoses are provided for men and women.
The diagnostic criteria for all sexual dysfunction specify that dysfunction should be persistent and recurrent and should cause clinically significant distress or problems with functioning.
A diagnoses of sexual dysfunction is not made it the problem is believed to be due entirely to a medical illness or another psychological disorder.
Many people with problems in one phase of the sexual cycle will often report problems in another phase. Some of this may just be a vicious circle.
Sexual problems in one person may lead to sexual problems in the partner.
Disorders involving sexual interest, desire, and arousal
DSM-5 criteria for Male hypoactive sexual desire disorder
- Sexual fantasies and desires, as judged by the clinician, are deficient or absent for at least 6 months.
DSM-5 criteria for Erectile disorder
- On at least 75 percent of sexual occasions for 6 months:
- Inability to attain an erection, or
- Inability to maintain an erection for completion of sexual activity, or
- Marked decrease in erectile rigidity interferes with penetration or pleasure
DSM-5 criteria for Female sexual interest/arousal disorder
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