What are sexual disorders and how can they be classified?

- a sexual disorder is a problem with sexual response that causes a person mental distress. (sexual dysfunction)

- can be classified as a lifelong sexual disorder or an acquired sexual disorder

- Lifelong sexual disorder has been present ever since the person began sexual functioning

- Acquired sexual disorder develops after a period of normal functioning.

Four categories of sexual disorders

Hypoactive sexual desire- lack of interest in sexual activity; inhibited sexual desire or low sexual desire

Discrepancy of sexual desire- sexual disorder in which the partners have considerably different levels of sexual desire

Sexual aversion disorder- person has a strong aversion involving anxiety, fear or disgust to sexual interaction and actively avoids any kind of genital contact with a person

Female sexual arousal disorder- sexual disorder in which there is a lack of response to sexual stimulation

Erectile disorder- inability to have or maintain an erection; erectile dysfunction, inhibited sexual excitement, impotence

Lifelong erectile disorder- cases of erectile disorder in which the man has never had an erection sufficient to have intercourse

Acquired erectile disorder- the man at one time was able to have satisfactory erections but can no longer do so

Premature ejaculation- the man ejaculates too soon and thinks he cannot control when he ejaculates; rapid ejaculation

Male orgasmic disorder- man cannot have an orgasm even though he is highly aroused and has had a great deal of sexual stimulation

Female orgasmic disorder- the woman is unable to have an orgasm

Lifelong orgasmic disorder- FEMALE disorder- the woman has never in her life had an orgasm

Acquired orgasmic disorder- FEMALE disorder in which the woman had orgasms at sometime in her life but no longer does

Situational orgasmic disorder- case of orgasmic disorder in which the woman is able to have an orgasm in some situations (aka masturbating) but not in others (sexual intercourse)

Vaginismus- spastic contraction of the muscles surrounding the entrance to the vagina, in some cases so severe that intercourse is impossible

Describe hypoactive sexual desire’s reaction of sexual situations.

What problems exist with defining hypoactive sexual desire?

- if somebody with HSD finds themselves in an arousing situation, they experience a rapid ‘turn-off’ so that they feel nothing. this may be so intense that they report negative, unpleasant feelings; aka sexual anesthesia

- HSD is common; hard to define because there are many circumstances where it’s normal for somebody’s interest to be inhibited

(ex: you’re not supposed to be turned on by every partner that you have.)

- about half as many men as women experience desire problems 

- too little sexual desire is the most common sexual issue reported by women

What is Female Sexual Arousal Disorder (FSAD)?

What may be its cause and how is it commonly treated?

Female Sexual Arousal Disorder (FSAD) is a lack of response to sexual stimulation including a lack of lubrication

-subjective, psychological and a psychological elements

- Possible cause: as estrogen levels decline, vaginal lubrication decreases

- Common treatment: use of sterile lubricants is an easy way to deal with this problem

Identify the two types of erectile disorder

 Describe the various reactions to erectile disorder

Lifelong erectile disorder and Acquired erectile disorder

Various reactions to erectile disorder: one of the most embarrassing things a man can imagine. Depression may follow from repeated episodes; may cause embarrassment or worry to the man’s partner

Know the different definitions of premature ejaculation

What problems are related to it?

Early ejaculation and rapid ejaculation

Problems:

- ejaculation may take place so soon after the erection occurs that it happens before intercourse begins or

-the man is able to delay the orgasm to some extent but not as long as he would like to

What is male orgasmic disorder?

How common is this type of disorder?

What are some partners’ reactions to this problem?

Male orgasmic disorder- RETARDED EJACULATION- the man cannot have an orgasm, even though he is highly aroused and has had a great deal of sexual stimulation

- far less common than premature ejaculation; more common among Asian Americans than Whites or Blacks

- some women react negatively to this condition seeing their partners inability to have an orgasm as a personal rejection

Describe female orgasmic disorder.

What other names are associated with this disorder?

What issues surround its classification?

Female orgasmic disorder- sexual disorder in which the woman is unable to have an orgasm

- other names: orgasmic dysfunction, anorgasmia, inhibited female orgasm, 'fridgity'

Issues: depends on whether it has been lifelong, acquired or situational.

Painful intercourse = dyspareunia.

-PAIN that happens to occur in the genitals; it is fundamentally about pain, not about sex.

Vaginismus is a spastic contraction of the outer third of the vagina; in some cases this is so severe that intercourse is impossible.

This is not a very common disorder but women who have it will seek treatment considering intercourse is impossible if they don’t.

physical causes = organic factors of sexual disorders.

Erectile disorders --> diseases associated with the heart and the circulatory system, diabetes mellitus

Hypogonadism --> excessive production of prolactin

Premature ejaculation --> more by psychological factors than physical factors. An infection can be to blame; or the evolutionary theory of ‘survival of the fastest.’

Male orgasmic disorder/retarded ejaculation --> multiple sclerosis, spinal cord injury and prostate surgery

Female orgasmic disorder --> severe illness, general bad health or extreme fatigue

Dyspareunia --> disorders of the vaginal entrance

- high levels of alcohol suppress sexual arousal

- repeated use of cocaine is associated with loss of sexual desire, orgasm disorders and erection problems

- All drugs have the reputation of increasing sexual desire and can increase the particular experience but over time, satisfaction decreases

4 Immediate causes:

1) anxieties such as fear or failure

2) cognitive inference- negative thoughts that distract a person from focusing on the erotic experience

- spectatoring is a type of cognitive inference; acting as an observer or judge of one's own sexual performance

3) failure of the partners to communicate

4) failure to engage in effective, sexually stimulating behavior.

Identify the psychological factors associated with sexual disorder. (Prior)

Three different types of prior learning that can contribute to sexual disorders:

1) first sexual act was traumatic

2) person was taught that sex is dirty/sinful

3) parents punish children severely for sexual activity

What does Barlow’s research tell us?

- Barlow’s research tells us that functionals (men who function well sexually) and dysfunctionals (men with sexual disorders) respond very differently to stimuli in sexual situations

- Barlow constructed a model that describes how anxiety and cognitive inference act together to produce sexual disorders such as erectile disorders

How do emotional factors and lifestyle factors impact sexual functioning?

- emotions such as anger and sadness can interfere with sexual response

- anxiety can be a powerful impediment to sexual functioning

- Smoking, alcohol consumption and obesity are all associated with higher rates of sexual disorders and all involve behavior

People with sexual disorders tend to interpret arousal as nervousness

- Disturbances in a couple’s relationship --> leading cause of sexual disorders

- Anger or resentment toward one’s partner

- sex being used as a weapon to hurt the partner

 - Conflicts over power

- Intimacy problems

- Fear of intimacy causes a person to draw back from a sexual relationship before it becomes truly fulfilling

1) Sexual problems due to sociocultural, political or economic factors

2) Sexual problems relating to partner and relationship

3) Sexual problems due to psychological factors

4) Sexual problems due to medical factors

What are the assumptions behind behavior therapy?

What techniques characterize this therapeutic approach?

What are the goals of this therapy?

Behavior therapy: system of therapy based on learning theory, in which the focus is on the problem behavior and how it can be modified or changed.

Basic assumption: sex problems are the result of prior learning and they are maintained by ongoing reinforcements and immediate causes. These problem behaviors can be unlearned by new conditioning.

 Key technique: desensitization; the client is gradually led through exercises that reduce anxiety. 

Goal: turn sex into a situation without any expectation or achievement; this way there can be no failure.

Define cognitive-behavior therapy. What is one of its primary techniques? How do therapists use this to address cognitive interference?

Cognitive-behavior therapy- form of therapy that combines behavior therapy and restructuring of negative thought patterns

Primary techniques: cognitive restructuring; the therapist helps the client restructure his/her thought patterns, helping them to become more positive. 

 General idea: reduce the presence of interfering thoughts during sex.

The therapist works with the patient by basically getting all of the bad thoughts out and more good thoughts in; helps them focus on something more erotic.

What is involved in couple therapy? What assumption is this therapy based on? What are the goals of this therapy?

Sex couple therapy is based on the assumption that there is a reciprocal relationship between interpersonal conflict and sex problems. Sex problems can cause conflicts and conflicts can cause sex problems.

- the relationship itself is treated with the goal of reducing antagonisms and tensions between the partners. As the relationship improves, the sex problem should be reduced.

- Goal: improve the relationship.

Components of Rosen’s treatment model:

1) sexual and performance anxiety reduction, (treated with techniques such as focus exercises)

2) education and cognitive intervention, (give them more realistic expectations)

3) script assessment and modification, (designed to help the couple break out of their restricted script)

4) conflict resolution and relationship enhancement, (conflicts are identified, making it easier to resolve)

5) relapse prevention training (help couples avoid or deal with relapses)

Advantages- chat room where you can talk to others about their sexual experiences and problems, more affordable, anonymity, advice columns can provide accurate, elicit, and nonjudgmental information, people who share a common theme can talk about their problem together, people of all different countries/locations can communicate

Disadvantages- no system for licensing online sex therapists, cannot give true intensive therapy would in-person sessions, the encouragement provided is not enough to solve people’s problems

used for premature ejaculation

woman uses her hand to stimulate the man to erection then stops; she resumes and then he loses it again etc, the man learns that he can have an erection and be highly aroused without having an orgasm; this technique extends the amount of foreplay and helps the man gain control over orgasm

most effective form of therapy for women with primary orgasmic disorder

technique most likely to produce orgasm in women, masturbation is a logical treatment for women with problems with having orgasms or those who have never masturbated; can be recommended for men as well

part of sex therapy for women with orgasmic disorder, in which the woman exercises the muscles surrounding the vagina

PC muscle exercises; useful for women who have stretched the muscle through childbirth or women with poor muscle tone

 enhance arousal and facilitate orgasm; increases the woman’s awareness of and comfort with their genitals; can be used for treatment of men

the use of a self help book to treat a disorder; effective for orgasmic disorders in women; shown to be effective for couples with a mixture of sexual disorders both in men and in women

Viagra- erectile disorder, facilitates the physiological treatment of an erection, side effects are not common, not helpful for any other dysfunction besides an erection, Cialis has a longer effect than Viagra; effective in treating erectile dysfunction even when there is/was a complete surgical removal of the prostate.

Other drugs that act on the central nervous system such as Uprima boost dopamine levels in the hypothalamus.

Viagra cannot cure women’s orgasm problems; there is current testing involving male hormones for drug treatment in women.

treatment for erectile disorders

injecting a drug into the corpora cavernosa of the penis; drug dilates the blood vessels in the penis --> more blood can accumulate there --> producing an erection

can have positive psychological effects, can cause penile pain, men with no erection problems but use these anyway can suffer from ‘super erections’

 surgical treatment for erectile dysfunction in which inflatable tubes are inserted into the penis (penile prosthesis)

 the man becomes able to literally pump up or inflate his penis so that he has a full erection; $10,000, small incision in the abdomen, only for cases that have not been cured by physical or drug therapy; a natural erection is never again possible

- never revealed a success rate; only a failure rate

- success rate of their sex therapy is probably lower than what they estimated

- they never fully defined ‘success’

- did not report clearly how their initial population of clients for therapy was chosen

- didn’t specify their exact criteria for a relapse so we don’t know the relapse rate

- never fully discussed the possible harmful effects of their therapy

Maintain a good sexual mental health; communicate with your partner, don’t be a spectator, don’t set up goals of sexual performance, be choosy about the situations in which you have sex, ‘failures’ will occur

statistical defintion- an approach to define abnormal sexual behavior

according to this approach, an abnormal sexual behavior is one that is rare or not practiced by many people

This definition is not accurate or specific enough

the problem of cultural dependence is explicitly acknowledged, might define deviant sexual behavior as a sexual behavior that violates the norms of society

 this approach recognizes the importance of the individual’s interaction with society and of the problems that people must face if their behavior is labeled ‘deviant’ in the culture in which they live

three criteria of abnormality:

 discomfort

 inefficiency

bizarreness

recognizes eight paraphilias:

1) fetishism

2) transvestic fetishism

3) sexual sadism

4) sexual masochism

5) voyeurism

6) fritters

7) exhibitionism

8) pedophilia

recurring, unconventional sexual behavior that is obsessive and compulsive

 Diagnostic criteria commonly used: fantasies, urges, behaviors have recurred over a period of at least six months and cause clinically significant distress or impairment in social, occupational or other important areas of functioning

- normal and abnormal behaviors are not two separate categories but rather gradations on a continuum; many people have minor fetishes and only when the fetish becomes extreme should it be considered abnormal

only when a fetish becomes a necessity does it cross the boundary into abnormal behavior

Fetishism- a person’s sexual fixation on some object other than another human being and attachment of great erotic significance to that object

media fetish is a fetish whose object is anything made of a particular substance (ie: leather) while a form fetish whose object is of a particular (ie: high-heeled shoe)

1) learning theory- fetishes result from classical conditioning in which a learned association is built between the fetish object and sexual arousal and orgasm (ex: man who first saw his uncle’s penny loafers and begin kissing and licking them leading to an orgasm and being turned on ever since)

2) cognitive theory- fetishists have a serious cognitive distortion in which they perceive a non-conventional stimulus (ie: black leather boots) as erotic; their perception of arousal is distorted, they’re driven to sexual behavior when aroused but the arousal may cause feelings of guilt and self loathing

3) sexual addiction model- person has a pathological relationship with a sexual event or process, substituting it for a healthy relationship with others

Transvestism- aka cross-dressing

 the practice of deriving sexual gratification from dressing as a member of the other gender

a drag queen- a male homosexual who dresses in woman’s clothing

a female impersonator- a man who dresses up as a woman as a part of a job in entertainment

Different types of cross dressing

- drag queens (gay men dressed as women)

- female impersonators (men who dress as woman as part of their jobs)

- transvestism fetishism (heterosexual man who dresses in female clothing to enhance arousal)

Wives' reactions: 60% are accepting; ‘he is a good husband otherwise’

Sexual compulsive behavior repeats a 4 step cycle:

preoccupation --> rituals --> compulsive sexual behavior -->despair

COMPULSIVE SEXUAL BEHAVIOR (CSB) is a disorder in which the individual experiences intense sexually arousing fantasies, urges, and associated sexual behaviors

There are sexaholic workshops similar to that of alcoholics anon.

Sadism- sexual satisfaction from inflicting pain, suffering, or humiliation on another person

Masochism- sexual satisfaction from experiencing pain

Who engages in S-M and B-D?

- bondage and discipline and dominance and submission

- humiliation, bondage, spanking, whipping, tying up, slave role playing

 - participants: heterosexual, well educated and interested in both dominant and switchable roles 

the use of physically restraining devices or psychologically restraining commands as a central aspect of sexual interactions; may enforce obedience and servitude without inducing any physical pain

interaction that involves a consensual exchange of power, the dominant partner uses his or her power to control and sexually stimulate the submissive partner

B & D- physical/psychological restraints to enforce ownership from which both participants derive sensual pleasure

Difference: in bondage, one person has more control and gives out the commands and in submission there is a consensual exchange of power

- exact causes are unknown; the theories discussed on fetishes can be applied here as well. For example, conditioning is a possible theory. Ex: a little boy is getting a spanking over his mother’s knee and as his penis rubs against her knee, he achieves an erection

-a possible theory for masochism but NOT sadism: the masochist is motivated by a desire to escape from self-awareness, masochistic behavior helps the individual escape from being conscious of the self in the same way as drunkenness would

- the male role is especially burdensome because of heavy pressures in autonomy and achievement; this allows an escape from these aspects of the male role which could explain why masochism is more common among males than among females

Top= the active

Bottom= the passive

The active is responsible for the submissive’s pleasure.

Subculture --> magazines, clubs and bars; creates culturally defined meanings for D&S acts; people take on roles and turn it in to a scripted act 

Roles: master, slave, naughty child. HOWEVER, there is an illusion of control; the master is not in complete control and the slave is not complete powerless as they are acting a script, this can explain why violent outcomes such as injuries or murders are rare

Sexual gratification derived from seeing others undress, naked or having sex when the watched person is unaware or unwilling, often the voyeur is masturbating (aka peeping tom.)

Usually men with poor social skills

1) Scotophilia- sexual variation in which the person becomes sexually aroused by observing other’s sexual acts and genitals

2) Voyeurism- sexual pleasure comes from viewing nudes, often while the voyeur is masturbating

 complement to voyeurism --> exhibitionism. (aka flashing)

Most exhibitionists are men.

15% have exposed themselves by age 12, recall their childhoods as having inconsistent discipline, lack of affection and little training in social behavior, sexual offenders possess fewer social skills

Exact causes of exhibitionism are unknown; the man may be doing it for attention or because he cannot form the social skills to maintain an adult relationship

Nymphomania- an excessive insatiable sex drive in a woman

Satyriasis- excessive, insatiable sex drive in a man; also called Don Juanism

**Both of these terms are included in hypersexuality

excessive insatiable sex drive in either men or women

Defining a hypersexual:

- compulsive sexual behavior in the sense that the person feels driven to it even if there are negative consequences; person may or may not be satisfied by the activity; may or may not be having orgasms

- hypersexual criteria: (MALES only) 7 or more orgasms per week for a duration of 6 months minimum; reported that their hypersexual activity began between the ages of 19-21

- hypersexual criteria: (WOMEN only) orgasms cannot be used for measuring since some women have multiple orgasms and others may not have any; one study suggests that highly sexual women refer to women who desire sexual stimulation to orgasm 6-7 times/week or who think of themselves as highly sexual and their sexuality strongly affects their lives

- women describe it as an ‘internal demand for sexual excitement and satisfaction that was too strong to be ignored.’

having no sexual attraction to a person of either sex

 little research has been done on this. In a survey of a national sample of British residents, 1% indicated they were asexual

Asexuals were more likely to be women, go to church regularly and have a lower social status. In another study, 41 persons out of 1,146 reported asexuality.

What is asphyxiophilia? What techniques are used in this practice? Does asphyxiophilia ever lead to death?

 the desire to induce in oneself a state of oxygen deficiency in order to create sexual arousal or to enhance excitement and orgasm

Techniques: temporary strangulation by a rope around the neck, a pillow against the face, or a plastic bag over the head or upper body

Causes between 250-1,000 deaths/year in the U.S.

Men and women engage in asphyxiophilia in the belief that arousal and orgasm are intensified by reduced oxygen (no evidence)

One theory is that women may experience an orgasm accompanied by urethral ejaculation. (no evidence) Another possible theory is that people are just curious.

- therapists/clinicians have reported cases of internet use leading to job loss, relationship difficulties or divorce, etc.

- internet is thought to be likely to lead to addictive or compulsive behavior because it is characterized by 3 A’s: anonymity, accessibility, affordability

Troilism- three people having sex together

Saliromania- desire to damage or soil a woman on her clothes or the image of a woman such as on a painting or a statue

Necrophilia- sexual contact with a dead person; very rare form of behavior

Zoophilia- sexual contact with an animal; bestiality & sodomy

Coprophilia- deriving sexual satisfaction from contact with feces

Urophilia- deriving sexual satisfaction from contact with urine

1) Preventing each separate variation. A distinction is made between primary prevention and secondary prevention. Primary prevention would be intervening in the home life or in other factors during childhood to prevent problems from developing. Secondary prevention is to diagnose and treat the problem as early as possible once it has arisen, so that difficulties are minimized. Primary prevention has is advantageous but it is difficult

2) Analyzing the components of sexual development. 1) gender identity 2) sexual responsiveness 3) formation with relationships with others

- surgical castration was used as a treatment for various kinds of uncontrollable sexual urges; today, surgical castration cannot be recommended as a treatment

- hormonal treatment involves the use of drugs to reduce sexual desire; 2 ways this is done: 1) drugs that reduce the production of androgen in the testes aka chemical castration 2) blocking the effects of androgens --> intended to produce a sharp decline in sexual desire

- most common in the U.S. is MPA which is given weekly through an injection; MPA reduces sexual interest and lowers sexual fantasies, decreases erections and ejaculation. The drop out rate is extremely high

- more recent approach is using ‘leuprolide acetate’ (LA) the continuous use of this hormone suppresses androgen production and reduces sexual fantasies and drive, fewer side effects than MPA. Highly effective

- we don’t know how effective the medical treatments are because of such a high drop out rate

-  paraphiliacs do not have the skills to initiate and maintain conversation and develop intimacy; such people may benefit from a treatment program that includes social skills training and possibly basic sexuality education

- the appropriate treatment for people who engage in uncontrollable, inappropriate sexual patterns or people who are addicted to their particular sexual practice

- combine cognitive restructuring, obtaining support from other members who have the same or similar problem behaviors and enhancing spirituality

What is prostitution?

Identify the different types of prostitution, or venues for sex work, and their status in the world of prostitution.

engaging in sexual acts in return for money or drugs and does so in a promiscuous, fairly non discriminating fashion

Different types of prostitution

- call girl

- brothel

- in call services

- massage parlor

- out call services

Pimps- a prostitute’s companion, protector and master; may become verbally or physically abusive

Madam- a woman who manages a brothel, in-call, out-call or escort service; may have social skills to provide a network of clients

Sex trafficking- the recruitment and control of persons for sexual exploitation

1) entering prostitution

2) go through an apprenticeship in which they learn the skills of the profession

3) learns how to hustle/negotiate her services

‘squaring up’ is such a hard task for women who are in a bad financial position, have a poor education, have no alternative to supporting themselves, women who are forced into it from a third world country may not think they have any other option

- 100 prostitutes were questioned at the beginning of their career; after two years ¼ were doing well and were satisfied, another ¼ was depressed and suffering physical effects, the remaining women were in the middle

Variables associated with their well being- whether they worked on the streets or in a safer environment.

Risks are especially high for women who are being trafficked. Risks: physical abuse, rape

coping: drugs, alcohol, shutting down their feelings, emphasizing the rewarding aspects, network of contacts with other sex workers as a source of support.

Having a history of victimization and trauma as children or adolescents, before they entered prostitution, was associated with poorer well-being

Describe the typical customer of prostitutes.

What do prostitutes call them?

Why do men use the services provided by prostitutes?

- typical customer: respectable business men who only seek occasional contact, the other 50% were repeat clients who seeked a regular relationship

- prostitutes call them ‘johns’; the average customer is 35 years old and had completed 1-2 years of college; 54% white

- used to satisfy sexual needs, it’s easy, it would be entertaining

settings/male prostitutes: escort services, massage parlors, gigolo, hustlers

Categories that hustlers fall into:

1) full time street and bar hustlers

2) full time call boys or kept boys

3) part-time hustlers

4) delinquents who use prostitution as an extension of other criminal activities

leisure travel with the purpose of purchasing sexual services

Sex tourism is made possible by three large scale social forces; 1) the migration of men and women from less developed nations or from rural to urban areas in search of jobs

2) the commodification of sexual intimacy, making all types of sex a commodity or service for sale

3) increased travel for recreational purposes

* all 3 of these forces are tied to increasing globalization

- Pornography- sexually arousing art, literature, or films

- Obscenity- something that is offensive according to accepting standards of decency; the legal term for pornography

- Erotica- sexually arousing material that is not degrading or demeaning

Difference- pornography can be considered unacceptable while erotica is acceptable

Hard core magazines --> no holds barred approach to what they present

Soft core magazines --> upper body

Photographs may include everything from vaginal intercourse to anal intercourse, sadomasochism, bondage and sex with animals.

1915- sexually explicit movies begin to be made

1970- industry emerged

1970- I am Curious, Yellow; first film to show sexual intercourse explicitly

1973- Deep throat; respectable and successful full length hard core porn

1980’s- x rated videocassettes became available

Viagra and other enhancers have enabled men without ‘stamina’ to star in films.

800 number or regular long-distance services

the typical recording is of a female voice describing a series of sexual activities in which the caller is a participant; some descriptions include violence or rape; some services provide live conversation

Describe internet chat rooms, news groups, commercial bulletin boards, and adult websites.

Internet chat rooms- same type of thing as phone sex but you cannot see the person; often involves graphic description of sexual activities or fantasies

 News groups- sexually oriented news or discussion groups; read messages posted by others and post messages themselves; stories can be printed and can include pictures

Commercial Bulletin board- sexually explicit photos, download images for a fee, may contain pedophilia

Adult websites- sells variety of pornographic services; thousands of photo organized by content; sex shows; cause for concern, no face to face contact

Both subtle and obvious sexual promises are used to sell a wide variety of products; uses not only bodily display or nudity and sexually suggestive interaction but also context

 sexual information attracts attention and viewers are more likely to remember the sexual image

Typical customer: an educated middle class male between the ages of 22 and 34

- women and students tend to buy and watch pornographic videos; computer porn attracts a more varied clientele; both men and women of all ages

1) pornography debases women

2) pornography associates sex with violence toward women

3) pornography shows and glamorizes unequal power relationships between women and men

Men report higher levels of arousal to sexually explicit material than women do

 the difference is much larger among college students than among older persons

What are the effects of pornography in terms of sexual arousal?

exposure to material that the viewer finds acceptable does produce arousal; men report higher arousal than women

What are the effects of pornography in terms of users’ attitudes?

the single exposure to stories, photographs or videos have little or no effect; massive exposure leads to more permissive attitudes

in response to erotic portrayals of consenting heterosexual activity, both men and women may report an increase in sexual thoughts and fantasies and in behaviors such as masturbation and intercourse

exposure to aggressive pornography increases males aggression toward women and may affect males attitudes making them more accepting of violence against women

Education can eliminate at least negative effects on attitudes

bacterial infections can be cured by using antibiotics; viral infections cannot be cured but they can be treated to reduce symptoms

Infections: Chlamydia, gonorrhea, syphilis

Viruses: herpes, AIDS, genital warts and hepatitis B

What is Chlamydia?

What are the symptoms of Chlamydia for men? For women? Treatment?

 How does Pelvic Inflammatory Disease (PID) cause infertility? What prevention method for Chlamydia are scientists working on?

- an organism causing a sexually transmitted infection

Male symptoms- thin, clear discharge and mild pain on urination

Female symptoms- frequently asymptomatic

- PID causes the uterus and the fallopian tubes to become inflamed

Prevention method- a vaccine is being worked on but the only current form of prevention is constantly using a condom and screening

What is HPV? Describe the relationship between HPV and cervical cancer.

human papillomavirus; organism that causes genital warts

- there are 30 different types of HPV but some types sharply increase the risk of cervical cancer and are called high risk types; HPV 16 & HPV 18 account for 70% of the cases of cervical cancer

How can doctors diagnose HPV? What are the different treatment options for HPV? How is the vaccine for HPV administered?

- diagnosed by inspecting the warts, analysis of the DNA from the cervix

- treatment: chemicals applied to the warts, cryotherapy, laser therapy

- 3 shots over a 6 month period

Disease of the genital organs caused by the herpes simplex virus; there are two different strands; 2 is genital and 1 is on the mouth; can be transmitted through oral or intercourse

There are drugs to reduce the symptoms and scientists are actively working towards an immunization against herpes

- Meningitis, narrowing of the urethra

 TWO MAJOR LONG TERM CONSEQUENCES:

1) increased risk of becoming infected with HIV

2) transfer of the virus from mother to infant in childbirth which in some cases leads to serious illness or death in the baby

Many people are able to cope; a lot of people don’t know they’re infected and are happily being sexual and possibly spreading the disease; the other people think they should abstain from sex and feel very different

Psychological therapies work by relaxation training, stress management, imagery technique.

What does AIDS stand for? Who is Robert Gallo and what is his major contribution to the study of AIDS? Why has AIDS become an epidemic? Is it a pandemic?

AIDS- acquired immune deficiency syndrome.

Robert Gallo discovered HIV & it's link to AIDS

It is a pandemic because it is world wide

Body fluids involved in transferring HIV/AIDS?

 What are the ways that HIV may be transmitted to another person?

 What is the sexual behavior that is most likely to lead to the transmission of HIV? How can you protect yourself from contracting HIV?

- semen, blood, possibly secretions of the vagina and cervix

- Transmission-1) sexual intercourse 2) contaminated blood 3) contaminated needles 4) from an infected woman to her baby during pregnancy or childbirth

Protection- condoms, less sexual partners

Sexual behavior that is most likely to lead to the transmission of HIV- heterosexual contact

What are the four classes of HIV infection?

What is the T-4 cell count for a healthy person?

- a normal count is approximately 1000 cells per cubic millimeter of blood

How does ELISA detect HIV?

What is the Western blot test? How are these tests used together?

- ELISA detects the presence of antibodies for HIV by screening blood that is donated; very sensitive leading to false positives

- The western blot test is more accurate; more expensive. The Western blot test is used if there are sketchy results from the ELISA test

There is no cure for AIDS; 

 AZT is used to treat HIV infected persons

HIV is difficult to create a treatment because it mutates into drug resistant forms

AIDS has been mostly just men in the past but is now turning to women; women need more recognition in research

HIV/AIDS is the leading cause of death for U.S. women between the ages of 25 and 44

Pediatric AIDS is children with AIDS.

Why are scientists having such a hard time developing a vaccine against HIV?

What strategies have been used to develop a vaccine?

HIV has many forms; it mutates rapidly and recombines creating more forms

strategy- develop a vaccine that works on monkeys; start off with people are recently infected and see if they can fight it off

they have no symptoms and no deterioration

HIV suppressor factor

scientists hope they will help lead to improved treatments and possibly a vaccine

there is a mutated gene that has a strong resistance to HIV; blocks the receptor

scientists are looking into gene therapy so they can inject this gene into the people who don’t have it

ointment form that can kill a microbe such as HIV

 gels are being produced that contain the microbicide to help kill the microbe

prevention is key; condoms; screening pregnant women; abstinence

What is the oldest of all sexually transmitted infections?

Why is gonorrhea a problem during wartime?

What are the sites for non-genital gonorrhea infection?

 How can gonorrhea be diagnosed? What are treatment options for gonorrhea?

- infection sites: mouth & throat, anus & rectum & the eyes

- diagnosis? urine test for men, a swab can be taken to test for gonorrhea of the throat, swab of the anus. For females, a sample of the cervical discharge is tested & a pelvic exam

- Treatment? penicillin was used; strands have become resistant and an antibiotic was being used; there is worry that it will become entirely resistant

What is syphilis? What other ways besides coitus can it be contracted? What can happen if syphilis is left untreated? What are the major early symptom of syphilis? What are other symptoms that can follow if left untreated?

- a sexually transmitted infection that causes a chancre to appear in the primary stage

- left untreated, it can damage the nervous system and even cause death.

- major early symptom: chancre

- if left untreated, the heart and blood vessels are attacked, insanity, death.

Primary stage syphilis- the first few weeks of a syphilis infection; chancre is present

Secondary stage-  several months after infection, chancre disappears and body rash appears

Latent syphilis- third stage of syphilis; may last for years; symptoms disappear but the person is still infected

Why is syphilis hard to diagnose? What methods can be used to diagnose syphilis? What are the treatment options for syphilis? Can it be eliminated?

- its symptoms are like so many other diseases

- methods used: blood tests, fluid can be taken from the chancre and put under a microscope to test for syphilis

Treatment options: penicillin in the buttocks; there are alternatives for those who are allergic to penicillin

- you're always infected

What is viral hepatitis? How can Hepatitis B (HBV) be transmitted? Can HBV be cured?

- viral hepatitis is a disease of the liver

- Hepatitis B can be transmitted through blood, saliva, semen, vaginal secretions, and other bodily fluids

- there is a vaccine for HBV; antiviral treatments are available

What is trichomoniasis? How can it be treated? How is it spread?

- form of vaginitis --> white or yellow discharge with an unpleasant odor

- can be spread nonsexually through toilet seats or other surfaces

- It can be treated by ‘Flagyl’ taken orally

What is vaginitis? What are different types of vaginitis? Are they considered to be STIs?

- an irritation or inflammation of the vagina, usually causing a discharge

Types:

 1) cystitis- inflammation of the urinary bladder

2) prostatitis.

 These are not considered STIs.

What are monilia, cystitis, and prostatitis? What are their symptoms?

Monilia- yeast infection; thick, white discharge

Cystitis- infection of the urinary bladder in women, causing painful burning urination

Prostatitis- an infection or inflammation of the prostate gland

** THESE ARE NOT STIS

How is rape defined?

What percent chance does a women in the US have of being raped over her lifetime?

What impact can rape have on a woman?

- rape = non consenting oral, anal or vaginal penetration obtained by force, by threat of bodily harm, or when the victim is incapable of giving consent

-15% chance of being raped in her lifetime; 14-25% is what most studies have found

Impact- emotional reactions, fear, anxiety, self esteem problems, sexual disorders, elevated risk of suicidal behavior, self blame.

Describe the symptoms of rape trauma syndrome.

How can rape affect women’s physical health?

How has post-traumatic stress disorder been used to describe the effects of rape on victims?

- physical injuries, vaginal cuts, bleeding, irritation of the area, STIS, rectal pain

- rape victims can experience flashbacks, avoiding certain activities, sleep difficulties, the woman will not reveal her full name in a phonebook, will check the back seat of a car before entering, afraid to sepnd the night alone etc.

Is date rape considered rape?

How does miscommunication occur in date rape cases? Why might this miscommunication occur? What is rohypnol and how is it related to date rape?

- Date rape is one of the most common forms of rape; results from male-female miscommunication of no really meaning yes; sexually aggressive men misperceive women’s signals, ’suspicious schema’

Rohypnol- ‘roofie’ date rape drug; causes drowsiness or sleep, the women doesn’t remember anything the next day

Is marital rape a common form of rape? What are some of the motivations behind marital rape?

National study- 13% of married women have been raped by their current husband; association between violent husbands and rape

Motivations- anger, power, domination, sadism, desire for sex that the woman may not have

1) victim precipitated rape- woman was ‘asking for it’

2) psychopathology of rapists- theoretical view that rape is an act committed by a psychologically disturbed man

3) Feminist- theorists view rapists as a product of our culture; men using sex to demonstrate power; eroticization of violence in our society; gender inequality is to blame

4) Social disorganization- sociologists believe that crime rates including rape rates increase when the social organization of a community is disrupted; the community can enforce its norms against crime

What does research tell us about the following factors that contribute to rape; cultural values, sexual scripts, early family influences?

- rape is significantly more common in cultures that are characterized by male dominance

- society’s expectations about dating and sex through culturally transmitted sexual scripts; message: man is supposed to be oversexed and the male aggressor

-  young men who are sexual aggressors were likely to have been abused when they were little

- peers can encourage men to rape, ex: fraternity

- if alcohol is involved, secluded places can foster rape

- men and women can have two totally different understandings of what occurs, subtle nonverbal cues

- sexual motives and power motives go hand in hand, rape is an expression of dominance, when a man experiences sexual arousal and is aggressive, he may not be able to fight the urge

- hyper masculine attitudes are correlated with men’s history of sexual aggression, hyper masculinity is a far more common cause than psychopathology

- stereotypes dictate that AA are such sexual beings that women cannot be raped; African American women think no one will believe them if they report rape

 - in a study in L.A., rape incidents are the same between A.A. and white women; both have same negative impact

- Latinas are less likely to be raped; possibly due to high values in Latino culture revolving around the family and patriarchal attitudes

1) avoid situations in which there is a high risk of rape- be alert; set sexual limits, decide earlier if you would like to have intercourse, do not give mixed messages, be forceful and firm, don’t do anything you don’t want to do just because its easier,

 2) if the first strategy has failed, knowing some self defense techniques in case a rape attempt is made

3) changing attitudes that contribute to rape

- girls are more often victims than boys

- majority of perpetrators are men

- almost all of the cases involved sexual contact with men

Incest- sexual activity between relatives

Most common form of incest- sibling

Describe the impact that child sexual abuse has on victims. Identify factors that might make symptoms more severe.

- anxiety, PTSD, depression, poor self esteem, health complaints, aggressive and anti social behavior, inappropriate sexual behavior, school problems, hyperactivity

Factors that might make symptoms more severe:

1) if the perpetrator was a member of the family

2) the sexual contact was frequent or occurred over a long period of time

3) sexual activity involved penetration

How can child sexual abuse affect a person, psychologically and physically, when that individual is an adult?

Psychological effects- depression, anxiety, eating disorders, alcohol/drug dependence, negative feelings about sex, difficulty forming stable safe romantic relationships, more likely to experience sexual disorders, lack of sexual desire, lack of arousal HOWEVER sometimes the victim is not effected later in life depending on the type of incest and if it was consensual- depends on the severity and how often

Physical effects- adults who were victims of CSA are one and a half times as likely as those who weren’t abused to have had health problems in the past year, however researchers concluded that childhood sexual experiences have no effect on adult sexual adjustment

Pedophile- child molester; age 13 or younger

Categories: incest offenders, child molester, attracted to boys or girls, pseudoincest offenders, molesters of familiar children or not

- low on heterosexual competence

- lack interpersonal skills

- more likely to have had head injuries before the age of 6; injury to the brain may create this disorder

- child molesters are 3x as likely to molest again; recidivism is higher among those who had committed previous sexual offenses, had begun sexual offending at an early age and had targeted male victims

- strongest predictor of recidivism: offenders are shown slides of children and their erection is measured

Treatments: surgical castration, anti androgen drugs, hormones, cognitive behavioral therapy, anti depressants (SSRI’s) are used when pedophilia is treated like an obsessive compulsive disorder.

Most successful: cognitive behavioral; cuts the recidivism rate in half

What are the two sides of the argument about recovered memories or false memory syndrome? What does the data say? What is the bottom line?

Side 1: Recovered Memory Side: therapists see clients who show symptoms of prior trauma and the client may or may not remember it but something sparked the memory; therapists are outraged of the trauma that results from childhood sexual abuse

Side 2: False Memory Syndrome: psychologists believe that these ‘memories’ never existed, their argument is that therapists planted the idea in their head

Data: evidence that unpleasant emotions are more likely to be forgotten; forgetting does occur in some cases. Abuse is more likely to be forgotten when it was more severe. It has been theorized that amnesia for traumatic events of this kind is an adaptive response.

Bottom line: there is evidence that some people do forget childhood sexual abuse and remember it later, also evidence that some people can form false memories based on suggestions made by another person; errors of justice occur on both sides.

Nonetheless, each year thousands of children are sexually abused; vast majority of the cases go unreported

How does the US equal employment opportunity commission define sexual harassment? What are the key ingredients of sexual harassment?

Definition: unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature constitute sexual harassment when a) made toward the individual’s employment or academic advancement b) used as the basis for academic or employment decisions affecting that individual c) has purpose or effect of interfering with the individual’s work or academic performance or could create a hostile or offensive working environment

Key ingredients: sexual advances are unwelcome and coercive in the sense that the victim’s job or grade is at stake ‘quid pro quo harassment’

Harassment of a student by a teacher or a professor may range from insults and come ons to sexual assault

Why might there be the potential for serious damage when psychotherapists and their clients have sex?

Dangerous because it is a situation of unequal power in which the more powerful person (therapist) imposes sexual activity on the less powerful person (the client). Particularly serious because people in therapy have opened themselves up emotionally to the therapist and therefore are extremely vulnerable emotionally