1
Q
What are the 5 phases of human sexual response
A
- Desire phase
- Arousal stage
- Plateau phase
- Orgasm phase
- Resolution phase
2
Q
What are the 4 categories of sexual dysfunctions?
A
- Desire disorders
- Arousal disorders
- Orgasmic disorders
- Sexual pain disorders
3
Q
What is hypoactive sexual desire disorder? Who experiences it?
A
- men
- dont have desire or interest in sex
4
Q
What is FSI/AD (female sexual interest desire disorder)? Who experiences it?
A
- women
- lacking interest. In sexual activity
5
Q
What is sexual aversion disorder?
A
- total disgust of sex, repulsed or frightened
6
Q
What is FSI/AD (female sexual interest arousal disorder)? Who experiences it?
A
- women
- repeated inability to maintain proper lubrication/genital swelling
7
Q
What is male erectile disorder?
A
- repeated inability to attain/maintain an adequate erection
- rates tend to increase with age
8
Q
What is rapid/premature ejaculation? Who experiences it?
A
Men
- ejaculation with ink 1 minute of beginning intercourse
9
Q
What is delayed ejaculation/male orgasmic disorder?
A
- unable to or have delayed ejaculation
10
Q
What is female orgasmic disorder?
A
- delay or absence of orgasm which is persistent
- could have one but it is not stimulating
11
Q
What is genital-pelvic pain/penetration disorder?
A
- when men or women have pain during intercourse
12
Q
What is vaginismus?
A
- involuntary/uncontrollable contractions of muscles of outer third of vagina
13
Q
What are the 4 classifications of sexual dysfunctions?
A
- Lifelong - have always had the problem
- Acquired - had a period of normal function before problem occurred
- Specific - limited to some situations or partners
- Generalized - applies to all sexual interactions
14
Q
What are the psychological causes of sexual dysfunctions?
A
- performance anxiety about failing
- leads to having more failures
- spectator role: not enjoying or participating
- hostility towards partner, relationship issues or life stressors like their job
- lack of sexual experiences or poor partner
- depression
- negative attitudes towards sex
- sociocultural factors
15
Q
What are the biological causes of sexual dysfunctions?
A
- low hormone levels (testosterone)
- cardiovascular issues
- medications and drugs
- low or too high sensitivity to sexual stimulation
- past masturbation habits
- postmenopausal changes for women which causes less estrogen leading to decreased reaction
- infection, disease or injury
16
Q
What are the 2 treatments for sexual dysfunctions. What is done?
A
- sex therapy
- dealing with couple problems
- sex education
- changing attitudes towards sex
- eliminate performance anxiety
- increase sexual and communication sills between partners
- sensate focus exercises
- practicing giving and receiving pleasurable stimulation in nongenital areas
- no pressure to reach orgasm which removes performance anxiety
- later add genitalia stimulation
17
Q
What are the treatments for erectile disorder?
A
- teasing technique : getting partner to ave an erection over and over again
- medications like viagra
- penile injection
- vacuum devices
- penile implant
18
Q
What are the treatments for FSI/AD?
A
- changing routine of sex
- self-stimulation exercises (masturbating) + fantasies
- sedate focusing
- relaxing leading to lubrication which leads to decreased performance anxiety
- if its due to impaired blood flow:
- alprostadil (vasodilator): cream inserted into vagina
- testosterone skin patches
- Eros device: suction to clitoris that increases vasocongestion
19
Q
What are paraphilias and the diagnostic criteria in the DSM-5?
A
- involves fantasies about things society finds abnormal like:
- nonliving objects
- humiliation of self or partner
- children
- non-consenting people
- lasts at least 6 months
- has distress/impairment because of it
- causes ris of harm or danger to self/others
- some paraphilias, you just need the behaviour alone to get the diagnoses
20
Q
What is fetishism?
A
- fantasies about using a nonliving object
- becomes a necessity to use/have object during sex
- common fetishes:
- women’s underwear
- shoes
- boots
21
Q
What are the causes of fetishism
A
- behavioural: classical conditioning
- association occurs once leading to doing it over and over again
22
Q
what are the 4 treatments for fetishism, transvestic fetishism & exhibitionism/flashing?
A
- AVERSION THERAPY
- getting rid of association by creating a different association with something unpleasant - COVERT SENSITIZATION
- imagining something not pleasant to get rid of association - MASTURBATION SATIATION
- making the person do it repeatedly to get rid of association since they get bored - ORGASMIC RECONDITIONNING
- forced masturbation to a different image to create a new association
23
Q
What is transvestic fetishism
A
- dressing in clothes of the opposite gender to achieve arousal
- typically married heterosexual men
- often begins in childhood or adolescence
24
Q
What are the causes of transvestic fetishism
A
- caused by operant conditioning
25
What is exhibitionism/flashing?
- aroused by exposing genitals in a public setting
- sexual contact isn’t typically initiated
- aroused by element of surprise
- usually begins before age of 18
- more men than women
- often lac social skills
26
What are the causes of exhibitionism/flashing?
- operant/classical conditioning
27
What are the treatments for exhibitionism?
- social sills training
- psychotherapy
- 4 other ones listed before
28
What is pedophilia?
- sexual activity with a child 13 years old or younger
- develops in adolescence
29
What is a possible cause of pedophilia?
- having a history of sexual abuse or neglect
- cycle of abuse
30
What are some treatments for pedophilia?
- behavioural: same as fetishishes (aversion therapy, covert sensitization, masturbator satiation & orgasmic reconditioning)
- biological: medications like anti-androgen drugs since it lowers desire (problem is it doesn’t change fact that they’re attracted to children)
- cognitive behavioural: relapse-prevention training
31
What is sexual sadism?
- only being able to get aroused if making partner suffer
- fantasies often appear in childhood
32
What are the causes of sexual sadism?
- behavioural: classical conditioning/modelling
- cognitive-behavioural: feelings of sexual inadequacy
- biological: brain/hormonal abnormalities
33
What is masochism?
- enjoying being humiliated or made to suffer
- most begin by fantasizing about being made to suffer
34
What is a cause of masochism?
- classical conditioning
35
What are the treatments for masochism?
- cognitive behavioural: CBT
- biological: medications like:
- anti-androgen
- antidepressants since they lower sex drive
36
What is gender dysphoria?
Being transgender meaning persons gender identity differs from the sex tat was assigned to them at birth
37
What was stated in the film clip on ender dysphoria?
- has cultural differences
- treatments can include:
- top surgery
- accepting and conforming to own gender identity
- people often know at a young age
- helps to accept and transition what who the person is
38
What are some treatments for gender dysphoria?
- psychotherapy recommends spending 1 year passing as gender the person sees themselves as which is followed by:
- medical interventions such as:
- hormone treatments (estrogen or testosterone )
- gender conforming surgery
39
What is psychosis?
- loss of contact with reality causing a disturbance in the ability to perceive and respond to ones environment
- causes impairment to functioning
- has hallucinations or delusions
40
What are the diagnostic criteria’s for schizophrenia?
- symptoms of psychosis for 6+ months
- deterioration in areas like:
- social relations
- work
- self-care/personal hygiene
41
What are the 3 types of symptoms one with schizophrenia may have?
1. Positive symptoms
2. Negative symptoms
3. Psychomotor symptoms
42
What are the positive symptoms of schizophrenia? (7)
1. Hallucinations (often auditory) & delusions (beliefs that other people dont have)
2. Loose associations/derailment : disorganized thinking
3. Nedogisms : made up words
4. Perseverations: doing same thing/words repeatedly
5. Clong: speaking in rhymes
6. Heightened perceptions: overwhelmed senses
7. Inappropriate affect: inappropriate feelings
43
What are negative symptoms of schizophrenia? (4)
1. Alogia: loss of speech
2. Blunted and flat affect: little to no feelings/affect
3. Loss of volition: loss of motivation, energy or interest
4. Social withdrawal: engaging with few people
44
What are psychomotor symptoms of schizophrenia? (4)
1. Awkward movements
2. Repeated grimaces: repeated movements
3. Odd gestures
4. Catalonia: freezing for long periods of time
45
What are the biological causes of schizophrenia?
- diathesis-stress model:
Biological predisposition+extreme environmental stressors = development of the disorder
- biochemical abnormalities:
- dopamine hypothesis - could be firing too often in brain
- abnormal brain structure:
- brain scans show that many patients with particularly negative symptoms have enlarged ventricles
46
What are the psychodynamic causes of schizophrenia?
- Freud said caused by regression to primary narcissism
- causing self-centered symptoms/thinking
- theory by Fromm-Reichman:
- due to a schizphrenogenic mother
- since they rejected or used the child to meet their own needs
47
What are the cognitive causes of schizophrenia?
- brain produces strange & unreal sensations which leads the patent struggling to nderstad te symptoms occurring to them
- trying to understand or rationalize symptoms leads to worsening of symptoms
- called “rational path to madness”
48
What are the sociocultural causes of schizophrenia?
- possibly the poverty effect
- ethnic bias by the therapist
- social labelling: once assigned, self-fulfilling prophecy
- family dysfunction:
- possibly linked to family stress
- difficulties in communication
- high “expressed emotion” - when family is hostile intruding or critical
* 4x more likely to relapse if they have this
49
What are the biological treatments of schizophrenia?
- medications (antipsychotics)
- conventional vs. Aypical antipsychotics
- reduces symptoms in at least 65% of patients
- most used approach
- symptoms will most likely to return if they stop
- may not work on negative symptoms especially with conventional medications
50
What are some side effects of conventional (D-2 receptors) antipsychotics
- extra pyramidal effects
- Parkinsonian symptoms (looks like Parkinson’s: odd movements like tremors rigidity diatonia [bizarre movements], restlessness and agitation)
- tardive dyskinesia
51
What are the side effects of atypical (D-1 receptor) antipsychotics?
- have less movement disorders
- have to get regular blood tests due to agronulocytosis (drop in white blood cell count leading to infection which could be lethal)
52
What are the cognitive behavioural treatments for schizophrenia?
- change how they view/react to hallucinations
- teach to react differently
- educate on how schizophrenia works
- teach more accurate interpretations of hallucinations
- teach co[ping skills (ex: ignoring the voices)
- medications management/encouragement to remain on medication
53
What are the sociocultural treatments for schizophrenia?
- family therapy
- social therapy
- problem solving and decision making
- social skills training
- medications management
- shows that it does reduce hospitalization
54
What is conduct disorder?
- repeatedly violating basic rights of others
- often aggressive, cruel and may tend to steal/rob
55
What are the causes of conduct disorder?
- biological and/or environmental
56
What are the sociocultural treatments for conduct disorder?
- family interventions:
1. Parent-child interactions (2 phases)
- phase 1: teach parent to be better/ more understanding/ not react negatively or violently
- phase 2: teach parent how to manage difficult behaviours
2. Video modeling
3. Parent management training
- residential treatment :
- foster care treatment
- school based interventions
57
What are the cognitive behavioural treatments for conduct disorder?
- child focused treatment:
- CBT interventions:
1. Problem solving skills training
2. Anger coping and coping power program
58
What are the biological treatments for conduct disorder?
- drug treatments (stimulants)
59
What was stated in the film clip “what its actually like living with ADHD?
- there are 3 types:
1. Inattentive
2. hyperactive
3. Combined
- brain lacks dopamine so things aren’t as rewarding leading to the person seeking rewarding activities to increase dopamine
- can present itself as anxiety especially for women
- women tend to internalize symptoms while men externalize them
- often tend to lose or misplace things
- fidget a lot since it helps the brain focus
- tend to hyperfocus: when something is really interesting to the person they get sucked into it
- excercise can help with focus
- medications (stimulants ) are used like: vyvanse, adderall
60
What are the features of ADHD?
- difficulty paying attention to tasks (attention) and/or behave over actively and impulsively (hyperactivity)
- persists through childhood and may have lessening of symptoms in mid-adolescence/learn to cope
61
What are the biological and sociocultural causes of ADHD?
- BIOLOGICAL:
- abnormal dopamine activity
- abnormalities in frontal-striatal areas
- SOCIOCULTURAL
- issues with social labelling leading to self-fulfilling prophecy
62
What are the biological treatments for ADHD?
- drug treatment: often stimulants
- ex: Ritalin, vyvanse, adderall
- problem is the long term effects are unknown
63
What are the behavioural treatments of ADHD?
- operant conditioning to modify behaviour (giving rewards if good behaviour to enforce it)
64
What are the features of autism spectrum disorder?
- lack of responsiveness and social reciprocity
- communication problems
- wide range of highly rigid and repetitive behaviors, interests and activities
- perseveration : sticking to a rigid routine and tantrums or extreme emotions if thrown off
- presents around age of 3
65
What are te psychological causes of autism spectrum disorder?
- a central perceptual or cognitive disturbance
- “mind blindness” : not understanding different feelings or perspectives of others
66
What are the biological causes of autism spectrum disorder?
- genetic factors leading to specific biological abnormalities
- in the: amygdala, hypocampus, cerebellum
- cells seem to be smaller/more densely packed in certain areas
- shorter dendrites
67
What was said in the film clip “theory of mind”
- trying to see if child sees different perspectives of others
- perspective test
- theory of mind test
68
What was stated in the film clip: “detection and treatment of ASD”
- mind disorder
- number of diagnoses are skyrocketing and the cause is unknown
- causes are genetic with environmental factors
- fall on a spectrum
- may not speak and have tantrums
- have difficulties interacting socially
- no treatment/standard of care
- gene mutation
- brains don’t make needed connections allowing for connections socially
- siblings have a 20% higher chance of developing it if sibling has ASD
- brain enlargement is shown which is why prevention is becoming important if it can be possible to treat before enlargement occurs
69
What are the cognitive behavioural treatments for autism spectrum disorder?
- teach new appropriate behaviours through modelling and operant conditioning for parents
- education and training in special education classes or programs
- better if done in early points of child’s life
70
What is communication training for autism spectrum disorder?
- ex: sign language and simultaneous communication or communication board
- child-initiated interaction
71
What is parent training for autism spectrum disorder?
- learning and applying behavioural techniques at home
- individual therapy and support groups for parents with ASD
72
How does screen time affect mental health
Frequent social media use = lower or decreased well-being
- BUT: some studies find the opposite
- depends on MOTIVATION for using social media
73
What was the objective of the study by Twenge et al. 2017?
- look at how teens spend their time:
- screen time
- nonscreen time
- assessed for:
- depression rates/prevalence of symptoms
- suicide-related outcomes ad death rates
- interested in demographic differences
- class, gender, age, ethnicity, etc
- looked at use of leisure time
- if economic factors play a role
74
What was the sample in the study by Twenge et al. 2017?
- 2 large nationally representative samples
- 8th to 12th grade
75
What were the results in the study by Twenge et al. 2017?
- almost exclusively in teenage girls
- depression and suicide outcomes rose during the 2010’s
- between 2009/2010 and 2015: 33% higher rates of depression and 12% more of at least 1 suicide outcomes. 31% more died by suicide
- more time of screens leads high depressive symptoms
- time spent on homework was negatively correlated with depressive symptoms
- using devices for 3+ hours a day = 34% more likely to attempt suicide
- 5+ hours = 66% more likely to attempt suicide
- using social media sites every day = 13% more likely to report depressive symptoms
- economic factors were mostly not correlated with depression and SS use
76
What is lower depression/suicide associated with?
- in person social interactions
- print media use (reading books)
- sports/exercise
- religious service attendance
77
What were the conclusions found in the study by Twenge et al. 2017
- screen time has a larger effect on girls
- homework stress is not a direct cause for depression
- linked to the increased availability of smartphones
- no social media use leads to less happy than those who used it less than 1h per day
- happiest teens: limited amount of time (everything in moderation is the lesson)
Limitations:
- its correlational so can’t determine cause
- its self-reporting
78
What are the positives of social media/internet on mental health or therapy? List 2 problems
- TELETHERAPY
- long-distance therapy with Skype or zoom
- treatments offered by a computer program
- internet based support groups
PROBLEMS
- ethical issues
- lack of quality control
- needs more research
79
What do studies show for prevention of mental illness?
- those who will develop mental health disorders show symptoms by age of 14
- shows that intervention at early in life is important
- can decrease suffering and costs
80
What are the recommended strategies for prevention of mental illness?
- invest during critical periods of development (childhood and in utero)
- apply evidence-based scientific research to clinical services (do what we know works)
- move towards at-risk-oriented detection and intervention
- ex: people suffering with poverty
- promote multidisciplinary and multilevel approaches (have all fields work together)
- psychiatry, cognitive, sociocultural, behavioural, psychodynamic, etc
- promote health lifestyle
- encourage school based interventions
81
What are the 3 stages of recovery from mental illness? What is the clinicians role?
1. Find correct diagnosis, relieve most severe symptoms and find social supports
2. More manageable/able to maintain stability
3. Help them return to an active life based on wants, preferences and abilities
Clinicians role is to engage in shared decision making, offer a range of services and supports
82
What are the 2 pillars in recovery of mental illness?
1. Uniqueness of each patient and their right to determine their path towards mental health and recovery
2. There are many intersecting factors that impact mental health
83
What are the 4 major dimensions in mental health recovery?
1. Health: make informed, healthy choices
2. Home: assure they have a stable and safe place to live
3. Purpose: help find meaningful daily activities
4. Community: help them find social support
84
What is part of a recovery plan/ what is done to create a recovery plan?
- have them identify goals for achieving wellness
- specify how to reach them
- track changes in mental health
- identify triggers/stressful events
* have them acknowledge there will be challenges but also hope
* Make sure they are active in their treatment/recovery since the more active/engaged they are the more chances they will have in making gains/recovering
85
What is voyeuristic disorder?
- sexual arousal is received from observing unsuspecting people undressing or naked
86
What is frotteuristic disorder?
- sexual arousal from touching or rubbing against a non-consenting person such as in a crowded subway
87
What is the duty to warn?
- mental health professionals responsibility to break confidentiality and notify the potential victim whom a client has specifically threatened
88
What are te 3 ethics and treatments of mental illness?
1. Boundary issues
- must be clear about professional boundaries to avoid conflicts of interest
- can’t exploit any relationships established
- can’t further own personal buisness, political interests or the advantage of trust
2. Requirement that psychologists do not harm
- record keeping can’t possibly lead to misinterpretation
- make referrals to other MH professionals to help needs of client if therapist can’t provide needed help
- prohibits any sexual activity before and after therapy
3. Need for psychologists to practice within their areas of competence
- must have proper training to treat a client with a specific project
- must obtain specific training (coursework, research, individual study, applied training or supervision)
89
What are the 3 core ethical principles for research participants?
1. Respect for the person
2. Concern for welfare
3. Concern for justice
Psychological Disorders
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