SEXUAL DISORDERS

Kshirabdhi Tanaya
Msc Tutor,SUM Nursing college
S‘O’A DTU,Bbsr.

1. SEXUAL AND GENDER IDENTITY DISORDER PRESENTED BY:- Kshirabdhi Tanaya Msc Tutor,SUM Nursing college S‘O’A DTU,Bbsr .

2. INTRODUCTION Humans are sexual beings. Sexuality is a basic human need and an innate part of the total personality. It influences our thoughts, actions, and interactions, and is involved in aspects of physical and mental health.

3. Sexuality Sexuality is the constitution and life of an individual relative to characteristics regarding intimacy. It reflects the totality of the person and does not relate exclusively to the sex organs or sexual behavior .

4. SEXUAL DISORDERS Paraphilic Disorders The term paraphilia is used to identify repetitive or preferred sexual fantasies or behaviors that involve (1) nonhuman objects, (2) suffering or humiliation of oneself or one’s partner, or (3) nonconsenting persons.

5. In a paraphilic disorder, these sexual fantasies or behavior are recurrent over a period of at least 6months and cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning.

6. Types of Paraphilic Disorders:- The following types of paraphilic disorders are identified by the DSM-5: Exhibitionistic Disorder Fetishistic Disorder Frotteuristic Disorder Pedophilic Disorder Sexual Masochism Disorder Sexual Sadism Disorder Transvestic Disorder Voyeuristic Disorder

7. 1-Exhibitionistic Disorder :- Exhibitionistic disorder is characterized by recurrent and intense sexual arousal (manifested by fantasies, urges, or behaviors of at least 6 months’ duration) from the exposure of one’s genitals to an unsuspecting individual (APA, 2013). Masturbation may occur during the exhibitionism. In most cases of exhibitionism, the perpetrators are men and the victims are women.

8. 2 -Fetishistic Disorder Fetishistic disorder involves recurrent and intense sexual arousal (manifested by fantasies, urges, or behaviors of at least 6 months’ duration) from the use of either non-living objects or specific non-genital body part(s) (APA, 2013). A common sexual focus is on objects intimately associated with the human body(e.g., shoes, gloves, stockings). The fetish object is usually used during masturbation or incorporated into sexual activity with another person in order to produce sexual excitation.

9. 3-Frotteuristic Disorder Frotteuristic disorder is the recurrent and intense sexual arousal (manifested by urges, behaviors , or fantasies of at least 6 months’ duration) involving touching or rubbing against a nonconsenting person (APA, 2013). Sexual excitement is derived from the actual touching or rubbing, coercive nature of the act. Almost without exception, the gender of the frotteur is male. The individual usually chooses to commit the act in crowded places, such as on buses or subways during rush hour.

10. 4-Pedophilic Disorder The essential feature of pedophilic disorder is sexual arousal from prepubescent or early pubescent children . The age of the molester is at least 16 years, and he or she is at least 5 years older than the child. This category of paraphilic disorder is the most common of sexual assaults. Sexual abuse of a child may include a wide range of behaviors , including speaking to the child in a sexual manner, indecent exposure and masturbation in the presence of the child, and inappropriate touching or acts.

11. 5-Sexual Masochism Disorder The identifying feature of sexual masochism disorder is recurrent and intense sexual arousal (manifested by urges, behaviors , or fantasies of at least 6 months’ duration) from the act of being humiliated, beaten, bound, or otherwise made to suffer (APA, 2013). These masochistic activities may be fantasized (e.g., being raped) and may be performed alone (e.g., self-inflicted pain) or with a partner (e.g., being restrained, spanked(hit several times on buttocks) or beaten by the partner). Some masochistic activities have resulted in death,

12. 6-Sexual Sadism Disorder The DSM-5 identifies the essential feature of sexual sadism disorder as recurrent and intense sexual arousal (manifested by urges, behaviors , or fantasies of at least 6 months’ duration) from the physical or psychological suffering of another individual (APA, 2013). The sadistic activities may be fantasized or acted on with a consenting or nonconsenting partner. In all instances, sexual excitation occurs in response to the suffering of the victim. Examples of sadistic acts include restraint, beating, burning, rape, cutting, torture,and even killing. The course of the disorder is usually chronic, with the severity of the sadistic acts often increasing over time.

13. 7-Transvestic Disorder Transvestic disorder involves recurrent and intense sexual arousal (as manifested by fantasies, urges, or behaviors of at least 6 months’ duration) from dressing in the clothes of the opposite gender. The individual is commonly a heterosexual man who keeps a collection of women’s clothing that he intermittently uses to dress in when alone. The sexual arousal may be produced by an accompanying fantasy of the individual as a woman with female genitalia, or merely by the view of himself fully clothed as a woman without attention to the genitalia. The disorder causes marked distress to the individual, or interferes with social, occupational, or other important areas of functioning.

14. 8-Voyeuristic Disorder Voyeuristic disorder is identified by recurrent and intense sexual arousal (manifested by urges, behaviors , or fantasies of at least at least 6 months’ duration) involving the act of observing an unsuspecting individual who is naked, in the process of disrobing, or engaging in sexual activity (APA, 2013). Onset of voyeuristic behavior commonly occurs during adolescence, but the minimum age for a diagnosis of voyeuristic disorder is 18 years (APA, 2013).

15. PREDISPOSING FACTORS TO PARAPHILIC DISORDERS 1-Biological Factors Various studies have implicated several organic factors in the etiology of paraphilic disorder. Destruction of parts of the limbic system in animals has been shown to cause hypersexual behavior .(Becker & Johnson,2008). Temporal lobe diseases, such as psychomotor seizures or temporal lobe tumors , have been implicated in some individuals with paraphilic disorder. Abnormal levels of androgens also may contribute to inappropriate sexual arousal.

16. 2-Psychoanalytic Theory The psychoanalytic approach defines an individual with paraphilic disorder as one who has failed the normal developmental process toward heterosexual adjustment ( Sadock & Sadock , 2007). This occurs when the individual fails to resolve the Oedipal crisis and either identifies with the parent of the opposite gender or selects an inappropriate object for libido cathexis.

17. 3-Behavioral Theory The behavioral model hypothesizes that whether or not an individual engages in paraphilic behavior depends on the type of reinforcement he or she receives following the behavior . The initial act may be committed for various reasons. Some examples include recalling memories of experiences from an individual’s early life (especially the first shared sexual experience),

18. modeling behavior of others who have carried out paraphilic acts, mimicking sexual behavior depicted in the media, and recalling past trauma such as one’s own molestation ( Sadock & Sadock , 2007). Once the initial act has been committed, the individual with paraphilic disorder consciously evaluates the behavior and decides whether to repeat it. A fear of punishment or perceived harm or injury to the victim, or a lack of pleasure derived from the experience, may extinguish the behavior .

19. TREATMENT

20. 1-Biological Treatment Biological treatment of individuals with paraphilic disorders has focused on blocking or decreasing the level of circulating androgens. The most extensively used of the antiandrogenic medications are the progestin derivatives that block testosterone synthesis or block androgen receptors. They are not meant to be the sole source of treatment and work best when given in conjunction with participation in individual or group psychotherapy.

21. Psychoanalytic Therapy In this type of therapy, the therapist helps the client to identify unresolved conflicts and traumas from early childhood. The therapy focuses on helping the individual resolve these early conflicts, thus relieving the anxiety that prevents him or her from forming appropriate sexual relationships. In turn the individual has no further need for paraphilic fantasies.

22. Behavior Therapy Aversion techniques have been used to modify undesirable behavior . Aversion therapy methods in the treatment of paraphilic disorders involve pairing noxious stimuli, such as electric shocks and bad odors,with the impulse, which then diminishes. Behavioral therapy also includes skills training and cognitive restructuring in an effort to change the individual’s maladaptive beliefs.

23. THANK YOU