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Sexual dysfunction
Definition
Desire phase
Reflects psychiatric concern with motivations, drives and personality Characterized by sexual fantasies and desire to have sexual activity
Excitement phase
Orgasm phase
Peaking of sexual pleasure with release of sexual tension and rhythmic contraction of perineal muscles and pelvic reproductive organs
Resolution phase
Paraphilias
Definition of paraphilias
A condition in which the sexual instinct is expressed in ways that are socially prohibited or unacceptable or are biologically undesirable (APA, 2000)
Epidemiology
Pedophilia is most common among legally identified cases Most often found in males
Etiology
Psychosocial factors Biological factors
DSM-IV paraphilias
Exhibitionism Fetishism Frotteurism Pedophilia Sexual masochism Sexual sadism Transvestic fetishism Voyeurism Paraphilia NOS
Exhibitionism
Recurrent urge to expose the genitals to a stranger or unsuspecting person Sexual excitement occurs in anticipation of the event Orgasm is brought on by masturbation during or after the event Almost all cases involve men exposing themselves to women
Fetishism
Sexual focus on objects that are intimately associated with the human body Disorder occurs almost exclusively in men
Frotteurism
Recurrent, intense sexually arousing fantasies, sexual urges or behaviors involving touching and rubbing against a nonconsenting person Incident usually occurs in crowded places
Pedophilia
Recurrent intense sexual urges towards, or arousal by, children 13 years or younger Persons with pedophilia are at least 16 years old and are at least 5 years older than the child or children About 60% of victims are male
Sexual masochism
Recurrent preoccupation with sexual urges and fantasies involving the act of being humiliated, beaten, bound or otherwise made to suffer More common among men than women
Sexual sadism
Recurrent sexual fantasies, urges or behaviors in which pleasure is derived from the psychological or physical suffering of another Most persons with this disorder are male
Transvestic fetishism
Fantasies and sexual urges to dress in clothing of the opposite gender as a means of arousal or as an adjunct to masturbation or coitus
Voyeurism
Recurrent preoccupation with fantasies and acts that involve an unsuspecting person who is naked, in the process of disrobing or engaging in sexual activity
Definition
Persistent desire to be, or the insistence than one is, the other sex Person experiences extreme discomfort with assigned sex and gender role
Epidemiology
No information about prevalence Estimates of prevalence based on number seeking sex-reassignment surgery suggests a male preponderance
Etiology
Biological factors Psychosocial factors