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Aantekeningen hoorcolleges Psychopathology: symptoms, classifications and diagnosis / Notes from the lectures of Psychopathology: symptoms, classifications and diagnosis. ISBN: 9780890425794

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Rijksuniversiteit Groningen (RuG)

Aantekeningen van de hoorcolleges van Psychopathology: symptoms, classifications and diagnosis. Bachelor Psychologie. Rijksuniversiteit Groningen. Collegejaar 2022/2023. / Notes from the lectures of Psychopathology: symptoms, classifications and diagnosis. Bachelor Psychology. University of Gron...

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Type College aantekeningen
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psychopathology
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symptoms
classifications
diagnosis
dsm
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psychology
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20222023
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Hoorcolleges psychopathology
College 1 – Introduction + sexual dysfunction
Exam
 Short essay questions
o Wat voor diagnoses komen in je op?
o Wat voor secondary diagnoses passen hierbij?
o Etc.
 3 case scenarios
 Open book exam  DSM

What are sexual dysfunctions?
 When the person feels distressed about their sexual life
o For approximately 6 months or more.
o A clinically significant disturbance in a person’s ability to respond sexually or to
experience sexual pleasure.
 People give a different meaning of sex.
 Sex is more then just penetration.

DSM is helpful but also problematic.
 It is helpful for treatment, for research.

DSM 4 distinction between desire and arousal  now combined together.

What can cause/maintain SD?
 Coordinated by
o Neurological
o Vascular
o Endocrine
 These 3 need to work together.
 Individual sexuality incorporates
o Family
o Societal
o Religious
 Beliefs
 Experience
 Sexual activity incorporates
o Inter-personal relationship
o Each partner (attitudes, needs, responses).
 This changes with age, phase, state etc.

Causal factors in sexual dysfunction 

,The bio-psycho-social assessment

Phases of sexual activity (Master and Johnson)
 Excitement  bloodflow, focus, tingling
 Plateau 
 Orgasm
 Resolution
 Sexual response is not linear & uniform process – thus distinction between phases might be
artificial.
 The majority of men endorsed the M&J model (48,5%) or the Kaplan model (38,3%; only
5,4% endorsed the Basson model, and 7,3% endorsed non of the models.

The sexual tipping point model
 Features that make you excitated.
 Features that inhibit you.

Specific sexual dysfunction
 Delayed ejaculation (304.74)
 Erectile disorder (302.72)
 Female orgasmic disorder (302.73)
 Female Sexual Interest/Arousal Disorder (302.73)
 Genito-Pelvic Pain/Penetration Disorders (302.76)
 Male Hypoactive Sexual Desire Disorder (302.71)
 Premature (Early) Ejaculation (302.75)
 Substance/medication-induced sexual dysfunction

,  Other specified sexual dysfunction (302.79)
 Unspecified sexual dysfunction (302.70)

Men’s sexual dysfunction
 Delayed Ejaculation (DE)
o A marked difficulty of inability to achieve desired ejaculation.
o More common in men over 50…  they need more visual and tactile information.
o Only 75% of men report always ejaculating during sexual activity.
o Many theories regarding the aetiology of DE but with little empirical data to support
any particular theory.
o 3 common factors associate with DE
 Higher frequency of masturbation
 Idiosyncratic masturbatory style
 Disparity between the reality of es with his partner compared to his
preferred sexual fantasy during masturbation
 DE is often mistakenly diagnosed as erectile disorder!
o In the clinical setting
 DE is often mistakenly diagnosed as ED!
 Focus on pleasure instead of function
 Learn to focus attention on sexual stimuli
 Cognitive restructuring
 Suspend masturbatory activity temporarily
 Use condoms during masturbation?
 Check relationship
 Erectile Disorder (ED)
o Failure to obtain or maintain erection during partnered sexual activities.
 Marked decrease in erectile rigidity.
 More common in men over 50.
o Most problems remit without professional intervention.
o Modern history:
 Sildenafil (ViagraR) in 1996
 European Edition in 1998
 Managing expectations!
o Cobra study: ED onset occurred before Coronary Artery Disease (CAD) in 71% with a
mean time interval of 25 months. 

 Penis arteries are the smallest arteries in the body of a man.
o Medication and relational drugs with a negative impact on erectile function (e.g.
antihypertensives, antidepressants, recreational substances etc.)
o Assessment
 Sexual development in childhood/adolescence
 Masturbatory experience?
 Rule out PE!
 Hetero-bi-or homosexual orientation?
 Chronic /permanent? Partner-/situation dependent?
 Partner-/family-/business-/financial problems?

,  Depressive symptoms?
 ED existing with masturbatory activities?
 General health conditions competing with sexual life?
 MORNINGs?
 Male Hypoactive Sexual Desire Disorder (MHSDD)
o Persistent deficient or absent sexual thoughts, fantasies or desires.
o 6% of younger 18-24 & 41% of older men 66-74 report problems with sexual desire;
persistent problem in only 1,8% of men.
o Many men are often treated for different sexual diagnoses while they are suffering
from HSDD.
o Sexual desire and sexual arousal are overlapping constructs since both depend on
the ability of an individual to process sexual information during sexual activity.
o HSDD limited to a single partner is not SD but a relationship problem.
o Erection and satisfaction are different things.
o Epidemiology of HSDD in men
 Prevalence in men aged 16 to 59 years 14% to 17% - Greater in older men -
In all literature: 3-50%
 Demographic survey in the US (1455 men aged 57 to 85 years) - 28% of men
reported a lack of desire for sex - 65% of affected men being bothered.
 By the time that individuals reach middle and old age, there is a natural
decline in sexual desire, sexual capacity and the frequency of sexual
behaviour.
o Sufficient sexual stimulation is important for arousal to follow for women but also for
men.  Eating the same food every day? No!
 Sexual feelings diminished during repeated erotic stimulation, and increased
with the introduction of novel stimulation
o A side note on sexual pleasures in LT relationships
 Sex play’s role in all phases of relationship (to start, to stay).
 Sexual desire is important to relationships satisfaction and stability  low
sexual desire source of relational distress.
 Most prevalent complaint in LT relations is low sexual desire.
 Important to focus on the process, same as food…. Let’s look at sexual
pleasure as flavour.
 But ↘ in sexual desire --> ↘ in sexual frequency --> not necessarily ↘ in
relationship satisfaction.
o In longer relationships you get sexual boredom.  You need to increase the
variation.
 Premature Early Ejaculation
o Persistent or recurrent pattern of ejaculation during partnered sexual activity within
1 minute following penetration or before individual wishes.
o 20%-30% of men report concern about
ejaculation speed; 1%-3% have persistent
problem.
o What if rapid ejaculation is… natural?
 In animals, sexual intercourse is
usually a brief episode.
 In chimpanzees, for example, the
sequence of approach, penetration
and ejaculation lasts just six
seconds.
o There are a lot of techniques

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Aantekeningen hoorcolleges Psychopathology: symptoms, classifications and diagnosis / Notes from the lectures of Psychopathology: symptoms, classifications and diagnosis. ISBN: 9780890425794

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