3.5. Eating, Sex and Other Needs
3.5. Eating, Sex and Other Needs
Psychology Erasmus University
Summary written by Amy van Wingerde
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,3.5. Eating, Sex and Other Needs
Week 4
Sources
1 & 2. APA 5th edition (2013), Frühauf et al. (2013), Easton et al. (2010)
3. Bancroft et al. (2009), Torrisi et al. (2016), Zemishlany et al. (2008)
APA 5th edition (2013)
- Sexual dysfunctions include delayed ejaculation, erectile disorder, female orgasmic disorder,
female sexual interest/arousal disorder, genito-pelvic pain/penetration disorder, male
hypoactive sexual desire disorder, premature (early) ejaculation, substance/medication-
induced sexual dysfunction, other specified sexual dysfunction, and unspecified sexual
dysfunction.
- Sexual dysfunctions are a heterogeneous group of disorders that are typically characterized
by disturbance in a person’s ability to respond sexually or to experience sexual pleasure.
- Someone can have multiple sexual dysfunctions at the same time.
- The diagnosis of a sexual dysfunction is not made when the sexual difficulties are due to a
lack of adequate sexual stimulation.
- Someone may have lack of knowledge about the right stimulation, but this is not a
disorder.
- Subtypes are used to appoint the onset of difficulty, this could be useful for identifying the
etiology or determine the right intervention.
- Lifelong: Sexual problem has been present from first sexual experiences.
- Acquired: Sexual disorders that develop after a period of relatively normal sexual
function.
- Generalized: Sexual difficulties that are not limited to certain types of stimulation,
situations, or partners.
- Situational: Sexual difficulties that only occur with certain types of stimulation,
situations, or partners.
- Other factors than the subtypes above must be considered to determine the etiology and/or
treatment and these factors may contribute across individuals:
- Partner factors (partner’s sexual problems, partner’s health status).
- Relationship factors (poor communication, discrepancies in sexual desire).
- Individual vulnerability factors (poor body image, history of sexual or emotional
abuse).
- Psychiatric comorbidity (depression, anxiety) or stressors (job loss, bereavement).
- Cultural or religious factors (inhibitions related to prohibitions against sex, attitudes
towards sexuality).
- Medical factors relevant to prognosis, course, or treatment.
- Aging (the older you get, the less sexual desire).
- Sexual response has a biological underpinning, but it functions in interaction with biological,
sociocultural, and psychological factors.
, 3.5. Eating, Sex and Other Needs
- Etiology of sexual dysfunctions mostly remains unknown, but it is important to
distinguish sexual dysfunctions from sexual problems as a result of medical
problems, substances or medications, or relationship problems.
Delayed ejaculation
DSM-5 diagnostic criteria
A. Either of the following symptoms must be experienced on almost all or all occasions
(approximately 75%-100%) of partnered sexual activity (in identified situational contexts or,
if generalized, in all contexts), and without the individual desiring delay:
1. Marked delay in ejaculation.
2. Marked infrequency or absence of ejaculation.
B. The symptoms of Criterion A have persisted for a minimum duration of approximately 6
months.
C. The symptoms in Criterion A cause clinically significant distress in the individual.
D. The sexual dysfunction is not better explained by a nonsexual mental disorder or as a
consequence of severe relationship distress or other significant stressors and is not
attributable to the effects of a substance/medication or another medical condition.
Specify whether:
Lifelong: The disturbance has been present since the individual became sexually
active.
Acquired: The disturbance began after a period of relatively normal sexual function.
Specify whether:
Generalized: Not limited to certain types of stimulation, situations, or partners.
Situational: Only occurs with certain types of stimulation, situations, or partners.
Specify current severity:
Mild: Evidence of mild distress over the symptoms in Criterion A.
Moderate: Evidence of moderate distress over the symptoms in Criterion A.
Severe: Evidence of severe or extreme distress over the symptoms in Criterion A.
Diagnostic features
- Men report significant distress with ejaculating, but there is no consensus about what the
average ‘right’ time is to ejaculate.
Associated features supporting diagnosis
- Exhaustion or genital discomfort.
- Ceasing efforts.
- Avoidance of sexual activity.
- Partners may feel inattractive, because their partners can’t ejaculate.
- Other factors needing consideration: Partner factors, relationship factors, individual
vulnerability factors, psychiatric comorbidity or stressors, cultural/religious factors, and
medical factors.
Prevalence
- Unclear due to lack of precise definition of this syndrome.
