Gender and Sexual Disorders 515
- Various factors contribute to sexual dysfunctions. Neurological
(and other biological) factors include disease, illness, surgery
or medications, and the normal aging process. - Psychological factors can be divided into three types: predis-
posing factors, such as negative attitudes toward sex, negative
conditioning experiences, and a history of sexual abuse; precipi-
tating factors, such as anxiety about sex and distraction because
of sexual or nonsexual matters; and maintaining factors, such as
worrying about future sexual problems. - Social factors include: the quality of the partners’ relationship
(how stress, confl ict, and communication are handled, and how
attracted the partners are to one another); the partner’s sexual
functioning; a history of abuse; and sexual mores in the individu-
al’s subculture (e.g., religious teachings). - Neurological (and other biological) factors that may contribute
to sexual dysfunctions are assessed through tests of endocrine
and hormone levels and of the functioning of sensory nerves,
internal organs, and the genitals. Psychological factors are
sometimes assessed through personality tests and inventories;
a clinician will also consider possible comorbid disorders and
assess a patient’s thoughts and feelings about sexual activities.
Social factors include the ways that sexual problems interact
with any relationship problems a couple may have. - Treatments that target neurological (and other biological) are
medications for erectile dysfunction and for analogous arousal
problems in women. - Treatments that target psychological factors include psychoed-
ucation, sensate focus exercises, and CBT to counter negative
thoughts, beliefs, and behaviors associated with sexual dys-
function. For certain sexual dysfunctions, specifi c techniques
may be particularly helpful. - Treatments that target social factors address problematic is-
sues in a couple’s relationship as well as teach the couple spe-
cifi c sex-related cognitive or behavioral strategies. - Treatments that focus on one type of factor for a given patient
can create complex feedback loops, which sometimes have un-
expected—and perhaps negative—consequences for the cou-
ple. Successful treatment for a patient might create problems
for the partner.
Making a Diagnosis
- Reread Case 11.7 about Sarah and Benjamin, and deter-
mine whether either of them meet the criteria for any sexual
dysfunction(s). Specifi cally, examine the criteria for each dis-
order and determine whether Sarah or Benjamin’s symptoms
meet each of the criteria for each disorder appropriate to their
sex. If you would like more information to determine their diag-
noses, what information—specifi cally—would you want, and in
what ways would the information infl uence your decision?- Reread Case 11.8 about Crystal, and determine whether her
symptoms meet the criteria for hypoactive sexual desire dis-
order. Specifi cally, list which criteria apply and which do not.
If you would like more information to determine her diagnosis,
what information—specifi cally—would you want, and in what
ways would the information infl uence your decision? - Reread Case 11.9 about the stockbroker, and determine whether
his symptoms meet the criteria for sexual aversion disorder.
Specifi cally, list which criteria apply and which do not. If you
would like more information to determine his diagnosis, what
information—specifi cally—would you want, and in what ways
would the information infl uence your decision? - Reread Case 11.10 about Harry, and determine whether his
symptoms meet the criteria for hypoactive sexual desire dis-
order. Specifi cally, list which criteria apply and which do not.
If you would like more information to determine his diagnosis,
what information—specifi cally—would you want, and in what
ways would the information infl uence your decision? - Reread Case 11.11 about Lola, and determine whether her
symptoms meet the criteria for female orgasmic disorder.
Specifi cally, list which criteria apply and which do not. If you
would like more information to determine her diagnosis, what
information—specifi cally—would you want, and in what ways
would the information infl uence your decision? - Reread Case 11.12 about the man who didn’t generally reach
orgasm during vaginal intercourse, and determine whether
his symptoms meet the criteria for male orgasmic disorder.
Specifi cally, list which criteria apply and which do not. If you
would like more information to determine his diagnosis, what
information—specifi cally—would you want, and in what ways
would the information infl uence your decision? - Reread Case 11.13 about Mr. Albert, and determine whether his
symptoms meet the criteria for premature ejaculation. Specifi -
cally, list which criteria apply and which do not. If you would
like more information to determine his diagnosis, what informa-
tion—specifi cally—would you want, and in what ways would
the information infl uence your decision? - Reread Case 11.14 about Lynn, and determine whether her
symptoms meet the criteria for vaginismus and/or dyspareunia.
Specifi cally, list which criteria of each disorder apply and which
do not. If you would like more information to determine her di-
agnosis, what information—specifi cally—would you want, and
in what ways would the information infl uence your decision?