PSYCHO SEXUAL

DISORDERS
Prepared by: Bella Faith A. Masong, MAN
Definition of Terms
 Sexual identity : male or female ; anatomy and
physiology
 Gender identity : individual’s perception and
understanding of self.
 Gender role: person’s expressions of his/her gender
identity by way of behaviors, attitudes, & emotions
appropriate for the gender.
 Sexual orientation: sexual preference/feelings &
attraction to the male &female.
Human Sexuality
Biological
Psychological
Psychosocial
Normal sexual behavior
It achieves three major functions for
human beings.
1. Procreation (reproduction)
2. Pastime, pleasure
3. Object relation, it is an expression of
relatedness, and preserves bonds
between human beings (families). This
is the most important function.
Brain and Sexual Behavior
The limbic system is directly involved
with elements of sexual functioning. In
all mammals the limbic system is
involved in behavior required for self-
preservation and the preservation of
the species.
Sexual Disorders
The DSM of Mental Disorders
1. Sexual Dysfunctions
2. Paraphilia's
3. Gender identity disorders
 Mental or emotional causes include:
 Depression
 Anxiety
 Traumatic sexual experience, such as abuse or
rape
 Guilty feelings
 Stress
 Negative body image
 SEXUAL
DYSFUNCTION
1. Sexual Dysfunction
A disturbance in the process that
characterize the sexual response
cycle or by pain associated w/
sexual intercourse
The dysfunction causes – disturbed
interpersonal relationships &
marked distress for the individual,
the partner, or both.
 The Human Sexual Responses
Masters & Johnsons 1960’s
 Sexual desire – interest, intention, willingness.
 Excitement/arousal – neurologic & vascular changes;
cognitive & emotional changes
 Orgasms –height of the arousal phase- strong rhythmic
contractions in the pelvis.
 Resolution – sense of general relaxation, well being, &
muscle relaxation.
1. Sexual Dysfunction
A. Sexual Desire disorders
For the diagnosis: both of this
conditions must include
 It causes the person marked
distress or interpersonal
difficulty
 That the disorder is not caused
by another disorder.
Hypoactive Sexual Desire
disorder
 Persistent or recurrent absent or
deficient sexual fantasies and
desire for sexual activity.
 Has sexual interest –
stress/interpersonal difficulties –
sexual desire is lost.
Sexual Aversion Disorder
 Persistent or recurrent extreme
aversion to and avoidance of all
or nearly all genital sexual
contact w/ a sexual partner.
 Anxiety, fear, or disgust – for a
sexual encounter
B. Sexual Arousal Disorders
Female sexual arousal disorder:
 may be accompanied by a sexual
desire/female orgasmic disorder
 Persistent or recurrent
partial/complete failure to attain or
maintain lubrication or swelling
response of sexual excitement
until completion of sexual activity;
Male Erectile Disorder
 Persistent or recurrent partial or complete
failure to attain/maintain erection until
completion of sexual activity or
 Persistent or recurrent lack of subjective
sense of sexual excitement & pleasure
during sexual activity.
 Associated w/ sexual anxiety, fear of
failure, concerns about sexual
performance.
C. Orgasmic Disorders
Female Orgasmic Disorders
 Persistent /recurrent delay in/absence of orgasm following a normal
sexual excitement phase.(Age/adequacy/experience)
Male Orgasmic Disorder
 Persistent /recurrent delay in or in absence of orgasm following a
normal sexual excitement phase, considering the person’s age &
other factors.
Premature Ejaculation
 Persistent /recurrent ejaculation w/ minimal sexual stimulation/or
before on, or shortly after penetration, and before the desires it ( age,
newness partner/situation/ frequency)
Sexual Pain Disorders
Dyspareunia
 Persistent/recurrent genital pain in either male/female

before, during/after sexual intercourse, not caused

solely by lack of lubrication or vaginismus.
Vaginismus
 Persistent/ recurrent involuntary spasm of musculature

of the outer third of the vagina. Which interferes with

coitus.
D. Substance Induced Sexual Dysfunction
Significant sexual dysfunction causing distress &
interference w/ interference w/ interpersonal relationships.
Symptoms of dysfunctions are substance specific
physiologic effects d/t drug abuse, medications or toxic
exposure.
Symptoms:
w/impaired desire w/impaired arousal
w/ impaired orgasm w/ sexual pain
E. Sexual Dysfunction not otherwise Specified
Do not meet criteria for any of the specific sexual
dysfunctions, ff:
 No erotic sensation/even complete anesthesia

 The female analog of premature ejaculation

 Genital pain - masturbation

PARAPHILIAS
2. PARAPHILIAS
Persistent, intense, and recurrent
sexual urges, fantasies, or behaviors
that involve nonliving objects, other
non consenting persons (
children/adults), or humiliation or pain
; occur at least 6 mos.

Pedophilia, exhibitionism, frotteurism

or voyeurism.
TYPES OF PARAPHILIAS
Exhibitionism
 exposure of one’s genitals
to unsuspecting
stranger(s), followed by
sexual arousal.
Fetishism
 use of objects for
purpose sexual
arousal and during
sexual activity.
Frotteurism
 touching or rubbing
against a non
consenting person, to
stimulate sexual
arousal.
Pedophilia
 sexual activity w/ a prepubescent child
/children 13 y/o or below
 at least 16 y/o & at least 5 years older
than the child/ren
 May be homosexual, heterosexual, or
bisexual
 May be limited to incest
 Exclusive type –attracted only to
children
 Non exclusive – attracted also to adults
Sexual Masochism
 the act of being humiliated,
beaten , bound, or
otherwise made to suffer
during sexual activity while
alone (masturbating) or
with others.
Sexual Sadism
 acts in which physical or
psychologic suffering of the
victim is sexually arousing
to the perpetrator.
Transvestic fetishism
 The act of cross dressing by a
heterosexual males
 Does not meet the criteria for
gender identity disorder, non
transexual type; or
transexualism.
Voyeurism
 The act of observing an
unsuspecting person who is
naked, in the act of disrobing,
or engaging in sexual activity
to achieve sexual arousal.
Paraphilias not otherwise specified:
 Telephone scatologia – lewdness; obcene phone calling; sex
line telephoning.

 Necrophilia – sexual activities w/ corpses.

 Partialism – exclusive focus on body part that generates
sexual arousal.
 Zoophilia – sexual activity w/ animals; bestiality.
 Coprophilia – sexual arousal on contact w/ feces
 Klismaphilia – sexual arousal generated by the use of
enemas
 Urophilia – sexual arousal on contact w/ urine
 Ephebophilia – fondling & other types of sexual activities –
dev. Sexual characteristics 13-18y/o
 Paraphilic coercive disorder – rape, aggressive sexual
assault – against female
Gender Identity
Disorder
3. Gender Identity Disorder
Persistent, strong desire to be the
opposite sex or insistence that one is
the opposite sex ( cross-gender
identification disorder)

Persistent discomfort w/ own sex &

feelings of inappropriateness in the
gender role of the assigned sex.
Examples: Nursing Diagnosis
 Sexual dysfunction r/t prenatal wt. gain as
evidence by verbal statements of physical
discomfort with intercourse
 Sexual dysfunction r/t joint pain as evidence by
decreased sexual desire
 Ineffective sexuality pattern r/t financial worries
as evidence by inability to reach orgasm
 Ineffective sexuality pattern r/t mastectomy e/b
statements such as “My husband won’t want to
touch me”
Nursing Intervention
 Interview in private, caring, thoughtful
manner.
 Use : reflection, voice concerns, use
silence, open ended questions, allow time.
 Offer information – if possible
 Use direct questioning
 Identify possible causes
 Suggest alternative activities –
sublimate/substitute
 Sexual education
Thank you!