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Abnormal Psychology (Outline Reviewer)
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(Out lined)
By: Claire Irish D. Borja
Reference: Bar low D, Durand and Hofmann S (2 0 1 8). Abnormal psychology: an int egrat ive appr oach, 8 th ed. New
York: Nelson Educat ion, Lt d.
A bnormal P sych ol ogy
Abnormal Behavior in Historical Context
UNDERSTANDING PSYCHOPATHOLOGY
What is Psychological Disorder? Psychological Disorder It is a psychological dysfunction within an individual that is associated with distress or impairment in functioning and a response that is not typical or culturally expected 1. Psychological Dysfunction - refers to a breakdown in cognitive, emotional, or behavioral functioning. 2. Distress or Impairment 3. Atypical or Not Culturally Expected 4. An accepted definition - describes behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and impairment in functioning, or increased risk of suffering, death, pain, or impairment.
The Science of Psychopathology Psychopathology - is the scientific study of psychological disorders. - Within this field are specially trained professionals, including clinical and counseling psychologists, psychiatrists, psychiatric social workers, and psychiatric nurses, as well as marriage and family therapists and mental health counselors. 1. Scientist-Practitioners - mental health professionals take a scientific approach to their clinical work 2. Clinical Description - represents the unique combination of behaviors, thoughts, and feelings that make up a specific disorder Prognosis anticipated course of disorder 3. Causation, Treatment, and Etiology Outcomes Etiology - study of origins, has to do with why a disorder begins (what causes it) and includes biological, psychological, and social dimensions. Historical Conceptions Supernatural Model - the driving forces behind are these agents, which might be divinities, demons, spirits, or other phenomena such as magnetic fields or the moon or the stars Ancient Greece - the mind has often been called the soul or the psyche and considered separate from the body. (3) Three models:
- the supernatural
- the biological
- the psychological
THE SUPERNATURAL TRADITION
Demons and Witches - last quarter of the 14th century, religious and lay authorities supported these popular superstitions and society as a whole began to believe more strongly in the existence and power of demons and witches. - Catholic Church had split - Roman Church fought back against the evil in the world - magic and sorcery to solve their problems. - Treatments included exorcism
Stress and Melancholy Treatments for Possession - reflected the enlightened view that insanity was a natural phenomenon, caused by mental or emotional stress, and that it was curable - Mental depression and anxiety were recognized as illnesses
Treatments for Possession - A creative therapist decided that han ging people over a pit full of poisonous snakes might scare evil spirits right out of their body
Mass Hysteria - characterized by large-scale outbreaks of bizarre behavior - the phenomenon of emotion contagion, in which the experience of an emotion seems to spread to those around us
Modern Mass Hysteria - problem, others will probably assume that their own reactions have the same source. In popular language, this shared response is sometimes referred to as mob psychology.
The Moon and the Stars - the movements of the moon and stars had
functioning.
Anxiety Disorder
- Apprehension over an anticipated problem
- Comorbid to Bipolar disorder, Substance Abuse, Personality Disorder and also Medical Conditions
Separation Anxiety Disorder - Developmentally inappropriate and excessive fear/anxiety in anticipating or experiencing separation from the individual to whom they are attached. - Applied only under 18 (DSM IV-TR) - Symptoms present for at least 4 weeks in children/adolescents and 6 months or more in adults Selective Mutism - Rare childhood anxiety disorder in which a child unable to speak in certain situation/people - Symptoms for at least 1 month not st month in school
Specific Phobia - Disproportionate fear caused by specific object/situation - At least 6 months - Object/situation is avoided/endured with intense anxiety - Only under age 18 (DSM IV-TR) Generalized Anxiety Disorder - Uncontrollably/persistent worrying about minor things - At least 3 months (6 Months in DSM IV- TR) - With muscle tension - Worry cognitive tendency to chew on a problems unable to let her go of it
Agoraphobia - Anxiety about situations in which it would be embarrassing or difficult to escape if anxiety symptoms occurred - At least 6 months Panic Disorder - Characterized by frequent panic attacks that are unrelated to specific situation and by worrying about having more panic attacks - At least 1 month Social Anxiety Disorder - Persistent, unrealistically intense fear of social situations that might involve being sanitized by exposed to unfamiliar people. - At least 6 months
SOCIOCULTURAL FACTORS - Women twice likely as men - Problems vary from culture to culture TAIJIN KYO-FUSHO Japan (fear of displeasing/ embarrassing others) GENETIC FACTORS - Twin studies heritability suggest 20-40% NEUROBIOLOGICAL FACTORS - Fear circuit involved amygdala (more activity) - Medial prefrontal cortex (less activity) PERSONALITY FACTORS - Behavioral inhibition during infancy - Neuroticism COGNITIVE FACTORS - Sustained negative beliefs about the future - Perceived control - Attention to threat
Obsessive-Compulsive and Related Disorders
Obsessions are intrusive and recurring thoughts images or impulses that are persistent and uncontrollable usually irrational
Compulsions repetitive, clearly excessive behavior or mental acts that the person feels driven to perform to reduce the anxiety caused by obsessive thoughts to prevent some calamity from occurring
Obsessive-compulsive Disorder - Characterized by obsessions or compulsions that are time-consuming (requires 1 hour per day) - Recognize as the product of their mind - Common in women than in men - *chronic - Begins in childhood Body Dysmorphic Disorder - Preoccupied with an imagined, exaggerated defect in their appearance - Has performed repetitive behaviors or mental acts in response to the appearance concerned - Slightly common in women than in men but is very rare Hoarding Disorder - Persistent difficulty discarding or parting with possessions
- Strong urges to save items
- More often to women than in men Excoriation (skin-picking disorder)
results in skin lesions and causes significant
Trichotillomania (hair-pulling disorder) Characterized by compulsive, mild to severe from anywhere on the body; can results in hair loss to ALOPECIA (bald spots on the scalp)
Somatic Symptom and Related Disorder
- An excessive concern about physical symptoms or health that had no known physical cause
Somatic Symptom Disorder - Having a significant focus on physical symptoms (pain, shortness or weakness of breath) resulting to major distress and problem in functioning - Excessive thoughts, feelings or behaviors relating to physical symptoms - At least 1 symptoms - More than 6 months - Usually begins by age of 30 Somatic delusion - Delusion whose content pertains to bodily functioning, bodily sensations or physical appearance. Usually the false belief is that the body is somehow diseased, abnormal or changed. Illness Anxiety Disorder
-
excessively that you are or may seriously ill/ ha ving serious medical condition
At least 6 months
Begins early adulthood
Common in men than women Conversion Disorder (Functional Neurological Disorder)
A psychological condition that causes symptoms that appear to be neurological (paralysis, speech impairment, tremors)
At least 2 sensory or motor impairment symptoms
Caused by psychological reaction to a highly stressful event
Women have higher risk
Incompatibility of evidence between symptoms and recognized medical condition Factitious Disorder
Falsification of psychological/physical symptoms or signs for secondary gain as emotional attention and affection
Persistent or recurrent experiences of unreality of surroundings
Sensation that the word becomes real
Dissociative Fugue (DSM IV-TR) - Memory loss revolves around an unexpected trip - They just take off and find themselves in a new place but unable to remember how they got there
Mood Disorders
DEPRESSIVE DISORDERS cardinal symptoms of depression include profound sadness and/or an inability to experience pleasure 1. Disruptive Mood Dysregulation Disorder - Severe recurrent temper outburst and persistent negative mood
- Atleast 1 year
- Before age 10
- Major Depressive Disorder
- Sad mood or loss of pleasure in usual activities
- At least 5 symptoms
- Nearly every day for at least 2 weeks (episodic) recurring
- With suicidal thoughts
- Persistent depression Disorder (Dysthymia)
- Depressed mood for most of the day
- At least 2 years in adult & 1 year for children and adolescents)
- At least 2 symptoms
- Premenstrual Dysphoric Disorder
- Depressive or physical symptoms in the week before menstruation
- Marked affective lability
- Seasonal Affective Disorder
- Seasonal subtype of Mood
- Winter blues
- Depression during 2 consecutive winters then clears during summers
BIPOLAR DISORDER people experiencing mania and depression during their lifetime Mania- state of intense elation/irritability Hypomania 1. Bipolar I Disorder - - - At least 1 lifetime manic episode
- Bipolar II Disorder
- At least 1 lifetime major depressive episode and one hypomanic episode
- Cyclothymic Disorder
- Frequent mild symptoms of depression alternating with mild symptoms of mania
- At least 2 years (1 year for children and Adolescents)
- *chronic Rapid Cycling experiencing 4 or more episodes of mania/depression in 1 year
NEUROBIOLOGICAL FACTORS
- Genetic heritability among twins
- Neurotransmitters ↓norepinephrine ↓dopamine =DEPRESSION ↑norepinephrine ↑dopamine
=MANIA
↑serotonin = ANTIDEPRESSANT
SOCIAL FACTORS
- Stressful life events
- Interpersonal problems within the families
- Constant reassurance-seeking of care PSYCHOLOGICAL FACTORS
- Neuroticism
- Negative thoughts and beliefs (pessimistic & self-critical thoughts)
- Hopelessness Desirable outcomes will not occur Ni response to change the situation
- Rumination Repeatedly dwell on sad experiences or thoughts To chew on material again and again Tendency to brood/regretfully ponder why an episode happened BIOLOGICAL TREATMENT
- Electro cumulative therapy (ECT)
- Repetitive Transcranial Magnetic Stimulation (rTMS)
- Vagus Nerve Stimulation
Suicide
THREE OTHER IMPORTANT INDICES OF
SUICIDAL BEHAVIOR ARE:
- suicidal ideation (thinking seriously about suicide)
BULIMIA NERVOSA - Out of control eating or binges followed by self-induced vomiting, excessive use of laxatives, or other attempts to purge (get rid of) the food.
ANOREXIA NERVOSA - The person eats only minimal amounts of food or exercises vigorously to offset food intake so body weight sometimes drops dangerously.
BINGE EATING DISORDER - Individuals may binge repeatedly and find it distressing, but they do not attempt to purge the food.
OBESITY - is not considered an official disorder in DSM, but we consider it here because it thought to be one of the most dangerous epidemics confronting public health authorities around the world today. PICA eating of one or more nonnutritive food, nonfood substances on a persistent basis
RUMINATION DISORDER repeated regurgitation of food occurring after feeding or eating (re-chewed, re-swallowed and re-spit out)
AVOIDANT/ RESTRICTIVE FOOD INTAKE
DISORDER avoidance of restriction of food intake manifested by persistent failure to meet appropriate nutritional and/or energy needs associated w/ one or more: 9weight loss, nutritional deficiency, dependence on enteral feeding/ oral nutritional supplements and marked interfere w/ psychosocial functioning
Ego dystonic with stress and anxiety Ego syntonic without stress and anxiety
BULIMIA NERVOSA
-eating a larger amount of food typically more junk food than fruits and vegetables than most people would eat under similar circumstances. -ashamed of both their eating issues and their lack of control Purging techniques- compensate for the binge eating and potential weight gain, almost always. Include self-induced vomiting immediately after eating. Subtypes: 1. Purging type 2. Non purging type Medical Consequences CHRONIC BULIMIA with PURGING
- Salivary gland enlargement caused by repeated vomiting, which gives the face chubby appearance.
- Repeated vomiting also may erode the dental enamel on the inner surface of the front teeth as well as tear the esophagus.
- Continued vomiting may upset the chemical balance of bodily fluids, including sodium and potassium levels. Electrolyte imbalance- results in serious medical complications if unattended. (e. cardiac arrthymia or disrupted heartbeat, seizures and renal/kidney failure
ANOREXIA NERVOSA
-
- Proud of both their diets and their extraordinary control.
- Intense fear of obesity and relentlessly pursue thinness.
*individuals with bulimia have a history of anorexia; that
is, they once used fasting to reduce their body weight
below desirable levels.
Medical Consequences
- Cessation of menstruation
- Medical signs and symptoms:
- Dry skin
- Brittle hair and nail
- Sensitivity to or intolerance of cold temperature.
- Lanugo
- Downy hair on the limbs and cheeks
- Cardiovascular problems
- Electrolyte imbalance
BINGE- EATING DISORDER
- Experience marked distress because of binge eating but do not engage in extreme
compensatory behaviors and therefore cannot be diagnosed with bulimia.
- Found in weigh control programs CAUSES OF EATING DISORDERS A. Social Dimensions For young women: Looking good than being healthy Self-worth, happiness and success are largely determining by BODY measurements and fats.
- Dietary restraint if cultural pressures to be thin are is important as they seem to be in trigger eating disorders, then such disorders would be expected to occur where these pressures are particularly severe (e ballet dancers; under extraordinary pressures to be thin)
- Family influences typical family of someone with anorexia is successful, hard driving, concerned about external appearances and eager to maintain harmony. B. Biological dimensions Genetic component Eating disorders runs in families Hypothalamus and Major n eurotransmitter; norepinephrine, dopamine and serotonin. That passes through it to determine whether something is malfunctioning when eating disorders occur. Low levels of serotonergic activity
- the system most often associated with eating disorders. -associated with impulsivity generally and binge eating disorders Association between ovarian hormones and dysregulated or impulsive eating in women prone to binge episodes.
C. Psychological Dimensions Young women with eating disorder diminished a sense of personal control and confidence in their own abilities and talents. More perfectionist attitude which may reflect attempts to exert control over important events in their lives. Preoccupied with how they appear to others Perceived themselves as frauds, considering false any impressions they make of being adequate, self- sufficient or worthwhile. Feel like impostors in their social group and experienced heightened levels of social anxiety. Women with bulimia judged that their bodies were larger after they ate a candy bar and soft drinks Difficulty tolerating any negative emotion (mood intolerance)
TREATMENT OF EATING DISORDER
A. Drug treatments Not been found effective in the treatment of anorexia nervosa May be useful for people with bulimia, particularly during the bingeing and purging cycle. (same antidepressant medications for anxiety and mood disorders) Prozac B. Psychological treatments BN:
- Short term cognitive behavioral therapy (CBT) to address behavior and attitudes on eating and body shape
- Interpersonal psychotherapy (IPT) to improve interpersonal functioning
- Tends to be chronic if left untreated AN:
- Outpatient treatment to restore weight and correct dysfunctional attitudes on eating and body shape.
- Family therapy
- Tends to be chronic if left untreated more resistant to treatment than bulimia BE:
- Short term CBT to address behavior and attitudes on eating and body shape.
- IPT to improve interpersonal functioning
- Self-help approaches
- Prevent Eating Disorders: Healthy Weight
OBESITY
- not formally considered as eating disorder in DSM
- increases risk of cardiovascular disease, diabetes,
hypertension, stroke and other physical problems.
Night eating syndrome
- Consume a third or more of their daily intake after their evening meal and get out of bed at least once during the night to have a high calories snack.
- In the morning, they are not hungry and do not usually eat breakfast.
CAUSE
Psychological Influences - Affects impulse control, attitudes and motivation towards eating and responsiveness to the consequences of eating Social Influences - Advancing technology promotes sedentary lifestyle and consumption of high fat foods. Biological Influences
brain wave activity (by EEG) eye movements (by electrooculagram) muscle movements (by electromyogram) heart activity (by electrocardiogram) Actigraph records the number of arm movements and the data can be downloaded into a computer to determine the length and quality of sleep. Sleep efficiency the percentage of time actually spent asleep. 100%: you fall asleep as soon as your head hits the pillow and do not wake up during the night. 50%: half of your time in bed is spent trying to sleep- you are half the time awake.
INSOMIA DISORDER:
- most common sleep wake disorder
- micro sleeps
- Fatal Insomnia: total lack of sleep eventually leads to death
- night (difficulty iniating sleep), if they wake up
sleep reasonable number of hours but still not rested the next day (NONRESTORATIVE SLEEP)
Primary Insomnia- sleep problems were not related to other medical or psychiatric problems.
CAUSE
Problems with the biological clock and its control of temperature. Delayed temperature rhythm: 1. 2. Drowsy until later at night People with Insomnia seems to have higher body temperature than good sleepers Drug use Environmental influences: light, noise and temperature
Sleep apnea - a disorder that involves obstructed nighttime breathing
Periodic limb movement disorder- excessive leg movements Family history of insomnia, narcolepsy or obstructed breathing. (Predispotioning Conditions)
Light sleeper- easily aroused at night
Sleep Stress- includes a number of events that can negatively affect sleep Rebound Insomnia- sleep problems reappear sometimes worst- may occur when the medication is withdrawn.
HYPERSOMNOLENCE DISORDER
- people who sleep all night find themselves falling asleep several times the next day.
- excessive sleepiness NARCOLEPSY
- experience cataplexy, a sudden loss of muscle tone. Cataplexy
- person is awake and can range from slight weakness in the facial muscles to complete physical collage
- preceded by strong emotion such as anger or happiness.
Two characteristics: 1. Sleep Paralysis brief period after awakening
frightening to those who go through. 2. Hyponagogic hallucinations vivid and often terrifying experiences that begin at the start of sleep and are said to be unbelievably realistic because they include not only visual aspects but also sensation of body movements.
Isolated sleep paralysis sleep paralysis commonly occurs with anxiety disorders.
BREATH-RELATED SLEEP DISORDERS - People whose breathing is interrupted during their sleep often experience numerous brief arousals throughout the nights and do not feel rested even after 8 or 9 hours. Hypoventilation breathing is constricted a great deal and may be labored - Signs: o loud snoring o heavy sweating during the night o morning headaches o sleep attacks
- Three types of Apnea
- OBSTRUCTURE SLEEP APNEA HYPOPNEA SYNDROME airflows stop continued activity by the respiratory system
snoring at night obesity used of MDMA (ecstasy) young and healthy adults (mostly male)
CIRCADIAN RHYTHM SLEEP DISORDERS
- Disturbed sleep (either insomnia or excessive
inability to synchronize its sleep patterns with the current patterns of day and night. Suprachiasmatic nucleus
- Our biological clock (hypothalamus)
- connected to it is a pathway that comes from our eyes
Types of Circadian Rhythm 1. Jet lag type caused by rapidly crossing multiple time-zones 2. Shift work type sleep associated with work schedules 3. Delayed sleep phase type sleep is delayed or there is a later than normal bedtime 4. Advanced sleep phase type early to bed early to rise 5. Irregular sleep wake type people who experience highly varied sleep cycles 6. Non- 24 hour sleep- wake type sleeping on a 25 -26 hour cycle with later and later bedtime ultimately going throughout the day.
TREATMENT OF SLEEP DISORDER
- Medical Treatment Insomnia: Benzodiazepine - can cause excessive sleep Medications: o triazolam (halcion) o zaleplon (sonata) o zolpidem (ambien) Long acting drug: flurazepam (dalmane) Short acting drug: Cause only brief drowsiness Drawbacks:
Benzodiazepines can cause excessive sleepiness
People can easily become dependent on them and rather easily misuse them
Meant for short-term treatment and are not recommended for use longer than 4 weeks.
Longer use may cause dependence and rebound insomnia.
Increase the likelihood of sleepwalking related problems
Not intended for long term chronic problems. Hypersomnolence or Narcolepsy
Methylphenidate
Modafinil Cataplexy
Antidepressant medication, suppress REM (dream) sleep Breathing- related sleeping disorder
Recommending weight loss Obstructive Sleep apnea
Mechanical device called CPAP or Continuous Positive Air Pressure Machine
- Environmental Treatments
- General principles in treating Circadian rhythm disorder Phase Delays (moving bedtime later) Phase advances (moving bedtime earlier)
- Light Therapy (using bright light to trick the brain into readjusting the biological clock)
- Psychological Treatment
- Relaxation treatment: reduce physical tension that seems to prevent some people from falling asleep at night.
- Cognitive Treatment: Focus on worries about sleep. a) Guided Imagery Relaxation Uses medication or imagery to help with relaxation at bedtime or after a night waking b) Graduated Extinction
- Instruct the parents of the child who has tantrums to check the progressively longer period until the child falls asleep on his or her own.
- Paradoxial Intention
- Instructing individuals in the opposite behavior from the desired outcome.
- Progressive Relaxation
- Relaxing muscles of the body in an effort to introduce drowsiness Sleep Hygiene changes in lifestyle can be relatively simple to follow and can help avoid problems such as insomnia for some people.
PARASOMNIAS
- Not problems with sleep itself but abnormal events that occur during sleep or during that twilight time between sleeping and waking.
Four Phases of sexual response cycle 1. Desire Phase refers to sexual interest/desire associated with arousing fantasies or thoughts 2. Excitement Phase experience of pleasure and increase blood flow to the genitalia 3. Orgasm phase sexual pleasure peaks in ways occurring a general muscle tension 4. Resolution phase relaxation and sense of well- being followed an orgasm
Types of Sexual Dysfunction Male Hypoactive Sexual Desire Disorder A. Persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity. The judgment of deficiency is made by the clinician, taking into account factors that affect sexual functioning, such as age and general and . Female Sexual Interest/Arousal Disorder A. Lack of, or significantly reduced, sexual interest/arousal, as manifested by at least three of the following:
- Absent/reduced interest in sexual activity.
- Absent/reduced sexual/erotic thoughts or fantasies.
- No/reduced initiation of sexual activity, and
initiate. 4. Absent/reduced sexual excitement/pleasure during sexual activity in almost all or all (approximately 75%-100%) sexual encounters (in identified situational contexts or, if generalized, in all contexts). 5. Absent/reduced sexual interest/arousal in response to any internal or external sexual/ erotic cues (e., written, verbal, visual). 6. Absent/reduced genital or nongenital sensations during sexual activity in almost all or all (approximately 75%-100%) sexual encounters (in identified situational contexts or, if generalized, in all contexts).
Erectile Disorder A. At least one of the three following symptoms must be experienced on almost all or all (approximately 75%-100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts): 1. Marked difficulty in obtaining an erection during sexual activity. 2. Marked difficulty in maintaining an erection until the completion of sexual activity. 3. Marked decrease in erectile rigidity. Female sexual interest/arousal disorder recurring inability to maintain adequate lubrication Female Orgasmic Disorder A. Presence of either of the following symptoms and experienced on almost all or all (approximately 75%-100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts): 1. Marked delay in, marked infrequency of, or absence of orgasm. 2. Markedly reduced intensity of orgasmic sensations. Premature (Early) Ejaculation A. A persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately 1 minute following vaginal penetration and before the individual wishes it. (approximately 75%-100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts). Delayed Ejaculation 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.
Sexual Pain Disorder Genito-Pelvic pain/Penetration Disorder - marked pain, anxiety, and tension associated with intercourse for which there is no medical cause Vaginismus muscle spasm in the front of the vagina that prevent the intercourse
- pelvic muscles in the outer third of the vagina undergo involuntary spasm s when intercourse is attempted
.
Assessing Sexual Behavior 1. Interview- supported by numerous questionnaire because patients may provide more information on paper than in verbal interview 2. Thorough medical evaluation- to rule out variety of medical conditions that can contribute to sexual problems 3. Psychophysiological assessment- to directly measure the physiological aspects of sexual arousal. Vaginal photoplethysmograph- smaller than a tampon, inserted by the woman into her vagina. Causes: Biological predisposition and psychological factors a. Neurological and other NS problems b. Vascular Disease c. Chronic illness d. Prescription medication e. Drug abuse, and alcohol f. Distraction g. Underestimates arousal h. Negative thought processes i. Erotophobia sexuality can be negative and somewhat threatening and the responses they develop reflect this belief j. Negative experiences, such as rape k. Deterioration of relationship
Treatment: 1. Education- ignorance of the most basic aspects of the sexual response cycle and intercourse often leads to long lasting dysfunction 2. Psychosocial treatments: SEX THERAPY providing a brief, and reasonably successful therapeutic program for sexual dysfunction. - Conducted over a 2-weeks period - Primary goal is to elim inate psychologically based performance 3. Sensate and nondemand pleasuring-couples are instructed to refrain from intercourse or genital caressing and simply explore and enjoy each
massaging or similar kinds of behavior. 4. Squeeze technique- penis is stimulating usually by the partner, to nearly full erection. Partners firmly squeeze the penis near the top where the head of penis joins the shaft, which quickly reduces arousal. Steps are repeated until eventually penis is briefly inserted in the vagina without thrusting.
- Explicit training in masturbatory procedure- Lifelong female orgasmic disorder
- To treat vaginismus and pain related to penetration in genital pelvic pain/ penetration disorder, the woman and eventually the partner gradually insert increasingly larger dilators at the
carried out in the context of genital and nongenital pleasuring so as to retain arousal. 7. MEDICAL: b. Viagra, Levitra and Cialis c. Four most popular procedures: A. Oral medication, B. Injection of vasoactive substances directly into the penis, C. surgery and D. Vacuum device therapy 8. Testosterone- treat erect dysfunction 9. Papaverine or prostaglandin- vasodilating drugs that inject directly into the penis when they want to have sexual intercourse. 10. Medical Urethral System for Erection (MUSE) a soft capsule that contains papaverine inserted directly into the urethra, somewhat painful, is less effective than injections and remain awkward and artificial enough to preclude wide acceptance 11. Penile Protheses- implants, good enough to approximate normal sexual functioning. 12. Vacuum Device Therapy- creating a vacuum in a cylinder and placed over the penis it draws blood into the penos, which is then trapped by a specially designed ring placed around the base of the penis.
Abnormal Psychology (Outline Reviewer)
Course: BS in Psychology
University: University of Makati
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