Title: Sexual Deviations and Dysfunctions
Course: Question bank check

Q: Animal research suggests that which structures are especially important for sexual motivation?
- endocrine system structures such as the hypothalamus and the thyroid (Incorrect. Given the hypothalamus’s role in endocrine function, it is not surprising that hormones secreted by the endocrine system also play important roles in sexual motivation and behavior. For example, many animals show no sign of sexual motivation in the absence of the appropriate combination of sex hormones from their gonads. While this is not the case for humans, there is considerable evidence that sexual motivation for both men and women varies as a function of circulating testosterone levels.)
- limbic system structures such as the amygdala and hippocampus (Incorrect. The hippocampus plays an important role in memory consolidation, but not sexual motivation. It has increased the functional connectivity with anterior cingulate or amygdala during emotional regulation and recalling of positive memory.)
- Limbic system structures such as the thalamus and hypothalamus. (Incorrect. While the thalamus has significant roles in motor activity, emotion, memory, arousal, and other sensorimotor association functions, the thalamus has generally been regarded as a group of relay nuclei that serve as a gate for sexual information from the spinal cord towards higher centers.)
- limbic system structures such as the amygdala and nucleus accumbens (Animal research suggests that limbic system structures such as the amygdala and nucleus accumbens are especially important for sexual motivation. Damage to these areas results in a decreased motivation to engage in sexual behavior, while leaving the ability to do so intact.)
A: limbic system structures such as the amygdala and nucleus accumbens

Q: Which of the following statements is true about sexual function/dysfunction?
- Sexual excitement continues to build even during the resolution phase. (Incorrect. Resolution is the relatively rapid return to an unaroused state accompanied by a decrease in blood pressure and muscular relaxation.)
- Damage to the hypothalamus results in an increased motivation to engage in sexual behavior. (Incorrect. Lesions to an area of the hypothalamus, called the medial preoptic area, completely disrupt a male rat’s ability to engage in sexual behavior.)
- Sexual dysfunctions are associated with all phases of the human sexual response. (Incorrect. Sexual dysfunctions are associated with the arousal and orgasm phases.)
- Masters and Johnson identified four phases of the sexual response: cycle-excitement, plateau, orgasm, and resolution. (Correct! Masters and Johnson divided the human sexual response cycle into four phases that are fairly similar in men and women: excitement, plateau, orgasm, and resolution. These stages are important for understanding the sexual dysfunctions because most of the dysfunctions are associated with the arousal and orgasm phases.)
A: Masters and Johnson identified four phases of the sexual response: cycle-excitement, plateau, orgasm, and resolution.

Q: Although human sexual behavior is much more complex than that seen in rats, what are some parallels between animals and humans that can be drawn from research in the field of sexual motivation and behavior?
- Dissociations of sexual motivation and sexual ability have never been observed in females. (Incorrect. Dissociations of sexual motivation and sexual ability have also been observed in the female rat.)
- The hypothalamus plays an important role in motivated behaviors for humans and animals, but sex is the exception. (Incorrect. The hypothalamus plays an important role in motivated behaviors, and sex is no exception.)
- Contrary to animals, sexual motivation for both men and women does not vary as a function of circulating sex hormone levels. (Incorrect. Sexual motivation for both men and women varies as a function of circulating testosterone levels.)
- Sexual motivation and the ability to engage in sexual behavior can also be dissociated in humans. (Correct! The medial preoptic area, an area of the hypothalamus, is involved in the ability to engage in sexual behavior, but it does not affect sexual motivation. In contrast, the amygdala and nucleus accumbens are involved in motivation for sexual behavior, but they do not affect the ability to engage in it.)
A: Sexual motivation and the ability to engage in sexual behavior can also be dissociated in humans.

Q: Which disorder is characterized by a discrepancy between an individual's biological sex and his or her gender identity?
- homosexuality (Incorrect. As a sexual orientation, homosexuality is “an enduring pattern of emotional, romantic, and/or sexual attractions” to people of the same sex.)
- transsexualism (Incorrect. Transgender people who attempt to alter their bodies through medical interventions such as surgery and hormonal therapy are called transsexual individuals.)
- gender identity disorder (Incorrect. Gender dysphoria (GD) is the distress a person feels due to a mismatch between their gender identity and their biological sex. The diagnostic label gender identity disorder (GID) was used until 2013 with the release of the DSM-5. The condition was renamed to remove the stigma associated with the term disorder.)
- gender dysphoria (Correct! Gender dysphoria (GD) is the distress a person feels due to a mismatch between their gender identity and their biological sex.)
A: gender dysphoria

Q: A person’s sense of their own gender, or sociocultural classification (i.e., man, woman, or another gender) based on biological sex (i.e., male, female, or intersex) is referred to as
- gender dysphoria. (Incorrect. Gender dysphoria is the distress a person feels due to a mismatch between their gender identity and their biological sex.)
- sexual orientation. (Incorrect. Sexual orientation is an enduring pattern of romantic or sexual attraction (or a combination of these) to persons of the opposite sex or gender, the same sex or gender, or to either sexes or more than one gender.)
- gender expression. (Incorrect. Gender expression, or how one demonstrates gender (based on traditional gender role norms related to clothing, behavior, and interactions) can be feminine, masculine, androgynous, or somewhere along a spectrum.)
- gender identity. (Correct! Gender identity is a person’s sense of their own gender, or sociocultural classification (i.e., man, woman, or another gender) based on biological sex (i.e., male, female or intersex).)
A: gender identity.

Q: An enduring pattern of romantic or sexual attraction (or a combination of these) to persons of the opposite sex or gender, the same sex or gender, or to both sexes or more than one gender is called
- gender identity. (Incorrect. Gender identity is a person’s sense of their own gender, or sociocultural classification (i.e., man, woman, or another gender), based on biological sex (i.e., male, female, or intersex).)
- homosexuality. (Incorrect. However, as a sexual orientation, homosexuality is “an enduring pattern of emotional, romantic, and/or sexual attractions” to people of the same sex. Other attractions are generally subsumed under heterosexuality, bisexuality, and asexuality.)
- pansexuality. (Incorrect. Pansexuality, or bisexuality, is defined as romantic or sexual attraction to people of any sex or gender identity.)
- sexual orientation. (Correct! These attractions are generally subsumed under heterosexuality, homosexuality, and bisexuality, while asexuality (the lack of sexual attraction to others) is sometimes identified as the fourth category.))
A: sexual orientation.

Q: When children have preferences for opposite sex-typical toys, games, or activities; great dislike of their own genitalia; and a strong preference for playmates of opposite sex, these may be symptoms of
- gender identity crisis. (In 2013, the term gender dysphoria was renamed from gender identity disorder after criticisms that the latter term was stigmatizing. If you look up gender identity crisis, you will be directed to gender dysphoria.)
- gender fluidity. (Incorrect. However, many people who are diagnosed with gender dysphoria identify as genderfluid, a gender that varies over time.)
- gender non-conformity. (Incorrect. Gender non-conforming refers to anyone whose appearance and behavior does not reflect the gender roles expected of them. Not everyone who identifies gender non-conforming experiences gender dysphoria.)
- gender dysphoria. (Correct! Symptoms of GD in children include preferences for opposite sex-typical toys, games, or activities; great dislike of their own genitalia; and a strong preference for playmates of opposite sex. Some children may also experience social isolation from their peers, anxiety, loneliness, and depression.)
A: gender dysphoria.

Q: Samantha is a 15-year-old high school student who has an expressed desire for others to treat or perceive her as a boy; she is uncomfortable with her genitals and wishes she had a penis. It has only been six months since she has had a strong sense of being male despite how feminine others perceive her. Samantha may be diagnosed as having
- gender distress. (Incorrect. Distress associated with feeling that a person has the wrong gender is known as gender dysphoria.)
- transvestic disorder. (Incorrect. Unlike in gender dysphoria, individuals with transvestic disorder do not typically report a desire to be the opposite gender; they also typically do not have a history of cross-gender behavior, only cross-dressing. Symptoms can coexist though, as can the two disorders.)
- sexual dysfunction. (Incorrect. Sexual dysfunction is a problem that can happen during any phase of the sexual response cycle. It prevents you from experiencing satisfaction from sexual activity. The sexual response cycle traditionally includes excitement, plateau, orgasm, and resolution.)
- gender dysphoria. (Correct! Children and adults are typically diagnosed with gender dysphoria if they have experienced significant distress for at least six months and at least six of the following: expressed desire for others to treat or perceive them as another gender, discomfort with their genitals or sex characteristics, wishing these genitals or sex characteristics were different or aligned with another gender, and/or a strong sense of being another gender despite how others perceive them.)
A: gender dysphoria.

Q: Research has shown a higher prevalence of gender dysphoria in monozygotic twins than dizygotic twins. As a result of this research, GD has also been identified as being associated with
- psychosocial factors. (Incorrect. The etiology of gender dysphoria (GD) remains unclear, but it is thought to originate from a complex biopsychosocial link, as heritability and familiality of GD have been identified.)
- cultural factors. (Incorrect. The etiology of gender dysphoria (GD) remains unclear, but it is thought to originate from a complex biopsychosocial link, as heritability and familiality of GD have been identified.)
- environmental factors. (Incorrect. The etiology of gender dysphoria (GD) remains unclear, but it is thought to originate from a complex biopsychosocial link, as heritability and familiality of GD have been identified.)
- genetic factors. (Correct! A genetic association is identified as one of the causes of GD. Heritability and familiality of GD have also been identified: for instance, there is higher prevalence in monozygotic twins than dizygotic twins. The etiology of gender dysphoria (GD) remains unclear, but it is thought to originate from a complex biopsychosocial link.)
A: genetic factors.

Q: The theory that suggests that, up to a certain age, gender identity is relatively fluid and subject to constant negotiation, is called the
- gender performativity theory. (Incorrect. The concept of gender performativity argues that both sex and gender are constructed.)
- theory of psychosexual development. (Incorrect. The theory of psychosexual development gives evidence that in the pregenital phase children do not distinguish between sexes, but assume both parents have the same genitalia and reproductive powers.)
- oedipus complex. (Incorrect. Oedipus complex where they had sexual fantasies for the parent ascribed the opposite gender and hatred for the parent ascribed the same gender, and this hatred transformed into (unconscious) transference and (conscious) identification with the hated parent who both exemplified a model to appease sexual impulses and threatened to castrate the child’s power to appease sexual impulses.)
- interactionist theory of gender identity. (Correct! The interactionist theory of gender identity suggests that, up to a certain age, gender identity is relatively fluid and subject to constant negotiation.)
A: interactionist theory of gender identity.

Q: What were the main ideas of Freud in regards to gender identity achievement?
- Struggles with gender identity developed from biological gender variances, influences on gender variances, and early social experiences that may create lasting epigenetic changes related to sex differences. (Incorrect. These ideas do not come from Freud. As you have read, in the past, gender identity development was mostly viewed through a cognitive and behaviorist lens—arguing that struggles with gender identity developed from the environment or cognitive schemas. More recent research has been done to understand biological and influences on gender variances and how early social experiences may create lasting epigenetic changes related to sex differences.)
- Gender dysphoria exists when a person suffers discontent due to gender identity, causing them emotional distress. (Incorrect. This is true, but these were not the main ideas of Sigmund Freud, who presented his theory of psychosexual development in Three Essays on the Theory of Sexuality, giving evidence that in the pregenital phase children do not distinguish between sexes, but assume both parents have the same genitalia and reproductive powers.)
- Up to a certain age, gender identity is relatively fluid and subject to constant negotiation. (Incorrect. Behavioral psychologist John Money was instrumental in the development of early theories of gender identity. His work at Johns Hopkins Medical School’s Gender Identity Clinic (established in 1965) popularized an interactionist theory of gender identity, suggesting that, up to a certain age, gender identity is relatively fluid and subject to constant negotiation.)
- Heterosexuality results from repression of bisexuality, the original sexual orientation, during the phallic stage of psychosexual development, after which gender identity becomes possible. (Correct! In 1905, Sigmund Freud presented his theory of psychosexual development in Three Essays on the Theory of Sexuality, giving evidence that in the pregenital phase children do not distinguish between sexes, but assume both parents have the same genitalia and reproductive powers. On this basis, he argued that bisexuality was the original sexual orientation and that heterosexuality was resultant of repression during the phallic stage, at which point gender identity became ascertainable.)
A: Heterosexuality results from repression of bisexuality, the original sexual orientation, during the phallic stage of psychosexual development, after which gender identity becomes possible.

Q: Present-day research into genetic variation, hormones, and differences in brain functioning and brain structures suggests evidence for what kinds of etiological factors associated with gender dysphoria?
- environmental (Incorrect. However, other studies have shown that children's upbringing and social environments also impact their developing gender identities.)
- psychosocial (Incorrect. Psychosocial factors are influences that affect a person psychologically or socially.)
- cultural (Incorrect. Culture encompasses the set of beliefs, moral values, traditions, language, and laws (or rules of behavior) held in common by a nation, a community, or other defined group of people. However, culturally determined characteristics do include acceptable gender roles.)
- biological (Research into genetic variation, hormones, and differences in brain functioning and brain structures suggest evidence for the biological etiology of the symptoms associated with gender dysphoria. Much of this research is preliminary and still controversial.)
A: biological

Q: What is the form of therapy considered as abusive and dangerous, and involves the pseudoscientific practice of trying to change an individual’s sexual orientation from homosexual or bisexual to heterosexual using psychological, physical, or spiritual interventions?
- behavioral modification (Incorrect. Before the American Psychiatric Association's 1973 decision to remove homosexuality from the DSM, practitioners of conversion therapy employed behavioral modification techniques such as aversive conditioning techniques, involving electric shock and nausea-inducing drugs during the presentation of same-sex erotic images. Cessation of the aversive stimuli was typically accompanied by the presentation of opposite-sex erotic images, with the objective of strengthening heterosexual feelings.)
- aversion therapy (Incorrect. Techniques used in conversion therapy have included aversive treatments, such as the application of electric shock to the hands and/or genitals and nausea-inducing drugs administered simultaneously with the presentation of homoerotic stimuli.)
- reparative therapy. (Incorrect. The term reparative therapy has been used as a synonym for conversion therapy generally, but refers to a specific kind of therapy associated with the psychologists Elizabeth Moberly and Joseph Nicolosi. The term reparative refers to Nicolosi's postulate that same-sex attraction is a person's unconscious attempt to self-repair feelings of inferiority.)
- conversion therapy (Correct! Conversion therapy is the pseudoscientific practice of trying to change an individual's sexual orientation from homosexual or bisexual to heterosexual using psychological, physical, or spiritual interventions. There is no reliable evidence that sexual orientation can be changed and medical institutions warn that conversion therapy practices are ineffective and potentially harmful.)
A: conversion therapy

Q: Gender confirmation surgery (or sexual reassignment surgery) refers to
- any form of surgery performed to improve the patient's quality of life. (Incorrect. This refers to reconstructive surgery in general.)
- any form of surgery performed to restore to a normal appearance of "abnormal" or "malformed" body parts caused by a condition. (Incorrect. This refers to reconstructive surgery in general.)
- any surgical procedure that results in the construction or reconstruction of the vagina. (Incorrect. Vaginoplasty is any surgical procedure that results in the construction or reconstruction of the vagina.)
- any form of surgical procedure performed on a transgender person in order to change their sex characteristics to better reflect their gender identity. (Correct! Gender confirmation surgery (or sexual reassignment surgery) refers to any form of surgical procedure performed on a transgender person in order to change their sex characteristics to better reflect their gender identity.)
A: any form of surgical procedure performed on a transgender person in order to change their sex characteristics to better reflect their gender identity.

Q: What is the aim of psychotherapy in the treatment of individuals with gender dysphoria?
- to alleviate GD by changing the patient’s gender identity to reflect birth characteristics (Incorrect. Until the 1970s, psychotherapy was the primary treatment for gender dysphoria and generally was directed to helping the person adjust to the gender of the physical characteristics present at birth. Attempts to alleviate GD by changing the patient’s gender identity to reflect birth characteristics have been ineffective.)
- to produce functional sex organs from sex organs that are already present in the patient (Incorrect. This describes transition surgeries.)
- to change an individual’s sexual orientation from homosexual or bisexual to heterosexual using psychological, physical, or spiritual interventions (Incorrect. This describes the goal of conversion therapy, a therapy considered ineffective and potentially harmful.)
- helping the patient to adapt or to support the individual’s preferred gender through hormone therapy, gender expression and role, or surgery (Correct! Psychotherapy is any therapeutic interaction that aims to treat a psychological problem. This may include psychological counseling, resulting in lifestyle changes, or physical changes, resulting from medical interventions such as hormonal treatment, genital surgery, electrolysis or laser hair removal, chest/breast surgery, or other reconstructive surgeries. Psychotherapeutic treatment of GD involves helping the patient to adapt.)
A: helping the patient to adapt or to support the individual’s preferred gender through hormone therapy, gender expression and role, or surgery

Q: Christine often wondered what intercourse and orgasm would feel like. She realized that she was probably missing something because her friends always described the experience as “mind blowing.” In fact, she never could experience orgasm when she was with a man in any kind of sexual activity. She could feel sensual pleasure, but her response to her partners always stopped just short of climax. She is embarrassed to seek professional help, despite her ongoing distress. Which of the following sexual dysfunctions is Christine experiencing?
- hypoactive sexual desire disorder (Incorrect. Hypoactive sexual desire disorder (HSDD) in men and women is a sexual dysfunction and is characterized as a lack or absence of sexual fantasies and desire for sexual activity, as judged by a clinician.)
- vulvodynia (Incorrect. vulvodynia is chronic pain in the vulva, the area on the outside of a woman’s genitals. It is usually described as a sensation of burning, stinging, itching or rawness.)
- female sexual interest/arousal disorder (FSIAD) (Incorrect. female sexual interest/arousal disorder (FSIAD) is characterized by persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity.)
- female orgasmic disorder (Correct! Female orgasmic disorder represents a type of sexual dysfunction in which a person cannot achieve orgasm despite adequate stimulation.)
A: female orgasmic disorder

Q: Rob is a 30-year-old banker who has struggled with being unable to control his orgasms. He customarily ejaculates seconds after penetration. Because of this problem, his relationships over the years have been strained and difficult. Which of the following sexual dysfunctions is Rob experiencing?
- anorgasmia (Incorrect. Anorgasmia is a type of sexual dysfunction in which a person cannot achieve orgasm despite adequate stimulation.)
- male erectile disorder (Incorrect. Men with erectile disorder cannot attain or maintain an erection during sexual activity that is sufficient to allow them to initiate or maintain sexual activity.)
- dyspareunia (Incorrect. Dyspareunia is painful sexual intercourse due to medical or psychological causes.)
- premature (early) ejaculation (Correct! Premature ejaculation (PE) is a prevalent sexual dysfunction in men characterized as a persistent and undesirable premature ejaculation that occurs around one minute or less of vaginal penetration, and must be experienced in almost all or all (75–100%) occasions during partnered sexual activity.)
A: premature (early) ejaculation

Q: Tammy is a school teacher and has two young children. She often says that she has “no time or energy” for sex with her husband, who pressures her for intimacy. Tammy loves her husband, but she does not think about sex and has not wanted to be sexual since the birth of her second child. Although she is sad about the change this has had on her marriage, she feels no motivation to have sexual intimacy. Which of the following sexual dysfunctions is Tammy experiencing?
- anorgasmia (Incorrect. Although, anorgasmia is one of the most common sexual problems in women, the symptoms associated with the disorder are most often the marked infrequency/absence of experiencing orgasm or delayed orgasm, heightened frustration and inhibition of sexual desire, fear of failure, prejudices, and avoidance of sexual contact for various reasons.)
- female orgasm disorder (Incorrect. Female orgasm disorder represents a type of sexual dysfunction in which a person cannot achieve orgasm despite adequate stimulation. Anorgasmia is also found in men, but not as often as in women.)
- genito-pelvic pain/penetration disorder (Incorrect. Genito-pelvic pain/penetration disorder (GPPPD) is a combination of painful sex (dyspareunia) and involuntary vaginal muscle spasms (vaginismus).)
- female sexual interest/arousal disorder (Correct! Female sexual interest/arousal disorder is defined as a “lack of, or significantly reduced, sexual interest/arousal,” manifesting as no or little interest in sexual activity, no or few sexual thoughts, and no or few attempts to initiate sexual activity or respond to partner’s initiation.)
A: female sexual interest/arousal disorder

Q: Viagra is an appealing pharmacological treatment option for individuals with erectile problems because
- it is safe for individuals taking certain heart medications to use. (Incorrect. A person should only take Viagra if it's been prescribed to them by a doctor who knows their medical history.)
- it is the most valid treatment for men with sexual problems and pelvic pain. (Incorrect. Pelvic floor physical therapy has been shown to be a valid treatment for men with sexual problems and pelvic pain.)
- it has been used to treat problems with body image. (Incorrect. Sensate focus therapy has been used to treat problems with body image, erectile dysfunction, orgasm disorders, and lack of sexual arousal.)
- it provides an easy, safe, and effective treatment solution for approximately 60% of men. (Correct! Several oral medications like Viagra, Cialis, and Levitra have become available to help people with erectile dysfunction and have become first-line therapy. These medications provide an easy, safe, and effective treatment solution for approximately 60% of men.)
A: it provides an easy, safe, and effective treatment solution for approximately 60% of men.

Q: As a part of sex therapy, one type of behavioral therapy techniques developed by Masters and Johnson focus on
- improving physiological functioning through medication. (Incorrect. In behavior therapy, the focus is not on medications.)
- uncovering unconscious conflicts that interfere with sexual performance. (Incorrect. Uncovering unconscious conflicts is a focus of the psychodynamic perspective.)
- helping couples to come to relax or to overcome negative preconceived notions about sex. (Incorrect. While this would be helpful, this is not the focus of a behavioral therapy.)
- talk therapy with a couple making behavioral changes together, which they work on as homework assignments following a therapy session. (Correct! Generally, several types of psychotherapies may be used in sex therapy, including psychodynamic, rational emotive therapy, CBT, or behavioral therapies such as systematic desensitization, and Masters and Johnson’s behavioral therapy techniques, which focus on talk therapy with a couple making behavioral changes together (which they work on as homework assignments following a therapy session).)
A: talk therapy with a couple making behavioral changes together, which they work on as homework assignments following a therapy session.

Q: Sensate focus is a sex therapy technique that works by
- helping clients focus on their partner instead of their own experiences. (Incorrect. This is not a primary goal of a sensate focus.)
- helping a person understand how their beliefs influence their sexual experience and they can be modified. (Incorrect. This describes CST.)
- helping participants to be more flexible in their sexual roles and scripts. (Incorrect. The focus of CST interventions is to aid patients and partners towards the development of more flexible and adaptable sexual cognitions and behavioral patterns.)
- refocusing the participants on their own sensory perceptions and sensuality instead of orgasm or penetrative sex. (Correct! Sensate focus is a sex therapy technique introduced by the Masters and Johnson team. It works by refocusing the participants on their own sensory perceptions and sensuality, instead of goal-oriented behavior focused on the genitals and penetrative sex.)
A: refocusing the participants on their own sensory perceptions and sensuality instead of orgasm or penetrative sex.

Q: Ethan has been having recurrent desires to wear his wife’s clothes. The thought was very distressing to him, but kept coming to his mind again and again. One day when his wife left for work, he closed all the blinds in the house, wore a complete set of her clothes and masturbated in it. Ethan now keeps a small wardrobe of women's underwear, stockings, high heels, makeup, a wig, and dresses. He has been wearing the clothes secretly for the past two years solely for the purpose of pleasure. While at work, he thinks about his secret wardrobe frequently during the day, which causes him to become sexually excited. Eventually, he started wearing women's underwear under his work clothes and sneaking off to the men's room to masturbate. This is an example of
- pedophilic disorder. (Incorrect. Pedophilic disorder refers to recurrent and intense sexual arousal and fantasies related to sexual activity with a prepubescent child or children under age 13.)
- sexual sadism disorder. (Incorrect. Sexual sadism disorder refers to the “recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors.” The formal diagnosis of sexual sadism disorder would apply if the individual has acted on these urges with a nonconsenting person or if the urges cause significant distress to the individual.)
- voyeuristic disorder. (Incorrect. Voyeurism is the sexual interest in or practice of spying on people engaged in intimate behaviors, such as undressing, sexual activity, or other actions usually considered to be of a private nature.)
- transvestic disorder. (Correct! Ethan has transvestic disorder, which is characterized by intense sexual arousal from cross-dressing that has occurred for at least six months, which also cause significant distress or impairment.)
A: transvestic disorder.

Q: Lucas thrives on the opportunity to ride crowded subways, where he becomes sexually stimulated by brushing up against unsuspecting women. Lucas is often able to take advantage of women without their comprehending what he is doing. On one particularly busy morning during his commute to work, Lucas felt an uncontrollable urge to rub himself against the unknowing woman crammed onto the train in front of him, and allowed himself to reach orgasm. The woman reported Lucas’s actions, and the local police arrested him. What is the name of Lucas’s paraphilia?
- voyeuristic disorder (Incorrect. Voyeurism is the sexual interest in or practice of spying on people engaged in intimate behaviors, such as undressing, sexual activity, or other actions usually considered to be of a private nature.)
- sexual sadism disorder (Incorrect. Sexual sadism disorder refers to the “recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors.” The formal diagnosis of sexual sadism disorder would apply if the individual has acted on these urges with a nonconsenting person or if the urges cause significant distress to the individual.)
- sexual masochism disorder (Incorrect. Sexual masochism disorder (SMD) is the condition of experiencing recurring and intense sexual arousal in response to enduring moderate or extreme pain, suffering, or humiliation. Behaviors associated the disorder can be acted out alone (e.g., binding, self-sticking pins, self-administration of electric shock, or self-mutilation) or with a partner (e.g., physical restraint, blindfolding, paddling, spanking, whipping, beating, electric shock, cutting, pinning and piercing, and humiliation such as by being urinated or defecated upon, being forced to crawl and bark like a dog, or being subjected to verbal abuse).)
- frotteuristic disorder (Correct! Frotteuristic disorder is a sexual dysfunction disorder characterized by sexual arousal from rubbing against or touching a non-consenting person. This activity is often done in circumstances where the victim cannot easily respond, in a public place such as a crowded train or concert. Usually, such nonconsensual sexual contact is viewed as a criminal offense: a form of sexual assault albeit often classified as a misdemeanor with minor legal penalties. Conviction may result in a sentence or psychiatric treatment.)
A: frotteuristic disorder

Q: Isaac has always felt sexually inadequate. He has previously been arrested for public exposure. Each time he has “flashed” an unsuspecting young woman, jumping out at her from behind a doorway, a tree, or a car parked at the sidewalk. Isaac reported to a psychologist that he fantasized that his victim was so impressed by his sexual endowment that she pleaded for him to make love to her. In reality, Isaac has never touched any of these girls, but on several occasions after fleeing the scene, he masturbated immediately after the exposure. This is an example of which of the following disorders?
- sexual sadism disorder (Incorrect. Sexual sadism disorder refers to the “recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors.” The formal diagnosis of sexual sadism disorder would apply if the individual has acted on these urges with a nonconsenting person or if the urges cause significant distress to the individual.)
- homosexualism (Incorrect. This is not a disorder. Research has consistently failed to produce any empirical or scientific basis for regarding homosexuality as anything other than a natural and normal sexual orientation that is a healthy and positive expression of human sexuality.)
- voyeuristic disorder (Incorrect. Voyeurism is the sexual interest in or practice of spying on people engaged in intimate behaviors, such as undressing, sexual activity, or other actions usually considered to be of a private nature.)
- exhibitionistic disorder (Correct! When exhibitionistic sexual interest is acted on with a non-consenting person or interferes with a person’s quality of life or normal functioning, it can be diagnosed as exhibitionistic disorder in the DSM-5. There is a pattern in which males exhibit themselves and there are three characteristic features of the exhibition: 1) It is performed for unknown women. 2) It takes place where sexual intercourse is impossible (e.g., a crowded shopping center). 3) It seems designed to surprise and shock the woman. The male exhibitionist usually exposes his erect penis, but it is not necessarily essential for the activity. Ejaculation may occur at the moment of exposure or develop later with masturbatory stimulation. Some exhibitionists are aware of a conscious desire to shock or upset their target; while others fantasize that the target will become sexually aroused by their display.)
A: exhibitionistic disorder

Q: Which of the following is true about pedophilic disorder?
- The exact causes of pedophilia have been conclusively established. (Incorrect. The exact causes of pedophilia have not been conclusively established. Some studies of pedophilia in child sex offenders have correlated it with various neurological abnormalities and psychological pathologies.)
- Pedophilia often emerges during late adulthood, and is a chosen behavior. (Incorrect. Pedophilia emerges before or during puberty, and is stable over time. It is self-discovered, not chosen. For these reasons, pedophilia has been described as a disorder of sexual preference, phenomenologically similar to a heterosexual or homosexual orientation.)
- Consumption of child pornography is not a reliable indicator of pedophilia because some non-pedophiles also view child pornography. (Incorrect. Consumption of child pornography is a more reliable indicator of pedophilia than molesting a child, although some non-pedophiles also view child pornography. Child pornography may be used for a variety of purposes, ranging from private sexual gratification or trading with other collectors, to preparing children for sexual abuse as part of the child grooming process. Pedophilic viewers of child pornography are often obsessive about collecting, organizing, categorizing, and labeling their child pornography collection according to age, gender, sex act and fantasy.)
- The key feature of this disorder is that the adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children. (Correct! The key feature of this disorder is that the individual experiences sexual arousal when with children that may be equal to, if not greater than, that which he or she experiences with individuals who are physically mature. Pedophilia is a paraphilia involving intense and recurrent sexual urges towards and fantasies about prepubescent children that have either been acted upon or which cause the person with the attraction distress or interpersonal difficulty.)
A: The key feature of this disorder is that the adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children.

Q: Which of the following would be the most radical physiological intervention utilized to treat paraphilic disorders, particularly pedophilic disorder?
- SSRIs (selective serotonin reuptake inhibitors) (Incorrect. SSRIs are commonly used to treat depression.)
- chemical castration (Incorrect. Chemical castration is also used in some countries and in the United States to treat male sex offenders. Unlike physical castration, it is reversible by stopping the medication. For male sex offenders with severe or extreme paraphilias, physical castration appears to be effective, although more radical.)
- antiandrogens (Incorrect. Not as radical as castration, antiandrogens, with emphasis on gonadotropin-releasing hormone (GnRH) analogs, have shown to considerably reduce the frequency and intensity of both deviant sexual arousal and behavior. GnRH analogs are also considered to be among the most promising pharmacological management for those sex offenders at high risk of particularly violent acts, particularly serial rapists or those individuals with pedophilic disorder. Informed consent is obligatory.)
- surgical castration, or removal of the testes (Correct! Castration as a treatment for men with paraphilic disorder, particularly pedophilic disorder, is intended to destroy the body’s production of testosterone through surgical castration (removal of the testes) or chemical castration, in which the individual receives medications that suppress the production of testosterone.)
A: surgical castration, or removal of the testes

Q: Many pedophiles may not perceive anything wrong and view their perceptions and behavior as reasonable and appropriate, thus making their treatment difficult. These types of perceptions and behaviors that are acceptable to the needs and goals of the ego are called
- egodystonic. (Incorrect. Egodystonic (or ego alien) is the opposite, referring to thoughts and behaviors (dreams, compulsions, desires, etc.) that are in conflict, or dissonant, with the needs and goals of the ego, or, further, in conflict with a person’s ideal self-image.)
- contact-driven behaviors. (Incorrect. Contact-driven behavior refers to behavior that is directly related to contact sex offending, such as a behavioral substitute, a facilitator or product of a contact offense.)
- fantasy-driven behaviors. (Incorrect. Fantasy-driven behavior refers to behavior that is confined to engagement with images, such as a facilitator of sexual fantasy or collecting behavior.)
- egosyntonic. (Correct! Many mental disorders, including pedophilic disorder, are egosyntonic. Egosyntonic refers to the behaviors, values, and feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one’s ideal self-image. This corresponds to the general concept in psychiatry of poor insight.)
A: egosyntonic.

Q: Which of the following may be considered a major controversy in regards to the diagnosis of paraphilic disorders?
- not having clear criteria on what constitutes a paraphilia (Incorrect. Criteria is specified, but there is a great deal of controversy concerning paraphilia, and defining what is normal versus deviant or disordered behavior. In part, this stems from the malleability of sexual norms across time and cultures, which creates problems for those defining and diagnosing paraphilia. Given that, in some circumstances, such diagnoses can be used to imprison and/or commit an individual based on their future likely danger to society, this adds another dimension to this problem.)
- Systematically including all individuals with paraphilic disorder on the sexual offense registry. (Incorrect. When the paraphilia becomes a paraphilic disorder, individuals suffer harm, distress, and functional impairment. Legal ramifications do not always ensue, but when they do, this can lead to a life of incarceration and/or probation, forensic psychiatric hospital confinement, as well as permanent induction onto the sexual offender registry.)
- All individuals diagnosed with paraphilic disorder are mandated to have medical treatment. (Incorrect. The management of paraphilic disorders falls into two main categories, incorporating both psychological and biological constituents, but are not mandatory. Despite medications used in the management of paraphilic disorders, better preventative measures are deemed necessary to reduce victimization, as many of those with paraphilic disorders will only be under evaluation upon incarceration after the harm has been inflicted.)
- systematically diagnosing sexual preference and the practice of various sexual behaviors with consenting partners as a mental disorder (Correct! Sexual preference itself cannot be considered a mental disorder, which is how how a homosexual orientation was considered in the 1970s in the United States of America. No consensus has been found for any precise border between unusual sexual interests and paraphilic ones. There is debate over which, if any, of the paraphilias should be listed in diagnostic manuals, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD).)
A: systematically diagnosing sexual preference and the practice of various sexual behaviors with consenting partners as a mental disorder

Q: Patients suffering from paraphilic disorders rarely seek treatment voluntarily, as many individuals
- feel that the only cure for paraphilic disorder is incarceration. (Incorrect. Many psychiatrists and mental healthcare providers feel that the only cure for pedophilic disorder is incarceration. As paraphilias and paraphilic disorders are deeply ingrained thoughts and irresistible behaviors of the individual, whether viewed as right or wrong, it is currently deemed as merely impossible to fix.)
- feel that the medications used in the management of paraphilic disorders do not work. (Incorrect. Despite the medications used in the management of paraphilic disorders, better preventative measures are deemed necessary to reduce victimization, as many of those with paraphilic disorders will only be under evaluation upon incarceration after the harm has been inflicted.)
- want to avoid being put on the sexual offender registry. (Incorrect. When the paraphilia becomes a paraphilic disorder, individuals suffer harm, distress, and functional impairment. Legal ramifications do not always ensue, but when they do, they can lead to a life of incarceration and/or probation, forensic psychiatric hospital confinement, as well as permanent induction onto the sexual offender registry.)
- feel indignity, culpability, or discomfiture. (Correct! Overall, the majority of patients suffering from paraphilic disorders rarely seek treatment voluntarily, as many individuals feel indignity, culpability, or discomfiture, while others focus on the difficulty and lack of desire to halt efforts of achieving intense sexual pleasure and ultimate satisfaction. Furthermore, the very nature of paraphilic disorders in many individuals leads to victimization and often legal repercussions. This will only further deter patients from seeking treatment.)
A: feel indignity, culpability, or discomfiture.

Q: Paraphilic disorder is diagnosed when
- an individual has recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors. (Incorrect. This is the formal diagnosis of sexual sadism disorder that would only apply if the individual has acted on these urges with a nonconsenting person or if the urges cause significant distress to the individual.)
- an individual has recurrent and intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, or behaviors. (Incorrect. This is the formal diagnosis of sexual masochism disorder, which according to the DSM-5 involves “recurrent and intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, or behaviors.” It applies only if the individual experiences clinically significant distress or impairment in social, occupational, or other important areas of functioning.)
- individuals willingly engage in consenting forms of pain or humiliation, typically for sexual purposes. (Incorrect. This describes BDSM (bondage, domination, sadomasochism), a colloquial term that describes the activities between consenting partners that contain sadistic and masochistic elements. Many behaviors such as erotic spanking, tickling, and love-bites that many people think of only as “rough” sex also contain elements of sado-masochism. BDSM is not currently a diagnosable condition in either the DSM or ICD system.)
- an individual has persistent and recurrent sexual interests, urges, fantasies, or behaviors of marked intensity involving objects, activities, or even situations that are atypical in nature. (Correct! Paraphilic disorder is a disorder in which an individual has persistent and recurrent sexual interests, urges, fantasies, or behaviors of marked intensity involving objects, activities, or even situations that are atypical in nature.)
A: an individual has persistent and recurrent sexual interests, urges, fantasies, or behaviors of marked intensity involving objects, activities, or even situations that are atypical in nature.

Q: What statement is true about sexual assault?
- Sexual assault is an act in which a person unintentionally sexually touches another person without that person’s consent. (Incorrect. Sexual assault is an act in which a person intentionally sexually touches another person without that person’s consent, or coerces or physically forces a person to engage in a sexual act against their will.)
- Sexual assault does not includes child sexual abuse. (Incorrect. Sexual assault is a form of sexual violence, which includes child sexual abuse, groping, rape (forced vaginal, anal, or oral penetration or a drug-facilitated sexual assault), or the torture of the person in a sexual manner.)
- More men have been victims of attempted or completed rape during their lifetime. (Incorrect. 17.6% of women have been victims of attempted (2.8%) or completed (14.8%) rape during their lifetime. Three percent of men have been victims of attempted or completed rape during their lifetime.)
- Women under the age of 30 are more likely than the general population to be victims of rape, attempted rape, or sexual assault. (Correct! 80% of assault victims are under age 30 and 88.7% of rape victims are women, the other 11.3% being men.)
A: Women under the age of 30 are more likely than the general population to be victims of rape, attempted rape, or sexual assault.

Q: What was specifically created after the Adam Walsh Child Protection and Safety Act?
- sexually violent predator laws (Incorrect. In the United States, following Kansas v. Hendricks, sex offenders who have certain mental disorders, including pedophilia, can be subject to indefinite civil commitment under various state laws (generically called SVP laws or sexually violent predator laws).)
- the Sexually Violent Predator Act (Incorrect. In Kansas vs. Hendricks, the U.S. Supreme Court upheld as constitutional a Kansas law, the Sexually Violent Predator Act, under which Hendricks, a pedophile, was found to have a mental abnormality defined as a “congenital or acquired condition affecting the emotional or volitional capacity which predisposes the person to commit sexually violent offenses to the degree that such person is a menace to the health and safety of others,” which allowed the State to confine Hendricks indefinitely, irrespective of whether the State provided any treatment to him.)
- Indefinite civil commitment laws. (Incorrect. In the United States, following Kansas v. Hendricks, sex offenders who have certain mental disorders, including pedophilia, can be subject to indefinite civil commitment under various state laws (generically called SVP laws or sexually violent predator laws))
- a national sex offender registry (Correct! The Adam Walsh Child Protection and Safety Act created a national sex offender registry and instructs each state and territory to apply identical criteria for posting offender data on the internet (i.e., offender’s name, address, date of birth, place of employment, photograph, etc.). The act was named after Adam Walsh, an American boy who was abducted from a Florida shopping mall and later found murdered.)
A: a national sex offender registry

Q: Which category of internet offenders uses online child grooming—persuading a youngster to have sex, online and/or offline with an adult?
- passion-driven (Incorrect. Child grooming is befriending and establishing an emotional connection with a child, and sometimes the family, to lower the child’s inhibitions with the objective of sexual abuse. Contact-driven pedophiles and predators use online grooming to carry out cybersex trafficking crimes. Some abusers will pose as children online and make arrangements to meet (contact) with them in person.)
- fantasy-driven (Incorrect. Fantasy-driven offenders will engage in sexually arousing activities while online with the child or adolescent. Contact-driven pedophiles and predators use online grooming to carry out cybersex trafficking crimes. Some abusers will pose as children online and make arrangements to meet (contact) with them in person.)
- purpose-driven (Incorrect. Child grooming is befriending and establishing an emotional connection with a child, and sometimes the family, to lower the child’s inhibitions with the objective of sexual abuse.)
- contact-driven (Correct! Sexual grooming of children also occurs on the internet. Some abusers will pose as children online and make arrangements to meet (contact) with them in person. Child grooming is befriending and establishing an emotional connection with a child, and sometimes the family, to lower the child’s inhibitions with the objective of sexual abuse.)
A: contact-driven

Q: According to John Money, a person’s emotional, internal blueprint for their ideal erotic, sexual situations is referred to as a
- vandalized lovemap. (Incorrect. According to Money, vandalized lovemaps occur when the love mapping process becomes traumatized, as when a young child is either exposed to, or forced to participate in such inappropriate behaviors as child sexual abuse, incest, or sadomasochism.)
- paraphilia. (Incorrect. Paraphilia is the experience of intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals.)
- sexual perversion. (Incorrect. Perversion is a type of human behavior that deviates from that which is understood to be orthodox or normal. Although the term perversion can refer to a variety of forms of deviation, it is most often used to describe sexual behaviors that are considered particularly abnormal, repulsive, or obsessive.)
- lovemap (Correct! Money defined it as “a developmental representation or template in the mind and in the brain depicting the idealized lover and the idealized program of sexual and erotic activity projected in imagery or actually engaged in with that lover.”)
A: lovemap

Q: Camila was a victim of incest from the age of five until the age of 13. Today, at the age of 30, she has been diagnosed with a paraphilic disorder. According to John Money, her “lovemap” may been
- penalized. (Incorrect. In paraphilic disorders, lust is attached to fantasies and practices that are socially forbidden, disapproved, ridiculed, or penalized. According to Money, it can result from lust being displaced from a “vandalized” area of an ordinary lovemap following abuse.)
- sexualized. (Incorrect. A lovemap, the mental image of what you want in a relationship, guides the way your actual relationships unfold. Sex researcher John Money, who first used the term, defined a lovemap as the mental guide that shapes your erotic desires in relationships. Vandalized lovemaps, according to Money, occur when the lovemapping process becomes traumatized, as when a young child is exposed to incest.)
- constructed. (Incorrect. A lovemap is typically formed between the ages of five and eight. More specifically to this scenario, a vandalized lovemap may be paraphilic.)
- vandalized. (Correct! Vandalized lovemaps, according to Money, occur when the love mapping process becomes traumatized, as when a young child is either exposed to, or forced to participate in such inappropriate behaviors as child sexual abuse, incest, or sadomasochism. He states that such a lovemap is typically formed between the ages of five and eight. A vandalized lovemap may be paraphilic or hyposexual.)
A: vandalized.

Q: Caleb is being treated for pedophilic disorder at the demand of his family because he began replicating the abuse he experienced as a child. The therapist that he sees asks him to look at images of children that are the same as he was when he was abused by his uncle. The therapist then simultaneously administers electric shocks of mild to higher intensities. What form of therapy is the therapist using with Caleb?
- operant conditioning (Incorrect. Operant conditioning approaches use reward and punishment to train new behavior, such as problem-solving.)
- chemical castration (Incorrect. Chemical castration is a treatment in which the individual receives medications that suppress the production of testosterone.)
- covert sensitization (Incorrect. Covert sensitization refers to eliminating the unwanted behavior by creating a profound and lasting association between the behavior and a highly disturbing covert (i.e., imagined) stimulus or consequence.)
- aversion therapy (Correct! Aversion therapy is a form of treatment in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort.)
A: aversion therapy

Q: Which of the following pharmacological treatments have shown to considerably reduce the frequency and intensity of both deviant sexual arousal and behavior?
- SSRIs (Incorrect. Studies have shown SSRIs to be particularly useful in the adolescent population and milder paraphilias, including exhibitionism, as well as in patients suffering from comorbidities of obsessive-compulsive disorders (OCD) or depression. SSRIs have also been used in the attempted alleviation of hypersexuality, but strong evidence of actual efficacy has yet to be established.)
- castration (Incorrect. Castration as a treatment for men with paraphilic disorder, particularly pedophilic disorder, is intended to destroy the body’s production of testosterone through surgical castration (removal of the testes) or chemical castration, in which the individual receives medications that suppress the production of testosterone.)
- covert sensitization (Incorrect. Covert sensitization is eliminating the unwanted behavior by creating a profound and lasting association between the behavior and a highly disturbing covert (i.e., imagined) stimulus or consequence. It is a form of aversion therapy.)
- antiandrogens (Correct! Antiandrogens, with emphasis on gonadotropin-releasing hormone (GnRH) analogs, have shown to considerably reduce the frequency and intensity of both deviant sexual arousal and behavior.)
A: antiandrogens

Q: Behavior modification programs have been shown to reduce recidivism in sex offenders. Which forms of therapy have had the most ethical challenges?
- cognitive behavioral therapy (Incorrect. The cognitive-behavioral perspective is particularly useful in helping clients recognize their distortions and denial. At the same time, these clients benefit from training in empathy, so that they can understand how their victims are feeling.)
- psychoanalysis (Incorrect. Treatments within the psychological perspective seem most effective when combining any individual therapy, such as psychoanalysis, with group therapy. In psychoanalytic treatment, the developmental aspect remains an important way to access and understand the function of deviant sexual behavior, especially regarding the treatment of violent and sexual crimes.)
- prevention therapy (Incorrect. The prevention model to sexual violence is a model that adopts a developmental approach, with interventions before birth, during childhood, and in adolescence and young adulthood, and is not a part of behavior modification programs.)
- aversion therapy (Correct! The use of aversion therapy remains controversial, and is an ethical issue related to the professional practice of behavior analysis. Such programs are effective in lowering recidivism by 15–18 percent. Previous research in the early 1990s has shown covert conditioning to be effective with sex offenders as part of a behavior modification treatment package. Clinical studies continue to find it effective but with little generalization from office to natural environment with this population.)
A: aversion therapy

Q: According to the prevention model of sexual violence, when childhood environments are physically violent, emotionally unsupportive, and characterized by competition for scarce resources, prevention of sexually aggressive behavior should start with prenatal interventions that address which of these issues?
- myths about rape, how to set boundaries for sexual activity, and breaking the links between sex, violence, and coercion (Incorrect. The prevention model to sexual violence adopts a developmental approach, with interventions before birth, during childhood, and in adolescence and young adulthood has been developed and is used by some health providers. During adolescence and young adulthood, discussions would cover myths about rape, how to set boundaries for sexual activity, and breaking the links between sex, violence, and coercion.)
- the need to model behaviors and attitudes that avoid stereotyping (Incorrect. The prevention model to sexual violence adopts a developmental approach, with interventions before birth, during childhood, and in adolescence and young adulthood has been developed and is used by some health providers. In later childhood, health promotion would include modeling behaviors and attitudes that avoid stereotyping, encouraging children to distinguish between good and bad touching, and enhancing their ability and confidence to take control over their own bodies.)
- the need to encourage children to distinguish between good and bad touching (Incorrect. The prevention model to sexual violence adopts a developmental approach, with interventions before birth, during childhood, and in adolescence and young adulthood has been developed and is used by some health providers. In later childhood, health promotion would include modeling behaviors and attitudes that avoid stereotyping, encouraging children to distinguish between good and bad touching, and enhancing their ability and confidence to take control over their own bodies.)
- parenting skills, the stereotyping of gender roles, stress, conflict, and violence (Correct! With regard to early childhood environments, research has stressed the importance of encouraging nurturing, with better and more gender-balanced parenting, to prevent sexual violence. The prenatal element would include discussions of parenting skills, the stereotyping of gender roles, stress, conflict, and violence.)
A: parenting skills, the stereotyping of gender roles, stress, conflict, and violence

Q: Levi is 32 years old and during the past six months, he and his girlfriend have frequently tried to have intercourse, but each time they have become frustrated by Levi’s inability to maintain an erection for more than a few minutes. When this happens, Levi becomes very upset and his anxiety gets worse every time he thinks about it. He fears he is “impotent” and will never be able to have a normal sex life, despite his girlfriend's reassurance that things will work out. Levi's condition is an example of
- hypoactive sexual desire disorder. (Incorrect. Although hypoactive sexual desire disorder (HSDD) is considered a sexual dysfunction, it is characterized as a lack or absence of sexual fantasies and desire for sexual activity, as judged by a clinician.)
- premature ejaculation. (Incorrect. This would be the case if there had been a persistent and undesirable premature ejaculation that occurs around one minute or less of vaginal penetration.)
- delayed ejaculation. (Incorrect. This would be the case if there had been a marked delay in ejaculation or infrequency/absence of ejaculation in 75–100% of partnered sexual activity.)
- erectile disorder. (Correct! Men with erectile disorder cannot attain or maintain an erection during sexual activity that is sufficient to allow them to initiate or maintain sexual activity. Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis.)
A: erectile disorder.

Q: Brooklyn is a 30-year-old single woman who dates frequently. When she has attempted to have sex, she has found herself unable to tolerate penetration. She is able to achieve orgasm through masturbation ,however. Brooklyn says she feels a sense of readiness to have sex, but her vaginal muscles inevitably tighten up and her partner is unable to penetrate. She tries to convince herself that the problem will go away if she can just find the right man who will understand her problems. Brooklyn shows the symptoms of
- anorgasmia. (Incorrect. The term female orgasm disorder is often referred to as anorgasmia. It represents a type of sexual dysfunction in which a person cannot achieve orgasm despite adequate stimulation. Anorgasmia is one of the most common sexual problems in women. Symptoms associated with the disorder are most often the marked infrequency/absence of experiencing orgasm or delayed orgasm, heightened frustration and inhibition of sexual desire, fear of failure, prejudices, and avoidance of sexual contact for various reasons.)
- female orgasmic disorder. (Incorrect. Female orgasmic disorder refers to a delay in, absence of, or markedly reduced intensity of orgasms during 75–100% of sexual activity.)
- female sexual interest/arousal disorder. (Incorrect. Female sexual interest/arousal disorder (FSIAD) refers to a lack of interest or significantly reduced interest in sexual activity. At least three of the following symptoms occur for a minimum of six months: reduced interest in sex, reduced sexual thought or fantasies, reduced initiation of sexual activity, reduced excitement during sexual activity, reduced excitement to sexual cues, and reduced sensation during sexual encounters.)
- genito-pelvic pain/penetration disorder. (Correct! Formerly called dyspareunia and vaginismus, genito-pelvic pain/penetration disorder (GPPPD) is characterized by difficulty or pain during vaginal penetration during intercourse. This may also include fear or anxiety about penetration or tensing and tightening of pelvic floor muscles during intercourse.)
A: genito-pelvic pain/penetration disorder.

Q: For a number of years, Wyatt has insisted that his wife, Kaylee, submit him to pain and abusive sexual behavior. Wyatt’s requests usually involved pleas that Kaylee bite his genitals, slap his face and then bind him while they were sexually intimate. Over time his requests for pain increased. He was able to get Kaylee to agree to use hot wax and whips to inflict pain. Wyatt has no interest in sexual intimacy other than that involving pain. Which of the following disorders indicates Wyatt’s condition?
- exhibitionistic disorder (Incorrect. When exhibitionistic sexual interest is acted on with a non-consenting person or interferes with a person’s quality of life or normal functioning, it can be diagnosed as exhibitionistic disorder in the DSM-5. Exhibitionism is the act of exposing in a public or semi-public context those parts of one’s body that are not normally exposed—for example, the breasts, genitals, or buttocks. The practice may arise from a desire or compulsion to expose themselves in such a manner to groups of friends or acquaintances, or to strangers for their amusement or sexual satisfaction or to shock the bystander.)
- voyeuristic disorder (Incorrect. Voyeurism is the sexual interest in or practice of spying on people engaged in intimate behaviors, such as undressing, sexual activity, or other actions usually considered to be of a private nature.)
- sexual sadism disorder (Incorrect. Sexual sadism disorder refers to the “recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors.” The formal diagnosis of sexual sadism disorder would apply if the individual has acted on these urges with a nonconsenting person or if the urges cause significant distress to the individual.)
- sexual masochism disorder (Correct! Sexual masochism disorder (SMD) is the condition of experiencing recurring and intense sexual arousal in response to enduring moderate or extreme pain, suffering, or humiliation. Behaviors associated the disorder can be acted out alone (e.g., binding, self-sticking pins, self-administration of electric shock, or self-mutilation) or with a partner (e.g., physical restraint, blindfolding, paddling, spanking, whipping, beating, electric shock, cutting, pinning and piercing, and humiliation such as by being urinated or defecated upon, being forced to crawl and bark like a dog, or being subjected to verbal abuse).)
A: sexual masochism disorder