Deck 13: Sexual Dysfunctions, Gender Dysphoria, and Paraphilic Disorders

Question 1

Lindau et al. (2007) suggests that among older adults ages 57-85, ____.

A) over half report having sex at least twice a month
B) sexual activity and enjoyment is quite low
C) sexual dysfunctions actually decrease in frequency
D) sexual activity and masturbation are seen as evil

Answer 1

A

Question 2

Mr. and Mrs. Bell are concerned about their sex lives. Mr. Bell is usually unresponsive to sexual stimulation after he has an orgasm. Mrs. Bell is capable of multiple orgasms. Prior to orgasm, Mrs. Bell experiences neither vaginal lubrication nor expansion of the clitoris. What should a therapist tell the Bells?

A) "Mrs. Bell's lack of lubrication may reflect an arousal phase problem."
B) "Everything the Bells experience is part of the normal sexual response cycle."
C) "Mrs. Bell's having multiple orgasms is a sign of an orgasm disorder."
D) "Mr. Bell's unresponsiveness is a sign of an orgasm disorder."

Answer 2

A

Question 3

Scott has sexual fantasies and engages in sexual behavior that is focused on objects and situations that are not part of the usual pattern of affectionate sexual activity. His behavior often puts him at risk for being arrested. If Scott has a sexual problem, it is likely to be in the general category of ____.

A) sexual dysfunctions
B) gender dysphoria
C) paraphilic disorders
D) sexual personality disorders

Answer 3

C

Question 4

Diane is a typical 68-year-old woman who is in a committed relationship. She indicates that sex is important in her life. It is likely that Diane will also state that ____.

A) sex is more important than relationships
B) relationships and closeness to her partner are more important than sex
C) she is having more sex now because she no longer worries about pregnancy
D) she is not satisfied with the quality of her sex life

Question 5

The highly publicized allegations against such well known people as former president Bill Clinton, boxer Mike Tyson, and golfer Tiger Woods underscore the magnitude and seriousness of problems related to ____.

A) sexual dysfunction
B) sexual addiction
C) paraphilias
D) gender dysphoria

Question 6

Elizabeth, married for six years, has no interest in either fantasizing or engaging in sexual activity. In fact, she does whatever she can to avoid situations where intercourse is a possibility. According to the DSM-5, Elizabeth has ____.

A) the rarest form of sexual dysfunction
B) a normal variant of the human sexual response cycle
C) a sexual arousal disorder
D) a sexual interest disorder

Question 7

Nancy has a sexual problem that is diagnosed as occurring during the appetitive phase of sexual response. We can guess that Nancy's problem involves ____.

A) an inability to experience relaxation after orgasm
B) difficulties during the last two stages of the response cycle
C) difficulties concerning thoughts or fantasies about sex
D) an inability to experience orgasm

Question 8

Unlike ____, which can occur in both men and women, ____ is a problem for women only.

A) vaginismus; dyspareunia
B) interest or desire disorders; vaginismus
C) erectile dysfunction; inhibited arousal
D) premature ejaculation; vaginismus

Question 9

Graham has been sexually active since he turned 16. After turning 20, he begins to experience a problem with lack of arousal. Which category best fits Graham's disorder?

A) gender dysphoria
B) paraphilia
C) sexual deviance disorder
D) sexual dysfunction

Question 10

Which type of disorder involves a conflict between one's anatomical sex and one's psychological feeling of being male or female?

A) gender dysphoria
B) dissociative identity disorder
C) sexual desire disorder
D) paraphilia

Question 11

Which statement best describes the central problem in determining whether or not a sexual practice is abnormal?

A) The abnormal behavior usually does not threaten society, impair social or occupational functioning, or cause distress to the individual.
B) While the laws are usually clear about what is illegal, people are often unaware of the laws.
C) Acceptable, "normal" sexual practices differ between cultures and historical times.
D) The DSM-5 only lists sexual disorders that are illegal, not ones that are merely unusual or abnormal.

Question 12

Shalisa has little desire for sexual activity; Karina experiences no breast swelling despite direct sexual stimulation. Which person is paired with the correct stage of the sexual response cycle (during which the problem is experienced)?

A) Shalisa-resolution; Karina-arousal
B) Shalisa-appetitive; Karina-arousal
C) Shalisa-arousal; Karina-appetitive
D) Shalisa-appetitive; Karina-orgasm

Question 13

Research on female orgasmic disorders suggests that ____.

A) the problem is due to neurotransmitter deficits
B) it may be related to inhibited sexual desire
C) around 10 percent of all woman have never achieved an orgasm
D) the difficulty is much more widespread than previously believed

Question 14

Which of the following is a stage in the human sexual response cycle?

A) appetitive
B) dyspaurenia
C) erectile
D) satyriasis

Question 15

George and Laura are seeing a sex therapist because of problems in their sex life. The therapist tells them that they are suffering from one of the most common complaint of couples seeking sex therapy. We could conclude from this statement that George and Laura are having problems with ____.

A) sexual arousal
B) sexual interest
C) orgasm
D) refraction

Question 16

Artise suffers from a rare disorder in which the uncontrolled spasms of her vaginal muscles prevents her husband from having intercourse with her. What is this disorder?

A) dyspareunia
B) paraphilia
C) dysphoria
D) vaginismus

Question 17

Hypersexuality, or sexual addiction, ____.

A) has been classified as a sexual disorder since DSM-III-R
B) was included as a sexual disorder in DSM-IV-TR
C) has been broadened from its original name, nymphomania, to include men as well as women
D) is not recognized as a classification of sexual disorder in the DSM-5

Question 18

Cynthia enters therapy because she is concerned about her inability to become sexually aroused. Which circumstance is her therapist most likely to find has caused her inability to become aroused?

A) She has an expectation that she should be sexually satisfied when she has sex.
B) She was given realistic, age-appropriate information about sex when she was a child.
C) She has a history of satisfactory sexual relationships.
D) She has conflicts with her sexual partner.

Question 19

The definition of sexual disorders is ____.

A) unique because it does not include subjective distress
B) among the clearest of all forms of psychological disorders to identify
C) based primarily on the statistical rarity criterion
D) difficult because it is influenced by cultural norms and values

Question 20

Dr. Ward says, "Premature ejaculation is a relatively uncommon sexual dysfunction in which the inability to achieve an erection leads to ejaculating reflexively during instances of excessive sexual stimulation. It is a source of great distress for many males." What part of the statement is accurate?

A) Premature ejaculation involves an inability to achieve an erection.
B) Premature ejaculation is uncommon.
C) Premature ejaculation involves excessive sexual stimulation.
D) Premature ejaculation is a source of great distress for many males.

Question 21

Which psychological or social factor is thought to contribute to development of gender dysphoria in boys?

A) parental encouragement of autonomy
B) excessive attention and overprotection by the father
C) a relatively powerful or overly-involved father figure
D) parental encouragement of feminine behavior

Question 22

Jennifer is a classic "tomboy" and insists she has a penis. She says she wants to be a man when she grows up. Most children with ideas like Jennifer's ____.

A) become transvestites
B) develop gender dysphoria as adults
C) do not develop gender dysphoria as adults
D) engage in paraphilias as adults

Question 23

Although the relationship between hormones and sexual functioning is complex and unclear, we would expect that low levels of testosterone are associated with ____.

A) paraphilias
B) erectile difficulties
C) premature ejaculation
D) vaginismus

Question 24

Connie's therapist attempts to replace the misconceptions and sexual myths that Connie has learned since childhood with accurate information about sexual anatomy and feelings. Which component of psychological treatment is the therapist using?

A) anxiety reduction
B) education
C) communication training
D) graded tasks

Question 25

Research suggests that vaginismus among women ____.

A) has a genetic predisposition
B) is the result of rigid religious beliefs about sex
C) is a very rare occurrence
D) is due to having a husband or partner who was impotent

Question 26

How successful is gender reassignment surgery for males transitioning to females?

A) It is completely successful.
B) Many report satisfaction, but some report problems with sexual arousal.
C) Most report that the process was painful and unsuccessful.
D) Surgery decreases the risk of serious psychiatric issues including suicidality.

Question 27

Keith is diagnosed with gender dysphoria. What types of psychological explanations have been proposed for gender dysphoria?

A) "You cross-dress because it allows you to experience sexual arousal."
B) "As a child, you over-identified with your strong and independent father."
C) "Your mother encouraged you to have male friendships when you were growing up."
D) "Your parents must have discouraged your development of autonomy."

Question 28

A sex therapist counsels his clients to masturbate and use tactile exploration and sexual imagery both individually and with a partner. The clients who hear this advice are most likely to have which sexual dysfunction?

A) sexual pain disorder
B) premature ejaculation
C) female orgasmic dysfunction
D) paraphilia

Question 29

In the multipath model of sexual dysfunctions, what is a psychological factor that may cause sexual dysfunction?

A) guilt, anger, or resentment toward one's sexual partner
B) being raised in a strict religious environment
C) desiring a closer relationship with one's sexual partner
D) pain when engaging in sexual intercourse

Question 30

In the multipath model of sexual dysfunctions, which factor is psychological, and most associated with female orgasmic dysfunction?

A) being raised in a sexually permissive home
B) having a partner who is sexually healthy and functional
C) having issues with body image
D) being over-informed about sexuality or sexual technique

Question 31

Professor Newell tells her students, "Vaginismus is a relatively common sexual dysfunction involving recurrent or persistent pain in the genitals before, during, or after sexual intercourse. Spasms of the outer third of the vaginal wall prevent sexual intercourse. Surprisingly, a lack of history of incestuous molestation is often found in women with this disorder." Which part of Professor Newell's statement is accurate?

A) Vaginismus is a relatively common sexual dysfunction.
B) A lack of history of incestuous molestation is often found in women with this disorder.
C) Vaginismus involves recurrent or persistent pain in the genitals before, during, or after sexual intercourse.
D) Spasms of the outer third of the vaginal wall prevent sexual intercourse.

Question 32

A therapist instructs Mrs. Weaver: "Stimulate your husband's penis until he feels ejaculation is about to happen, then stop all stimulation for a while. Continue with stimulation and then stop, repeating until he can tolerate longer periods of stimulation without ejaculating." What sexual dysfunction is being treated?

A) early ejaculation
B) secondary erectile dysfunction
C) sexual aversion disorder
D) vaginismus

Question 33

What disorder is being treated when a woman is taught to relax and then insert increasingly large dilators into her vagina until the comfortable insertion of a penis is possible?

A) dyspareunia
B) female orgasmic dysfunction
C) vaginismus
D) sexual aversion disorder

Question 34

Norman is diagnosed with gender dysphoria. We can expect that as a child, he ____.

A) was considered a very aggressive boy
B) avoided rough-and-tumble activities
C) was sexually attracted to other boys
D) cross-dressed as a way of attracting attention from others

Question 35

The controversy about gender reassignment surgery will likely continue because ____.

A) insurance companies are becoming more open to paying for the procedures
B) the issue of personal freedoms continues to be a political "football"
C) therapists have not done a very good job of identifying which patients are good candidates
D) some patients benefit from the procedures and others seem to be emotionally worsened by it

Question 36

Which of the following is considered to be a biological influence of gender dysphoria?

A) abnormal levels of prenatal testosterone
B) excessive amounts of certain neurotransmitters
C) lack of development in certain brain structures
D) stress-related organ dysfunction

Question 37

Giovanni has been treated with vascular surgery to increase blood flow to his genitals. When that did not cure his sexual dysfunction, he was given extra hormones. Now he is a candidate for implant surgery. What disorder is he most likely to suffer from?

A) premature ejaculation
B) hypoactive desire disorder
C) male orgasmic disorder
D) erectile dysfunction

Question 38

Which description best illustrates gender dysphoria?

A) Pedro is sexually attracted to other men.
B) Carlos experiences sexual arousal only if he dresses in women's clothes.
C) Miguel is constantly preoccupied with thoughts of castration.
D) Luis feels he should be a woman, and experiences great distress as a result.

Question 39

Oral medications like Viagra, Levitra, and Cialis ____.

A) result in erections even in the absence of sexual stimulation
B) enable the body to follow through the sexual response cycle to completion
C) cause stiffer erections among men who do not have sexual dysfunctions
D) have redefined erectile dysfunction as a medical problem rather than a quality-of-life issue

Question 40

Which statement about the cause of sexual dysfunctions is accurate?

A) Recent studies indicate that biological and factors interact to cause the disorders.
B) Masters and Johnson tended to deemphasize the importance of psychological factors.
C) All primary forms of these disorders stem from a sociocultural basis.
D) Recent studies show that biological factors sufficiently account for the disorders.

Question 41

Which individual exhibits a paraphilia?

A) Jules, who becomes sexually aroused when he sees his wife in a sexy negligee
B) Jake, who can only become sexually aroused when he is tied up and spanked by his partner
C) John, who consensually rubs against his wife to become sexually aroused
D) Joe, who becomes sexually aroused in the presence of an attractive woman

Question 42

Mary has a fetish for men's clothes and has two other forms of paraphilia as well. She is distressed with her fantasies and actions. These paraphilias have lasted several years. What aspect of Mary's case is unusual?

A) It is unusual for a paraphilia to last several years.
B) It is unusual for a person with paraphilias to be a woman.
C) It is unusual for a person to have more than one paraphilia.
D) It is unusual for a person with a paraphilia to be distressed.

Question 43

Professor Diebold tells his class, "Pedophilic disorder is a disorder in which an adult obtains sexual gratification through urges, acts, or fantasies of sexual contact with prepubescent children. The pedophile must be at least 14 years of age and at least five years older than the victim. Most pedophiles prefer boys, but some choose girls. Regrettably, sexual abuse of children is common." Which part of Professor Diebold's statement is accurate?

A) Pedophilic disorder is a disorder in which an adult obtains sexual gratification through urges, acts, or fantasies of sexual contact with prepubescent children.
B) The person with pedophilic disorder must be at least 14 years of age and at least two years older than the victim.
C) Most pedophiles prefer boys, but some choose girls.
D) Sexual abuse of children is common.

Question 44

The sexual disorders that involve intense sexual urges regarding situations, objects, or people that are not part of the usual arousal pattern leading to reciprocal and affectionate sexual activity are called ____.

A) gender dysphoria
B) paraphilias
C) dyspareunia
D) psychosexual disorders

Question 45

What paraphilia is relatively common, and involves urges or fantasies about exposing one's genitals to strangers in order to cause shock in the observer.

A) exhibitionistic disorder
B) voyeuristic disorder
C) fetishistic disorder
D) frotteuristic disorder

Question 46

Which statement about treatment of gender dysphoria is accurate?

A) Gender reassignment surgery is much less complicated for women who wish to be men than for men who wish to be women.
B) Men who change to females are generally more satisfied with gender reassignment surgery than women who change to males.
C) The only valuable therapy is gender reassignment surgery.
D) Although hormone therapy is helpful for some transgender people, others may also undergo reassignment surgery.

Question 47

What is a paraphilia involving non-consenting others?

A) fetishistic disorder
B) frotteuristic disorder
C) sexual masochism disorder
D) transvestic disorder

Question 48

For the past three years, Larry has repeatedly fondled his preteen stepdaughter and has sworn her to secrecy. Larry's behavior illustrates ____.

A) pedophilic disorder
B) voyeuristic disorder
C) transvestic disorder
D) sexual masochism disorder

Question 49

Brent has been diagnosed with transvestic disorder. Although he is married, he has long wanted a sex-change operation. He must dress as a woman to be able to have intercourse with his wife. If the diagnosis is accurate, what is unusual about Brent's case?

A) It is unusual for cross-dressing to be used for heterosexual sex.
B) It is unusual for a man to have transvestic disorder.
C) It is unusual for a person with transvestic disorder to be married.
D) It is unusual for a person diagnosed with transvestic disorder to want a sex-change operation.

Question 50

Norm is suspected of being a child molester. If he is a pedophile, which of the following might be found on evaluation?

A) sexual arousal to slides of neutral, clothed women
B) neurological abnormalities including less white matter
C) high intelligence and right-hemisphere dysfunction
D) lack of interest in hard-core pornography

Question 51

All of these men were diagnosed with exhibitionistic disorder. Who is typical of men with this disorder?

A) Wayne, who maintains complete self-control throughout his episodes of exposing himself
B) Lars, who is 49 and is sexually aroused only by pictures of women in the nude
C) Jim, who is 24 years old and likes pornography
D) Arnold, who is 53 years old and unmarried

Question 52

What sexual practice refers to sexual relations between a brother and sister?

A) incest
B) oral sex
C) homosexuality
D) sadomasochism

Question 53

Serena has been sexually molested. Who is least likely to be the molester?

A) her father
B) her grandfather
C) a stranger
D) a family friend

Question 54

Wayne has neither homosexual fantasies nor an attraction to other men. He knows he is male, but he can only achieve sexual arousal by shopping for women's clothes, dressing in them, and masturbating in front of a mirror. An appropriate diagnosis for Wayne is ____.

A) gender dysphoria
B) transsexualism
C) transvestic disorder
D) exhibitionism

Question 55

A man has persistent fantasies about having sex with non-consenting people. Although he has not acted on them, these fantasies have lasted for almost a year and cause the man severe distress. What diagnosis is appropriate and why?

A) paraphilia, because the man is severely distressed by his fantasies even though he has not acted on them
B) no mental disorder, because unless the man acts on his fantasies, there is no form of sexual deviance
C) sexual dysfunction, because the man is not able to achieve sexual arousal normally
D) gender dysphoria, because the man has fantasies about having sex with non-consenting people

Question 56

Jordan is an exhibitionist. Jordan most likely ____.

A) wants no contact with the person to whom he exposes himself
B) experiences a great deal of difficulty in becoming sexually aroused
C) is the stereotypical "dirty old man"
D) is generally quite satisfied with his life

Question 57

When an object such as shoes or women's underwear is used during masturbation as the sole means of achieving sexual gratification and this practice is distressing to the individual, the diagnosis is ____.

A) frotteuristic disorder
B) fetishistic disorder
C) transvestic fetishism
D) transsexualism

Question 58

Brad, who was identified as female at birth and named Brenda, takes hormones and had gender reassignment surgery. Research suggests that Brad will ____.

A) find that life is far more difficult than before the surgery
B) quickly relapse to gender identity disorder
C) be satisfied with the outcome, including his sexual functioning
D) find that his lifelong depression and suicidal thoughts are gone

Question 59

An individual who presents with a paraphilia is likely to ____.

A) have a homosexual orientation
B) have experienced a stressful life event
C) have more than one paraphilia
D) be a female

Question 60

People cross dress for a variety of reasons. People diagnosed with transvestic disorder ____.

A) are typically gay men who work as drag queens
B) are dissatisfied with their birth sex
C) are typically heterosexual
D) live openly as the opposite sex

Question 61

Tad is an exhibitionist. His therapist has him expose himself to a preselected group of females. He is made to be fully aware of his actions and thoughts because he must talk about his penis and his fantasies in front of these women. This form of treatment is ____.

A) based on psychodynamic assumptions
B) usually considered a form of chemical castration
C) an example of aversive behavior rehearsal
D) one that often backfires because many exhibitionists enjoy the procedure

Question 62

Which statement about rape is accurate?

A) Rape is a crime that targets only women.
B) Rape is often committed by someone known to the victim.
C) Wearing suggestive clothing is just asking for a rape to occur.
D) Rape is not defined within a marital context.

Question 63

Dr. Monte says about a patient, "As a child, he was often spanked on the bare buttocks by his very attractive governess. He cannot remember these incidents clearly, but as an adult, he always associates pain with sexual arousal." Dr. Monte's patient likely has which disorder?

A) voyeuristic disorder
B) exhibitionistic disorder
C) pedophilic disorder
D) sexual sadomasochism disorder

Question 64

Recent research suggests what biological difference in individuals with pedophilic disorder?

A) low levels of testosterone and high levels of estrogen
B) anomalies in the genitourinary system
C) less white matter in the brain
D) higher levels of activity in the frontal cortex

Question 65

Shame and humiliation are most likely to be used by behavior therapists to treat ____.

A) people with sexual dysfunction
B) masochists
C) people with gender dysphoria
D) exhibitionists

Question 66

During which phase of the rape trauma syndrome is the rape survivor likely to have feelings of self-blame, fear, and depression, and to believe she was responsible for the rape?

A) short-term
B) acute
C) long-term
D) reorganization

Question 67

Dr. Julius says to his exhibitionist patient, "Your dreams tell us that, for you, fear of castration requires that you prove to others that you still have a penis by exposing yourself. Once you acknowledge and overcome that fear, your need to exhibit will disappear." Dr. Julius holds which viewpoint on the disorder?

A) psychodynamic
B) cognitive-behavioral
C) operant conditioning
D) humanistic-existential

Question 68

Which of the following is a problem with the research on the effectiveness of behavioral treatment for paraphilias?

A) Most research involves the prison population.
B) Most research involves single subjects.
C) Most research is done a control group.
D) Most research involves the use of multiple techniques.

Question 69

A group of 100 female undergraduate students are surveyed. More than half say they have been victims of sexual aggression. The men who coerced them into intercourse did so without planning to do so and manipulated them by using alcohol and interpreted their protests of sexual advances as meaning "go ahead." What, if any, aspect of this group's survey results is unusual?

A) It is unusual for most acts of rape to be unplanned.
B) It is unusual for one-half of undergraduate females to report being victims of sexual aggression.
C) It is unusual for men who coerce sex to use alcohol.
D) It is unusual for men who coerce sex to interpret protests as insincere.

Question 70

Maria went on a date with a guy she knew from her office. After dinner, he attacked her and forced her to have sex. Maria's experience illustrates ____.

A) incestuous sex
B) date rape
C) sadomasochism
D) violent voyeurism

Question 71

Dr. Estes treats patients who have sexually deviant behavior. He uses extinction and aversive conditioning to eliminate inappropriate behaviors and helps them acquire or strengthen appropriate behaviors. He also helps them develop social skills. Dr. Estes uses which approach for treating his patients?

A) psychodynamic
B) behavioral
C) humanistic
D) cognitive

Question 72

Statistics show that over the past several years in the United States, the number of reported rapes ____.

A) has been slowly declining
B) has risen dramatically
C) has declined dramatically
D) has remained relatively stable

Question 73

Stefanie has intense sexually arousing fantasies of being utterly helpless while being tied up and humiliated and she regularly finds sex partners who fulfill these urges. A reasonable assumption is ____.

A) a diagnosis of sexual masochism disorder
B) that she was a victim of child sexual abuse
C) a diagnosis of pedophilia
D) a diagnosis of sadism

Question 74

A therapist working with child victims of sexual abuse is likely to see symptoms that most closely parallel ____ in some cases.

A) bipolar disorder
B) dissociative identity disorder
C) paraphilias
D) posttraumatic stress disorder

Question 75

Suppose that, in a research study, slides of nude women were shown to men at the same time they held or stroked white feathers. If these stimuli were paired enough times for the feathers alone to produce an erection, this would ____.

A) suggest that paraphilias are actually under the voluntary control of the individual
B) suggest that paraphilias are unrelated to "preparedness"
C) provide support for the biological perspective on paraphilias
D) provide support for a learning perspective of paraphilias

Question 76

Hal frequently coerces women into having intercourse. Assuming that he shares typical characteristics with other men who force women to have sex, Hal likely ____.

A) came from a home in which his mother was more dominant than his father
B) actively creates situations in which sexual encounters may occur
C) attributes his failed attempts at sexual encounters to perceived negative features of himself
D) tries to entice women into sexual encounters by talking about how great he is

Question 77

Research with sadomasochists found that about 40% ____.

A) reported that "straight" sex is more satisfying than sadomasochistic activities
B) played either a dominant or a submissive role but not both
C) engaged in behaviors that caused only minor pain
D) reported that they seek to injure others or be injured themselves

Question 78

A key concept in the psychodynamic explanation of transvestic disorder, exhibitionistic disorder, sexual sadism disorder, and sexual masochism disorder is ____.

A) excessive superego
B) castration anxiety
C) inadequate id impulses
D) the defense mechanism of projection

Question 79

Which statement about rape and rapists is most accurate?

A) Rape is a sexual act performed by men with higher-than-average sexual desire.
B) Rapists are impulsive and are aroused quickly by sexual cues.
C) Rapists usually rape women they do not know.
D) Rape has more to do with power, aggression, and violence than with sex.

Question 80

Ali is being treated for a shoe fetish. The therapist pairs electric shock with the sight and touch of shoes. The therapist also is teaching Ali to engage in appropriate social skills and how to feel sexual pleasure without resorting to shoes. The therapist probably supports which approach to treatment?

A) behavioral
B) psychodynamic
C) biogenic
D) cognitive