Categorizing the Dysfunctions | Психология взаимоотношений

Sexual dysfunctions are categorized as either primary or secondary, and situational or global. A primary sexual dysfunction is one that has always existed, whereas a secondary sexual dysfunction is one in which a dysfunction developed after a period of adequate functioning. A situational sexual dysfunction is a dysfunction that occurs during certain sexual activities or with certain partners (for instance, a man who can get an erection with his girlfriend but not his wife; or a woman who can have orgasms during masturbation but not during oral sex). A global sexual dysfunction is a dysfunction that occurs in every situation, during every type of sexual activity, and with every sexual partner.

It is important to clarify these differences, for they may affect treatment strategies. For instance, primary problems tend to have more biological or physiological causes, whereas secondary problems tend to have more psychological causes. Sex therapists further categorize dysfunctions as those of sexual desire, sexual arousal, orgasm, or pain disorders (most sex therapists use the DSM-IV-TR to help in their diagnosing). Each of these may be primary or secondary, situational or global. See Table 14.1 for an overview of sexual dysfunctions.

TABLE 14.1 The Sexual Dysfunctions

Sexual Desire Disorders	Symptoms: Sexual Interest
Hypoactive Sexual Desire Disorder	Primary—Lifelong diminished or absent feelings of sexual interest or desire; absent sexual thoughts and/or fantasies Secondary—Acquired diminished or absent feelings of sexual interest or desire; diminished or absent sexual thoughts and/or fantasies
Sexual Aversion Disorder	Primary—Lifelong persistent or recurrent extreme aversion to, and avoidance of, all genital sexual contact with a sexual partner Secondary—Acquired persistent or recurrent extreme aversion to, and avoidance of, all genital sexual contact with a sexual partner
Sexual Arousal Disorders	Symptoms: Physiological Arousal
Female Sexual Arousal Disorder	Primary—Lifelong diminished or absent lubrication response of sexual excitement Secondary—Acquired diminished or absent lubrication response of sexual excitement
Male Erectile Disorder	Primary—Lifelong diminished or absent ability to attain or maintain, until completion of the sexual activity, an adequate erection Secondary—Acquired diminished or absent ability to attain or maintain, until completion of the sexual activity, an adequate erection
Orgasm Disorders	Symptoms: Orgasm Difficulties
Female Orgasmic Disorder	Primary—Lifelong delay or absence of orgasm following normal sexual excitement Secondary—Acquired delay or absence of orgasm following normal sexual excitement
Male Orgasmic Disorder	Primary—Lifelong absence of orgasm in men Secondary—Acquired diminished ability to orgasm or markedly decreased orgasmic intensity from any type of stimulation
Premature Ejaculation	Primary—Lifelong pattern of ejaculating with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it Secondary—Acquired pattern of ejaculating with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it
Sexual Pain Disorders	Symptoms: Genital Pain
Dyspareunia	Primary—Lifelong recurrent or persistent genital pain associated with sexual intercourse, in either a male or female Secondary—Acquired recurrent or persistent genital pain associated with sexual intercourse, in either a male or female
Vaginismus	Primary—Lifelong pattern of recurrent or persistent involuntary spasms of the outer third of the vagina that interferes with sexual intercourse Secondary—Acquired pattern of recurrent or persistent involuntary spasms of the outer third of the vagina that interferes with sexual intercourse
Other Sexual Dysfunctions Due to a General Medical Condition	Presence of Sexual Dysfunction That Is Due to the Physiological Effects of a General Medical Condition

multimodal

using a variety of techniques.