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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Primary ED is present when attaining or sustaining an erection has never been possible. Psychologic causes of primary ED include fear of intimacy, guilt, anxiety, or depression. Secondary ED is acquired later in life after previously having had normal function. It is the most common form, with more than 90% of cases having an organic etiology. Reactive psychologic difficulties may later develop, worsening the condition. Causes may be related to performance anxiety, stress, or depression. Psychogenic ED may involve a certain place, time, or partner. Organic causes of ED are usually vascular or neurologic disorders, often due to diabetes or atherosclerosis. Atherosclerosis of the cavernous arteries of the penis is highly common. Endothelial dysfunction is due to diabetes, smoking, and low testosterone levels. Neurologic causes include diabetic neuropathy. One of the most common causes of retrograde ejaculation is prostate surgery for noncancerous prostate enlargement. Other common causes include diabetes, certain drugs, spinal cord injuries, and major abdominal or pelvic surgery. Aside from diabetes, decreased vaginal lubrication may be due to hormonal changes related to menopause, pregnancy, or breastfeeding. It is also caused by irritation from contraceptive creams and foams, fear, and anxiety about sexual intimacy, OTC antihistamines, oral contraceptives, and reduced estrogen levels because of aging.
Deaddictive Mechanisms
Published in Albert A. Kurland, S. Joseph Mulé, Psychiatric Aspects of Opiate Dependence, 2019
Albert A. Kurland, S. Joseph Mulé
Control is important in the clinical management of the addict, not only to prevent self-destruction but also to overcome the sociopath’s fear of intimacy. His wish to run from the path of honest human encounter and tenderness can be frustrating. The restriction superimposed upon these individuals confronts the psychiatrist with the necessity of assisting the sociopath to differentiate control from punishment and to separate help and confrontation from social isolation and retribution. On the other hand, too generous intervention or protection from harm can be as bad as too little. The extent to which their anxiety should or should not be controlled is not always easy to determine nor is at what point intervention should be considered. “The therapist must recognize that his wish to control the sociopath’s anxiety [whether by psychotropic drugs or by solitary confinement] is countertransference.”3 The attempts at interpreting their defenses, employing psychological concepts such as projection, denial through fantasy, masochism, and merely acting out, are rarely effective. For many, confrontation may be the most expedient technique for exposing immature defenses.
Non-Consensual Sex and Psychosexual Problems
Published in Philipa A Brough, Margaret Denman, Introduction to Psychosexual Medicine, 2019
The practitioner/patient relationship is the cornerstone of our work. While working with victims of sexual trauma there will, however, be times when we struggle to build a strong therapeutic alliance. There may naturally be a fear of intimacy (7) and possibly a need for the survivor to remain in control within relationships to feel safe from harm. At times this dynamic can be played out during the consultation. The power imbalance that inevitably occurs when someone visits your consulting room, often after several months wait, to seek your advice for a very personal intimate problem may invoke a defence. The consultation risks being experienced as a re-creation of the abusive situation. There are times when you might begin to feel like a perpetrator. This is most likely during a genital examination. Asking someone to undress, expose their genitalia and possibly permit penetration by a swab or speculum in an environment which makes them feel uncomfortable to begin with could re-create some very distressing feelings. However, it may be something totally unpredictable that triggers a disturbing reaction, something that is not even identifiable to the patient and unrelated to the previous trauma.
Couple and parenting functioning of childhood sexual abuse survivors: a systematic review of the literature (2001-2018)
Published in Journal of Child Sexual Abuse, 2021
Heather B. MacIntosh, A. Dana Ménard
Davis and Petretic-Jackson (2000) reviewed clinical intervention studies and the little empirical research available to them at the time and proposed a typology of interpersonal problems experienced by CSA survivors. These included 1) fear of intimacy, mistrust, difficulty with setting healthy boundaries, and sexualization of relationships; 2) active fear and avoidance of intimate relationships and sexuality; and 3) a desperate need to be in a relationship but difficulty choosing trustworthy partners, leading to a series of negative relationships. Results of their review suggested that little research had been grounded in a well-articulated theory or model of the potential pathway from CSA to interpersonal difficulties, the impacts on partners, and on parenting and children of survivors. They recommended future researchers emphasize the importance of developing an understanding of the underlying psychological and emotional lives of survivors rather than just focusing on symptoms and behaviors (Davis & Petretic-Jackson, 2000).
Demystifying Zoophilia: Classification and Psychological Aspects of Humans Having Sexual Relationships with Animals
Published in International Journal of Forensic Mental Health, 2021
Lisa Emmett, Lisa Klamert, Birgit U. Stetina
Moreover, this study provides further evidence for theoretical assumptions that are important to identify relevant factors associated with zoosexuality and creating evidence-based interventions for zoophiles suffering from their sexual desires. More specifically, enhancing social and emotional skills based on cognitive behavioral techniques could be a highly applicable starting point for future manualized and standardized treatment plans. Singg (2017) has already reported positive outcomes when using these techniques with people who experience distress over their sexual activity with animals. Specific interventions include treatment elements like coping with feelings of isolation or fear or intimacy with potential sexual partners. Additionally, it is relevant to consider that zoophiles mostly seem to be online communities (e.g., Sendler, 2019a) and therefore also online intervention programs should be developed. Finally, the results and especially the newly proposed classification may hopefully contribute to an improvement in scientific and clinical communication. In addition, enhanced understanding of this paraphilia in particular for clinicians is necessary. This understanding may enable clinicians to adopt an empathic regard which then leads to zoophiles being able to trust clinicians when seeking treatment because of experiencing distress in relation to their sexual desires and any other psychological needs.
Adult attachment and drinking context as predictors of alcohol problems and relationship satisfaction in college students
Published in The American Journal of Drug and Alcohol Abuse, 2018
Elise C. Hocking, Raluca M. Simons, Jeffrey S. Simons, Harry Freeman
In contrast, it is theorized that avoidant individuals utilize deactivation of the attachment system as an affect-regulation strategy in response to threat (16,19). While these individuals report less subjective distress regarding intimate partner relationships, physiological evidence suggests otherwise (32). Hence, deactivation of the attachment system may assist avoidant individuals in coping with fear of intimacy, similar to the function of hyperactivation in anxious individuals. Attachment deactivation is characterized by avoidance of threat-related cues and distancing oneself from the attachment figure. The resulting distancing behaviors are associated poorer relationship functioning (42,43).