数字S-ONapp法治疗女性性高潮障碍

Rosoiu Mircela, Camelia Stanciu, Loredana Vâșcu
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Reaching orgasm by the patient was not a stated goal, not to accentuate the distress, but the development of sexual behaviors aimed to increase the duration and intensity of arousal and more frequent manifestation of sexual desire, designed to create the conditions for its occurrence.\nMethod: This is a case study on a 44-year-old patient, during 20 sex therapy sessions of 1 hour each, for 22 weeks, May-September 2021. Assessment methods for Axis I and Axis II, anamnesis and clinical observation, structured, semi-structured and unstructured clinical interviews (Delcea C., 2021) and investigation of medical, family, sexual, socio-cultural, and psycho-social history (individual completion) - MCMI III psychometric tests (Millon), Scale of Anxiety Hamilton, HRSA (SEC), PDA Affective Distress Profile, Opris D., Macavei B. (SEC), YSQ-S3 Short Form Cognitive Questionnaire (SEC), DAS Dysfunctional Attitude Scale Beck A., Weissman A. ( SEC); For sexual testing: Genogram of excitatory stimuli, (Delcea C., 2021), FSFI Female Sexual Function Index, Rosen M. 2000, FSDS Female Sexual Distress Scale, Derogatis, 2019, FOS Female Orgasm Scale, McIntyre, Smith, 2019, ORS The Orgasm Rating Scale, Mah K., Binik, 2019, MISSA Multiple Indicators of Subjective Sexual Arousal, Mosher DL, 2019- SISES Sexual Inhibition / Excitation Scale, (Milhausen RR 2019). Methods used in sex therapy intervention (face to face): to identify stimuli of pleasure, arousal and sexual relaxation, having as source the partner's body we used the Genogram of excitatory stimuli, the technique of anticipating excitatory stimuli and the technique of defocusing irrelevant stimuli. (Delcea C., 2021). Sensate focus and directed masturbation to identify individual arousal stimuli, and self-monitoring through journals. 3. Cognitive restructuring of dysfunctional cognitions. 4. Progressive desensitization, in the construction and practice of new exciting sexual behaviors. 6. Psychoeducation. 7. Relaxation techniques (eg breathing, mindfulness).\nResults: Following the standard psychological assessment, the patient has no Axis I and II emotional disorders, and no history of sexual abuse. The MCMI profile shows a person without clinical personality disorders, but a very high level of Distress (PDA), present cognitive schemas, Negativism and Need for approval that outlines a possible anxious predisposition, as well as present dysfunctional attitudes of medium level, considered as predispositions for depression. Sexual testing with the score sc = 19 FSDS scale, (Derogatis, LR 2002) The sexual distress scale in women shows that the patient has a high level of stress that positively correlates with the existence of sexual dysfunction, manifested by feelings of shame, guilt , inadequacy, and average sexual satisfaction. From the 2 orgasm measurement scales, FOS (McIntyre - Smith, 2019) and ORS (Mah K., Binik, Y., 2019) there is a lack of experience of orgasm by the subject, throughout life and an increased dissatisfaction. The FSFI Scale Index of sexual functioning in women (Rosen R., 2000) shows the same difficulty in experiencing orgasm in the context in which sexual desire exists and the level of arousal is high, from the subjective assessment of the patient. Sexual desire - 4.2; Excitation - 5.1; Lubrication - 4.2; Orgasm - 1.2; Sexual satisfaction - 4.4; Disappearance - 0.9 (maximum = 6.0). The genogram of excitatory stimuli shows an insufficient register of excitatory stimuli on the partner's body, 4 out of 8 (face, chest and arms) and an absent register of excitatory physical stimuli having as source its own body, absent fantasies, unique, poor and repetitive scenarios.\nConclusions: This is a patient without mental disorders with clinical significance, with predispositions for the installation of anxiety and depression, high level of distress. There is a poor sexual history and reduced and inadequate arousal. Absent fantasies, absent masturbation, dysfunctional cognitions about sex, \"sex is unknown, forbidden, dangerous\", register of excitatory stimuli on one's own absent body, and reduced for the partner's body, sexual pattern during predominantly passive sexual intercourse, on receiving pleasure, focused on the partner's body. 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引用次数: 3

摘要

目的:目前的工作主体提出了一个案例研究,以解决原发性性无高潮患者的性行为发展,以减少由内疚,尴尬和表现焦虑表现的情绪困扰,以及学习新的性模式,以增加快乐和性满意度。具体来说,我们试图建立一种积极的态度,把性作为心理健康的一部分,增加表达性的自信。患者达到性高潮并不是一个明确的目标,不是为了加重痛苦,而是性行为的发展旨在增加性唤起的持续时间和强度,以及更频繁地表现性欲,旨在为其发生创造条件。方法:这是一项针对一名44岁患者的案例研究,在2021年5月至9月的22周内进行了20次性治疗,每次1小时。轴I和轴II的评估方法,记忆和临床观察,结构化、半结构化和非结构化临床访谈(Delcea C., 2021)以及医疗、家庭、性、社会文化和心理社会史调查(个人完成)- MCMI III心理测量测试(Millon),焦虑汉密尔顿量表,HRSA (SEC), PDA情感困扰概况,Opris D., Macavei B. (SEC), YSQ-S3简短认知问卷(SEC),DAS功能失调态度量表Beck A, Weissman A.;性测试:兴奋性刺激基因谱,(Delcea C., 2021), FSFI女性性功能指数,Rosen M. 2000, FSDS女性性痛苦量表,Derogatis, 2019, FOS女性性高潮量表,McIntyre, Smith, 2019, ORS性高潮评定量表,Mah K., Binik, 2019, MISSA主观性兴奋多重指标,Mosher DL, 2019- SISES性抑制/兴奋量表,(Milhausen RR, 2019)。在性治疗干预中使用的方法(面对面):为了识别愉悦、兴奋和性放松的刺激,我们以伴侣的身体为来源,使用兴奋性刺激的基因图谱、预测兴奋性刺激的技术和分散无关刺激的技术。(Delcea C., 2021)。感觉焦点和定向手淫,以识别个人唤醒刺激,并通过日志进行自我监控。3.功能失调认知的认知重组。4. 渐进脱敏,在建构和实践新的令人兴奋的性行为。6. 心理教育。7。放松技巧(如呼吸、正念)。结果:经标准心理评估,患者无I、II轴情绪障碍,无性侵犯史。MCMI档案显示一个人没有临床人格障碍,但非常高水平的痛苦(PDA),目前的认知图式,消极主义和需要认可,概述了可能的焦虑倾向,以及目前的中等水平的功能失调态度,被认为是抑郁症的倾向。性测试得分sc = 19 FSDS量表,(克罗提斯,LR 2002)女性的性痛苦量表显示,患者的压力水平较高,与性功能障碍的存在正相关,表现为羞耻感、内疚感、不足感和平均性满意度。从两种性高潮测量量表FOS (McIntyre - Smith, 2019)和ORS (Mah K., Binik, Y., 2019)中可以看出,受试者在一生中缺乏性高潮体验,并且对性高潮的不满不断增加。女性性功能的FSFI量表指数(Rosen R., 2000)显示,从患者的主观评价来看,在性欲存在且兴奋程度高的情况下,体验性高潮同样困难。性欲- 4.2;激励- 5.1;润滑- 4.2;高潮- 1.2;性满意度- 4.4;消失- 0.9(最大值= 6.0)。兴奋性刺激的基因图谱显示,伴侣身体上的兴奋性刺激记录不足,8个中有4个(面部、胸部和手臂),兴奋性身体刺激记录缺失,没有幻想,没有独特的、糟糕的和重复的场景。结论:该患者无精神障碍,具有临床意义,易患焦虑抑郁,苦恼程度高。性生活史不佳,性唤起减少或不足。没有幻想,没有手淫,对性的认知功能失调,“性是未知的,被禁止的,危险的”,对自己身体的兴奋性刺激的记录缺失,对伴侣身体的刺激减少,主要是被动性交的性模式,在接受快感时,关注伴侣的身体。缺乏唤起刺激的发展,因此性行为维持性高潮功能障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment of orgasm disorder in women with the digital S-ONapp method
Objectives: The present body of work presents a case study addressing the development of sexual behaviors in a patient with primary anorgasmia in order to reduce emotional distress manifested by guilt, embarrassment and performance anxiety, as well as learning new sexual patterns to increase pleasure and sexual satisfaction. Specifically, we sought to create a positive attitude toward sexuality as part of mental health and increase self-confidence in expressing one's sexuality. Reaching orgasm by the patient was not a stated goal, not to accentuate the distress, but the development of sexual behaviors aimed to increase the duration and intensity of arousal and more frequent manifestation of sexual desire, designed to create the conditions for its occurrence. Method: This is a case study on a 44-year-old patient, during 20 sex therapy sessions of 1 hour each, for 22 weeks, May-September 2021. Assessment methods for Axis I and Axis II, anamnesis and clinical observation, structured, semi-structured and unstructured clinical interviews (Delcea C., 2021) and investigation of medical, family, sexual, socio-cultural, and psycho-social history (individual completion) - MCMI III psychometric tests (Millon), Scale of Anxiety Hamilton, HRSA (SEC), PDA Affective Distress Profile, Opris D., Macavei B. (SEC), YSQ-S3 Short Form Cognitive Questionnaire (SEC), DAS Dysfunctional Attitude Scale Beck A., Weissman A. ( SEC); For sexual testing: Genogram of excitatory stimuli, (Delcea C., 2021), FSFI Female Sexual Function Index, Rosen M. 2000, FSDS Female Sexual Distress Scale, Derogatis, 2019, FOS Female Orgasm Scale, McIntyre, Smith, 2019, ORS The Orgasm Rating Scale, Mah K., Binik, 2019, MISSA Multiple Indicators of Subjective Sexual Arousal, Mosher DL, 2019- SISES Sexual Inhibition / Excitation Scale, (Milhausen RR 2019). Methods used in sex therapy intervention (face to face): to identify stimuli of pleasure, arousal and sexual relaxation, having as source the partner's body we used the Genogram of excitatory stimuli, the technique of anticipating excitatory stimuli and the technique of defocusing irrelevant stimuli. (Delcea C., 2021). Sensate focus and directed masturbation to identify individual arousal stimuli, and self-monitoring through journals. 3. Cognitive restructuring of dysfunctional cognitions. 4. Progressive desensitization, in the construction and practice of new exciting sexual behaviors. 6. Psychoeducation. 7. Relaxation techniques (eg breathing, mindfulness). Results: Following the standard psychological assessment, the patient has no Axis I and II emotional disorders, and no history of sexual abuse. The MCMI profile shows a person without clinical personality disorders, but a very high level of Distress (PDA), present cognitive schemas, Negativism and Need for approval that outlines a possible anxious predisposition, as well as present dysfunctional attitudes of medium level, considered as predispositions for depression. Sexual testing with the score sc = 19 FSDS scale, (Derogatis, LR 2002) The sexual distress scale in women shows that the patient has a high level of stress that positively correlates with the existence of sexual dysfunction, manifested by feelings of shame, guilt , inadequacy, and average sexual satisfaction. From the 2 orgasm measurement scales, FOS (McIntyre - Smith, 2019) and ORS (Mah K., Binik, Y., 2019) there is a lack of experience of orgasm by the subject, throughout life and an increased dissatisfaction. The FSFI Scale Index of sexual functioning in women (Rosen R., 2000) shows the same difficulty in experiencing orgasm in the context in which sexual desire exists and the level of arousal is high, from the subjective assessment of the patient. Sexual desire - 4.2; Excitation - 5.1; Lubrication - 4.2; Orgasm - 1.2; Sexual satisfaction - 4.4; Disappearance - 0.9 (maximum = 6.0). The genogram of excitatory stimuli shows an insufficient register of excitatory stimuli on the partner's body, 4 out of 8 (face, chest and arms) and an absent register of excitatory physical stimuli having as source its own body, absent fantasies, unique, poor and repetitive scenarios. Conclusions: This is a patient without mental disorders with clinical significance, with predispositions for the installation of anxiety and depression, high level of distress. There is a poor sexual history and reduced and inadequate arousal. Absent fantasies, absent masturbation, dysfunctional cognitions about sex, "sex is unknown, forbidden, dangerous", register of excitatory stimuli on one's own absent body, and reduced for the partner's body, sexual pattern during predominantly passive sexual intercourse, on receiving pleasure, focused on the partner's body. There is a lack of development of arousal stimuli and consequently sexual behaviors maintain orgasm dysfunction.
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