271 research outputs found

    Cognitive Behavioral Therapy Plus a Serious Game as a Complementary Tool for a Patient With Parkinson Disease and Impulse Control Disorder: Case Report

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    Background: Impulse control disorders (ICDs) are commonly developed among patients who take dopamine agonist drugs as a treatment for Parkinson disease (PD). Gambling disorder and hypersexuality are more frequent in male patients with PD, with a prevalence over 4% in dopamine agonists users. Although impulsive-compulsive behaviors are related to antiparkinsonian medication, and even though ICD symptomatology, such as hypersexuality, often subsides when the dopaminergic dose is reduced, sometimes ICD persists in spite of drug adjustment. Consequently, a multidisciplinary approach should be considered to address these comorbidities and to explore new forms of complementary interventions, such as serious games or therapies adapted to PD. Objective: The aim of this study is to present the case of a patient with ICD (ie, hypersexuality) triggered by dopaminergic medication for PD. A combined intervention was carried out using cognitive behavioral therapy (CBT) for ICD adapted to PD, plus an intervention using a serious game-e-Estesia-whose objective is to improve emotion regulation and impulsivity. The aim of the combination of these interventions was to reduce the harm of the disease. Methods: After 20 CBT sessions, the patient received the e-Estesia intervention over 15 sessions. Repeated measures, before and after the combined intervention, were administered to assess emotion regulation, general psychopathology, and emotional distress and impulsivity. Results: After the intervention with CBT techniques and e-Estesia, the patient presented fewer difficulties to regulate emotion, less emotional distress, and lower levels of impulsivity in comparison to before the treatment. Moreover, the frequency and severity of the relapses also decreased. Conclusions: The combined intervention-CBT and a serious game-showed positive results in terms of treatment outcomes

    Online Pornography and its Clinical Relevance in Sexual Dysfunctions among young heterosexual men: A Literature Review.

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    Nos Ășltimos 20 anos, o mundo da pornografia online sofreu uma expansĂŁo maciça. O acesso fĂĄcil e nĂŁo controlado ao conteĂșdo sexual online permite a qualquer pessoa de qualquer idade, em qualquer lugar com Internet e um smartphone, aceder ao mesmo se lhe apetecer. Simultaneamente, as disfunçÔes sexuais, tradicionalmente vistas como dependentes da idade, começaram a ser cada vez mais reportadas pelos homens mais jovens. VĂĄrios estudos exploraram a forma como o uso da pornografia se relaciona com a saĂșde sexual, mas a literatura tem numerosas limitaçÔes quanto aos resultados obtidos. Esta revisĂŁo visa analisar a literatura disponĂ­vel para que a investigação futura possa melhorar o seu foco de estudo, investindo em estudos clĂ­nicos em larga escala e, portanto, obter resultados mais precisos. A comunidade cientĂ­fica ainda nĂŁo chegou a um consenso, contudo, no ano passado, "uso de pornografia" e "cibersexo" foram acrescentados ao diagnĂłstico de Doenças do Comportamento Sexual Compulsivo nas classificaçÔes internacionais. Durante o desenvolvimento sexual podem surgir vĂĄrias questĂ”es que podem promover a procura de respostas na Internet, de forma anĂłnima para evitar o sentimento de vergonha, apesar do risco de desinformação. Os mĂ©dicos devem começar a considerar esta conduta como uma possĂ­vel causa de determinadas queixas e estarem preparados para abordar uma situação destas, reconhecendo os fatores de risco de disfunçÔes sexuais e perfis distintos de utilização da pornografia.Over the past 20 years, the world of online pornography underwent on a massive expansion. The easy and uncontrolled access to sexual content online allows anyone of any age, anywhere with internet and a smartphone, to consume it if they feel like it. Simultaneously, sexual dysfunctions, traditionally seen as age-dependent, started to be increasingly reported by younger men. Several studies have explored how pornography use relates to sexual health, but the literature has numerous limitations to collect strong data. This review aims to analyse the available literature so that future research can improve its study focus, investing in large-scale clinical studies and therefore obtain more accurate results. The scientific community has not yet reached a consensus, however, last year, "pornography use" and "cybersex" were added to the Compulsive Sexual Behaviour Disorder diagnosis on international classifications. During sexual development, several questions may arise, which can promote the search for answers on the internet anonymously to avoid the feeling of shame, despite the risk of misinformation. Clinicians must start to consider this conduct as a possible cause of some complaints and be prepared to approach such a case, recognizing risk factors for sexual dysfunctions and distinct pornography-use profiles

    Religiosity, Moral Disapproval, Shame and Pornography Use: Assessing the Relationship Between Shame and Sexual Behaviors

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    Many compulsive and hypersexualized behaviors, including pornography use, have been associated with negative emotional, neurological, and psychosocial problems in a subset of users. Research showed that the constructs of shame, shame-proneness, and attachment may be related to the use of pornography as well as the theory of addiction. Shame-proneness is a construct that is consistently and positively associated with a variety of internalizing symptoms including depression, social, and generalized anxiety as well as a linked to an assortment of externalizing and risky behaviors such as anger, substance use, and criminal offending. Research suggested that higher levels of religiosity have a strong relationship to the moral disapproval of the use of pornography based on individual religious beliefs. This study examined the correlation between religiosity and sexual shame based on earlier research, which hypothesized that moral disapproval would mediate the relationship between religiosity and sexual shame. This research also hypothesized that shame-proneness would moderate the relationships between religiosity and moral disapproval, moral disapproval, and sexual shame, and finally the relationship between religiosity and sexual shame. The results showed that consistent with earlier research; moral disapproval mediated the relationship between religiosity and sexual shame. The study found that shame-proneness was a direct predictor of sexual shame however it did not moderate direct or indirect effects on the proposed theoretical relationships

    Pedophilia: Understanding the Origins and Problems within the Criminal Justice System

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    Societal stigma, criminal sanctions, and the mental illness or disorder of pedophilia are explored in this paper because of the considerable research gaps that have accumulated over the past decade. Most of the data acquired regarding individuals with pedophilia have been predominantly from male offenders, with most of the information coming from reports to local law enforcement and the FBI. The outcome of multiple studies shows that neuroimaging, associated brainwaves, and related sexual attraction are significantly different for individuals with pedophiliac tendencies than for others. Studies also reveal that research has been limited to prevention techniques and therapy for nonoffenders seeking help as well as the criminal justice system\u27s definition of pedophilia. Most minor-attracted people are subjected to self-reporting, and the definition of pedophiliac tendencies within mental illness is vague and can be misused. Additionally, many reporting systems and avenues exist for professionals working with individuals with pedophilia. Still, mandatory reporting has long been part managing mental illness and the potential for offending or reoffending. Using qualitative research methods, this approach is assessed in light of newer studies and interviews with mental health professionals; examination results show that pedophilia is both a mental disorder and a criminal consideration for which society currently has no established proactive measures to prevent offenses. The need and potential for handling pedophiliac acts before they can occur, the accurate risk assessment of pedophilia in the criminal justice system, and society\u27s view of the topic are all judged based on previous treatment options that have not worked

    Nonparaphilic Sexual Addiction

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    Men who identify as sex addicts – an IPA study

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    Sex addiction is the subject of much debate, as it was considered and then refused as an entry in the DSM5. Despite being referred to by different nomenclature, the most accepted definition is that it is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behaviour over an extended period, that causes marked distress or impairment in personal, family, social, educational, occupational or other important areas of functioning. Research in the field has been predominantly medical-model based, focusing on symptomatology and correlates. There are fewer qualitative studies on the experience of the sex addict. This qualitative study uses Interpretative Phenomenological Analysis to explore six self-identified sex addicts’ experiences of sex addiction. Participants were recruited through an open invitation to attendees of Sex Addicts Anonymous. Six participants came forward from different fellowships around the UK. Semi-structured interviews were carried out and analysis of the data revealed four major themes: Experience of the Self, Relational Dynamics, the Sex Addict and Addiction, and Recovery. The results were congruent with preexisting literature, however new light was shed on the developmental perspectives and relational styles related to sex addiction, as well as reasons for acting out. Implications to therapy include understanding and addressing early relational ruptures and insecure attachments, grandiose selfstatements, and enhancing intersubjectivity, not only focusing on symptom-management. The study also highlights the need for supervision, and researcher and therapist reflexivity. Future research should focus further on the role of early relational trauma, and on couple’s therapy for sex addiction

    Sexual compulsion — Relationship with sex, attachment and sexual orientation

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    BACKGROUND AND AIMS: Sexual addiction, also known as hypersexual disorder, is associated with serious psychosocial problems for many people. METHODS: This study used questionnaires to investigate the effects of gender, sexual orientation and attachment (avoidance and anxiety) on sexual compulsion among 100 heterosexual and homosexual men and women. RESULTS: A positive correlation was found between anxious attachment and sexual compulsivity (r = 0.46; p < 0.01) and a positive correlation between avoidant attachment and sexual compulsivity (r = 0.39; p ≀ 0.01) in all participants. Secondly, an analysis of covariance showed a gender by sexual orientation interaction effect [F(1, 103) = 6.39, p < 0.01] but no attachment effect on sexual compulsivity. A follow-up comparison showed that lesbian women had higher rates of sexual compulsivity than heterosexual women [t (2, 50) = 5.08, p < 0.001] whereas there was non-significant difference in sexual compulsivity between homosexual and heterosexual men [t (2, 50) = 1.30, p = N.S.]. DISCUSSION: The results provide preliminary evidence for an association between attachment and sexual compulsivity and the effects of gender and sexual orientation on sexual compulsivity

    Problematic Sexual Beliefs and Behaviors in the Church: A Content Analysis of Faith-Based Curricula Related to Evidence-Based Interventions

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    Internet pornography use, sexual problems, and sexual addiction are problematic not only for society but also for the church. The religious community needs interventions that can effectively treat sexually addictive and non-addictive problems that do no harm to individuals. The purpose of this study was: (a) to examine five faith-based curricula available for use in churches to determine whether they include key evidence-based treatment (EBT) components found effective in treating sexual addiction, and (b) to determine whether these curricula differentiate between addictive versus non-addictive sexual behaviors. Because no known studies have been conducted to examine faith-based treatment (FBT) curricula for EBT key components, the research design for this study was a qualitative inductive content analysis. The results showed that all five FBT curricula include EBT key components but the FBTs varied in how many EBT components they contained. The results also showed that only one of the five FBTs differentiates between and offers different treatment approaches for addictive versus non-addictive sexual behaviors. The recommendations were that the FBTs should expand their curricula to incorporate more EBT components, implement assessment measures to differentiate between addictive versus non-addictive sexual behaviors, and provide approaches that differentiate between sexual addiction, non-sexual addiction, and moral/sin issues. With these added components, the FBT curricula can make a significant difference in helping the church deal with sexual addiction, which can also positively influence the spiritual climate in the church

    Effects of dance therapy on balance, gait and neuro-psychological performances in patients with Parkinson's disease and postural instability

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    Postural Instability (PI) is a core feature of Parkinson’s Disease (PD) and a major cause of falls and disabilities. Impairment of executive functions has been called as an aggravating factor on motor performances. Dance therapy has been shown effective for improving gait and has been suggested as an alternative rehabilitative method. To evaluate gait performance, spatial-temporal (S-T) gait parameters and cognitive performances in a cohort of patients with PD and PI modifications in balance after a cycle of dance therapy

    Exploring the etiological pathways of Problematic Pornography Use in NoFap/PornFree rebooting communities: A critical narrative analysis of Internet forum data

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    Objective: Problematic pornography use (PPU) has been extensively studied in terms of its negative implications for various life domains. The empirical literature reveals measured outcomes of interpersonal and intrapersonal dysfunction in participants’ everyday living, supporting its classification as a disorder. The increasing number of complaints around PPU opens the door to the creation of online self-help rebooting communities. Method: This qualitative study aims to provide a better understanding of this behavior by investigating potential etiological pathways contributing to the onset of PPU, as they were expressed by members of the online NoFap/PornFree self-help communities with self-perceived PPU. Results: The critical narrative analysis reveals a complex web of mutually informing causal connections. The dialectical relationship between situational resources, material conditions and an embodied spectator gives rise to an online persona with motivations of self-exploration, experimentation and socializing. A sense of vulnerability, also, renders the use of pornography as a means of escape and validation. Furthermore, commitment to abstinence, framed by the notions of recovery and relapse, is found to be a major factor for maintaining distress. Conclusions: The study highlighted the need for a thorough understanding of the etiological pathways of PPU for a more effective and targeted intervention. Moving beyond biomedical conceptualizations suggests an intervention whereby PPU is placed in a context of a crisis of meaning
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