Um capítulo esquecido na história da psicologia? sexualidades desviantes, psicopatologia e normalidade / A forgotten chapter in the history of psychology? deviant sexualities, psychopathology, and normality / ¿Un capítulo olvidado en la historia de la psicología? sexualidades desviadas, psicopatología y normalidad

Este artigo tem como objetivo produzir uma análise histórica sobre as intersecções entre Psicologia e sexualidade desviantes da norma no Brasil, de fins do século XIX a meados da década de 1980. Esta temporalidade foi escolhida por abarcar o surgimento das pesquisas científicas sobre sexualidade e desvios sexuais, a consolidação dos estudos psicológicos sobre a temática e o processo mais recente de despatologização da homossexualidade. Em termos teóricos e metodológicos, foram adotados os pressupostos da História Social da Psicologia e da historiografia das homossexualidades no Brasil. Desse modo, buscou-se compreender como as ideias, concepções e práticas psicológicas foram mudando ao longo do tempo, em conexão com as transformações socioculturais e políticas que ocorreram durante o século XX. Para isto, foram utilizadas fontes primárias e secundárias de pesquisa com vistas à produção de interpretações sobre as conexões entre as ideias, os atores e os eventos narrados. Argumenta-se, ao longo do artigo, que as ideias e práticas psicológicas estão intrinsecamente conectadas aos contextos socioculturais e políticos de seu tempo, sendo os movimentos dinâmicos e os conflitos presentes nesses contextos fatores determinantes para a sua constituição.(AU)

This article aims to produce a historical analysis of the intersections between Psychology and sexualities that deviate from the norm in Brazil, from the late 19th century to the mid-1980s. This period was chosen because it encompasses the emergence of scientific research on sexuality and sexual deviations, the consolidation of psychological studies on the subject and the most recent process of de-pathologization of homosexuality. Theoretically and methodologically, the assumptions of the Social History of Psychology and the historiography of homosexualities in Brazil were adopted. Therefore, we sought to understand how psychological ideas, conceptions and practices have changed over time, in connection with the sociocultural and political transformations that occurred throughout the 20th century. For this, primary and secondary sources of research were used to produce interpretations about the connections between the ideas, the actors and the narrated events. It is argued, throughout the article, that the psychological ideas and practices are intrinsically connected to the sociocultural and political contexts of their time, being the dynamic movements and conflicts present in these contexts determining factors for their constitution.(AU)

Este artículo tiene como objetivo realizar un análisis histórico de las intersecciones entre la Psicología y las sexualidades desviadas de la norma en Brasil desde finales del siglo XIX hasta mediados de la década de 1980. Esta temporalidad fue elegida por abarcar el surgimiento de las investigaciones científicas sobre sexualidad y desvíos sexuales, la consolidación de los estudios psicológicos sobre el tema y el más reciente proceso de despatologización de la homosexualidad. En el marco teórico y metodológico, se adoptaron los presupuestos de la Historia Social de la Psicología y de la historiografía de las homosexualidades en Brasil. De esta manera, se pretende comprender cómo las ideas, concepciones y prácticas psicológicas han cambiado a lo largo del tiempo, en conexión con las transformaciones socioculturales y políticas ocurridas durante el siglo XX. Para ello, se utilizaron las fuentes de investigación primarias y secundarias con miras a generar interpretaciones sobre las conexiones entre las ideas, los actores y los eventos narrados. Se argumenta, a lo largo de este artículo, que las ideas y las prácticas psicológicas están intrínsecamente conectadas a los contextos socioculturales y políticos de su tiempo, y los movimientos dinámicos y los conflictos presentes en estos contextos fueron los factores determinantes para su constitución.(AU)

Compulsive sexual behavior, religiosity, and spirituality: A systematic review.

BACKGROUND AND AIMS: In recent years, increasing attention has been given to the relationship between compulsive sexual behavior (CSB), religiosity, and spirituality. This review summarizes research examining the relationship CSB has with religiosity and spirituality, clarifying how these constructs inform the assessment and treatment of this syndrome. METHODS: The present paper reviews research published through August 1, 2021, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Only studies providing quantitative analyses were included. RESULTS: This review identified 46 articles, subsuming 59 studies, analyzing the relationship between CSB and religiosity or spirituality. Most studies used cross-sectional designs with samples primarily composed of heterosexual White men and women. Generally, the studies found small to moderate positive relationships between religiosity and CSB. Studies considering the mediating or moderating role of moral incongruence identified stronger, indirect relationships between religiosity and problematic pornography use (PPU), a manifestation of CSB. Few studies examined the association between spirituality and CSB, but those that did either reported negative relationships between indicators of spiritual well-being and CSB or positive relationships between CSB and aspects of spiritual struggles. DISCUSSION AND CONCLUSIONS: Although research examining CSB and religiosity has flourished, such growth is hampered by cross-sectional samples lacking in diversity. Moral incongruence assists in explaining the relationship between religiosity and PPU, but future research should consider other manifestations of CSB beyond PPU. Attention should also be given to examining other religiosity and spirituality constructs and obtaining more diverse samples in research on CSB, religiosity, and spirituality.

Hands-off: Study protocol of a two-armed randomized controlled trial of a web-based self-help tool to reduce problematic pornography use.

BACKGROUND AND AIMS: The past-year prevalence of problematic pornography use (PPU) was 1-6% in adult populations. As a result of treatment obstacles and barriers, such as unaffordable treatments, only a minority of problematic pornography users may seek treatment. Having a free, online, self-help program may overcome treatment barriers and may help those individuals who cannot receive traditional or offline treatment for PPU. Although the effectiveness of such online programs reducing substance use and problematic gambling have been reported, no prior study has examined the efficacy of an online self-help intervention aiming to reduce PPU. METHODS: This two-armed randomized controlled trial (RCT) will examine the effectiveness of an online self-help program (Hands-off) to reduce PPU, while also considering psychopathological comorbidities. The six-week intervention condition includes six core modules developed to reduce PPU based on motivational interviewing, cognitive behavioral therapy, mindfulness, and wise social-psychological intervention techniques. The target sample size is 242 participants. Self-report questionnaires will be administered at baseline, right after the end of the intervention, at one-month, and three-month follow-ups after the end of the intervention. The primary outcome will be the level of PPU. Secondary outcomes will include pornography use frequency, pornography craving, pornography use-avoidance self-efficacy, sex mindset, sexual satisfaction, negative and positive emotions, and life satisfaction. Data will be analyzed on an intention-to-treat basis using linear mixed models. RESULTS: Results will be reported at conferences and published in a scientific peer-reviewed journal. The participants will be sent a lay-person-friendly summary of the results via e-mail.

A mindful model of sexual health: A review and implications of the model for the treatment of individuals with compulsive sexual behavior disorder.

BACKGROUND AND AIMS: Mindfulness-based approaches, derived from centuries of eastern philosophy and practice, have been increasingly incorporated into western medicine. For example, data support the efficacy of mindfulness-based therapies to reduce stress and promote mental health. METHODS: In this study, we briefly review models and approaches to sexual health in the context of considering compulsive sexual behavior disorder, describe mindfulness-based approaches to stress, addiction, and compulsive sexual behaviors, and present a Mindful Model of Sexual Health (MMSH) that incorporates elements of eastern and western philosophies. We further illustrate the clinical utility of the MMSH in a clinical case description. RESULTS: We propose the MMSH as a holistic and integrative model that honors and acknowledges individual differences and provides mindfulness-based tools and practices to support individuals to proactively manage, balance, and promote sexual and mental health. The MMSH may be used as a framework to organize information regarding physical, mental, emotional, sexual, and relational health, as well as a conceptual map offering navigational skills to access information within one's mind/body to make informed decisions to promote well-being regarding sexual satisfaction and health. In its organizational structure, the MMSH is divided into eight domains that are theoretically linked to biological functions and may be used to identify and overcome barriers to sexual health through mindful inquiries in clinical practice or educational settings. DISCUSSION AND CONCLUSION: Given its focus on awareness of interoceptive processes through mind/body connectedness, the MMSH may resonate with a wide range of individuals, including those with compulsive sexual behavior disorder.

Zoophilia in an adolescent with high-functioning autism from Sri Lanka.

OBJECTIVE: Zoophilia is a rare paraphilic disorder with intense sexual urges involving animals. Autism is characterised by impairments in social communication and repetitive, restricted behaviours (RRB). Reported cases of zoophilia are limited worldwide, and zoophilia in autism is rarer. METHOD: This is a case report describing this unique and relatively unrecognised association in a male adolescent from Sri Lanka. RESULTS: A 17-year-old boy diagnosed with autism has average intelligence and academic capabilities. He had spent increasing time at his grandparents' cattle house. First, he was found masturbating near the cows and later having penetrative intercourse with a heifer. The shocked parents first sought traditional healing in the form of 'thovil', a demonic ritual of exorcist nature. Later, clinical evaluation found intense sexual urges towards cattle, which had led to marked distress and academic impairment. Sex hormone profile was normal. The adolescent was treated with a combination of cognitive-behaviour therapy and a selective serotonin reuptake inhibitor. CONCLUSION: We postulate that his persistent social difficulties contributed to the development of a paraphilic disorder. Unlike with his RRBs, he was markedly distressed about this sexual behaviour. Further research is required to explore this rarely reported, potential association.

Assessment of problematic sexual interests with the penile plethysmograph: an overview of assessment laboratories.

Phallometric testing, or penile plethysmography (PPG), is an objective measure of sexual arousal for males. While extensive research on the reliability and validity of PPG has promoted its reputation as the "gold standard" of objective measurement of sexual arousal, there is a lack of standardization of stimulus sets and interpretation of results between sites. This article describes the laboratory protocol employed for PPG at the Royal Ottawa Mental Health Centre's Sexual Behaviours Clinic (SBC) in Ottawa, Ontario, as well as those used by the Sexual Behaviors Clinic and Lab (SBCL) in the Community and Public Safety Psychiatry Division (CPSPD) of the Department of Psychiatry and Behavioral Sciences at Medical University of South Carolina (MUSC) in Charleston, South Carolina. The need for standardization in both testing protocol and stimuli use across sites are highlighted.

Choline associated hypersexuality in a 79-year-old man.

Hypersexuality, also referred to as sexually inappropriate behavior and sexual disinhibition, involves persistent, uninhibited sexual behaviors directed at oneself or at others, sometimes associated with neurodegenerative disorders. Choline is a water-soluble essential nutrient, used as a dietary supplement in different diseases. This report was aimed at considering choline intake as a possible cause of iatrogenic hypersexuality. After an evaluation, a 79-year-old man affected by memory loss was diagnosed with mild cognitive impairment and treated with oral choline. After 6 weeks of regular choline assumption, the patient showed a pathological increase in libido with sexual urges. As choline was withdrawn, the hypersexuality disappeared within 5 days. Since hypersexuality may be an underreported and overlooked adverse effect of drugs and dietary supplements acting on the cholinergic pathway, this should be considered when treating and counselling patients with inappropriate sexual behavior.

Paralyzed by desire: a new type of body integrity identity disorder.

BACKGROUND: Body incongruity in body integrity identity disorder (BIID) manifests in the desire to have a healthy limb amputated. We describe a variant of the disorder: the desire to become paralyzed (paralysis-BIID). METHOD: Sixteen otherwise healthy participants, recruited through Internet-based forums, websites, or word of mouth, completed questionnaires about details of their desire and accompanying symptoms. RESULTS: Onset of the desire for paralysis typically preceded puberty. All participants indicated a specific level for desired spinal cord injury. All participants simulated paralysis through mental imagery or physical pretending, and 9 (56%) reported erotic interest in paraplegia and/or disability. Our key new finding was that 37.5% of paralysis-BIID participants were women, compared with 4.4% women in a sample of 68 individuals with amputation-BIID. CONCLUSIONS: BIID reflects a disunity between self and body, usually with a prominent sexual component. Sex-related differences are emerging: unlike men, a higher proportion of women desire paralysis than desire amputation, and, while men typically seek unilateral amputation, women typically seek bilateral amputation. We propose that these sex-related differences in BIID manifestation may relate to sex differences in cerebral lateralization, or to disruption of representation and/or processing of body-related information in right-hemisphere frontoparietal networks.

Impotence in the 18th and 19th century: concepts of etiology and approaches to therapy.

The old word impotence is derived from the Latin word impotencia, which literally translated means "lack of power." Impotence, in the course of the history, has been attributed to mental pathology, anxiety, or demons or witches. Historically, the pharmacological treatments for impotence started in Greek times, when a myriad of herbal medications were applied locally to the genitals to enhance "sexual strength." In the 18th century, theories about the main factors inducing impotence saw it as an abnormal state of the fibers, a defect in the solid or liquid substances or a bad structure (tumor, inflammation, abscess, ulcer or foreign body). According to these mechanisms, when impotence depended on the state of the muscular fibers, treatment included a tepid bath and a clyster. In very fat or very weak people, who get particularly tired, it was important to use the remedies able to give energy to the fibers, such as ferrous mineral waters, for a month. Moreover, other suggestions were to ride a horse, to sleep few hours, to breathe good country air, to take a purge every 2 weeks, to drink half a glass of wine from Borgogne or to distract the mind continuously. In the 19th century, therapies regarding impotence included slight electric stimulation through the application of stimulators on the scrotum in the testis or epididymis areas, until pain was induced. In the same period, another method for treating impotence was flagellation. This method consisted of little flagellations with leather strips.

Measurement of risk of sexual violence through phallometric testing.

The use of phallometric testing to determine risk of sexual violence is becoming more widely recognized throughout the world. This technique involves the precise measurement of circumferential change in the penis from flaccidity to erection in response to both 'normal' and deviant sexual stimuli. Phallometric testing is the only pure measure of sexual arousal, and unlike other physiological measures such as heart rate and GSR it is not influenced by arousal states such as fear and anger. The current published research compares the phallometric testing profiles of incarcerated sexual offenders with those of incarcerated nonsexual offenders. Specifically, the sexual arousal of 100 convicted rapists, pedophiles, and nonsexual offenders is examined. This research identifies what differentiates these groups and what best predicts risk of sexual aggression. Implications of these results include the possibility of using phallometric testing as a screening tool for those who work with vulnerable populations (e.g., child care workers, teachers). The principal benefit of phallometric testing, however, lies in the identification of those incarcerated men who are at greatest risk to sexually reoffend and who should thus be denied release from jail.

[Review of symptoms and therapy of paraphylias]. / A parafíliák tünettanák és terápiajának áttekintése.

The authors review the historical main milestones in the legislative aspects of sexual deviances, from ancient times through age of enlightenment to present times, including the factors affecting the Hungarian public attitudes towards it. The evolution of nomenclature of sexual orientation disorders is also evaluated thoroughly, detailing the DSM-IV-TR classification and the attempts and difficulties to further develop the present classification system. The authors also review the difficulties of epidemiological studies and sum up the pioneer work of Alfred Kinsey. The etiology of paraphylias is summed up based on biological, psychodynamic and learning theory approaches. Finally, the pharmacological and psychotherapeutic interventions are evaluated considering also comorbidity, outer control and forensic psychiatric aspects.

Inappropriate sexual behaviors in dementia.

Dementias are the most common type of neurodegenerative disorder. Behavioral disturbances are seen in more than 80% of patients suffering from these disorders. Although sexually inappropriate behaviors are not as common as some of the other behaviors seen in dementia, they can cause immense distress to all those who are affected. There are no randomized trials for the treatment of these behaviors, but the available data suggest efficacy for some commonly used treatment modalities. In this review, we systematically discuss various aspects of these behaviors and available treatments.

Perfil sexual de natrum muriacum

Este trabajo tiene como objetivo investigar la sexualidad de los hombres y mujeres que corresponden a la dinámica mental del medicamento Natrum Muriaticum.

The monoamine hypothesis for the pathophysiology of paraphilic disorders: an update.

A monoamine hypothesis for the pathophysiology of paraphilic disorders was first articulated in 1997 by Kafka. This hypothesis was based on four converging lines of empirical evidence. First, the monoamine neurotransmitters, dopamine, norepinephrine, and serotonin serve a modulatory role in human and mammalian sexual motivation, appetitive, and consummatory behavior. Second, the sexual effects of pharmacological agents that affect monoamine neurotransmitters can have both significant facilitative and inhibitory effects on sexual behavior. Third, paraphilic disorders appear to have Axis I comorbid associations with nonsexual psychopathologies that are associated with monoaminergic dysregulation. Last, pharmacological agents that enhance central serotonergic function in particular, have been reported to ameliorate paraphilic sexual arousal and behavior. Contemporary data supporting or refuting a monoaminergic hypothesis as a biological component associated with paraphilic sex offending behaviors will be reviewed. Particular attention will be given to pharmacological-metabolic probe studies, reports of Axis I comorbidity, the proposed role of disinhibited sexual motivation or sexual appetitive behavior, and cumulative pharmacological treatment data sets.

Zoofilia como complicación tardía de la enfermedad de Parkinson. Las drogas de Circe y los antídotos de Mercurio / Zoofilia as late complication os Parkinson´s disease. Circe drugs and Mercury antidotes

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Acquired sexual paraphilia in patients with multiple sclerosis.

BACKGROUND: Sexual dysfunction in patients with multiple sclerosis is typically characterized by diminished libido, erectile and ejaculatory dysfunction in men, and poor lubrication and anorgasmy in women. In contrast, hypersexual behavior and paraphilias are distinctly uncommon in this population of patients, but have been associated with various focal brain lesions. PATIENT AND METHODS: We describe a man with clinically definite multiple sclerosis who developed profound and abrupt disinhibition and paraphilic behavior during an exacerbation. RESULTS: Neuroimaging revealed a marked increase in the number of enhancing lesions in the right sides of the hypothalamus and mesencephalon and extending into the right sides of the red nucleus, substantia nigra, and internal capsule. The altered sexual behavior was characterized by an obsessive and insatiable desire to touch women's breasts. CONCLUSIONS: Acquired sexual paraphilic behavior is uncommon in patients with multiple sclerosis but may occur when inflammatory demyelination involves the hypothalamic and septal regions of the basal prosencephalon. Our experience with this man illustrates the great difficulty involved in treating such patients when the paraphilic behavior becomes persistent.