paraphilic masturbation

https://www.psychologytoday.com/us/blog/sex-life-the-american-male/201403/unacknowledged-harm-masturbation

by Michael Shelton, MS, LPC [Sex Life of the American Male] "An unacknowledged harm of masturbation (When does masturbation become problematic or unhealthy?)"

PARAPHILIA = [o] recurrent and intense sexually arousing FANTASIES, SEXUAL URGES, or SEXUAL BEHAVIORS that cause significant DISTRESS or IMPAIRMENT in social, occupational, or other areas of functioning" (American Psychiatric Association).

What we do know is that paraphilic development begins early in life (most males develop a paraphilic interest by the age of 17). The text Human Sexuality summarized the literature regarding the etiology of paraphilia and concluded: “People with paraphilia seem to have grown up in dysfunctional environments and to have had early sexual experiences that limited their ability to be sexually stimulated by consensual sexual activity.” (p. 341)[iv] Also, all paraphilias are primarily reinforced by masturbation. Unable to obtain sexual satisfaction by engagement in the activity most sexually stimulating to them, adolescents with paraphilic interest instead use fantasy and masturbation as a primary means of gratification thus keeping their desire hidden and unknown even to the people closest to them.

Each episode of masturbation however only further reinforces the paraphilic interest and reduces the possibility of modifying or eradicating it in the future. When people joke about the harm of masturbation, they almost always neglect to consider its truly most harmful effect. Each time a male masturbates to a paraphilic fantasy he further etches it into the hardwiring of his brain and increases the risk of future “significant distress and impairment,” particularly regarding sexual functioning and satisfaction. Once a paraphilic interest has fully developed, it is almost impossible to ameliorate.

References

[i] American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4^th ed.). Washington, DC: Author.

[ii] Kafka, W.P. (2007). Paraphilia-related disorders. In S.R. Leiblum (Ed.), Principles and practice of sex therapy (pp. 442 – 476). New York: Guilford Press.

[iii] Feierman J.R. & Feierman, L.A. (2000). Paraphilias. In L.T. Szuchman & F. Muscarella (Eds.), Psychological perspectives on human sexuality (pp. 480 – 518). New York: John Wiley & Sons.

[iv] Strong, B., DeVault, C., Sayad, B.W., & Yarber W.L. (2005). Human sexuality: Diversity in contemporary America. Boston: McGraw Hill.

comoribid = direct vs indirect causal relationship vs common factors

https://comorbidityguidelines.org.au/a1-what-is-comorbidity/why-does-comorbidity-occur

"There are a number of possible explanations as to why comorbidity may occur (see Figure 2):

>The presence of a mental health condition may lead to an AOD use disorder, or vice versa (known as the direct causal hypothesis).

>There may be an indirect causal relationship.

>There may be factors that are common to both the AOD and mental health condition, increasing the likelihood that they will co-occur.

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https://comorbidityguidelines.org.au/why-does-comorbidity-occur/why-does-comorbidity-occur/direct-casual-hypothesis

1. OAD as EFFECT of a MH condition 

MH condition --> AOD (alcohol or other drugs) ["SELF-MEDICATION" Hypothesis] = substances are sued to medicate MH symptoms

2. AOD as CAUSE of a MH condition 

AOD --> MH condition ["SUBSTANCE-INDUCED DISORDERS"]

-- alcohol --> depression, anxiety

-- stimulants, steroids, or hallucinogens --> mania

-- alcohol withdrawal, amphetamines, cocaine, cannabis, LSD (lyserfic acid diethylamide) --> psychotic symptoms

-- OAD --> substance-induced neurocognitive disorder, sexual dysfunction, sleep disorder

comorbid = mutual influence relationship

"There are a number of possible explanations as to why two or more disorders may co-occur. It is most likely, however, that the relationship between comorbid conditions is one of mutual influence."

https://comorbidityguidelines.org.au/part-a-what-is-comorbidity-and-why-is-it-important/a1-what-is-comorbidity

drug and tobacco abuse: common comorbidity

"Indeed, one of the most common and often overlooked comorbidities in AOD clients is tobacco use (discussed in Chapter B1) [9-12]."

https://comorbidityguidelines.org.au/part-a-what-is-comorbidity-and-why-is-it-important/a1-what-is-comorbidity

suicidal depression = severe

 "For example, people who report symptoms of depression but do not meet diagnostic criteria have reduced productivity, increased help-seeking, and an increased risk of attempted suicide [22]. Therefore, rather than viewing mental health as merely the presence or absence of disorder, mental health conditions can be viewed as a continuum ranging from mild symptoms (e.g., mild depression) to severe disorders (e.g., schizophrenia or psychotic/suicidal depression)."

https://comorbidityguidelines.org.au/part-a-what-is-comorbidity-and-why-is-it-important/a1-what-is-comorbidity

panic disorder: essential feature

https://en.wikipedia.org/wiki/Panic_disorder

key word: PAROXYSMAL [Gk. para = beyond + oxys = sharp, pointed] = sudden & uncontrolled, occurring periodically (medicine)dictionary.com], sudden attack, convlusions; periodic worsening of a disease [etymonline.com]

--ICD-10-CM Code F31.0 Panic Disorder (Episodic PAROXYSMAL Anxiety) without Agoraphobia

>"The essential feature is recurrent attacks of SEVERE ANXIETY (panic) which are NOT RESTRICTED to any PARTICULAR situation or set of circumstances and are therefore UNPREDICTABLE."

>"Often the first attacks are triggered by physical illnesses, major stress, or certain mediation."

>Rule Out Depression: "Panic disorder should NOT be given as the main diagnosis if the person has a depressive disorder at the time the attacks start; in these circumstances, the panic attacks are probably SECONDARY TO DEPRESSION."