Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, 1300 South Second Street, Minneapolis, MN 55454, USA.
Arch Sex Behav. 2011 Apr;40(2):469-78. doi: 10.1007/s10508-010-9673-5. Epub 2010 Sep 28.
Using the Sexual Health Model as a framework, this case study illustrates the treatment of female orgasmic and low desire disorder in a long-term case with numerous complexities and other co-morbid mental health diagnoses. Derived from a sexological approach to education, the Sexual Health Model defines 10 key components posited to be essential aspects of healthy human sexuality: talking about sex, culture and sexual identity, sexual anatomy and functioning, sexual health care and safer sex, challenges to sexual health, body image, masturbation and fantasy, positive sexuality, intimacy and relationships, and spirituality. The client was selected because of the commonality of her initial presenting concerns and the etiological and treatment complexity of the case, which necessitated the use of all the sexual health treatment modalities provided at our center-individual, couple, and group therapy, sexual medicine, and psychiatric care. Her case is distinct in that her sexual dysfunctions and negative cognitions, while common, occurred in the context of serious relational, family sexual abuse, depression, and life-threatening medical problems, which necessitated long-term treatment. This case illustrates the multifactoral etiology of complex sexual dysfunctions requiring treatment that deals with varied psychosocial and biological factors.
本案例研究以性健康模型为框架,阐述了对一位长期患有多种复杂性问题且伴有其他合并精神健康诊断的女性性功能障碍和低性欲障碍的治疗方法。性健康模型源自一种性教育的方法,它定义了 10 个关键组成部分,这些组成部分被认为是健康人性行为的重要方面:谈论性、文化和性身份、性解剖学和功能、性保健和安全性行为、性健康挑战、身体形象、自慰和幻想、积极的性行为、亲密关系和人际关系以及精神信仰。选择该案例是因为其初始呈现的问题具有普遍性,而且该案例的病因和治疗都很复杂,需要使用我们中心提供的所有性健康治疗方式,包括个体、伴侣和团体治疗、性医学和精神科护理。该案例的独特之处在于,她的性功能障碍和消极认知虽然很常见,但发生在严重的关系、家庭性虐待、抑郁和危及生命的医疗问题背景下,这需要长期治疗。该案例说明了需要针对多种心理社会和生物因素进行治疗的复杂性功能障碍的多因素病因。