TY - CHAP M1 - Book, Section TI - Chapter 25. Sexual Dysfunction and Paraphilias A1 - Balon, Richard A1 - Segraves, R. Taylor A2 - Ebert, Michael H. A2 - Loosen, Peter T. A2 - Nurcombe, Barry A2 - Leckman, James F. Y1 - 2008 N1 - T2 - CURRENT Diagnosis & Treatment: Psychiatry, 2e AB - Sexual dysfunctions and paraphilias are disorders of either disturbance of processes in sexual functioning (sexual dysfunctions) or sexual behavior(s) (paraphilias). Human sexuality presents a very complex interaction of biology and psychology, which is reflected in complex physiological responses. A seemingly very simple event, such as erection, is regulated on the central nervous system and peripheral nervous system level, modified by various hormones, impacted by vascular changes, and influenced by various expectations, interpersonal issues, intrapsychic processes, not to mention the influences of medications and substances of abuse, the aging processes, diseases and personal habits. While there is a substantial body of literature on human sexuality in general and sexual dysfunctions and paraphilias in particular, there is mostly a lack of good evidence-based literature on most aspects of these disorders. The focus has definitely moved from psychology to biology and medicalization of human sexuality. The biological sciences, such as pharmacology, have contributed enormously to the developments in this area. However, an exclusive focus on biology and medical aspects of human sexuality is unwarranted and may trivialize a very complex area of human behavior. Even the clearly “biological” treatment approaches to sexual dysfunction may fail in certain situations due to various psychological factors. Thus, we caution the reader to always consider all factors, biological and psychological, in making the diagnosis and in planning treatment. In most cases, the judicious combination of biological and psychological treatment approaches will yield the most satisfactory results. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=3287823 ER -