tailieunhanh - Handbook of sexual dysfunction - part 10

WS điều trị thất bại liên quan (96). Tuy nhiên, dựa trên phản ứng điều trị giải thích etiological để có hiệu lực hạn chế. Lâm sàng làm việc trong thời đại Internet Cung cấp các hỗ trợ quan sát cho vai trò của các điều trong paraphilias. Tiếp xúc với vật liệu Internet dựa trên tình dục rõ ràng và kèm theo mức độ cao của kích thích tình dục xuất hiện, | 310 Osborne and Wise exhibitionist fantasies implying stronger conditioning was associated with treatment failure 96 . However etiological explanations based on responses to treatment have limited validity. Clinical work in the Internet era provides observational support for the role of conditioning in the paraphilias. Exposure to Internet-based sexually explicit material and accompanying high levels of sexual arousal appear to in some individuals profoundly influence the development of conditioned sexual fantasy and arousal responses. However there is a wide range of responses to comparable levels of exposure. Therefore caution must be exercised in drawing conclusions about any direct causative effects of exposure Internet or otherwise on the development or latensification of psychosexual pathology. Fisher and Barak have presented eloquent reviews on the effects of exposure to pornography concluding that it is difficult to distinguish between the effects of exposure and the effects of pre-existing underlying personality factors in individuals who seek such exposure 97 . In contrast to classic conditioning is the theory of imprinting which proposes that early childhood is a critical period in which animals instinctually grow attached to a primary object. Species such as precocial birds are thought to become imprinted or physiologically programed to follow whatever creature or object they see shortly after hatching 98 . Binet hypothesized pathological imprinting in humans as a possible explanation for the development of fetishes 41 . Owing to events in sensitive developmental periods an association between arousal and a particular object or experience becomes imprinted. Study of nonhuman species suggests that behavior learned through imprinting is extremely difficult if not impossible to unlearn whereas in classic conditioning models deconditioning and reconditioning are theoretically possible. Overall empirical attempts to validate conditioning theories in the .