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Manual, 6th Edition.
Sexologies.book Page 8 Mercredi, 2. avril 2008 4:36 16
S8
the impact of ED on emotional well being and on sexual satisfaction (i.e., satisfaction with sexual intercourse, sex life,
and sexual relationship). However, it is crucial for patients
with ED non only to improve erectile symptoms but to optimise response to the treatment proposed. This allows to
improve sexual function, patient satisfaction and overall
couple relationship. In this context a novel patient assessment consisting of erection hardness evaluation has been
proposed. Erection hardness is a physiologic response which
can be easily graded subjectively with the Erection Hardness
Grading Scale (EHGS).
The importance of the ability to achieve a hard erection
has been recently recognized by an International Consensus
Advisory Panel of urology, psychology, and reproductive
health specialists with experience in assessing and treating
ED. This panel defined ED treatment efficacy as “…the ability of a pharmacologic agent to promote achievement and
maintenance of firm or adequate erections” and described
a complete response as “…consistent achievement and
maintenance of full erection”. Several prospective doubleblind trials have indeed demonstrated how erection hardness positively correlated with successful sexual intercourse
rate, patient satisfaction, and satisfaction with overall couple relationship. Therefore, achievement of hard erections
may be considered a unifying factor that defines response
in ED treatment. Completely hard and fully rigid erections
should be thus recognized as the optimal goal of an ED therapy.
Sexual motivation and violent crime today
F. Bruno. Dipartimento di Scienze Psichiatriche e Medicina
Psicologica - Università degli Studi “La Sapienza”, Roma, Italy
The paper is focused on the role of the sexual motivation in
committing violent crimes.
Target of this report is to assess the eventual change of
the phenomenology of the violent crime for reason of sex the
last years which are characterized, in western countries,
from a large liberalization of the sexual habits. In particular,
on the basis of the available figures, we would like to evaluate the phenomenon and its long time trends from a social
point view.
From a psychological and criminological points of view,
we evaluate the actual characteristics of some crimes associated with the individual’s behaviour and sexual drives. In
this perspective, we try to analyze the motivation of the
serial killer and of the other monstrous offenders due to their
sexual mental desires.
In this work, we take into account the role of the paraphilies, of the drug abuse, of the pornography, and finally
of the effect of the mass media transmitted violence on the
dynamics and genetics of the violent behaviour today.
Sex and brain and neurological disorders
C. Caltagirone1, M. Musicco1,2. 1Fondazione IRCCS Santa
Lucia, Rome, Italy; 2Istituto di Tecnologie Biomediche.
Consiglio Nazionale delle Ricerche Segrate, MI, Italy
Speakers
Sexual pleasure originates in the brain, from the “reward
sites”, erotic stimulation activate specific brain regions and,
at peripheral level, genitalia are connected to the central
nervous system via the autonomic nervous system. Damage
to or modification of these central and peripheral structures
is expected to alter sexual function.
In severe brain injuries of traumatic or vascular origin the
patients frequently report to have discontinued sex with the
partners. Sexual consequences of traumatic brain injuries
and stroke are similar, but in stroke it is not clear whether
these effects are attributable to the concomitant use of
antypertensive.
In epilepsy, sexual gestures, genital automatisms and
even spontaneous orgasms may be manifestations of complex partial seizures. In temporal seizures erotic perceptions
may be manifestations of the epileptic aura. Erectile dysfunction and premature ejaculation is common in men
affected by Parkinson’s disease probably in relation to the
alteration of dopamine system that characterize this neurodegenerative disorder. Hypersexuality is on the contrary
traditionally described in association with the treatment of
this disease with levodopa. Erectile disfunction may be an
early sign of extrapyramidal disorders affecting the autonomous nervous system as in the case of multiple system
atrophy.
Sexual dysfunction is frequently reported when the spinal
cord is involved by traumatic injuries or multiple sclerosis.
Altered sexual function may be consequence of compression
of cauda equina, peripheral neuropaties, or injuries to the
peripheral autonomc neurvous system.
We suggest that accurate neurological investigation
should be mandatory in the management of persons with
sexual problems.
Cognitive-interpersonal psychotherapy of
sexual offender: a case report
T. Cantelmi, M. Toro, A. Violo, T. Corsini. Istituto di
Psicoterapia Cognitivo-Interpersonale, Rome, Italy
Objective: The present work aims to describe the CognitiveInterpersonal Psychotherapy (CIP) applied to Sexual Offenders (SO). SOs are often referred to group psychotherapy
when they are in prison. Marshall created a specific cognitive
psyvhotherapeutic treatment to 1) enhance SO’s selfesteem, 2) change cognitive distortions, 3) improve the
empathy with victims, 4) provide SOs with a better intimacy,
5) change their dysfunctional sexual preferences, 6) prevent
crime relapses. A case report will be introduced and discussed to evidence the features of clinical relevance of CIP
and its limitations.
Materials and methods: Case-report. L., a 65 years-old
man convicted with paedophilia. He has been perpetrating
sexual offences to a 6 years-old child since 2000 to 2005. L.
received a psychotherapeutic treatment based on CIP to
solve his sexual obsessions and his trait anxiety.
Diagnosis was gathered using his personal history, several
interviews, the Genogram and direct observation.
Results: A sexual hyper arousal was detected in every
domain of L.’s life. He had an anxious style of attachment.