Case Illustration · Applied Exercise
The Symptom and Its Context
A diagnosis has already been made and a course of treatment has already failed. This exercise works the reassessment.
The referral
A client, AFAB, 34, presents reporting low sexual desire for approximately three years. She was previously assessed at another clinic and given a diagnosis of FSIAD, and completed eight sessions of sensate focus and psychoeducation with no meaningful change. She describes herself as not a sexual person, and reports never having experienced desire in a partnered context, though she occasionally notices desire in response to media or in the absence of a partner.
A careful history in the current assessment reveals that her first sexual relationship at 22 involved a partner who consistently pressured her when she said no, and that the relationship lasted four years. She does not describe this as assault. She describes leaving her body during sex as normal.
Estimated time to complete this exercise: 12 minutes
Part 1 of 5
Which features of this history argue against a primary FSIAD formulation?
Select all that do. Three of the six. You get one submission.
References
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
- Basson, R. (2000). The female sexual response: A different model. Journal of Sex & Marital Therapy, 26(1), 51–65. https://doi.org/10.1080/009262300278641
- O’Driscoll, C., & Flanagan, E. (2016). Sexual problems and post-traumatic stress disorder following sexual trauma: A meta-analytic review. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12077