Paraphilic disorders included in DSM-5 are voyeuristic disorder (spying on others in private activities), exhibitionistic disorder (exposing the genitals), frotteuristic disorder (touching or rubbing against a nonconsenting individual), sexual masochism disorder (undergoing humiliation, bondage, or suffering), sexual sadism disorder (inflicting humiliation, bondage, or suffering), pedophilic disorder (sexual focus on children), fetishistic disorder (using nonliving objects or having a highly specific focus on nongenital body parts), and transvestic disorder (engaging in sexually arousing cross-dressing) 3). It is not rare for an individual to manifest two or more paraphilias. Common fetishistic objects include the following: The prevalence of fetishistic disorder is unknown. google_ad_client: "ca-pub-9759235379140764", Although mechanisms were not clearly elucidated, exposure to excessive sexual stimulation outside socially sanctioned heterosexual marriage was believed to put individuals at risk for sexual deviations.
Sexual disorders and crime. 1975. 8(6):1650-9. Please confirm that you are a health care professional. In women, fetishism is less common, largely because of anatomic differences that allow females to conceal inadequate sexual response more readily than males can.
Kruger TH, Schiffer B. Neurocognitive and personality factors in homo- and heterosexual pedophiles and controls. The term voyeurism refers to the fairly common desire to view nudity and acts of coition. Many individuals with pedophilic disorder have had sexual fantasies about children for a long time. Many exhibitionists are very prudish with their wives. Learn more about our commitment to Global Medical Knowledge. There are also specific paraphilias that are generally better described as preferential sexual interests than as intense sexual interests. The Diagnostic and Statistical Manual fifth edition (DSM-5) definition of paraphilia as “any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners” 1). The morbidity or mortality of a paraphilia depends on the act practiced, the comorbidity involved, the patient’s cooperation with the therapist, and whether or not the legal system is involved. Others include sexual masochism disorder and sexual sadism disorder. Physicians must be aware that not every therapist treats people with paraphilias. Learn. Frotteuristic disorder, including uninvited sexual touching of or rubbing against another individual, may occur in as many as 30% of adult males in the general population; 10-14% of adult males seen in the outpatient setting for paraphilic disorder and hypersexuality meet the diagnostic criteria. Individual expressive-supportive therapy requires a psychologically minded patient who is willing to focus on the paraphilia. The DSM-5 diagnostic criteria for voyeuristic disorder are as follows 17): Further specifiers include the following: The DSM-5 diagnostic criteria for exhibitionistic disorder are as follows 18): The DSM-5 diagnostic criteria for frotteuristic disorder are as follows 19): The DSM-5 diagnostic criteria for sexual masochism disorder are as follows 20): The DSM-5 diagnostic criteria for sexual sadism disorder are as follows 21): The DSM-5 diagnostic criteria for pedophilic disorder are as follows 22): The DSM-5 diagnostic criteria for fetishistic disorder are as follows 23): The DSM-5 diagnostic criteria for transvestic disorder are as follows 24): The various paraphilic disorders affect a wide variety of people. This feature is also viewed as a mechanism through which the masochist maintains control. World Health Organization. Approximately 37% of sexual assault victims reported to law enforcement agencies were juveniles (< 18 years); 34% of all victims were younger than 12 years. History Comments Share. Multiprofessional assessment may be helpful, particularly when paraphilias result in criminal behavior. For men, the fetish serves a defensive function, a reinforcing adjunct for a penis of uncertain potency. In some cases, the paraphilic foci are closely related and the connection between the paraphilias is intuitively comprehensible (e.g., foot fetishism and shoe fetishism). Paraphilias are emotional disorders defined as sexually arousing fantasies, urges, or behaviors that are recurrent, intense, occur over a period of at least 6 months, and cause significant distress or interfere with important areas of functioning. The pattern of disturbed erotic arousal is usually fairly well developed before puberty.
266-275). Women may cross-dress, but no cross-dressing females who become sexually excited by the activity have been described in the English-language literature. J Sex Med. On one hand, they must keep their anger under tight control, yet on the other, they may become tyrannical with their family because they feel safe from retaliation. Ejaculation Disorder, “Recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving 1) nonhuman objects, 2) the suffering or humiliation of oneself or one’s partner, or 3) children or other non-consenting persons, that occur over a period of at least 6 months.”, “The behavior, sexual urges, or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”. The majority of pedophiles have a clear sexual preference. Some paraphilias (such as pedophilia) are illegal and may result in imprisonment and life-time registration as a sex offender. Terms in this set (8) Exhibitionistic Disorder. West D, ed. There are currently eight specific types of paraphilia documented in the DSM-IV and one classification for unspecified paraphilia which includes several particular paraphilic assignations. The onset of exhibitionistic disorder is usually before age 18 years but may occur later. Treatment of the specific condition (fetish) rather than the primary underlying disorder (eg, organic pathology or personality disorder) is generally unsuccessful. Many theories exist regarding the etiology of paraphilias, including psychoanalytical, behavioral, biologic, and sociobiologic theories. Rosen I, ed. Masochistic acts commonly involve a wide range of activities, such as restraint, blindfolding, beating, electrical shock, cutting, piercing, and humiliation (eg, being urinated or defecated on, forced to bark, verbally abused, or forced to cross-dress). Washington, DC: American Psychiatric Association; 2013. The Search for the Self.
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