Chapter 13: Atypical Sexuality

Question 1

What is the DSM-5 definition of paraphilia?

Answer 1

• is “any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physiologically mature, consenting human partners.”

Question 2

What are the two main reasons for the DSM to select these disorders (paraphilic, voyeuristic, exhibitionistic, frotteuristic, sexual masochism, sexual sadism, pedophilic, fetishistic, and transvestic)?

Answer 2

they are relatively common, in relation to other paraphilic disorders do not exhaust the list of possible paraphilic disorders.
by virtue of its negative consequences for the individual or for others, rise to the level of a paraphilic disorder.

Question 3

What is the DSM-5 voyeuristic disorder definition?

Answer 3

a. over a period of at least 6 months, recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviors.
b. the individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
c. the individual experiencing the arousal and/or acting on the urges is at least 18 years of age.
- individuals living in institutional or other settings where opportunities to engage in voyeuristic behavior are restricted.

Question 4

What is other specified paraphilic disorder?

Answer 4

• this applies to presentations in which symptoms characteristics of a paraphilic disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominant but do not meet the full criteria for any of the disorders in the paraphilic disorders diagnostic class.
• this is done by recording “other specific paraphilic disorder” followed by the specific reason (e.g., zoophilia).
• examples of presentations that can be specified using the ‘other specified’ designation include, but are not limited to, things like necrophilia.

Question 5

What is unspecified paraphilic disorder?

Answer 5

• this category is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific paraphilic disorder and includes presentations in which there is insufficient information to make a more specific diagnosis.

Question 6

What is kink?

Answer 6

Kink is a casual term for a paraphilia.

Question 7

What is the definition of fetish?

Answer 7

• fetish is sometimes used the same way.
• but, most commonly, it has a narrower definition: fetishism involves sexual arousal by objects, materials, or body parts.

Question 8

What is the DSM-5 fetishistic disorder definition?

Answer 8

a. an intense sexual arousal from either the use of nonliving objects or a highly specific focus on nongenital body part(s), as manifested by fantasies, urges, or behaviors.
b. the fetish objects are not limited to articles of clothing used in cross-dressing (as in transvestic disorder) or devices specifically designed for the purpose of tactile genital stimulation. (e.g., vibrator).

Question 9

What are the sexual interests in children among an online sample of men and women: prevalence and correlates.

Answer 9

• about 6% of men and 2% of women indicated ‘some likelihood’ of having sex with a child if they definitely would not be caught/punished.
• this study also considers the association with Adverse childhood experiences.

Question 10

What is the Wechsler adult intelligence scale by age orientation?

Answer 10

pedophilia - prepubescent
hebephilia- pubescent
Teleiophilia - adults

• some evidence of differences between pedophiles and others, including intelligence, executive functions, social skills, emotional disturbances.

Question 11

What is the heterosexual preference groups to laboratory stimuli depicting towards prepubescent, pubescent, and physically mature females?

Answer 11

physiological data supports the idea that hebephilia is a distinctive, discernable preference, but there has been great debate over whether it should be ‘pathologized.’

Question 12

What are the fixated vs. regressed pedophile?

Answer 12

pedophilic vs non-pedophilic molesters
based on impulsiveness, high impulsiveness is a predictor of greater recidivism.

Question 13

What are the executive dysfunctions in pedophilic and non-pedophilic child molesters?

Answer 13

• results indicate that pedophilic child molesters exhibited less performance deficits in cognitive functioning than non-pedophilic child molesters.
• Compared to healthy controls and nonsexual offenders, the pedophilic child molesters only showed executive dysfunction concerning response inhibition, whereas the non-pedophilic child molesters revealed more severe dysfunction, especially on tasks associated with cognitive flexibility and verbal memory.

Question 14

What is the neuropsychology of pedophilia and child sexual offending: effects on intelligence, handedness, and prefrontal function?

Answer 14

• general dysfunction (in pedophilic child molesters) = overall IQ is lower, higher frequency of left-handedness, lower levels of academic achievement, lower job capacity.
• Specific accentuated cognitive deficits (additionally noticed in pedophilic child molesters) = verbal word fluency, verbal and spatial working memory, emotion recognition and empathy, attention, executive functioning.

Question 15

Does sexual offending run in families?

Answer 15

sexual crime rates in fathers and brothers of age-matched population control men without sexual crime convictions.
more likely to commit child molestation if related to someone convicted of similar crimes.

Question 16

is there an inevitable recidivism for pedophiles?

Answer 16

the belief in inevitable recidivism turns out to be absolutely essential to both the justification for, and the structure of the sexually violent predator laws.
however, there is a huge gap exists between what is assumed and what the data actually show because most sex offenders do not in fact re-offend.
there are actually low rates of recidivism.

Question 17

What is the effectiveness of sex offender registration and notification: a meta-analysis of 25 years.

Answer 17

• the model demonstrated that SORN does not have a statistically significant impact on recidivism.
• this null effect exists when examining a combined model and when disaggregating studies by sexual or non-sexual offenses, or conceptualizing recidivism by arrest or conviction.
• recidivism rates among juvenile offenders are particularly low: 2.75% over 5 years according to this meta-analysis.

Question 18

What is the comparison of 12–17-year-old boys who had engaged in harmful sexual behaviors and were on or not on a sex offender registry?

Answer 18

• being on the sexual offender registry cause those on it a higher mental health problem in relation.
• a higher rate of suicide attempts
• sexual assault victimization
• approached by an adult for sex in past year grows.

Question 19

How is recidivism risk determined?

Answer 19

Static-99R
is an ‘actuarial risk assessment’ tool.
a questionnaire that scores into risk categories.
also, a penile plethysmography and eye tracking data has also been used with pretty good accuracy.

Question 20

What is the prevalence of BDSM-related fantasies and activities in the general population?

Answer 20

• 48.6% of people reported at least one lifetime BDSM activity.
• 22% more had fantasized
• 12.5% engaged in it regularly.

Question 21

What is the prevalence of paraphilic interests and behaviors in the general population: a provincial survey?

Answer 21

prevalence in Quebec of sadism, masochism, and other paraphilic behaviors.

Question 22

What is the practice of consensual BDSM and relationship satisfaction?

Answer 22

no differences in terms of relationship satisfaction (above), nor most facets of personality, self-esteem, etc.

Question 23

What are the comparisons between doms and subs?

Answer 23

empathy is higher in subs.
altruism is higher in doms
self-esteem is higher in doms
life satisfaction is higher in doms as well.

Question 24

Is BDSM an altered state of consciousness?

Answer 24

• researchers randomly assigned BDSM practitioners as tops (doms) and bottoms (subs).
• they hypothesized that tops enter an altered state of consciousness known as flow.

Question 25

What is transient hypo frontality as a mechanism for the psychological effects of exercise?

Answer 25

• and that bottoms enter a different altered state, transient hypo frontality, a decline in frontal lobe activity associated with runner’s high, meditation, and some drugs.
• they tested transient hypo frontality using the Stroop test, because cognitive tasks like this rely on the frontal lobe.

Question 26

Does BDSM impair cognitive functioning?

Answer 26

• higher score = worse
• in bottoms, supporting the hypothesis of transient hypo frontality.
• Tops showed more flow, although bottoms also reported some aspects of flow.

Question 27

What is the sexual sadism disorder definition in the DSM-5?

Answer 27

• the individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Question 28

What is the definition of exhibitionistic disorder in DSM-5?

Answer 28

• sexually aroused by exposing genitals to prepubertal children
• sexually aroused by exposing genitals to physically mature individuals
• sexually aroused by exposing genitals to prepubertal children and to physically mature individuals.

Question 29

What is the more than nuisance: the prevalence and consequences of frotteurism and exhibitionism?

Answer 29

• females tend to be traumatized by acts of flashing or a male touching them without permission.
• as in many cases, primarily female victims and male perpetrators (Clark et al.,2016)
• feelings of violation, changed behavior, and psychological distress.

Question 30

How serious and concerning a problem is exhibitionism?

Answer 30

researchers followed 200 exhibitionists, seen at the Royal Ottawa Hospital Sexual Behaviors Clinic, for up to 20 years.
they found relatively high rates of recidivism, including both violent and sexual crimes (line going down =recidivism).
Research reveals that cognitive distortions often contribute to paraphilic behaviors, including exhibitionistic and voyeuristic disorders.
paraphilias are often comorbid, with over half of individuals exhibiting more than one. common origins.

Question 31

What are the three main categories of fetishisms?

Answer 31

foot fetishism (podophilic) is an example of partialism.
Trichophilia is another example of partialism.
media fetishism concerns materials.
Transvestism

Question 32

What is object fetishism?

Answer 32

concerns inanimate objects that are neither body parts nor materials.

Question 33

What are the characteristics of those experiencing objectophilia?

Answer 33

there is a link between synaesthesia and autism led us to recognize potential features of both conditions from anecdotal descriptions given by OS individuals – and these features have also been noted by others.

Question 34

What are the contributions of classical conditioning in the development of atypical sexual interests including fetishes?

Answer 34

• they put a naked woman with a piggy bank till eventually just seeing the piggy bank gets the man aroused.
• not just a weird, random example.
• Plaud and Martini (1999) actually did this.
• penile circumference is way above baseline when viewing just the piggybank.