Paraphilias and gender dysphoria

Question 1

Voyeuristic Disorder

Answer 1

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.

Question 2

Exhibiosnistic Disorder

Answer 2

A. Over a period of at least 6 months, recurrent and intense sexual arousal from the ex­posure of one’s genitals to an unsuspecting person, 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.

Question 3

Frotteruristic Disorder

Answer 3

A. Over a period of at least 6 months,recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, 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.

Question 4

Sexual Masochism Disorder

Answer 4

A. Over a period of at least 6 months, recurrent and intense sexual arousal from the act of being humiliated, beaten, bound, or othenwise made to suffer, as manifested by fan­tasies, urges, or behaviors.
B. Thefantasies,sexualurges,orbehaviorscauseclinicallysignificantdistressorimpair­ ment in social, occupational, or other important areas of functioning.

Question 5

Sexual Sadism Disorder

Answer 5

A. Over a period of at least 6 months, recurrent and intense sexual arousal from the phys­ical or psychological suffering of another person, 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.

Question 6

Pediphilic Disorder

Answer 6

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sex­ual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).

B. The individual has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.

C. The individual is at least age 16 years and at least 5 years older than the child or children in Criterion A.

Question 7

Fetishistic Disorder

Answer 7

A. Over a period of at least 6 months, recurrent and 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. Thefantasies,sexualurges,orbehaviorscauseclinicallysignificantdistressorimpair­ ment in social, occupational, or other important areas of functioning.

C. The fetish objects are not limited to articles of clothing used in cross-dressing (as in transvestic disorder) or devices specifically designed for the puφose of tactile genital stimulation (e.g., vibrator).

Question 8

Transvestic Disorder

Answer 8

A. Over a period of at least 6 months, recurrent and intense sexual arousal from cross­ dressing, as manifested by fantasies, urges, or behaviors.

B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impair­ment in social, occupational, or other important areas of functioning.

Question 9

Gender Dysphoria

Answer 9

A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months’ duration, as manifested by at least two of the following:

1. A marked incongruence between one’s experienced/expressed gender and pri­mary and/or secondary sex characteristics (or in young adolescents, the antici­pated secondary sex characteristics).
2. A strong desire to be rid of one’s primary and/or secondary sex characteristics be­cause of a marked incongruence with one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated second­ary sex characteristics).
3. A strong desire for the primary and/or secondary sex characteristics of the other gender.
4. A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender).
5. A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender).
6. A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender).

B. The condition is associated with clinically significant distress or impairment in social, occupational or other important areas of functioning.

Question 10

Body Dysmorphic Disorder

Answer 10

A. Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.

B. At some point during the course of the disorder, the individual has performed repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking, reassurance seek­ing) or mental acts (e.g., comparing his or her appearance with that of others) in re­sponse to the appearance concerns.

C. The preoccupation causes clinically significant distress or impairment in social, occu­pational, or other important areas of functioning.

D. The appearance preoccupation is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder.

Question 11

Conversion disorder

Answer 11

A. One or more symptoms of altered voluntary motor or sensory function.
B. Clinical findings provide evidence of incompatibility between the symptom and recog­nized neurological or medical conditions.
C. The symptom or deficit is not better explained by another medical or mental disorder.

Question 12

Somatic symptom Disorders

Answer 12

A. One or more somatic symptoms that are distressing or result in significant disruption of daily life.
B. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associ­ated health concerns as manifested by at least one of the following:
1. Disproportionate and persistent thoughts about the seriousness of one’s symptoms.
2. Persistently high level of anxiety about health or symptoms.
3. Excessive time and energy devoted to these symptoms or health concerns.
C. Although any one somatic symptom may not be continuously present, the state of be­ing symptomatic is persistent (typically more than 6 months).

Question 13

Ilness Anxiety Disorder

Answer 13

A. Preoccupation with having or acquiring a serious illness.

B. Somatic symptoms are not present or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition (e.g., strong family history is present), the preoccupation is clearly excessive or dispro­portionate.
C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.
D. The individual performs excessive health-related behaviors (e.g., repeatedly checks his or her body for signs of illness) or exhibits maladaptive avoidance (e.g., avoids doc­ tor appointments and hospitals).
E. Illness preoccupation has been present for at least 6 months, but the specific illness that is feared may change over that period of time.

Question 14

Facticious Disorder

Answer 14

Factitious Disorder Imposed on Self
A. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception.
B. The individual presents himself or herself to others as ill, impaired, or injured.
C. The deceptive behavior is evident even in the absence of obvious external rewards.
D. The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder.

Factitious Disorder Imposed on Another
(Previously Factitious Disorder by Proxy)
A. Falsification of physical or psychological signs or symptoms, or induction of injury ordisease, in another, associated with identified deception.
B. The individual presents another individual (victim) to others as ill, impaired, or injured.
C. The deceptive behavior is evident even in the absence of obvious external rewards.
D. The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder.