Paraphilias-Kohlenberg Flashcards
What is a paraphilia?
Any intense and persistent sexual interest other than sexual interest in genital stimulation or fondling with phenotypically normal, physically mature, consenting human partners.
What is a paraphilic disorder?
A paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk or harm, to others.
**just having a paraphilia doesn’t mean you have a disorder
What are the 2 DSMV categories for paraphilias?
Anomalous Activity Preferences
Anomalous Target Preferences
Anomalous activity preferences includes what?
courtship disorders (voyeurism, exhibitionism, frotteurism) algolagnic disorders (involving pain & suffering)
Anomalous target preferences includes what?
other humans (pedophilia) directed elsewhere (fetishes, transvestic disorder)
You need both Criterion A & B to have a paraphilic disorder. What does this mean?
A: specifies the qualitative nature of the paraphilia (erotic focus on children or exposing genitals to others)
B: specifies negative consequences of the paraphilia (distress, impairment)
What is voyeuristic disorder?
A: at least 6 mo sexual arousal unsuspecting person who is naked B: acted on this--distress & impairment in social occupational, or other important areas of functioning 18 or over more common in men
When may voyeurism be considered normal? Is sexual contact usu sought? When is the usual onset?
May be considered normal in adolescent males.
Generally, no sexual contact is sought.
Onset tends to be before age 15 years.
The course tends to be chronic.
What is exhibitionistic disorder?
A: Over 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: Acted on them with a non-consenting person, or these feelings cause significant distress or impairment.
(specify…to kids, adults, both)
Prevalence: Unknown (2-4%?) M
T/F Exhibitionists make up 1/3 of sex offenders referred for treatment.
True.
what are the 2 categories of exhibitionists?
Two categories:
Inhibited temperament – tend to struggle with their urges and expose a flaccid penis
Aggressive temperament – expose an erect penis and masturbate
What are the reconviction rates like for exhibitionists?
low after 1st reconviction rate
high after 2nd reconviction rate
What is frotteuristic disorder?
A. 6 months…touching or rubbing against a nonconsenting person…
B. Acted upon these urges with a nonconsenting person….distress or impairment…
Prevalence: 30% of adult males.
What is sexual masochism disorder?
A…6 months…arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, behaviors.
B. Clinically significant distress…
Specify: With asphyxiophilia
Prevalence: 2.2% males, 1.3% of females
What is sexual sadism disorder?
A: 6 months…pleasure from physical or psychological suffering of another person, as manifested by fantasies, urges…
B: Nonconsenting person, distress.
Prevalence: 2-30%
Among people who have committed sexually motivated homicides, this disorder ranges from 37-75%.
What is sadomasochism?
pre-determined acts & themes
can be consensual or can cross threshold to disorder
ex: master & slave
What are the characteristics of sadomasochists?
predominately male female 1/4 of them are prostitutes come from all SES etc 1/3 hetero 1/3 bi 1/3homo
WHat is psychopathic sexual sadism?
serial murderers–aroused by inflicting pain & killing
lack of guilt or compassion for the victim, euphoria during murder, mentally disturbed, but rarely psychotic
What is pedophilic disorder?
A. 6 months…sexually arousing fantasies, urges or behaviors involving sexual activity with a prepubescent child or children (13 or younger).
B. Acted upon these urges, or the fantasies are distressing.
C. Must be at least 16 and at least 5 years older than the child.
(not a person in late adolescence, in a sexual relationship with a 12,13 year old)
Prevalence: 3-5%?
What is fetishistic disorder?
A: 6 months…arousal from nonliving objects or nongenital body parts.
B: Distressing
What is transvestic disorder?
A: 6 months…arousal from cross dressing…
B: Distress
What are some things that fall into paraphilias NOS?
Coprophilia Hypoxyphilia (autoerotic asphyxiation) Infantialism: dress up as babies Klismophilia Necrophilia Partialism Telephone scatalogia Urophilia Zoophilia (bestiality)
What do we know about paraphilias?
Generally begin in adolescence
Occur predominantly in men
Most are heterosexual
People often meet criteria for several paraphilias at once
Co-occurring psychiatric disorders are common
Paraphilias may “wax and wane” throughout a person’s life
What is olfactophilia?
sexual pleasure from smells
What is the treatment for paraphilias?
Aversion therapy: covert sensitization; satiation therapy
Cognitive therapy: counter distorted thinking, combined with social skills & empathy training
biological: meds: hormonal agents to reduce androgens (depo-provera), SSRIs
