Paraphilias-Kohlenberg Flashcards
What are the 2 categories of paraphilias?
- Anomalous activity preferences
- Anomalous target preferences
What are the types of anomalous activity preferences?
- courtship disorders
- algolagnic disorders
What are the types of anomalous target preferences?
- other humans (pedophilia)
- Directed elsewhere (fetishes, transvetic disorders)
What are types of courtship disorders?
What are the types of algolagnic disorders?
- voyeurism, exhibitionism, frotteurism
- involving pain and suffering
What is this:
Any intense and persistent sexual interest other than sexual interest in genital stimulation or fondling with phenotypically normal, physically mature, consenting human partners.
Paraphilia
What is this:
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.
Paraphilic disorder
T or F
A paraphilia is necessary but not a sufficient condition for having a paraphilic disorder and a paraphilia by itself does not necessarily jutify or require clinical intervention
Why?
T
because you have to have personal distress or have a need to involve others that dont consent
What is criterion A and B for a paraphilic disorder?
A: Specifies the qualitative nature of the paraphilia (eg, erotic focus on children or on exposing the genitals to others).
B: Specifies the negative consequences of the paraphilia (i.e, distress, impairment, harm to others).
You need both to have a paraphilic disorder
What is this:
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: Acted on these urges with a non-consenting person, has distress or impairment in social, occupational, or other important areas of functioning.
Voyeuristic disorder
How long do you have to be showing signs of a voyeuristic disorder for it to be a disorder and how old do you have to be to be diagnosed? What is the prevalence?
6 months
18 or over
12% in males and 4% in females
T or F
Voyeurism may be considered normal in adolescent males
T
In voyeurism, is sexual contact generally sought? When is the typical onset? Is the course acute or chronic?
no
before age 15
chronic
T or F
most people with atypical sexual interests do not have a mental disorder
T
T or F
To be diagnosed with a paraphilic disorder, DSM-5 requires that people with these interests: feel personal distress about their interest, not merely distress resulting from society’s disapproval;
Or have a sexual desire or behavior that involves another person’s psychological distress, injury, or
death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.
T
What is this:
Over at least (blank) months, recurrent and intense sexual arousal from the exposure of ones genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors.
6
Exhibitionistic Disorder
What is the criteria to have an exhibitionist disorde?
-over at least 6 months, exposing genitals to unsuspecting people for arousal AND acting on them with a non-consenting person to cause significant distress or impairment
What is this:
arousal from the act of being humiliated, beaten, bound or otherwise made to suffer, as manifested by fantasies, urges, behaviors. AND causes signif distress.
How long does this have to be happening for, for the diagnosis to happen?
What is the prevalence?
Sexual masochism disorder
6 months
Males 2.2%, females 1.3%
(blank) make up 1/3 of sex offenders referred for treatment
Exhibitionists
What are the two categories of exhibitionists?
If you get caught doing this what happens?
Inhibited temperament-tend to struggle with their urges and expose a flaccid penis
Aggressive temperament-expose an erect penis and masturbate
-you wont do it again, but if you do, you are more likely to keep repeating it
What is this:
touching or rubbing against a nonconsenting person, AND acting upon these urges with a nonconsenting person, distress or impairment. How long has it been going on to get the diagnosis?
What is the prevalence?
Frotteuristic Disorder
6 months
30% of adult males
What is this: 6 months arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as a manifested by fantasties, urges, behaviors. Causes clinically signif distress What is the prevalence?
Sexual masochism
2.2% males, 1.3% females
What is asphyxiophilia?
The practice of intentionally reducing the amount of oxygen to the brain during sexual stimulation in order to heighten the received pleasure from orgasm.
What is this:
A: 6 months…pleasure from physical or psychological suffering of another person, as manifested by fantasies, urges…
B: Nonconsenting person, distress.
What is the prevalence?
Sexual sadism disorder
2-30%
In sexual sadism disoder,
Among people who have committed sexually motivated homicides, this disorder ranges from (blank)
37-75%.
What is sadomasochism (S & M)? Is this a disorder?
getting sexual aroused by inflicting pain or recieving pain but not causing distress
-no
What are some types of S and M?
pre-determined acts activities & themes: -flagellation -bondage -water sports (urophilia, --coprophilia, mysophilia) -penis and nipple torture -master & slave -severe boss and naughty -secretary -queen and many slaves -arrest -military training
What are the characteristics of S and M?
Characteristics
- predominantly male
- female: 25% prostitutes
- meet through S & M magazines
- On line
- come from all walks of life, SES, educ. etc
- 1/3 heterosexual, 1/3 bisexual, 1/3 homosexual
What is psychopathic sexual sadism?
What are the characteristics of psychopathic sexual sadists?
- sexual sadism
- antisocial personality disorder (ASPD)
- serial murder (arousal from inflicting pain and killing)
Characteristics:
- lack of guilt or compassion for victim
- Euphoria during murder
- mentally disturbed, rarely psychotic
What is this:
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)
What is the prevalence?
Pedophilic Disorder
3-5%
What is this:
6 months…arousal from nonliving objects or nongenital body parts
-distressing
Fetishistic Disorder
What is this:
6 months….arousal from cross dressing
-distress
Transvestic Disorder
What is this need to hear filthy language to become sexually aroused What is this: arousal by making obscene phone calls What is this: golden showers on or watching
coprolalia
telephone scatalogia
urophilia
What is this:
need to smell or see feces to become aroused
What is this:
observing others engaged in sexual intercourse
What is this:
marking body, insterting objects into the body
What is this:
aroused by sight of certain foods
coprophilia
scoptophilia
stigmatophilia
sotophilia
What is this: sexual arousal by being given an enema What is this: arousal by filth or filthy suroundings What is this: having sex with someone who is sleeping What is this: ingestion of anothers sweet or saliva What is this: arousal by sharing partner and looking on and all participate (threesome)
klismaphilia mysophilia somnophilia salirophilia troilism
What is the prevalence of paraphilias?
What are the most common?
- uncommon in psychiatric practice
- Pedophilia, exhibitionism, voyeurism
Why are most paraphilias not reported?
because activity takes place b/w consenting adults or alone
The large commercial market in paraphilic pornography and paraphernalia suggests that its prevalence in the community is likely to be (blank).
Approximately (blank) of individuals seen clinically for paraphilias are married.
higher
½
When do paraphilias usually begin? What gender do they occur most in? Are they typically hetero or homosexual? Is it usually just one paraphilia or multipe? Is it comorbid? Are they consistant?
adolescence males hetero multiple yes no, they wax and wane
What is eproctophilia?
What is olfactophilia?
fart fetish
sexual pleasure from smells
What is the most common reason for tx for paraphilias?
Why is it hard to treat?
-incarceration and court ordered tx common
- difficult ot interpret outcome from tx studies (studies vary, lack controls, drop out rates high)
- denial and minimization of problem often present lack of motivation for tx and some blame the victim
What are the treatments for paraphilias?
Averison therapy -covert sensitization -satiation therapy Cognitive therapy -counter distorted thinking -often combined w/ social skills and empathy training Biological treatments -catration used in past -meds
What meds are used for paraphilias?
- hormonal agents to reduce androgens (depo-provera)
- SSRIs
