Paraphilias - Kohlenberg Flashcards

1
Q

what are the two categories of paraphilias in the DSMV?

A

anamalous activities

anomalous targets

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2
Q

what is a paraphilia?

A

Any intense and persistent sexual interest other than sexual interest in genital stimulation or fondling with phenotypically normal, physically mature, consenting human partners.

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3
Q

what is a paraphilic disorder?

A

paraphilia that causes impairment or distress or one that includes personal harm or risk of harm to someone else

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4
Q

does paraphilia by itself justify clinical intervention?

A

nope

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5
Q

what are the two Dx criteria of a paraphilic disorder?

A

A: erotic nature of the paraphilia
B: negative consequences of paraphilia
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.

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6
Q

Does atypical sexual interest indicate a mental disorder?

A

nope

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7
Q

how long must you do things to be a voyeur?

A

6 months

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8
Q

what is voyeurism?

A

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.
acting on the urges causes distress

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9
Q

how old must you be to be a voyeur?

A

18 or older

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10
Q

what is the prevalence of voyeurism?

A

12% males

4% females

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11
Q

is voyeurism normal in adolescents?

A

yes

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12
Q

is sexual contact sought in voyeurism?

A

nope

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13
Q

when does voyeurism onset?

A

before 15; chronic course

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14
Q

Describe the criteria for exhibitionistic disorder?

A

6 months
arousal from exposing genitals to an unexpected person
can be fantasies, urges, or behaviors
acted on with non-consenting, or feelings of do so cause distress

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15
Q

What percent of sex offenders referred for treatment are exhibitionists?

A

1/3

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16
Q

what is the inhibited temperament exhibitionist?

A

tend to struggle with their urges and expose a flaccid penis

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17
Q

what is the aggressive temperament exhibitionist?

A

expose an erect penis and masturbate

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18
Q

reconviction rate for exhibitionists after the first is (low/high) while after the second exposure is (low/high)

A

first: low
second: high

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19
Q

What is frotteuristic disorder?

A

touching or rubbing against a non-consenting partner

20
Q

what percent of males have forotteurisitc disorder?

A

30%

21
Q

what is sexual masochism d/o?

A

arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, behaviors.

22
Q

Sexual masochism can present specfically with….

A

asphyxiphilia

23
Q

What is sexual sadism d/o?

A

months…pleasure from physical or psychological suffering of another person, as manifested by fantasies, urges…
B: Nonconsenting person, distress.

24
Q

what is the prevalence of sexual sadism?

A

2-30%

25
Q

what percent of people who have committed sexually motivated homicides have sexual sadism/

A

35-75%

26
Q

In SnM, the acts are on the fly or predetermined?

A

predetermined

27
Q

What are some of the activities involved in SnM?

A
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
28
Q

What gender is more likely to be SnM?

A

male

29
Q

What percent of females in SnM are prostitutes

A

25%

30
Q

What is the breakdown of SnM in the hetero-homo spectrum?

A

1/3 straight
1/3 bi
1/3 homo

31
Q

What two things make up psychopathic sexual sadism?

A

sexual sadism

antisocial personality disorder

32
Q

What are the characteristics of psychopathic sexual sadism?

A

Lack of guilt or compassion for victim
Euphoria during murder
mentally disturbed, rarely psychotic

33
Q

What is pedophilic disorder?

A

sexually arousing fantasies, urges or behaviors involving sexual activity with a prepubescent child or children (13 or younger).

34
Q

what are the two age qualifiers regarding pedophilia?

A

must be at least 16 and five years older than the child

not a person in late adolescence, in a sexual relationship with a 12,13 year old

35
Q

what is the prevalence of pedophilia?

A

3-5%

36
Q

What is neccessary to be committed for life involuntarily?

A

sexually violent offenders can be committed for life after serving their prison sentence if they have a Dx of a disorder

37
Q

what is fetishistic disorder?

A

arousal from non-living objecgs or non-genital body parts

distressing

38
Q

what is transvestic disorder?

A

A: 6 months…arousal from cross dressing…
B: Distress

39
Q

What are some other paraphilias NOS?

A
Coprophilia
Hypoxyphilia (autoerotic asphyxiation)
Infantialism
Klismophilia
Necrophilia
Partialism
Telephone scatalogia
Urophilia
Zoophilia (bestiality)
40
Q

what are the most common paraphiias IN PSYCH PRACTICE?

A

pedophilia
exhibitioism
Voyeurism

41
Q

why are most paraphilias not reported?

A

happens between consenting adults or alone

42
Q

what percent of people seen for paraphilias are married?

A

1/2

43
Q

what are the common features of the demographics of paraphilia?

A

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

44
Q

what are the types of aversion therapy you can use for paraphilia?

A

covert sensitization

satiation therapy

45
Q

What are the cognitive therapies you can use for paraphilia?

A

counter distorted thinking

combined with social skills and empathy training

46
Q

What are the biological treatments for paraphilias?

A

Depo shot

SSRIs