Paraphilias - Kohlenberg Flashcards
what are the two categories of paraphilias in the DSMV?
anamalous activities
anomalous targets
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?
paraphilia that causes impairment or distress or one that includes personal harm or risk of harm to someone else
does paraphilia by itself justify clinical intervention?
nope
what are the two Dx criteria of a paraphilic disorder?
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.
Does atypical sexual interest indicate a mental disorder?
nope
how long must you do things to be a voyeur?
6 months
what is voyeurism?
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
how old must you be to be a voyeur?
18 or older
what is the prevalence of voyeurism?
12% males
4% females
is voyeurism normal in adolescents?
yes
is sexual contact sought in voyeurism?
nope
when does voyeurism onset?
before 15; chronic course
Describe the criteria for exhibitionistic disorder?
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
What percent of sex offenders referred for treatment are exhibitionists?
1/3
what is the inhibited temperament exhibitionist?
tend to struggle with their urges and expose a flaccid penis
what is the aggressive temperament exhibitionist?
expose an erect penis and masturbate
reconviction rate for exhibitionists after the first is (low/high) while after the second exposure is (low/high)
first: low
second: high
What is frotteuristic disorder?
touching or rubbing against a non-consenting partner
what percent of males have forotteurisitc disorder?
30%
what is sexual masochism d/o?
arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, behaviors.
Sexual masochism can present specfically with….
asphyxiphilia
What is sexual sadism d/o?
months…pleasure from physical or psychological suffering of another person, as manifested by fantasies, urges…
B: Nonconsenting person, distress.
what is the prevalence of sexual sadism?
2-30%
what percent of people who have committed sexually motivated homicides have sexual sadism/
35-75%
In SnM, the acts are on the fly or predetermined?
predetermined
What are some of the activities involved in SnM?
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 gender is more likely to be SnM?
male
What percent of females in SnM are prostitutes
25%
What is the breakdown of SnM in the hetero-homo spectrum?
1/3 straight
1/3 bi
1/3 homo
What two things make up psychopathic sexual sadism?
sexual sadism
antisocial personality disorder
What are the characteristics of psychopathic sexual sadism?
Lack of guilt or compassion for victim
Euphoria during murder
mentally disturbed, rarely psychotic
What is pedophilic disorder?
sexually arousing fantasies, urges or behaviors involving sexual activity with a prepubescent child or children (13 or younger).
what are the two age qualifiers regarding pedophilia?
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
what is the prevalence of pedophilia?
3-5%
What is neccessary to be committed for life involuntarily?
sexually violent offenders can be committed for life after serving their prison sentence if they have a Dx of a disorder
what is fetishistic disorder?
arousal from non-living objecgs or non-genital body parts
distressing
what is transvestic disorder?
A: 6 months…arousal from cross dressing…
B: Distress
What are some other paraphilias NOS?
Coprophilia Hypoxyphilia (autoerotic asphyxiation) Infantialism Klismophilia Necrophilia Partialism Telephone scatalogia Urophilia Zoophilia (bestiality)
what are the most common paraphiias IN PSYCH PRACTICE?
pedophilia
exhibitioism
Voyeurism
why are most paraphilias not reported?
happens between consenting adults or alone
what percent of people seen for paraphilias are married?
1/2
what are the common features of the demographics of paraphilia?
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 are the types of aversion therapy you can use for paraphilia?
covert sensitization
satiation therapy
What are the cognitive therapies you can use for paraphilia?
counter distorted thinking
combined with social skills and empathy training
What are the biological treatments for paraphilias?
Depo shot
SSRIs
