Paraphilias - Kohlenberg

Question 1

what are the two categories of paraphilias in the DSMV?

Answer 1

anamalous activities

anomalous targets

Question 2

what is a paraphilia?

Answer 2

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

Question 3

what is a paraphilic disorder?

Answer 3

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

Question 4

does paraphilia by itself justify clinical intervention?

Answer 4

nope

Question 5

what are the two Dx criteria of a paraphilic disorder?

Answer 5

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.

Question 6

Does atypical sexual interest indicate a mental disorder?

Answer 6

nope

Question 7

how long must you do things to be a voyeur?

Answer 7

6 months

Question 8

what is voyeurism?

Answer 8

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

Question 9

how old must you be to be a voyeur?

Answer 9

18 or older

Question 10

what is the prevalence of voyeurism?

Answer 10

12% males

4% females

Question 11

is voyeurism normal in adolescents?

Answer 11

yes

Question 12

is sexual contact sought in voyeurism?

Answer 12

nope

Question 13

when does voyeurism onset?

Answer 13

before 15; chronic course

Question 14

Describe the criteria for exhibitionistic disorder?

Answer 14

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

Question 15

What percent of sex offenders referred for treatment are exhibitionists?

Answer 15

1/3

Question 16

what is the inhibited temperament exhibitionist?

Answer 16

tend to struggle with their urges and expose a flaccid penis

Question 17

what is the aggressive temperament exhibitionist?

Answer 17

expose an erect penis and masturbate

Question 18

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

Answer 18

first: low
second: high

Question 19

What is frotteuristic disorder?

Answer 19

touching or rubbing against a non-consenting partner

Question 20

what percent of males have forotteurisitc disorder?

Answer 20

30%

Question 21

what is sexual masochism d/o?

Answer 21

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

Question 22

Sexual masochism can present specfically with….

Answer 22

asphyxiphilia

Question 23

What is sexual sadism d/o?

Answer 23

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

Question 24

what is the prevalence of sexual sadism?

Answer 24

2-30%

Question 25

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

Answer 25

35-75%

Question 26

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

Answer 26

predetermined

Question 27

What are some of the activities involved in SnM?

Answer 27

``` 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 ```

Question 28

What gender is more likely to be SnM?

Answer 28

male

Question 29

What percent of females in SnM are prostitutes

Answer 29

25%

Question 30

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

Answer 30

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

Question 31

What two things make up psychopathic sexual sadism?

Answer 31

sexual sadism | antisocial personality disorder

Question 32

What are the characteristics of psychopathic sexual sadism?

Answer 32

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

Question 33

What is pedophilic disorder?

Answer 33

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

Question 34

what are the two age qualifiers regarding pedophilia?

Answer 34

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

Question 35

what is the prevalence of pedophilia?

Answer 35

3-5%

Question 36

What is neccessary to be committed for life involuntarily?

Answer 36

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

Question 37

what is fetishistic disorder?

Answer 37

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

Question 38

what is transvestic disorder?

Answer 38

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

Question 39

What are some other paraphilias NOS?

Answer 39

``` Coprophilia Hypoxyphilia (autoerotic asphyxiation) Infantialism Klismophilia Necrophilia Partialism Telephone scatalogia Urophilia Zoophilia (bestiality) ```

Question 40

what are the most common paraphiias IN PSYCH PRACTICE?

Answer 40

pedophilia exhibitioism Voyeurism

Question 41

why are most paraphilias not reported?

Answer 41

happens between consenting adults or alone

Question 42

what percent of people seen for paraphilias are married?

Answer 42

1/2

Question 43

what are the common features of the demographics of paraphilia?

Answer 43

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

Question 44

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

Answer 44

covert sensitization | satiation therapy

Question 45

What are the cognitive therapies you can use for paraphilia?

Answer 45

counter distorted thinking | combined with social skills and empathy training

Question 46

What are the biological treatments for paraphilias?

Answer 46

Depo shot | SSRIs