Paraphilic D/o Flashcards
What is paraphilic d/o defined as?
Anomalous sexual activity preferences, which include “deviant” patterns of sexual interests, fantasies, and behaviors
Is there a difference between a paraphilia and paraphilic d/o?
Yes, a paraphilia is a preferential sexual interest and paraphilic d/o is a d/o resulting from an anomalous sexual interest
To receive a dx of having a paraphilic d/o, one must have a recurrent and intense sexual arousal from these anomalous preferences and have ______ on these urges and have caused significant ______ and _____ impairment
acted
distress and social/occupational
What are the 8 paraphilic d/o defined in DSM5? Is this list exhaustive?
Exhibitionist d/o, Frotteuristic d/o, Sexual masochist, Sexual sadism d/o, Pedophilic d/o, Transvestic d/o, Fetishistic d/o, Voyeuristic d/o
No, sexual desires may be continuous/spectrum
Sx of a paraphilic d/o may only arise in a time of _____, then the pt can return to “normal” sexual function
stress/other trigger
In order for dx of a paraphilic d/o, pts must have been experiencing urges/behaviors for at least ___ months, intermittent or constant
6 months
Paraphilic disorders are overwhelmingly seen in (men/women) and pts are mostly (homosexual/heterosexual)
men, heterosexual
Prevalence of paraphilic d/o is unknown, however, the prevalence of exhibitionism is ___% and voyeurism is ____%
3%; 7%
Nearly all patients with fetishism are (men/women)
men
Do some people believe that sexual deviance is hereditary and can be modified by social/psychological factors?
yes
Freudians believe that sexual deviance stems from ____ of developmental process from childhood
failures
Learning theorists believe that sexual deviance is a result of ______ becoming linked to deviant fantasies and reinforced by _____
positive experiences (orgasm) masturbation
Sex offenders have abnormal ____ that provide neurobiological basis for sexual deviance
EEG
Sexual deviance is already well established by ____ (age)
adolescence
Common comorbid conditions for sexual deviance include ___, ___/___, and ___
depression, mood/anxiety d/o, and substance abuse
Sexual deviance is typically a(n) (acute/chronic) condition that can fluctuate over time depending on _____ and other factors such as _____ and _____
chronic
stress
opportunity for sex, current sex drive
T/F: Most individuals with paraphilias have a “normal” sexual interaction with their partners/spouses, who often do not know about their particular paraphilia
True!
What is the recommended tx for pts with a paraphilia? What are other methods that can be used?
CBT
Others: Masturbatory satiation, covert sensitization, and masturbatory conditioning (using these methods, 82% at 12 mo had not engaged in pedophilic activities)
What is masturbatory satiation?
satiation or boring the pt with their own deviant fantasies
What is covert sensitization?
replace fantasies with unpleasant imagery
What is masturbatory conditioning?
used to generate arousal to non-deviant themes
Are there medications that can be used for these paraphilic conditions?
No FDA drugs
SSRIs and Naltrexone can decrease fantasies and impulsive behaviors and should be used FIRST
Testosterone inhibitors are last resort
(Men/Women) more frequently have exhibitionist d/o?
Men
What is exhibitionist d/o?
exposure of one’s genitals to an unsuspecting person
____% of sexual offenders will qualify for the dx of exhibitionist d/o?
33%
Does an individual with exhibitionist d/o usually or not usually masturbate while exposing themselves?
usually masturbates
Does a pt with exhibitionist d/o usually touch other people while exposing themselves?
No, no contact is attempted
If onset of exhibitionist d/o is later in life, what other d/o should be suspected?
neurocognitive
Frotteuristic d/o is usually dx in (males/females) and is most common in what age range?
males, 15-25 y/o
What is Frotteuristic d/o?
Touching or rubbing against a nonconsenting person with genitals that usually occurs in crowded places
Sexual masochism involves sexual fantasies, urges, or behaviors of _____, ____, or ______.
being humiliated, bound, or suffer pain/discomfort
Sexual sadism involves the desire to inflict _____ on someone else, and frequently involves _____
psychological suffering
humiliation
Pts diagnosed as having sexual sadism d/o have engaged in these behaviors with a ______ person
non-consenting
Pedophilic d/o is more common in (males/females) attracted to (boys/girls) and involves attraction to (pre-pubescent/pubescent) children
males, boys, prepubescent
In order to be dx with pedophilic d/o, the pt must be at least ___ y/o and ___ yrs older than their victim
16 y/o
5+ years older
T/F: Pts with pedophilic d/o have an attraction to any age range
F; usually attracted to a specific age range
Is there a requirement for social impairment for feeling distress about what they are doing for dx of pedophilic d/o?
No
T/F: Transvestic d/o applies to only men
F; men and women!
Transvestic d/o is characterized by the act of _____ that usually begins (before/after) puberty
cross-dressing, before puberty
Initially, the act of _____ is arousing to pts with transvestic d/o, then, in time, their comfort grows and they may _____ in public . As they age, and sexual desires decline, the incidence of ___ may also decline
cross dressing
Transvestic d/o is occasionally seen in pts with _____
gender dysphoria
Fetishistic d/o is characterized by a pt who is aroused by _____, or ______
a non-living object (does not count if a sex toy)
a part of the body not usually associated with sex
Contact with _____ produce sexual arousal in a pt with fetishistic d/o, usually followed by ______
object
masturbation
Patients with fetishistic d/o usually spend (a little/a lot of) time engaged in these activities
a lot!
Voyeuristic d/o dx can be made in pts ____ y/o but usually starts at ____ y/o, and is characterized by looking/observing people (with/without) their knowing for the purpose of sexual arousal. Targets are usually ____ and engaging in _____
18+y/o 15y/o without naked sexual acts
