Paraphilic Disorders Flashcards
why have the 8 disorders in the paraphilias section of the DSM been chosen to be listed specifically (even though it is not an exhaustive list of possible paraphilias)
- they are relatively common
- some of them entail actions for their satisfaction that, because of their noxiousness or potential harm to others, are classified as criminal offenses
what are the “courtship disorders”
voyeuristic
exhibitionistic
frotteuristic
*resemble distorted components of human courtship beahviour
what are the “algolagnic disorders”
sexual masochism disorder
sexual sadism disorder
*involve pain and suffering
what is the commonality among the courtship and algolagnic disorders
“anomalous activity preferences”
what is the other group of paraphilias in the DSM, other than the group reflecting anomalous activity preference
anomalous target preference
define paraphilia
any intense and persistent SEXUAL INTEREST OTHER THAN sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners
*there are also specific paraphilias that are generally better described as “preferential” sexual interests rather than intense sexual interests
define “paraphilic disorder”
a paraphilia that is currently causing DISTRESS or impairment to the person or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others
what is criterion B for all the paraphilic disorders
the criterion that requires there be distress/impairment/harm to others (the negative consequences of the paraphilia)
what is the most widely applicable framework for assessing the strength of a paraphilia itself
comparing the paraphilic sexual fantasies/urges/behaviours to the persons normophilic sexual interests and behaviours
criterion A for voyeuristic disorder
over a period of at least SIX 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 behaviours
criterion B for voyeuristic disorder
individual has ACTED ON these sexual urges with a NONCONSENTING person or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
criterion C for voyeuristic disorder
the patient is at least 18
what are the two specifiers for voyeuristic disorder
in a controlled environment (i.e institutional or other settings where opportunity to engage in voyeuristic behaviour is limited)
in full remission (individual has not acted on the urges with a nonconsenting person, and there has been no distress or impairment, for at least FIVE YEARS while in an UNcontrolled environment)
what is considered “recurrent” spying on unsuspecting persons in the context of voyeuristic disorder
as a general rule: 3 or more victims on separate occasions
which are the most common of potentially law breaking behaviours
voyeuristic disorder
what is the highest possible prevalence of voyeuristic disorder in nonclinical samples
12% males, 4% females
(real prevalence of voyeuristic disorder unknown)
what are 3 possible risk factors for voyeuristic disorder
childhood sexual abuse
substance misuse
sexual preoccupation/hypersexuality
(causal relationship and specificity are unclear)
while gender is more represented amongst clinical samples of voyeuristic disorder
males
ddx voyeuristic disorder
conduct disorder
ASPD
SUDs
criterion A for exhibitionistic disorder
over a period of at least SIX MONTHS, recurrent and intense sexual arousal from the exposure of ones genitals to an unsuspecting person, as manifested by fantasies, urges or behaviours
criterion B for exhibitionistic disorder
individual has acted on these sexual urges with a NONconsenting person, or there is clinically significant distress/impairment
what are the specifiers available for exhibitionistic disorder
- sexually aroused by exposing genitals to pre-pubertal children
- sexually around by exposing genitals to physically mature individuals
- sexually aroused by exposing genitals to prepubertal children and to physically mature adults
- in a controlled environment
- in full remission
what is the highest possible prevalence for exhibitionistic disorder in the male population
2-4% (actual is unknown)