Paraphilic Disorders

paraphilic disorder

A — is a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others

paraphilia

The term — denotes any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, phys ically mature, consenting human partners

anomalous activity preferences

• The first group of disorders is based on —-

  • These disorders are subdivided into courtship disorders and algolagnic disorders

courtship disorders

, which resemble distorted components of human courtship behavior (voyeuristic disorder, exhibitionistic disorder, and frotteuristic disorder)

algolagnic disorders

, which involve pain and suffering (sexual masochism disorder and sexual sadism disorder

anomalous target preferences

The second group of disorders is based on —. These disorders include one directed at other humans (pedophilic disorder) and two directed elsewhere (fetishistic disorder and transvestic disorder).

Voyeuristic Disorder

• recurrent and intense sexual arousal from observ ing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviors

• is a mental health condition characterized by repeated and intense sexual arousal from observing unsuspecting individuals who are naked, disrobing, or engaging in sexual activity. This behavior is often associated with significant distress or impairment in social, occupational, or other important areas of life.  

• A. Over a period of at least 6 months, recurrent and intense sexual arousal from observ ing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviors.

• B. The 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.

• C. The individual experiencing the arousal and/or acting on the urges is at least 18 years of age.

Diagnostic Criteria for Voyeuristic Disorder

In a controlled environment (VD)

This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in voyeuristic behavior are restricted.

In full remission VD)

The individual has not acted on the urges with a nonconsenting per son, and there has been no distress or impairment in social, occupational, or other ar eas of functioning, for at least 5 years while in an uncontrolled environment.

voyeuristic sexual interest

On the other hand, if they declare no distress, demon strated by lack of anxiety, obsessions, guilt, or shame, about these paraphilic impulses and are not impaired in other important areas of functioning because of this sexual interest, and their psychiatric or legal histories indicate that they do not act on it, they could be ascertained as having —- but should not be diagnosed with voyeuristic disorder

Exhibitionistic Disorder

• is a mental health condition characterized by the repeated and intense sexual arousal from exposing one's genitals to unsuspecting others, often strangers. This behavior is typically accompanied by fantasies or urges to engage in such acts.

• recurrent and intense sexual arousal from the ex posure of one’s genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors.

• A. Over a period of at least 6 months, recurrent and intense sexual arousal from the exposure of one’s genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors.

• The 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.

Diagnostic Criteria for Exhibitionistic Disorder

exhibitionistic sexual interest

In contrast, if they declare no distress (exemplified by absence of anxiety, obsessions, and guilt or shame about these paraphilic impulses) and are not impaired by this sexual interest in other important areas of functioning, and their self-reported, psychiatric, or legal histories indicate that they do not act on them, they could be ascertained as having — but not be diagnosed with exhibitionistic disorder.

Frotteuristic Disorder

• recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or be haviors.

• is a paraphilia characterized by the repeated and intense sexual arousal from touching or rubbing against a non-consenting person. This behavior is often associated with significant distress or impairment in social, occupational, or other important areas of life

• A. Over a period of at least 6 months, recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or be haviors.

• B. The 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.

Diagnostic Criteria for Frotteuristic Disorder

In a controlled environment (FD)

This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to touch or rub against a noncon senting person are restricted.

In full remission (FD)

The individual has not acted on the urges with a nonconsenting per son, and there has been no distress or impairment in social, occupational, or other ar eas of functioning, for at least 5 years while in an uncontrolled environment.

Sexual Masochism Disorder

• recurrent and intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fan tasies, urges, or behaviors.

• is a paraphilia characterized by recurrent and intense sexual arousal from being humiliated, beaten, bound, or otherwise made to suffer. This arousal is manifested in fantasies, urges, or behaviors

masochistic sexual interest

In contrast, if they declare no distress, exemplified by anxiety, ob sessions, guilt, or shame, about these paraphilic impulses, and are not hampered by them in pursuing other personal goals, they could be ascertained as having — but should not be diagnosed with sexual masochism disorder.

With asphyxiophilia (SMD)

If the individual engages in the practice of achieving sexual arousal related to restriction of breathing.

In a controlled environment (SMD)

This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in masochistic sexual behaviors are restricted.

in full remission (SMD)

There has been no distress or impairment in social, occupational, or other areas of functioning for at last 5 years while in an uncontrolled environment. (SMD)

sexual sadism disorder

• is a mental health condition characterized by the recurrent and intense sexual arousal from inflicting physical or psychological suffering on another person. This arousal is manifested in fantasies, urges, or behaviors.

• To be diagnosed with — , the individual must experience significant distress or impairment in their social, occupational, or other important areas of life due to these fantasies, urges, or behaviors.

• A. Over a period of at least 6 months, recurrent and intense sexual arousal from the phys ical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors.

• B. The 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.

Diagnostic Criteria for Sexual Sadism Disorder

Pedophilic Disorder

• recurrent, intense sexually arousing fantasies, sex ual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).

• is a serious mental health condition that causes harm to children.

• may experience significant distress or impairment in their social, occupational, or other important areas of life due to these fantasies, urges, or behaviors.

• A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sex ual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).

• B. The individual has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.

• C. The individual is at least age 16 years and at least 5 years older than the child or chil dren in Criterion A.

  • Note: Do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12- or 13-year-old.

Diagnostic Criteria for Pedophilic Disorder

pedophilic sexual interest

However, if they report an absence of feelings of guilt, shame, or anxiety about these impulses and are not functionally limited by their paraphilic im pulses (according to self-report, objective assessment, or both), and their self-reported and le gally recorded histories indicate that they have never acted on their impulses, then these individuals have a —- but not pedophilic disorder.

Fetishistic Disorder

• recurrent and intense sexual arousal from either the use of nonliving objects or a highly specific focus on nongenital body part(s), as manifested by fantasies, urges, or behaviors

• is a paraphilia, a type of mental disorder characterized by recurrent, intense sexual arousal focused on specific objects or body parts that are not typically associated with sexual activity

• A. Over a period of at least 6 months, recurrent and intense sexual arousal from either the use of nonliving objects or a highly specific focus on nongenital body part(s), as manifested by fantasies, urges, or behaviors.

• B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impair ment in social, occupational, or other important areas of functioning.

• C. The fetish objects are not limited to articles of clothing used in cross-dressing (as in transvestic disorder) or devices specifically designed for the purpose of tactile genital stimulation (e.g., vibrator).

Diagnostic Criteria for Fetishistic Disorder

In a controlled environment (Fetishistic Disorder)

This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in fetishistic behaviors are restricted.

In full remission (Fetishistic Disorder)

There has been no distress or impairment in social, occupational, or other areas of functioning for at least 5 years while in an uncontrolled environment.

fetish

Many individuals who self-identify as fetishist practitioners do not necessarily report clinical impairment in association with their fetish-associated behaviors. Such individuals could be considered as having a —- but not fetishistic disorder

Transvestic Disorder

• is a paraphilia, a type of mental disorder, characterized by recurrent and intense sexual arousal from cross-dressing, which may manifest as fantasies, urges, or behaviors.

• This arousal causes significant distress or impairment in social, occupational, or other important areas of life.

• A. Over a period of at least 6 months, recurrent and intense sexual arousal from cross dressing, as manifested by fantasies, urges, or behaviors.

• B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impair ment in social, occupational, or other important areas of functioning.

Diagnostic Criteria for Transvestic Disorder

with fetishism (Transvestic Disorder)

If sexually aroused by fabrics, materials, or garments.

With autogynephilia (Transvestic Disorder)

If sexually aroused by thoughts or images of self as female (Transvestic Disorder)

In a controlled environment (TD)

This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to cross-dress are restricted.

In full remission (TD)

There has been no distress or impairment in social, occupational, or other areas of functioning for at least 5 years while in an uncontrolled environment (TD)