Title 16 AbPsy - Paraphilic Disorders.pdf ✅

16 – Paraphilic Disorders ABPSY | 2024 - 2025 | NOT FOR SALE OUTLINE 1. Voyeuristic Disorder 2. Exhibitionistic Disorder 3. Frotteuristic Disorder 4. Sexual Masochism Disorder 5. Sexual Sadism Disorder 6. Pedophilic Disorder 7. Fetishistic Disorder 8. Transvestic Disorder OVERVIEW OF PARAPHILIC DISORDERS DEFINING PARAPHILIC DISORDERS Paraphilia – any sexual interest greater than or equal to normophilic sexual interests ● Paraphilia by itself does not necessarily justify or require clinical intervention ● Paraphilic Disorders: paraphilia that is currently causing distress or impairment to the individual or has entailed harm ○ Abnormal targets of sexual attraction ○ Unusual courtship behaviors ○ The desire for pain and suffering of oneself or others ● Criterion A specifies the qualitative nature of the paraphilia ● Criterion B specifies the negative consequences ● It is not rare for an individual to manifest two or more paraphilias ● Paraphilic behaviors are evaluated in relation to their normophilic sexual interests and behaviors Rare Paraphilic Disorders ● Telephone Scatologia: obscene phone calls ● Necrophilia: sexual desire for corpses ● Zoophilia: sexual interest in animals ● Apotemnophilia: sexual excitement and desire about having a limb amputated ● Coprophilia: sexual arousal to feces CLASSIFICATIONS OF PARAPHILIC DISORDERS Anomalous Activity Preferences Courtship Disorders Involve distorted components of human courtship behavior Voyeuristic Disorder Exhibitionistic Disorder Frotteuristic Disorder Algolagnic Disorders Involve pain and suffering Sexual Masochism Disorder Sexual Sadism Disorder Anomalous Target Preferences Directed at Humans Pedophilic Disorder Directed Elsewhere Fetishistic Disorder Transvestic Disorder VOYEURISTIC DISORDER DEFINING VOYEURISTIC DISORDER Voyeuristic Disorder – recurrent, intense sexually arousing fantasies, urges, or behaviors involving the observation of unsuspecting people who are undressing or of couples engaging in sexual activity ● Popularly known as peeping toms ● Often co-occurs with exhibitionism ● Associated with interest in sadomasochism and crossdressing ● Voyeuristic activities often provide important compensatory feelings of power and secret domination over an unsuspecting victim DIAGNOSTIC CRITERIA A. Over a period of at least 6 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 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 CAUSES / RISK FACTORS Environmental ● Childhood sexual abuse ● Substance misuse ● Sexual preoccupation/hypersexuality DIAGNOSTIC ISSUES Gender ● Very uncommon among females in clinical settings ● Male-to-female ratio for single sexually arousing voyeuristic acts might be 3:1 1 | @studywithky


TRANSVESTIC DISORDER DEFINING TRANSVESTIC DISORDER Transvestic Disorder – men who experience recurrent, intense sexually arousing fantasies, urges, or behaviors that involve cross-dressing as a female ● They experience significant distress or impairment due to the condition ● Onset of transvestism is during adolescence ● Involves masturbation while wearing female clothing or undergarments ● Blanchard ○ Hypothesized that the psychological motivation of most heterosexual transvestites includes autogynephilia ○ Autogynephilia: paraphilic sexual arousal by the thought or fantasy of being a woman ● Magnus Hirschfeld ○ First identified a class of cross-dressing men who are sexually aroused by the image of themselves as women ○ They feel attracted not by the women outside them, but by the woman inside them ● Not all men with transvestic fetishism show clear evidence of autogynephilia ● The strength of autogynephilic fantasies strongly predicts gender dysphoria DIAGNOSTIC CRITERIA A. Over a period of at least 6 months, recurrent and intense sexual arousal from crossdressing, as manifested by fantasies, urges, or behaviors. B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Specify if: With fetishism: If sexually aroused by fabrics, materials, or garments. With autogynephilia: If sexually aroused by thoughts or images of self as female. TREATMENT OF PARAPHILIC DISORDERS Psychological Treatments ● Covert Sensitization ○ Carried out entirely in the imagination of the patient ○ Patients associate sexually arousing images in their imagination with some reasons why the behavior is harmful or dangerous ● Orgasmic Reconditioning ○ Patients are instructed to masturbate to their usual fantasies but to substitute more desirable ones just before ejaculation ● Relapse prevention Medical Treatments ● Cyproterone Acetate ○ An antiandrogen ○ “Chemical castration” drug ○ Eliminates sexual desire and fantasy by reducing testosterone levels dramatically ● Medroxyprogesterone ○ Depo-Provera is the injectable form ○ A hormonal agent that reduces testosterone CAUSAL FACTORS OF PARAPHILIC DISORDERS Sexual Abuse ● Incest: involves sexual activity between blood relatives ● Rape: sexual activity that occurs under actual or threatened forcible coercion by one person on another ● Pedophilia: sexual activity with a prepubertal child REFERENCES American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 Barlow, D., Durand, V., Lalumiere, M., & Hofmann, S. (2018). Abnormal psychology: An integrative approach (8th ed.). Cengage Learning. Hooley, J., Nock, M., & Butcher, J. (2021). Abnormal psychology (18th ed.). Pearson. 4 | @studywithky