Paraphilias

 Definition

Paraphilias are complex psychiatric disorders that are manifested as unusual sexual behavior. Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-IV-TR) defined it as a “recurrent, intensely sexually arousing fantasies, sexual urges, or behaviors generally involving:

• Inanimate objects (non-human objects)
• Suffering or humiliation of oneself or partner
• Children
• Nonconsenting person

Diagnosis

The criteria for diagnosing this disorder are:

Criterion A: the unusual sexual behavior should occur over a period of 6 months

Criterion B: the sexual behavior caused a clinically significant distress or impairment in social, occupational or other important areas of functioning. Criterion B differs in for some disorders.

• For pedophilia, voyeurism, exhibitionism and frotteurism, the diagnosis is formulated if acting out on these urges or if the urge itself caused a significant distress or interpersonal difficulty.
• For sadism, a diagnosis is made if these urges are done to a nonconsenting person.
• For the other paraphilias, a diagnosis created when the sexual behavior, urges or fantasies caused a clinically significant distress or impairment in social, occupational or other important areas of functioning.

Eight specific disorders of paraphilia

1. Exhibitionism – the repeated urge or behavior of exposing one’s genitals to strangers or masturbating in public areas.
2. Exhibitionism – this is characterized by the use of inanimate objects (fetish) to achieve orgasm or gain sexual excitement. Common fetishes are women’s undergarments (brassiere, lingerie, and panty), shoes and other apparels. An individual with this disorder masturbates while holding or rubbing the object to them.
3. Frotteurism – persistent urges of touching or rubbing against a nonconsenting person in a place where a person with this disorder can make a quick escape (e.g. crowded places, public transportation, shopping mall or a crowded sidewalk). The person rubs his hands against a victim’s breasts or genitalia or he can rub his genitals against the victim’s thigh or buttocks.
4. Pedophilia – a sexual activity done with a child 13 years younger is a characteristic of this disorder. The pedophile should be at least 16 years old or at least 5 years older than the victim.
5. Sexual masochism – the intense and persistent sexual urge involving acts of suffering (beaten or bound) and being humiliated.
6. Sexual sadism – sexual urge involving acts in which the pain, suffering or humiliation of a partner is arousing a person.
7. Transvestic fetishism – sexual fantasies, urge and behaviors involving cross-dressing by a heterosexual male.
8. Voyeurism – sexual arousal by observing an unsuspecting person who is naked, in the process of undressing or engaging in sexual activity.