Slide on paraphilia

1. PARAPHILIA
PRESENTER: UG18/MDMD/1027

2. Outline
• Introduction
• Epidemiology
• Classification
• Diagnosis
• Differentials
• Treatment
•

3. Introduction
• Paraphilia: persistent and intense pattern of atypical sexual arousal,
manifested by fantasies, urges or behaviour
• Some paraphilia primarily concern individual erotic activities, other
concern erotic target

4. cont.
• Paraphilic disorder
• is a paraphilia that is currently causing distress or impairment to the
individual occupational, social and important functions
• or the person has acted upon with non consenting person

5. Epidemiology
• Paraphilias are practiced by only a small percentage of the population
• Among legally identified cases of paraphilias, pedophilia is
most common
• More commnner in males, but do occasionally occur in females
• The higher prevalence of paraphilias in males probably results from
the testosterone levels in males compared with females, leading to
greater sexual drive at an earlier age.

6. Etiology
• Psychosocial

7. Classification
• Paraphilic disorder can be classified into: anolomous activity
preference and anolomous target preference
• Anolomous activity preference
• Courtship disorder
• Voyeuristic disorder
• Exhibitionistic disorder
• Frotteuristic disorder

8. Cont.
• Algolagnic disorder
• Sexual masochism
• Sexual sadism
• Anolomous target preference
• Directed toward other person
• Pedophilic disorder
• Directed elsewhere
• Fatishistic disorder
• Transvestic disorder

9. Diagnostic criteria
• Voyeuristic disorder
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.

10. • Exhibitionistic disorder
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
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.

11. • Frotteuristic disorder
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 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

12. • Sexual masochism
A. Over a period of at least 6 months, recurrent and intense sexual
arousal from the act of being humiliated, beaten, bound, or
otherwise made to suffer, 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

13. • Sexual sadism
A. Over a period of at least 6 months, recurrent and intense sexual
arousal from the physical 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

14. • Pedophilic disorder
A. Over a period of at least 6 months, recurrent, intense sexually
arousing fantasies, sexual 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 children in Criterion A.

15. • Fatishistic disorder
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
impairment 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)

16. • Transvestic disorder
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 impairment in social, occupational, or other important
areas of functioning

17. Cont.
• Other specified paraphilic disorder
• Necrophilia
• zoophilia
• coprophilia
• klismaphilia
• urophilia
• Unspecified paraphilic disorder

18. Differentials diagnosis
• Paraphilia
• Manic episode
• Conduct disorder
• Anti social personality disorder
• Experimentation
• Mental retardation
• Obsessive compulsive d/o

19. Management
• Psychological
• Psychoanalysis and psychoanalytic therapy
• Behavioural therapy
• Social
• External control
• Medical/pharmacological
• Antipsychotics is something useful
• Antiandrogens
• Castration in severe cases
• Treat comorbidities like alcohol abuse

20. Conclusion
• Paraphilia encompasses a range of atypical sexual behaviour and
interest, some forms may be harmless not necessarily requiring
medical intervention, when such interest are acted upon by non
consenting or when it causes significant impairement, such condition
becomes paraphilic disorder and requires medical intervention