16. PARAPHILIAS AND PARAPHILIC DISORDERS..pptx

PARAPHILIC DISORDERS

1. PARAPHILIAS/SEXUAL VARIATIONS

2. Sexual variation/Paraphilias Refers to sexual desires and behaviors outside what is considered to be the normal range, although what is unusual or atypical varies between cultures and from one period to another. The cause of this is thought to be due to fixation at certain developmental stages, different complexes, immature personality, too much love or hatred for father/mother or broken homes.

3. Sexual variations in men Exhibitionism: These men expose their sex organs to girls. They are not oversexed but are attention seekers. They get sexual satisfaction when the girls frown, scream, run or get shocked. Voyeurism: These are ―peeping toms. A voyeurist gets sexual pleasure by peeping at a nude woman in the bathroom or at the couples engaged in sex. This is supposed to be an infantile form of sexual behavior

4. Sadism-Masochism: Sadism: Is a sexual deviation when the person gets sexual satisfaction by inflicting pain on the sexual partner. Sadism is sometimes life-threatening. Masochism: Is quite the opposite of it. A masochist gets sexual satisfaction when he receives pain from his sexual partner.

5. Transvestism : These men dress as opposite sex to get the sexual satisfaction. They do not do it openly. Secretly these men wear bra or female underwear. However, they maintain their identity as males. Trans-sexuals: These are persons who have a body of a man and a mind of a woman. • There are also women whose mind is of a man. They strongly feel that they have got a wrong body and hence insist on changing their sex. They go for sex change operation. e.g Hijras [a community in south Asia] are male trans sexuals. They cut off their sex organs in an attempt to become a female

6. Sodomy: Introducing penis in the anus of the partner. This is practiced by homosexuals. A heterosexual male may also do it. This can transmit HIV, STD & Hepatitis infection Bestiality: Having sex with animals may be seen among farmers. Fetichism: These men get sexually stimulated when they see a particular object belonging to the opposite sex, e.g., a handkerchief, underwear or shoes.

7. Incest: Having sex with a person of blood relation. Frottege: These men rub their sex organs against the body of others to get sexual satisfaction. It is common to meet such people in a rush in railways, cinemas, market places, where they get a chance to do so Bisexuality: Men and women derive sexual pleasure by displaying homosexuality and heterosexuality behavior e.g. amophrodites

8. Pedophilia: Men and women who derive sexual satisfaction from minors (children) preferably below 5 years Incest. Men or women who derive sexual satisfaction from close biological relatives (blood relatives) Co-prophilia Men or women who derive sexual satisfaction from passing and handling faeces especially in a swimming pool, bath basin, or during sex.

9. Tele-scaltogia . Sex satisfaction when listening to ones voice from an admired opposite sex e.g. through talking face to face, telephone or singing, reciting a poem. Foudlist. Men or women who derive sexual gratification by being held, kissed or cuddled by an admired opposite sex, desire lots of pleasure from oral sex and self masturbation.

10. Course and Prognosis Poor prognostic factors are having multiple paraphilias, early age of onset, comorbid substance use, high frequency of behavior, and referral by law enforcement agencies (i.e., after an arrest). Good prognostic factors are having only one paraphilia, self-referral for treatment, sense of guilt associated with the behavior, and history of otherwise normal sexual activity in addition to the paraphilia

11. Treatment Difficult to treat Psychotropic medication if associated with a comorbid psychiatric illness Although controversial, antiandrogens, long-acting gonadotropin-releasing hormones, SSRIs, and naltrexone have been used to decrease sex drive and fantasies Cognitive-behavioral therapy can be used to disrupt learned patterns and modify behavior Social skills training Group therapy Insight-oriented therapy has been used but has questionable benefit