Paraphilic disorders in psychiatry DSMV.pptx

Paraphilic disorders are psychiatric disorders where an individual has sexual inclination towards unnatural things/objects

1. Paraphilias Dr Ashaba Schola Psychiatrist

2. Introduction Sexual disorders where the patient has sexual urges that are not socially acceptable such as Sexual arousal involving non-consenting partners Partners who are suffering or being humiliated through the use of an object.

3. Introduction cont… Paraphilias also frequently have a compulsive quality, with some paraphilic individuals requiring orgasmic release as often as four to ten times a day . Paraphilic individuals may or may not have persistent desires to change their sexual preferences .

4. Causes of paraphilias Regression conditioning Predisposition

5. Types of paraphilias Pedophilia Voyeurism Exhibitionism Fetishism Frotteurism Sexual Masochism Sexual Sadism Transvestitism

6. Exhibitionism Exhibitionism is a tendency to sexually expose oneself to others. For example, a man’s behavior is exhibitionistic when he exposes part of his naked body, usually his genitals, to a total stranger. The sexual behavior is almost always limited to the genital exposure, and the person may make no further harmful advances toward the stranger. Most often exhibitionism begins during adolescence and continues into adulthood.

7. Fetishism People with a fetishism experience sexual urges and behavior which are associated with non-living objects. For example, the object of the fetish could be an article of female clothing, like female underwear. Usually the fetish begins in adolescence and tends to be quite chronic into adult life.

8. Frotteurism Men have a paraphilia called Frotteurism when the focus of their sexual urges are related to the touching or rubbing of their body against a non-consenting, unfamiliar woman. Usually the male rubs his genital area against the female. Most commonly, the man chooses to attack in a crowded public location and then he disappears into the throng of people Frotteurism usually begins in adolescence and the abnormal behavior tends to decrease when the man reaches his late twenties.

9. Pedophilia A pedophile is a person, most frequently a man, who focuses his sexual fantasies and behavior toward children. People who enjoy child pornography are pedophiles. Some pedophiles are sexually attracted only toward children and are not at all attracted toward adults. Pedophilia is usually a chronic condition. When a pedophile becomes sexually active with a child he/she may: Undress the child Encourage the child to watch them masturbate Touch or fondle the child’s genitals Forcefully perform sexual acts on the child

10. Masochism Masochism is the getting of pleasure, often sexual, from being hurt or humiliated. Sometimes the masochistic acts are limited to verbal humiliation or blindfolding. However, masochistic behavior might include being bound or beaten. Masochism may become even more harmful, however, when a person permits another to use arm or leg restraints accompanied by acts of beating, whipping, or cutting.

11. Sadism Sadism is deriving pleasure, often sexual, from mistreating others. Like other paraphilias, some people have fantasies which are sadistic, but they never act upon them. Also, some people have sexual urges of a sadistic nature, and they find a willing partner who agrees to participate in the sadistic activity. There are people, however, who have sadistic sexual urges who find others whom they victimize with their behavior. Some of the severe activities involved in sexual sadism include burning, beating, stabbing, raping, and killing

12. Transvestism Cross-dressing by heterosexual males is called transvestic fetishism or transvestitism. The male with this fetish usually has a variety of female clothes that he uses to cross-dress. While some males will wear only one special piece of female apparel, others fully dress as a female and use full facial make-up to achieve a total female appearance. Often this disorder begins in childhood. It tends to be chronic in nature.

13. Voyeurism Voyeurism is seeking sexual pleasure by secretly observing another. The activity brings on sexual excitement and may conclude with masturbation by the voyeur. Voyeurism usually starts in adolescence and tends to persist into adulthood

14. Treatment Cognitive, behavior, and psychoanalytic therapies are used to treat individuals with paraphilias. Some prescription medicines have been used to help decrease the compulsive thinking associated with the paraphilias. Hormones are prescribed occasionally for individuals who experience intrusive sexual thoughts, urges, or abnormally frequent sexual behaviors. Almost always the treatment must be long-term if it is to be effective.

15. Prognosis The course of paraphilias is usually chronic in nature. The prognosis for complete recovery is generally considered to be guarded.