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Results for “Paraphilic Disorders”

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PubMed1996

Auto-erotic asphyxiation: three case reports.

Men who indulge in auto-erotic asphyxial practices are rarely encountered by psychiatrists. More often, they come to light at a coroner's inquest, and a verdict of "accidental death" is usually rendered (e.g., from hanging/suffocation). This paper describes and contrasts three cases of auto-erotic asphyxial practices. The first case, of accidental death by hanging, was an apparently highly successful young man who functioned at a high level and was without "serious psychopathology." In contrast, the other two, both survivors of asphyxial practices, manifested multiple paraphilias and other types of psychopathology. The syndrome may be extremely diverse, and survivors who consult psychiatrists require holistic assessment and treatment tailored to multifarious needs.

Adolescent↗
PubMed1977

Rape: a sexual deviation.

Clinical work with offenders and victims is cited to support the concept of rape as a sexual deviation, as well as a sexual offense. It is suggested that rape is directed toward the sexual expression and gratification of needs that are not basically sexual, and that it represents a developmental crisis for the offender, which in turn triggers a situational crisis for the victim.

Aggression↗
PubMed1987

Sadistic homosexual pedophilia: treatment with cyproterone acetate: a single case study.

This single case study demonstrates the effects of antiandrogen treatment on a subject with a very serious sexual deviation and a poor prognosis. It assesses the effects of cyproterone acetate (CPA) on an individual with a serious chronic organic brain syndrome combined with sadistic homosexual pedophilia. Furthermore, this individual had failed to respond to a behavioural treatment program and long-term milieu therapy. Finally, this case study is the first report of CPA differentially affecting penile responses to deviant and non-deviant stimuli.

Adult↗
PubMed2000

Civil commitment of sex offenders to mental institutions: should the standard be based on serious mental illness or mental disorder?

Civil commitment to mental institutions requires that an individual be both seriously mentally ill and dangerous. This principle is erroneously being applied to incarcerated sex offenders nearing release from prison under the theory that they have antisocial personalities or paraphilia disorders, which are called mental illnesses. However, the mental health and legal communities are at odds regarding the use of a diagnosis of personality disorder or paraphilia to justify civil commitment. The author reviews the differences between serious mental illness and mental disorder, the flaws with assessing sex offenders as mentally ill, and the ethical dilemma for social workers employed in mental hospitals.

Commitment of Persons with Psychiatric Disorders↗
PubMed1984

Classifying sexual disorders: the Diagnostic and Statistical Manual of the American Psychiatric Association.

The objectivity of the classification of sexual disorders in the third edition of the Diagnostic and Statistical Manual (DSM-III) of the American Psychiatric Association is explored via a critical examination of the replacement of homosexuality per se by ego-dystonic homosexuality, DSM's working concept of a mental disorder, the notion of a paraphilia, components of sexual identity, and the literature on variant sexual behaviors. It is argued that the same criteria that led to the removal of homosexuality per se as a mental disorder require the removal of all the paraphilias per se, there is no empirical warrant to justify their continued inclusion, and while there is legitimacy for a generalized ego-dystonic category, such ego-dystonias are only incidentally sexual. It is suggested that the present classification of sexual disorders is merely the codification of social mores.

Cues↗
PubMed1984

The ethical and moral implications of sexual classification: a commentary.

This paper reviews the relationship between psychiatric diagnosis and morality, suggesting that moral reasoning has been the primary determinant in the diagnosis of sexual disorders. It suggests two hypotheses to explain why homosexuality was eliminated from DSM. One, that homosexuality is now viable as a lifestyle and therefore has become socially regulated; and two, that the normal is the intractible. It further suggests that there is no scientific reason to keep the paraphilias in DSM.

Ethics, Medical↗
PubMed1999

Psychiatric features of 36 men convicted of sexual offenses.

BACKGROUND: To increase understanding of the relationship between sexual violence and mental illness, the authors assessed the legal histories and psychiatric features of 36 males convicted of sexual offenses. METHOD: Thirty-six consecutive male sex offenders admitted from prison, jail, or probation to a residential treatment facility received structured clinical interviews for DSM-IV Axis I and II disorders. The participants' legal histories, histories of sexual and physical abuse, and family histories of psychiatric disorders were also assessed. RESULTS: The participants' mean +/- SD age was 33+/-8 years. They had been convicted a mean of 1.8+/-1.4 times (range, 1-9 times) for sexual offenses and incarcerated a mean of 8+/-6 years (range, 0-22 years). Participants displayed high rates of lifetime DSM-IV Axis I disorders: 30 (83%) had a substance use disorder; 21 (58%), a paraphilia; 22 (61%), a mood disorder (13 [36%] with a bipolar disorder); 14 (39%), an impulse control disorder; 13 (36%), an anxiety disorder; and 6 (17%), an eating disorder. Participants also displayed high rates of Axis II disorders, with 26 (72%) meeting DSM-IV criteria for antisocial personality disorder. In addition, subjects reported experiencing high rates of sexual (but not physical) abuse and high rates of Axis I disorders, especially substance use and mood disorders, in their first-degree relatives. Compared with subjects without paraphilias, subjects with paraphilias displayed statistically significantly higher rates of mood, anxiety, and eating disorders, as well as significantly higher rates of childhood sexual abuse. CONCLUSION: Recognition and treatment of major psychiatric disorders among sex offenders may increase chances for successful rehabilitation, reduce recidivism and public victimization, and produce significant public health and economic benefits. More studies in this area appear warranted to search for more effective interventions for this severe public health problem.

Adolescent↗
PubMed1963

[A pervert].

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Antisocial Personality Disorder↗