PARAPHILIAS

BEFORE WE START
ARE YOU 18 YEARS OLD OR
ABOVE?
WHAT IS A
PARAPHILIA?
WHAT IS PARAPHILIA?
 Paraphilias are emotional disorders defined as
sexually arousing fantasies, urges or behaviors
that are recurrent, intense, occur over a specific
period of time, and cause significant distress
involving non-consenting partners, partners who
are suffering or being humiliated (simulated or
real) or through the use of an object. 
TWO MAIN TYPES OF
PARAPHILIA
The first group of disorders is classified as anomalous activity
preferences, which are subdivided into voyeuristic disorder,
exhibitionistic disorder, and frotteuristic disorder which involve
pain and suffering (sexual masochism disorder and sexual
sadism disorder)
The second group of disorders is classified as anomalous
target preferences, which include pedophilic disorder, fetishistic
disorder, and transvestic disorder. Pedophilic disorder was
coined to refer to sexual attraction to peripubescent children.
FETISHISM: SEXUAL FASCINATION WITH NONLIVING OBJECTS OR HIGHLY SPECIFIC
BODY PARTS (PARTIALISM). EXAMPLES OF SPECIFIC FETISHISMS INCLUDE SOMNOPHILIA
(SEXUAL AROUSAL BY A PERSON WHO IS UNCONSCIOUS) AND UROPHILIA (DERIVING
SEXUAL PLEASURE FROM SEEING OR THINKING ABOUT URINE OR URINATING)
TRANSVESTISM: CROSS-DRESSING THAT IS
SEXUALLY AROUSING AND INTERFERES
WITH FUNCTIONING
AUTOGYNEPHILIA IS A SUBTYPE OF TRANSVESTISM THAT
REFERS SPECIFICALLY TO MEN WHO BECOME AROUSED
BY THINKING OR VISUALIZING HIMSELF AS A WOMAN.
EXHIBITIONISM: EXPOSING
ONE’S OWN GENITALS TO AN
UNSUSPECTING PERSON
VOYEURISM: WATCHING AN
UNSUSPECTING/NON-CONSENTING
INDIVIDUAL WHO IS EITHER NUDE,
DISROBING, OR ENGAGING IN SEXUAL
ACTIVITY
SEXUAL SADISM: THE PHYSICAL OR EMOTIONAL
SUFFERING OF ANOTHER PERSON
SEXUAL MASOCHISM: BEING HUMILIATED,
BEATEN, BOUND, OR OTHERWISE SUFFERING
FROTTEURISM: TOUCHING OR
RUBBING AGAINST A NON-
CONSENTING PERSON
PEDOPHILIA: SEXUAL ACTIVITY WITH A
CHILD THAT IS PREPUBESCENT
(USUALLY 13 YEARS OLD OR YOUNGER)
Other specified paraphilia: some paraphilias do not
meet full diagnostic criteria for a paraphilic disorder
but may have uncontrolled sexual impulses that
cause enough distress for the sufferer that they are
recognized. Examples of such specific paraphilias
include necrophilia (corpses), scatologia (obscene
phone calls), coprophilia (feces and defecation), and
zoophilia (animals
NECROPHILIA IS A PATHOLOGICAL FASCINATION WITH
DEAD BODIES, WHICH OFTEN TAKES THE FORM OF A
DESIRE TO ENGAGE WITH THEM IN SEXUAL ACTIVITIES,
SUCH AS INTERCOURSE.
SCATOLOGIA, ALSO CALLED COPROLALIA,
DEVIANT SEXUAL PRACTICE IN WHICH SEXUAL
PLEASURE IS OBTAINED THROUGH THE
COMPULSIVE USE OF OBSCENE LANGUAGE. THE
AFFECTED PERSON COMMONLY SATISFIES HIS
DESIRES THROUGH OBSCENE TELEPHONE CALLS,
USUALLY TO STRANGERS.
COPROPHILIA IS A SEXUAL FETISH PEOPLE FEEL WHEN
THEY COME INTO CONTACT WITH FECES. COPROPHILIA
CAN BE SAID TO BE LIKING THE SMELL, TASTE, OR FEEL
OF FECES IN A SEXUAL WAY. THE FEELING CAN BE EITHER
THROUGH TOUCHING THE SKIN OR THROUGH RUBBING
THE PENIS HEAD AGAINST FECES.
ZOOPHILIA, SEXUAL ATTRACTION OF A HUMAN TOWARD A
NONHUMAN ANIMAL, WHICH MAY INVOLVE THE
EXPERIENCE OF SEXUAL FANTASIES ABOUT THE ANIMAL
OR THE PURSUIT OF REAL SEXUAL CONTACT WITH IT
WHAT ARE CAUSES AND RISK
FACTORS FOR PARAPHILIA?
 Biological issues
 Mental health professionals have found that male pedophiles have lower IQ scores on
psychological testing compared to men who are not pedophiles.
 Research has also determined that they tend to have a history of earning lower grades in
school than their non-pedophilic counterparts, regardless of intellectual abilities and learning
styles.
 Others believe paraphilias are the result of the sufferer associating something with sexual
arousal and interests, or by having unusual early life sexual experiences reinforced by having
an orgasm
Another theory about paraphilia risk factors
is that they are linked to stages of childhood
psychological development like
temperament, early relationship formation, 
trauma repetition, and disrupted
development of sexuality, as follows:
TEMPERAMENT: A TENDENCY TO BE OVERLY INHIBITED
OR UNCONTROLLED WITH EMOTIONS AND BEHAVIORS
EARLY RELATIONSHIP FORMATION: A LACK OF STABLE
SELF-AWARENESS, TROUBLE MANAGING EMOTIONS,
AND IN SEEKING HELP AND COMFORT FROM OTHERS
VICTIM OF SEXUAL OR OTHER FORMS OF ABUSE,
ESPECIALLY IF IT OCCURS DURING CHILDHOOD,
MAY IDENTIFY WITH THE ABUSER SUCH THAT
THEY ACT OUT WHAT WAS INFLICTED ON THEM
BY VICTIMIZING OTHERS IN SOME WAY. THEY MAY
ALSO ACT OUT THE TRAUMA BY SOMEHOW
HARMING THEMSELVES.
DEVELOPMENT OF
SEXUALITY: THE
PATTERNS OF WHAT
BRINGS ONE SEXUAL
PLEASURE TEND TO
FORM BY
ADOLESCENCE.
PEOPLE RAISED IN A
HOUSEHOLD THAT IS
EITHER EXCESSIVELY
SEXUALLY
PERMISSIVE OR
INHIBITED ARE AT
HIGHER RISK FOR
FAMILY RISK FACTORS FOR
PARAPHILIA DEVELOPMENT
INCLUDE HIGH CONFLICT
BETWEEN PARENTS OR LOW
SUPERVISION BY PARENTS, A
LACK OF AFFECTION FROM THE
MOTHER, AND GENERALLY NOT
FEELING TREATED WELL BY
THEIR PARENTS. PEOPLE WITH
PARAPHILIA TEND TO HAVE
TROUBLE MAKING AND KEEPING
FRIENDS AND OTHER
RELATIONSHIPS.
EPIDEMIOLOGY
 Exact prevalence is unknow
 Disorders are apparently rare
 Virtually all cases have been in males
 Over 50% of these patients develop the onset of the paraphilic arousal prior to age 18
WHAT ARE PARAPHILIA
SYMPTOMS AND SIGNS?
 Specifically, people with a paraphilia tend to experience arousal by the stimulant to the
exclusion or near exclusion of more common sources of sexual interest, like an attractive
person of similar age.
 The unusual or forbidden nature of a paraphilia often causes symptoms of guilt and fear of
punishment.
 Symptoms of paraphilia can include preoccupation to the point of obsessiveness that may
intrude on the person’s attempts to think about other things or engage in more conventional
sexual activity with an age-appropriate partner. Paraphilia sufferers may experience depression
or anxiety that is temporarily relieved by engaging in paraphilic behavior, thus leading to an
addictive cycle.
HOW DO HEALTH
PROFESSIONALS DIAGNOSE
PARAPHILIAS?
 Usually providers of mental-health care help make the diagnosis of paraphilias,
including licensed mental-health therapists, psychiatrists, psychologists,
psychiatric nurses, and social workers
 As part of this examination, the sufferer may be asked a series of questions from
a standardized questionnaire or self-test to help assess the presence of paraphilic
symptoms.
 In order to qualify for the diagnosis of a paraphilic disorder, the individual has to
experience recurrent, significant sexual arousal by the object of their attraction;
act on that attraction in urges, fantasies, or actions; and experience the
symptoms for at least 6 months to the point that the individual suffers significant
levels of distress or interference with his or her work, social function, or other
important aspects of life.
WHAT IS THE TREATMENT
FOR PARAPHILIA?
Treatment modalities currently used fall into three categories:
surgical castration, psychotherapy , and pharmacotherapy.
Pharmacological interventions consist of antiandrogens.Cyproterone and medroxyprogesterone
 acetates are the two antiandrogens more commonly used.
Psychotropic drugs may be effective solely in men with a definite obsessive-compulsive
disorder component.
Group therapy helps in breaking through the denial so commonly found in people.
 Cognitive therapies described include restructuring cognitive distortions and empathy training.
Also social skills are a better way to treat patients with these types of disorders.
WHAT MEDICATION CAN BE
TAKEN?
 Medications that suppress production of the male hormone testosterone reduce the frequency
or intensity of sexual desire in pedophiles.

 Studies of the effectiveness of selective serotonin reuptake inhibitors (SSRIs) in treating

 There is some preliminary research that stimulant medications like methylphenidate (Ritalin)
can increase the effectiveness of SSRIs, and naltrexone can decrease some of the sexual
obsessiveness associated with paraphilias.
WHAT IS THE PROGNOSIS OF
PARAPHILIA?
 Paraphilias are quite chronic such that a minimum of 2 years of treatment is recommended for
even the mildest paraphilia. While most people with a paraphilia do not sexually offend, and
sexual offending is not a mental illness, people who commit sexual offenses sometimes also
have a paraphilia.
IS IT POSSIBLE TO PREVENT
PARAPHILIAS?
 Given that paraphilic behavior tends to be highly stigmatized and some paraphilic behaviors
are illegal, tracking how successful treatment often involves rates of criminal recidivism.
Therefore, prevention of future paraphilic behavior often focuses on preventing sexual
offenders from having access to potential victims. Prevention for the development of any
paraphilic behavior usually involves alleviating the psychosocial risk factors for its
development