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Molen LV, Ronis ST, Benoit AA. Paraphilic Interests Versus Behaviors: Factors that Distinguish Individuals Who Act on Paraphilic Interests From Individuals Who Refrain. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2023; 35:403-427. [PMID: 35699951 DOI: 10.1177/10790632221108949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Little is known about distinct factors linked with acting on paraphilic interests or refraining from engaging in paraphilic behaviors. Participants from Canada and the United States (N = 744), aged 19-42 years (M = 29.2; SD = 3.18), were recruited through Amazon's Mechanical Turk. Participants completed questionnaires about their paraphilic interests and behaviors, as well as potential key factors linked to behavioral engagement (i.e., perceptions of consent, sexual excitation/inhibition, impulsivity, moral disengagement, empathy). Results indicated that higher moral disengagement and impulsivity, lower sexual control (i.e., high sexual excitation, low sexual inhibition), and maladaptive understandings of consent were best able to differentiate individuals who reported highly stigmatized (e.g., hebephilia, pedophilia, coprophilia) or Bondage and Dicipline, Dominance and Submission, Sadism and Masochism(BDSM)/Fetish paraphilic interests and engagement in the paraphilic behaviours associated with these interests relative to individuals who did not report such paraphilic interests or behaviors. Moreover, higher moral disengagement, impulsivity, and maladaptive perceptions of consent were best able to differentiate non-consensual paraphilic interests and behaviours (e.g., voyeurism, exhibitionism) compared to individuals who did not report these paraphilic interests or behaviours. These results provide future directions for the exploration of mechanisms that may contribute to engagement in paraphilic behaviors and may be targets for intervention aimed at preventing engagement in potentially harmful paraphilias.
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Affiliation(s)
| | - Scott T Ronis
- University of New Brunswick, Fredericton, NB, Canada
| | - Aryn A Benoit
- University of New Brunswick, Fredericton, NB, Canada
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Lin IJ, Tzeng NS, Chung CH, Chien WC. Psychiatric disorders in female psychosexual disorders-a nationwide, cohort study in Taiwan : Psychiatric disorders and female psychosexual disorders. BMC Psychiatry 2021; 21:63. [PMID: 33509146 PMCID: PMC7845000 DOI: 10.1186/s12888-021-03060-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 01/18/2021] [Indexed: 12/02/2022] Open
Abstract
We aimed to investigate whether females with psychosexual disorders were associated with the risk of affective and other psychiatric disorders. A total of 2240 enrolled individuals, with 560 patients with psychosexual disorders and 1680 subjects without psychosexual disorders (1:3) matched for age and index year, from the Longitudinal Health Insurance Database, retrieved from the National Health Insurance Research Database (NHIRD), between 2000 and 2015 in Taiwan. The multivariate Cox regression model was used to compare the risk of developing psychiatric disorders during the 15 years of follow-up. There were 98 in the cohort with psychosexual disorders (736.07 per 100,000 person-year) and 119 in the non-cohort without psychosexual disorders (736.07 per 100,000 person-year) that developed psychiatric disorders. The multivariate Cox regression model revealed that the adjusted hazard ratio (HR) was 9.848 (95% CI = 7.298 - 13.291, p < 0.001), after the adjustment of age, monthly income, urbanization level, geographic region, and comorbidities. Female patients with psychosexual disorders were associated with the risk of psychiatric disorders. This finding could be a reminder for clinicians about the mental health problems in patients with psychosexual disorders.
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Affiliation(s)
- Iau-Jin Lin
- grid.260565.20000 0004 0634 0356Graduate Institute of Life Sciences, National Defense Medical Center, 9314R, No.161, Section 6, Min-Chuan East Road, Neihu District, Taipei, 11490 Taiwan, Republic of China
| | - Nian-Sheng Tzeng
- grid.260565.20000 0004 0634 0356Department of Psychiatry, School of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China ,grid.260565.20000 0004 0634 0356Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chi-Hsiang Chung
- grid.260565.20000 0004 0634 0356Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Gung Road, Neihu District, Taipei, 11490 Taiwan, Republic of China ,grid.260565.20000 0004 0634 0356School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China ,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, Republic of China
| | - Wu-Chien Chien
- Graduate Institute of Life Sciences, National Defense Medical Center, 9314R, No.161, Section 6, Min-Chuan East Road, Neihu District, Taipei, 11490, Taiwan, Republic of China. .,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Gung Road, Neihu District, Taipei, 11490, Taiwan, Republic of China. .,School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China. .,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, Republic of China.
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Thibaut F, Cosyns P, Fedoroff JP, Briken P, Goethals K, Bradford JMW. The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders. World J Biol Psychiatry 2020; 21:412-490. [PMID: 32452729 DOI: 10.1080/15622975.2020.1744723] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objectives: The primary aim of these guidelines is to evaluate the role of pharmacological agents in the treatment and management of patients with paraphilic disorders, with a focus on the treatment of adult males. Because such treatments are not delivered in isolation, the role of specific psychotherapeutic interventions is also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients, including sexual offenders, with paraphilic disorders. The aim of these guidelines is to bring together different views on the appropriate treatment of paraphilic disorders from experts representing different countries in order to aid physicians in clinical decisions and to improve the quality of care.Methods: An extensive literature search was conducted using the English-language-literature indexed on MEDLINE/PubMed (1990-2018 for SSRIs) (1969-2018 for hormonal treatments), supplemented by other sources, including published reviews.Results: Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. The type of medication used depends on the severity of the paraphilic disorder and the respective risk of behaviour endangering others. GnRH analogue treatment constitutes the most relevant treatment for patients with severe paraphilic disorders.Conclusions: An algorithm is proposed with different levels of treatment for different categories of paraphilic disorders accompanied by different risk levels.
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Affiliation(s)
- Florence Thibaut
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin, University of Paris, INSERM U1266, Institute of Psychiatry and Neurosciences, Paris, France
| | - Paul Cosyns
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - John Paul Fedoroff
- Division of Forensic Psychiatry, The Royal Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Kris Goethals
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp and University Forensic Centre, Antwerp University Hospital, Antwerp, Belgium
| | - John M W Bradford
- The Royal Institute of Mental Health Research, University of Ottawa, McMaster University, Ottawa & Hamilton, ON, Canada
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Joyal CC, Carpentier J. The Prevalence of Paraphilic Interests and Behaviors in the General Population: A Provincial Survey. JOURNAL OF SEX RESEARCH 2017; 54:161-171. [PMID: 26941021 DOI: 10.1080/00224499.2016.1139034] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Paraphilic sexual interests are defined as unusual or anomalous, but their actual occurrence in nonclinical samples is still unknown. This study looked at desire for and experience of paraphilic behaviors in a sample of adult men and women in the general population. A secondary goal was to compare the results of two survey modes-traditional landline telephone versus online. A total of 1,040 persons classified according to age, gender, education, ethnic background, religious beliefs, area of residency, and corresponding to the norm for the province of Quebec were interviewed. Nearly half of this sample expressed interest in at least one paraphilic category, and approximately one-third had had experience with such a practice at least once. Voyeurism, fetishism, frotteurism, and masochism interested both male and female respondents at levels above what is usually considered to be statistically unusual (15.9%). Interestingly, levels of interest in fetishism and masochism were not significantly different for men and women. Masochism was significantly linked with higher satisfaction with one's own sexual life. As expected, the online mode generated more acknowledgment of paraphilic interest than the telephone mode. These results call into question the current definition of normal (normophilic) versus anomalous (paraphilic) sexual behaviors.
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Affiliation(s)
- Christian C Joyal
- a University of Quebec at Trois-Rivieres and Philippe Pinel Institute of Montreal
| | - Julie Carpentier
- a University of Quebec at Trois-Rivieres and Philippe Pinel Institute of Montreal
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