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Lassche MM, Lasogga L, de Roos MS, Leeflang A, Ajazi V, Axioti M, Rassin E, van Dongen JDM. Dark Tetrad personality traits, paraphilic interests, and the role of impulsivity: an EEG-study using a Go/No-Go paradigm. Sci Rep 2024; 14:10884. [PMID: 38740864 DOI: 10.1038/s41598-024-61214-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 05/01/2024] [Indexed: 05/16/2024] Open
Abstract
Maladaptive personality traits, such as 'dark personalities' are found to result in a diverse set of negative outcomes, including paraphilic interests and associated (illegal) behaviors. It is however unclear how these are exactly related, and if related, if then only those individuals higher on dark personality traits and higher impulsivity engage in paraphilic behaviors. In the current study, 50 participants were recruited to investigate the relationship between Dark Tetrad personality traits (i.e., narcissism, psychopathy, Machiavellianism and everyday sadism), paraphilic interests (arousal and behavior) and the moderating role of impulsivity. Personality and paraphilic interests were investigated through self-report questionnaires. Impulsivity was measured both through self-reported dysfunctional impulsivity and the P3 event related potential using electroencephalography during the Go/No-Go task (i.e. response inhibition). The results showed that there was a positive association between psychopathy, sadism and paraphilic interests. Whereas everyday sadism was associated with paraphilic (self-reported) arousal, psychopathy was associated with paraphilic behavior. Although P3 amplitude was not associated with paraphilic interests, self-reported dysfunctional impulsivity was associated with paraphilic behavior specifically. However, there was no moderating role of dysfunctional impulsivity and response inhibition (P3) in the relationship between psychopathy and paraphilic behavior. Findings indicate that the relation between specific dark personalities and paraphilic interests may be more complex than initially thought. Nevertheless, risk assessment and intervention approaches for paraphilia and related behavior both may benefit from incorporating Dark Tetrad and impulsivity measurements.
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Affiliation(s)
- Maria M Lassche
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Luca Lasogga
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen, Aachen, Germany
| | - Melissa S de Roos
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Amber Leeflang
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Vanesa Ajazi
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
- Department of General Psychology, University of Padua, Padua, Italy
| | - Magda Axioti
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Eric Rassin
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Josanne D M van Dongen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.
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Hillert J, Haubrock LS, Dekker A, Briken P. Web-Based Initiatives to Prevent Sexual Offense Perpetration: A Systematic Review. Curr Psychiatry Rep 2024; 26:121-133. [PMID: 38509408 PMCID: PMC10978615 DOI: 10.1007/s11920-024-01489-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE OF REVIEW Web-based programs to prevent sexual offense perpetration could provide an opportunity that avoids many of the barriers associated with in-person treatment. The aim of this systematic review is to give an overview of the literature on web-based initiatives aimed at sexual offense perpetration prevention published during the last 10 years (2013-2023) and to report data on the efficacy as well as issues of the discussed initiatives. RECENT FINDINGS We included 18 empirical studies discussing web-based perpetration prevention initiatives, of which six are randomized controlled trials. Among the articles, four cover programs focusing on prevention of sexual reoffending and 14 discuss programs aimed at preventing initial sexual offenses. Evaluations and observations of web-based initiatives aimed at preventing sexual offense perpetration show overall promising results and are well-appreciated. However, evaluation studies are scarce and more randomized controlled trials replicating this effect are warranted.
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Affiliation(s)
- Jana Hillert
- Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20251, Hamburg, Germany
| | - Lina Sophie Haubrock
- Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20251, Hamburg, Germany
| | - Arne Dekker
- Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20251, Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20251, Hamburg, Germany.
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Zakreski E, Androvičová R, Bártová K, Chronos A, Krejčová L, Martinec Nováková L, Klapilová K. Childhood Adversity and Offense-Supportive Cognitions Among Czech Adults with a Sexual Interest in Violence or Children. Arch Sex Behav 2024:10.1007/s10508-024-02837-1. [PMID: 38514492 DOI: 10.1007/s10508-024-02837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024]
Abstract
Individuals with paraphilic interests in sexual violence or children may be more likely to sexually offend if they possess offense-supportive cognitions. These cognitions may develop in response to childhood adversity. However, this idea is largely based on research in men convicted of sexual offenses and may not generalize to non-incarcerated adults with paraphilic interests. In a sample of 178 adults screened for paraphilic interests in violence or children (from the general Czech population), we hypothesized that childhood sexual abuse and emotional neglect would be associated with offense-supportive cognitions about rape and child molestation. Participants came from a nationally representative sample of Czech adults and were selected if they self-reported high levels of sexual interest in violence and/or children. Participants completed an online survey with self-report measures of sexual orientation, offense-supportive cognitions (Bumby RAPE and MOLEST scales), and childhood sexual abuse and emotional neglect (Childhood Trauma Questionnaire). Controlling for gender, age, and sexual orientation, we found that both rape-supportive cognitions and child molestation-supportive cognitions were significantly associated with higher levels of childhood sexual abuse, but not emotional neglect. These findings indicate that childhood sexual abuse may lead to offense-supportive cognitions among men and women with paraphilia.
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Affiliation(s)
- Ellen Zakreski
- Centrum Pro Sexuální Zdraví a Intervence, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.
- Faculty of Humanities, Charles University, Prague, Czech Republic.
| | - Renáta Androvičová
- Centrum Pro Sexuální Zdraví a Intervence, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Klára Bártová
- Centrum Pro Sexuální Zdraví a Intervence, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Agatha Chronos
- Faculty of Psychology, Universitetet i Bergen, Bergen, Norway
| | - Lucie Krejčová
- Centrum Pro Sexuální Zdraví a Intervence, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Lenka Martinec Nováková
- Centrum Pro Sexuální Zdraví a Intervence, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Kateřina Klapilová
- Centrum Pro Sexuální Zdraví a Intervence, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Faculty of Humanities, Charles University, Prague, Czech Republic
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Pang NTP, Masiran R, Alimuddin AS. Paraphilia without symptoms of primary psychiatric disorder: a case report. J Med Case Rep 2023; 17:46. [PMID: 36775819 DOI: 10.1186/s13256-023-03774-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 01/12/2023] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND Paraphilias are recurrent and arousing fantasies, thoughts, and behaviors that cause distress to sufferers and surrounding people. This case report details the challenge of managing multiple paraphilias with compulsive sexual behavior. CASE PRESENTATION A 48-year-old Malay man presented with compulsive sexual behavior, encompassing voyeuristic, frotteurism, and exhibitionistic behavior, increasing progressively over the years, with accompanying overvalued ideas of erotomania. Despite the high level of dysfunction occupationally and socially, there were no apparent psychotic, manic, or depressive symptoms. An organic workup was unremarkable, and he was diagnosed with multiple paraphilias. Treatment with selective serotonin reuptake inhibitors was commenced, and psychologically he was managed with techniques specific to compulsive sexual behavior. CONCLUSION Though rare in the literature, both paraphilic disorders and compulsive sexual behaviors are very distressing to sufferers and their families alike, and thorough biopsychological investigations are essential to ensure reversible causes are not overlooked.
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Abstract
Understanding sexual fantasies is central to understanding human sexuality. The current review synthesizes recent trends and findings in sexual fantasy research and points to several important conclusions. First, few sexual fantasies appear to be statistically unusual or rare. Second, while the bulk of sexual fantasy research to date has focused on young, cisgender, heterosexual adults in North America, studies that have accounted for diversity (e.g., LGBTQ+ inclusion, cross-cultural work) reveal multiple similarities in sexual fantasy content, but also several notable differences. Third, what people fantasize about is not necessarily synonymous with what they are interested in or do in person. Limitations and directions for future research on sexual fantasy are discussed.
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Affiliation(s)
| | - Aki M Gormezano
- Department of Psychology, Queen's University, Kingston, ON, Canada
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Fox MH, Seto MC, Refaie N, Lavrinsek S, Hall V, Curry S, Ashbaugh AR, Levaque E, Fedoroff JP, Bradford JM, Lalumière ML. The Relation Between the Paraphilias and Anxiety in Men: A Case-Control Study. Arch Sex Behav 2022; 51:4063-4084. [PMID: 36201142 DOI: 10.1007/s10508-022-02346-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 06/16/2023]
Abstract
Despite a multitude of theoretical views, it is still unclear how individuals develop and sustain paraphilic interests (e.g., sexual attraction to children, interest in non-consensual violence). It is also not clear from these views why many paraphilic interests, and especially many paraphilias and paraphilic disorders, are much more common in men than in women. One possible factor affecting male's higher rate of paraphilias is anxiety, because anxiety can potentiate sexual arousal in men. We speculated that paraphilic interests could develop when feelings of anxiety are recurrently generated by atypical sexual stimuli, and when that anxiety repeatedly potentiates sexual arousal, reinforcing sexual response to atypical stimuli. It follows that men with paraphilic interests are susceptible to anxiety disorders, because an anxiety disorder would facilitate the hypothesized developmental process. We conducted a retrospective file review of 1048 consecutive patients (944 male patients retained for analysis) referred to an outpatient sexual behavior clinic at a psychiatric hospital to investigate the link between paraphilias and anxiety. Male patients with a paraphilia had 1.64 greater odds than male patients without a paraphilia of having been diagnosed with an anxiety disorder, but they also had elevated rates of many other types of disorders. Therefore, there does not seem to be a specific link between paraphilias and anxiety in this sample. The discovery of a general link between the paraphilias and psychological disorders in men opens new avenues for studying the developmental origins and consequences of male paraphilic interests.
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Affiliation(s)
- Mélanie H Fox
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Correctional Service of Canada, Ottawa, ON, Canada
| | - Michael C Seto
- School of Psychology, University of Ottawa, Ottawa, ON, Canada.
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, K1Z 7K4, Canada.
| | - Nabhan Refaie
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Gordon S. Lang School of Business and Economics, The University of Guelph, Guelph, ON, Canada
| | - Sofija Lavrinsek
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Victoria Hall
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
| | - Susan Curry
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, K1Z 7K4, Canada
| | | | - Enya Levaque
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - J Paul Fedoroff
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, K1Z 7K4, Canada
- The Royal Ottawa Health Care Group, Brockville, ON, Canada
| | - John M Bradford
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, K1Z 7K4, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Martin L Lalumière
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, K1Z 7K4, Canada
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Zidenberg AM, Olver ME. Measurement and Correlates of Zoophilic Interest in an Online Community Sample. Arch Sex Behav 2022; 51:4179-4193. [PMID: 36192665 DOI: 10.1007/s10508-022-02429-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Sexual interest in animals (zoophilia) is a scant investigated topic owing partially to difficulties in assessing the behavior outside of a clinical setting. While there have been previous attempts to categorize individuals with a sexual interest in animals into classification systems, this requires extensive clinical interviews and psychometric testing. Previous classifications also lack clarity on the adjacent concept of furryism (i.e., interest in anthropomorphized animals) and how it may be related to zoophilia. As there are currently no validated psychometric measures of zoophilia, individuals with a sexual interest in animals are a challenging population to research and may be underdetected in clinical settings. The central aim of the present study was to examine the measurement and correlates of sexual attraction to nonhuman animals through the development and refinement of psychometric and visual stimulus measures of animal sexual interest. Participants included 1,228 respondents (72% zoophilic and 35% furries; 67% men and 22.9% women) recruited from the online community. The results indicated that a Sexual Interest in Animals-Self-Report (SIA-SR) scale had four distinct subscales with excellent discrimination for self-reported zoophilia. Moreover, endorsement of sexual interest in horses and dogs from visual stimuli was most common among the individuals in the sample, while dog and horse sexual and romantic attractiveness ratings also had the largest and most consistent associations with SIA-SR scores and self-reported zoophilia. The results contribute to a greater understanding of the sexual interest patterns for persons with zoophilia and have implications for theory, future research, and clinical practice.
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Affiliation(s)
- Alexandra M Zidenberg
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, S7N 5A5, Canada.
| | - Mark E Olver
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, S7N 5A5, Canada
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Wibowo E, Wong STS, Wassersug RJ, Johnson TW. Paraphilic Sexual Attraction to Males Without Genitals Is Associated with Traumatic Childhood Experience, Body Image, and Thoughts/Behaviors Related to Genital Ablation. Arch Sex Behav 2022:10.1007/s10508-022-02427-z. [PMID: 36222942 DOI: 10.1007/s10508-022-02427-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 08/11/2022] [Accepted: 09/10/2022] [Indexed: 05/12/2023]
Abstract
In rare cases, some male individuals are sexually attracted to men who have their genitals removed. We investigate here if paraphilic attraction to men without genitals was associated with childhood experience, body image, and thoughts/behaviors related to body modification. An online survey, consisting of both validated questionnaires and questions developed by our team, was launched on the Eunuch Archive and MTurk websites. Out of 875 participants, 48.5 and 32.2% reported being attracted to males without testicles or without a penis, respectively; 49.7 and 31.0% felt they would themselves be attractive without testicles and without a penis, respectively. In terms of body modification, many reported having tattoos (19.0%) and piercings (26.1%). About half (48.3%) had played as children with male action figures without genitals, i.e., GI Joe, and Ken dolls. Additionally, some participants reported having: (1) witnessed animal castration (23.7%); (2) having been threatened with castration during their childhood (11.9%); (3) receiving genital injuries inflicted by others (11.0%); (4) pretending to be castrated (60.2%); (5) thinking of self-castration (54.2%); or (6) injuring their own penis (23.4%). Having received genital injuries inflicted by others was associated with attraction to males without testicles (OR = 1.997, p < .05), but not for attraction to males without a penis. Paraphilic attraction to males without genitals (i.e., castrated or penectomized) was associated with feeling attractive without genitals, having pretended to be castrated, considering self-castration, and having injured one's own penis. In conclusion, paraphilic attraction to males without genitals may be associated with traumatic early life events, body image, and desire for one's own genital ablation.
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Affiliation(s)
- Erik Wibowo
- Department of Anatomy, University of Otago, 270 Great King St., Dunedin, 9016, New Zealand.
| | - Samantha T S Wong
- Department of Educational and Counselling Psychology, McGill University, Quebec, Canada
| | - Richard J Wassersug
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Thomas W Johnson
- Department of Anthropology (Emeritus), California State University, Chico, CA, USA
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Piccolo EEL, Johnson TW, Wassersug RJ. Castration for Pleasure: Exploring Extreme Castration Ideations in Fiction. Arch Sex Behav 2022; 51:2337-2351. [PMID: 35556189 DOI: 10.1007/s10508-022-02295-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 05/26/2023]
Abstract
The Eunuch Archive (EA) is an online community which includes individuals who read and write sexual fantasies with themes related to castration and eunuchs. Here we analyzed the 100 stories rated highest by EA readers among the >8800 currently posted. Our goal was to gain insights into commonalities within, and specifics of, castration sexual fantasies. Simply stated, we want to know what the authors (and readers) fantasize about and why. The most popular EA stories link sexual gratification and romantic partnership with genital abuse. They are characterized by the absence of consent for genital ablations and multiple SM-related paraphilias. Many stories feature attraction to, and ablation of, the genitals of pubescent or adolescent males. Some EA members have acted on their interests and been voluntarily castrated. Others wish to be. The most popular stories in the EA collection typically link the sacrifice via SM abuse to securing a permanent sexual partnership. The idea of sacrificing one's genitals to build dyadic adhesion has been noted before in individuals with extreme castration ideations. Here we identify the common features of sexualized fantasies that are popular among individuals with exceptional interest in castration.
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Affiliation(s)
| | - Thomas W Johnson
- Department of Anthropology (Emeritus), California State University, Chico, CA, USA
| | - Richard J Wassersug
- Department of Cellular & Physiological Sciences, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada.
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Madill A, Zhao Y. Are Female Paraphilias Hiding in Plain Sight? Risqué Male-Male Erotica for Women in Sinophone and Anglophone Regions. Arch Sex Behav 2022; 51:897-910. [PMID: 34811651 PMCID: PMC8888501 DOI: 10.1007/s10508-021-02107-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
Female-oriented male-male erotica is a genre of popular culture often know as Boys' Love (BL), yaoi, and danmei. It is one of the largest by-and-for women sexual subcultures and a global phenomenon. With the largest data sets in the field, we ask: Which risqué sexual content do Sinophone (Chinese-speaking) and Anglophone (English-speaking) participants particularly enjoy in BL and does this differ between cultures?, and Are there sub-demographics in Sinophone and in Anglophone culture who enjoy particular forms of risqué sexual content in BL and do these forms relate also to enjoyment of particular storylines and concern with legal issues? The material studied meets the DSM-5 definition of the paraphilic, and little is known about paraphilias in women or in the general population. Using Categorical Principal Component Analysis we explored one 15-response question from our Sinophone (N = 1922) and Anglophone (N = 1715) BL fandom surveys: Which risqué sexual content do you particularly enjoy in BL? We also tested for associations with seven demographic and other BL content-related questions. Notably, the component structure was nearly replicated between the two independent samples, in order of strength: BDSM Specialist, Mechanoid/Animal Sex Specialist, Underage Sex Specialist, and Minority Paraphilia Specialist. In both samples, it was the avid BL fans and/or those who liked explicitly sexual stories, a largely overlapping demographic, who most engage the risqué content, while, for the Sinophone, this included also more non-heterosexual and/or other-gendered people. We conclude that women's paraphilias have been largely overlooked because they might be expressed more commonly through fantasy than action, that their mass expression has awaited both the means and the market force, and that current conceptualization of, and assumptions about, paraphilias is overly modeled on that of men.
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Affiliation(s)
- Anna Madill
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.
| | - Yao Zhao
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
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Bögemann H, Rettenberger M, Eher R. [Aggressiveness, assertiveness, and sexual deviance: An empirical-quantitative examination of Stoller's perversion theory]. Z Psychosom Med Psychother 2021;:OA14. [PMID: 34842501 DOI: 10.13109/zptm.2021.67.oa14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Aggressiveness, assertiveness, and sexual deviance: An empirical-quantitative examination of Stoller's perversion theory Objectives: The main aim of the present study was to empirically examinate the psychodynamic-founded perversion theory of Robert D. Stoller (1979), particularly his assumption of a transformation of aggressive impulses into sexual deviant fantasies due to traumatic experiences. Methods: In the present study different aspects of the theory were examined by using a sample (N = 954) of individuals convicted of sexually motivated offenses who had been clinically and forensically assessed between 2002 and 2018 at the Federal Evaluation Centre for Violent and Sexual Offenders (FECVSO) in the Austrian Prison System. As a part of the psychological testing procedure, German-speaking questionnaires for the assessment of aggressiveness and assertiveness were applied. Results: The results indicated that participants with a diagnosis of paraphilia showed significantly less spontaneously expressed aggression and less social competence compared to individuals without such a diagnosis. Conclusions: The findings of the present study are in line with the core assumptions of Stoller's perversion theory by demonstrating an inverse relationship between the diagnosis of paraphilia and self-reported aggression.
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Ramírez-Rodríguez R, León-Sequeda I, Salomón-Lara L, Perusquia-Cabrera D, Herrera-Covarrubias D, Fernández-Cañedo L, García LI, Manzo J, Pfaus JG, López-Meraz ML, Coria-Avila GA. Enhanced D2 Agonism Induces Conditioned Appetitive Sexual Responses Toward Non-reproductive Conspecifics. Arch Sex Behav 2021; 50:3901-3912. [PMID: 34665381 DOI: 10.1007/s10508-021-02023-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 06/13/2023]
Abstract
Brain mechanisms of sexual attraction toward reproductive partners develop from a systematic interrelationship between biology (nature) and learning (nurture). However, the causes of attraction toward non-reproductive partners are poorly understood. Here, we explored the role of Pavlovian learning under dopaminergic agonism on the development of sexual preference and brain activation for young male rats. During conditioning, adult sexually naïve males received either Saline (Saline-Paired) or the D2-receptor agonist quinpirole (QNP-Paired) and cohabited in contingency, or out of contingency (QNP-Unpaired) during 24 h with an almond-scented prepubertal juvenile male (PD25). Conditioning occurred every 4 days for three trials. Social and sexual responses were assessed four days after the last conditioning trial in a drug-free test, and males chose freely between a scented young male (PD37) and a novel receptive female. Four days later, males were exposed to the conditioned odor only and brain Fos-IR and serum testosterone were analyzed. Saline-Paired and QNP-Unpaired males displayed more non-contact erections (NCEs) and genital investigations for females, whereas QNP-Paired males expressed more NCEs and genital investigations for young males. In the QNP-Paired group, exposure to the young male-paired odor evoked more Fos-IR in limbic, hypothalamic and cortical areas, but no differences in serum testosterone were observed. Cohabitation with juvenile males during enhanced D2 agonism results in atypical appetitive sexual responses and a higher pattern of brain response for the young male-paired odor, with no changes in serum testosterone. We discuss the potential implications for the development of pedophilic disorder and perhaps other paraphilias.
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Affiliation(s)
- Rodrigo Ramírez-Rodríguez
- Maestría en Neuroetología, Universidad Veracruzana, Xalapa, Veracruz, Mexico
- Doctorado en Investigaciones Cerebrales, Universidad Veracruzana, Xalapa, Veracruz, Mexico
| | - Isabel León-Sequeda
- Doctorado en Investigaciones Cerebrales, Universidad Veracruzana, Xalapa, Veracruz, Mexico
| | - Lázaro Salomón-Lara
- Doctorado en Investigaciones Cerebrales, Universidad Veracruzana, Xalapa, Veracruz, Mexico
| | | | - Deissy Herrera-Covarrubias
- Instituto de Investigaciones Cerebrales, Universidad Veracruzana, Avenida Luis Castelazo S/N Col. Industrial Ánimas, 91190, Xalapa, Veracruz, Mexico
| | | | - Luis I García
- Instituto de Investigaciones Cerebrales, Universidad Veracruzana, Avenida Luis Castelazo S/N Col. Industrial Ánimas, 91190, Xalapa, Veracruz, Mexico
| | - Jorge Manzo
- Instituto de Investigaciones Cerebrales, Universidad Veracruzana, Avenida Luis Castelazo S/N Col. Industrial Ánimas, 91190, Xalapa, Veracruz, Mexico
| | - James G Pfaus
- Instituto de Investigaciones Cerebrales, Universidad Veracruzana, Avenida Luis Castelazo S/N Col. Industrial Ánimas, 91190, Xalapa, Veracruz, Mexico
| | - María-Leonor López-Meraz
- Instituto de Investigaciones Cerebrales, Universidad Veracruzana, Avenida Luis Castelazo S/N Col. Industrial Ánimas, 91190, Xalapa, Veracruz, Mexico
| | - Genaro A Coria-Avila
- Instituto de Investigaciones Cerebrales, Universidad Veracruzana, Avenida Luis Castelazo S/N Col. Industrial Ánimas, 91190, Xalapa, Veracruz, Mexico.
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Schippers EE, Smid WJ, Huckelba AL, Hoogsteder LM, Beekman ATF, Smit JH. Exploratory Factor Analysis of Unusual Sexual Interests. J Sex Med 2021; 18:1615-1631. [PMID: 37057429 DOI: 10.1016/j.jsxm.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/23/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Unusual sexual interests are largely intercorrelated, yet not much is known about underlying patterns of clusters between various sexual interests. AIM To identify underlying clusters of unusual sexual interests using exploratory factor analysis. METHODS We conducted exploratory factor analysis with self-reported interest in a wide variety of unusual sexual acts for an online, international sample (N = 669; 61% female), and for women and men separately. Factor regression weights were correlated to self-reported sex life satisfaction, sexual outlet, and psychiatric symptoms. OUTCOMES Participants rated the attractiveness of 50 unusual sexual activities, and reported on their sex life satisfaction (Arizona Sexual Experiences Scale), sexual outlet, and symptoms regarding ADHD (Adult ADHD Self-Report Screening Scale for DSM-5), depression, anxiety, and stress (Depression, Anxiety, and Stress Scale). RESULTS We identified 5 factors of unusual sexual interests that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia (attraction to dirtiness or soiled things), and fetishism. For women, unusual sexual interests related to more psychiatric symptoms and higher sexual outlet, whereas this relation was less explicit for men. CLINICAL IMPLICATIONS Different factors of unusual sexual interests may serve different underlying functions or motivations, for instance related to sexual, and emotional regulation. A better understanding of the nature of unusual sexual interests is important to be able to influence sexual interests that are unwanted or cause damage to others. STRENGTHS & LIMITATIONS Strength of this study include its anonymity, the avoidance of sexual orientation effects, and the possibility to indicate only a slight endorsement toward sexual items. Limitations include the sample's generalizability and the truthfulness of online responding. CONCLUSION Unusual sexual interests could be clustered into 5 factors that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia, and fetishism. Schippers EE, Smid WJ, Huckelba AL, et al. Exploratory Factor Analysis of Unusual Sexual Interests. J Sex Med 2021;18:1615-1631.
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Affiliation(s)
- Eveline E Schippers
- Forensic Care Specialists, Utrecht, the Netherlands; Department of Psychiatry, and GGZ inGeest, Amsterdam University Medical Centers, Free University Amsterdam, Amsterdam, the Netherlands.
| | | | - Anna Laura Huckelba
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - Aartjan T F Beekman
- Department of Psychiatry, and GGZ inGeest, Amsterdam University Medical Centers, Free University Amsterdam, Amsterdam, the Netherlands
| | - Jan H Smit
- Department of Psychiatry, and GGZ inGeest, Amsterdam University Medical Centers, Free University Amsterdam, Amsterdam, the Netherlands
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Cranstoun LM, Moser C. The Paraphilias and Medical Licensure in the United States. J Sex Med 2021; 18:1130-1133. [PMID: 37057470 DOI: 10.1016/j.jsxm.2021.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/15/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND As part of their mission to protect the public from exploitation, state medical boards query physicians about a wide range of topics prior to licensure, including in some cases whether the applicant has been diagnosed with or been treated for paraphilias or paraphilic disorders. AIM We investigated the prevalence of questions inquiring about the applicants' history of paraphilias and paraphilic disorders on applications for medical licensure. METHODS The allopathic medical licensure application forms for each of the 50 United States and the District of Columbia were reviewed. Medical boards with questions pertaining to paraphilias or paraphilic disorders were asked how many affirmative responses had been obtained in the prior 5 years and how they would treat an affirmative response. OUTCOMES Eight medical boards inquired about paraphilias or paraphilic disorders, however there was no evidence of an affirmative response to these questions in the prior 5 years. RESULTS Of the 51 applications reviewed, 8 (16%) inquired whether the applicant had, was diagnosed with, or had been treated for a paraphilia or paraphilic disorder. The wording of the questions was variable and often failed to distinguish between paraphilias and paraphilic disorders. All but one medical board responded to requests for further information. The medical board staff members stated that an affirmative response would result in case-by-case review, including request for further information and possibly an in-person appearance before the board. None of the medical boards were willing or able to provide a formal count of affirmative responses in the last 5 years. CLINICAL IMPLICATIONS Medical boards may be contributing to the stigma experienced by both physicians and patients with diverse sexual interests. The benefit of retaining these questions is not clear. STRENGTHS AND LIMITATIONS This study is the first to investigate the use of paraphilias and paraphilic disorders as screening questions for medical licensure. Data regarding the number of affirmative responses were limited by the medical boards' inability or unwillingness to respond to share the information. CONCLUSIONS Eliminating or modifying physician licensing application questions pertaining to paraphilias and paraphilic disorders may decrease the stigma encountered by persons with diverse sexual interests. Removal also may diminish the barriers to accessing health care services for both physicians and patients with diverse sexualities. If the questions are retained, they should conform to the current DSM-5 nosology, which distinguishes between the mere presence of a paraphilia and a diagnosis of a paraphilic disorder. Cranstoun LM, Moser C. The Paraphilias and Medical Licensure in the United States. J Sex Med 2021;18:1130-1133.
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Affiliation(s)
| | - Charles Moser
- Diverse Sexualities Research and Education Institute, San Francisco, CA, USA
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Wong STS, Wassersug RJ, Johnson TW, Wibowo E. Differences in the Psychological, Sexual, and Childhood Experiences Among Men with Extreme Interests in Voluntary Castration. Arch Sex Behav 2021; 50:1167-1182. [PMID: 32935176 DOI: 10.1007/s10508-020-01808-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 05/12/2023]
Abstract
Some genetic males seek voluntary castration. We designed a survey to compare the psychological, sexual, and childhood experiences for subgroups of men with extreme interest in castration. The survey was posted on the Eunuch Archive, an online platform for individuals interested in the topic. Data from 822 individuals were included in the analyses. Respondents were divided into four groups: Interested (claiming only an interest in castration topics), Fantasy (fantasize about castration sexually, but not desiring castration), Wannabe (considering being castrated in the future), and Castrated (already castrated). More individuals desiring castration (Wannabe and Castrated groups) claimed equal attraction to both sexes than individuals in the Interested group. The Interested group was more religious than the other groups, and the Fantasy group had lower sexual guilt than those with castration desire. All groups had similar psychological well-being and body image acceptance, despite the Castrated group having lower sexual functioning than the others. Childhood trauma was more common in those with castration desire than those without. The Interested group had a lower desire for castration, lower erotic attraction to castration, and pretended to be castrated at a younger age than the others. Childhood trauma and sexual guilt are common, but not limited, predictors for castration desire and erotic attraction to castration, respectively. In conclusion, childhood experiences, as well as psychological and sexual parameters, may vary in different subgroups of males with interests in castration.
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Affiliation(s)
- Samantha T S Wong
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Richard J Wassersug
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Thomas W Johnson
- Department of Anthropology, California State University, Chico, CA, USA
| | - Erik Wibowo
- Department of Anatomy, University of Otago, 270 Great King Street, Dunedin, 9016, New Zealand.
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Noegroho BS, Siregar S, Ramdhani R, Partogu B, Mustafa A. Penile strangulation injury by metallic ring: A study of 4 cases. Int J Surg Case Rep 2021; 80:105609. [PMID: 33601327 PMCID: PMC7898070 DOI: 10.1016/j.ijscr.2021.01.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 01/14/2023] Open
Abstract
Penila strangulation required emergency management to preserve the organ function. Each case managed individually according to its clinical finding and operative settings. Management depends on the type and size of constricting object, time after incarceration, degree of injury, available instrument, and experience of the physicians. Different methods and tools may arise due to circumstance and individual cases differences. Surprisingly, there is no erection problem after removing the strangulation.
Penile strangulation by metallic ring is an emergency situation which requires urgent management. Strangulation of the penis usually performed in order to increase sexual performance or because underlying mental disorder or paraphilia. It is an uncommon urological emergency, if not treated as soon as possible it can lead to complications such as gangrene and amputation of the penis. There is no standard of care that has been found to be superior, with each case managed individually according to its clinical findings and operative settings. In this study, we present four cases of penile strangulation in last two years in a tertiary care hospital.
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Affiliation(s)
- Bambang Sasongko Noegroho
- Department of Urology, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin Hospital, Indonesia.
| | - Safendra Siregar
- Department of Urology, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin Hospital, Indonesia
| | - Rizky Ramdhani
- Department of Urology, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin Hospital, Indonesia
| | - Bernard Partogu
- Department of Urology, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin Hospital, Indonesia
| | - Akhmad Mustafa
- Department of Urology, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin Hospital, Indonesia
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Abstract
Exhibitionism has been viewed through many lenses, from the perspectives of sexual deviance, forensic psychiatry, psychopathology, psychological dynamics, feminism, behaviorism, and psychopharmacology. Starting from the description of one psychotherapy patient, the aim of this paper is to synthesize this disparate literature. The findings of the synthesis include an estimate of the lifetime male prevalence of exhibitionism, 2-4%, peaking in late adolescence. Insecure attachment, sexual abuse in childhood, substance abuse, and sexual dysfunction are acknowledged risk factors. Motives behind the act of genital exposure remain obscure, constructed of both sexual and non-sexual impulses. The usual response of women victims is alarm and disgust. Successful treatment relies on a strong therapeutic alliance with specific psychological and psychopharmacological interventions - comparative effectiveness not yet determined. In conclusion, precedents for exhibitionism vary. The frequency of the behavior usually wanes with age and, while exhibitionists may pose a risk to others, they usually do not. There is, as yet, no gold standard treatment; the recommendation for therapists is to respond to individual facets of the patient's circumstances and history.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, 260 Heath St. W. Suite #605, Toronto, ON, M5P 3L6, Canada.
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18
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Chong SC, Ang JK, Hashim H. The fear of what goes up must come down: A case report of vulnerable narcissism. Asian J Psychiatr 2020; 54:102117. [PMID: 32623189 DOI: 10.1016/j.ajp.2020.102117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 10/24/2022]
Abstract
Pathological narcissism or narcissistic personality disorder is commonly characterized by an exaggerated sense of self-importance, condescending attitude, need for excessive admiration, diminished empathy and exploitativeness. In contrast to these overt attributes, there is a different presentation of pathological narcissism which is underrecognized, as one's preoccupation with hypervigilant, self-effacement and proneness to shame in the context of covert grandiose fantasies. This report illustrates a patient who had this subtype of vulnerable narcissism, and how his defence had been activated to preserve own self agency during a session with the doctor by revealing his paraphilic fantasy.
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Affiliation(s)
- Seng Choi Chong
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia.
| | - Jin Kiat Ang
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia.
| | - Hazleana Hashim
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia.
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Bauer K, Schön CA, Jackowski C. Fatal strangulation during consensual BDSM activity: three case reports. Int J Legal Med 2021; 135:347-53. [PMID: 33106895 DOI: 10.1007/s00414-020-02449-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Abstract
Autoerotic accidents are well-known occurrences in forensic casework. Reports about unintentional deaths in a sexual context involving other persons are much rarer. Three cases of fatal incidents related to asphyxiophilia during consensual BDSM activity are reported. Two men died while visiting a dominatrix, the third one in the presence of a male casual sexual partner. Paraphernalia associated with BDSM/fetishism were found at the scene in all cases. Autopsy findings were compatible with death by strangulation. The cases are compared with published autoerotic accidents and similar unintentional deaths involving other individuals. The difficulties concerning the forensic assessment and reconstruction of the cases are discussed.
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Brown A, Barker ED, Rahman Q. Erotic Target Identity Inversions Among Men and Women in an Internet Sample. J Sex Med 2020; 17:99-110. [PMID: 31813772 DOI: 10.1016/j.jsxm.2019.10.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/09/2019] [Accepted: 10/18/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Erotic target identity inversions (ETIIs) are poorly studied paraphilias that involve sexual arousal by the idea or fantasy of being the object of one's sexual desires. AIM To conduct a large non-clinical online survey to investigate self-reported sexual arousal, behavioral expression, and psychological correlates of 4 proposed ETIIs. METHODS A total of 736 natal males and 549 natal females responded to items about self-reported sexual arousal to the idea of acting as an animal (autoanthropomorphozoophilia) or the idea of acting as a child or infant (autonepiophilia), natal males reporting arousal to the idea of acting as a woman (autogynephilia), and natal females reporting arousal to the idea of acting as a man (autoandrophilia). Data pertaining to sexual orientation, childhood gender nonconformity, gender identity discomfort, autism, masochism, and humiliation were also collected. MAIN OUTCOME MEASURES The main outcome was a measure of self-reported arousal and expression of the ETIIs being explored using 4 items: arousal level (-3 to 3) when imagining being the erotic target exemplar; frequency of engagement in dressing or behaving like their preferred target (0-4); strength of feeling that they would be better off as the target (0-4); and the frequency of consideration of making physical changes to look or function more like the target (0-4). RESULTS Mild levels of reported sexual arousal to the idea of being the preferred erotic target were common among the 4 groups, characterizing about half of them. Gender identity discomfort was associated with autogynephilia, autoandrophilia, and autoanthropomorphozoophilia. Greater gender nonconformity was associated with autogynephilia, autoandrophilia, and autonepiophilia. Autism scores were associated with autoandrophilia and autonepiophilia. Masochism was not associated with ETII scores, but humiliation was. CLINICAL IMPLICATIONS Findings suggest that it may be important to distinguish between subgroups of those with different levels and types of ETII arousal/expression. STRENGTHS & LIMITATIONS Strengths of this study include the large, non-clinical sample of men and women for the investigation of ETIIs and the inclusion of measures of psychological correlates. The use of an Internet sample with self-report measures may be unrepresentative, although the Internet has the advantage of allowing recruitment from stigmatized or unusual groups. The cross-sectional nature limits our conclusions, as no causal inferences can be made. CONCLUSION The results support the concept of ETIIs as a paraphilic dimension in non-clinical samples and the possible role of gender-related psychological factors. Brown A, Barker ED, Rahman Q. Erotic Target Identity Inversions Among Men and Women in an Internet Sample. J Sex Med 2020;17:99-110.
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Davis KA, Knight RA. Childhood maltreatment experiences and problematic sexual outcomes in adult males who have sexually offended: Further evidence of the potency of male caregiver psychological abuse. Child Abuse Negl 2019; 96:104097. [PMID: 31437771 DOI: 10.1016/j.chiabu.2019.104097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 07/18/2019] [Accepted: 07/22/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Although research on the developmental antecedents of sexual offending has tended to focus on sexual abuse, recent research in juveniles and adults who have sexually offended suggests that psychological abuse perpetrated by a male caregiver may be a particularly important factor in the development of problematic sexual interests and behaviors. OBJECTIVE This study aimed to extend previous findings by investigating the association between psychological abuse by a male caregiver and problematic sexual outcomes in a sample of adult males who had sexually offended. PARTICIPANTS Participants were 529 adult males incarcerated for sexual offenses, 21% of whom were civilly committed. METHODS Childhood maltreatment and problematic sexual outcomes were assessed using the Multidimensional Assessment of Sex and Aggression, a contingency-based inventory that assesses domains related to sexual aggression. Hierarchical regressions were calculated examining the association between childhood abuse types and sexual outcomes. RESULTS Childhood sexual abuse was associated with child sexual (β = .247, p < .001) and other paraphilic interests (β = .189, p < .001). Male caregiver psychological abuse also emerged as marginally associated with child sexual interest (β = .100, p = .059), even after controlling for other abuse types. CONCLUSIONS These results partially replicate recent findings in a juvenile sample and challenge conventional developmental theories of sexual offending, by suggesting that male caregiver psychological abuse may play a role in the etiology of child sexual interest among males who have sexually offended. This study also suggests a possible gender symmetry effect moderating the developmental consequences of abuse.
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Affiliation(s)
- Kathryn A Davis
- Department of Psychology, Brandeis University, Waltham, MA, United States.
| | - Raymond A Knight
- Department of Psychology, Brandeis University, Waltham, MA, United States
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Davis KA, Knight RA. The Relation of Childhood Abuse Experiences to Problematic Sexual Behaviors in Male Youths Who Have Sexually Offended. Arch Sex Behav 2019; 48:2149-2169. [PMID: 30627932 DOI: 10.1007/s10508-018-1279-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/22/2018] [Accepted: 07/15/2018] [Indexed: 06/09/2023]
Abstract
Psychological abuse and sexual abuse, either alone or in combination, have been implicated as developmental antecedents of problematic sexual thoughts and behaviors in studies of sexually aggressive males (Jesperson, Lalumière, & Seto, 2009; Knight & Sims-Knight, 2011; Levenson & Grady, 2016; Seto & Lalumière, 2010). Recently, psychological abuse perpetrated by a male caregiver has emerged as strongly associated with subsequent hypersexuality in adult males who had sexually offended. In a study of 529 adult male sexual offenders, Kingston, Graham, and Knight (2017) found that male caregiver psychological abuse was the most prominent correlate of hypersexual thoughts and behaviors in adulthood, above and beyond the effects of other abuse types, such as physical abuse and sexual abuse. Consequently, we hypothesized that, among juveniles who had sexually offended, higher self-reported levels of childhood psychological and sexual abuse, in contrast to other types of childhood maltreatment experiences, would covary with higher subsequent levels of normophilic sexualized thoughts and behaviors. Consistent with Kingston et al., Male Caregiver Psychological Abuse accounted for a significant amount of the variance in subsequent reported hypersexuality in this juvenile sample. Furthermore, this factor also emerged as a significant correlate of deviant sexual behaviors and fantasies, such as paraphilic interests and pedophilic preference. Sexual Abuse was also found to be significantly associated with hypersexuality. These findings provide additional support for the demonstrated relation between psychological abuse by a male caregiver and subsequent problematic sexual thoughts and behaviors. These data are also consistent with other research that suggests a gender symmetry effect in the impact of parental discipline and the differential effect of male caregiver abuse on male children.
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Affiliation(s)
- Kathryn A Davis
- Department of Psychology, MS 062, Brandeis University, Waltham, MA, 02454-9110, USA
| | - Raymond A Knight
- Department of Psychology, MS 062, Brandeis University, Waltham, MA, 02454-9110, USA.
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Turner D, Briken P. Treatment of Paraphilic Disorders in Sexual Offenders or Men With a Risk of Sexual Offending With Luteinizing Hormone-Releasing Hormone Agonists: An Updated Systematic Review. J Sex Med 2019; 15:77-93. [PMID: 29289377 DOI: 10.1016/j.jsxm.2017.11.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 10/28/2017] [Accepted: 11/20/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Different pharmacologic agents are used in the treatment of paraphilic disorders in sexual offenders or men with a risk of sexual offending, with luteinizing hormone-releasing hormone (LHRH) agonists being the agents introduced more recently to treatment regimens. AIM To summarize the relevant literature concerning LHRH agonist treatment of paraphilic disorders in sexual offenders and update the previously published systematic review by Briken et al (J Clin Psychiatry 2003;64:890-897). METHODS The PubMed and Google Scholar databases were searched for literature published from January 2003 through October 2017 using the following key words: LHRH agonists, GnRH agonists, antiandrogens AND paraphilia, pedophilia, sex offenders. OUTCOMES Evaluation of the effectiveness and side effects of LHRH agonist treatment of paraphilic disorders in sexual offenders. RESULTS After screening for duplicates and applying specific selection criteria, the search yielded 24 eligible studies reporting on a sample of 256 patients. There is increasing evidence that LHRH agonists are more effective than steroidal antiandrogens in lowering paraphilic sexual thoughts and behaviors. Current research also is based on methods that might be less susceptible to faking (eg, eye-tracking, brain imaging, and viewing-time measures). Side effects occurring most frequently are fatigue, hot flashes, depressive mood, weight gain, high blood pressure, diabetes, gynecomastia, loss of erectile function, and loss of bone mineral density. CLINICAL IMPLICATIONS Although LHRH agonists seem to be the most effective drugs in the treatment of paraphilic fantasies and behaviors, they should be reserved for patients with a paraphilic disorder and the highest risk of sexual offending because of their extensive side effects. STRENGTHS AND LIMITATIONS This systematic review considers all types of research on LHRH agonist treatment in patients with paraphilic disorders, thereby providing a complete overview of the current state of research. However, most studies are case reports or observational studies and randomized controlled clinical trials have not been conducted or published. CONCLUSIONS LHRH agonists are a useful treatment when combined with psychotherapy in patients with a paraphilic disorder and the highest risk of sexual offending. However, throughout treatment, close monitoring of side effects is needed and ethical concerns must always be kept in mind. Turner D, Briken P. Treatment of Paraphilic Disorders in Sexual Offenders or Men With a Risk of Sexual Offending With Luteinizing Hormone-Releasing Hormone Agonists: An Updated Systematic Review. J Sex Med 2018;15:77-93.
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Affiliation(s)
- Daniel Turner
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Abstract
This essay places psychiatrist and philosopher Frantz Fanon's anti-colonial, anti-racist message from Peau Noire, Masques Blancs/Black Skin, White Masks (1952; 1967; 2008) in conversation with the new diagnoses of "Gender Dysphoria" and "Transvestic Disorder" in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Specifically, the essay discusses sexologist Ray Blanchard's controversial theory of autogynephilia alongside Fanon's ambivalent rendering of transgender desire and interracial trans phenomenology in a crucial but frequently overlooked passage in Black Skin. Fanon's anti-colonial critique of psychiatry allows us to reconsider how Blanchard's theories on paraphilia engage with the foundational psychoanalytic concepts of identification and desire, as identified by the Freudian and Lacanian models and explored in the writings of Judith Butler, Catherine Millot, Charles Shepherdson, and others. By offering a fresh interpretation of the French text, this essay argues that a "trans of color critique" can benefit from Black Skin's unexpected insight into trans desire: Fanon's "man of color," who simultaneously undergoes a gender transition and a racial transformation, represents the literal embodiment of his critique of colonial racism. Given the role of the new paraphilias in the DSM-V, this essay concludes that a trans of color critique is well positioned to reinforce the anti-colonial message Fanon addressed to the psychiatric and psychoanalytical fields, which have tended to diagnose psychic injury while ignoring its causation, and which continue to neglect the fact that medical access is just as important as material support and security for minority subjects, in particular.
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Affiliation(s)
- Stephanie Hsu
- Pace University, 41 Park Row, 15th Floor, New York, NY, 10038, USA.
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Sendler DJ. Contemporary understanding of zoophilia - A multinational survey study. J Forensic Leg Med 2019; 62:44-51. [PMID: 30639855 DOI: 10.1016/j.jflm.2018.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 12/26/2018] [Accepted: 12/31/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION People with paraphilias have sexual interests that are unusual, including inanimate objects, places, or individuals (children, corpses). This study explores zoophiles (=PSA, people who have sex with animals) recruited from the Internet. METHOD We administered a survey of own design via the Internet on popular discussion forums targeting the communities of PSA. All responses were quantified as the percentage of agreeing with one of the possible answer choices, plus the interpretation of qualitative data that may have been supplied in additional space. RESULTS Survey questions were thematically categorized into four groups - worldview, personal space, sex life, and online space. PSA are remarkably self-aware of their sexuality and recognize that their behavior is illegal (even though they perceive it as an expression of love); they often relate their struggles with finding social acceptance to homosexuality, believing that one way of de-stigmatizing them would be to remove zoophilia from the list of disorders listed in the DSM. Concerning sex life, PSA believe that the quality of sex with animals is much higher than with humans, and physical features, such as the presence of a fur, can be sexually arousing to PSA, especially when seeing animals in public. PSA utilize the Internet to network and connect with other PSA; these Internet-based friendships usually do not extend beyond online conversations, given that PSA tend to be mistrustful of other zoophiles particularly in the area of personal safety. CONCLUSIONS One of the most essential basis of zoophilia is relationship seeking behavior as well as interest in forming a long-term relationship with an animal partner.
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Affiliation(s)
- Damian Jacob Sendler
- Laboratory of Forensic Sexology, Legal Medicine, and Digital Ethnography, Felnett Health Research Foundation, 175 Zoe St, Staten Island, NY, 10305, United States; Program in the Study of Sexual Minorities and Health Policy, Felnett Health Research Foundation: Division for Eastern Europe, Warsaw, Poland.
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Choi JH, Lee JW, Lee JK, Jang S, Yoo M, Lee DB, Hong JW, Noh IS, Lim MH. Therapeutic Effects of Leuprorelin (Leuprolide Acetate) in Sexual Offenders with Paraphilia. J Korean Med Sci 2018; 33:e231. [PMID: 30190656 PMCID: PMC6125314 DOI: 10.3346/jkms.2018.33.e231] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 06/14/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This study examined the clinical effects of leuprolide acetate in sexual offenders with paraphilic disorders evaluated by means of objective psychiatric assessment. METHODS The subjects of this study were seven sexual offenders who were being treated by means of an injection for sexual impulse control by a court order. They had been diagnosed with paraphilia by a psychiatrist based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and had been put on probation by the Ministry of Justice between January 2016 and December 2016. RESULTS After twelve months, we observed significant improvement in symptoms, as decrease of abnormal sexual interest and activity, sexual fantasy, Clinical Global Impression-Severity (CGI-S), and Clinical Global Impression-Impulsivity (GCI-I). There were a mild feminization of the body shape, feelings of fatigue, and mild hot flushes. No other adverse effect was reported. CONCLUSION These results suggested that the clinical effects of leuprolide acetate in sexual offenders might be an effective treatment and safety strategy.
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Affiliation(s)
- Jong Hyuk Choi
- Department of Psychiatry, National Forensic Hospital, Gongju, Korea
| | - Jae Woo Lee
- Department of Psychiatry, National Forensic Hospital, Bugok, Korea
| | - Jang Kyu Lee
- Sex Offenders and Treatment Center, National Forensic Hospital, Gongju, Korea
| | - Soyeong Jang
- Department of Psychiatry, National Forensic Hospital, Gongju, Korea
| | - Mi Yoo
- Department of Psychiatry, National Forensic Hospital, Gongju, Korea
| | - Dae-bo Lee
- Department of Psychiatry, National Forensic Hospital, Gongju, Korea
| | - Jeong-Won Hong
- National Institution of Probation and Parole Office, Chuncheon, Korea
| | - Il Suk Noh
- National Institution of Probation and Parole Office, Cheonan, Korea
| | - Myung Ho Lim
- Department of Psychology and Psychotherapy, College of Health Science, Dankook University, Cheonan, Korea
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Abstract
Paraphilic disorders range from nearly normal behaviour to a behaviour which may be considered as destructive or menacing to the society at large. In accordance with Diagnostic and Statistical Manual of Mental Disorders-V, the terms Paraphilia and Paraphilic disorders, denote different interpretations. Multiple paraphilias connected to childhood either directly or indirectly has been documented in scientific literature. Paraphilic Infantilism, Diaperism and Pedophilia constitute major portion among them. Paraphilic infantilism denotes paraphilic desire of being a baby. Diaperism deals with fetishistic behaviour in relation to diapers and pedophilia stands for sexual attraction towards children. Behaviourally these three paraphilias do share some characteristics and show overlapping of certain features, but psychologically they are diverse. In a number of literature on digital media, the terms have been used interchangeably or are described in a manner that creates confusion. However, when described individually they are precisely written, hence it necessitates to be elaborated collectively to surpass the current trends of mixing them. The review focuses on behavioral, developmental, psychological and legal aspects of these paraphilias.
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Sendler DJ. Lethal asphyxiation due to sadomasochistic sex training - How some sex partners avoid criminal responsibility even though their actions lead to someone's death. J Forensic Leg Med 2018. [PMID: 29533207 DOI: 10.1016/j.jflm.2018.03.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Erotic asphyxiation is a sexual phenomenon in which one partner reduces the other person's brain oxygen level through strangulation. This study analyzes deaths caused by sexually-motivated strangulation to cases of homicidal choking - summarizing criminal penalties for defendants, depending on the presence of drugs, or alcohol intoxication. METHODS The mode of analysis involves three sources of data. First, a retrospective chart review of our clinics' two recent cases. Second, a meta-analysis of these materials in relationship to forensic reports obtained from prosecutor's office. Third, we examine the prevalence of death due to strangulation in erotic and non-erotic cases using central court database. Lastly, we provide the summary of interviews involving the country's only forensic unit, which investigates criminal cases involving voluntary and involuntary strangulation. RESULTS In total, we analyzed 15 cases of sexual asphyxiation - 2 of our own; 5 reported in prosecutor's archives; 8 control cases ruled as a non-sexual homicide. The two of our clinical cases describe two victims of voluntary erotic asphyxiation, involving complex sexual environment in which a sexual partner accidentally strangulated the other one during sex. The first case describes a 30 years-old female, who required all of her past sexual partners to choke her with hands in order to reach orgasm. The second case is that of a 41 years-old homosexual male, who was still a novice to kinky play and succumbed to death as a result of being tied with a set of ropes around his neck and body. By combining findings from the analysis of our clinic's cases with 5 files obtained from prosecutor's office - we are able to compare results of these cases to controls (involving homicidal suffocation using the plastic bag). In our cases, the defendants who avoid serving prison time for strangulating in course of erotic play typically exhibit these characteristics - at the time of the killing, they were not under influence of drugs; the deceased had documented (based on witness interview, review of personal items, or medical documentation) long-standing paraphilic disorder. In controls, the likelihood of being convicted of voluntary manslaughter was lower for people who acted under the influence of drugs but higher for those under the influence of alcohol. CONCLUSIONS These findings show that documented presence of paraphilic tendencies in the deceased might serve as grounds for not sentencing their sex partners for prison time if they acted to satisfy someone else's kinky needs.
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Affiliation(s)
- Damian Jacob Sendler
- Laboratory of Forensic Sexology, Legal Medicine, and Digital Ethnography, Felnett Health Research Foundation, 175 Zoe St, Staten Island, NY 10305, United States; Program in the Study of Sexual Minorities and Health Policy, Felnett Health Research Foundation: Division for Eastern Europe, Warsaw, Poland.
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Jahnke S. Emotions and Cognitions Associated with the Stigma of Non-Offending Pedophilia: A Vignette Experiment. Arch Sex Behav 2018; 47:363-373. [PMID: 29159755 DOI: 10.1007/s10508-017-1073-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 08/11/2017] [Accepted: 08/31/2017] [Indexed: 06/07/2023]
Abstract
Cognitive and affective antecedents of the desire to avoid or punish non-offending pedophilic individuals are not well understood. In this article, we examined the effects of non-offending motivation (internal vs. external) and sexual orientation (pedophilic vs. teleiophilic) on cognitive apprehensions (amorality, dangerousness, abnormality), emotions (fear, anger, disgust), punitive attitudes, and social distance toward a man experiencing a sexually transgressive impulse. A total of 205 U.S.-based MTurk workers were randomly assigned to one of four groups in this 2 × 2 factorial vignette study. As expected, pedophilic orientations and extrinsic non-offending motivations led to stronger negative apprehensions and emotions, as well as higher social distance and punitive attitudes. When controlling for the other emotions, disgust mediated the effect of pedophilic orientation on social distance, while anger and fear mediated the effect of non-offending motivation on punitive attitudes. Disgust, fear, and anger were furthermore differentially associated with perceived amorality, dangerousness, and abnormality. This research helps clarify why desires to punish or avoid non-offending pedophilic men are so strong, even when they never commit sexual crimes.
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Affiliation(s)
- Sara Jahnke
- Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Hohe Str. 53, 01187, Dresden, Germany.
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Blom RM, van der Wal SJ, Vulink NC, Denys D. Role of Sexuality in Body Integrity Identity Disorder (BIID): A Cross-Sectional Internet-Based Survey Study. J Sex Med 2017; 14:1028-1035. [PMID: 28711223 DOI: 10.1016/j.jsxm.2017.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/14/2017] [Accepted: 06/15/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Body integrity identity disorder (BIID)-a strong desire for amputation or paralysis-is often accompanied by feelings and cognitions of sexual arousal, although this sexual component has been largely neglected in the recent literature. AIM To examine the presence of BIID-related sexual arousal in subjects with BIID and explore clinical and demographic variables of subjects with BIID who do and do not possess this sexual arousal. METHODS Eighty individuals with BIID responded to an internet-based survey we created. For all subjects, restoring identity was the primary motivation for preferred body modification. We collected data about respondents' demographic, clinical, and sexual characteristics. Based on responses to questions about BIID-specific sexual desires, subjects were assigned to the group with BIID-related sexual feelings (S-BIID; n = 57) or the group without such feelings (NS-BIID; n = 23). OUTCOMES Differences in clinical, demographic, and sexual characteristics between S-BIID and NS-BIID groups. RESULTS Of the respondents, 71.3% endorsed S-BIID. Subjects with S-BIID were significantly more often men, religious, and of a homosexual identity compared with the NS-BIID group. Subjects with S-BIID also significantly more often reported a change in localization and/or intensity of their BIID feelings over time. Furthermore, 66.7% of subjects with S-BIID reported S-BIID as an additional motivation for body modification. Seven of the 57 subjects with S-BIID achieved their preferred body modification through (self)-amputation, whereas none of the subjects with NS-BIID did. CLINICAL IMPLICATIONS BIID is a heterogeneous disorder in which subjects who self-reported comorbid sexual arousal more often resorted to (self-induced) amputation. STRENGTHS AND LIMITATIONS This study contains the largest BIID cohort presented in the literature and is the first to genuinely research sexuality in BIID. The first limitation is the lack of face-to-face interviews with the subjects, so no clinical diagnoses could be made. Moreover, there is an ascertainment bias because subjects were collected through the internet and in English, which excluded those who spoke other languages or subjects without an internet connection. CONCLUSION The present study provides preliminary evidence for a subpopulation or distinct group of individuals with BIID based on the presence of S-BIID. Blom RM, van der Wal SJ, Vulink NC, Denys D. Role of Sexuality in Body Integrity Identity Disorder (BIID): A Cross-Sectional Internet-Based Survey Study. J Sex Med 2017;14:1028-1035.
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Affiliation(s)
- Rianne M Blom
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Sija J van der Wal
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Nienke C Vulink
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; The Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
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Cantor JM, Lafaille SJ, Hannah J, Kucyi A, Soh DW, Girard TA, Mikulis DJ. Independent Component Analysis of Resting-State Functional Magnetic Resonance Imaging in Pedophiles. J Sex Med 2017; 13:1546-54. [PMID: 27641922 DOI: 10.1016/j.jsxm.2016.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Neuroimaging and other studies have changed the common view that pedophilia is a result of childhood sexual abuse and instead is a neurologic phenomenon with prenatal origins. Previous research has identified differences in the structural connectivity of the brain in pedophilia. AIM To identify analogous differences in functional connectivity. METHODS Functional magnetic resonance images were recorded from three groups of participants while they were at rest: pedophilic men with a history of sexual offenses against children (n = 37) and two control groups: non-pedophilic men who committed non-sexual offenses (n = 28) and non-pedophilic men with no criminal history (n = 39). MAIN OUTCOME MEASURE Functional magnetic resonance imaging data were subjected to independent component analysis to identify known functional networks of the brain, and groups were compared to identify differences in connectivity with those networks (or "components"). RESULTS The pedophilic group demonstrated wide-ranging increases in functional connectivity with the default mode network compared with controls and regional differences (increases and decreases) with the frontoparietal network. Of these brain regions (total = 23), 20 have been identified by meta-analytic studies to respond to sexually relevant stimuli. Conversely, of the brain areas known to be those that respond to sexual stimuli, nearly all emerged in the present data as significantly different in pedophiles. CONCLUSION This study confirms the presence of significant differences in the functional connectivity of the brain in pedophilia consistent with previously reported differences in structural connectivity. The connectivity differences detected here and elsewhere are opposite in direction from those associated with anti-sociality, arguing against anti-sociality and for pedophilia as the source of the neuroanatomic differences detected.
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Affiliation(s)
- J M Cantor
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, ON, Canada.
| | - S J Lafaille
- Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - J Hannah
- Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, ON, Canada; University of Rochester, Rochester, NY, USA
| | - A Kucyi
- Toronto Western Research Institute, University Health Network, Toronto, ON, Canada
| | - D W Soh
- Department of Psychology, York University, Toronto, ON, Canada
| | - T A Girard
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - D J Mikulis
- Toronto Western Research Institute, University Health Network, Toronto, ON, Canada
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Brotto LA, Yule M. Asexuality: Sexual Orientation, Paraphilia, Sexual Dysfunction, or None of the Above? Arch Sex Behav 2017; 46:619-627. [PMID: 27542079 DOI: 10.1007/s10508-016-0802-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 06/15/2016] [Accepted: 06/27/2016] [Indexed: 05/21/2023]
Abstract
Although lack of sexual attraction was first quantified by Kinsey, large-scale and systematic research on the prevalence and correlates of asexuality has only emerged over the past decade. Several theories have been posited to account for the nature of asexuality. The goal of this review was to consider the evidence for whether asexuality is best classified as a psychiatric syndrome (or a symptom of one), a sexual dysfunction, or a paraphilia. Based on the available science, we believe there is not sufficient evidence to support the categorization of asexuality as a psychiatric condition (or symptom of one) or as a disorder of sexual desire. There is some evidence that a subset of self-identified asexuals have a paraphilia. We also considered evidence supporting the classification of asexuality as a unique sexual orientation. We conclude that asexuality is a heterogeneous entity that likely meets conditions for a sexual orientation, and that researchers should further explore evidence for such a categorization.
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Affiliation(s)
- Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, 2775 Laurel Street, 6th Floor, Vancouver, BC, V5Z 1M9, Canada.
| | - Morag Yule
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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Hsu KJ, Rosenthal AM, Miller DI, Bailey JM. Sexual Arousal Patterns of Autogynephilic Male Cross-Dressers. Arch Sex Behav 2017; 46:247-253. [PMID: 27620319 DOI: 10.1007/s10508-016-0826-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 06/23/2016] [Accepted: 07/23/2016] [Indexed: 06/06/2023]
Abstract
Men's sexual arousal patterns have been an important window into the nature of their erotic interests. Autogynephilia is a natal male's paraphilic tendency to be sexually aroused by the thought or image of being a woman. Autogynephilic arousal per se is difficult to assess objectively, because it is inwardly focused. However, assessing sexual arousal patterns of autogynephilic males in response to external stimuli is also potentially useful. For example, there is substantial association between autogynephilia and gynandromorphophilia (GAMP), or sexual attraction to gynandromorphs (GAMs), colloquially "she-males." GAMP men's sexual arousal patterns in response to GAM, female, and male stimuli have recently been characterized. In the present study, we extended this understanding by comparing the sexual arousal patterns of autogynephilic male cross-dressers, GAMP men, heterosexual men, and homosexual men. Erotic stimuli included sexually explicit videos of men, women, and GAMs. Autogynephilic men were much more similar in their arousal patterns to heterosexual and GAMP men than to homosexual men. However, similar to GAMP men, autogynephilic men showed increased arousal by GAM stimuli relative to female stimuli compared with heterosexual men.
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Affiliation(s)
- Kevin J Hsu
- Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA.
| | - A M Rosenthal
- Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - David I Miller
- Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - J Michael Bailey
- Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
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Rosenthal AM, Hsu KJ, Bailey JM. Who Are Gynandromorphophilic Men? An Internet Survey of Men with Sexual Interest in Transgender Women. Arch Sex Behav 2017; 46:255-264. [PMID: 27858199 DOI: 10.1007/s10508-016-0872-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 09/19/2016] [Accepted: 09/21/2016] [Indexed: 06/06/2023]
Abstract
Gynandromorphophilia (GAMP) is attraction to gynandromorphs (GAMs), who are natal males with both breasts and a penis, colloquially known as "she-males." Men with GAMP (n = 314) and heterosexual men not attracted to GAMs (n = 211) completed an Internet survey regarding their sexual attraction patterns, relationship history, and potential correlates of GAMP. Men with GAMP reported much higher attraction to natal women than to men, although they also reported slightly higher levels of bisexual feelings compared with controls. Men with GAMP were equally attracted to natal women and GAMs, on average. Thus, GAMP is best considered an unusual form of heterosexuality rather than a separate sexual orientation. Indeed, men with GAMP scored much higher than controls on a measure of autogynephilia, or sexual arousal by the idea or fantasy of being a woman, which is also considered a variant of heterosexual attraction.
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Affiliation(s)
- A M Rosenthal
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA
| | - Kevin J Hsu
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA.
| | - J Michael Bailey
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA
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Taktak Ş, Yılmaz E, Karamustafalıoglu O, Ünsal A. Characteristics of paraphilics in Turkey: A retrospective study-20years. Int J Law Psychiatry 2016; 49:22-30. [PMID: 27180212 DOI: 10.1016/j.ijlp.2016.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 05/02/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE This study is carried out to research the frequency of occurrence and the characteristics of paraphilic cases in Turkey and forensic aspects of them and to explain forensic psychiatric studies of people show paraphilic actions and assess them from legal aspects. METHOD This research is done by studying a total of 101,208 cases who were sent to Istanbul Forensic Medicine Institute (FMI) by the judicial organs of 4th Specialization Board between 1984 and 2004 to decide whether they show paraphilic actions or not. When choosing the cases of pedophilic actions, incest incidents were excluded and 307 incidents were taken into assessment. RESULTS The male subjects are 97.4%, 39.7% of them are 19-29years old, 10% of them are over age 60, 59% of the subjects are single, 36.5% of them are unemployed, 71.7% of the incidents have no physical disorder. The subjects who were imprisoned before were 20.2% and 22.1% of them had undergone psychiatric treatment before the incident. Twenty separate diagnosis are determined by the FMI for the subjects. There were mental retardation, schizophrenia and various personality disorders on the top the diagnosis list. The paraphilia type of the incidents are pedophilia (60.3%), exhibitionism (8.1%), pedophilia and exhibitionism (7.5%) and fetishism (5.9%). It was determined that there were more than one paraphilia type in 40 incidents (13%). FMI decided that 54.7% of them have criminal responsibility, 25.1% of them have no criminal responsibility, and 20.2% of them have reduced criminal responsibility. CONCLUSION There were 20 separate type of diagnosis for the incidents. It is understood that paraphilic incidents do not seek for help although they have the symptoms of disorder and they are exposed to psychiatric assessment only when they face a criminal inquiry. This suggests that there are more paraphilic incidents in the society than what we encounter.
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Affiliation(s)
- Şafak Taktak
- Psychiatry and Forensic Medicine Departments, Ahi Evran University Education and Research Hospital, Turkey.
| | - Ebru Yılmaz
- Forensic Medicine Department, Forensic Medicine Institution, Istanbul, Turkey
| | | | - Ayla Ünsal
- Nursing Department, School of Health, Ahi Evran University, Turkey
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Carstens P, Stevens P. Paraphilia and sex offending - A South African criminal law perspective. Int J Law Psychiatry 2016; 47:93-101. [PMID: 27182003 DOI: 10.1016/j.ijlp.2016.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Historically, the link between sexual deviance and criminality has been described and documented, asserted by psychiatry, and manifested in law. Laws that have regulated sexual behaviour have referred to terms such as 'sexual deviation', 'sexual perversion' or even archaic moral terms such as 'unnatural acts and unspeakable crimes against nature'. A possible link between sexual perversion, psychopathy, and criminality, specifically manifesting in sexual homicide, has been the subject of remarkable research in forensic psychiatry. This contribution examines the phenomenon of paraphilia with specific reference to its definition, diagnostic classification and characteristics, as well as a few selections of incidences of paraphilia in South African criminal case law. A brief assessment is made of how South African criminal courts have dealt with paraphilia. In this regard, an analysis is made of the criminal liability of the paraphiliac. The South African response to sexual deviation as addressed in the Criminal Law (Sexual Offences and Related Matters) Amendment Act 32 of 2007 will also be addressed with reference to its efficacy in addressing paraphilia within South African criminal law. The interface between criminal law and medical ethics within the context of this theme will also be canvassed. In conclusion, recommendations for possible reform are canvassed.
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Affiliation(s)
- Pieter Carstens
- Department of Public Law, University of Pretoria, South Africa.
| | - Philip Stevens
- Department of Public Law, University of Pretoria, South Africa.
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Abstract
Introduction According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM‐5), a sexual fantasy (SF) is paraphilic if it concerns activities outside the realm of “genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners” (normophilic). Intensity of the paraphilic SF is also “greater than or equal to normophilic interests.” Surprisingly, however, very few data are available to corroborate that definition of a paraphilic SF. Although the relatively high prevalence of paraphilic SF in the general population is well known, the magnitude of difference between intensity of “normophilic” and “paraphilic” SF remains to be assessed. Aim The main goal of this study was to analyze the SF of adults recruited in the general population to obtain person profiles based on the nature and intensity of their SF. Methods Multiple correspondence analysis (MCA) were used with data collected from 1,501 adults recruited in the general population to generate subgroups of participants based on the nature and intensity of their SF. Main outcome measures The main outcome measures used was a revised version of the Wilson Sex Fantasy Questionnaire. Results When all participants are considered as a unique group, the mean intensity of the most intense “normophilic” SF (oral sex) is significantly higher than the mean intensity of the most intense “paraphilic” SF (being sexually dominated for women and watching two women having sex for men), as expected from the DSM‐5. When clusters of participants are considered separately, however, conclusions are nuanced. Four significant clusters of participants (two predominantly female and two predominantly male) reported at least one paraphilic SF with intensity as high as that of their most intense “normophilic” SF. In fact, 57% of this sample met the criteria of paraphilia. Conclusion These results suggest that the current criteria for paraphilia are too inclusive. Suggestions are given to improve the definition of pathological sexual interests, and the crucial difference between SF and sexual interest is underlined. Joyal CC. Defining “normophilic” and “paraphilic” sexual fantasies in a population‐based sample: On the importance of considering subgroups. Sex Med 2015;3:321–330.
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Affiliation(s)
- Christian C Joyal
- Université du Québec à Trois-RivièresTrois-RivieresQuébecCanada; Philippe-Pinel Institute of MontrealMontrealQuébecCanada
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Jahnke S, Schmidt AF, Geradt M, Hoyer J. Stigma-Related Stress and Its Correlates Among Men with Pedophilic Sexual Interests. Arch Sex Behav 2015; 44:2173-2187. [PMID: 25933669 DOI: 10.1007/s10508-015-0503-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 01/24/2015] [Accepted: 02/06/2015] [Indexed: 06/04/2023]
Abstract
Despite decades of research on the adverse consequences of stereotyping and discrimination for many stigmatized groups, little is known about how people with pedophilia perceive and react to stigma. In this article, we present a framework that outlines how stigma-related stress might negatively affect emotional and social areas of functioning, cognitive distortions, and the motivation to pursue therapy, all of which may contribute to an increased risk of sexual offending. We tested our hypotheses in an online survey among self-identified German-speaking people with pedophilia (N = 104) using a wide range of validated indicators of social and emotional functioning (Brief Symptom Inventory-53, UCLA Loneliness Scale, Emotion Subscale of the Coping Inventory for Stressful Situations, Fear of Negative Evaluation-5, Rosenberg Self-Esteem Scale). Specific risk factors such as self-efficacy, cognitive distortions, and the motivation to seek treatment were also assessed. In line with our hypotheses, fear of discovery generally predicted reduced social and emotional functioning. Contrary to our predictions, perceived social distance and fear of discovery were not linked to self-efficacy, cognitive distortions, or treatment motivation. Results were controlled for the effects of confounding variables (e.g., age, educational level, social desirability, relationship status). We critically evaluate the empirical contribution of this study to research on stigma and child sex offenses, including a discussion of the results in light of the potential indirect effects that public stigma may have on the overall risk for sexual offenses.
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Affiliation(s)
- Sara Jahnke
- Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Hohe Straße 53, 01187, Dresden, Germany.
| | - Alexander F Schmidt
- INSIDE Research Unit, Institute for Health and Behaviour, University of Luxembourg, Walferdange, Luxembourg
| | - Max Geradt
- Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Hohe Straße 53, 01187, Dresden, Germany
| | - Jürgen Hoyer
- Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Hohe Straße 53, 01187, Dresden, Germany
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Jahnke S, Philipp K, Hoyer J. Stigmatizing attitudes towards people with pedophilia and their malleability among psychotherapists in training. Child Abuse Negl 2015; 40:93-102. [PMID: 25085206 DOI: 10.1016/j.chiabu.2014.07.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 07/09/2014] [Accepted: 07/14/2014] [Indexed: 06/03/2023]
Abstract
Offering counseling and psychotherapy to patients with pedophilia is considered an essential part of sexual abuse prevention by many experts in the field. Yet, professionals' willingness to offer treatment might be compromised by stigmatizing attitudes towards these patients. In the present study, we developed and tested a 10-min online intervention (including educational material and a video about a person with pedophilia) to reduce stigma and increase motivation to work with this particular patient group. Psychotherapists in training were either assigned to the anti-stigma intervention group (n=68) or the control group (n=69) that received information about violence-free parenting. In the anti-stigma condition, agreement with the stereotypes controllability and dangerousness, anger, reduced pity and social distance were significantly reduced after the intervention, compared to the control group, while motivation to work with this group remained unchanged. The effects persisted, though slightly reduced in size, for perceived controllability, anger and social distance at follow-up. Our results suggest that stigmatizing attitudes, negative affective responses and social distance regarding people with pedophilia among psychotherapists in training can be positively influenced by a low-cost intervention. Practical implications of these findings for high quality health care and child sexual abuse prevention are discussed.
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Affiliation(s)
- Sara Jahnke
- Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - Kathleen Philipp
- Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - Juergen Hoyer
- Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
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Abstract
The Catholic Church has held that every human being is a child of God, and every person deserves to be treated with dignity and love regardless of their actions. The phrase "love the sinner, hate the sin" is a simple summary of the approach the Church takes to loving all human beings. The Church has also held firmly that both homosexual acts and homosexual inclinations are disordered, although the origins or contributing factors of homosexual inclinations are not entirely understood. In this paper, I apply principles from St. Thomas Aquinas's treatise on the passions to show that habitual mis-identification of the cause of pleasure associated with the apprehension of beauty, or misjudgments, may be involved in the psychogenesis of same-sex attraction disorder.
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Abstract
The treatment of paraphilias remains a challenge in the mental health field. Combined pharmacologic and psychotherapeutic treatment is associated with better efficacy. The gold standard treatment of severe paraphilias in adult males is antiandrogen treatment with cognitive behavioral therapy. Selective serotonin reuptake inhibitors have been used in mild types of paraphilia and in cases of sexual compulsions and juvenile paraphilias. Antiandrogen treatments seem to be effective in severe paraphilic subjects committing sexual offenses. In particular, gonadotropin-releasing hormone analogs have shown high efficacy working in a similar way to physical castration but being reversible at any time. Treatment recommendations, side effects, and contraindications are discussed.
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Affiliation(s)
- Alessandra Almeida Assumpção
- Department of Psychiatry, INCT-Medicina Molecular, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190 Sala 240, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Frederico Duarte Garcia
- Department of Psychiatry, INCT-Medicina Molecular, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190 Sala 240, Belo Horizonte, Minas Gerais, 30130-100, Brazil; INSERM U1073, Rouen University Hospital, Rouen University, 22 Boulevard Gambetta, Rouen Cx 76183, France.
| | - Heloise Delavenne Garcia
- Department of Psychiatry, INCT-Medicina Molecular, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190 Sala 240, Belo Horizonte, Minas Gerais, 30130-100, Brazil; INSERM U1073, Rouen University Hospital, Rouen University, 22 Boulevard Gambetta, Rouen Cx 76183, France
| | - John M W Bradford
- Institute of Mental Health Research, Brockville Mental Health Centre, University of Ottawa, 1804 Highway 2 East, Brockville, Ontario K6V 5W7, Canada
| | - Florence Thibaut
- Psychiatry and Addictive Disorders, University Hospital Cochin-Tarnier, 89 rue d'Assas, 75006 Paris, France; Department of Psychiatry and Addictive Disorders, Faculté de Médecine Paris V Descartes, 75000 Paris, France; INSERM U894, Centre des Neurosciences, 2 ter rue d'Alesia, 75000 Paris, France
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Abstract
Persons with intellectual disabilities who have been identified because they committed a sexual offense may have done so because of a sexual paraphilia. However, special consideration in assessment is required to determine whether the offense is caused by a paraphilia alone or whether other factors relating to the individual's intellectual disabilities may be especially significant. This article reviews some factors that have been identified as significant and provides an overview of treatment approaches from multiple perspectives.
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Affiliation(s)
- Dorothy M Griffiths
- International Dual Diagnosis Certificate Programme, Department of Child and Youth Studies, Centre of Applied Disability Studies, Brock University, 500 GlenRidge Avenue, St Catharines, Ontario L2S 3A1, Canada.
| | - Paul Fedoroff
- Sexual Behaviours Clinic, Division of Forensic Psychiatry, Institute of Mental Health Research, Royal Ottawa Mental Health Centre, University of Ottawa, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
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Firoz K, Nidheesh Sankar V, Rajmohan V, Manoj Kumar G, Raghuram TM. Treatment of fetishism with naltrexone: a case report. Asian J Psychiatr 2014; 8:67-8. [PMID: 24655631 DOI: 10.1016/j.ajp.2013.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 10/31/2013] [Accepted: 11/18/2013] [Indexed: 10/25/2022]
Abstract
Fetishism is a paraphilic sexual disorder characterized by recurrent, intense sexually arousing fantasies, sexual urges or behaviors involving the use of nonliving objects. We describe a case of fetishism with comorbid alcohol and cannabis dependence. A 40-year-old man was presented with sexual fantasies and urges toward women's undergarments since the age of 25 years. He had fetish behavior even during prolonged period of abstinence from substance use. Our case remitted from fetishism and cannabis and alcohol use on treatment with naltrexone and maintains remission for the last 11 months. Experience with our patient suggests that naltrexone may be effective to treat fetishism with comorbid substance use. Our case is reported as it is the first reported case of successful use of naltrexone in fetishism comorbid with cannabis and alcohol dependence.
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Affiliation(s)
- K Firoz
- Department of Psychiatry, MES Medical College, Perinthalmanna, Kerala, India.
| | - V Nidheesh Sankar
- Department of Psychiatry, MES Medical College, Perinthalmanna, Kerala, India
| | - V Rajmohan
- Department of Psychiatry, MES Medical College, Perinthalmanna, Kerala, India
| | - G Manoj Kumar
- Department of Psychiatry, MES Medical College, Perinthalmanna, Kerala, India
| | - T M Raghuram
- Department of Psychiatry, MES Medical College, Perinthalmanna, Kerala, India
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Rancati A, Crudele GDL, Gentile G, Zoja R. The case of a prosthetic limb used to cause lethal intravaginal injuries: forensic medical aspects in a case of intimate partner violence. Forensic Sci Int 2013; 234:e21-4. [PMID: 24252425 DOI: 10.1016/j.forsciint.2013.10.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 10/17/2013] [Indexed: 11/24/2022]
Abstract
A common form of violence against women is sexual coercion on the part of their husbands/partners, the uncontrollable effects of which can lead to extreme consequences, as in the case of uxoricide examined in this report. It involved a 59-year-old female alcoholic, under observation on the part of social services as the possible victim of abuse by her husband, an amputee with a transtibial prosthesis. The woman had never admitted to her social workers that her husband was abusing her. One night, she was admitted to hospital in a state of hemorrhagic shock due to massive vaginal bleeding, but despite treatment, she died 20 min after arrival. The anatomical-pathological examination conducted by the hospital revealed serious genital lesions which warranted reporting the case to the Judicial Authorities, who arranged for a forensic autopsy. The cause of death was identified as acute meta-hemorrhagic anemia in a cirrhotic woman, secondary to a large, irregular vaginal lesion involving both the vaginal wall and the soft perivaginal tissues as well as the medium and small urogenital vascular branches. To identify the foreign body used to inflict this injury, a scanning electron microscope and energy dispersive X-ray spectrometer (SEM-EDS) were used. This revealed tiny splinters of wood in the vaginal tissues examined. In addition to the genetic-forensic techniques used, this finding allowed the investigators to identify the husband's prosthetic limb as the instrument of sexual coercion. The report describes a particular case of marital rape that resulted in uxoricide, in which the overall concordance of the investigations carried out played a fundamental role in identifying the offending body and, consequently, the murderer.
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Affiliation(s)
- Alessandra Rancati
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
| | - Graziano Domenico Luigi Crudele
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
| | - Guendalina Gentile
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
| | - Riccardo Zoja
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
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Abstract
OBJECTIVE To know the new concept of paraphilias, their clinical presentation and their link with a personality disorder as perversion, the French legislation concerning them and the different therapeutic options. MATERIAL AND METHODS Review of guidelines published on this subject in the Medline database and a reflexion from our own clinical experience, especially in the judicial expertise. RESULTS Deviant sexual behavior is, in current classifications, known as paraphilia. This clinical entity corresponds to any sexual behavior considered "abnormal" compared with sexual acts in the society where the person lives. It means precisely, firstly, suffering caused by this disorder or deterioration of social, professional, or family life. Paraphilia such as pedophilia have strict age limits. The victim must be aged below 16 years, with an age difference of at least 5 years with the author of the act. Sexual acts which are illegal are crimes or offences according to the degree, and are sanctioned by the law. In ordinary terms, they are known as perverts, committing perversions. This concept is different from that of paraphilia, a pervert can have, or not have, paraphiliac behavior. In order to diagnose a personality disorder such as perversion, all the criteria must be included: narcissism, use of a person as an object for pleasure, with, primarily, mechanisms of denial and a split personality which removes any feeling of guilt from the perpetrator. CONCLUSION Medical treatment of paraphilia alone is not satisfactory for the denial mechanism is such that only the sex drive is affected with a high risk of recurrence. Only psychotherapy can modify the pathological element of a perverted personality.
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Mehdizadeh-Zareanari A, Ghafarinezhad A, Soltani H. Fetishism due to methamphetamine (glass) abuse: a case report. Addict Health 2013; 5:73-6. [PMID: 24494161 PMCID: PMC3905562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 11/08/2012] [Indexed: 11/13/2022]
Abstract
BACKGROUND Fetishism is a type of paraphilia. The focus of sexual arousal in fetishism is oriented towards inanimate objects. Sexual arousal and craving are some of the reasons the youth resort to crystal (glass). Drug abuse may cause disorders in sexual function. CASE REPORT The patient was a 41 years old man. He married in age 22 years and experienced frequent intercourses with his wife from which he gained pleasure and it was his preferable method. Her wife left ten years ago. The patient started crystal administration through insufflations since seven months ago. Simultaneous with crystal abuse, wearing women's underwear was the only medium through which the patient reached sexual orgasm. DISCUSSION A lot of psychological symptoms related to new substances (for example glass) are new to psychiatrists treating dependency in medical clinics. Fetishism may coexist with addiction as comorbidity. Another point to be mentioned is that, symptoms of fetishism increased and decreased with more and less glass administration, indicating that symptoms of paraphilia emerge as a result of glass use. In addition, prior to glass use, the patient maintained normal sexual tendencies, had experienced sexual intercourse and did not suffer from any type of paraphilia.
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Affiliation(s)
- Ali Mehdizadeh-Zareanari
- Psychiatrist, Researcher, Kerman Neuroscience Research Center, Student Counseling Center, Kerman University of Medical Sciences, Kerman, Iran,Correspondence to: Ali Mehdizadeh-Zareanari MD,
| | - Alireza Ghafarinezhad
- Associate Professor, Department of Psychiatry, Kerman University of Medical Sciences, Kerman, Iran
| | - Hoda Soltani
- Department of Chemistry, Kerman University of Medical Sciences, Kerman, Iran
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Usmani MA, K Gaur R, Ahmad Azmi S, Gangwar S. Treatment of transvestic fetishism with fluoxetine: a case report. Iran J Psychiatry Behav Sci 2012; 6:100-1. [PMID: 24644490 PMCID: PMC3940015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 08/09/2012] [Accepted: 08/26/2012] [Indexed: 11/30/2022]
Abstract
Transvestic fetishism is having a sexual or erotic interest in cross-dressing. This case report describes a 17-year-old male with transvestic fetishism who suffered from obsessive thoughts and subsequent masturbation as compulsion. He was managed successfully with fluoxetine.
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Affiliation(s)
- Mohammad Amir Usmani
- Department of Psychiatry, J.N. Medical College, A.M.U. Aligarh, U.P., INDIA. ,Corresponding author: Mohammad Amir Usmani MD, Senior Resident, Department of Psychiatry, J.N. Medical College, A.M.U. Aligarh, U.P.,INDIA, 202002. Tel: +919897763522 Fax: +1942481166 E mail-
| | - Rakesh K Gaur
- Department of Psychiatry, J.N. Medical College, A.M.U. Aligarh, U.P., INDIA.
| | - Suhail Ahmad Azmi
- Department of Psychiatry, J.N. Medical College, A.M.U. Aligarh, U.P., INDIA.
| | - Sheshank Gangwar
- Department of Psychiatry, J.N. Medical College, A.M.U. Aligarh, U.P., INDIA.
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Pawar AA, Valdiya PS, Chaudhury S. Paraphillia : a case report. Indian J Psychiatry 2001; 43:76-7. [PMID: 21407845 PMCID: PMC2955939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A case of paraphilia presenting with multiple sexual deviations is reported. The disorder occurred against a background of disordered childhood and was later associated with alcohol abuse.
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Affiliation(s)
- A A Pawar
- A.A. PAWAR, Psychiatrist, INHS Asvini, Colaba, Mumbai
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