ParaphiliasDSM-IVSlide 3FetishesSlide 5Slide 6Transvestites & Transvestic FetishismSlide 8Slide 9Sex OffendersCourtship DisordersVoyeurismSlide 13ExhibitionismSlide 15FrotteurismSadism & MasochismSlide 18Sadomasochism (S & M)Slide 20Major Sexual SadismSlide 22Psychopathic Sexual SadismSlide 24PedophiliaDevelopment of ParaphiliasSlide 27Slide 28Treatment of ParaphiliasAdditional ParaphiliasParaphilia-Related Disorders1Paraphilias2DSM-IV•6-months, recurrent, intense, sexually arousing fantasies/sexual urges•fantasies/urges involve a specific act•involving:–non-human objects–suffering or humiliation of oneself or another–children or non-consenting persons•cause significant distress or impairment3Paraphilias•Fetishes•Transvestic fetishism•Voyeurism•Exhibitionism•Frotteurism•Sadism/masochism•Pedophilia4Fetishes•Sexual arousal by:–using or thinking about an inanimate object–viewing a particular part of the body–Common items:•womens’ clothing (shoe, stockings, underpants, bras)•feet5Fetishes•Characteristics:–male–25% homosexual•Causes:–temporal lobe abnormalities–learned behavior - classical conditioning•5/7 men conditioned to become sexually aroused to a knee length leather boot•3/7 generalized to other shoes (Rachman & Hodgson, 1968)–women not classically conditioned (Letourneau & O’Donohue, 1997; Meston & Rachman, 1994)6FetishesDear Dr. E,I'm dating a man with a foot fetish. He has never asked me to do anything with my feet, but he watches foot fetish videos. Is this healthy?J, St. LouisDear J,You're in a better position to answer your question than I am. How are you and your friend getting along? Does his fascination with feet interfere with your relationship? How well does he function at work and at home? If he's functioning well and you're getting along, you probably don't have anything to worry about. Some people get aroused by eyes, some by breasts, some by lags. What do you have against feet?7Transvestites & Transvestic Fetishism•Sexual arousal by dressing in clothes of the opposite sex•crossdressing8Transvestites & Transvestic Fetishism•Characteristics:–broad age range–broad religious affiliation–well educated–in committed relationships–parents–heterosexual–began before age 109Transvestites & Transvestic Fetishism•Causes–Family:•positive paternal role model•negative maternal relationship–associated with learning disabilities–temporal lobe abnormalities10Sex Offenders•Voyeurism•Exhibitionism•Frotteurism•Preferential Rape Pattern•Pedophilia•Psychopathic Sexual Sadism11Courtship Disorders•Voyeurism:–“peeping tom”–sexual arousal by observing nude individuals without their knowledge or consent–intense urges and recurrent behavior•Exhibitionism: sexual arousal by exposing genitals to unsuspecting strangers - typically in inappropriate settings•Frotteurism: sexual arousal by rubbing one’s genitals against others in public•Preferential rape pattern: prefer rape over consensual sex12Voyeurism•Characteristics:–youngest child–few sisters–good relationship with parents–parents with poor relationship–underdeveloped socially•later 1st sexual experience•less likely to marry13Voyeurism•Females:–rare–peeping fantasies not uncommon (Friday, 1975)14Exhibitionism•Characteristics:–almost exclusively male–timid/unassertive–undeveloped social skills–uncomfortable with anger/hostility–more likely to be raised in puritanical background15Exhibitionism•Females:–do not derive pleasure–motivation: money (e.g., strippers) or attention (e.g., Marti Gras)16Frotteurism•Characteristics:–comorbidity: 79% –Average number of acts:•849 (Abel et al., 1987)–in females: molestation secondary to erectile failure, low desire (Sarrel & Masters, 1982)17Sadism & Masochism•Sadism: sexual arousal by inflicting pain on another•Masochism: sexual arousal by having pain inflicted upon oneself18Sadism & Masochism•History–“masochist” (1886) Krafft-Ebing, after Leopold von Sacher-Masoch–“sadist” (1700s) after Marquis de Sade19Sadomasochism (S & M)•Major vs minor sexual sadism•Sadomasochism (S & M)–pre-determined acts–activities & themes (Arndt, 1991; Weinberg et al., 1984):•flagellation•bondage•water sports (urophilia, coprophilia, mysophilia)•penis and nipple torture•master & slave•severe boss and naughty secretary•queeen and many slavves•arrest•military training20Sadomasochism (S & M)•Characteristics–predominantly male–female: 25% prostitutes–meet through S & M magazines–come from all walks of life, SES, educ. etc–1/3 heterosexual, 1/3 bisexual, 1/3 homosexual21Major Sexual Sadism•Seto & Kuban (1996)–sadistic rapist, non-sadistic rapist, controls–penile volume changes–Five films:•nonviolent, non-sexual w/ female•consensual sex w/ female•non-sexual violence against female•rape•violent rape22Major Sexual Sadism•Seto & Kuban (1996) continued–both types of rapist equally aroused by different types of sex–controls differentiated between consensual and non-consensual sex•Temporal lobe abnormalities (Langevin et al., 1988)23Psychopathic Sexual Sadism•DSM-IV–sexual sadism–antisocial personality disorder (ASPD)•Serial murderer–arousal from inflicting pain–arousal from killing•Characteristics–Lack of guilt or compassion for victim–Euphoria during murder–mentally disturbed, rarely psychotic24Psychopathic Sexual Sadism•Geberth & Turco (1997)–387 serial murders–248 sexually assaulted victims–68 met criteria for sexual sadism & ASPD•childhood aggressiveness•childhood antisocial behavior•killing involving sexual violence, humiliation, domination and control•derived pleasure from killing–examples: Ted Bundy, Gary Ridgeway25Pedophilia•Sexual fantasies, urges, or behavior involving children under 14 years old•prevalence•Characteristics/Causes:–40% homosexual•high maternal age•low IQ•developmental disorder?–history of childhood sexual abuse (49%) by a male abuser26Development of Paraphilias27Pedophilia•Physiological characteristics:–higher baseline cortisol, prolactin, body temperature–stronger cortisol response–disturbance in serotonin regulation --> OCD28Pedophilia•Freund et al. (1991)–showed slides of nude male and female children–pedophiles and controls–measured penile volume changes–Results: pedophiles less