Paraphilic D/o

Question 1

What is paraphilic d/o defined as?

Answer 1

Anomalous sexual activity preferences, which include “deviant” patterns of sexual interests, fantasies, and behaviors

Question 2

Is there a difference between a paraphilia and paraphilic d/o?

Answer 2

Yes, a paraphilia is a preferential sexual interest and paraphilic d/o is a d/o resulting from an anomalous sexual interest

Question 3

To receive a dx of having a paraphilic d/o, one must have a recurrent and intense sexual arousal from these anomalous preferences and have ______ on these urges and have caused significant ______ and _____ impairment

Answer 3

acted

distress and social/occupational

Question 4

What are the 8 paraphilic d/o defined in DSM5? Is this list exhaustive?

Answer 4

Exhibitionist d/o, Frotteuristic d/o, Sexual masochist, Sexual sadism d/o, Pedophilic d/o, Transvestic d/o, Fetishistic d/o, Voyeuristic d/o
No, sexual desires may be continuous/spectrum

Question 5

Sx of a paraphilic d/o may only arise in a time of _____, then the pt can return to “normal” sexual function

Answer 5

stress/other trigger

Question 6

In order for dx of a paraphilic d/o, pts must have been experiencing urges/behaviors for at least ___ months, intermittent or constant

Answer 6

6 months

Question 7

Paraphilic disorders are overwhelmingly seen in (men/women) and pts are mostly (homosexual/heterosexual)

Answer 7

men, heterosexual

Question 8

Prevalence of paraphilic d/o is unknown, however, the prevalence of exhibitionism is ___% and voyeurism is ____%

Answer 8

3%; 7%

Question 9

Nearly all patients with fetishism are (men/women)

Answer 9

men

Question 10

Do some people believe that sexual deviance is hereditary and can be modified by social/psychological factors?

Answer 10

yes

Question 11

Freudians believe that sexual deviance stems from ____ of developmental process from childhood

Answer 11

failures

Question 12

Learning theorists believe that sexual deviance is a result of ______ becoming linked to deviant fantasies and reinforced by _____

Answer 12

positive experiences (orgasm)
masturbation

Question 13

Sex offenders have abnormal ____ that provide neurobiological basis for sexual deviance

Answer 13

EEG

Question 14

Sexual deviance is already well established by ____ (age)

Answer 14

adolescence

Question 15

Common comorbid conditions for sexual deviance include ___, ___/___, and ___

Answer 15

depression, mood/anxiety d/o, and substance abuse

Question 16

Sexual deviance is typically a(n) (acute/chronic) condition that can fluctuate over time depending on _____ and other factors such as _____ and _____

Answer 16

chronic
stress
opportunity for sex, current sex drive

Question 17

T/F: Most individuals with paraphilias have a “normal” sexual interaction with their partners/spouses, who often do not know about their particular paraphilia

Answer 17

True!

Question 18

What is the recommended tx for pts with a paraphilia? What are other methods that can be used?

Answer 18

CBT
Others: Masturbatory satiation, covert sensitization, and masturbatory conditioning (using these methods, 82% at 12 mo had not engaged in pedophilic activities)

Question 19

What is masturbatory satiation?

Answer 19

satiation or boring the pt with their own deviant fantasies

Question 20

What is covert sensitization?

Answer 20

replace fantasies with unpleasant imagery

Question 21

What is masturbatory conditioning?

Answer 21

used to generate arousal to non-deviant themes

Question 22

Are there medications that can be used for these paraphilic conditions?

Answer 22

No FDA drugs
SSRIs and Naltrexone can decrease fantasies and impulsive behaviors and should be used FIRST
Testosterone inhibitors are last resort

Question 23

(Men/Women) more frequently have exhibitionist d/o?

Answer 23

Men

Question 24

What is exhibitionist d/o?

Answer 24

exposure of one’s genitals to an unsuspecting person

Question 25

____% of sexual offenders will qualify for the dx of exhibitionist d/o?

Answer 25

33%

Question 26

Does an individual with exhibitionist d/o usually or not usually masturbate while exposing themselves?

Answer 26

usually masturbates

Question 27

Does a pt with exhibitionist d/o usually touch other people while exposing themselves?

Answer 27

No, no contact is attempted

Question 28

If onset of exhibitionist d/o is later in life, what other d/o should be suspected?

Answer 28

neurocognitive

Question 29

Frotteuristic d/o is usually dx in (males/females) and is most common in what age range?

Answer 29

males, 15-25 y/o

Question 30

What is Frotteuristic d/o?

Answer 30

Touching or rubbing against a nonconsenting person with genitals that usually occurs in crowded places

Question 31

Sexual masochism involves sexual fantasies, urges, or behaviors of _____, ____, or ______.

Answer 31

being humiliated, bound, or suffer pain/discomfort

Question 32

Sexual sadism involves the desire to inflict _____ on someone else, and frequently involves _____

Answer 32

psychological suffering | humiliation

Question 33

Pts diagnosed as having sexual sadism d/o have engaged in these behaviors with a ______ person

Answer 33

non-consenting

Question 34

Pedophilic d/o is more common in (males/females) attracted to (boys/girls) and involves attraction to (pre-pubescent/pubescent) children

Answer 34

males, boys, prepubescent

Question 35

In order to be dx with pedophilic d/o, the pt must be at least ___ y/o and ___ yrs older than their victim

Answer 35

16 y/o | 5+ years older

Question 36

T/F: Pts with pedophilic d/o have an attraction to any age range

Answer 36

F; usually attracted to a specific age range

Question 37

Is there a requirement for social impairment for feeling distress about what they are doing for dx of pedophilic d/o?

Answer 37

No

Question 38

T/F: Transvestic d/o applies to only men

Answer 38

F; men and women!

Question 39

Transvestic d/o is characterized by the act of _____ that usually begins (before/after) puberty

Answer 39

cross-dressing, before puberty

Question 40

Initially, the act of _____ is arousing to pts with transvestic d/o, then, in time, their comfort grows and they may _____ in public . As they age, and sexual desires decline, the incidence of ___ may also decline

Answer 40

cross dressing

Question 41

Transvestic d/o is occasionally seen in pts with _____

Answer 41

gender dysphoria

Question 42

Fetishistic d/o is characterized by a pt who is aroused by _____, or ______

Answer 42

a non-living object (does not count if a sex toy) | a part of the body not usually associated with sex

Question 43

Contact with _____ produce sexual arousal in a pt with fetishistic d/o, usually followed by ______

Answer 43

object | masturbation

Question 44

Patients with fetishistic d/o usually spend (a little/a lot of) time engaged in these activities

Answer 44

a lot!

Question 45

Voyeuristic d/o dx can be made in pts ____ y/o but usually starts at ____ y/o, and is characterized by looking/observing people (with/without) their knowing for the purpose of sexual arousal. Targets are usually ____ and engaging in _____

Answer 45

``` 18+y/o 15y/o without naked sexual acts ```