The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders is currently undergoing its fifth revision (DSM-V). The Work Group for Sexual and Gender Identity Disorders includes a Subworkgroup focusing on potential changes to the various paraphilia diagnoses.
This talk describes some of the options being considered by that Subworkgroup. First, the Subworkgroup is considering a distinction between paraphilias and paraphilic disorders along the following lines: A paraphilia is any powerful and persistent sexual interest other than that in copulatory or precopulatory behavior with phenotypically normal, consenting adult human partners.
A paraphilic disorder is a paraphilia that causes distress or impairment to the individual or harm to others. One would ascertain a paraphilia (according to actions and self-report, e.g., sexual attraction to amputees or inanimate objects) but diagnose a paraphilic disorder (on the basis of distress and impairment). In this conception, having a paraphilia would be a necessary but not a sufficient condition for having a paraphilic disorder. Second, the Subworkgroup is considering a replacement for the diagnosis of Pedophilia. The DSM-IV-TR defines pedophilia as sexual attraction to prepubescent children. A substantial body of evidence indicates that this definition excludes from diagnosis a sizable proportion of those men whose strongest sexual feelings are for physically immature persons. These are the hebephiles, that is, men whose strongest sexual feelings are for pubescent children (roughly, ages 11–14). One possible solution is to replace the diagnosis of Pedophilia with Pedohebephilic Disorder and offer three subtypes: Pedophilic, Hebephilic, and Pedohebephilic.
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