10 - paraphilias - part 1

DSM-IV-TR criteria include the following:

• Exhibitionism

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• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors that involve exposing their genitals to unsuspecting strangers.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Exhibitionism typically involves men exposing themselves to women (not a DSM-IV-TR criterion).
• Fetishism

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• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving nonliving objects.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Patients do not limit the fetish objects to articles of female clothing used in cross-dressing or to devices designated for the purpose of tactile genital stimulation.
• Patients may have a particular pathological displacement of erotic interest and satisfaction for their entire lives (not a DSM-IV-TR criterion).
• Frotteurism

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• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving rubbing against and touching a nonconsenting person.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Patients typically practice this behavior in crowded places (not a DSM-IV-TR criterion).
• Pedophilia

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• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• The patient must be aged 16 years or older and at least 5 years older than the child or children involved.