Signs and Symptoms of Paraphilic Disorders

Table of ContentsView AllTable of ContentsSymptoms of Paraphilic DisordersIdentifying Paraphilic DisordersCauses of Paraphilic DisordersTypes of Paraphilic DisordersTreatment for Paraphilic DisordersA Word from Verywell

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Table of Contents

Symptoms of Paraphilic Disorders

Identifying Paraphilic Disorders

Causes of Paraphilic Disorders

Types of Paraphilic Disorders

Treatment for Paraphilic Disorders

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Paraphilic disorders are a group ofmental health conditionsthat cause recurring and intense sexual arousal to atypical thoughts, fantasies, and behaviors. These disorders involve clinically significant distress or impairment in functioning.

Sex is a normal part of life, and having unconventionalsexual thoughtsand fantasies isn’t unusual. However, when these urges and thoughts become so intense as to interfere with your daily functioning, it may be a paraphilic disorder. People with paraphilic disorders will often engage in sexual behaviors that can cause harm to themselves and others. Some paraphilias focus explicitly on causing pain and suffering to oneself or others.

Not all paraphilic interests make up a paraphilic disorder. It’s important to distinguish between paraphilia and a paraphilic disorder. While the former includes unusual sexual urges and behaviors, the latter features paraphilic symptoms that cause distress or impairment to the individual or the risk of harm to yourself or others.

Symptoms of paraphilic disorders are wide and varying. A common thread of paraphilic disorders is their potential to cause harm. They are often so intense that they cause significant distress and disrupt daily functioning. Many paraphilic disorders listed in TheDiagnostic and Statistical Manual (DSM-5)must have persisted for at least six months before they may be classified as a disorder.

It’s important to note that there’s a distinct difference between paraphilias and paraphilic disorders. Paraphilias can be harmless if they aren’t causing harm or distress to yourself or others. If there’s a risk of harm, it could also be classified as a paraphilic disorder. For unknown reasons, paraphilias appear more common in men than women.To be diagnosed with a paraphilic disorder, the DSM-5 requires the following criteria to be met:

It’s a little unclear what exactly causes paraphilic disorders. Scientists and researchers suspect that a combination of neurobiological, genetic, developmental, behavioral, and interpersonal factors play a role. In a 2019 study on paraphilic disorders, researchers observed that people with paraphilic disorders have elevated levels ofserotoninandnorepinephrineand decreased levels of a metabolite of dopamine called dihydroxyphenylacetic acid (DOPAC).

According to the DSM-5, there are eight specified paraphilic disorders. They are:

Fetishism Disorder

With fetishism, a person has recurrent and intense sexual arousal from inanimate objects or nongenital body parts.Fetishismcan be harmless. It’s only classified as a disorder when it causes significant distress or causes some form of harm and occurs for at least six months. Some common fetishes include undergarments, feet, rubber and leather items.

Frotteuristic Disorder

Sexual Sadism Disorder

Sexual sadism involves inflicting physical or psychological pain on another person to achieve sexual gratification. It’s important to distinguish between sexual sadism disorder, a paraphilic disorder, and sadistic sexual behavior, which is not. It’s normal for mild sadistic sexual behavior to occur between two adults who consent. With sexual sadism disorder, for at least six months the sadistic sexual urges cause significant distress, impairment or the individual has acted on these urges with a non-consenting person.

Exhibitionistic Disorder

People with an exhibitionistic disorder experience recurrent and intense arousal from the exposure of their genital to an unsuspecting person. They may become distressed and unable to function properly due to their urges or have acted on these urges with a non-consenting person. On the other hand, exhibitionism isn’t a paraphilic disorder, which is simply the desire to expose your genitalia to a consenting party for the purpose of sexual arousal.

Pedophilic Disorder

Pedophilia is sexual attraction to children. According to the DSM-5, a person with pedophilic disorder must have felt intense and recurrent sexual urges, behaviors, and fantasies toward prepubescent children for at least six months. A vital component of the condition is that it must bring significant distress or impairment to a person with it. It’s important to note that acting onsexual attractionto children is a crime.

Sexual Masochism Disorder

Sexualmasochismmay be seen as the flip side of sexual sadism. With sexual masochism, being beaten, humiliated, or abused will bring sexual excitement and gratification.Asphyxiophilia, a desire to have your breathing restricted during sexual activity, is sometimes considered a subtype of sexual masochism.

Voyeuristic Disorder

Voyeuristic disordercauses a person to have intense and recurrent urges to watch a non-consenting person engage in sexual activity. Voyeuristic disorder causes significant distress and can limit a person’s ability to function. Voyeuristc disorder is more common amongst men than women.

Transvestic Disorder

Treatment for paraphilic disorders is highly individualized. It depends on various factors, including which type of paraphilic disorder you have and the personal goals of the person being treated. In general, different forms of therapy and medications are used in treating paraphilic conditions. A combination of psychotherapy and medication is often recommended for the most effective results.

Medication

Psychotherapy

Psychotherapy may help someone manage or cope with their paraphilic symptoms and behaviors. Cognitive behavioral therapy (CBT) has been the most commonly used approach for paraphilic disorders.

Paraphilias and paraphilic disorders are two separate terms. Paraphilias are atypical sexual urges and behaviors. However, these interests and behaviors are much more commonplace than you may think and shouldn’t alarm you if you’re experiencing them. With a paraphilic disorder, you will likely experience these urges in ways that bring about significant distress, impact daily functioning or cause one to act on them with a non-consenting person. It’s crucial to get treatment for a paraphilic disorder to save yourself from harm and prevent harm to others.

A Beginner’s Guide to the World of BDSM and Consensual Kink

13 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Yakeley J, Wood H.Paraphilias and paraphilic disorders: diagnosis, assessment and management.Advances in Psychiatric Treatment. 2014;20(3):202-213.Coluccia A, Gabbrielli M, Gualtieri G, Ferretti F, Pozza A, Fagiolini A.Sexual masochism disorder with asphyxiophilia: a deadly yet underrecognized disease.Case Rep Psychiatry. 2016;2016:5474862.Fuss J, Briken P, Klein V.Gender bias in clinicians’ pathologization of atypical sexuality: a randomized controlled trial with mental health professionals.Sci Rep. 2018;8(1):3715.American Psychiatric Association.Paraphilic Disorders.2013Kamenskov MYu, Gurina OI.Neurotransmitter mechanisms of paraphilic disorders.Z nevrol psikhiatr im SS Korsakova. 2019;119(8):61.MSD Manual Professional Edition.Sexual sadism disorder - psychiatric disorders.MSD Manual Consumer Version.Exhibitionism - mental health disorders.Tenbergen G, Wittfoth M, Frieling H, et al. The neurobiology and psychology of pedophilia: recent advances and challenges. Front Hum Neurosci. 2015;9.MSD Manual Professional Edition. Sexual masochism disorder - psychiatric disorders.September 2022Fedoroff JP.Voyeuristic disorder. In: The Paraphilias.Oxford University Press; 2019:209-216.MSD Manual Professional Edition. Transvestic disorder - psychiatric disorders.September 2022Assumpção AA, Garcia FD, Garcia HD, Bradford JMW, Thibaut F.Pharmacologic treatment of paraphilias.Psychiatric Clinics of North America. 2014;37(2):173-181.Kaplan, Meg & Krueger, Richard. (2012).The Israel journal of psychiatry and related sciences. Cognitive-Behavioral Treatment of the Paraphilias. 49. 291-6.

13 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Yakeley J, Wood H.Paraphilias and paraphilic disorders: diagnosis, assessment and management.Advances in Psychiatric Treatment. 2014;20(3):202-213.Coluccia A, Gabbrielli M, Gualtieri G, Ferretti F, Pozza A, Fagiolini A.Sexual masochism disorder with asphyxiophilia: a deadly yet underrecognized disease.Case Rep Psychiatry. 2016;2016:5474862.Fuss J, Briken P, Klein V.Gender bias in clinicians’ pathologization of atypical sexuality: a randomized controlled trial with mental health professionals.Sci Rep. 2018;8(1):3715.American Psychiatric Association.Paraphilic Disorders.2013Kamenskov MYu, Gurina OI.Neurotransmitter mechanisms of paraphilic disorders.Z nevrol psikhiatr im SS Korsakova. 2019;119(8):61.MSD Manual Professional Edition.Sexual sadism disorder - psychiatric disorders.MSD Manual Consumer Version.Exhibitionism - mental health disorders.Tenbergen G, Wittfoth M, Frieling H, et al. The neurobiology and psychology of pedophilia: recent advances and challenges. Front Hum Neurosci. 2015;9.MSD Manual Professional Edition. Sexual masochism disorder - psychiatric disorders.September 2022Fedoroff JP.Voyeuristic disorder. In: The Paraphilias.Oxford University Press; 2019:209-216.MSD Manual Professional Edition. Transvestic disorder - psychiatric disorders.September 2022Assumpção AA, Garcia FD, Garcia HD, Bradford JMW, Thibaut F.Pharmacologic treatment of paraphilias.Psychiatric Clinics of North America. 2014;37(2):173-181.Kaplan, Meg & Krueger, Richard. (2012).The Israel journal of psychiatry and related sciences. Cognitive-Behavioral Treatment of the Paraphilias. 49. 291-6.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Yakeley J, Wood H.Paraphilias and paraphilic disorders: diagnosis, assessment and management.Advances in Psychiatric Treatment. 2014;20(3):202-213.Coluccia A, Gabbrielli M, Gualtieri G, Ferretti F, Pozza A, Fagiolini A.Sexual masochism disorder with asphyxiophilia: a deadly yet underrecognized disease.Case Rep Psychiatry. 2016;2016:5474862.Fuss J, Briken P, Klein V.Gender bias in clinicians’ pathologization of atypical sexuality: a randomized controlled trial with mental health professionals.Sci Rep. 2018;8(1):3715.American Psychiatric Association.Paraphilic Disorders.2013Kamenskov MYu, Gurina OI.Neurotransmitter mechanisms of paraphilic disorders.Z nevrol psikhiatr im SS Korsakova. 2019;119(8):61.MSD Manual Professional Edition.Sexual sadism disorder - psychiatric disorders.MSD Manual Consumer Version.Exhibitionism - mental health disorders.Tenbergen G, Wittfoth M, Frieling H, et al. The neurobiology and psychology of pedophilia: recent advances and challenges. Front Hum Neurosci. 2015;9.MSD Manual Professional Edition. Sexual masochism disorder - psychiatric disorders.September 2022Fedoroff JP.Voyeuristic disorder. In: The Paraphilias.Oxford University Press; 2019:209-216.MSD Manual Professional Edition. Transvestic disorder - psychiatric disorders.September 2022Assumpção AA, Garcia FD, Garcia HD, Bradford JMW, Thibaut F.Pharmacologic treatment of paraphilias.Psychiatric Clinics of North America. 2014;37(2):173-181.Kaplan, Meg & Krueger, Richard. (2012).The Israel journal of psychiatry and related sciences. Cognitive-Behavioral Treatment of the Paraphilias. 49. 291-6.

Yakeley J, Wood H.Paraphilias and paraphilic disorders: diagnosis, assessment and management.Advances in Psychiatric Treatment. 2014;20(3):202-213.

Coluccia A, Gabbrielli M, Gualtieri G, Ferretti F, Pozza A, Fagiolini A.Sexual masochism disorder with asphyxiophilia: a deadly yet underrecognized disease.Case Rep Psychiatry. 2016;2016:5474862.

Fuss J, Briken P, Klein V.Gender bias in clinicians’ pathologization of atypical sexuality: a randomized controlled trial with mental health professionals.Sci Rep. 2018;8(1):3715.

American Psychiatric Association.Paraphilic Disorders.2013

Kamenskov MYu, Gurina OI.Neurotransmitter mechanisms of paraphilic disorders.Z nevrol psikhiatr im SS Korsakova. 2019;119(8):61.

MSD Manual Professional Edition.Sexual sadism disorder - psychiatric disorders.

MSD Manual Consumer Version.Exhibitionism - mental health disorders.

Tenbergen G, Wittfoth M, Frieling H, et al. The neurobiology and psychology of pedophilia: recent advances and challenges. Front Hum Neurosci. 2015;9.

MSD Manual Professional Edition. Sexual masochism disorder - psychiatric disorders.September 2022

Fedoroff JP.Voyeuristic disorder. In: The Paraphilias.Oxford University Press; 2019:209-216.

MSD Manual Professional Edition. Transvestic disorder - psychiatric disorders.September 2022

Assumpção AA, Garcia FD, Garcia HD, Bradford JMW, Thibaut F.Pharmacologic treatment of paraphilias.Psychiatric Clinics of North America. 2014;37(2):173-181.

Kaplan, Meg & Krueger, Richard. (2012).The Israel journal of psychiatry and related sciences. Cognitive-Behavioral Treatment of the Paraphilias. 49. 291-6.

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