Roxanne Dryden-Edwards, MD
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
- Paraphilia facts
- What is a paraphilia? What are the different types of paraphilias?
- What are causes and risk factors for paraphilia?
- What are paraphilia symptoms and signs?
- How do health professionals diagnose paraphilias?
- What is the treatment for paraphilia?
- What is the prognosis of paraphilia?
- Is it possible to prevent paraphilias?
- Find a local Psychiatrist in your town
- Paraphilias are emotional disorders defined as sexually arousing fantasies, urges, or behaviors that are recurrent, intense, occur over a period of at least six months, and cause significant distress or interfere with important areas of functioning.
- Except for masochism, paraphilias are almost exclusively diagnosed in men.
- There are a number of different types of paraphilias, each of which has a different focus of the sufferer’s sexual arousal.
- There are thought to be biological, psychological, and social risk factors for developing paraphilias.
- While the desired sexual stimulant for the paraphilia sufferer depends on the specific paraphilia, the characteristics of the illness are often very similar.
- In order to establish the diagnosis of a paraphilia, mental-health professionals usually conduct or refer the person for a medical interview, physical examination, and routine laboratory tests. The professional will assess for any history of mental-health symptoms.
- Treatment of paraphilias usually involves the combination of psychotherapy and medication.
- Paraphilias have been found to be quite chronic, such that a minimum of two years of treatment is recommended for even the mildest paraphilia.
- Prevention for the development of any paraphilic behavior usually involves alleviating the psychosocial risk factors for its development.
What is a paraphilia? What are the different types of paraphilias?
The word paraphilia is derived from Greek; para means around or beside, and philia means love. Paraphilias are emotional disorders that are defined as sexually arousing fantasies, urges, or behaviors that are recurrent, intense, occur over a period of at least six months, and cause significant distress or interfere with the sufferer’s work, social function, or other important areas of functioning. This is as opposed to sexual variants, which are sexual behaviors that are not typical but are not a part of any illness.
The number of people who suffer from a paraphilia is thought to be difficult to gauge for a number of reasons. Many people with one of these disorders suffer in secret or silence out of shame, and some are engaging in sexual offending behaviors and so are invested in not reporting their paraphilia. Therefore, many of the estimates on the prevalence of paraphilia are gained from the number of people involved with the criminal-justice system due to pedophilia. Most pedophiles are men, with just 1%-6% being women.
Except for masochism, which is 20 times more common in women than men, paraphilias are almost exclusively diagnosed in men. Many people who suffer from one paraphilia have more than one. For example, about one-third of pedophiles also have another paraphilia. More than half engage in three or four such kinds of behaviors rather than just one. Most people who develop a paraphilia begin having fantasies about it before they are 13 years old.
There are a number of different types of paraphilias, each of which has a different focus of the sufferer’s sexual arousal:
- Voyeurism: watching an unsuspecting/nonconsenting individual who is either nude, disrobing, or engaging in sexual activity
- Exhibitionism: exposing one’s own genitals to an unsuspecting person
- Frotteurisim: touching or rubbing against a nonconsenting person
- Sexual masochism: being humiliated, beaten, bound, or otherwise suffering
- Sexual sadism: the physical or emotional suffering of another person
- Pedophilia: sexual activity with a child that is prepubescent (usually 13 years old or younger)
- Fetishism: sexual fascination with nonliving objects or highly specific body parts
- Transvestism: cross-dressing that is sexually arousing and interferes with functioning
- Other specified paraphilia: some paraphilias do not meet full diagnostic criteria for a paraphilic disorder but may have uncontrolled sexual impulses that cause enough distress for the sufferer that they are recognized. Examples of such specific paraphilias include necrophilia (corpses), scatologia (obscene phone calls), and zoophilia (animals).
Urges to engage in coercive or otherwise aggressive sex like rape are not considered to be symptoms of a mental illness. Such sexual offending is therefore not considered to be a paraphilia.
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