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Paraphilias Diagnosis

(Also Known As: Paraphilia Diagnosis, Paraphilic Diagnosis, Sexual Abuse Diagnosis)

(Reviewed by: Paul Peterson, Licensed Therapist)

How is Paraphilias Diagnosed?

Mental health evaluation is the key to diagnosing paraphilias. The evaluation is conducted by a psychologist, psychiatrist, or other mental health professionals that include taking the patient’s history on sexual thoughts, consequences, and behaviors. A physical examination is also carried out in order to rule out other physical condition and disorders that may be associated with the patient’s symptoms and behavior. The American Psychiatric Association established criteria for the diagnosis of paraphilias as follow:

  • The patient’s symptoms should consist of recurring sexual fantasies, urges, and behaviors that occur for at least six months.
  • The patient acted on the urges with significant distress and difficulties with relationships or jobs as a consequence of the urges.

Each type of paraphilia conditions has its own diagnostic criteria:

  • To be diagnosed with pedophilia the patient must be at least 16 years old and must be at least 5 years older than the child involved. Any sexual activity with older and younger teens (typically more than 13 years old) is not considered pedophilia.
  • To be diagnosed with transvestic fetishism the focus is on the element of cross-dressing.
  • To be diagnosed with fetishism there must be the use of non-living objects as the source of stimulating sexual arousal.

Many paraphilias conditions remain undiagnosed unless the paraphiliacs subject themselves for evaluation and treatment, or when their act is caught and exposed. Because unusual sexual behavior may also occur in some cases, such as in mental retardation, schizophrenia, dementia, manic episodes, and substance abuse, it is significantly important to rule our paraphilias under the following conditions:

  1. It is not the preferred or necessary means for sexual arousal
  2. The behavior usually occurs in adulthood and not in the adolescent years
  3. The sexual act is an isolated incident rather than a chronic one
  4. It occurs only during the course of an existing condition

Penile Plethysmography (PPG)

This is a test oftentimes used to diagnosis paraphilias, which involves measuring blood flow changes within the penis as a response to an audio or visual stimulus. The test is a way to measure the sexual arousal in paraphiliac as a response to the inappropriate and abnormal cues. This form of diagnostic test however is often questioned as to the reliability of the result, since the reaction obtained from the patient may be based only on mental images that are not related to the stimuli used in the test. This diagnostic test is often used when there is involvement with legality issues.

Clinical Assessments 7

  • Clinical interview (assessing frequency and chronology of the behavior, possibility of multiple paraphilias)
  • Paper and pencil test
  • Behavioral assessment (role playing assessment)
  • Psycho-physiological assessment (viewing time tests and phallometry)
  • Psychiatric diagnosis such as personality assessment
  • Substance abuse history
  • History of aggression
  • Neuropsychological factors

Could You Have Paraphilias?

Paraphilias Topics

Related Conditions

Anxiety Disorder NOS – Pathological Fears, Chronic Anxiety, Depression, Stress, Fatigue, Exhaustion
Gender Dysphoria (Gender Identity Disorder) – Gender Dysphoria, Transgender, Transvestism, Transsexuality
Obsessive Compulsive Disorder – Anxiety, Intrusive Thoughts, Depression, Obsession, Compulsive Behavior, Anxiety
Personality Disorder NOS – Changes in Personality and Behavior, Pervasive Behavioral Deviation, Inflexible Personality
Post Traumatic Stress Disorder – Anxiety, Traumatic Events, Stress, Depression, Psychological Trauma
Schizophrenia – Abnormal Perception of Reality, Hallucinations, Paranoid, Delusion, Disorganized Thinking and Speech
Sexual Addiction – Unmanageable Sexual Behavior, Hypersexuality, Sexual Dependency, Sexual Compulsivity