Pharmacological therapy, (158) however, is a viable option for many, particularly those with
paraphilias. One of the most noteworthy studies on pharmacological therapy for sex offenders tested the efficacy of triptorelin, a drug that reduces male testosterone levels, in decreasing the deviant sexual desire and behavior of thirty men.
Money, Lovemaps: Clinical Concepts of Sexual/Erotic Health and Pathology,
Paraphilia, and Gender Transposition in Childhood, Adolescence, and Maturity (New York: Irvington Publishers, 1986).
Participants completed the 40-item
Paraphilia Scale that assesses 14 paraphilic interests and behaviours (Chivers, Roy, Grimbos, Cantor, & Seto, 2014; Dawson et al., 2016; Seto, Lalumiere, Harris, & Chivers, 2012); the names and descriptions of the paraphilic behaviours are shown in Table 1.
It appears that the DSM-V will further formalize this idea and separate
paraphilias from paraphilic disorders.
This problem gets more acute as we move beyond the rather narrow parameters of sexual paraphilias--even given the catch all classification, "
Paraphilia not Otherwise Specified" (APA, DSM IV TR, 2000, 576)--to a consideration of all the "sexual disorders" listed in the current DSM.
According to DSM IV, fetishism falls into the category of
paraphilias and is recognized as the revelation of one's sexual urges or behavior, or intensely sexually arousing fantasies by using such nonhuman objects as women's underwear.
After defining ephebophilia, in accord with the Diagnostic and Statistical Manual, as not a sexual disorder or
paraphilia while allowing that it may have harmful effects on teenagers,(24) this report only pages later explicitly categorizes ephebophilia as disease,
paraphilia, and sexual disorder, and states that such phenomena are called diseases or disorders because they cause suffering or damage.(25)
It!s clear the mechanisms of
paraphilia (preference for unusual sexual practices) can be terribly complex Keenan observes that offenders say "they never really thought about it.
Examples of clinical samples included a focus on participants with diagnosable conditions or disorders such as vulvodynia, fibromyalgia,
paraphilia, or autism.
Medical hypotheses associate the debut of
paraphilia with neurological disorders and other biological anomalies, such as hipertestosteronemia, schizophrenia, juvenile dyslexia, Klinefelter syndrome, cortical atrophy, and epilepsy of the temporal lobe (Blumer & Walker 1969; Langevin et al 1987).
Cyproterone acetate 150 mg given every 2-4 weeks IMI is effective in combating
paraphilia in non-dementing patients and those with dementia.