Paraphilic Fantasies Research Articles

The Problematic Pornography Consumption and Paraphilic Fantasies among Chinese Undergraduates’ Student

The Problematic Pornography Consumption and Paraphilic Fantasies among Chinese Undergraduates’ Student

Paraphilic fantasies and behavior in attention deficit/hyperactivity disorder and their association with hypersexuality.

Previous research has found some peculiarities in sexual functioning of adults with attention deficit/hyperactivity disorder (ADHD). Using a set of questionnaires that had to be answered online, we assessed the prevalence of paraphilic fantasies and behaviors in a sample of 160 adults with ADHD in comparison to 75 adults without ADHD and evaluated the association between paraphilias and hypersexuality in the ADHD group. Both groups reported high rates of paraphilic fantasies and behaviors. ADHD individuals were more likely to report about very sexually arousing paraphilic fantasies (ADHD: 58.2% vs. non-ADHD: 40.5%; χ2 = 6.323, p = 0.01) and behaviors (ADHD: 44.9% vs. non-ADHD: 28.4%; χ2 = 5.774, p = 0.02). Furthermore, ADHD individuals reported on average about more very sexually arousing paraphilic behaviors compared to non-ADHD individuals (ADHD: M = 1.28, SD = 0.10 vs. non-ADHD: M = 0.81, SD = 0.09; T = 2.68, p < 0.01). Furthermore, in ADHD individuals both very sexually arousing paraphilic interests in masturbation fantasies (r(158) = 0.17, p = 0.03) and in sexual behaviors (r(158) =0.19, p = 0.02) showed a significant correlation with hypersexuality. In non-ADHD individuals no such significant correlation could be found. Altogether, it can be concluded that individuals with ADHD seem to be more prone to develop and act out paraphilic sexuality than those without ADHD, however, found differences were rather small. The results of the present study add to the current trend to depathologize paraphilic sexuality in the general as well as in clinical populations.

Sexuality in ADHD: empirical data concerning hypersexual and paraphilic fantasies and behaviors in adults with ADHD

IntroductionADHD is a neurodevelopmental disorder displaying inattention, hyperactivity, and impulsivity as core symptoms. It can affect several areas of life including sexual health. Clinicians have often made assumptions concerning the bound of specific ADHD symptoms affecting sexual desire by increasing its frequency and intensity. Yet, there is still a lack of knowledge about the comorbidity between ADHD, hypersexuality, and paraphilias. A recent literature review could show that some individuals who suffer from ADHD report about hypersexual and paraphilic fantasies and behaviors, but as far as we know, no clear empirical data has emerged supporting the idea that hypersexuality and paraphilias are more frequent in individuals with ADHD.ObjectivesThe present investigation aimed to compare several sexuality related aspects between individuals with and without ADHD.MethodsTherefore, we designed an extensive online survey based on established questionnaires, such as the Hypersexual Behavior Inventory (HBI). The survey was implemented in a outpatient sample, ADHD specific fora as well as other general online channels.ResultsIn total, N = 238 individuals participated in the survey (n = 160 with ADHD). Thereby, individuals with ADHD reported significantly more often about a wide range of hypersexual fantasies and behaviors in comparison to individuals without ADHD. Furthermore, individuals with ADHD reported significantly more often about paraphilic fantasies and behaviors including fetishistic and sadistic sexual fantasies. No differences were found concerning other paraphilias. Further results regarding other facets of sexuality, such as sexual orientation, are to be presented and discussed.ConclusionsThe present study contributes to closing the knowledge gap regarding sexuality in individuals with an ADHD.DisclosureNo significant relationships.

Pharmacological treatment of sexual offenders in German outpatient treatment centers.

In Germany, depending on a sexual offender's culpability and the severity of the offence, he/she can be placed either in the forensic-psychiatric or the correctional system. Numbers related to the pharmacological treatment of sexual offenders for the correctional system are missing so far. In sexual offenders, the pharmacological treatment of paraphilic disorders is of special importance. The present study aimed at assessing the prevalence of pharmacological sexual offender treatment in German outpatient treatment centers supervising mainly clients from the correctional sector. An online questionnaire was sent to 112 outpatient treatment centers and 21 provided data relevant for the present study. The included institutions reported about a total of 813 sexual offenders, of whom 200 (24.6%) were treated with pharmacological agents, most frequently antipsychotics (14.8%) and selective-serotonin-reuptake-inhibitors (7.1%). Of the total sample, 26.7% of sexual offenders were diagnosed with a paraphilic - mainly with a pedophilic - disorder. Only 2% were treated with androgen-deprivation therapy. Compared with forensic-psychiatric institutions, only a minority of sexual offenders are treated with medication specifically addressing paraphilic symptomatology. However, the prevalence of paraphilic disorders found in the present study suggests that pharmacological treatment of paraphilic fantasies and behaviors could be of great importance in the correctional sector as well.

Deviance or Normalcy? The Relationship Among Paraphilic Thoughts and Behaviors, Hypersexuality, and Psychopathology in a Sample of University Students

IntroductionThe actual definitions of paraphilic thoughts or behaviors and hypersexuality are still a matter of debate in the scientific community, and few studies have evaluated their psychopathological correlates in non-clinical samples of both men and women. AimThis study aimed at shedding light on the gender differences in terms of frequency of paraphilic fantasies and behaviors, and the relationship among paraphilias, hypersexuality, and general psychopathology. MethodsA sample of 775 university students (243 men, 532 women) was recruited from 6 Italian universities using questionnaires posted in social networks. Paraphilic behaviors, fantasies, and masturbation during these fantasies were evaluated, as well as hypersexuality, psychopathological correlates, self-perceived gender identity, and a history of adverse childhood conditions. Main Outcome MeasuresParticipants were assessed on the presence of paraphilic fantasies, behaviors, and masturbation related to paraphilic thoughts, and evaluated by means of the Symptom Checklist 90-Revised, the Hypersexual Disorder Screening Inventory, the International Index of Erectile Function, the Female Sexual Function Index, the Gender Identity/Gender Dysphoria Questionnaire, and the Childhood Experience of Care and Abuse Questionnaire. ResultsIn the present survey, 50.6% of the men and 41.5% of the women reported at least 1 behavior considered paraphilic. A gender difference in the prevalence of the main paraphilic interests and behaviors was observed, with men reporting a higher prevalence of voyeurism, exhibitionism, sadism, and frotteurism, and a higher prevalence of fetishism and masochism in women. Both general psychopathology and sexual dysfunctions were associated with hypersexuality, rather than with the content of sexual fantasies. Finally, an association between childhood adversities and hypersexuality was found in women but not in men. Clinical ImplicationsUnderstanding the psychopathological correlates of paraphilic fantasies/behaviors and hypersexuality may allow clinicians to develop specific psychological and pharmacological interventions. Strengths & LimitationsThis is one of the few studies assessing paraphilic phenomenology and psychopathological correlates of hypersexuality in a non-clinical sample of both men and women. ConclusionThe results seem to demonstrate that paraphilic thoughts and behaviors are not really a deviation from normalcy, rather they are quite widespread in the young population, and the distinction between healthy and pathological sexual interests may be better replaced by an all-encompassing approach considering ego-dystonic sexuality, hypersexuality, and their psychopathological correlates.Castellini G, Rellini AH, Appignanesi C, et al. Deviance or Normalcy? The Relationship Among Paraphilic Thoughts and Behaviors, Hypersexuality, and Psychopathology in a Sample of University Students. J Sex Med 2018;15:1322–1335.

Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder

Like nonaffected adults, individuals with autism spectrum disorders (ASDs) show the entire range of sexual behaviors. However, due to the core symptoms of the disorder spectrum, including deficits in social skills, sensory hypo- and hypersensitivities, and repetitive behaviors, some ASD individuals might develop quantitatively above-average or nonnormative sexual behaviors and interests. After reviewing the relevant literature on sexuality in high-functioning ASD individuals, we present novel findings on the frequency of normal sexual behaviors and those about the assessment of hypersexual and paraphilic fantasies and behaviors in ASD individuals from our own study. Individuals with ASD seem to have more hypersexual and paraphilic fantasies and behaviors than general-population studies suggest. However, this inconsistency is mainly driven by the observations for male participants with ASD. This could be due to the fact that women with ASD are usually more socially adapted and show less ASD symptomatology. The peculiarities in sexual behaviors in ASD patients should be considered both for sexual education and in therapeutic approaches.

Hypersexuality, Paraphilic Behaviors, and Gender Dysphoria in Individuals with Klinefelter's Syndrome.

An increased risk of autistic traits in Klinefelter syndrome (KS) has been reported. In addition, some studies have shown an increased incidence of gender dysphoria (GD) and paraphilia in autism spectrum disorder. The aim of this study was to evaluate the presence of (i) paraphilic fantasies and behaviors; and (ii) GD symptomatology in KS. A sample of 46 KS individuals and 43 healthy male controls (HC) were evaluated. Subjects were studied by means of several psychometric tests, such as Autism Spectrum Quotient (AQ) and Reading the Mind in the Eyes Revised (RME) to measure autistic traits, Gender Identity/GD questionnaire (GIDYQ-AA), and Sexual Addiction Screening Test (SAST). In addition, body uneasiness psychopathological symptoms were assessed using Symptom Checklist 90 Revised (SCL-90-R). The presence and frequency of any paraphilic fantasy and behavior was assessed by means of a clinical interview based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition criteria. Finally, all individuals included were assessed by Wechsler Adult Intelligence Scale-Revised to evaluate intelligence quotient (IQ). Data from a subsample of a previous published series of male to female GD individuals, with the battery of psychological measures useful to provide a psychopathological explanation of GD in KS population available, was also considered. When compared with HC, KS reported significantly lower total, verbal and performance IQ scores and higher SCL-90 obsession-compulsive symptoms (all P < 0.001). In line with previously reported findings, KS showed higher autistic traits according with both RME and AQ tests (P < 0.001). With respect to sexuality, KS showed a significant higher frequency of voyeuristic fantasies during masturbation (52.2% vs. 25.6%) and higher SAST scores (P = 0.012). A mediation role of obsessive symptoms on the relationship between Klinefelter and SAST was confirmed (unstandardized estimate b = 2.75, standard error = 0.43 P < 0.001). Finally, KS individuals showed significantly higher gender dysphoric symptoms than HC (P = 0.004), which were mediated by the presence of autistic traits (Sobel's test; P < 0.05). KS is associated with hypersexuality, paraphilic behaviors, and GD, which were mediated by obsessive-compulsive and autistic traits.

Transtornos parafílicos em pacientes com transtorno obsessivo-compulsivo: série de casos

Com o intuito de elucidar a relação entre transtornos do controle de impulsos (TCI) e transtorno obsessivo-compulsivo (TOC), faz-se mister estudar subgrupos mais clinicamente homogêneos de transtornos impulsivos. Por meio do relato de quatro casos de pacientes com TOC e diferentes tipos de transtornos parafílicos (fetichismo transvético, sadismo, ginandromorfofilia e exibicionismo), são discutidos os conceitos de compulsividade, impulsividade e a relação temporal entre ambos. O estudo dos casos aqui descritos mostra que (1) pacientes com TOC e transtornos parafílicos tendem a desenvolver o TOC primeiro, (2) diante de desejos, fantasias ou atos sexuais parafílicos, pacientes com TOC podem lançar mão de comportamentos tipicamente compulsivos, (3) pacientes com TOC e obsessões sexuais egodistônicas podem desenvolver desejos, fantasias ou atos sexuais parafílicos de conteúdo semelhante ao das obsessões, (4) em um mesmo paciente, TOC e parafilias podem apresentar cursos independentes, e (5) pacientes com TOC e parafilias podem não apresentar obsessões sexuais. O sofrimento de pacientes com TOC e parafilias justifica a investigação continuada de tais condições no intuito de elucidar os mecanismos que subjazem esta associação e de criar estratégias que aumentem a adesão ao tratamento.

Integrative Strategies for Treating Internet Sexuality

This article introduces strategies for deepening the understanding of paraphilias and the therapeutic process of treating them. The case study explores a young man's compulsive sexual fantasies over the Internet, his compulsive masturbation, and his pedophilic and paraphilic fantasies as adaptations from early developmental conflicts. A therapeutic process supports this young man's understanding of his rejection of himself and promotes acceptance of developmentally appropriate and integrated sexual expression. In particular, this case discussion addresses three aspects in them ultiplicity of one's sexuality: the sexual self, the “voices” of sexuality, and the “dance” of sexuality. Additionally, management of transference and countertransference are discussed as means of strengthening the therapeutic alliance.