Abnormal Psychology

(PSY 206) 
CLA-2

Submitted By:
Veda Pranavi Dodda
AP21211210010
4th Semester
B.SC. Psychology(Hons.)
 
Submitted To:
Dr.Aehsan Ahmed Dar
Department of Psychology
SRM University, Amaravati, Andhra Pradesh
 Paraphilic Disorders
The American Psychiatric Association (APA) defines paraphilic
disorders as a “group of sexual disorders characterized by recurrent and
intense sexual arousing fantasies, urges, or behaviors involving non-
human objects, non-consenting individuals, or the suffering or
humiliation of oneself or others”. These interests or behaviors cause
significant distress or impairment in social, occupational, or other areas
of functioning and may pose a risk of harm to oneself or others.

It's important to note that not all sexual interests or behaviors that are
considered unusual or outside of societal norms necessarily qualify as a
paraphilic disorder. To be diagnosed with a paraphilic disorder, the
sexual interests or behaviors must cause significant distress or
impairment and be persistent over time.

The term “paraphilia” was coined in 1920s and later made popular in an
effect to describe the preferences of these individuals without derogatory
judgements.

There are 8 types of Paraphilic disorders or Paraphilias. They are:

(1) Fetishism
(2) Transvestic Fetishism
(3) Pedophilia
(4) Voyeurism
(5) Exhibitionism
(6) Frotteurism
(7) Sexual sadism
(8) Sexual masochism
(5) Exhibitionism:
Exhibitionism is diagnosed in a person with recurrent, intense urges,
fantasies or behaviors that involve exposing his genitals to others
(usually strangers) in inappropriate circumstances and without their
consent.
 Frequently, the shock of the victim is highly arousing to these
individuals.
 This might occur near the unsuspecting person(s), or from a
distance.
 The exposure may take place in some secluded location such as
park or in a more public space such as a department store, church,
theatre and or bus.
 True exhibitionistic disorder is better defined as any kind of
exhibitionistic behavior that an individual is not able to control,
with the potential to cause a significant amount of psychological
distress to the exhibitionist and their victims.

The DSM-5 criteria for exhibitionistic disorder includes the following;

 The individual’s compulsive exhibitionistic behaviours must
consistently occur over a six-month period
 The act and desire to show their genitals to nonconsenting
strangers results in extreme sexual arousal 
 Their exhibitionistic behaviour causes them acute distress
 Their social life, career, and ability to function are disrupted by
their compulsive desires
 Other mental and physical conditions have been ruled out.

Causes of Exhibitionistic Disorder:

Exhibitionistic disorder usually develops during young adulthood.

The exact causes of this disorder are unknown but it is thought that one
or multiple factors such as antisocial personality disorder, substance
abuse, or other paraphilic disorders may play a role.
Research suggests that there may be a combination of biological,
psychological, and other social factors that contribute to the
development of this disorder. Here are some of the potential causes:
 Psychological factors: Some individuals with this disorder may
have a history of childhood trauma, such as sexual abuse or
neglect, which can contribute to the development of this disorder.
Other psychological factors such as low self-esteem, poor body
image, or a need for attention or validation, may also play a role.
 Neurobiological factors: Some studies suggest that abnormalities
fill certain areas of the brain such as the prefrontal cortex and
limbic system may contribute to the development of exhibitionistic
disorder. Neurotransmitter imbalances or abnormalities in hormone
levels may also play a role.
 Social factors: Social and cultural factors such as exposure to
sexual content in media, family attitudes towards sex, and peer
pressure may contribute to the development of exhibitionistic
disorder.
 Behavioral factors: Some individuals may develop exhibitionistic
disorder as a result of repeated exposure to sexually explicit
material or through learned behaviors from others who engage in
similar behaviors.
It is important to note that these factors may not cause exhibitionistic
disorder on their own and that the development of the disorder is likely
the result of a complex interplay between these and other factors.

Symptoms of exhibitionistic disorder:

The following are a few of the surface-level, straightforward

signs and symptoms of exhibitionistic disorder:
 Strong, obsessive urges to expose your genitalia to another person
in order to terrorize, startle, or thrill them sexually
  A disdain for the privacy and emotional boundaries of others, even
complete strangers and/or your love interests. And a history of, or
propensity for, dangerous or widely visible sexual behavior

 Strong urges for display that are affecting your relationships, job,
or daily life

Effects of Exhibitionistic disorder:

 Negative implications for the individuals as it can cause feelings of

shame guilt and other emotional turmoil
 Trouble communicating in sexual relationships
 Social isolation
 Sexual dysfunction such as delayed ejaculation or erectile
dysfunction also may occur
  Partners of the affected individuals may also go through emotional
distress. For example, they can feel unattractive or inadequate.

Treatment for Exhibitionistic Disorder:

Treatment for exhibitionistic disorder may include psychotherapy,

medication, or a combination of both. The goal of treatment is to help
individuals manage their sexual urges and develop healthier coping
mechanisms, and to reduce the risk of harm to others.

 Psychotherapy: Cognitive-behavioral therapy (CBT) is a

commonly used form of psychotherapy for exhibitionistic disorder.
CBT helps individuals identify and manage their triggers, develop
coping strategies, and learn new ways of thinking about their
behaviors. Other forms of psychotherapy, such as psychodynamic
therapy or group therapy, may also be helpful for some individuals.

 Medication: Medications such as selective serotonin reuptake

inhibitors (SSRIs) may be prescribed to help reduce the intensity of
sexual urges. Anti-androgen medications may also be used to
reduce sexual arousal.

 In addition to psychotherapy and medication, individuals with

exhibitionistic disorder may benefit from joining a support group
or seeking help from a sexual addiction specialist.

 It is important to note that exhibitionistic disorder is considered a

form of sexual deviance and is illegal in most jurisdictions.
Therefore, seeking professional help is critical for individuals
struggling with this disorder.

Overall, treatment for exhibitionistic disorder can be effective,

especially with a combination of psychotherapy and medication. The
specific treatment plan will vary depending on the individual's unique
needs and circumstances.

(6) Frotteurism:

The Diagnostic and Statistical Manual of Mental Disorders, Fifth

Edition (DSM-5) defines frotteurism as a form of paraphilic disorder
that involves recurrent, intense, and sexually arousing fantasies, urges,
or behaviors that involve touching or rubbing against a non-consenting
person. The individual may seek to touch the victim's buttocks, breasts,
or genitalia, or they may simply brush against them in a sexually
suggestive way. This majorly takes place in places which are crowded
like buses or subway trains etc.
This disorder is considered a type of sexual paraphilia, which is a
condition characterized by atypical sexual interests or behaviors. It is
typically classified as a non-contact sexual paraphilia, as it does not
involve physical contact with the victim's genitalia.
The individual must have acted on these urges with a non-
consenting person, or they must have caused significant distress or
impairment in social, occupational, or other important
areas of functioning.

Causes of Frotteurism:

The exact causes of frotteuristic disorder are not well understood, but
research suggests that it may be caused by a combination of biological,
psychological, and social factors. Here are some potential contributing
factors:

 Childhood experiences: Early life experiences such as sexual

abuse, neglect, or trauma may increase the risk of developing a
paraphilic disorder, including frotteurism.
  Social and cultural factors: Frotteurism is more common in
societies with high population densities and in situations where
anonymity is maintained, such as in crowded public places.
Cultural norms and values related to sexuality may also contribute
to the development of paraphilic disorders.

 Personality traits: Certain personality traits, such as impulsivity,

low self-esteem, and a history of aggression or violence, may
increase the risk of developing a paraphilic disorder.

 A person may struggle with loving and sexually intimate

behaviour, which is another explanation for this behaviour. Their
emotional well-being and impulse control may be impacted by
aberrant brain structure, which might be the reason for this.

Before adolescence, paraphilias frequently start to show

symptoms. A person who is obsessed with sex may be more prone
to frotteurism.

The majority of cases of this illness are found in males between the
ages of 15 and 25. Some elderly, socially awkward guys have also
been shown to have the syndrome. Women are frequently the
targets of these behaviours.

It's important to note that while these factors may contribute to the
development of frotteuristic disorder, not everyone who experiences
them will develop the disorder. More research is needed to fully
understand the causes of frotteuristic disorder.
Common symptoms of Frotteurism:

 Recurrent and intense sexual fantasies, urges, or behaviors

involving touching or rubbing against a non-consenting person.

 Sexual arousal that is triggered by crowded places or situations

where the individual can remain anonymous.

 Engaging in frotteuristic behavior despite the risk of being caught,

arrested, or otherwise punished.

 Feeling guilty, ashamed, or anxious about frotteuristic behaviors,

but unable to stop them.

 Difficulty forming or maintaining healthy sexual relationships with

consenting partners.
It's important to note that not all individuals with frotteuristic disorder
will exhibit all of these symptoms, and that the severity and frequency of
the behavior may vary depending on the individual. A comprehensive
clinical evaluation by a mental health professional is necessary to
diagnose frotteuristic disorder.

Treatment for Frotteuristic disorder:

When improper or unlawful behaviour takes place and/or the

sexual urges result in considerable harm or distress, frotteuristic desires
necessitate therapy. Psychotherapy is the most popular treatment method
for those who need it. When used in conjunction with therapy, several
drugs have been demonstrated to be useful in lowering the obsessive
behaviour connected to frotteuristic disorder.

 Sex therapy: A skilled and understanding approach to

psychotherapy will be provided through sex therapy with a
licenced sex therapist who specialises in paraphilias. To identify
the causes of frotteuristic desire and its manifestation in cravings,
fantasies, and behaviours, they will conduct a thorough sexual and
psychological history. Then, they will investigate how the
symptoms started and their context, paying particular attention to
any alterations in the circumstances or signals that have intensified
frosty impulses or ideas. They will probably also provide
instruction in behavioural and mindfulness practises. It will also be
evaluated and treated if there are any co-occurring psychiatric
issues, such as mood disorders or hypersexuality.

 Cognitive Behavioural Therapy: Cognitive restructuring strategies

are used by sexual therapists with training in cognitive behavioural
therapy to recognise and alter beliefs and behaviours. In order to
lessen their desire to engage in frotteuristic behaviour, they could
use guided visualisation or aversion treatment. When combined
 with pharmacological therapy, studies have demonstrated that CBT
is an effective treatment for frotteuristic disorder.
 Antidepressants: Selective serotonin reuptake inhibitors (SSRIs)
such as Prozac/fluoxetine can help with co-occurring mood
disorders, such as depression or anxiety, while simultaneously
lowering sex drive. A lowered sex drive can help with the
impulsivity associated with frotteuristic thoughts and behaviors,
however does not directly address the frotteuristic urge
without therapy

 Antiandrogens: Members of a family of medications called

“medroxyprogesterone acetate and cyproterone acetate” can be
used to temporarily suppress testosterone levels to lessen sex urges
and enable more effective treatment. These medications assist in
lowering circulating testosterone levels and prepare the patient for
cognitive restructuring treatment methods.
 Group Therapy: Group therapy conducted in conjunction with
individual therapy has been shown to be effective in reducing
inappropriate behaviors and enhancing social skills.

It's important to note that the success of treatment for

frotteuristic disorder depends on various factors, including the
individual's willingness to participate in therapy, the severity and
duration of their behavior, and any co-occurring mental health or
medical conditions. Treatment is typically a long-term process, and
relapse prevention strategies are often used to help individuals maintain
their progress over time.