engleski

Changes in DSM-5 regarding paraphilias and their clinical relevance

In 2013 new edition of the Diagnostic and Statistical Manual for Mental Disorders was launched after more than a decade of consultations, discussions and field trials, DSM- 5 (Croatian translation was published in late 2014). In regard to paraphilias, the most noted change from the previous edition is that paraphilias in themselves are not regarded as mental disorders, but one of many varieties of human sexuality. There is a distinction between paraphilias and paraphilic disorders. A paraphilic disorder is a paraphilia that causes distress or impairment, or entails personal harm or risk of harm to others. Therefore a paraphilia does not justify or require clinical intervention, only a paraphilic disorder does. Diagnostic criteria for paraphilic disorders consist of two criteria: criterion A that specifies the nature of the paraphilia, and criterion B that specifies the negative consequences. Only those who meet both criteria would be diagnosed with a diagnosis of a paraphilic disorder. Those who meet only criterion A have a paraphilia, which is not a mental disorder. A paraphilia is nonnormative sexual behaviour or nonnormative sexual preference, which should not be pathologised. Specific paraphilic disorders described in DSM-5 are: voyeuristic disorder, exhibitionistic disorder, frotteuristic disorder, sexual masochism disorder, sexual sadism disorder, paedophilic disorder, fetishistic disorder and transvestic disorder. This new distinction should have impact on sexual rights, clinical work and everyday contact of professionals with people with nonnormative sexual preferences.

DSM-5; paraphilias; paraphilic disorders

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