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Arch Sex Behav 2020 Jun 10. Epub 2020 Jun 10.

Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada.

Arch Sex Behav 2020 Jul 27;49(5):1403-1407. Epub 2020 May 27.

Centro de Investigaciones Cerebrales, Universidad Veracruzana, Xalapa, VER, CP 91193, Mexico.

World J Biol Psychiatry 2020 May 26:1-79. Epub 2020 May 26.

The Royal Institute of Mental Health Research, University of Ottawa, McMaster University, Ottawa & Hamilton, ON, Canada.

The primary aim of these guidelines is to evaluate the role of pharmacological agents in the treatment and management of patients with paraphilic disorders, with a focus on the treatment of adult males. Because such treatments are not delivered in isolation, the role of specific psychotherapeutic interventions is also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients, including sexual offenders, with paraphilic disorders. Read More

Front Psychiatry 2020 20;11:318. Epub 2020 Apr 20.

Department of Psychiatry and Psychotherapy, Eberhard-Karls University of Tübingen, Tübingen, Germany.

Background: Hypersexual and paraphilic disorders have been frequently associated with concomitant psychiatric disorders, including schizophrenia. A growing number of published cases has recently indicated that hypersexual behavior may also arise in conjunction with treatment with second-generation antipsychotics. Although hypersexuality has been acknowledged as a possible side effect of antipsychotic treatment with partial dopamine agonists, including aripiprazole, only very few cases of olanzapine-associated hypersexuality have been reported in the literature. Read More

Nervenarzt 2020 May 11. Epub 2020 May 11.

Institut für Sexualforschung, Sexualmedizin und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.

Background: For the assessment of criminal responsibility in the context of sexual delinquency, the evaluation of the severity of a paraphilic disorder and the ability to be controlled are of particular importance. Established assessment criteria are insufficiently operationalized.

Aim And Methods: The existing criteria were tested by experts of various professional groups with respect to the reliability. Read More

J Sex Res 2020 Apr 30:1-10. Epub 2020 Apr 30.

Department of Research Synthesis, Intervention, and Evaluation, Friedrich-Schiller-University Jena.

Except for pedophilia, little is known about public attitudes toward paraphilias and psychological conditions that are considered risk factors for sexual offending. In the present study we sought to compare the stigma attached to pedophilia with attitudes toward sexual sadism and antisocial tendencies (Study 1, = 720) and with attitudes toward necrophilia and zoophilia (Study 2, = 210) in convenience samples of community individuals. When investigating social distance intentions both studies explicitly referred to people with paraphilic sexual interests or antisocial tendencies who had not committed any crimes. Read More

J Forensic Sci 2020 Apr 20. Epub 2020 Apr 20.

Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

There is a lack of knowledge on mentally disordered sex offenders (MDSOs) targeting adult victims, especially regarding recidivism patterns and the specific subgroup with psychiatric disorders. This paper presents index offense data, clinical data, and recidivism patterns over up to 24 years in a cohort of 146 MDSOs, with and without psychotic disorders, sentenced in Sweden between 1993 and 1997. At the time of the offense, all offenders were affected by clinical, developmental, and criminal history factors. Read More

Rev Med Suisse 2020 Mar;16(686):519-520

Unité de médecine sexuelle et sexologie, Département de psychiatrie, HUG, Genève.

Sex Abuse 2020 Mar 13:1079063220910723. Epub 2020 Mar 13.

Johannes Gutenberg-University Mainz, Germany.

For a particular subgroup of individuals with severe paraphilic disorders and a high risk of sexual recidivism, the combination of sex drive-reducing medications and psychotherapy is a promising treatment approach. The present quasi-experimental study aims at comparing differences in clinical characteristics and dynamic risk factors between persons receiving (+TLM, = 38) versus not receiving (-TLM, = 22) testosterone-lowering medications (TLMs). Individuals receiving TLM were more frequently diagnosed with paraphilic disorders. Read More

Psychiatr Danub 2019 Dec;31(Suppl 5):826-830

Department of Forensic Psychiatry, University Psychiatric Hospital Vrapče, Bolnička cesta 3, 10000 Zagreb, Croatia,

Background: The aim of the study was to compare the characteristics of sex offenders today, and those who committed a sex crime fifteen years ago, in regard to their psychiatric-forensic aspects.

Subjects And Methods: Data from the University psychiatric hospital Vrapče, Center for forensic psychiatry on court people sent for psychiatric and forensic evaluation, who were accused of sex offense in two time frames (1998-2001 and 2010-2016) were analysed. In total there were 50 and 57 male subjects sent for an evaluation. Read More

J Sex Med 2020 Jun 5;17(6):1182-1194. Epub 2020 Mar 5.

Human Behaviour Laboratory and Interdisciplinary Transgender Health Care Centre, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. Electronic address:

Background: One of the most prominent etiological theories of gender incongruence in trans women proposes a paraphilic erotic target location error (ie, autogynephilia) as a causal factor in gynephilic (ie, exclusively gynephilic and bisexual) trans women. We hypothesized that a paraphilic erotic target location should manifest itself in various aspects of sexual behavior, solitary and dyadic sexual desire, and psychosexual experience.

Aim: To compare sexual behavior, sexual desire, and psychosexual experience of exclusively gynephilic and bisexual trans women with that of androphilic trans women to explore whether their sexuality differs substantially. Read More

Annu Rev Clin Psychol 2020 May 5;16:379-399. Epub 2020 Feb 5.

Department of Family Medicine and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K2P 0X4, Canada; email:

There is no accepted definition of the term paraphilia despite its being listed as an essential feature of a class of mental disorders known as the paraphilic disorders. The origin of the term, history of its inclusion as a diagnosis, and logical flaws inherent in the various definitions are discussed in this review. We examine the basis for pathologizing individuals with paraphilias, consider what paraphilias can tell us about how humans develop their sexual interests, and question the usefulness of dividing sexual interests into paraphilias and normophilias. Read More

Front Psychiatry 2019 8;10:922. Epub 2020 Jan 8.

Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada.

Psychiatric diagnoses, static risk factors, and criminogenic needs at time of admission and release were examined in a mentally ill sample of psychiatrically detained sexual offenders. Although clinically found to be at low or even very low risk at discharge, 12% reoffended sexually over an average follow-up of 7 years. Psychotic disorders were present in only 5% of offenders, whereas 93% had a personality disorder diagnosis and 76% a paraphilic disorder diagnosis. Read More

Psychiatr Pol 2019 Oct 30;53(5):1103-1112. Epub 2019 Oct 30.

Uniwersytet Jagielloński, Instytut Psychologii.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders published in 2013 has proved to be particularly interesting in the field of sexuality. It introduced a number of significant changes in the definition of sexual norms, among them a widely discussed distinction between paraphilias and paraphilic disorders. The key criterion separating the abnormal sexual interests from the disordered ones is clinically significant distress resulting directly from sexual behavior and/or the risk of suffering or harm to another person as a result of one's sexual behavior. Read More

J Sex Med 2020 Mar 15;17(3):491-504. Epub 2020 Jan 15.

Faculty of Medicine, Department of Psychiatry, American University of Beirut, Beirut, Lebanon. Electronic address:

Introduction: The World Health Organization's general assembly, in its last meeting of May 2019, has approved the suggested changes to the International Classification of Diseases manual, 11th version (ICD-11). Some of the proposed recommendations include the revision of "Disorders of Sexual Preference", now called Paraphilic Disorders, currently listed under the International Classification of Diseases-10 Mental and Behavioural Disorders.

Aim: This article presents findings on the analysis of the existing laws and policies that are relevant to paraphilic disorders in Lebanon. Read More

Int J Offender Ther Comp Criminol 2019 Dec 30:306624X19895905. Epub 2019 Dec 30.

University of New Brunswick, Fredericton, Canada.

This study examined the association of sexually appetitive fantasies and sexually coercive behaviors among adult men convicted of nonsexual crimes ( = 159) and adult men with no criminal histories ( = 219). Individuals completed the Multidimensional Assessment of Sex and Aggression (MASA) and, on the basis of these reports, were classified whether or not they had ever attempted to assault or coerce someone sexually. Consistent with fewer opportunities to engage in sexual behavior, individuals with criminal histories reported generally less preoccupation, compulsivity, and frequency than did noncriminal individuals. Read More

J Sex Med 2020 01 5;17(1):99-110. Epub 2019 Dec 5.

Psychology Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London. Electronic address:

Introduction: Erotic target identity inversions (ETIIs) are poorly studied paraphilias that involve sexual arousal by the idea or fantasy of being the object of one's sexual desires.

Aim: To conduct a large non-clinical online survey to investigate self-reported sexual arousal, behavioral expression, and psychological correlates of 4 proposed ETIIs.

Methods: A total of 736 natal males and 549 natal females responded to items about self-reported sexual arousal to the idea of acting as an animal (autoanthropomorphozoophilia) or the idea of acting as a child or infant (autonepiophilia), natal males reporting arousal to the idea of acting as a woman (autogynephilia), and natal females reporting arousal to the idea of acting as a man (autoandrophilia). Read More

Curr Psychiatry Rep 2019 12 6;21(12):135. Epub 2019 Dec 6.

Forensic-Psychiatric Hospital, Bezirksklinikum Ansbach (District Hospital), Feuchtwanger Str. 38, 91522, Ansbach, Germany.

Purpose Of Review: Coercive sexual sadism can be distinguished from consensual BDSM (bondage discipline/dominance submission/sadism masochism) role-play and from everyday sadism, a personality trait. The purpose of this paper is to provide a systematic qualitative review of the pertinent literature on coercive sexual sadism from the last three years.

Recent Findings: Clinical assessment of sexual sadism can be made more objective through behavioral checklists based on crime scene actions. Read More

Int J Law Psychiatry 2019 Nov - Dec;67:101508. Epub 2019 Oct 24.

Department of General Psychology, University of Padova, Padova, Italy.

Neurological disorders can be mis-diagnosed as psychiatric ones. This might happen to pedophilia emerging as a symptom of brain insult (i.e. Read More

Curr Psychiatry Rep 2019 11 18;21(12):121. Epub 2019 Nov 18.

School of Psychology, University of Ottawa, Ottawa, Canada.

Purpose Of Review: We examine the state of scientific research on the assessment of paraphilic interests among women who have committed sexual offences.

Recent Findings: Research on the assessment of sexual interests in women using genital measures shows little evidence, overall, that women's genital responses are indicative of sexual interests. Some non-genital measures of sexual interest may be a valid indicator of age interests. Read More

Arch Sex Behav 2020 01 29;49(1):25-30. Epub 2019 Oct 29.

Department of Criminal Justice, Kutztown University, Kutztown, PA, USA.

Arch Sex Behav 2020 01 24;49(1):53-55. Epub 2019 Oct 24.

Department of Psychology, Northwestern University, Evanston, IL, USA.

Medicina (Kaunas) 2019 Oct 20;55(10). Epub 2019 Oct 20.

Departments of Psychology & Psychotherapy, Environmental Health Center, College of Health Science, Dankook University, 119 Dandae-Rho, Dongnam-Gu, Cheonan 31116, Korea.

Paraphilia is a complex psychological and psychiatric disorder that has been difficult to treat. Leuprorelin has been used as one of the therapeutic methods for paraphilia. Leuprorelin administration could change insulin resistance and accelerate bone loss. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2019 ;119(8):61-67

Serbsky National Medical Research Centre for Psychiatry and Narcology, Ministry of Health, Moscow, Russia.

Aim: To investigate serotonin and catecholamine levels in people with paraphilic disorders and identify correlations between transmitter dysfunction and clinical signs of paraphilic disorders.

Material And Methods: Fifteen men with paraphilic disorders were studied using clinical-psychopathological, sexological, biochemical and statistical methods.

Results: There were an increase in the levels of serotonin and norepinephrine and a decrease in the concentration of DOPAC (3,4-dihydroxyphenylacetic acid) in the urine of patients with paraphilic disorders. Read More

Rev Bras Epidemiol 2019 26;22Suppl 1(Suppl 1):e190004. Epub 2019 Sep 26.

Post-Graduate Program in Collective Health, School of Health Sciences, University of Brasília, Brasília (DF), Brazil.

Introduction: Travestis and transgender women resort to the use of hormones for body modification. Due to restrictions in the access to health services, self-medication is frequent. The aim of this study was to describe the self-reported prevalence of hormones used by travestis and transgender women in the Federal District. Read More

Med Hist 2019 10;63(4):411-434

Faculty of Arts and Social Sciences, Maastricht University (external PhD programme), The Netherlands.

A tropology of moral injury and corruption long framed the plight of the sex crime victim. Nineteenth-century psychiatric acknowledgment of adverse sexual experience reflected general trends in etiological thought, especially on 'epileptic' and hysteric seizures, but on the whole remained descriptive, guarded and limited. Various experiential threats to the modern sexual self beyond assault and rape were granted etiological significance, however: illegitimate motherhood, masturbatory guilt, sexual enlightenment, 'homosexual seduction' and chance encounters leading to fetishistic fixation. Read More

J Sex Med 2019 11 21;16(11):1814-1819. Epub 2019 Sep 21.

Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; Department of Psychiatry, Santa Casa de São Paulo Medical School, São Paulo, Brazil.

Introduction: The World Health Organization (WHO) Department of Mental Health and Substance Abuse appointed a Working Group on Sexual Disorders and Sexual Health in order to revise and propose changes to ICD-10 categories.

Aim: Analyze ethical and legal implications in Brazil of the proposed ICD-11 diagnostic criteria for paraphilic disorders.

Methods: A forensic working group of Brazilian experts in collaboration with representatives of WHO reviewed the proposed modifications to the classification of Disorders of Sexual Preference in ICD-10 (F65), which is recommended to be replaced by Paraphilic Disorders in ICD-11. Read More

J Child Sex Abus 2019 Nov-Dec;28(8):945-967. Epub 2019 Sep 16.

Department of Psychology, University of Portsmouth, Portsmouth, UK.

Individuals who are attracted to minors but have abstained from sexual offending (non-offending minor-attracted persons) are an under-researched, hard-to-reach population. The current study explored professionals' perspectives of the barriers this population faces in seeking and receiving help and how these barriers can be reduced. Twenty professionals read an original vignette and answered a series of questions via an online survey. Read More

J Sex Med 2019 10 9;16(10):1623-1637. Epub 2019 Sep 9.

Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA. Electronic address:

Introduction: The World Health Organization (WHO) has made substantial changes to the classification of paraphilic disorders for the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11), recently approved by the World Health Assembly. The most important is to limit paraphilic disorders primarily to persistent and intense patterns of atypical sexual arousal involving non-consenting individuals, manifested through persistent sexual thoughts, fantasies, urges, or behaviors, that have resulted in action or significant distress.

Aim: To analyze the legal, regulatory, and policy implications of the changes in the ICD-11 classification of paraphilic disorders for forensic practice, health systems, adjudication of sex offenders, and the provision of treatment in Mexico. Read More

J Child Sex Abus 2019 Nov-Dec;28(8):968-989. Epub 2019 Sep 11.

School of Psychology, University of Kent, Canterbury, England.

'Non-offending pedophiles' or 'minor attracted persons' are individuals who suppress an attraction to children. Previous analyses of this population's mental illness employed overt self-report methods, limited by social desirability. Additionally, studies assessing the coping mechanisms employed to remain offense-free are underpowered; understanding of these would facilitate the rehabilitation of prior offenders. Read More

Ugeskr Laeger 2019 Aug;181(35)

In this review, we discuss paedophilia, which is a persistent and intense sexual interest in prepuberty children. Paedophilia is related to but not identical to sexual offending. Valid and reliable identification of paedophilia is complicated. Read More

J Interpers Violence 2019 10;34(20):4303-4327

2 Griffith University, Brisbane, Queensland, Australia.

This study examined the role of the reaction of the victim, the nature of the physical setting, and the proximity of third parties in deterring offenders from completing an act of child sexual abuse (CSA). A self-report study was conducted with 238 adult males serving a custodial sentence for CSA, of whom 82 identified an occasion in which they had tried to have sexual contact with a child but did not because they were stopped or discouraged. We examined the situational characteristics of the noncompleted offense and compared these with the most recent completed offense by the same offenders. Read More

J Sex Med 2019 10 22;16(10):1547-1556. Epub 2019 Aug 22.

Institute of Legal Medicine at University Hospital, Goethe University, Frankfurt, Germany.

Introduction: Non-natural deaths associated with sexual activity may occur either with or without the involvement of other persons.

Aim: The present study provides an overview of cases of non-natural death related to sexual activities as well as recommendations of how to handle these cases and to identify potentially dangerous pleasure-enhancing techniques.

Methods: This medicolegal, postmortem, retrospective, and prospective study is based on data of autopsies performed at the Institute of Legal Medicine at University Hospital, Goethe University, Frankfurt, Germany. Read More

J Sex Med 2019 10 22;16(10):1615-1622. Epub 2019 Aug 22.

Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Global Mental Health Program, Columbia University Medical Center, New York, NY, USA.

Introduction: Recently the guidelines for the diagnosis of paraphilic disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11), have been published.

Aim: This article analyzes legal, regulatory, and policy issues relevant to the potential effects of the changes for the classification of paraphilic disorders in the ICD-11 in Germany.

Methods: A forensic and a legal expert in Germany worked with other international experts to conduct this evaluation using an assessment guide provided by the World Health Organization. Read More

J Sex Med 2019 10 22;16(10):1655-1663. Epub 2019 Aug 22.

The Royal's Institute of Mental Health Research, Ottawa, Canada; University of Ottawa, Ottawa, Canada.

Introduction: The Revised Screening Scale for Pedophilic Interests (SSPI-2) was developed as a screening measure for pedophilia (sexual interest in prepubescent children), but the SSPI-2 items reflect offending against both prepubescent and pubescent children, roughly corresponding to victims under age 15.

Aim: We examined whether the SSPI-2 is better interpreted as a measure of pedohebephilia (sexual interest in both prepubescent and pubescent children) by reanalyzing the original SSPI-2 data and reporting its new psychometric properties.

Methods: The sample was comprised of 1,900 men whose clinical assessment data were entered into an archival database. Read More

Arch Sex Behav 2020 01 14;49(1):19-23. Epub 2019 Aug 14.

Department of Psychology, University of Saskatchewan, Saskatoon, SK, S7N 5A5, Canada.

Cyberpsychol Behav Soc Netw 2019 Aug;22(8):552-557

2School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom.

Cyberbullying is a growing problem in the fast-evolving world of social media. Although this problem has been studied extensively, there is relatively little research examining it from the angle of the dark tetrad (i.e. Read More

Hist Psychiatry 2019 Dec 21;30(4):469-479. Epub 2019 Jul 21.

Maastricht University (external PhD program), The Netherlands.

The ostensibly bizarre crime of braid-cutting invited occasional alienist inferences from the late 1850s onwards, until it entered mid-1880s police profiles and forensic-psychiatric taxonomies as a corollary of perversion, specifically sadism and fetishism. Cases were rare, but were reported as late as the mid-1930s and enduringly cited as encompassing a staple variety of fetishism. This note briefly reconstructs entries in German, French and English forensic psychiatry, sexual psychopathology and psychoanalysis. Read More

J Am Psychoanal Assoc 2019 06;67(3):425-454

Although there is an extensive psychoanalytic literature on perversion, and numerous articles about creativity, few authors have explored relations between creativity and perversion. In particular, the role of childhood trauma and its impact on object relations has not been examined in patients with perversions whose creativity is blocked. In association with preoedipal anxieties and fantasies, childhood trauma can not only contribute to the development of perversion, but can also inhibit or distort the creative process by establishing an inner world characterized by the presence of a threatening internal bad object and the elusiveness of an internal good object. Read More

J Psychiatr Pract 2019 Jul;25(4):242-257

GIBBELS, KNEER, HARTMANN, KRUEGER: Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.

Sexual violence is a significant and devastating issue for men and women throughout the world. Its consequences are not only disastrous for victims of sexual violence but are also extremely costly (estimated cost of $41,000 per rape) for society. Successful treatment of sexual offenders is therefore an important goal for society as well as for victims and offenders themselves. Read More

Arch Sex Behav 2020 01 28;49(1):49-52. Epub 2019 Jun 28.

Understanding Infantilism.org, Sunnyvale, CA, USA.

Child Abuse Negl 2019 09 26;95:104035. Epub 2019 Jun 26.

Iowa State University, 203A East Hall, 510 Farm House Lane, Ames, IA, 50011-1070, United States. Electronic address:

Background: Adverse childhood experiences are associated with multiple negative behavioral outcomes and childhood sexual abuse (CSA) is particularly damaging. There is controversial evidence that CSA has a specialized effect on subsequent sexual offending.

Objective: The current study tested the hypothesis that CSA is associated with sexual offending. Read More

Int Rev Psychiatry 2019 03;31(2):111-113

a Sexual Behaviours Clinic, Integrated Forensic Program , The Royal , Ottawa , ON , Canada.

Med Hist 2019 07;63(3):330-351

The Czech Republic holds one of the highest numbers of men labelled as sexual delinquents worldwide who have undergone the irreversible process of surgical castration - a policy that has elicited strong international criticism. Nevertheless, Czech sexology has not changed its attitude towards 'therapeutic castration', which remains widely accepted and practised. In this paper, we analyse the negotiation of expertise supporting castration and demonstrate how the changes in institutional matrices and networks of experts (Eyal 2013) have impacted the categorisation of patients and the methods of treatment. Read More

J Sex Med 2019 08 14;16(8):1264-1273. Epub 2019 Jun 14.

Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland; Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California, San Diego, CA, USA.

Introduction: Human sexuality is a multidimensional phenomenon related to several factors, such as self-esteem, awareness of sexual needs, and ability to communicate them to others.

Aim: To examine the sexual characteristics of patients seeking treatment for compulsive sexual behavior disorder (CSBD)-a clinical diagnosis recently included in the 11th edition of the International Classification of Diseases classification.

Methods: We have investigated the sexual characteristics of 72 Polish men seeking treatment for CSBD compared with 208 men from the Polish general population. Read More