Clinical characteristics and psychiatric comorbidity in males with exhibitionism.
ABSTRACT This study was constructed to detail the demographic and phenomenological features of males with exhibitionism.
Male subjects with DSM-IV exhibitionism were administered a semistructured interview to elicit demographic data and information on the phenomenology, age at onset, and associated features of the disorder. Subjects also underwent structured clinical interviews to assess both Axis I and Axis II comorbidities. Data were collected from September 2003 to March 2005.
Twenty-five males with exhibitionism (mean +/- SD age = 35.0 +/-13.1 years [range, 14-68 years]) were studied. The majority of subjects were single (60% [N = 15]) and heterosexual (80% [N = 20]). The mean +/- SD age at onset for exhibitionism was 23.4 +/-13.1 years. All subjects reported urges to expose themselves with little control over these urges. Exposing oneself while driving was the most common expression of the disorder. Twenty-three (92%) suffered from a current comorbid Axis I disorder (major depressive disorder, compulsive sexual behavior, and substance use disorders were most common), and 40% (N = 10) suffered from a personality disorder. Suicidal thoughts were common (52% [N = 13]), and many (36% [N = 9]) had been arrested for exhibitionism.
Exhibitionism appears to be associated with high rates of psychiatric comorbidity and impairment. Research is needed to optimize patient care for men with this disorder.
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- "Psychotropic drugs may be effective solely in men with a definite obsessive-compulsive disorder component (Rosler & Witztum, 2000). The neurobiological, neuropharmacological, and pharmacological treatment of paraphilias and compulsive sexual behavior are useful in the treatment of paraphilia-disordered sexual offenders, and these can enhance the remitting process in offenders (Bradford, 2001; Briken, Hill, & Berner, 2003; Briken, Hill, Nika, & Berner, 2005; Grant, 2005; Maletzky & Field, 2003; Pontius & LeMay, 2003). We argue that it would be useful to carry out treatment where there is a combination of medical treatment and therapy that addresses thoughts and behavior, such as cognitive–behavioral therapy and schema-focused therapy (Beech & Mitchell, 2005). "
ABSTRACT: This article renders the results of research that investigated personality disorders in a sample of paraphilic and nonparaphilic child molesters. The sample contained 36 paraphilic child molesters and a matched comparison group of 34 nonparaphilic child molesters. The analyses of the research results show that four personality disorders discriminate between both groups. Only the obsessive-compulsive personality disorder contributes significantly to the explanation of paraphilic child molestation. This result also contributes to the development and differentiation of the treatment of paraphilia-related disorders. For several child molesters, psychological approaches to the treatment of sexual offending (e.g., cognitive-behavioral treatment, psychotherapy in general) are limited and cannot be expected to immediately reduce risk. Interest has been expressed in medical approaches to reduce recidivism, in combination with psychotherapy.International Journal of Offender Therapy and Comparative Criminology 03/2008; 52(1):21-30. DOI:10.1177/0306624X07308261 · 0.84 Impact Factor
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- "De fato, este curso de aparecimento dos sintomas parece refletir o período habitual de desenvolvimento dos transtornos psiquiátricos em análise. Em outras palavras, pacientes com TOC costumam apresentar início precoce ou até mesmo pré-puberal dos sintomas (Rosário-Campos et al., 2001; Fontenelle et al., 2003), enquanto pacientes com parafilias só apresentam os sintomas deste transtorno quando se encontram em um estágio mais avançado do desenvolvimento psicossexual (Grant, 2005). A relação temporal entre os transtornos psiquiátricos aqui descritos também contradiz a hipótese de que o TOC possa ser uma condição secundária às parafilias, ou seja, uma tentativa de suprimir desejos, fantasias ou atos sexuais inaceitáveis (Stein, 1994). "
ABSTRACT: LF, Mendlowicz MV, Marques C, Versiani M. Early- and late-onset obsessive- compulsive disorder in adult patients: an exploratory clinical and therapeutic Gijs L, Gooren L. Hormonal and psychopharmacological interventions in the treatment of : an updateJornal brasileiro de psiquiatria 01/2007; DOI:10.1590/S0047-20852007000300010
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- "Mood disorders and attention-deficit/hyperactivity disorder have been reported as prevalent among males with paraphilic disorders (Grant, 2005; Kafka & Hennen, 2002; Kafka & Prentky, 1998), including pedophiles (Raymond, Coleman, Ohlerking, Christenson, & Miner, 1999), as well as other sexual offender subtypes (Ahlmeyer, Kleinsasser, Stoner, & Retzlaff, 2003; Dunsieth et al., 2004). Attention-deficit/hyperactivity disorder, combined subtype, has been associated with conduct disorder (common in adolescent sexual offenders; Kavoussi, Kaplan, & Becker, 1988) and is a precursor to antisocial personality disorder (APD) in adult sexual (and nonsexual) offenders. "
ABSTRACT: Adjudication of sexually violent predator commitment laws places demands on science. In the current article, the authors discuss the determination of mental abnormality and its reliance on medical nosological systems. Second, the authors examine the determination of current risk by reviewing three common concerns: (a) mechanistic estimations of risk, (b) mitigation of risk as a function of age, and (c) estimation of contemporaneous (dynamic) risk. The authors focus specifically on determinations of risk posed by the nexus of mental abnormality with prior history of sexually violent acts. Third, the article examines relevant, though sometimes nonstatutory, considerations, namely, the standards and the expectation for the treatment provided in high-security civil commitment programs. Potentially important dynamic or time-varying factors that may mitigate risk, such as offender age and treatment, are considered. Recommendations to promote good science and to avoid bad science are included with respect to determinations of mental abnormality, risk of reoffending, and treatment.Psychology Public Policy and Law 10/2006; DOI:10.1037/1076-89220.127.116.117 · 1.93 Impact Factor