Richard Krueger

Richard Krueger
Columbia University | CU · Department of Psychiatry

About

53
Publications
70,739
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1,806
Citations
Citations since 2016
18 Research Items
1232 Citations
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2016201720182019202020212022050100150200
2016201720182019202020212022050100150200

Publications

Publications (53)
Article
Full-text available
Aim: This study aimed to identify whether clinicians' gender, clinical experience, and personal attitudes influenced their perception of criminality of specific sexual behaviours, their judgments about criminal liability if mentally disordered, and the need for treatment as part of criminal settings for those having ICD-11 paraphilic disorders. Me...
Article
Background The diagnosis of paraphilic disorder is a complicated clinical judgment based on the integration of information from multiple dimensions to arrive at a categorical (present/absent) conclusion. The recent update of the guidelines for paraphilic disorders in ICD-11 presents an opportunity to investigate how mental health professionals use...
Article
Full-text available
It has often been suggested that the field would benefit from a single, unified classification of mental disorders, although the priorities and constituencies of the two sponsoring organizations are quite different. During the development of the ICD-11 and DSM-5, the World Health Organization (WHO) and the APA made efforts toward harmonizing the tw...
Article
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 pa...
Article
Full-text available
During the last decade, there has been heated debate regarding whether compulsive sexual behaviour should be classified as a mental/behavioural disorder. Compulsive sexual behaviour disorder has been proposed for inclusion as an impulse control disorder in the ICD-11. It is characterized by a persistent pattern of failure to control intense, repeti...
Article
Full-text available
Objectives The present study aims to evaluate existing policy and practice relating to the use of pharmacological treatments with patients suffering from paraphilic disorders who are at risk of committing further sexual offences. Methods A systematic literature search was conducted to document current legal policies across 26 different countries....
Article
Full-text available
The World Health Organization is currently developing the 11th revision of the International Classifications of Diseases and Related Health Problems (ICD-11), with approval of the ICD-11 by the World Health Assembly anticipated in 2018. The Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH) was created and charged wi...
Data
Full-text available
En la próxima undécima revisión de la Clasifcación Internacional de las Enfermedades y Problemas de Salud Relacionados (ICD-11) de la Organización Mundial de la Salud, se han propuesto cambios sustanciales a la clasificación de los trastornos mentales y conductuales relacionados con la sexualidad y la identidad de género de la ICD-10. Estos concier...
Article
Full-text available
Diagnoses that could refer to compulsive sexual behavior have been included in the DSM and ICD for years and can now be diagnosed legitimately in the United States using both DSM-5 and the recently mandated ICD-10 diagnostic coding. Compulsive sexual behavior disorder is being considered for ICD-11.
Article
Full-text available
In the World Health Organization's forthcoming eleventh revision of the International Classification of Diseases and Related Health Problems (ICD-11), substantial changes have been proposed to the ICD-10 classification of mental and behavioural disorders related to sexuality and gender identity. These concern the following ICD-10 disorder groupings...
Chapter
Full-text available
This chapter will review the noncontact crimes of exhibitionism, voyeurism, possession of child pornography, and interacting with children over the Internet. Epidemiology, comorbidity, offender characteristics, risk of recidivism, relevant diagnoses according to DSM-IV-TR and NB-DSM-5 including methods for making them, and relevant treatment modali...
Chapter
This chapter reviews the major paraphilic disorders included in DSM-5. Voyeurism and exhibitionism are among the most common paraphilic disorders in clinical studies. The study of neurobiological factors and paraphilic disorders is in its infancy, but it is clear that they play a significant role in paraphilic behavior and paraphilic disorders. Tre...
Article
Traumatic brain injury (TBI) is one of the leading causes of permanent disability in young adults and is frequently accompanied by changes in sexual behaviors. Satisfying sexuality is an important factor for overall quality of life in people with disabilities. The purpose of this article is to review the studies evaluating the assessment, correlate...
Article
Full-text available
Use of the Internet has been increasingly associated with sexual behaviors. Referred to as online sexual activity, these sexual behaviors include cybersexual behavior and pornography usage. Child custody evaluators are increasingly being asked to assess the impact of these behaviors on child custody and visitation determinations. In this article, w...
Article
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Background: The DSM-5 has been under revision since 1999 and is scheduled for publication in 2013. This article will review the major proposed modifications of the Paraphilias. Method: The information reviewed was obtained from PubMed, PsychInfo, the DSM-5.org website and other sources and reviewed. Results: Pedohebephilia, Hypersexual Disorde...
Article
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Background: Sexual offenders continue to occupy the public's attention; a significant proportion of this population is diagnosed with paraphilias. Cognitivebehavioral treatment has been the mainstay of treatment for sex offenders and for the paraphilias for the past three decades. This article will review the history of cognitivebehavioral therapy...
Article
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I reviewed the empirical literature for 1900-2008 on the paraphilia of Sexual Masochism for the Sexual and Gender Identity Disorders Work Group for the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The results of this review were tabulated into a general summary of the criticisms relevant to the DSM diagnos...
Article
Full-text available
This article reviews the current evidence base for the diagnosis, assessment, and treatment of hypersexual conditions. Controversy concerning this diagnosis is discussed. Terminology and diagnostic criteria, as well as psychological, psychopharmacological, and other treatment approaches, are presented.
Article
Full-text available
I reviewed the empirical literature for 1900-2008 on the paraphilia of Sexual Sadism for the Sexual and Gender Identity Disorders Workgroup for the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The results of this review were tabulated into a general summary of the criticisms relevant to the DSM diagn...
Article
Full-text available
This study was conducted to describe Axis I sexual diagnoses of 60 males arrested for possession of child pornography obtained via the Internet and/or attempting to meet children via the Internet. Data was obtained from a chart review of evaluations conducted on 60 males referred for a psychosexual evaluation following an arrest for possession of c...
Article
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This article describes the characteristics of sex offenders, discusses various registration and notification laws, addresses the civil commitment of sex offenders, analyzes the various problems with current responses to sex offenders, reports current options for treating sex offenders, and provides various recommendations for implementing a more ap...
Article
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This article provides a case report of a patient with pedophilia who was treated over a 4-year period with medroxyprogesterone acetate (MPA) at a dose of 300 mg/day and as a consequence developed Cushing's Syndrome and adrenal insufficiency, for which he was treated and from which he recovered. He also reported a hypersexual reaction to his own pas...
Article
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In this article, the second of a two-part series, the authors present information on the clinical assessment of individuals with paraphilias and hypersexual disorders. They review ethical considerations in the assessment and treatment of individuals with paraphilias. The role of interview and subjective and objective instruments in the assessment o...
Article
In this article, the first of a two-part series, the authors present reasons for considering the paraphilic and hypersexual disorders together and provide an overview of these disorders. The DSM-IV diagnostic criteria for paraphilias are reviewed, and proposed criteria for hypersexual disorders are presented. The question of whether the paraphilic...
Article
Full-text available
A new class of antiandrogen medications, gonadotropin-releasing hormone agonists, offers promise in the treatment of the paraphilias, with substantially less side effects than medroxyprogesterone acetate or cyproterone acetate. This paper reports the results of treatment using a depot suspension of leuprolide acetate on 12 patients with paraphilic...
Article
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This article reviews hypersexuality in individuals with neuropsychiatric disorders and its psychopharmacologic treatment. A brief review of the neurology, neuroendocrinology, and neuropharmacology of sexual behavior is presented. Literature describing the occurrence and treatment of hypersexuality in individuals with neuropsychiatric disorders is r...
Article
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This article briefly reviews objective methods of assessing sexual interest and/or arousal and mentions some of the disadvantages of penile plethysmography. Literature that supports the use of viewing time as a measurement of sexual interest is reviewed. A detailed description of a new system of assessing sexual interest, called the Abel Assessment...
Article
Standard pretreatment clinical electroencephalograms (EEGs) were abnormal in 18.6% of 140 consecutive patients with Research Diagnostic Criteria (RDC) endogenous major depression. The patients were randomized to unilateral or bilateral and low- and high-dosage electroconvulsive therapy (ECT) conditions. Clinical features, short-term treatment respo...
Article
Recent evidence indicates that in major depressive disorder, the magnitude by which electrical dosage exceeds the individual's seizure threshold is critical to the efficacy of unilateral electroconvulsive therapy, and to the speed of response of bilateral electroconvulsive therapy. Electroconvulsive therapy appears to be as effective, if not more e...
Article
Empirical titration procedures increasingly are being used to estimate initial seizure threshold. These procedures involve the administration of subconvulsive electrical stimulation. There has yet to be evaluation of the impact of such stimulation on the acute cognitive consequences of electroconvulsive therapy. In two studies we randomized depress...
Article
Recent research has raised the possibility that electroconvulsive therapy (ECT) results in a persistent elevation of seizure threshold among males. In this study, seizure threshold, quantified by the method of limits procedure, was assessed at the first and last treatments of 148 consecutive depressed patients. Patients with and without a prior his...
Article
Electroconvulsive therapy (ECT) is an extremely effective treatment for a variety of psychiatric syndromes. However, it is frequently associated with transient cognitive side effects. Recent research has shown that these effects are sensitive to a number of treatment parameters, such as electrode placement and stimulus dosage, that the clinician ma...

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Project
The World Health Organization is developing the 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), planned for publication in 2018. The Working Group on the Classification of Sexual Disorders and Sexual Health was charged with reviewing and making recommendations on disease categories related to sexuality and gender identity in the chapter on mental and behavioral disorders in the 10th revision (ICD-10), published in 1990.