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In the iagnostic and Statistical Manual o Mental isorders (DSM), paraphilic disorders are oftenmisunderstood as a catch-all definition for any unusual sexual behavior. In the upcoming fifth edition ofthe book, DSM-5, the Sexual and Gender Identity Disorders Work Group sought to draw a line betweenatypical human behavior and behavior that causes mental distress to a person or makes the person aserious threat to the psychological and physical well-being of other individuals. While legal implicationsof paraphilic disorders were considered seriously in revising diagnostic criteria, the goal was to updatethe disorders in this category based on the latest science and effective clinical practice.Through careful consideration of the research as well as of the collective clinical knowledge of expertsin the field, several important changes were made to the criteria of paraphilic disorders, or paraphiliasas they have been called in previous editions of the manual.Choroderistics of Porophilic DisordersMost people with atypical sexual interests do not have a mental disorder. To be diagnosed with a paraphilic disorder, DSM-5 requires that people with these interests: feel personal distress about their interest, not merely distress resulting from society s disapproval;

or have a sexual desire or behavior that involves another person s psychological distress, injury, or

death, or a desire for sexual behaviors involving unwi lling persons or persons unable to give legalconsent.

To further define the line between an atypical sexual interest and disorder, the Work Group revised thenames of these disorders to differentiate between the behavior itself and the disorder stemming fromthat behavior (i.e., Sexual Masochism in DSM-IV will be titled Sexual Masochism Disorder in DSM-5).It is a subtle but crucial difference that makes it possible for an individual to engage in consensual atypical sexual behavior without inappropriately being labeled with a mental disorder. With this revision,DSM-5 clearly distinguishes between atypical sexual interests and mental disorders involving thesedesires or behaviors.The chapter on paraphilic disorders includes eight conditions: exhibitionistic disorder, fetishistic disorder, frotteuristic disorder, pedophilic disorder, sexual masochism disorder, sexual sadism disorder,transvestic disorder, and voyeuristic disorder.

dditional Changes to Paraphilic DisordersOther changes to diagnostic criteria for two DSM-5 paraphilic disorders also should be noted.The first concerns transvestic disorder, which identifies people who are sexually aroused by dressing asthe opposite sex but who experience significant distress or impairment in their lives socially or occupationally because of their behavior. DSM-IV limited this behavior to heterosexual males; DSM 5 hasno such restriction, opening the diagnosis to women or gay men who have this sexual interest. While

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the change could increase the numberof people diagno sed with transv estic disorder, the requirementremains th t individuals mu st experience signif icant distress or im pa irme nt because of their behav ior.In t he case of pedophi l ic disorder, the notable detail is what wasn t revised in the new manual. Although proposals were discussed th roughout the DSM -5 deve lopm ent process, d iagnostic criteria u ltimately remained the same as in DSM-IV TR. Onlyt he disorder na mewill be changed f rom pedop hiliatopedophilic disorder to m aintain consistency with the chapter s o ther listings.

DSM s the manual used by clinicians and researchers to diagnoseand classify mental disorders. The American PsychiatricAssociation {APA will publish DSM-5 in 2013 culminating a14-year revision process. For more inform ation go to ': :f_Ww.18:05&rg.APA is national medical specialty society whose morethan 36 000 physician members specialize in the diagnosis, treatment prevention and research of mental illnesses, including substance use disorders. Visit the APA t ;{L_vvw.osvchlatry..:.Qr:g.For more information pleasecontact Eve Herold at 703 907 8640or 2 r e _ ; ; _ , s @ o s \ ~ _ d ) . . , Q r . g . 20 13 American Psychiatric Association


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NEWS RELEASE

For Info rm atio n Contact:Eve Hero ld , 703-907-8640pres8@ psyc h.orqErin C onnors , 703-907-8562econnors@ psych .org

MERICNPsYcHI TRIC ssoci TION~ . . . ,t B o u u ; \ ~ l l ) . Surr 1825 [ l . ; o ~ . V 222 9 ~ For Im med ia te Releas e:October 31 2013

A PAState ment on DSM-5 T extE rr oredophilicdis ord ertext e rr ort becorre cte dTheAm eric an Psych ia tr ic Associa tio n 's (APA)Dia gnosti ca ndStatistic a l Manual of M enta lD is ord ers, F ifth Editi on(DSM -5) has recentlybeen publis hedaf te r acom prehens ive m u lt i- yearre search andrev ie w of allofits d ia gnostic cate gori es.Inth ecase of pedophi l ic d isord er, th e d ia gnostic criteria essenti a lly rem ain edt hes am eas inD SM -I V -T R . O n ly thed is order nam ew asc hanged fr om pedophilia topedophi l icd isord er tom ain ta in cons is te ncywith thechapter' s oth er d isorderlistings. Sexua lo rie ntati on isnot a term used in th ed ia gnosti c criteriafo rpedophilic isor erand itsusein theD SM -5 textd is cuss io n is an e rro r andshou ldread sexua l in te re st. Infact,APAconsiders pedoph ilic d isorde r a paraphilia , not a sexua lor ie nta tio n. Th is e rro rwi ll becorr ecte d in th ee le c tr on ic vers ionof D SM -5 and the nex tp rin tingofth em anual.P s tands fi rm ly behindeffo rts to crim ina ll yp rosecu teth ose who sexua lly a buseandexplo it ch ild re nand ado lescents .Wea lso support conti nued effo rts to deve lo ptrea tm ents fo r th osew ith pedoph ilic isor er withtheg oal ofpreventingfutu reactsofabuse.


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12-17681 #126