Cynthia S Osborne and Thomas N Wise

Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Introduction 294

Defining and Conceptualizing the Paraphilias 294

Prevalence 295

Gender and the Paraphilias 296

Comorbidity 297

The DSM-IV-TR Listed Paraphilias 298

Voyeurism, Exhibitionism, and Frotteurism 298

Voyeurism 298

Exhibitionism 298

Frotteurism 300

Sexual Sadism and Sexual Masochism 300

Fetishism and Transvestic Fetishism 302

Fetishism 302

Transvestic Fetishism 303

Pedophilia 305

Paraphilia Not Otherwise Specified 306

Etiology of the Paraphilias 307

Psychoanalytic Models of Etiology 307

Psychoanalytic View of Fetishism 307

Psychoanalytic View of Transvestic Fetishism 307

Psychoanalytic View of Exhibitionism 308

Psychoanalytic View of Sadomasochism 308

294

Osborne and Wise

Family Dysfunction Models of Etiology

309

Behavioral Models of Etiology

309

Conditioning Theories of Paraphilia

309

Deviant Arousal Theory of Paraphilia

310

Courtship Disorder Theory of the Paraphilias

311

Personality Theories of the Paraphilias

311

Biological Theories of the Paraphilias

312

Treatment of the Paraphilias

314

Pharmacological Treatment of the Paraphilias

314

Antidepressants

314

Antiandrogens

315

Neuroleptics and Other Agents

316

Psychological Treatment of the Paraphilias

317

Psychiatric Assessment of Paraphilias

318

Cognitive-Behavioral Treatment

320

Conclusion

322

References

323

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