12-24-2014 National:
by Fred S. Berlin, MD, 104 E. Biddle Street, Baltimore, MD 21202. E-mail: fredsberlinmd@comcast.net.
Psychiatric terminology should convey information in as clear and unambiguous a manner as possible. In light of the associated stigma, that is especially so of the terms Pedophilia and Pedophilic Disorder. Although from a psychiatric perspective the term Pedophilia is intended to define a recognized clinical entity, in the collective consciousness of contemporary society, the term has become a demonizing pejorative.
Many in society are likely to equate Pedophilia with child molestation. They are not the same. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)1 may be contributing inadvertently to the misconception that they are the same, for the following three reasons:
First, DSM-5 states that an indicator of a Pedophilic Disorder would be that an individual has “acted on” his sexual urges (Ref. 1, p 697). “Acted on” could mean that he has actually molested a child. On the other hand, it could also mean that he has masturbated to pedophilic fantasies or that he has viewed child pornography. The current criteria for diagnosing a Pedophilic Disorder place some persons who have never molested a child into the same diagnostic category as those who have done so. That could cause confusion, suggesting that the current definition of a Pedophilic Disorder may lack adequate diagnostic specificity. As a consequence, the distinction between being sexually attracted to children in some fashion (e.g., experiencing urges to view child pornography) and experiencing urges to act on that attraction with a child can easily be lost.
Second, at present, in discussing Pedophilia, DSM-5 makes reference to the term Pedophilic Sexual Orientation. Sexual Orientation is ordinarily used to designate the category, or categories, of persons whom a given individual finds to be sexually appealing. Those who are heterosexually oriented are sexually attracted to adults of the opposite sex; those who are homosexual, to adults of the same sex; men with a heterosexual pedophilic orientation, to prepubescent females; and men with a homosexual pedophilic orientation, to prepubescent boys.
In the face of significant criticism of its inclusion in the DSM-5, the American Psychiatric Association (APA) has stated its intention to remove the term Pedophilic Sexual Orientation from the diagnostic manual.2 Removing that term in response to public criticism would be a mistake. Experiencing ongoing sexual attractions to prepubescent children is, in essence, a form of sexual orientation, and acknowledging that reality can help to distinguish the mental makeup that is inherent to Pedophilia, from acts of child sexual abuse.
Third, in discussing the nature of a Pedophilic Disorder, DSM-5 has done little to characterize the multitude of psychiatric burdens associated with the condition, burdens that are frequently present, even in the absence of any acts of child sexual abuse. ..Continued....
Showing posts with label DSM. Show all posts
Showing posts with label DSM. Show all posts
December 24, 2014
Pedophilia and DSM-5: The Importance of Clearly Defining the Nature of a Pedophilic Disorder
December 8, 2012
APA rejects "hebephilia," last standing of three novel sexual disorders
To hear government experts on the witness stand in civil detention trials in recent months, the novel diagnosis of "hebephilia" was a fait accompli, just awaiting its formal acceptance into the upcoming fifth edition of the influential Diagnostic and Statistical Manual of Mental Disorders (DSM).
They were flat-out wrong.
In a stunning blow to psychology's burgeoning sex offender processing industry, the Board of Trustees of the American Psychiatric Association rejected the proposed diagnosis outright, not even relegating it to an appendix as meriting further study, its proponents' fall-back position.
The rejection follows the failure of two other sexual disorders proposed by the DSM-5's paraphilias subworkgroup. These were paraphilic coercive disorder (or a proclivity toward rape) and hypersexuality, an inherently hard-to-define construct that introduced the committee members' value judgments as to how much sex is within acceptable limits.
After abandoning those two disorders, the subworkgroup clung tenaciously to a whittled-down version of its proposed expansion of pedophilia to cover sexual attraction to early pubescent youngsters (generally in the age range of 11-14), ignoring widespread opposition from both within and outside of the APA.
The buzz is that senior psychiatrists in the APA were unhappy with the intransigence of psychologists in the subworkgroup who communicated the belief that if they just stuck to their guns, they could force the ill-considered proposal into the new manual, despite a lack of scientific support. ...continued... by In The News
Subscribe to:
Posts (Atom)
