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Paraphilia (in section). Also, it may describe sexual feelings toward otherwise non-sexual objects. =Clinical views of paraphilias= There is much debate about what (if anything) should constitute a paraphiliac, and how these should be clinically classified ''(see Controversy , below)''. Clinically recognized paraphilias Clinical literature discusses eight major paraphilias individually.http://psyweb.com/Mdisord/DSM_IV/jsp/Axis_I.jsp According to the '' Diagnostic And Statistical Manual Of Mental Disorders '', the activity must be the sole means of sexual gratification for a period of six (6) months, and either cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning" or involve a violation of Consent to be diagnosed as a paraphilia.http://ajp.psychiatryonline.org/cgi/content/full/159/7/1249
Homosexuality was previously listed as a paraphilia in the DSM-I and DSM-II . Consistent with the change in consensus among psychiatrists it was not included in later editions. A disorder of clinical distress caused by the ''repression'' of homosexuality is still listed. Literature also documents many other paraphilias, both common and rare. Intensity and specificity Clinicians distinguish between optional, preferred and exclusive paraphilias, though the terminology is not completely standardized. An "optional" paraphilia is an alternative route to sexual arousal. For example, a man with otherwise unremarkable sexual interests might sometimes seek or enhance sexual arousal by wearing women's underwear. In preferred paraphilias, a person prefers the paraphilia to conventional sexual activities, but also engages in conventional sexual activities. For example, a man might prefer to wear women's underwear during sexual activity, whenever possible. In exclusive paraphilias, a person is unable to become sexually aroused in the absence of the paraphilia. Optional paraphilias are far more common than preferred paraphilias, which are, in turn, far more common than exclusive paraphilias. Optional paraphilias sometimes disrupt stable relationships when discovered by an unsuspecting partner. Preferred paraphilias often disrupt otherwise stable relationships. Open communication and mutual support can minimize or prevent such disruption in both of these cases. Exclusive paraphilias often preclude normal courtship and committed romantic relationships, even when the person in question desires such a relationship. Loneliness or social isolation are common consequences. In extreme cases, preoccupation with a preferred or exclusive paraphilia completely displaces the more typical desire for loving human relationships. Psychology of paraphilias Behavioral imprinting Observation of paraphiliac behavior has provided valuable scientific information on the mechanisms of Sexual Attraction and Desire , such as Behavioral Imprinting . Careful investigation has also led to the tentative conclusions that normal biological processes may sometimes be manifested in idiosyncratic ways in at least some of the paraphilias, and that these unusual manifestations are frequently associated with unusual (and especially traumatic) events associated with early sexual experience. They tend to be caused by Classical Conditioning in that a sexual stimulus has been paired with stimuli and situations that do not typically result in sexual response and has then been perpetuated through Operant Conditioning because the sexual response is its own reward or Positive Reinforcement . NON-CLINICAL VIEWS ON PARAPHILIAS Religious views See Also: Religion and sexuality Some religious adherents view various paraphilias as deviations from their conception of their religion's deities' plan for human sexuality, or from their religious laws. Depending in part on the nature of the paraphilia in question, judgements can differ as to whether religiously it should be considered a case of sexual Sin , Mental Illness , or simply harmless sexual variation. Another variable is whether it is the acting out, or (less commonly) just the desirous thought alone, which is critically viewed in such cases. In any event, several paraphilias, as with many other behavior patterns outside the mainstream, are viewed negatively by various religions. Some religious traditions include forms of extreme Asceticism , such as Whipping , which, when practiced as sexual activities, would usually be considered masochism and popularly viewed as paraphilias. When practiced for non-sexual reasons, they are usually valued by the religious groups concerned as a part of their religious observance and submission to God . Legal views See Also: Sex and the law As a general rule, the law in many countries often intervenes in paraphilias involving young or adolescent children below the legal Age Of Consent , nonconsensual deliberate displays or illicit watching of sexual activity, consensual sex with animals, illegal manipulation of Dead People , harassment, nuisance, fear, injury, or assault of a sexual nature. Separately, it also usually regulates or controls Censorship of Pornographic material. ''Exhibitionism'', in cases where people who have not previously agreed to watch are exposed to sexual display, is also an offense in most jurisdictions, as is Voyeurism when unarranged. ''(See Indecent Exposure and Peeping Tom )'' ''Non-consensual'' sadomasochistic acts may legally constitute assault and therefore belong in the list below. Some jurisdictions criminalize some or all sadomasochistic acts, regardless of Legal Consent , and impose liability for any injuries caused. For these purposes, non-physical injuries are included in the definition of Grievous Bodily Harm in English Law . ''(See Consent (BDSM) ), Operation Spanner '') The paraphilias listed below may carry a condition of illegality in some areas if acted out (though they may usually be legally role-played between Consenting Partners ).
Paraphilia in popular culture In the late twentieth and early twenty-first century, previously censored or stigmatized images of many paraphilias became more prevalent in the popular culture of Western countries.
Controversy over the term The definition of various sexual practices as paraphilias has been met with opposition. Advocates for changing these definitions stress that, aside from "paraphilias" with a criminal element, there is nothing inherently pathological about these practices; they are undeserving of the stigmatism associated with being "singled out" as such. Those who profess such a view hope that, much as with the removal of Homosexuality from the Diagnostic And Statistical Manual Of Mental Disorders (''see'' Homosexuality And Psychology ), future psychiatric definitions will not include most of these practices. DRUG TREATMENT OF PARAPHILIAS The treatment of men with paraphilias and related disorders has been challenging for patients and clinicians. In the past, surgical castration was advocated as a therapy for men with paraphilias, but it was abandoned because it is considered a cruel punishment and is now illegal in most countries. Psychotherapy, self-help groups, and pharmacotherapy (including the controversial hormone therapy sometimes referred to as "chemical castration") have all been used but are often unsuccessful. Here are some current drug treatments for these disorders. Hormone drug treatments In humans, Testosterone has a crucial role not only in the development and maintenance of male sexual characteristics but also in the control of sexuality, aggression, cognition, emotion, and personality. Testosterone is a major determinant of sexual desire, fantasies, and behavior, and it increases the frequency, duration, and magnitude of spontaneous and nocturnal erections. The deviant sexual fantasies, urges, and behavior of men with paraphilias also appear to be triggered by testosterone. Therefore, reducing testosterone secretion or inhibiting its action is believed to control these symptoms. Antiandrogenic drugs such as medroxyprogesterone (also known as the long-acting contraceptive Depo Provera ) have been widely used as therapy in these men to reduce sex drive. However, their efficacy is limited and they have many unpleasant side effects, including breast growth, headaches, weight gain, and reduction in bone density. Even if compliance is good, only 60 to 80 percent of men benefit from this type of drug. Long-acting gonadotropin-releasing hormones, such as Triptorelin (Trelstar) which reduces the release of gonadotropin hormones, are also used. This drug is a synthetic hormone which may also lead to reduced sex drive. Psychoactive drug treatments Selective Serotonin Reuptake Inhibitor (SSRI) class of antidepressants such as fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), and paroxitine (Paxil), have all been used to treat paraphilias and related disorders by reducing impulse control problems and/or Sexual Obsessions with some success. SSRIs work by selectively inhibiting presynaptic serotonin reuptake with minimal effect on levels of norepinephrine or dopamine. Tricyclic antidepressants (TCA), such as imipramine (Tofranil) and desipramine (Norpramin), inhibit the reuptake of serotonin and noradrenaline, and can also modify the activity of glutamatergic neurons. This effect is caused by blocking the reuptake pumps in monoamine nerve synapses, extending the length of time neurotransmitters remain in the synapse and increasing their concentration. OCD responds preferentially to the TCA clomipramine (Anafranil), which is relatively selective for serotonin reuptake. Concern about these medications, however, persist as a result of their extensive side-effects, drug interactions, and toxicity when taken in excess. Lithium, the mood-stabilizing drug also known as Eskalith is typically used for the treatment of mania in bipolar disorder. There are some reports of reduced sexual compulsive behavior and a reduction in obsessive sexual thoughts in patients, which they attribute to the drug's enhancement of serotonergic functioning. Anxiolytics are not considered a typical treatment for these type of disorders, however the efficacy of buspirone (BuSpar) has been clinically demonstrated. Psychostimulants have been used recently to augment the effects of Serotonergic drugs in paraphiliacs. In theory, the prescription of a psychostimulant without pretreatment with an SSRI might further disinhibit sexual behavior, but when taken together, the psychostimulant may actually reduce impulsive tendencies. Methylphenidate (Ritalin) is a type of amphetamine used primarily to manage the symptoms of attention deficit hyperactivity disorder (ADHD). Recent studies imply that methylphenidate may also act on serotonergic systems; this may be important in explaining the paradoxical calming effect of stimulants on ADHD patients. Amphetamine is also used medically as an adjunct to antidepressants in refractory cases of depression. (Source: BrainPhysics About Sexual Compulsions ) LIST OF PARAPHILIAS Also see article -philia for "-philias" in other fields Used in a sexual context, terms with the ''-philia'' suffix refer to conditions in which the person's primary sexual interest involves the stimulus or situation mentioned (the suffix is also used for non-sexual interest in or admiration of a subject). Terms with the ''-lagnia'' suffix refer to an action involving the stimulus or situation. For example, someone who is consistently sexually excited by feces would have coprophilia; any sexual act involving feces, even by someone for whom that is not a primary interest, would be coprolagnia. The following terms mostly represent combinations of Greek or Latin words or roots, but few qualify as clinical paraphilias. Some of the following sexual interests are fairly common, while others are very rare.
:: Balloon Fetishism -- Breast Fetishism -- Bike Fetish -- Foot Fetishism (podophilia) -- Fur Fetishism -- Leather Fetishism -- Lipstick Fetishism -- Medical Fetishism -- Panty Fetishism -- Robot Fetishism -- Rubber Fetishism -- Shoe Fetishism -- Smoking Fetishism -- Spandex Fetishism -- Dental Braces Fetishism -- Transvestic Fetishism (see below)
Note: #Sadism and masochism are often grouped together, under "sado-masochism", As A Clinical Term ; see also Algolagnia . As a ''lifestyle interest'', see BDSM ( Bondage & Discipline , Domination & Submission , and Sadism & Masochism .) SEE ALSO
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