INDECENT EXPOSURE AND EXHIBITIONISM IN PAPUA NEW GUINEA : A CASE REPORT

Umadevi Ambihaipahar

Felix Y Attah Johnson

University of Papua Guinea, New Guinea, P.O. Box 5623, Boroko, Papua New Guinea

RESUMEN

La exhibición incidente es el deseo compulsivo de mostrar los órganos genitales ante personas extrañas en un lugar público. Es una de los contravenciones heterosexuales más frecuentes. Este articulo describe el primer caso de exhibicionismo en un hombre melanésico de Papúa Nueva Guinea(donde hasta hace unos años la desnudez era habitual), ilustrando así un caso de “desorden de cotejo” en un melanesio como resultado de un cambio cultural.

Palabras clave: exhibicionismo, Papúa-Nueva Guinea, cambios culturales.

ABSTRAT

Indecent exposure is the urge to expose the genitals, usually before strangers, in a public place. It is one of the most common heterosexual offences. This paper reports the first case of exhibitionism in a Melanesian male from Papaua New Guinea, (where nudity was not rare a few years ago), illustrating " courtshisp disorder" in a Melanesian male that results from cultural change.

Key words: exhibitionism, Papúa-Nueva Guinea, cultural change.

In 1824 indecent exposure was first disturbance that can be extremely persistent specified as a criminal offence. Indecent and disruptive. Sometimes the act is a crude exposure remained firmly in the realm of crime form of sexual invitation used by the mentally for another fifty years until Lasegue (1877) made impaired. (Gunn an Taylor 1995). Conviction the first of a series of medical attempts to have rate for indecent exposure per one million males the behaviour recategorized ( Indecent Exposure in England and Wales ( figures from Home ana Exhibitionism by Rooth in British Journal of Office) shows that adult conviction rate Hospital Medicine, April 1971). remained steady from 1948 to 1969 whereas the rates for those under 21 years of age have The term exhibitionism is confined to those doubled since 1948 (Rooth 1971). exposers for whom genital display to a member of the opposite sex is an end in itself. They are Diagnostic Criteria: ICD-10 Code F65.2 distinguished from those other exposers in WHO 1992 states: whom the behaviour simply expresses a wish for intercourse or masturbation, or is the preliminary Exhibitionism is " a recurrent or persistent to an intended sexual assault (Rooth, 1971). tendency to expose the genitalia to strangers ( usually of the opposite sex) or to people in public "Indecent exposure of the male person with places, without inviting or intending closer intent to insult a female is the statutory definition contact. There is usually, but not invariably, of the offence colloquially known as flashing". sexual excitement at the time of the exposure (Gunn and Taylor 1995). and the act is commonly followed by masturbation." Clinically, it is the urge to expose the genitals, usually in front of strangers in a public Diagnostic Criteria for DSM- IV Code No place. It is one of the most common of 302.4 heterosexual offences (Gunn and Taylor). Exhibitionism are as follows:

Despite its superficially innocuous nature, "(A) Over a period of at least six months, exhibitionism is a form of sexual recurrent, intense sexually arousing fantasies, sexual urges, or behaviours involving the

Rev.Latinoam.Der.Méd. Medic. Leg. 1(2) / 2(1): 69-71, 1996/1997 Revista Latinoamericana de Derecho Médico y Medicina Legal

exposure of one's genitals to an unsuspecting are lodging with his adoptive family. Other stranger". complaints were mutism ( not answering or responding to simple questions) and "(B) The fantasies, sexual urges, or occasionally laughing inappropriately. behaviours cause clinically significant distress or impairment in social, occupational, or other His adoptive father reported that the patient important areas of functioning". had the above symptoms for about one year before consultation and admisssion. He did not (DSM-IV of the American Psychiatric Association respond to persistent psychosocial counselling 1994 ). to stop him from exposing his external genitalia to females. Exhibitionism is mainly a disorder of males, but women sometimes indecently expose their On the day before admission to hospital, the genitals too. This may be done to please man indecently exposed his external genitalia to inmates, for exemple, during a prison visit his adoptive father's sister, who is a married (Gunn and Taylor 1995). The " flash" or "flash- woman in her middle age. up" may occur during prison visiting when a wife, girlfriend or even paid prostitute will briefly The patient was legally adopted by his expose her breasts or lift her skirt having gone to present social parents shortly after birth through the prison without the relevant items of Social Welfare Services. There is no information underclothing (Morris and Morris 1963). The about his biological parents. The adoptive father, fantasies which accompany acts of aged about 50, is a retired school teacher. His exhibitionism, or during masturbation to memory adoptive mother ( aged about 45 years ) is a of the scene of exbibitionism, give some clue to housewife. He has two other adoptive brothers the complex inner meaning of this superficially aged 23 and 15 years. irrational behaviour. If the victims appear shocked, or at least impressed by the act, this The patient's childhood was normal until he gives a feeling of sexual power and control, even was 16 years old, later on he showed some though at a safe distance, and thus signs of mixed emotional and conduct disorder. compensates for feelings of inferiority and He was disobedient and played truant from inadequacy in real life ( Rooth 1971) . school until he eventually stopped attending on the fifth grade. He also started drinking beer in According to Gunn an d Taylor (1995): The moderation and was caught somoking cigarettes conditioning effect resulting from constant occasionally. He denied any history of abusing repetition of their ritual act"may permit these cannabis. men to attain maximal sexual arousal more easily in these situations than in what are for He has never been arrested by the police them nore threatening personal relationships". for breaking any law.

Gebhard et al. (1965) found that the majority A complete physical examination ( including of exhibitionists do not resort to violence, but neurological examination) showed no 10% attempt or contemplate rape. abnormality. pulse rate was 80 beats per minute, with regular rhythm and normal volume, and The present case report is the first blood presure was 120/80 mm of mercury. published report in a Melanesiam from Papua New Guinea. This patient was admitted to the Psychiatric Unit of the Port Moresby General Hospital for a Case Report month. He responded well to supportive psychotherapy and pharmacotherapy with Patient is a 21 year old Melanesian male chlorpromazine Tablets 100 mg three times daily whose home in in the Central Province of and benzhexol Tablets 5 mg daily. Papua New Guinea. He was first admitted to hospital in early 1994. He had never married and He was discharged home under the was unemployed. supervision of his adoptive father on maintenance medication with chlorpromazine He was admitted to hospital mainly for 50mg Tablets three times daily. He was offered repeatedly exposing his external genitalia to outpatient follow-up appointment at monthly female strangers and his female cousins who intervals.

His father reported that he had not exposed himself eighteen months later. He

70 Umadevi Ambihaipahar / Felix Y. Attah Johnson / Indecent Exposure and Exibitionism in Papua New Guinea: a Case Report

continued to attent the psychiatric outpatient the existence of a discrete syndrome, which may clinic for a review of his mental state, which has be described as " courtship disorder" (Freund remained normal, at three month intervals. and Blanchard 1986).

Discussion References Two important factors have been proposed to explain the aetiology . The first aetiological 1. American Psychiatric Association. factor is enhancement of the infantile component Diagnostic and Statistical Manual of of sexual drives and the second is a disturbance Mental Disorders, Fourth Edition (DMS- in early objets relations. Parental attitude can IV). 1994 pp: 525-526. APA, exert a particular influence at puberty by Washington, D.C. enforcing rigid prohibitions against sexual enjoyment. The development of exhibitionism is 2. Comings, D.E., and Comings B.G. associated with a seductive relationships with Tourette Syndrome: Clinical and the mother and severe castration anxiety arising psychological aspects of 250 cases. from the child's incestuous yearning (Rooth American J. Human Genetics 1985, 37: 1971) . pp: 435-450.

Comings and Comings (1985) in their 3. Freund, K. and Blanchard. The clinical and psychological study of 250 patients Concept of Courtship Disorder. J. Sex with Tourette Syndrome showed that 15.9% of and Marital Therapy 1986. 12: 79-92 males and 6.1% of females had exhibitionism along with other psychiatric disorders. Grob 4. Gebhard, P.H., Gagnon, J.H., (1985) published a case report of a woman Pomeroy, W.B., and Christenson, C.V. whose emotional deprivation led to feelings of Sex Offenders 1965. Heinneman: rejection and inability to develop an empathic Londres relationship. 5. Grob C.S. Female Exhibitionism. J. Her self- esteem relied on success in her Nerv. Ment. Dis. 1985, 173: pp 253- profession and when she lost her position she 256. sought validation through exhibitionism. This case report demonstrated the existence of such 6. Gunn, J., and Taylor, P. Forensic phenomena in women. Psychiatry: Clinical, Legal and Ethical Issues. 1995: pp 547-548. Butterworth- The present case-report is the first Heinemann. Oxford. published report of exhibitionism in a Melanesiam male from Papua New Guinea. 7. Lasegue, C. Union Medicale, 1877, 23: 709. The case- report is also important for two reasons, namely,from the point of view of clinical 8. Morris, T. and Morris P. Pentoville: A practice and that of medico-legal ( forensic Sociological Study of an English Prison. psychiatric) practice. Our case - report is 1963. Routledge and Kegan, P. supported by the concept of " courtship Londres. disorder". which was described by Freund and Blanchard (1986) . They described four phases 9. Rooth, F, G. Some Historical Notes on of normal human male courtship behaviour as Indecent Exposure and Exhibitionism. follows: (1) location and appraisal of a potencial Med. Legal J. (Camb.) 1970, 38, pp: partner. (2) pretactile interaction, for exemple, 135-139. smiling at, posturing for, or talking to a prospective partner. (3) tactile interaction, for 10. Rooth, F.,G. Indecent Exposure and exemple, embracing and petting and (4) Exhibitionism. British Journal of effecting genital union. They further suggested Hospital Medicine, 1971, 5: pp: 521- 534.

11. World Health Organization. International Classification of Mental and Behavioural Disorders, Tenth Edition (ICD-10), 1992 P. 219.WHO. Geneva.

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