Open Access Journal of Forensic Psychology http://www.forensicpsychologyunbound.ws/ -- 2010.2: 241-272 Defining Paraphilia: Excluding Exclusion Andrew C. Hinderliter Department of Linguistics University of Illinois, Champaign-Urbana, USA Email:
[email protected] Abstract The development of the classification of the paraphilias is considered, with emphasis on justifications for their inclusion in DSM-III in light of the declassification of homosexual- ity. These justifications are found to be tenuous and do not work for the paraphilias in DSM-III-R because of changes made. Rationale for these changes is discussed based on inquires made to DSM-III-R paraphilias committee members. Changes in DSM-IV and DSM-IV-TR are also discussed. After considering and critiquing more recent argu- ments for including the paraphilias in the DSM, recommendations are made regarding proposals for DSM-5, whether the paraphilias belong in the DSM, and whether they should be used in SVP commitment. Keywords: Paraphilias, DSM-5, SVP Commitment Introduction DSM-IV-TR (American Psychiatric Association, 2000b) defines a paraphilia as, “recur- rent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving 1) nonhuman objects, 2) the suffering or humiliation of oneself or one’s partner, or 3) children or other nonconsenting persons” (p. 566); over at least six months. DSM-IV-TR lists eight paraphilias: exhibitionism, fetishism, frotteurism, pedophilia, sexual maso- chism, sexual sadism, transvestic fetishism, and voyeurism. It also has a not otherwise specified category (NOS) for less common paraphilias. In DSM-II (American Psychiatric Association, 1968), they were called sexual deviations, which is where homosexuality had been listed.