Personality And Paraphilic Disorders – Frotteuristic Disorder

Personality And Paraphilic Disorders – Frotteuristic Disorder

Paraphilias are recurrent and persistent sexual interests, fantasies, urges, or behaviours of substantial intensity involving activities objects or naturally atypical scenarios (Fisher and Marwaha, 2022). According to the DSM-5, a person has to present the following characteristics to be diagnosed with a paraphilic disorder: presenting with personal distress regarding their interest (rather than just distress arising from the disapproval of society) and having behaviour or sexual desire that injures or distress another person or a desire for sexual tendencies for unwilling persons or individuals unable to give legal consent (APA, 2013). The DSM-5 lists a total of 8 paraphilias but this discussion shall examine frotteurism Personality And Paraphilic Disorders – Frotteuristic Disorder.

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Frotteurism is the tendency to rub or touch one’s genitals up against the genitals of another person in a sexual manner without their consent to obtain sexual pleasure or climax (APA, 2013). The tendency is usually repetitive. The DSM-5 provides that a disorder can meet the criteria for frotteurism if, first, for over six months intense and recurrent sexual arousal is derived from rubbing or touching against a non-consenting individual is demonstrated in fantasies, urges, or behaviours. Secondly, the person must have acted on the fantasies behaviours or urges with a non-consenting individual or the sexual fantasies or urges must have caused clinically substantial distress or impairment in occupational, social, or other significant areas of functioning.

Controversies

The act is typified by an individual repeatedly rubbing their genitals against the thighs or buttocks of a victim (Schottle et al., 2017). The act can happen in several crowded public settings like subways, public transportation, malls, elevators, or other crowded areas. It has been suggested that most perpetrators of this act do not face legal action because most cases go unreported. As a result, the frotteurs have a large victim base and will rarely be arrested or ever serve long sentences. Individuals practising the disorder enjoy experiencing their sexual experiences in public areas (Pychology Today, 2021). The condition is rare among women. Mostly the condition is related to the development of an unusual understanding of romantic relationships and sex and is connected to childhood trauma (King et al., 2019). The condition is common among males aged between 15 and 25 who seemingly are shy as well as in socially withdrawn, older, and reserved men.

Professional Beliefs About the Disorder

The DSM-5 separates frotteurism sexual interest from frotteurism disorder by defining the former as an individual experiencing the interest but not executing the deed and hence experiencing no impairment or distress (APA, 2013; Bhattia and Parekh, 2021; Kamenskov and Gurina, 2019). Laboratory work-ups including hormone tests (like prolactin, thyroid function tests, testosterone tests, and luteinizing and follicle-stimulating hormone tests), metabolic panels, and suspected additional deviant behaviours can help improve the diagnosis. Because the condition is rarely reported it is poorly understood. The prevalence is 9% to 35% in adolescents and young persons aged between 15 and 25 years. The perpetrators mostly target young women and older women (Bhattia and Parekh, 2021). After the history and physical exam, a psychiatric assessment is necessary. The assessor is expected to be non-judgmental and should endeavour to enquire through open-ended questions to obtain as much data as possible. Often individuals can report cases of premature ejaculation and can have secondary paraphilias besides frotteurism Personality And Paraphilic Disorders – Frotteuristic Disorder.

 

Strategies For Maintaining The Therapeutic Relationship With A Patient

Maintaining a therapeutic relationship with a patient requires a non-judgmental approach during the evaluation and an endeavour to ask open-ended questions with minimal poking (Bhattia and Parekh, 2021; Pychology Today, 2021). The clinician can establish whether the patient conducted the act in a restricted environment with a non-consenting person or committed the act with the non-consenting individual in an uncontrolled environment. Most individuals do not seek treatment for the condition due to the absence of functional or clinical impairment on the part of the victims. The individuals may find it uncomfortable, guilty, or ashamed of their behaviour when reporting for help.

The disorder is mostly revealed when an individual is caught in the act enforced by the legal system to seek treatment due to sexual assault or if implored by friends and family (Bhattia and Parekh, 2021). One of the approaches is a multimodal method where family and individuals close to the perpetrator or the community contribute to the psychotherapeutic and pharmacological interventions. The treatment can involve exploring underlying conditions like low self-esteem anxiety and depression. Furthermore, the clinician is to differentiate the condition from substance abuse disorder, traumatic brain injury, conduct disorder, and antisocial personality disorder. The psychiatrist must be informed on the appropriate therapeutic interventions to lower recidivism and improve outcomes. A forensic psychiatrist can also be involved to assess diagnose and manage the therapy of the proteolytic person to lower future incidences of sexual offences Personality And Paraphilic Disorders – Frotteuristic Disorder.

Ethical And Legal Considerations

Ethical issues arise during treatment because the patient has to provide informed consent for GnRH analogs to be administered as antiandrogens to reduce hypersexuality and impulsivity in severe cases (Bhattia and Parekh, 2021). It implies that individuals who self-report may not have to be handed over to the criminal justice system. It would be safe for a clinician to presume that an individual seeking help or self-reporting can have a better prognosis with good community support and active compliance with therapy. Individuals fans discovered can suffer additional legal implications as well as societal stigma. Individuals with severe sexual disorders can undergo first registration with sex offender registries, housing and public area limitations, and regular check-ins with the legal system. The traumatic experiences of such limitations and stigma can be overwhelming for a victim with low self-esteem and thereby necessitating community support. Hence, it would be ethical to encourage individuals to seek treatment, education, or social support to overcome the stigma and the condition.

Conclusion

Frotteurism is a scarcely reported paraphilia and could necessitate therapy in self-reported or reffered cases. Clinicians should be aware that frotteuristic individuals can present with depression anxiety and obsessive-compulsive disorders. Individuals with repeat offences, frotteuristic disorder, and a history of coercive sexual behaviours should seek treatment. Otherwise, such individuals can be sued for criminal activity for conducting sexual offences over non-consenting persons. Victims can file suits against this behaviour as a sexual offence. Ethical issues regarding coerced or forced therapeutic interventions should be considered to prevent recidivism.

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Week 7: Personality and Paraphilic Disorders Personality disorders represent perhaps the most challenging disorders that psychiatric-mental health nurse practitioners will have to address in their professional careers. Personality disorders can co-occur in every mental health disorder and, in some cases, can mask other disorders. Although difficult to treat, the PMHNP must be able to identify personality disorders and endeavor to work with the patient to not only recognize the disorder but also treat a disorder that patients often do not believe exist. Although there is tremendous variety in what is considered normal sexual interests, paraphilic disorders occur when a persistent behavior or fantasy causes distress, harm, or risk of harm to oneself or others. Some paraphilic disorders include pedophilia, exhibitionism, fetishism, and voyeurism. This week, you will explore controversies related to personality and paraphilic disorders, as well as clinical, ethical, and legal issues that should be considered when working with patients with such diagnoses. Learning Objectives Students will: Analyze controversies related to the diagnosis and treatment of personality and paraphilic disorders Analyze professional beliefs about personality and paraphilic disorders Apply strategies for maintaining a therapeutic relationship with patients with personality and paraphilic disorders Analyze legal and ethical considerations related to personality and paraphilic disorders Learning Resources Required Readings (click to expand/reduce) Required Media (click to expand/reduce) Assignment: Controversy Associated with Personality and Paraphilic Disorders Between 10% and 20% of the population experience personality disorders. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others. Photo Credit: Joe Houghton – www.joehoughtonphotography.ie / Moment / Getty Images Paraphilic disorders are far more common in men than in women, and generally quite chronic, lasting at least two years. Treatment of these disorders usually involves both psychotherapeutic and pharmacologic treatments. In this Assignment, you will explore personality and paraphilic disorders in greater detail. You will research potentially controversial elements of the diagnosis and/or treatment and explain ethical and legal considerations when working with these disorders. To Prepare Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders. Select a specific personality or paraphilic disorder from the DSM-5-TR to use for this Assignment. Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations. The Assignment In 2–3 pages: Explain the controversy that surrounds your selected disorder. Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature. Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder. Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important. By Day 7 of Week 7 Submit your Assignment Personality And Paraphilic Disorders – Frotteuristic Disorder.

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
https:doi.org/10.1176/appi.books.9780890425596

Fisher, K. A., & Marwaha, R. (2022). Paraphilia. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554425/#:~:text=Paraphilias%20are%20persistent%20and%20recurrent,that%20are%20atypical%20in%20nature.

Kamenskov, M. Y., & Gurina, O. I. (2019). Neĭrotransmitternye mekhanizmy razvitiia parafil’nykh rasstroĭstv [Neurotransmitter mechanisms of paraphilic disorders]. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova, 119(8), 61–67. https://doi.org/10.17116/jnevro201911908161

King, A. R., Kuhn, S. K., Strege, C., Russell, T. D., & Kolander, T. (2019). Revisiting the link between childhood sexual abuse and adult sexual aggression. Child abuse & neglect, 94, 104022. https://doi.org/10.1016/j.chiabu.2019.104022

Schöttle, D., Briken, P., Tüscher, O., & Turner, D. (2017). Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder. Dialogues in clinical neuroscience, 19(4), 381–393. https://doi.org/10.31887/DCNS.2017.19.4/dschoettle Personality And Paraphilic Disorders – Frotteuristic Disorder