The aim of the workshop is to describe and discuss issues in the paraphilias/paraphilic disorders that are included in DSM-5/DSM-5-TR or were rejected for inclusion as listed diagnoses at various stages in the development of these versions of the DSM. An obvious theme in the workshop is the addition in DSM 5 of the word ‘disorder’ after every paraphilic diagnosis. Of course, there still remains a great deal of controversy regarding what a paraphilia actually is, and when an unusual sexual interest becomes a disorder. The workshop roughly falls into three sections.

Section 1: Summarizes and critically examines how the DSM-5/TR characterizes the following paraphilias/disorders, in relation to our field: Voyeuristic, Exhibitionistic, Frotteuristic, Sexual Masochism Sexual Sadism, and Pedophilic Disorder; with an up-to-date analysis and commentary on the latest research on these paraphilias. There were contentious areas where things were proposed for DSM-5, but not finally included in listed diagnoses. We will examine some of these, and the related developments that have since taken place. These include: a) The Pedophilia and Hebephilia distinction; b) The Dimensional vs. Categorical Models of paraphilic sexual interest debate; c) Where Hypersexual Disorder sits in terms of a paraphilia.

Section 2: In the second section we will discuss two of the more recent/contentious issues reviewed in Section 1. First, the decision not to revise Pedophilic Disorder to Pedohephilic Disorder will be examined (point a). Despite DSM-5 fudging the issue by encouraging evaluators to diagnose hebephilic preferences as Pedophilia, the construct of Hebephilia as a distinct but related paraphilia is now routinely referred to in published research. As for Point (b), an important development has been increasingly strong evidence for the presence of a taxon within pedophilia. This contrasts with studies of sexual sadism where the evidence strongly points to the underlying phenomena being dimensional. Furthermore, factor analytic research has shown that several putatively distinct paraphilias load on a common factor. This suggests that there are dimensions of paraphilic dysfunction that may manifest in qualitatively different ways. It may be that the current diagnostic scheme poorly represents the nature of problematic sexual interests.

Section 3: In this part of the presentation where Hypersexual Disorder sits in terms of a paraphilia will be discussed. While this diagnosis was not included in DSM-5, it was included in ICD-11 as Compulsive Sexual Behavior Disorder (CSBD). It may be that this is not a disorder per se. but may reflect either the extreme end of a sexual desire continuum and/or the emotional response to engaging in sexual behavior that is morally disapproved of. CNS pathways are consistent with substance use disorders. Research has implicated certain personality factors consistent with impulse control disorders and externalizing behavior are related to Hypersexual Disorder.

Finally, we will engage the audience in a discussion on where we are in understanding paraphilias and what a paraphilic diagnosis means in the treatment of individuals who have sexual interest that is deemed ‘’unlawful’.

Learning Goals:
•By the end of the session participants will be able to describe recent research relevant to offense-related paraphilias as defined by the DSM-5
•By the end of the session participants will be able to describe the evidence regarding whether paraphilic sexual interests are better understood as dimensions vs. as taxons
•By the end of the session participants will be able to describe current arguments regarding whether hypersexuality should be considered a disorder