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The DSM-5’s Proposed New Categories of Sexual Disorder: The Problem of False Positives in Sexual Diagnosis

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Abstract

The proposals that have emerged from the DSM-5 revision process have triggered considerable controversy, especially regarding potential invalid inflation of diagnostic categories. To illustrate the kinds of issues that have emerged, I closely examine the proposed new categories of sexual disorder. The DSM-5 Sexual and Gender Identity Disorders Work Group is proposing the addition of three categories of disorder to the DSM-5—hypersexuality, hebephilia (as part of a revised pedophilia category that would become pedohebephilia), and coercive paraphilic disorder (basically a “nonconsent” or rape paraphilia). These proposals are driven by perceived clinical or forensic needs. I argue, however, that their conceptual soundness remains problematic; each could lead to large numbers of false positive diagnoses (i.e., diagnoses that mistakenly label a normal variant of behavior as a mental disorder), with potential for serious forensic abuse in “sexually violent predator” civil commitment proceedings.

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  1. Silver School of Social Work and Department of Psychiatry, New York University (NYU), 1 Washington Square N., New York, NY, 10003, USA

    Jerome C. Wakefield

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  1. Jerome C. Wakefield
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Correspondence to Jerome C. Wakefield.

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Wakefield, J.C. The DSM-5’s Proposed New Categories of Sexual Disorder: The Problem of False Positives in Sexual Diagnosis. Clin Soc Work J 40, 213–223 (2012). https://doi.org/10.1007/s10615-011-0353-2

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