DSM-5 Proposals for Paraphilias: Suggestions for Reducing False Positives Related to Use of Behavioral Manifestations
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During each of the revisions of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Workgroups comprised of experts in their respective fields are convened with the goal of considering changes to the diagnostic criteria. Based on my experiences working on the DSM-III-R and DSM-IV revisions, there is a natural tendency for Workgroups to focus on making changes aimed at broadening the diagnostic umbrella of their assigned categories with the goal of increasing diagnostic coverage, i.e., reducing what they consider to be false negatives, an effort which inevitably comes at the cost of increasing false positives (Pincus, Frances, Davis, First, & Widiger, 1992).
In the overall scheme of the DSM, false positives (i.e., erroneously giving a diagnostic label to an individual for whom it is not justified) are problematic because of the unnecessary stigma and inappropriate treatment that may result. However, because of their central role as a proxy for...
KeywordsSexual Arousal Sexual Offense Sexual Fantasy False Positive Diagnosis Pedophilia
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.Google Scholar
- DSM-5 Paraphilia SubWorkgroup. (2010). Rationale for Exhibitionism changes. http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=62#.
- First, M. B., Frances, A., & Pincus, H. A. (2004). DSM-IV-TR guidebook. Washington, DC: American Psychiatric Publishing.Google Scholar
- Franklin, K. (2009). The public policy implications of "hebephilia". A response to Blanchard et al. [Letter to the Editor]. Archives of Sexual Behavior, 38, 319–320.Google Scholar
- Marshall, W. L., & Fernandez, Y. (2003). Phallometric testing with sexual offenders: Theory, research, and practice. Brandon, VT: Safer Society Press.Google Scholar
- Plaud, J. J. (2009). Are there "Hebephiles" among us? A response to Blanchard et al. (2008) [Letter to the Editor]. Archives and Sexual Behavior, 38, 326–327.Google Scholar
- Tromovitch, P. (2009). Manufacturing mental disorder by pathologizing erotic age orientation: A comment on Blanchard et al. (2008) [Letter to the Editor]. Archives of Sexual Behavior, 38, 328.Google Scholar
- Zander, T. K. (2009). Adult sexual attraction to early-stage adolescents: Phallometry doesn't equal pathology [Letter to the Editor]. Archives of Sexual Behavior, 38, 329–330.Google Scholar