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The DSM Diagnostic Criteria for Paraphilia Not Otherwise Specified

Archives of Sexual Behavior volume 39, pages 373–376 (2010)Cite this article

Abstract

The category of “Not Otherwise Specified” (NOS) for DSM-based psychiatric diagnosis has typically retained diagnoses whose rarity, empirical criterion validation or symptomatic expression has been insufficient to be codified. This article reviews the literature on Telephone Scatologia, Necrophilia, Zoophilia, Urophilia, Coprophilia, and Partialism. Based on extant data, no changes are suggested except for the status of Partialism. Partialism, sexual arousal characterized by “an exclusive focus on part of the body,” had historically been subsumed as a type of Fetishism until the advent of DSM-III-R. The rationale for considering the removal of Partialism from Paraphilia NOS and its reintegration as a specifier for Fetishism is discussed here and in a companion review on the DSM diagnostic criteria for fetishism (Kafka, 2009). In the DSM-IV and DSM-IV-TR, the essential features of a Paraphilia are recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving nonhuman objects, the suffering or humiliation of oneself or one’s partner, or children or other nonconsenting persons that occur over a period of at least 6 months (Criterion A). Given consideration for the erotic focus of Partialism and Autoerotic Asphyxia, amending the operational criteria for Paraphilia should be considered to include an atypical focus involving human subjects (self or others).

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Acknowledgments

The author is a member of the DSM-V Workgroup on Sexual and Gender Identity Disorders (Chair, Kenneth J. Zucker, Ph.D.). I wish to acknowledge the valuable input I received from members of my Paraphilias subworkgroup (Ray Blanchard, Richard Krueger, and Niklas Långström) and Kenneth J. Zucker. Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders V Workgroup Reports (Copyright 2009), American Psychiatric Association.

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  1. Department of Psychiatry, McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA

    Martin P. Kafka

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Correspondence to Martin P. Kafka.

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Kafka, M.P. The DSM Diagnostic Criteria for Paraphilia Not Otherwise Specified. Arch Sex Behav 39, 373–376 (2010). https://doi.org/10.1007/s10508-009-9552-0

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Keywords

  • DSM-V
  • Coprophilia
  • Necrophilia
  • Partialism
  • Telephone scatologia
  • Urophilia
  • Zoophilia