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The DSM Diagnostic Criteria for Fetishism

Abstract

The historical definitions of sexual Fetishism are reviewed. Prior to the advent of DSM-III-R (American Psychiatric Association, 1987), Fetishism was typically operationally described as persistent preferential sexual arousal in association with non-living objects, an over-inclusive focus on (typically non-sexual) body parts (e.g., feet, hands) and body secretions. In the DSM-III-R, Partialism, an “exclusive focus on part of the body,” was cleaved from Fetishism and added to the Paraphilia Not Otherwise Specified category. The current literature reviewed suggests that Partialism and Fetishism are related, can be co-associated, and are non-exclusive domains of sexual behavior. The author suggests that since the advent and elaboration of the clinical significance criterion (Criterion B) for designating a psychiatric disorder in DSM-IV (American Psychiatric Association, 1994), a diagnostic distinction between Partialism and Fetishism is no longer clinically meaningful or necessary. It is recommended that the diagnostic Criterion A for Fetishism be modified to reflect the reintegration of Partialism and that a fetishistic focus on non-sexual body parts be a specifier of Fetishism.

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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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Correspondence to Martin P. Kafka.

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Kafka, M.P. The DSM Diagnostic Criteria for Fetishism. Arch Sex Behav 39, 357–362 (2010). https://doi.org/10.1007/s10508-009-9558-7

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Keywords

  • DSM-V
  • Fetishism
  • Partialism
  • Paraphilia