DSM-5 proposed diagnostic criteria for sexual paraphilias: Tensions between diagnostic validity and forensic utility

Jerome C. Wakefield

    Research output: Contribution to journalArticle

    Abstract

    In order to prevent sexual crimes, "sexual predator" laws now allow indefinite preventive civil commitment of criminals who have completed their prison sentences but are judged to have a paraphilic mental disorder that makes them likely to commit another crime. Such proceedings can bypass the usual protections of criminal law as long as the basis for incarceration is the attribution of a mental disorder. Thus, the difficult conceptual distinction between deviant sexual desires that are mental disorders versus those that are normal variations in sexual preference (even if they are eccentric, repugnant, or illegal if acted upon) has attained critical forensic significance. Yet, the concept of paraphilic disorders - called "perversions" in earlier times - is inherently fuzzy and controversial and thus open to conceptual abuse for social control purposes. Consequently, the criteria used in diagnosing paraphilic disorders deserve careful scrutiny.The DSM-5 sexual disorders work group is proposing substantial revisions to the paraphilia diagnostic criteria in the DSM-5 nosology. It is claimed that the new criteria provide a reconceptualization that clarifies the distinction between normal variation and paraphilic disorder in a way relevant to forensic settings. In this article, after considering the logic of the concept of a paraphilic disorder, I examine each of the proposed changes to the DSM-5 paraphilia criteria and assess their conceptual validity. I argue that the DSM-5 proposals, while containing a kernel of an advance in distinguishing paraphilias from paraphilic disorders, nonetheless would yield criteria for paraphilic disorders that are conceptually invalid in ways open to serious forensic abuse.

    Original languageEnglish (US)
    Pages (from-to)195-209
    Number of pages15
    JournalInternational Journal of Law and Psychiatry
    Volume34
    Issue number3
    DOIs
    StatePublished - May 1 2011

    Fingerprint

    Paraphilic Disorders
    diagnostic
    mental disorder
    abuse
    sexual disorder
    Mental Disorders
    offense
    imprisonment
    group work
    Crime
    criminal law
    social control
    attribution
    commitment
    Criminal Law
    Law
    Prisons

    ASJC Scopus subject areas

    • Pathology and Forensic Medicine
    • Psychiatry and Mental health
    • Law

    Cite this

    DSM-5 proposed diagnostic criteria for sexual paraphilias : Tensions between diagnostic validity and forensic utility. / Wakefield, Jerome C.

    In: International Journal of Law and Psychiatry, Vol. 34, No. 3, 01.05.2011, p. 195-209.

    Research output: Contribution to journalArticle

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