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

Jerome C. Wakefield

    Research output: Contribution to journalArticle

    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.

    Original languageEnglish (US)
    Pages (from-to)213-223
    Number of pages11
    JournalClinical Social Work Journal
    Volume40
    Issue number2
    DOIs
    StatePublished - Jun 1 2012

    Fingerprint

    Paraphilic Disorders
    sexual disorder
    Sexual and Gender Disorders
    Pedophilia
    Rape
    Economic Inflation
    Mental Disorders
    pedophilia
    group work
    mental disorder
    rape
    inflation
    diagnostic
    abuse
    commitment
    gender

    Keywords

    • Diagnosis
    • DSM-5
    • False positive
    • Harmful dysfunction
    • Hebephilia
    • Hypersexual disorder
    • Paraphilic coercive disorder
    • Sexual disorder
    • Validity

    ASJC Scopus subject areas

    • Health(social science)
    • Public Health, Environmental and Occupational Health

    Cite this

    The DSM-5's Proposed New Categories of Sexual Disorder : The Problem of False Positives in Sexual Diagnosis. / Wakefield, Jerome C.

    In: Clinical Social Work Journal, Vol. 40, No. 2, 01.06.2012, p. 213-223.

    Research output: Contribution to journalArticle

    @article{aba188846ac24410ac3aa5674cf1f2ad,
    title = "The DSM-5's Proposed New Categories of Sexual Disorder: The Problem of False Positives in Sexual Diagnosis",
    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.",
    keywords = "Diagnosis, DSM-5, False positive, Harmful dysfunction, Hebephilia, Hypersexual disorder, Paraphilic coercive disorder, Sexual disorder, Validity",
    author = "Wakefield, {Jerome C.}",
    year = "2012",
    month = "6",
    day = "1",
    doi = "10.1007/s10615-011-0353-2",
    language = "English (US)",
    volume = "40",
    pages = "213--223",
    journal = "Clinical Social Work Journal",
    issn = "0091-1674",
    publisher = "Kluwer Academic/Human Sciences Press Inc.",
    number = "2",

    }

    TY - JOUR

    T1 - The DSM-5's Proposed New Categories of Sexual Disorder

    T2 - The Problem of False Positives in Sexual Diagnosis

    AU - Wakefield, Jerome C.

    PY - 2012/6/1

    Y1 - 2012/6/1

    N2 - 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.

    AB - 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.

    KW - Diagnosis

    KW - DSM-5

    KW - False positive

    KW - Harmful dysfunction

    KW - Hebephilia

    KW - Hypersexual disorder

    KW - Paraphilic coercive disorder

    KW - Sexual disorder

    KW - Validity

    UR - http://www.scopus.com/inward/record.url?scp=84862141389&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=84862141389&partnerID=8YFLogxK

    U2 - 10.1007/s10615-011-0353-2

    DO - 10.1007/s10615-011-0353-2

    M3 - Article

    AN - SCOPUS:84862141389

    VL - 40

    SP - 213

    EP - 223

    JO - Clinical Social Work Journal

    JF - Clinical Social Work Journal

    SN - 0091-1674

    IS - 2

    ER -