Author Description

While sexual deviance and the diagnostic presence of algolagnic paraphilic disorders are often found within forensic settings, the developmental pathway of sexual deviance and such disorders are less well understood. A number of controversial changes were considered during the DSM-V (APA, 2013) revision process, but not included in the final text. However, changes to paraphilic disorder were made which make it easier to diagnose a specific paraphilia. While changes to diagnostic criteria have attempted to add clarity in clinical practice, the developmental influences and maintenance of sexual deviance and paraphilic disorders remains aloof. The present proposal aims to clarify these issues as well as expanding on areas of assessment, management, and treatment of sexual deviance and paraphilic disorders. Since the assignment of a paraphilic disorder diagnosis can result in adverse legal consequences, the actual forensic impact of the changes will depend on how the legal system incorporates these new definitions into statutes and case law. The text begins by exploring the emerging theories in explaining the development of sexual deviance before considering the developmental influences such as neurobiological pathways as well as the effects of pornography. Particularly attention is paid to the assessment and diagnosis of sexual deviance, which is followed by a section on the links to offending behaviour including rape fantasy, algolagnic paraphilic, online viewing of indecent images of children and sexual sadism. The next section examines the effectiveness of current treatments (behavioural, pharmacological, cognitive behavioural treatment, systemic) for (illegal) DSM paraphilias, and sexual offending more generally.