Exhibitionism

Exhibitionism is a behavioral health disorder in which an individual compulsively exposes his genitals to other people in public settings orderto achieve sexual satisfaction, or intentionally arranges for others to observe him engaged in sexual activity via masturbation or with another person. The observers are typically caught by surprise, non-consenting, and do not report deriving sexual satisfaction from the experience.

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), exhibitionism was renamed exhibitionistic disorder. The diagnostic criteria are: either the individual's experience of harm from exhibitionistic behavior, generally in the form of internal emotional distress not arising from the taboo nature of the behavior within the dominant culture; or the behavior causes harm to others by violating their legal rights by causing emotional distress or infliction of physical injury. For diagnosis, actual exhibitionistic behavior, fantasies about engaging in this behavior, or a strong internal drive to engage in exhibitionistic behavior must have been present for at least six months. The majority of individuals with exhibitionistic disorder are male.

Treatment usually involves psychotherapy, pharmacotherapy, and, in more severe cases, medications that reduce or restrict sexual urges or prohibit sexual performance. Cognitive behavior therapy (CBT) is generally considered the best mode of psychotherapy; the medications most often used are selective serotonin reuptake inhibitors (SSRIs) antidepressants/antianxiety medications. When arousal-reducing drugs are used, they are usually antiandrogens, which either significantly decrease or stop the production of testosterone. When the individual with exhibitionistic disorder is in a committed relationship, the predicted longterm success of treatment is increased significantly if both members of the couple participate in the psychotherapy portion of the treatment regimen.

See also Antidepressant drugs ; Autoeroticism ; Cognitive behavior therapy; Paraphilia ; Psychotherapy ; Risk-taking behavior.

Resources

BOOKS

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Washington, DC: Author, 2013.

Balon, Richard. Sexual Dysfunction: Beyond the Brain-Body Connection. Basel, Switzerland: Karger, 2011.

Butcher, James N., Jill M. Hooley, and Susan M. Mineka. Abnormal Psychology. 16th ed. New York: Pearson, 2013.

Karpman, Benjamin. The Sexual Offender and His Offenses; Etiology, Pathology, Psychodynamics, and Treatment. [New York]: Julian Press, 1962.

Meltzer, Donald. Sexual States of Mind. Harris Meltzer Trust, 2008.

Muller, Martin N., and Richard W. Wrangham. Sexual Coercion in Primates and Humans: An Evolutionary Perspective on Male Aggression against Females. Cambridge, MA: Harvard University Press, 2009.

Rutter, Virginia, and Pepper Schwartz. The Gender of Sexuality: Exploring Sexual Possibilities. Lanham, MD: Rowman & Littlefield, 2012.

Wilson, Glenn. Variant Sexuality (Routledge Revivals) Research and Theory. Hoboken, NJ: Taylor and Francis, 2014.

Yarber, William L., Barbara Werner Sayad, and Bryan Strong. Human Sexuality: Diversity in Contemporary America. 8th ed. New York: McGraw-Hill, 2012.

PERIODICALS

McManus, M. A, et al. “Paraphilias: Definition, Diagnosis and Treatment.” F1000 Prime Medicine Reports 5, no. 36 (September 2, 2013). Available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769077/ (accessed July 15, 2015).

Wakefield. J. C. “DSM-5 Proposed Diagnostic Criteria for Sexual Paraphilias: Tensions Between Diagnostic Validity and Forensic Utility.” International Journal of Law and Psychiatry 34 (2011): 195–209.

WEBSITES

Centers for Disease Control and Prevention (CDC). “Sexual Violence.” http://www.cdc.gov/ncipc/dvp/SV/default.htm (accessed July 15, 2015).

ORGANIZATIONS

American Psychological Association, 750 First St. NE, Washington, DC, 20002, (202) 336-5500, (800) 3742721, http://www.apa.org .