背景:由于潜在误诊的严重影响,有效和可靠的诊断标准在法医精神病学和性医学中是必不可少的。该领域的一个挑战是性施虐障碍(SSD)和强制性亲热障碍(CP)定义的可操作性差。
目的:本范围界定文献综述的目的是全面概述SSD和CP+之间的关键概念差异,以及考虑他们的诊断配方的实用和临床有用的方法。
方法:遵循Arksey和O\'Malley的方法框架。Medline的文献检索,PsychInfo,WebofScience,并对护理和相关健康文献电子数据库进行了累积索引。包括描述SSD或CP+的构造和/或操作定义的英文出版物。2位作者对全文研究进行了综述,并对数据进行了定性图表和综合。
结果:最初的搜索提供了1,271条记录,之后,120篇全文论文被认为符合资格,48项研究最终被纳入.SSD和CP+最常见的定义来源是精神疾病诊断和统计手册(n=53)和国际疾病分类(n=12)。与SSD相比,CP+使用的术语变化更多。CP+和SSD都因有效性低而受到综述文献的批评,可靠性,和一致性,以及与性犯罪混为一谈。由于具有诊断标准和经过验证的诊断工具,因此更好地描述了SSD。
结论:目前,临床医生主要依靠DSM来诊断SSD或CP+。由于SSD和CP+定义的应用各不相同,临床医生之间的解释可能无法推广。此外,具体诊断实际上可能无益且不可靠.因此,通过伤害风险来确定治疗可能是有益的。除了这些担忧,与SSD和CP+相关的病耻感也可能影响治疗。
■这项研究的优势包括重复审查和图表,以提高方法的严谨性,透明的报告,以尽量减少出版偏见,涵盖了一个全面的范围。局限性包括综述文献强度低的弱点和发表偏见的风险。
结论:尽管它们具有重要意义,SSD和CP+的定义不一致,缺乏可靠性。未来的研究对于开发更强大的诊断标准和工具是必要的。
Valid and reliable diagnostic criteria are essential in forensic psychiatry and sexual medicine due to the severe implications of potential misdiagnoses. One challenge in this field is the poor operationalization of sexual sadism disorder (SSD) and coercive paraphilic disorder (CP+) definitions.
The aim of this scoping literature
review is to provide a comprehensive overview of the key conceptual differences between SSD and CP+, as well as consider pragmatic and clinically useful approaches to their diagnostic formulation.
Arksey and O\'Malley\'s methodological framework was followed. A literature search of Medline, PsychInfo, Web of Science, and Cumulative Index to Nursing and Allied Health Literature electronic databases was conducted. Publications in English describing the construct and/or operational definition of SSD or CP+ were included. Full-text studies were reviewed by 2 authors and data was charted and synthesized qualitatively.
The initial search provided 1,271 records, after which 120 full-text papers were considered for eligibility and 48 studies were ultimately included. The most common sources of definitions for SSD and CP+ were the Diagnostic and Statistical Manual of Mental Disorders (n = 53) and the International Classification of Disease (n = 12). There was more variation of terms used for CP+ than SSD. Both CP+ and SSD are critiqued by reviewed literature for having low validity, reliability, and consistency, as well as being conflated with sexual crime. SSD is better described due to having diagnostic criteria and validated diagnostic tools.
Currently, clinicians rely mostly on the DSM to diagnose SSD or CP+. As applications of SSD and CP+ definitions vary, interpretations may not be generalizable between clinicians. Furthermore, specific diagnoses may be practically unhelpful and unreliable. It may therefore be beneficial for treatment to be determined by risk of harm. In addition to these concerns, the stigma associated with SSD and CP+ may also impact treatment.
Strengths of this study include duplicate
review and charting to increase methodological rigor, transparent reporting to minimize publication bias, and encompassing a comprehensive scope. Limitations include the weaknesses of low strength of reviewed literature and risk of publication bias.
Despite their significant implications, the definitions of SSD and CP+ are inconsistent and lack reliability. Future research is necessary to develop stronger diagnostic criteria and tools.