Paraphilic Disorders

Parphilic Disorders
  • 文章类型: Journal Article
    STATIC-99工具是用于评估累犯风险的工具之一,符合精算方法。科学文献表明的具有最大意义的风险因素之一是性偏好障碍。该研究的目的是验证被诊断为性偏好障碍的性犯罪者是否有更高的再犯风险。该研究还旨在提出,第一次在波兰,对STATIC-99R中的个体危险因素及其患病率进行定量评分,允许在分析波兰性犯罪者人口时验证STATIC-99R文书的理论有效性。
    该研究材料包括来自11个波兰刑事机构和还押中心的100个侵犯性自由罪行肇事者的法庭和监狱档案。我们使用STATIC-99R评估每个病例。
    介绍了个别STATIC-99R危险因素在波兰性犯罪者人群中的分布。性偏好障碍的诊断对STATIC-99R总评分没有影响,但与其个体因素有关。
    可以得出结论,STATIC-99R工具的理论有效性也与波兰研究人群有关,可能用于临床实践。
    UNASSIGNED: The STATIC-99 instrument is one of the tools used for the assessment of the risk of recidivism, in line with the actuarial approach. One of the risk factors indicated by the scientific literature as having the greatest significance is sexual preference disorder. The aim of the study was to verify whether sexual offenders diagnosed with sexual preference disorders have a higher risk of recidivism. The study also aimed to present, for the first time in Poland, a quantitative scoring of individual risk factors in STATIC-99R and their prevalence, allowing for the verification of the theoretical validity of the STATIC-99R instrument in the analysis of the population of sexual offenders in Poland.
    UNASSIGNED: The study material consisted of 100 court and penitentiary files of perpetrators of crimes against sexual freedom from 11 Polish penal institutions and remand centers. We used the STATIC-99R to evaluate each case.
    UNASSIGNED: The distribution of the individual STATIC-99R risk factors in the population of the Polish sexual offenders is presented. The diagnosis of sexual preference disorders had no influence on the total STATIC-99R score but was associated with its individual factors.
    UNASSIGNED: It can be concluded that the theoretical validity of the STATIC-99R tool is also relevant to the Polish study population and may be used in clinical practice.
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  • 文章类型: Journal Article
    束缚/纪律,支配/提交,近年来,Sadism/Masochism(BDSM)引起了越来越多的关注和讨论。这种流行伴随着对BDSM的看法的转变,包括将受虐狂解密为一种亲热障碍。进化心理学提供了一个独特的视角,说明为什么有些人对BDSM感兴趣,以及为什么有些人喜欢BDSM的某些元素而不是其他元素(例如,优势与屈服)。在本文中,我们从进化的角度研究BDSM,研究构成BDSM兴趣和实践基础的生物心理社会因素。我们通过以下方面的探索来阐明这一观点:接近的过程,比如童年经历的作用,性条件,和生理因素;以及对BDSM的力量发挥和疼痛发挥维度的最终解释,强调每种方法的潜在适应性优势。虽然BDSM本身可能不是自适应的,我们研究了有关BDSM角色偏好中性别差异的文献,并认为这些偏好可能源于提高生殖成功率的极端行为形式。在痛苦游戏的领域,我们从生理和心理的角度探索痛苦和快乐的交集,强调心理和发挥伙伴因素在调节疼痛体验中的关键作用。最后,我们鼓励未来的社会科学研究利用进化框架来进一步探索这一主题,并帮助缓解围绕BDSM的神秘感。这种对BDSM的多方面探索为临床医生提供了宝贵的见解,扭结识别的个体,和学者寻求了解人类性行为和偏好的进化观点。
    Bondage/discipline, Dominance/submission, and Sadism/Masochism (BDSM) have gained increased attention and discussion in recent years. This prevalence is accompanied by a shift in perceptions of BDSM, including the declassification of sadomasochism as a paraphilic disorder. Evolutionary psychology offers a unique perspective of why some individuals are interested in BDSM and why some prefer certain elements of BDSM over others (e.g., dominance versus submission). In this paper, we examine BDSM from an evolutionary standpoint, examining biopsychosocial factors that underlie the BDSM interests and practice. We articulate this perspective via an exploration of: proximate processes, such as the role of childhood experiences, sexual conditioning, and physiological factors; as well as ultimate explanations for power play and pain play dimensions of BDSM, highlighting the potential adaptive advantages of each. While BDSM may not be adaptive in itself, we examine the literature of sex differences in BDSM role preferences and argue that these preferences may stem from the extreme forms of behaviors which enhance reproductive success. In the realm of pain play, we explore the intersection of pain and pleasure from both physiological and psychological perspectives, highlighting the crucial role of psychological and play partner factors in modulating the experience of pain. Finally, we encourage future research in social sciences to utilize evolutionary frameworks to further explore the subject and help alleviate the mystification surrounding BDSM. This multifaceted exploration of BDSM provides valuable insights for clinicians, kink-identified individuals, and scholars seeking to understand the evolutionary perspectives of human sexual behavior and preferences.
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  • 文章类型: Journal Article
    适应不良的人格特质,例如“黑暗人格”被发现会导致一系列不同的负面结果,包括亲热利益和相关(非法)行为。然而,目前还不清楚这些到底是如何相关的,如果相关,如果只有那些在黑暗人格特质和冲动性较高的个体参与亲热行为。在目前的研究中,招募了50名参与者来调查DarkTetrad人格特质之间的关系(即,自恋,精神病,马基雅维利主义和日常虐待狂),副反应性兴趣(唤醒和行为)和冲动性的调节作用。通过自我报告问卷调查了人格和异性恋兴趣。在Go/No-Go任务期间使用脑电图通过自我报告的功能失调冲动性和P3事件相关电位(即反应抑制)来测量冲动性。结果显示,精神病之间存在正相关,虐待狂和亲热的利益。而日常施虐与亲热(自我报告)唤醒有关,精神病与性交行为有关。尽管P3振幅与亲热兴趣无关,自我报告的功能失调性冲动与亲缘行为特别相关。然而,在精神病与性交行为之间的关系中,功能失调的冲动性和反应抑制(P3)没有调节作用。研究结果表明,特定的黑暗人格与亲民兴趣之间的关系可能比最初认为的要复杂得多。然而,对亲热症和相关行为的风险评估和干预方法都可能受益于纳入DarkTetrad和冲动性测量。
    Maladaptive personality traits, such as \'dark personalities\' are found to result in a diverse set of negative outcomes, including paraphilic interests and associated (illegal) behaviors. It is however unclear how these are exactly related, and if related, if then only those individuals higher on dark personality traits and higher impulsivity engage in paraphilic behaviors. In the current study, 50 participants were recruited to investigate the relationship between Dark Tetrad personality traits (i.e., narcissism, psychopathy, Machiavellianism and everyday sadism), paraphilic interests (arousal and behavior) and the moderating role of impulsivity. Personality and paraphilic interests were investigated through self-report questionnaires. Impulsivity was measured both through self-reported dysfunctional impulsivity and the P3 event related potential using electroencephalography during the Go/No-Go task (i.e. response inhibition). The results showed that there was a positive association between psychopathy, sadism and paraphilic interests. Whereas everyday sadism was associated with paraphilic (self-reported) arousal, psychopathy was associated with paraphilic behavior. Although P3 amplitude was not associated with paraphilic interests, self-reported dysfunctional impulsivity was associated with paraphilic behavior specifically. However, there was no moderating role of dysfunctional impulsivity and response inhibition (P3) in the relationship between psychopathy and paraphilic behavior. Findings indicate that the relation between specific dark personalities and paraphilic interests may be more complex than initially thought. Nevertheless, risk assessment and intervention approaches for paraphilia and related behavior both may benefit from incorporating Dark Tetrad and impulsivity measurements.
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    文章类型: Journal Article
    BACKGROUND: Drug use in a sexualised context provides unique challenges both in specialised clinics (psychiatric and sexual health clinics) as well as general practice. Layered onto this leads some inequalities in health care to poorer outcomes in specific groups. This article aims to provide evidence based harm reduction strategies that can easily be applied in primary care to reduce complications, identify those at higher risk and deploy appropriate treatments.
    UNASSIGNED: Chemsex – primär auf ein sexuelles Erlebnis ausgerichteter Drogenkonsum: Patienten, die durch die Maschen fallen.
    UNASSIGNED: Drogenkonsum in einem sexualisierten Kontext stellt sowohl spezialisierte Kliniken (psychiatrische Kliniken und Kliniken für sexuelle Gesundheit) als auch die Allgemeinmedizin vor besondere Herausforderungen. Hinzu kommen einige Ungleichheiten in der Gesundheitsversorgung, die zu ungünstigen Auswirkungen in bestimmten Gruppen führen. In diesem Artikel werden evidenzbasierte Strategien zur Schadensminimierung vorgestellt, die in der Primärversorgung leicht angewandt werden können, um Komplikationen zu verringern, Personen mit erhöhtem Risiko zu identifizieren und geeignete Behandlungen einzusetzen. Schlüsselwörter: Chemsex, sexualisiertes Drogenkonsum, Methamphetamin-Abhängigkeit.
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  • 文章类型: Journal Article
    (1)背景:嗜血性疾病,以强烈的性幻想和行为为标志,带来了巨大的挑战。这篇评论解决了丑闻和虐待儿童引发的担忧。强调亲缘关系的复杂性,它系统地回顾了药物治疗文献,旨在增进理解并指导未来的研究。(2)方法:从1990年到2023年,对主要数据库进行了全面搜索,确定了28项相关的英语研究。纳入标准集中在成人药物治疗上,结果采用纽卡斯尔-渥太华量表进行评估。(3)结果:综合选定研究的数据,分析了SSRIs和抗雄激素等多种治疗方法,揭示可变的有效性和副作用概况。目前已有文献报道质量差。(4)结论:突出5-羟色胺能系统的关键作用,这篇综述强调了SSRIs和雄激素剥夺治疗的疗效。讨论了GnRH类似物相关的副作用以及联合评估方法的重要性。批判性的见解有助于理解和道德方面的考虑。
    (1) Background: Paraphilic disorders, marked by intense sexual fantasies and behaviors, present formidable challenges. This review addresses concerns fueled by scandals and child abuse. Emphasizing paraphilias\' complexity, it systematically reviews the pharmacotherapy literature, aiming to enhance understanding and guide future research. (2) Methods: A comprehensive search from 1990 to 2023 across major databases identified 28 relevant English-language studies. Inclusion criteria focused on adult pharmacotherapy for paraphilias, and results were evaluated using the Newcastle-Ottawa Scale. (3) Results: Synthesizing data from selected studies, diverse treatments such as SSRIs and antiandrogens were analyzed, revealing variable effectiveness and side effect profiles. Poor quality of the current literature has been reported. (4) Conclusions: Highlighting the pivotal role of the serotonergic system, this review underscores the efficacy of SSRIs and androgen deprivation therapy. GnRH analog-associated side effects and the importance of a combined assessment approach are discussed. Critical insights contribute to understanding and ethical considerations in paraphilic disorders.
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  • 文章类型: Journal Article
    背景:将强迫性行为障碍(CSBD)添加到ICD-11关于精神,行为,或神经发育障碍极大地激发了围绕强迫性行为的研究和争议,或者所谓的“性欲障碍”,“\”性成瘾,\"\"色情成瘾,性强迫症,“和”失控的性行为。\"
    目的:从性医学的角度确定存在的问题以及可以采取哪些措施来解决这些问题。
    方法:由国际性医学学会召集的科学审查委员会审查了相关文献,并讨论了与CSBD诊断和误诊相关的临床研究和经验。病理性的非异型规范性行为,关于CSBD潜在根本原因的基础研究,它与亲热障碍的关系,及其潜在的性健康后果。小组使用改进的德尔菲方法就这些问题达成共识。
    结果:根据ICD-11诊断标准,CSBD与其他性活动区分开来,并确定了有关性医学和性健康的问题。人们对自我标记过程提出了担忧,敌视性快感的态度,非异性恋性行为和高性欲的病理,规范态度与临床痛苦的混合,以及认为手淫和色情使用代表“不健康”的性行为。提出了CSBD病例制定和护理/治疗建议指南。
    结论:在精神-心理治疗背景下诊断和治疗CSBD的临床性学和性医学专业知识对于区分和理解CSBD和相关的“失控性行为”对精神和性健康的决定因素和影响是必要的,检测法医相关和不相关的形式,并完善护理和治疗的最佳实践。循证,应提供性医学知情疗法,以实现积极和尊重的性行为方法,并有可能拥有愉快和安全的性经历。
    BACKGROUND: The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed \"hypersexual disorder,\" \"sexual addiction,\" \"porn addiction,\" \"sexual compulsivity,\" and \"out-of-control sexual behavior.\"
    OBJECTIVE: To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them.
    METHODS: A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues.
    RESULTS: CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent \"unhealthy\" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed.
    CONCLUSIONS: Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related \"out-of-control sexual behaviors\" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
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  • 文章类型: Journal Article
    对性暴力或儿童有亲热兴趣的人如果拥有犯罪支持性认知,则更有可能发生性犯罪。这些认知可能是对童年逆境的反应。然而,这个想法主要是基于对被判定犯有性犯罪的男性的研究,并且可能无法推广到具有副翼兴趣的非监禁成年人。在178名成年人的样本中,对暴力或儿童的亲热兴趣进行了筛查(来自一般捷克人口),我们假设儿童时期的性虐待和情感忽视与关于强奸和猥亵儿童的犯罪支持认知相关.参与者来自具有全国代表性的捷克成年人样本,如果他们自我报告对暴力和/或儿童的性兴趣很高,则被选中。参与者完成了一项在线调查,其中包括自我报告的性取向指标,进攻支持认知(BumbyRAPE和MOLEST量表),和童年性虐待和情感忽视(童年创伤问卷)。控制性别,年龄,和性取向,我们发现,强奸支持性认知和儿童猥亵支持性认知与儿童性虐待的较高水平显著相关,但不是情感上的忽视。这些发现表明,儿童期性虐待可能会导致患有性交的男性和女性的犯罪支持性认知。
    Individuals with paraphilic interests in sexual violence or children may be more likely to sexually offend if they possess offense-supportive cognitions. These cognitions may develop in response to childhood adversity. However, this idea is largely based on research in men convicted of sexual offenses and may not generalize to non-incarcerated adults with paraphilic interests. In a sample of 178 adults screened for paraphilic interests in violence or children (from the general Czech population), we hypothesized that childhood sexual abuse and emotional neglect would be associated with offense-supportive cognitions about rape and child molestation. Participants came from a nationally representative sample of Czech adults and were selected if they self-reported high levels of sexual interest in violence and/or children. Participants completed an online survey with self-report measures of sexual orientation, offense-supportive cognitions (Bumby RAPE and MOLEST scales), and childhood sexual abuse and emotional neglect (Childhood Trauma Questionnaire). Controlling for gender, age, and sexual orientation, we found that both rape-supportive cognitions and child molestation-supportive cognitions were significantly associated with higher levels of childhood sexual abuse, but not emotional neglect. These findings indicate that childhood sexual abuse may lead to offense-supportive cognitions among men and women with paraphilia.
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  • 文章类型: Journal Article
    尽管许多与睡眠有关的行为是良性的,其他人可能会导致对床上伴侣或其他人的身体或性侵犯。从事与睡眠有关的暴力(SRV)和睡眠中的性行为(SBS)的个人可能会因其行为而面临法律制裁。律师或法律决策者可以要求专家评估被告,并对所谓的失眠症诊断的真实性发表意见,被告的刑事责任,以及他对他人施暴的风险.本文回顾了SRV和SBS的现象,并指导评估人员进行与失眠症相关的法医考虑。
    Although many sleep-related behaviors are benign, others can result in physical or sexual aggression toward bed partners or others. Individuals who engage in sleep-related violence (SRV) and sexual behavior in sleep (SBS) may face legal sanctions for their behavior. Attorneys or legal decision-makers may call on an expert to evaluate a defendant and opine about the veracity of an alleged parasomnia diagnosis, the criminal responsibility of the defendant, and his risk of violence to others. This article reviews the phenomena of SRV and SBS and guides evaluators in the forensic considerations relevant to parasomnias.
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  • 文章类型: Journal Article
    目标:2007年,纽约颁布了《性犯罪者管理和治疗法》,授权国家对犯有性犯罪(受访者)并被认为具有精神异常(MA)的个人进行民事管理,使他们在服刑事判决后容易性再犯。我们试图复制和扩展先前的研究(Lu等人。,2015)确定预测法律决定的因素。
    目标:我们预测,在前人研究的基础上,该临床信息(例如,诊断)以及经验支持的风险因素(例如,性偏差)将预测试验结果。
    方法:我们分析了多个人口统计,犯罪,以及基于法律程序的三个嵌套子样本的临床数据:MA同意(n=713),MA试验(n=316),和处置听证(n=643)。感兴趣的二元结果如下:对于MA同意子样本,是受访者是否放弃了他们的MA试验;对于MA试验子样本,是在审判中是否发现被告有MA;对于处置听证会,问题是被告是否被命令住院或门诊民事管理。
    结果:放弃试验的最强预测因素是地理位置;纽约市和长岛以外的受访者更有可能放弃试验(ORs=2.38-3.37)。MA试验和处置听力结果的最强预测因子是精神障碍诊断和统计手册;恋童癖(ORs=4.05-7.22)和性施虐(ORs=2.68-7.03)的诊断增加了MA发现和禁闭顺序的可能性。
    结论:法官和陪审团非常重视临床信息,特别是恋童癖的诊断,在做出民事管理法律决定时。(PsycInfo数据库记录(c)2024APA,保留所有权利)。
    OBJECTIVE: In 2007, New York enacted the Sex Offender Management and Treatment Act, empowering the state to civilly manage individuals who have committed sexual offenses (respondents) and are deemed to have a mental abnormality (MA) that predisposes them to sexually recidivate after serving their criminal sentences. We sought to replicate and extend a previous study (Lu et al., 2015) to identify factors predicting legal decisions.
    OBJECTIVE: We predicted, on the basis of previous research, that clinical information (e.g., diagnosis) as well as empirically supported risk factors (e.g., sexual deviance) would predict trial outcomes.
    METHODS: We analyzed multiple pieces of demographic, criminogenic, and clinical data on three nested subsamples of respondents on the basis of the legal process: MA consent (n = 713), MA trial (n = 316), and disposition hearing (n = 643). The binary outcomes of interest were as follows: For the MA consent subsample, it was whether the respondent waived their MA trial; for the MA trial subsample, it was whether the respondent was found at trial to have an MA; and for the disposition hearing, it was whether the respondent was ordered to inpatient or outpatient civil management.
    RESULTS: The strongest predictor of waiving the trial was geographic location; respondents outside New York City and Long Island were more likely to waive their trials (ORs = 2.38-3.37). The strongest predictors of MA trial and disposition hearing outcomes were Diagnostic and Statistical Manual of Mental Disorders diagnoses; pedophilia (ORs = 4.05-7.22) and sexual sadism (ORs = 2.68-7.03) diagnoses increased the likelihood of an MA finding and confinement order.
    CONCLUSIONS: Judges and juries give significant weight to clinical information, particularly pedophilia diagnoses, when making civil management legal decisions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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  • 文章类型: Journal Article
    目的:人类性二态和健康性别差异的研究集中在表面上普遍的分子性别差异上,如性染色体和循环激素水平,而忽略了生物学中非凡的多样性,行为,以及不同人群在其独特的进化史上获得的文化。
    方法:使用来自1000G和HGDP的RNA-Seq数据和全基因组序列,我们调查了11个人群中性别偏倚基因表达的变异,并检验了性别偏倚表达的人群水平变异是否可能是由含有性别特异性调控变异的区域的适应性进化引起的.
    结果:我们发现人类性别偏倚的基因表达高度可变,主要是针对特定人群,并在人口逆转之间进行演示。表达数量性状基因座作图揭示了性别特异性调节区域,并有近期积极自然选择的证据,这表明性别偏见表达的变化可能已经进化为对人类祖先环境的适应性反应。
    结论:这些结果表明,性别偏倚的基因表达比以前认为的更灵活,并且在人群中通常不共享。相反,与性别相关的分子表型取决于群体特异性分子进化和对当代社会生态学的生理反应之间的复杂相互作用。
    Studies of human sexual dimorphism and gender disparities in health focus on ostensibly universal molecular sex differences, such as sex chromosomes and circulating hormone levels, while ignoring the extraordinary diversity in biology, behavior, and culture acquired by different human populations over their unique evolutionary histories.
    Using RNA-Seq data and whole genome sequences from 1000G and HGDP, we investigate variation in sex-biased gene expression across 11 human populations and test whether population-level variation in sex-biased expression may have resulted from adaptive evolution in regions containing sex-specific regulatory variants.
    We find that sex-biased gene expression in humans is highly variable, mostly population-specific, and demonstrates between population reversals. Expression quantitative trait locus mapping reveals sex-specific regulatory regions with evidence of recent positive natural selection, suggesting that variation in sex-biased expression may have evolved as an adaptive response to ancestral environments experienced by human populations.
    These results indicate that sex-biased gene expression is more flexible than previously thought and is not generally shared among human populations. Instead, molecular phenotypes associated with sex depend on complex interactions between population-specific molecular evolution and physiological responses to contemporary socioecologies.
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