Exhibitionistic Disorder

Exhibitionistic Disorder involves recurrent and intense sexual arousal from the exposure of one’s genitals to non-consenting and unsuspecting persons, usually a stranger, and being overwhelmed by such thoughts to the point of dysfunction. This condition is considered a paraphilic disorder, which refers to persistent and intense atypical sexual arousal patterns that are accompanied by clinically significant distress or impairment.

 

Sub-Types of Exhibitionistic Disorder

The Subtypes of Exhibitionistic Disorder are determined by the age of the non-consenting witness:

  • Exposure to prepubertal children (children who have not yet gone through puberty)
  • Exposure to physically mature individuals
  • Exposure to prepubertal children and mature individuals

 

Diagnosis of Exhibitionistic Disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a formal diagnosis requires that an individual:

  • Experiences repeated and intense arousal by exposing genitals to an unsuspecting person, or being observed by other people during sexual activity.
  • Acted on urges with a nonconsenting person, or such fantasies, intense urges, or behaviours cause significant distress or impair functioning at work, in social situations, or in other important areas.
  • These symptoms have been present for at least 6 months.

 

Prevalence of Exhibitionistic Disorder

Due to underreporting, the actual prevalence of exhibitionism is unknown, and individuals are likely to only seek help after police involvement. In non-clinical or general populations, it is estimated that 2% to 4% of the male population engages in exhibitionistic acts; there is a lack of reported figures for the female population.

 

Risk Factors

Exhibitionistic Disorder typically develops during adolescence. Individuals with a history of anti-social behaviour, alcohol or other substance misuse, and  paedophilic sexual preference may increase the risk of developing Exhibitionistic Disorder. Additionally, childhood abuse and hypersexuality may also have increased likelihood in the onset of Exhibitionistic Disorder. 

 

Treatment for Exhibitionistic Disorder

Cognitive Behavioural Therapy (CBT)

  • Identification of triggers that cause their urges 
  • Cognitive Restructuring: Identifying and changing the thoughts that drive the behaviour
  • Behavioural Training: Improve control of urges and use more acceptable means of coping 
  • Relaxation Training: To reduce exposure impulses
  • Coping Skills Training: Different ways to behave when feeling aroused

✽   Medications

Certain medications can inhibit sexual hormones such as testosterone or oestrogen, and this can help to reduce sexual desire. Individuals might also be prescribed Selective Serotonin Reuptake Inhibitors (SSRIs), as SSRIs have been shown to reduce sex drive.

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