Exhibitionistic Disorder

What is 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.

 

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 DSM5

  • 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.
  • Manifesting for  ≥ 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 being arrested. In non-clinical or general populations, it is estimated that 2% to 4% of the male population engages in exhibitionistic acts; there are no reported figures for the female population.

 

Risk Factors of Exhibitionistic Disorder

    Exhibitionistic Disorder typically develops during adolescence and antisocial history, 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

    Psychotherapy

      Cognitive Behavioural Therapy (CBT)

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

    Medications

    1. Inhibitors of sexual hormones (testosterone or oestrogen) to reduce sexual desire
    2. Selective serotonin reuptake inhibitors (SSRIs)
      1. Reduction of SSRIs to reduce sex drive

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