Paraphilias, problematic sexual behaviours and personality disorder-To what extent are they linked?

BACKGROUND

Since DSM-III, mental disorders have been classified based on overt symptoms and behaviours rather than underlying psychological and personality processes.

AIMS: This study examines the occurrence of personality dysfunction in individuals with paraphilic disorders and problematic sexual behaviours.

METHOD: The Shedler-Westen Assessment Procedure (SWAP-200), a clinician-rated assessment measure of personality disorders, was administered in a sample of 303 patients referred to a specialist forensic psychotherapy clinic. Sixty-six percent (N = 200) of the sample were diagnosable with traits of one or more DSM-5 personality disorders, and 35% (N = 106) were diagnosable with categorical DSM-5 personality disorders. When an alternative set of empirically derived personality diagnoses was examined, 94% (N = 285) had significant traits of the personality syndromes, and 62% (N = 188) of the sample met criteria for categorical diagnoses.

CONCLUSIONS

Paraphilic fantasies and behaviours may be linked to underlying personality pathology, suggesting implications for assessment and treatment.