A CASE PRESENTATION

FOR
PARAPHILIC DISORDER
Alcalde, Geralyn Claire S.
Bonifacio, Marian Ammylou M.
Tan, Ma. Cristina Chesca M.

INTRODUCTION
Sexual Disorder
History of the Disorder
1950's psychoanalysis as freud's theory

1960's psychiatry started moving away from

theory and toward empirical
1973 American Psychiatric Association removed
homosexuality from the DSM list of paraphilias
1980 and replaced it as "ego-dystonic
homosexuality"

Epidemiology
practiced by only a small percentage of the
population
the repetitive nature of the disorder results
in a high frequency of such acts
the prevalence of paraphilias is significantly higher
than the number of cases diagnosed in general
clinical facilities

Epidemiology
pedophilia is most common of all childern, 10 to
20% have been molested by age 18
of adults females, 20% haven been the target of
persons w exhibitionism and voyeurism
fetishism almost always occurs in men
more than 50% of all paraphilias have their onset
before age 18
the occurrence of the behavior peaks bet ages 15
and 25 and gradually declines

Etiology
Psychosocial Factors
- classic psychoanalytic model
- failed to complete the normal developmental
process toward sexual adjustment
Biological Factors
-positive organic findings 74% with abnormal
hormone levels

PARAPHILIC DISORDERS
CLASSIFICATIONS OF DSM-5
1. Voyeuristic Disorder

2. Exhibitionistic Disorder
3. Frotteuristic Disorder
4. Sexual Masochism Disorder
5. Sexual Sadism Disorder

6. Pedophilic Disorder
7. Fetishistic Disorder
8. Transvestic Disorder
9. Other Specified Paraphilic Disorder
10. Unspecified Paraphilic Disorder

CLINICAL CASE FORMULATION

Profile of the Client

NAME: Mr. SB
AGE: 46
PLACE OF BIRTH: Undisclosed
CURRENT PLACE TO LIVE: Undisclosed
REFERRED TO CLINICIAN BY: Court Order
DATE REFERRED TO CLINICIAN: Undisclosed

MENTAL STATUS EXAMINATION

Appearance Dressed like a teenager
Behavior Ostensibly uncomfortable
Speech Hesitant, long delay
Emotion Humiliated, Mortified, Distressed
Thought Process coherent, Blocking
Thought Content Consistent with reality
Cognition & Intellectual Resources Responsive

CLINICAL CASE FORMULATION

CLINICAL CASE HISTORY
Physically abused by his Father
Somewhat neglected by the Mother
Sexually abused by his Fathers Good Friend
Became a volunteer at the Camps
Decided to get married

CLINICAL CASE FORMULATION

ASSESSMENT
A. Personality Test/s:
MMPI-2 guarder and suspiscious
Rorschach- Impulsive & Restricted ability to
fantasize
TAT Naive/ unfounded optimism/ Unrealistic
happily ever after
B. Intelligence Test/s- WAIS-III
Average Inteligence

CLINICAL CASE FORMULATION

DIAGNOSIS : Exclusive Type, Sexually attracted to

Males, Pedophilic Disorder

Criteria A
Over a period of 6 months, recurrent, intense
sexually arousing fantasies, sexual urges, or
behaviors involving sexual activity with a
prepubescent child or children

CLINICAL CASE FORMULATION

Criteria B
The individual has acted on these sexual urges or
fantasies caused marked distress or
interpersonal difficulty
Criteria C
The individual is at least age 16 years and at
least 5 years older than the child or children in
criterion A
*Exclusive Type

*Sexually attracted to males

CLINICAL CASE FORMULATION

TREATMENT PLAN
Out-patient Care
Intensive individual & group Psychotherapy
Aversion Therapy

References:
DSM-V
Sadock, B.J.; Sadock, V.A; Ruiz, P. M.D. Kaplan
and Sadock's Synopsis of Psychiatry:
Behavioral Sciences/Clinical Psychiatry.
Eleventh Ed. (p.541)
Whitbourne, S.; Halgin, R.P. Abnormal
Psychology: Clinical Perspectives On
Psychological. (p. 242-246)