Psychiatria pre prax 1/2020

Sexual violence and paraphilia, does pathological sexual aggression exists or not?

Only a minority of perpetrators of violent sexual violence acts has a diagnosed paraphilia. The risk of committing violent behavior is associated with the diagnosis of sadism and pedophilia (in the case of acts against children). A significant percentage of acts are committed by persons who since the 1960s have been diagnosed as a group of paraphilic offenders, distinguishable from sadistic perpetrators and nonparaphillic offenders. In Czech tradition, this disorder is classified as pathological sexual aggression. Their sexually aggressive behavior (sometimes referred to as predatory behavior) is characterized by skipping the stages of partner interaction; the victims are usually unknown, non-cooperating women. While DSM-5 authors include this disorder as a research item, in ICD-11, these patients can be classified as Paraphilic Disorder Involving Non-Consenting Individuals. To diagnose this atypical sexual arousal manifested by sexual thoughts, fantasies, and desires for a non-consenting person, the long-term profile of these fantasies or actions is needed, in exclusion of other paraphilic and mental disorders.

Keywords: paraphilia, sexual aggression, pathologic sexual aggression, MKN-11, non‑consenting person