| Curr Psychiatry Rep. 2018 Jul 21;20(8):54. doi: 10.1007/s11920-018-0919-6. In his 2008 book on sexual pathologies, Anil Aggrawal compiled a list of 547 terms describing paraphilic sexual interests. Except for masochism, which is 20 times more common in women than men, paraphilias are almost exclusively diagnosed in men. Masochists may act out their fantasies on themselves by such acts as cutting or piercing their skin or burning themselves. Paraphilias are characterized by sexual fantasies, urges, and behaviors involving unusual objects or activities. Lithium, the mood-stabilizing drug also known as Eskalith is typically used for the treatment of mania in bipolar disorder. Behavioral learning models suggest that a child who is the victim or observer of inappropriate sexual behaviors may learn to imitate that behavior, and is later reinforced for it. Most paraphilias are rare and are about 20 times more common among males than among females. This therapy tends to take an approach to treating sexual offenders using a relapse prevention model that is similar to treating people with a drug addiction. © 2005 - 2019 WebMD LLC. Clinical literature discusses eight major paraphilias individually. However, the reason for this disparity is not clearly understood. Individuals with this disorder use the act -- real, not simulated -- of being humiliated, beaten, or otherwise made to suffer in order to achieve sexual excitement and climax. It might not necessarily be a paraphilic disorder unless distress or their behaviour puts them at odds with the law. While several of these disorders are associated with aggressive behavior, others are not aggressive or harmful. The intensity of the sexual attraction can be overwhelming enough to cause distress. Cognitive therapies described include restructuring cognitive distortions and empathy training. The associated behaviors may also have serious social and legal consequences. People with paraphilia may also benefit from social skills training to help them develop age-appropriate, reciprocal relationships. While the desired sexual stimulant for the paraphilia sufferer depends on the specific paraphilia, the characteristics of the illness are often very similar, as described in the most current standard reference for. They may also act out the trauma by somehow harming themselves. Drug interactions, dosage, and a pregnancy and breastfeeding safety information should be reviewed prior to taking this medication. Some behaviors that might be classified as paraphilias by some subsets of society may be viewed as harmless eccentricities by other subsets of society, or entirely normal behavior within other societies. These individuals need intensive psychiatric treatment and may be jailed for these activities. Consistent with the change in consensus among psychiatrists it was not included in later editions. Often, a paraphilia may be necessary for the person who has it to function sexually, despite the fact it may also be a source of significant distress. In exclusive paraphilias, a person is unable to become sexually aroused in the absence of the paraphilia. The sexual arousal usually does not involve a real partner but includes the fantasy that the individual is the female partner as well. There are some reports of reduced sexual compulsive behavior and a reduction in obsessive sexual thoughts in patients, which they attribute to the drug's enhancement of serotonergic functioning. Some view these disorders as a manifestation of arrested psychosexual development, with the paraphilic behaviors defending the person's psyche against anxiety (defense mechanisms).
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