Sunday, May 6, 2012

DSM-V Open Comment Period May 2 thru June 15

According to the APA page for the DSM-V the comment period is open The comment period is the period of time that people can register on the DSM site and send in a comment pertaining to the current proposed changes. I want to encourage people to do this. A big concern I have is that pedophiles on the boychat forums are well organized and they are working on a plan to send in comments. Here is the link to my YouTube page that shows the video of this I personally find it very scary that pedophiles are working hard at having input into the proposed changes in the DSM-5. Their goal of course is to get pedophilia out of the DSM because of their belief that it is a sexual orientation not a mental illness. Just like homosexuality used to be.

I thought I would start this blog post discussing paraphilic disorders. According to the APA DSM-V these are the disorders that are currently proposed as paraphilic disorders:
Paraphilic Disorders. This category contains diagnoses that were listed in DSM-IV under the chapter of Sexual and Gender Identity Disorders. The Sexual and Gender Identity Disorders Work Group has been responsible for addressing these revisions. Many of the disorders that were previously listed in the Sexual and Gender Identity Disorders chapter in DSM-IV also have been distributed throughout separate chapters on Sexual Dysfunctions and Gender Dysphoria.  The work group has proposed that this chapter be renamed from Paraphilias to Paraphillic Disorders. They have also added two course specifiers (In a Controll Environment and In Remission) to all of the diagnostic criteria sets included in this chapter. Pedophilic Disorder now has an additional subtype (Hebephilic Subtype). Finally, the work group is proposing Hypersexual Disorder and Paraphilic Coercive Disorder for inclusion in Section III, which is a section of the DSM-5 text in which conditions that require further research will be included.
I am especially concerned with some of the changes in wording and wanted to show what the current criteria are compared to what the proposed criteria changes are. The wording may be slight changes but the implications can be large.

Here is the following criteria from the DSM-IV:  
A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).
B. The person has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.
C. The person is at least age 16 years and at least 5 years older than the child or children in Criterion A.
Note: Do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12- or 13- year-old.
Specify if:
Sexually Attracted to Males
Sexually Attracted to Females
Sexually Attracted to Both
Specify if:
Limited to Incest
Specify type:
Exclusive Type (attracted only to children)
Nonexclusive Type
The following are the proposed criteria for the DSM-V:
Pedophilic Disorder

A. Over a period of at least 6  months, an equal or greater sexual arousal from prepubescent or early pubescent children than from physically mature persons, as manifested by fantasies, urges, or behaviors.

B. The individual has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or impairment in social, occupational, or other important areas of functioning. 

C. The individual must be at least     18 years of age and at least 5 years older than the children in Criterion A.
Specify type:
Classic Type—Sexually Attracted to Prepubescent Children (Tanner Stage 1)
Hebephilic Type—Sexually Attracted to Early Pubescent Children (Tanner Stages 2-3)
Pedohebephilic Type—Sexually Attracted to Both
Specify type:
Sexually Attracted to Males
Sexually Attracted to Females
Sexually Attracted to Both
Specify if:
In a Controlled Environment
In Remission (No Distress, Impairment, or Recurring Behavior for Five Years and in an Uncontrolled Environment
Obviously they have recommended changing the name of the disorder from Pedophilia to  Pedophilic Disorder. Under Criterion A they use the wording "physically mature persons." That concerns me because their is no definition of what those words mean. Without a clear definition or understanding of what they mean, it opens the possibility that those words will mean something different to different people. I'll explain, there is a movement to change the AOC (age of consent) laws. One hundred years ago life expectancy in the US was 48.4 years for males and 51.8 years for females. The AOC was 12 years. The life expectancy according to the between in 2008 in the US is 75.3 years for males and 80.3 years for females. The average AOC in the US is 16 years It makes sense that as life expectancy increases so would the AOC. One of the arguments that I have seen over and over again by those pushing for the AOC laws to be lowered; is that the AOC laws were 12 years or sometimes lower so why can't they be changed back? My answer is because on average life expectancy has increased by almost 30 years. This was 2/3's of someone's life a hundred years ago.

According to the recommended changes if someone is 18 years or older and is having fantasy's, urges and behaviors toward a "physically mature person" they will not be defined as having pedophilic disorder.  If they are 18 years or older and the "physically mature person" has gone through puberty and is only 12 year old, does that mean they have pedophilic disorder? What if the person is 18 years or older and the "physically mature person" is 13, 14, or 15 years old does that mean they have pedophilic disorder? I think this is too gray of an area. If the 18 year or older person acts on their fantasy's, behaviors or urges and has a sexual relationship with a "physically mature person" can they claim they don't have pedophilic disorder? Or can they claim they didn't break the law because they had sex with a "physically mature person?" Granted, in most places on the plant they will be considered a sexual offender  because of AOC laws, and would be breaking the law. Although according to this gray area they won't be a pedophilic sexual offender. I ask what is worse? Everyone can agree that being a pedophile is one of the worst imaginable things to be called. It automatically conjurers up strong emotions of hatred and disgust. Breaking the law by harming a "physically mature person" softens the wording compared with breaking the law by harming a child. I know this seems like semantics, but it isn't.

To further discuss the AOC if a "physically mature person" is 12,13, 14, or 15 years old, should we change the AOC laws to reflect this? This is where I feel the conversations will lead to. When we start describing 12, 13, 14, or 15 year old's as a "physically mature person" it will be a soap box for those who want the AOC laws lowered to stand upon. This will be a slippery slope and will help the movement to normalize pedophilia. This is why we have to be careful with our words. 

Another proposed change I note with the DSM-V compared to the DSM-IV is under the criterion for pedophilia under the; to specify list. One of the terms under the to specify list, in the DSM-IV is incest. I do commend the committee for recommending taking this requirement out of the DSM-V. As someone who has personal experience with incestuous pedophilia I feel it is important to note this change. Incest is a horrible thing to live through, it impacts one's life similarly to those who are abused by a pedophilic sexual offender. The difference is that the pedophile happens to be a family member. This is also known as opportunistic pedophilia. To see the recommended change means to me that those who perpetuate child sexual abuse on family members are being called out for what they are pedophiles. 
One last thing I'd like to talk about is the recommended change in the DSM-V under the specify heading, Remission. I did some research into remission and pedophilia and there isn't a lot of information out on this topic, yet. I was surprised to see the word remission and pedophilic disorder together. I don't think this is a word that those who are pro-pedophilia would like. Most pro-pedophilia proponents feel that pedophilia is a sexual orientation not a mental illness. Having one's pedophilia be in remission would lend credence to the fact that pedophilia is a mental illness. 

Some questions I have around this are; how does a psychiatrist determine if one's pedophilia is in remission? How does the psychiatrist know that the pedophile hasn't been using grooming techniques on him/her? To help lead them to the conclusion that they are in remission? I'd like to be a fly on the wall witnessing B4U-ACT's response to this. Rosie

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