Sunday, October 24, 2010

Paraphilias debate at the annual meeting of the American Association of Psychiatry and Law

On forensic psychologist Karen Franklin's blog, she recently posted about some very interesting news about the current DSM-5 paraphilias controvercy: Psychiatrists vote no on controversial paraphilias.

The DSM-5 Paraphilias Subworkgroup has made a number of controversial proposals (many of which I've blogged about before), among these are expanding Peophilia (attraction to prepubescent chilren) to Pedohebephilia (attraction to prepubescent or pubescent children), adding Paraphilic Coercive Disorder, and adding Hypersexuality. At the annual meeting of the American Association of Psychiatry and Law (AAPL), they had a debate on the matter (stirring the DSM cauldron), and afterwards, it seems, they had a (non-binding) vote. The results:
The votes were 31-2, 31-2, and 29-2, respectively, against Paraphilic Coercive Disorder, Pedohebephilia, and Hypersexual Disorder.

Based on a presentation at last year's AALP meeting, in a comment in the Psychiatric Times, one forensic pyschiatrist one forensic psychiatrist asked
"Is this workgroup immune to critique? Has it "gone rogue"? What is its agenda?"

I'm coming to suspect that they have indeed "gone rogue," and their agenda seems rather transparent to many. Franklin writes:
The "pro" debate team repeatedly insisted that these diagnoses are being proposed based on their scientific merit, not their utility to government evaluators in civil commitment cases. They said these new diagnoses are needed so people suffering with these conditions can get adequate treatment...

The audience of forensic psychiatrists clearly did not buy the clinical justification. As more than one audience member asked the panel, If the rationale is strictly clinical, why are attorneys serving as advisors to the work group?

A very good question indeed. Especially given that they had one of these advisor's--a prosecutor--write a report about how much he would love to have Paraphilic Coercive Disorder in DSM-5.

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