197 - 6D34 Frotteuristic disorder

6D34 Frotteuristic disorder

583 Paraphilic disorders Boundary with sexual crimes that do not involve a paraphilic disorder Sexual crimes involving coercive sexual behaviours may consist of actions or behaviours that are not associated with a sustained underlying paraphilic arousal pattern. Rather, these behaviours may be transient and occur impulsively or opportunistically. The diagnosis of coercive sexual sadism disorder requires these behaviours to be a manifestation of a sustained, focused and intense pattern of sexual arousal. Frotteuristic disorder Essential (required) features • A sustained, focused and intense pattern of sexual arousal – as manifested in persistent sexual thoughts, fantasies, urges or behaviours – that involves touching or rubbing against a non-consenting person is required for diagnosis. • The individual must have acted on these thoughts, fantasies or urges, or be markedly distressed by them. Additional clinical features • Frotteuristic disorder should not be diagnosed among children, and should be diagnosed only with the utmost caution among adolescents. Sexual experimentation is typical during adolescence, and sexual acts may occur impulsively or opportunistically rather than representing a recurrent pattern of sexual arousal. • The diagnosis of frotteuristic disorder is generally not adequately supported when the evidence indicating a sustained, focused and intense pattern of sexual arousal consists solely of a single or very limited number of instances of frotteuristic behaviour, as there may be other explanations for specific occurrences (e.g. intoxication, opportunity). In the absence of a report of the individual’s sexual thoughts, fantasies or urges, examples of other forms of evidence supporting the presence of an frotteuristic arousal pattern include a preference for specific types of pornography; preference over other forms of sexual beh aviour; or planning and repeatedly seeking out opportunities to engage in frotteuristic behaviour. Boundary with normality (threshold) • By definition, frotteuristic disorder specifically excludes consensual touching or rubbing that occurs with the consent of the individual involved. 6D34 Paraphilic disorders | Frotteuristic disorder

Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural or Neurodevelopmental Disorders Course features • Individuals with frotteuristic disorder often report the onset of frotteuristic sexual interest during adolescence. • Frotteuristic disorder is relatively stable after young adulthood, but sexual thoughts, fantasies, urges and behaviours may change over time, such that an individual who was assigned a diagnosis of frotteuristic disorder no longer meets the diagnostic requirements. Developmental presentations • Advancing age may be associated with decreasing paraphilic sexual arousal and decreasing behavioural manifestations of frotteuristic disorder due to increased impulse control and decreased sexual drive. Sex- and/or gender-related features • Frotteuristic disorder is much more prevalent among men. Boundaries with other disorders and conditions (differential diagnosis) Boundary with compulsive sexual behaviour disorder Both frotteuristic disorder and compulsive sexual behaviour disorder may involve repetitive sexual impulses, urges or behaviours that result in marked distress or impairment. Frotteuristic disorder is characterized by sexual impulses, urges or behaviours that are manifestations of a sustained, focused and intense pattern of sexual arousal that involves touching or rubbing against a non-consenting person. In contrast, compulsive sexual behaviour disorder is characterized by a persistent pattern of failure to control sexual impulses, urges or behaviours, regardless of the focus of sexual arousal. If an individual with frotteuristic disorder is able to exercise some degree of control over the behavioural expressions of the arousal pattern, an additional diagnosis of compulsive sexual behavioural disorder is generally not warranted. Boundary with disorders due to substance use Episodes of impulsive or disinhibited sexual behaviour, including frotteuristic behaviour, may occur during substance intoxication. Such episodes may not be a manifestation of a sustained, focused and intense sexual arousal pattern. At the same time, some individuals with frotteuristic Paraphilic disorders | Frotteuristic disorder