{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:34:18Z","timestamp":1791196458018,"version":"4.1.0"},"reference-count":43,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2002,10,1]],"date-time":"2002-10-01T00:00:00Z","timestamp":1033430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sex Abuse"],"published-print":{"date-parts":[[2002,10]]},"abstract":"<jats:p>One hundred and twenty consecutively evaluated outpatient males with paraphilias (PAs; n = 88, including 60 sex offenders) and paraphilia-related disorders ( PRDs; n = 32) were systematically assessed for certain developmental variables and DSM-IV-defined Axis I comorbidity. In comparison with the PRDs, the PA group was statistically significantly more likely to self-report a higher incidence of physical (but not sexual) abuse, fewer years of completed education, a higher prevalence of school-associated learning and behavioral problems, more psychiatric\/substance abuse hospitalizations, and increased employment-related disability as well as more lifetime contact with the criminal justice system. In both groups, the most prevalent Axis I disorders were mood disorders (71.6%), especially early onset dysthymic disorder (55%) and major depression (39%). Anxiety disorders (38.3%), especially social phobia (21.6%), and psychoactive substance abuse (40.8%), especially alcohol abuse (30%), were reported as well. Cocaine abuse was statistically significantly associated with PA males (p = .03). There was a statistically significant correlation between the lifetime prevalence of Axis I nonsexual diagnoses and hypersexual diagnoses (PAs and PRDs). The prevalence of retrospectively diagnosed attention deficit hyperactivity disorder (ADHD) was 35.8%, the third most prevalent Axis I disorder. ADHD (p = .01), especially ADHD-combined subtype (p = .009), was statistically significantly associated with PA status. ADHD was statistically significantly associated with conduct disorder, and both of these Axis I disorders were associated with the propensity for multiple PAs and a higher likelihood of incarceration. When the diagnosis of ADHD was controlled, the differences reported above between PAs and PRDs either became statistically nonsignificant or remained as only statistical trends. Thus, ADHD and its associated developmental sequellae and Axis I comorbidities was the single most common nonsexual Axis I diagnosis that statistically significantly distinguished males with socially deviant sexual arousal (PAs) from a nonparaphilic hypersexual comparison group (PRDs). Sex offender paraphiliacs were more likely to be diagnosed with conduct disorder, alcohol abuse, cocaine abuse, and generalized anxiety disorder. The prevalence of any ADHD in the sex offender paraphiliacs was 43.3%, and nearly 25% of offenders were diagnosed with ADHD-combined subtype.<\/jats:p>","DOI":"10.1177\/107906320201400405","type":"journal-article","created":{"date-parts":[[2009,11,6]],"date-time":"2009-11-06T19:46:05Z","timestamp":1257536765000},"page":"349-366","source":"Crossref","is-referenced-by-count":227,"title":["A DSM-IV Axis I Comorbidity Study of Males (n = 120) With Paraphilias and Paraphilia-Related Disorders"],"prefix":"10.1177","volume":"14","author":[{"given":"Martin P","family":"Kafka","sequence":"first","affiliation":[{"name":"Department of Psychiatry, McLean Hospital, Belmont,\rMassachusetts,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Hennen","sequence":"additional","affiliation":[{"name":"Biostatistics Laboratory, McLean Hospital, Belmont,\rMassachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2002,10,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.60.6.881"},{"key":"atypb2","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association.","year":"1980","edition":"3"},{"key":"atypb3","volume-title":"Diagnostic and statistical manual","author":"American Psychiatric Association.","year":"1987","edition":"3"},{"key":"atypb4","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association.","year":"1994","edition":"4"},{"key":"atypb5","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1542\/peds.92.2.212","volume":"92","author":"Barkley, R.A.","year":"1993","journal-title":"Pediatrics"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.150.12.1792"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.152.11.1652"},{"key":"atypb8","first-page":"217","volume":"4","author":"Black, D.W.","year":"1998","journal-title":"Journal of Psychiatry and Behavior"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.154.2.243"},{"key":"atypb10","unstructured":"Carnes, P. (1990). Sexual addiction. In A. Horton, B. L. Johnson, & L. M. Roundy (Eds.), The incest perpetrator: A Family member no one wants to treat (pp. 126-143). 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(1985). Sexual aggression: Constructing a predictive equation: A controlled pilot study. In R. Langevin (Ed.), Erotic preference, gender identity, and aggression in men (pp. 39-72). Hillsdale, NJ: Erlbaum."},{"key":"atypb31","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.120.2.209"},{"key":"atypb32","unstructured":"Mannuzza, S. & Gittelman, R. (1985). Informant variance in the diagnostic assessment of hyperactive children as young adults. In J. Barrett & R. Rose (Eds.), Mental disorders in the community: Progress and challenge: Proceedings of the American Psychopathological Association (pp. 243-254). 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