Review Question - QID 217674

This patient who experiences intense sexual arousal in response to an inanimate object (ropes) both in isolation and when associated with women most likely has fetishistic disorder.

According to the Diagnostic and Statistical Manual for Mental disorders 5th edition (DSM-5), fetishistic disorder can be diagnosed if an individual has experienced sexual urges focused on a non-genital body part or inanimate object and has acted out urges, fantasies, or behaviors related to these urges. The desires must persist for at least 6 months. Importantly, the fantasies, urges, or behaviors must cause distress or impairment in functioning as attractions that do not cause impaired function may be abnormal yet benign and not diagnosable. Finally, the fetishistic object cannot be an article of clothing employed in cross-dressing, or a sexual stimulation device (such as a vibrator).

Schippers et al. performed an exploratory factor analysis regarding unusual sexual interests and found that males and females were similar across all domains of sexual interests.

Incorrect Answers:
Answer 2: Gender dysphoria refers to patients who have a strong desire to be a gender other than the one assigned at birth and has dysphoria related to this desire. This patient has not expressed any desire to be a different gender than male.

Answer 3: Masochistic disorder can be diagnosed in patients who experience sexual arousal in response to degrading or painful situations and who experience dysphoria as a result of these urges. While ropes are associated with bondage in masochism; this patient's attraction to ropes also occurs in isolation.

Answer 4: Sexual sadism disorder can be diagnosed in patients who experience sexual arousal in response to domination or causing pain in others and who have dysphoria as a result of these urges. While this patient's pornography watching habits likely include sadism given the presence of ropes, his attraction is to the inanimate object rather than the act.

Answer 5: Transvestic disorder can be diagnosed in patients who have strong sexual arousal in response to cross-dressing and who have significant psychosocial impairment as a result of these desires. In this case, the patient's object of arousal is an inanimate object that is not clothing.

Bullet Summary:
Fetishistic disorder is when a patient experiences sexual urges focused on a non-genital body part or an inanimate object and has dysphoria or psychosocial impairment related to these urges.