Frotteuristic Disorder
Frotteurism: Receiving sexual pleasure through the act of touching or rubbing a non-constantly
person.
Diagnostic Criteria
Classified as a paraphilic disorder
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B.
Over a period of at least 6 months, recurrent and intense sexual arousal from touching or rubbing
against a person who did not give consent, as manifested by fantasies, urges, or behaviors
The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges
or fanatics caused by clinically significant distress or impairment in social, occupational, on other
important areas of functioning
Specify if:
In a controlled environment: Individuals living in institutional or other settings where
opportunities to touch or rub against a nonconsenting person are restricted
In full remission: Individual has not acted on the urges with a nonconsenting person, and there
has been no distress or impairment in a social, occupational, or other areas of functions, for at
least 5 years in an uncontrolled environment.
Ethilogy
Exact cause is not known, by there are many theories about the cause:
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Freud proposed that these individuals have problems with normal sexual interactions.
Have unmet needs to rub themselves against the victim and cuddle
May fantasize that they share an actual relationship with their nonconsenting victims
Paraphilias have been associated with the additional mental health diagnoses:
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Social anxiety
Traumatic brain injury
History of sexual abuse
Substance abuse
Intellectual disabilities
More than one paraphilia, especially exhibitionism and frotteurism
Prevalence
The population prevalence of the disorder is fairly unknown, it is not likely that it exceeds the rate found
in selected clinical settings.
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Frotteuristic acts occur in up to 30% of adult males in the general population
10-14% of adult males seen in outpatient settings have symptoms that meet the diagnostic
criteria.
Adult male often report becoming interested in frotteurism during late adolescence or emerging
adulthood.
Its possible children or adolescents rub or touch unwilling others in the absence of the diagnosis
No minimum age for diagnosis, it can be difficult to differentiate from conduct disorder behavior
without sexual motivational
Course
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Adult male often report becoming interested in frotteurism during late adolescence or emerging
adulthood.
Its possible children or adolescents rub or touch unwilling others.
No minimum age for diagnosis, it can be difficult to differentiate from conduct disorder behavior
without sexual motivational
The persistence of the disorder over time is unclear
Requires one or more contributing factor that may change time with or without treatment: Subjective
distress(guilt, shame, loneliness), psychiatric morbidity, hypersexuality and sexual impulsivity,
psychosocial impairment, tendency to act out sexually by touching or rubbing against a nonconsenting
person
Cultural Consideration
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Sexual deviance vary across cultures, may be considered as behavioral norms
With paraphilic disorders it's tricky because a lot of cultures vary on what's legal and illegal
Characteristics of cultures influences the reporting of the act, leads to underreporting
Assessment
Objective tools: Penile plethysmography, polygraph, and abel assessment for sexual interest
Self-Report: Multidimensional inventory of development, sex and aggressive behavior(MIDSA), multiple
sex inventory( MSI), bradford sexual history inventory, and clarke sex history questionnaire for malesrevised(SHQ-R).
● MSI is able to distinguish between the types of sexual offenders
● MIDSA, MSI, and SHQ-R assess sexual interest and behavior
● MIDSA is the most comprehensive psychometric
Treatment
Selective Serotonin Inhibitors( SSRI)- SSRI can reduce libido, orgasm, and ejaculation through activation
of the 5HT2 receptor. Most studies of SSRI involve doses of fluoxetine and sertraline. These have been
shown to be extremely effective in reducing paraphilic behavior
CBT- Most effective way to treat this disorder. Targets to identify cognitive distortion and patient
rejection. Focuses on decreasing sexual urges and teaching to transition thoughts into more normative
stimuli. Also tries to induce empathy for the victim.
Psychoanalytic- Aims to explore the past related trauma, trying to make an association of trauma and
sexual behavior in adulthood.
Case Study
Tom is a 19 year old man who has struggled with adderall use since he was 16. He has not used the
substance for a year but still goes to therapy to maintain his sobriety. In a recent session, he has admitted
to rubbing his genitals against his classmates when they are not looking. He said it started at the
beginning of the school year, which was 7 months ago. He also admitted to touching an unsuspecting
coworker, which resulted in him getting fired. He feels guilty and knows he can possibly be expelled from
college for doing this but he is unable to restrain himself due to the intense sexual gratification he gets
from these acts.