The main change in the new DSM-5 Paraphilic Disorders chapter is that sexual paraphilias are not de facto mental disorders. This reflects the change in mindset that paraphilias are considered “normal” unless they cause distress or impairment to the individual or cause personal harm or risk of harm to others.
The criteria for a Paraphilic Disorder must now include both a description of the paraphilia as well as negative consequences of the paraphilia (e.g. distress, impairment, risk of harm to self or others).
By Dr. Terra Caudill, MD, MS