Paraphilia Comorbidity

Another important consideration associated with the paraphilias is the . According to the Diagnostic and Statistics Manual, it is not uncommon for those with a paraphilia to have more than one paraphilia (American Psychological Association, 2000). As well as additional paraphilias, it is also common for those with paraphilias to have one or more other disorders. Kafka and Hennen (2002) conducted a study of 120 males and found that, of those with paraphilias, the most prevalent Axis I disorders were mood disorders, particularly early onset dysthymic disorder and major depression. Anxiety disorders were also reported, particularly social phobia, as well as psychoactive substance abuse, especially alcohol abuse (Kafka & Hennen). Furthermore, it was also found that retrospectively diagnosed attention deficit hyperactivity disorder was present for 35.8% of the individuals (Kafka & Hennen). One problem with the comorbidity of the paraphilias is the varying discrepancy in the percentages reported by different researchers. For example, when looking at paraphilias and mood disorders, a study by Cochrane, Griss, and Frederick (2001) reported that 5% of sexual offenders also met the criteria for a mood disorder. A study by Kafka and Prentky (1992) however, showed that 95% of sexual offenders also met the criteria for a mood disorder. In terms of those convicted of sexual offences and anxiety disorders, the numbers go from a low of 2.9% of sexual offenders also meeting the criteria for a diagnosis of an anxiety disorder (Firestone, Bradford, Greenberg, Larose, & Curry, 1998), to a high of 38.6% of sexual offenders also meeting the criteria for a diagnosis of an anxiety disorder (Kafka & Hennen). When looking at sexual offenders and substance-related disorders, Langstrom, Grann, and Sjostedt (2004) reported that 7.8% of sexual offenders also met the criteria for a substance-related disorder, while Raymond, Coleman, Ohlerking, Christensons, and Miner (1999) reported that 60.0% of sexual offenders also met the criteria for substance-related disorders. Clearly there is a problem with establishing a true comorbidity of the paraphilias on account of the, sometimes very large, discrepancies between the percentage of those meeting the criteria for additional disorders as reported by different researchers. Another problem with determining a precise comorbidity is that all of the studies mentioned have been carried out on individuals who have been classified as sexual offenders. Since these studies deal exclusively with sexual offenders, it cannot be determined whether or not these findings would also apply to those with paraphilias who have not been classified as criminal offenders.