DSM – Diagnostic and Statistical Manual of Mental Disorders

About The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM)

By Svein Skeid

The American Psychiatric Association, APA, considerably revised their Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994. SM and Fetishism were considered to be healthy forms of sexual expression, as long as they do not impair the daily functioning of the subject.

According to DSM-IV, SM and Fetishism only become diagnosable dysfunctions when the urges, fantasies or behaviors “cause clinically significant distress or impairment in social, occupational or other important areas of functioning.”

In addition APA said that “a paraphilia must be distinguished from the non-pathological use of sexual fantasies, behaviors or objects as a stimulus for sexual excitement.”

The DSM-IV revision, in 1994, was seen as a step forward, but is far from satisfactory. Stigma knowledge shows that many psychological, physical and social problems are not caused by the individual afflicted, but by taboos, prejudices, and discrimination imposed by the environment.

According to Charles Moser, the diagnostic criteria changed yet again in 2000 for the worse introducing version DSM-IV-TR (2000).

According to The Differential Diagnosis of the Paraphilias “A Paraphilia must be distinguished from the non-pathological use of sexual fantasies, behaviors, or objects as a stimulus for sexual excitement in individuals without a Paraphilia. Fantasies, behaviors, or objects are paraphilic only when they lead to clinically significant distress or impairment (e.g., are obligatory, result in sexual dysfunction, require participation of nonconsenting individuals, lead to legal complications, interfere in social relationships). (DSM, p. 568)

“The way this diagnosis is interpreted, any reason that you are seen by a physician or therapist (including court order, as to assess who should get custody of your children in the event of a divorce), can bring about the diagnosis even if it has nothing to do with the issue being investigated.”  Charles Moser on the ReviseF65 discussion group January 22, 2006.

In a press release November 25, 2008, NCSF, National Coalition for Sexual Freedom says about DSM-IV TR:

“We know from the hundreds of requests for help that NCSF gets every year through our Incident Response program that the Sexual Sadism, Sexual Masochism, Fetishism and Transvestic Fetishism diagnoses in the DSM reinforce the negative stereotypes and stigma against alternative sexual behaviors.”

From the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders

The DSM-IV defines mental disorders. Previous editions of the DSM listed sadism and masochism as diagnosable disorders just for having such fantasies or urges over a period of time. The new edition adds modifying criteria: with both masochism and sadism, both A & B criteria must be met in order to make a diagnosis. That is, you must have the fantasies, urges, etc., and the fact that you have them must make you effectively dysfunctional in an important area of your life.

Diagnosic criteria for 302.83 Sexual Masochism

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act (real, not simulated) of being humiliated, beaten, bound or otherwise made to suffer.

B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Diagnostic criteria for 302.84 Sexual Sadism

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.

B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.


DSM Revision White Paper: http://ncsfreedom.org/index.php?option=com_keyword&id=305

Charles Moser and Peggy J. Kleinplatz:
DSM-IV-TR and the Paraphilias:
An Argument for Removal
http://home.netcom.com/~docx2/mk.html

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