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Introdução: Ao longo da história, as parafilias foram ora consideradas patologias, ora não consideradas. O Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-5) estabeleceu a distinção entre parafilias e Transtornos Parafílicos (TP), sendo que apenas os TP foram considerados doenças. Por outro lado, a associação entre sintomas obsessivos e parafilias já foi cogitada por muitos autores. Porém, a falta de melhores definições dos sintomas parafílicos dificultava tais estudos. Objetivos: Avaliar a presença de TP e/ou parafilias em mulheres e a possível associação com transtorno obsessivo-compulsivo (TOC) e/ou com transtorno de personalidade obsessivocompulsiva (TPOC). Casuística e Métodos: As alunas (N=190) foram avaliadas por meio de questionários anônimos e autorresponsivos de TOC, TPOC, parafilias e TP. Para o TOC foi utilizada a escala de Yale-Brown. Para as demais variáveis foram utilizadas escalas baseadas no DSM-5, segundo o qual indivíduos parafílicos com comportamentos exibicionistas, frotteuristas, voyeuristas e pedofílicos são considerados portadores de TP porque, por definição, seus impulsos são realizados com quem não consentiu ou não tem capacidade de consentir essas práticas sexuais. Porém, se o indivíduo preenche os critérios para estas parafilias e não tem o respectivo comportamento nem sofrimento, ele terá a respectiva parafilia, mas não o TP. Resultados: As fantasias parafílicas mais frequentes foram: pelo menos uma parafilia (53,2%), Voyeurismo (30,2%) e Fetichismo (25,4%). As parafilias mais frequentes foram: pelo menos uma parafilia (24,5%), Voyeurismo (9%) e Fetichismo (8,5%). Quanto aos TP, os mais frequentes foram: pelo menos um TP (13,8%), Voyeurista (6,9%), do Masoquismo (3,7%) e Frotteurista (3,7%). O TOC subclínico (Yale-Brown entre 8 e 15) foi estatisticamente significativo quando associado a fantasias parafílicas, enquanto o TOC (Yale-Brown >= 16) quando associado a parafilias e TP. O TPOC foi estatisticamente significativo quando associado a fantasias, parafilias e TP. Conclusões: A intensidade dos sintomas de TOC foi diretamente relacionada à intensidade dos sintomas parafílicos, enquanto que o TPOC foi relacionado a fantasias parafílicas, parafilias e TP. Devido a limitações metodológicas como a ausência de instrumentos padronizados validados, os resultados obtidos nesta pesquisa foram considerados traços de associação / Introduction: Throughout history, paraphilias have been at times considered pathologies or not. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) established the distinction between paraphilias and Paraphilic Disorders (PD), with only PD considered as a disease. On the other hand, the association between obsessive symptoms and paraphilias has been considered by many authors. However, the lack of better definitions for paraphilic symptoms made such studies more difficult. Objectives: To assess the presence of PD and/or paraphilias in women and its possible association with obsessive-compulsive disorder (OCD) and/or with obsessive-compulsive personality disorder (OCPD). Case Series and Methods: Students (N=190) were assessed by means of anonymous, self-reported questionnaires on OCD, OCPD, paraphilias and PD. For OCD, the Yale-Brown scale was used. For the other variables scales based on DSM-5 were used, according to which paraphilic individuals with exhibitionistic, frotteuristic, voyeuristic, and pedophilic behaviors were considered as having PD, since, by definition, their impulses are carried out with non-consenting individuals or those unable to consent with such sexual practices. However, if the individual meets the criteria for such paraphilias but does not have the respective behavior or distress, he/she will have said paraphilia, but not PD. Results: The most frequent paraphilic fantasies were: at least one paraphilia (53.2 %), Voyeurism (30.2 %) e Fetishism (25.4 %). The most frequent paraphilias were: at least one paraphilia (24.5 %), Voyeurism (9 %) e Fetishism (8.5 %). As regard to PD, the most frequent were: at least one PD (13.8%), Voyeurist (6.9 %), of Masochism (3.7 %) and Frotteurist (3.7 %). Sub-clinical PD (Yale-Brown between 8 and 15) was statistically significant when associated with paraphilic fantasies, whereas OCD (Yale-Brown >= 16) when associated with paraphilias and PD. OCPD was statistically significant when associated with fantasies, paraphilias, and PD. Conclusions: The intensity of OCD was directly related to the intensity of paraphilic symptoms, whereas OCPD was related to paraphilic fantasies, paraphilias, and PD. The results point to traits of association between these clinical conditions, which recommends research in this direction

This thesis addresses the possibilities and limitations of Rorschach Inkblot Method in the psychological assessment of preferential rapists. The theoretical part of the thesis summarizes the general characteristics of paraphilias, introduces the contemporary theories on sexual aggression and rape, and presents selected studies related to the use of RorschachInkblot Method (using Exner's Comprehensive System) in the research of paraphilias. The empirical part focuses on my research project. I have theoretically deduced variables and composites and subsequently compared them with the normative values the CS reference populations. I have also analysed the number of criterions of the Banality Profile (of psychopathy), which were fulfilled by the sample of the sexual offenders. Then I have analysed the sequence of the clusters according to the most prominent key variable among the subjects that were the most clinically disturbed. I have found statistically significant differences between the rapists and the normative population in several variables. The most prominent ones were associated with the interpersonal perception, and mediation. I have also showed that the psychopathy profile (Banality Profile) is only partially suitable for characterization of preferential rapists. Through the analysis of the...

Introdução: Ao longo da história, as parafilias foram ora consideradas patologias, ora não consideradas. O Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-5) estabeleceu a distinção entre parafilias e Transtornos Parafílicos (TP), sendo que apenas os TP foram considerados doenças. Por outro lado, a associação entre sintomas obsessivos e parafilias já foi cogitada por muitos autores. Porém, a falta de melhores definições dos sintomas parafílicos dificultava tais estudos. Objetivos: Avaliar a presença de TP e/ou parafilias em mulheres e a possível associação com transtorno obsessivo-compulsivo (TOC) e/ou com transtorno de personalidade obsessivocompulsiva (TPOC). Casuística e Métodos: As alunas (N=190) foram avaliadas por meio de questionários anônimos e autorresponsivos de TOC, TPOC, parafilias e TP. Para o TOC foi utilizada a escala de Yale-Brown. Para as demais variáveis foram utilizadas escalas baseadas no DSM-5, segundo o qual indivíduos parafílicos com comportamentos exibicionistas, frotteuristas, voyeuristas e pedofílicos são considerados portadores de TP porque, por definição, seus impulsos são realizados com quem não consentiu ou não tem capacidade de consentir essas práticas sexuais. Porém, se o indivíduo preenche os critérios para estas parafilias e não tem o respectivo comportamento nem sofrimento, ele terá a respectiva parafilia, mas não o TP. Resultados: As fantasias parafílicas mais frequentes foram: pelo menos uma parafilia (53,2%), Voyeurismo (30,2%) e Fetichismo (25,4%). As parafilias mais frequentes foram: pelo menos uma parafilia (24,5%), Voyeurismo (9%) e Fetichismo (8,5%). Quanto aos TP, os mais frequentes foram: pelo menos um TP (13,8%), Voyeurista (6,9%), do Masoquismo (3,7%) e Frotteurista (3,7%). O TOC subclínico (Yale-Brown entre 8 e 15) foi estatisticamente significativo quando associado a fantasias parafílicas, enquanto o TOC (Yale-Brown >= 16) quando associado a parafilias e TP. O TPOC foi estatisticamente significativo quando associado a fantasias, parafilias e TP. Conclusões: A intensidade dos sintomas de TOC foi diretamente relacionada à intensidade dos sintomas parafílicos, enquanto que o TPOC foi relacionado a fantasias parafílicas, parafilias e TP. Devido a limitações metodológicas como a ausência de instrumentos padronizados validados, os resultados obtidos nesta pesquisa foram considerados traços de associação / Introduction: Throughout history, paraphilias have been at times considered pathologies or not. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) established the distinction between paraphilias and Paraphilic Disorders (PD), with only PD considered as a disease. On the other hand, the association between obsessive symptoms and paraphilias has been considered by many authors. However, the lack of better definitions for paraphilic symptoms made such studies more difficult. Objectives: To assess the presence of PD and/or paraphilias in women and its possible association with obsessive-compulsive disorder (OCD) and/or with obsessive-compulsive personality disorder (OCPD). Case Series and Methods: Students (N=190) were assessed by means of anonymous, self-reported questionnaires on OCD, OCPD, paraphilias and PD. For OCD, the Yale-Brown scale was used. For the other variables scales based on DSM-5 were used, according to which paraphilic individuals with exhibitionistic, frotteuristic, voyeuristic, and pedophilic behaviors were considered as having PD, since, by definition, their impulses are carried out with non-consenting individuals or those unable to consent with such sexual practices. However, if the individual meets the criteria for such paraphilias but does not have the respective behavior or distress, he/she will have said paraphilia, but not PD. Results: The most frequent paraphilic fantasies were: at least one paraphilia (53.2 %), Voyeurism (30.2 %) e Fetishism (25.4 %). The most frequent paraphilias were: at least one paraphilia (24.5 %), Voyeurism (9 %) e Fetishism (8.5 %). As regard to PD, the most frequent were: at least one PD (13.8%), Voyeurist (6.9 %), of Masochism (3.7 %) and Frotteurist (3.7 %). Sub-clinical PD (Yale-Brown between 8 and 15) was statistically significant when associated with paraphilic fantasies, whereas OCD (Yale-Brown >= 16) when associated with paraphilias and PD. OCPD was statistically significant when associated with fantasies, paraphilias, and PD. Conclusions: The intensity of OCD was directly related to the intensity of paraphilic symptoms, whereas OCPD was related to paraphilic fantasies, paraphilias, and PD. The results point to traits of association between these clinical conditions, which recommends research in this direction

Le présent projet doctoral vise à considérer les lacunes dans la documentation scientifique sur le Trouble Paraphilique Coercitif (TPC) en mettant l’accent sur la validité des critères diagnostiques proposés pour inclusion dans le DSM-5 et les marqueurs comportementaux. À ce fait, les données archivées d’individus ayant sexuellement agressé des femmes adultes ont été étudiées. La thèse est constituée de trois articles empiriques. Le premier article présente des résultats clés découlant des analyses, élaborés dans les articles subséquents. Le second (N = 47) évalue les fréquences observées du TPC, la validité et l’impact du recours au nombre minimal de victimes comme critère diagnostique, ainsi que les indices prédisant la récidive sexuelle. Le troisième article (N = 52) compare les groupes diagnostiques sur une série de comportements délictuels, tels que les gestes sexuels et les comportements violents, dans le but d’identifier les marqueurs comportementaux associés avec la propension au viol qui pourraient assister dans le processus diagnostique. Dans le même ordre d’idées, nous avons créé des typologies de violeurs à partir des gestes sexuels commis, d’un côté, et des comportements violents, de l’autre côté. Conséquemment, les caractéristiques des typologies ainsi obtenues et leur association avec le TPC furent examinées. Dans l’ensemble, nos résultats ne soutiennent pas le recours au nombre de victimes. Nos données suggèrent que, globalement, les violeurs avec le TPC utilisent un niveau de gestes sexuels plus envahissant et un niveau de violence moindre que les violeurs n’ayant pas ce diagnostic, et que l’exhibitionnisme et l’attouchement pourraient servir de marqueurs comportementaux pour le TPC. En outre, les violeurs avec le TPC sont caractérisés davantage par demande indécente, exhibitionnisme, attouchement, masturbation, tentative de pénétration et pénétration digitale que par pénétration vaginale et sodomie. De plus, ces derniers font moins recours à l’utilisation d’armes, semblent ne pas frapper/donner des coups à la victime et sont caractérisés par la manipulation plutôt que par le recours aux menaces de mort, force excessive et utilisation d’armes. En somme, nos données soulignent la nécessité de s’appuyer sur une combinaison de méthodes d’évaluation afin d’améliorer la validité diagnostique et discriminante du TPC. / The present dissertation aims to address the shortcomings in the current literature on Paraphilic Coercive Disorder (PCD) by focusing on two main objectives: assessing the validity of the diagnostic criteria proposed for inclusion in the DSM-5 and investigating behavioral markers. To this end, archival files of rapists who offended against adult women were studied. The thesis consists of three empirical articles. The first article presents a succinct account of some of the key results emanating from the analyses. The second article (N = 47) examines the observed frequencies of PCD and assesses the validity and impact of relying on minimum number of victims as a diagnostic criterion. Furthermore, a number of variables of interest are examined to determine predictors of sexual recidivism. The third article (N = 52) compares diagnostic groups on a number of offense conduct characteristics – specifically sexual acts and violent behaviors – in an attempt to identify behavioral markers associated with rape-proneness that could aid with the diagnosis of PCD. Similarly, rapist typologies were created by classifying the sample into groups of sex offenders based on their sexual acts, on one hand, and violent behaviors, on the other hand. Consequently, their characteristics and association with PCD were examined. Our results do not support the reliance on number of victims. Our findings suggest that rapists with PCD are more sexually intrusive and resort to less violence overall than sex offenders without such a diagnosis and that exhibitionism and fondling could serve as behavioral markers for PCD. Moreover, rapists with PCD are characterised more by indecent request, exhibitionism, fondling, masturbation, attempted intercourse and digital penetration rather than by intercourse and sodomy. In terms of violent behaviors, rapists with PCD resort less to the use of weapons, seem not to hit their victims, and are likely characterised more by manipulation rather than by the use of death threats, excessive force and weapons. In sum, the present study highlights the necessity of relying on a combination of assessment methods in order to improve diagnostic and discriminant validity of PCD.