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Martin Paul Kafka (born 1947) is an American psychiatrist best known for his work on sex offenders, paraphilias and what he calls "paraphilia-related disorders" such as sex addiction and hypersexuality.
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Martin Paul Kafka (born 1947) is an American psychiatrist best known for his work on sex offenders, paraphilias and what he calls "paraphilia-related disorders" such as sex addiction and hypersexuality.
Kafka earned his undergraduate degree at Columbia College of Columbia University in 1968 and his M.D. cum laude in 1973 from the Medical College at SUNY Downstate Medical Center. He completed his psychiatric residency at the University of Michigan Medical Center in 1977.
He was Clinical Instructor of Psychiatry at University Hospital in Ann Arbor, Michigan from 1977 to 1983. He has taught at Harvard Medical School since 1983 and is affiliated with McLean Hospital. In 1999 Kafka was elected a full member of the International Academy of Sex Research. He joined the editorial board of Sexual Abuse: A Journal of Research and Treatment in 1999 and Sexual Addiction & Compulsivity: The Journal of Treatment and Prevention in 2001. Kafka was a charter member of the International Association for the Treatment of Sex Offenders (IATSO) in 2000. He has been president of the Massachusetts Chapter of the Association for the Treatment of Sexual Abusers (MATSA) from 2002 to 2008 and a member of the national ATSA ethics committee from 2004 to 2005. In 2010 he was named a Distinguished Life Fellow of the American Psychiatric Association. In 2008, Kafka was selected to be a member of the American Psychiatric Association's Work Group on Sexual and Gender Identity Disorder for the development of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (2013)
Kafka was the only American in a panel of eight non-Catholic scientists commissioned by the church to prepare a report on Catholic sex abuse cases. [1] His article questioned whether "Catholic clerical education and socialization could be associated with an increased risk of expressing or experimenting with socially immature but aberrant sexual behaviors." [2]
Kafka notes that "we don't know" the causes of atypical sexual behaviors. He cautions that "the research is in infancy," but it appears that physiological factors and environmental factors may both play roles. [3] Though sexual abusers of children are more likely to have been child sexual-abuse victims themselves, "most pedophiles have not been sexually abused." Kafka believes "social skills deficits" can be a factor. [3]
Kafka's work on hypersexuality bases an evaluation on total sexual outlet. While previous treatments attempted to reduce androgen levels via chemical castration, Kafka uses drugs that regulate monoamines such as dopamine and norepinephrine, but especially serotonin. He states that "sexual deviance is linked to an as-yet-unidentified disregulation affecting the serotonin system." After treating a sex offender among a group of people diagnosed with eating disorders, Kafka connected the two: "I began to see that the sex offenders were just like the bulimics. Both groups were suffering from a disregulation of appetite." [4]
5. American Psychiatric Association:Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington VA, American Psychiatric Association, 2013.
A paraphilia is an experience of recurring or intense sexual arousal to atypical objects, places, situations, fantasies, behaviors, or individuals. It has also been defined as a sexual interest in anything other than a legally consenting human partner. Paraphilias are contrasted with normophilic ("normal") sexual interests, although the definition of what makes a sexual interest normal or atypical remains controversial.
Frotteurism is a paraphilic interest in rubbing, usually one's pelvic area or erect penis, against a non-consenting person for sexual pleasure. It may involve touching any part of the body, including the genital area. A person who practices frotteuristic acts is known as a frotteur.
Antisocial personality disorder (ASPD) is a personality disorder defined by a chronic pattern of behavior that disregards the rights and well-being of others. People with ASPD often exhibit behavior that conflicts with social norms, leading to issues with interpersonal relationships, employment, and legal matters. The condition generally manifests in childhood or early adolescence, with a high rate of associated conduct problems and a tendency for symptoms to peak in late adolescence and early adulthood.
Hypersexuality is a medical condition that causes unwanted or excessive sexual arousal, causing people to engage in or think about sexual activity to a point of distress or impairment. It is controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomaniac and sex maniac were terms previously used for the condition in women and men, respectively.
Pornography addiction is the scientifically controversial application of an addiction model to the use of pornography. Pornography use may be part of compulsive behavior, with negative consequences to one's physical, mental, social, or financial well-being. While the World Health Organization's ICD-11 (2022) has recognized compulsive sexual behaviour disorder (CSBD) as an "impulsive control disorder", CSBD is not an addiction, and the American Psychiatric Association's DSM-5 (2013) and the DSM-5-TR (2022) do not classify compulsive pornography consumption as a mental disorder or a behavioral addiction.
Hebephilia is the strong, persistent sexual interest by adults in pubescent children who are in early adolescence, typically ages 11–14 and showing Tanner stages 2 to 3 of physical development. It differs from pedophilia, and from ephebophilia. While individuals with a sexual preference for adults may have some sexual interest in pubescent-aged individuals, researchers and clinical diagnoses have proposed that hebephilia is characterized by a sexual preference for pubescent rather than adult partners.
Kleptomania is the inability to resist the urge to steal items, usually for reasons other than personal use or financial gain. First described in 1816, kleptomania is classified in psychiatry as an impulse control disorder. Some of the main characteristics of the disorder suggest that kleptomania could be an obsessive-compulsive spectrum disorder, but also share similarities with addictive and mood disorders.
Chronophilia are forms of romantic preferences and/or sexual attractions limited to individuals of particular age ranges. Some such attractions, specifically those towards prepubescents and those towards the elderly, constitute types of paraphilia. The term was coined by John Money and has not been widely adopted by sexologists, who instead use terms that refer to the specific age range in question. An arguable historical precursor was Richard von Krafft-Ebing's concept of "age fetishism". Importantly, chronophilia are technically not determined by age itself, but by human sexual maturity stages, such as body type, secondary sexual characteristics and other visible features, particularly as measured by the stages of the Tanner scale.
Psychosexual disorder is a sexual problem that is psychological, rather than physiological in origin. "Psychosexual disorder" was a term used in Freudian psychology. The term "psychosexual disorder" has been used by the TAF for homosexuality as a reason to ban the LGBT people from military service.
The affective spectrum is a spectrum of mood disorders. It is a grouping of related psychiatric and medical disorders which may accompany bipolar, unipolar, and schizoaffective disorders at statistically higher rates than would normally be expected. These disorders are identified by a common positive response to the same types of pharmacologic treatments. They also aggregate strongly in families and may therefore share common heritable underlying physiologic anomalies. Affective disorders are linked to higher rates of cardiovascular disease.
Sexual addiction is a state characterized by compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences. The concept is contentious; as of 2023, sexual addiction is not a clinical diagnosis in either the DSM or ICD medical classifications of diseases and medical disorders, which instead categorize such behaviors under labels such as compulsive sexual behavior.
Ray Milton Blanchard III is an American-Canadian sexologist who researches pedophilia, sexual orientation and gender identity. He has found that men with more older brothers are more likely to be gay than men with fewer older brothers, a phenomenon he attributes to the reaction of the mother's immune system to male fetuses. Blanchard has also published research studies on phallometry and several paraphilias, including autoerotic asphyxia. Blanchard also proposed a typology of transsexualism.
Pedophilia is a psychiatric disorder in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children. Although girls typically begin the process of puberty at age 10 or 11, and boys at age 11 or 12, psychiatric diagnostic criteria for pedophilia extend the cut-off point for prepubescence to age 13. People with the disorder are often referred to as pedophiles.
James M. Cantor is an American-Canadian clinical psychologist and sexologist specializing in hypersexuality and paraphilias.
Frederick "Fred" Saul Berlin is an American psychiatrist and sexologist specializing in sex offenses.
Compulsive sexual behaviour disorder (CSBD), is an impulse control disorder. CSBD manifests as a pattern of behavior involving intense preoccupation with sexual fantasies and behaviours that cause significant levels of psychological distress, are inappropriately used to cope with psychological stress, cannot be voluntarily curtailed, and risk or cause harm to oneself or others. This disorder can also cause impairment in social, occupational, personal, or other important functions. CSBD is not an addiction, and is typically used to describe behavior, rather than "sexual addiction".
Sexual sadism disorder is the condition of experiencing sexual arousal in response to the involuntary extreme pain, suffering or humiliation of other people. Several other terms are used to describe the condition, and it may overlap with other conditions that involve inflicting pain. It is distinct from situations in which consenting individuals use mild or simulated pain or humiliation for sexual excitement. The words sadism and sadist are derived from the French writer and libertine Marquis de Sade, who wrote several novels depicting sexualized torture and violence.
According to some classification systems, Sexual masochism disorder is the condition of experiencing recurring and intense sexual arousal in response to enduring moderate to extreme pain, suffering, or humiliation. The Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association indicates that a person may have a masochistic sexual interest but that the diagnosis of sexual masochism disorder would only apply to individuals who also report psychosocial difficulties because of it.
Raymond A. Knight is a psychologist and academic most known for his research on schizophrenia and on aggressive behavior, particularly sexual aggression, psychopathy, and bullying, exploring their causes, life course, and outcomes, and for developing the Multidimensional Inventory of Development, Sex, and Aggression (MIDSA) that assesses treatment targets for those who have sexually offended. He is a professor emeritus of Human Relations at Brandeis University.