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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.
Paraphilia is the experience of intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals.
Transvestic fetishism is a psychiatric diagnosis applied to those who are thought to have an excessive sexual or erotic interest in cross-dressing; this interest is often expressed in autoerotic behavior. It differs from cross-dressing for entertainment or other purposes that do not involve sexual arousal. Under the name transvestic disorder, it is categorized as a paraphilia in the DSM-5. Sexual arousal in response to donning sex-typical clothing is homeovestism.
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.
Hypersexuality is extremely frequent or suddenly increased libido. It is currently controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomania and Satyriasis were terms previously used for the condition in women and men, respectively.
Pornography addiction is an addiction model of compulsive sexual activity with concurrent use of pornographic material, despite negative consequences to one's physical, mental, social, or financial well-being. Neither the DSM-5 nor the ICD-11 classify compulsive pornography consumption as a mental disorder or 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.
The term chronophilia was used by John Money to describe a form of paraphilia in which an individual experiences sexual attraction limited to individuals of particular age ranges. The term 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".
The affective spectrum is a spectrum of affective 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.
Sexual addiction, also known as sex addiction, is a state characterized by compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences.
Ray Milton Blanchard is an American-Canadian sexologist, best known for his research studies on transsexualism, pedophilia and sexual orientation. He 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.
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, criteria for pedophilia extend the cut-off point for prepubescence to age 13. A person must be at least 16 years old, and at least five years older than the prepubescent child, for the attraction to be diagnosed as pedophilia.
Partialism is sexual interest with an exclusive focus on a specific part of the body other than genitals. Partialism is categorized as a fetishistic disorder in the DSM-5 of the American Psychiatric Association only if it causes significant psychosocial distress for the person or has detrimental effects on important areas of their life. In the DSM-IV, it was considered a separate paraphilia, but was merged into fetishistic disorder by the DSM-5. Individuals who exhibit partialism sometimes describe the anatomy of interest to them as having equal or greater erotic attraction for them as do the genitals.
Courtship disorder is a theoretical construct in sexology in which a certain set of paraphilias are seen as specific instances of anomalous courtship instincts in humans. The specific paraphilias are biastophilia, exhibitionism, frotteurism, telephone scatologia, and voyeurism. According to the courtship disorder hypothesis, there is a species-typical courtship process in humans consisting of four phases, and anomalies in different phases result in one of these paraphilic sexual interests. That is, instead of being independent paraphilias, this theory sees these sexual interests as individual symptoms of a single underlying disorder.
James M. Cantor is an American-Canadian clinical psychologist and sexologist specializing in hypersexuality and paraphilias.
Frederick S. "Fred" Berlin is an American psychiatrist and sexologist specializing in sex offenses.
Hypersexual disorder is a pattern of behavior involving intense preoccupation with sexual fantasies and behaviours that cause distress, are inappropriately used to cope with stress, cannot be voluntarily curtailed, and risk or cause harm to oneself or others. This disorder can also cause impairment in social, occupational or other important functions. It was proposed in 2010 for inclusion in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) of the American Psychiatric Association (APA).
Sexual sadism disorder is the condition of experiencing sexual arousal in response to the extreme pain, suffering or humiliation of others. Several other terms have been used to describe the condition, and the condition 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 Marquis de Sade.
Sexual masochism disorder (SMD) is the condition of experiencing recurring and intense sexual arousal in response to enduring moderate or 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.