Abstract
The recommendation to include a Paraphilic Coercive Disorder (PCD) diagnosis in the DSM-5 represents an improvement over current options and would lead to the shrinking of the pool of individuals considered for detention as Sexually Violent Predators. A precise description of the diagnostic criteria for PCD would permit psychologists and psychiatrists to use more specific and narrow criteria for those who seek sexual gratification by coercing others to engage in unwanted sexual behavior. This might permit mental health professionals to abandon the Paraphilia NOS designation in favor of the more defined PCD in appropriate cases. Various critics have attacked the proposal on what appears to be misplaced ideological grounds. Not only should ideological concerns not play a part in a scientific debate, but the critics’ predictions of how the PCD diagnosis would play out in the legal arena are likely wrong. Paraphilic Coercive Disorder would give the judicial system the best opportunity to most accurately identify the small group of men who have previously committed, and are likely in the future to commit, this type of predatory sexual violence.
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Notes
In the 6 years after the effective date of the Washington State SVP statute, only 5% of the sex offenders released from custody who met the statutory criteria for SVP commitment were even referred to prosecutors for consideration of filing a SVP petition. Prosecutors declined to file in two-thirds of those cases. Thus, the number of SVP petitions filed in Washington State was approximately 1.5% of the number of cases reviewed (Milloy, 2003).
A federal civil commitment statute was upheld by the United States Supreme Court on May 17, 2010. United States v. Comstock, 560 U.S. ___, (2010), 2010 WL 1946729 (US) (case 08-1224).
A second criticism raised of the PCD diagnosis is that it may be based exclusively on “behaviors.” That critique is odd. A pattern of behavior is used as the basis for a variety of diagnoses in those who have committed criminal behavior, such as Antisocial Personality Disorder (301.7) and Conduct Disorder (312.8x) (American Psychiatric Association, 2000).
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Acknowledgments
The author is an Advisor to the DSM-V Paraphilias subworkgroup of the Sexual and Gender Identity Disorders Workgroup (Chair, Kenneth J. Zucker, Ph.D.). The opinions expressed in this article are the thoughts and opinions of the author only, and do not necessarily represent the opinions or reflect any policies of the Snohomish County Prosecutor’s Office. Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders V Workgroup Reports (Copyright 2010), American Psychiatric Association.
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Stern, P. Paraphilic Coercive Disorder in the DSM: The Right Diagnosis for the Right Reasons. Arch Sex Behav 39, 1443–1447 (2010). https://doi.org/10.1007/s10508-010-9645-9
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DOI: https://doi.org/10.1007/s10508-010-9645-9