Abnormal Psychology

Gender and Sexual Disorders 491

Understanding Paraphilias

Researchers are only just beginning to learn why paraphilias emerge and persist,

and not enough is known to understand how feedback loops might arise among

neurological, psychological, and social factors. However, some facts related to these

factors—and their interactions—have been reported, including neurological simi-

larities to OCD and the role of classical conditioning in sexual arousal.

Neurological Factors

Many theorists who have considered the neurological underpinnings of paraphil-

ias have noted the apparent similarities between these disorders and OCD, both of

which involve obsessions and compulsions. As discussed in Chapter 7, OCD ap-

pears to arise from abnormal functioning in a neural system that includes the basal

ganglia (which play a central role in producing automatic, repetitive behaviors) and

the frontal lobes (which normally inhibit such behaviors). In fact, researchers found

that people with pedophilia have very specifi c cognitive defi cits when performing

tasks that rely on this neural system (Tost et al., 2004). For example, these patients

were strikingly impaired in inhibiting responses and in working memory—both of

which rely heavily on the frontal lobes (Smith & Kosslyn, 2006).

In addition, evidence suggests that the neurotransmitters that are used in this

neural system, such as dopamine and serotonin, do not function properly in people

who have paraphilias (Kafka, 2003). Indeed, SSRIs decrease the sexual fantasies and

behaviors related to paraphilias, which is consistent with the view that neural inter-

actions involved in OCD are also involved in the paraphilias (Abouesh & Clayton,

1999; Bradford, 2001; Kafka & Hennen, 2000; Roesler & Witztum, 2000).

Finally, there is a hint that genes contribute to the paraphilic disorders. For

example, researchers have identifi ed monozygotic twins who have both paraphilias

and OCD (Cryan, Butcher & Webb, 1992). In addition, researchers have found that

paraphilias have a slight tendency to run in families; moreover, pedophilia occurs

more frequently in families in which a member has pedophilia than in families in

which members have another sort of paraphilia (Gaffney, Lurie, & Berlin, 1984). If

such fi ndings are replicated, they would suggest that distinct sets of genes contribute

to pedophilia.

Psychological Factors: Conditioned Arousal

Both psychodynamic and cognitive-behavioral theories have been invoked to ex-

plain paraphilias, but research to date does not generally support either type of

explanation (Osborne & Wise, 2005). Behavioral theory, though, can answer one

intriguing question about paraphilias: Why are almost all people with paraphilias

male? One contributing factor may simply stem from male physiology: The position

of the penis and testicles on the body can easily lead to their being inadvertently

stimulated (Munroe & Gauvain, 2001); this is important because such stimulation

can result in classical conditioning.

Classical conditioning principles can explain how certain objects or situations

come to produce sexual arousal in general, and paraphilias in males in particular

(Domjan, Cusato, & Krause, 2004; Köksal et al., 2004). Consider this example: A

fetish for objects such as women’s shoes can develop when an unconditioned stimu-

lus that led to sexual arousal became paired with a conditioned stimulus (women’s

shoes). Thus, a boy who coincidentally saw his mother’s shoes before—intentionally

or accidentally—touching his penis may come to have a conditioned response of sex-

ual arousal to women’s shoes in the future. Moreover, the pleasurable consequence

of arousal and possible orgasm provides positive reinforcement (Laws & Marshall,

1991). And, as discussed in Chapter 2, classical conditioning alters neural commu-

nication so that neurons that store particular associations come to fi re together more

easily. In fact, humans—or at least human males—may be biologically prepared to de-

velop classically conditioned sexual arousal to some situations or objects (Osborne &

Wise, 2005), which would explain why a pillow fetish is not a common fetish.

Some men who fought in World War II developed

what would be considered a paraphilia: These

men, who were in their formative years during the

war, spent time with women who wore gas masks

and bathrobes, and such attire became a sexual

turn-on for the men (Kaplan, 1991).

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