Columbia faculty Dr. Michael First, Dr. Richard Krueger, Dr. Tahilia Rebello, and Dr. Geoffrey Reed, along with US-based and international collaborators, have recently published “Can Clinicians Use Dimensional Information to Make a Categorical Diagnosis of Paraphilic Disorders? An ICD-11 Field Study” in the Journal of Sexual Medicine.
Their study represents a large international sample of 1,263 health professionals and is the first to examine clinicians’ ability to apply the ICD-11 diagnostic guidelines for paraphilic disorders. The study results indicate that clinicians were able to simultaneously use multiple dimensions (arousal, consent, action, distress, and risk) in arriving at a diagnosis, even given the complex and interactive nature of these dimensions. However, there was some evidence of over-diagnosis of paraphilic disorders to cases where it was not warranted. In the future, targeted training on the diagnostic guidelines along with education about the large range and variation of healthy sexual fantasies and behaviors may help to reduce biases and improve diagnostic outcomes.
Article: Keeley, J. W., Briken, P., Evans, S. C., First, M. B., Klein, V., Krueger, R. B., Matsumoto, C., Fresán, A., Rebello, T. J., Robles, R., Sharan, P., & Reed, G. M. (2019). Can clinicians use dimensional information to make a categorical diagnosis of paraphilic disorders? An ICD-11 field study. The Journal of Sexual Medicine, 18(9), 1592-1606. https://doi.org/10.1016/j.jsxm.2021.06.016