An Examination of the Relationship Between the Paraphilias and Anxiety

Abstract

Despite many proposed theories (e.g., biological, learning, evolutionary) it is still unclear how individuals develop paraphilic interests. It is not even clear from these theories why paraphilic interests are much more common in men than in women. One possible factor affecting male preponderance is anxiety. Anxiety can potentiate sexual arousal in men and deter sexual arousal in women. It has been proposed that paraphilic interests (e.g., sexual interest in children, in violence) can develop when anxious feelings are generated by unconventional sexual stimuli. According to this hypothesis, when anxiety is repeatedly elicited by an unconventional sexual stimulus, and when anxiety potentiates sexual arousal in men, over time, paraphilic interests may develop. It follows that men (but not women) with paraphilic interests may be susceptible to anxiety disorders – an anxiety disorder would facilitate the hypothesized developmental process. Part 1 of this dissertation consisted of a meta-analysis of 29 studies to determine the link between paraphilias and anxiety. Part 2 was a large-scale file review of 1,048 patients referred to a sexual behaviour clinic to investigate the link between paraphilias and anxiety. Both the meta-analysis and the file review showed a link between paraphilias and anxiety, but paraphilias were also associated with many other psychological disorders. Therefore, there does not seem to be a specific link between the paraphilias and anxiety, casting doubt on the validity of the hypothesis tested in this dissertation. The discovery of a general link between paraphilias and psychological disorders, however, opens new avenues for studying the development of paraphilic interests.