ISSN: 0022-1198
CODEN: JFSCA
Published Online: 1 May 1992
Page Count: 10

Simulated Paraphilias: A Preliminary Study of Patients Who Imitate or Exaggerate Paraphilic Symptoms and Behaviors
Hanson, A
Resident in Psychiatry, The Johns Hopkins Medical Institutions, MD

Berlin, FS
Associate professor, The Johns Hopkins School of Medicine, MD

Malin, HM
Clinic manager, The Johns Hopkins Sexual Disorders Clinic, MD

Paul Fedoroff, J
Fellow in Forensic Psychiatry, Forensics Division, The Clarke Institute of Psychiatry, Ontario

McGuire, M
Resident in Psychiatry, The Johns Hopkins Medical Institutions, MD

Abstract

In a consecutive series of admissions to the Johns Hopkins Sexual Disorders Unit, 4 out of 20 patients appeared to have simulated paraphilic symptoms that further assessment indicated were either exaggerated or not present. The paper presents case histories of these 4 patients. A descriptive comparison is made between these patients and control groups of patients who admitted having paraphilic symptoms and a group of patients accused to having paraphilic symptoms but who denied them. Patients who simulated paraphilias tended to be self-referred (75%) and without current legal charges (100%). None of these patients was referred or sought treatment for pedophilia, in contrast to the other two patient groups, in which pedophilia accounted for 75% of the referrals. Several possible explanations for why patients might simulate paraphilias and implications for therapists who evaluate or treat sex offenders are discussed.

Keywords:
psychiatry, criminal sex offenses, paraphilia, simulation, sex offenders, factitious disorders

Paper ID: JFS12004J
DOI: 10.1520/JFS12004J
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