Abstract

    Open Access Research Article Article ID: IJSRHC-4-123

    Sexual fantasies: The boundary between physiology and psychopathology. Clinical evidence

    Giulio Perrotta*

    Purpose: In order to study in depth the paraphiliac universe of the patient, avoiding diagnostic errors in terms of sexuality, sexual fantasies and disorders codified by the DSM-V, this research work focused on the importance of the exact identification of relevant sexual behaviours, in order to facilitate the relationship with the patient and the therapeutic pathway. 

    Methods: Clinical interview with administration of the “Perrotta Integrative Clinica Interview” (PICI-1) and “Perrotta Individual Sexual Matrix Questionnaire” (PSM-1). 

    Results: Once the questionnaire was completed, it was tested on a population sample of 122 subjects (69 male and 53 female), demonstrating diagnostic error in 22.13% of cases (27 total) and in particular in the two youngest groups of both sexes (14-24 years and 25-35 years), reaching 37% error in females and 40.7% in males. 

    Conclusions: The present research work has laid the foundations for a more accurate and detailed investigation of the diagnostic universe linked to paraphiliac disorder, demonstrating that: 1) At the diagnostic stage, it is always possible to commit an interpretative error by mistaking a simple paraphilia for paraphiliac disorder, also taking into account the psychological disorders present in comorbidity. 2) The MMPI-II identifies some characteristics that can be traced back to paraphiliac disorder and other related personality disorders but does not specify in detail the paraphiliac universe of the patient and therefore the exact therapeutic intervention to be carried out in psychotherapy. 3) The PICI-1TA fully absorbs the results of the MMPI-II and notes its critical aspects, such as the absence of the indications of the specific personality traits, useful in the diagnostic and therapeutic phases, without however listing in detail the paraphiliac universe of the patient. 4) The PSM-1, if associated with the PICI-1TA, allows to identify the primary disorder, the characterizing secondary traits and the whole paraphiliac universe of the patient, for the purposes of the clinical diagnostic profile and of the specific targeted therapeutic intervention to be carried out, giving also information about the medical history and other possible associated sexual disorders. 5) The PSM-1 was able to detect, on a sample of population n. 122, n. 27 (16 male and 11 female) diagnostic errors (22.13%) in the phase of centering of the patient, depowering the diagnosis of paraphiliac disorder to simple paraphilia to be managed in a framework more deprived of judgment. 6) The PSM-1, unlike other psychosexual tests and questionnaires, allows to analyse at the same time with precision the following aspects: a) personal and family psychophysical history; b) information about orientation, gender and related sexual disorders; c) the paraphiliac universe, with specific indications of the object/content of individual behaviours; d) the psychodynamic profile of the patient, on the basis of his disorder (if present) or of the simple behavioural manifestation of a paraphiliac matrix; e) categorisation by intensity, severity and content. 7) The present research work has therefore demonstrated the reliability of the psychodiagnostic instrument, also noting that the highest percentage of diagnostic error on the subject of sexual behaviour is present in both males and females in the 25-35 age band, followed by the 14-24 age band, for an overall total of 40.7% in males and 37% in females. It would appear that diagnostic errors are less frequent in the older and more mature age groups. In relation then to the MMPI-II and the PICI-1 it proved particularly functional with the latter, in order to proceed to the therapeutic contract with the patient and therefore to the implementation of the necessary strategies in support, assistance and therapy.

    Keywords:

    Published on: Jun 17, 2021 Pages: 42-52

    Full Text PDF Full Text HTML DOI: 10.17352/ijsrhc.000023
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