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CHAPTER 14: Paraphilias: Atypical Sexual Behaviors
1. “Paraphilia” literally means ________.
i. abnormal love
j. strange sexual practices
k. fantasy fixation
l. attraction to paras
Answer: A
Rationale:
Paraphilia literally means abnormal love.
2. The paraphilias are considered in the context of two categories, those that ________.
a. involve humans and those that do not
b. involve nonconsenting victims and those that are nonvictimizing
c. are legal and those that are not
d. are normal and those that are abnormal
Answer: B
Rationale:
Paraphilias are categorized as victimizing and nonvictimizing.
3. One of the first detailed accounts of paraphilic behaviors was in a medical text written in
1886, called Psychopathia Sexualis, by ________.
a. Henry Havelock Ellis
b. Masters and Johnson
c. Richard von Krafft-Ebing
d. Sigmund Freud
Answer: C
Rationale:
Richard von Krafft-Ebing wrote the first detailed accounts of paraphilic behavior in his book
Psychopathia Sexualis.
4. One example cited from the 1886 book, Psychopathia Sexualis, discussed a man who
enjoyed having intercourse with ________.
a. shoes
b. horses

c. dead people
d. hens
Answer: D
Rationale:
A case study described in Psychopathia Sexualis was about a man who had sex with hens.
5. A case presented from the 1886 book Psychopathia Sexualis involved a fetish in which a
man was sexually aroused by a ________.
a. handkerchief
b. high heel
c. coat hanger
d. feather
Answer: A
Rationale:
A case study described in Psychopathia Sexualis was about a man who had a fetish for
handkerchiefs.
6. In Krafft-Ebing’s time, ________ was condemned as abnormal or a paraphilia.
a. masturbation
b. oral sex
c. anal sex
d. all of the above
Answer: D
Rationale:
In Krafft-Ebing’s time, behaviors such as masturbation, oral sex, and anal sex were all
condemned as abnormal or a paraphila.
7. John’s counselor says his sexual activity would generally be considered to be a paraphilia
because it meets all of the following conditions except ________.
a. the behavior is engaged in for the purpose of sexual arousal or gratification
b. the behavior tends to be compulsive and recurrent
c. a clear majority of those in a given cultural setting would consider the behavior to be
strange, deviant, pathological or abnormal
d. the behavior involves another person
Answer: D

Rationale:
A paraphilia must meet three criteria: 1) the behavior is engaged in for the purpose of sexual
arousal or gratification, 2) the behavior tends to be compulsive and recurrent, and 3) a clear
majority of those in a given cultural setting would consider the behavior to be strange,
deviant, pathological or abnormal.
8. The ________ component of paraphilias is manifested in the inability to stop the
undesirable behavior.
a. depressive
b. compulsive
c. fetish
d. post-traumatic stress
Answer: B
Rationale:
The compulsive component of the paraphilia is manifested in the inability to stop the
undesirable behavior.
9. Paraphilias are sexual behavior that would strike ________ people in a particular cultural
setting as strange or abnormal.
a. few
b. some
c. most
d. all
Answer: C
Rationale:
A paraphilia is a sexual behavior that would be seen as strange or abnormal to most people in
the culture.
10. Dan’s paraphilic behavior would be considered victimizing. Which of the following is his
behavior?
a. transvestism
b. voyeurism
c. fetishism
d. klismaphilia
Answer: B
Rationale:

An example of a victimizing paraphilia is voyeurism.
11. All of the following paraphilias would be considered victimless except ________.
a. transvestism
b. klismaphilia
c. formicophilia
d. exhibitionism
Answer: D
Rationale:
Examples of victimless paraphilias include transvestism, klismaphilia, and formicophilia.
12. The Diagnostic and Statistical Manual of the American Psychiatric Association lists
specific criteria for the diagnosis of all of the following except ________.
a. voyeurism
b. exhibitionism
c. fetishism
d. deadophilia
Answer: D
Rationale; The DSM lists criteria for the diagnosis of various paraphilias, including
voyeurism, exhibitionism, and fetishism.
13. Jim has a sexual attraction to animals, which is referred to as ________.
a. coprophilia
b. klismaphilia
c. zoophilia
d. dogphilia
Answer: C
Rationale:
Zoophilia refers to the sexual attraction to animals.
14. Brian is sexually turned on by sex with dead people; his behavior is referred to as
________.
a. necrophilia
b. urophilia
c. gerontophilia

d. deadophilia
Answer: A
Rationale:
Necrophilia refers to a sexual attraction to dead people.
15. According to the text, it is unclear whether or not David’s particular paraphilic behavior
of ________ is considered to be victimizing or victimless.
a. fetishism
b. sadism
c. zoophilia
d. pedophilia
Answer: C
Rationale:
Zoophilia is considered victimizing and nonvictimizing.
16. Joshua is a urophiliac and is sexually aroused by ________, while Keith is a coprophiliac
and is sexually aroused by ________.
a. looking at genitals; looking at feet
b. copulation; fornication
c. urine; feces
d. underarm hair; facial hair
Answer: C
Rationale:
Urophila is sexual arousal by urine and coprophilia is sexual arousal by feces.
17. When considering paraphilias, all of the following are examples of behaviors that are
harmful or destructive to the person engaging in it except a ________.
a. person who participates in extreme masochism to the point of serious injury
b. man who dresses in women’s clothes in public and is ridiculed
c. teenager involved in autoerotic asphyxiation behaviors
d. man who enjoys ordering high heels online
Answer: D
Rationale:
Paraphilic behaviors that are considered harmful or destructive might include a person who
participates in extreme masochism to the point of serious injury, a man who dresses in

women’s clothes in public and is ridiculed, and a teenager involved in autoerotic asphyxiation
behaviors.
18. According to the text, a paraphilia will be more likely to be judged negatively for all of
the following reasons except that the behavior ________.
a. is harmful or destructive to the person engaging in it
b. is illegal
c. interferes with the person’s ability to form and maintain loving, intimate and sexual
relationships with others
d. occurs outside a marital relationship
Answer: D
Rationale A paraphilia is likely to be judged more negatively if the behavior is harmful or
destructive to the person engaging in it, if it is illegal, and if the behavior interferes with the
person’s ability to form and maintain loving, intimate and sexual relationships with others.
19. In terms of consent and paraphilias, ________.
a. it can still be a paraphilia, even if the other person gives consent
b. as long as the person consents, it is not a paraphilia
c. consensual, victimless acts cannot be considered paraphilic
d. paraphilias imply that there is always consent
Answer: A
Rationale:
It can still be a paraphilia, even if the other person gives consent.
20. In terms of gender and paraphilias, ________.
a. nearly all those who engage in paraphilias are male
b. most of the coercive paraphilias are associated with males
c. men and women are likely to exhibit paraphilias
d. most paraphiles are women
Answer: A
Rationale:
Nearly all those who engage in paraphilias are male.
21. The one paraphilic behavior that is found in both men and women (although still more
common in men) is ________.
a. transvestism

b. voyeurism
c. sexual masochism
d. exhibitionism
Answer: C
Rationale:
Sexual masochism is the one paraphilic behavior found in both men and women.
22. In terms of the origins of paraphilias, our understanding could best be summarized by
saying ________.
a. nobody really knows what causes paraphilias
b. most paraphilias are caused by hormonal imbalances in utero
c. paraphilias are the result of childhood trauma
d. most paraphilias have a medical basis in their development
Answer: A
Rationale:
Nobody really knows what causes paraphilias.
23. The ________ theory of paraphilic origin suggests that dysfunctional or problematic
behaviors in adulthood are caused by traumatic events that occurred in childhood.
a. behavioral
b. psychodynamic
c. biological
d. hormonal
Answer: B
Rationale:
Psychodynamic theory suggests that dysfunctional or problematic behaviors in adulthood are
caused by traumatic events that occurred in childhood.
24. The psychodynamic theory of the origins of paraphilias can be most closely associated
with ________.
a. Masters and Johnson
b. Henry Havelock Ellis
c. Sigmund Freud
d. Maslow
Answer: C

Rationale:
Sigmund Freud is most closely linked to the psychodynamic theory of the origins of
paraphilias.
25. Dr. Stone believes the origin of Ted’s paraphilia relies on components of classical and
operant conditioning. Dr. Stone would be considered a ________ theorist.
a. behavioral
b. psychodynamic
c. biological
d. hormonal
Answer: A
Rationale:
Behavioral theory includes the components of classical and operant conditioning to explain
the origin of paraphilias.
26. Steve’s doctor feels that by giving him a prescription for medications that will block the
action of ________, Steve may find that his paraphilic compulsions are reduced to more
controllable levels.
a. testosterone
b. serotonin
c. hormones
d. blood platelets
Answer: A
Rationale:
Medications that block the action of testosterone have been found to reduce paraphilic
compulsions.
27. One hormone that appears to be related to compulsive sexual behavior is ________.
a. testosterone
b. estrogen
c. progestin
d. serotonin
Answer: A
Rationale:
Testosterone appears to be related to compulsive sexual behavior.

28. One study discussed in the text found levels of ________ in men who have pedophilia to
be significantly higher.
a. estrogen
b. serotonin
c. adrenaline
d. while blood cells
Answer: C
Rationale:
Higher levels of adrenaline have been found in men who have pedophilia.
29. Andrew, Terry, and Eugene are in a support group for voyeurs. One thing they all have in
common as voyeurs is that they ________.
a. often seek arousal by going to topless beaches
b. prefer to remain unseen while watching their victims without their consent
c. are aroused when their victims notice them
d. like to be in the nude to view their victims
Answer: B
Rationale:
Voyeurs prefer to remain unseen while watching their victims without their consent.
30. A “peeping Tom” is another name for ________.
a. an exhibitionist
b. machismo
c. frotteurism
d. a voyeur
Answer: D
Rationale:
A voyeur is also called a “peeping Tom.”
31. The use of spy cameras and “web cams” are examples of high-tech devices used by
________.
a. voyeurs
b. exhibitionists
c. frotteurists

d. masochists
Answer: A
Rationale:
Voyeurs may use spy cams or “web cams.”
32. As an exhibitionist, Eric’s sexual arousal usually ________.
a. decreases if he thinks he will get caught
b. decreases if the victim shows shock
c. increases if his victim shows shock
d. increases if the victim approaches him
Answer: C
Rationale:
Exhibitionists become sexually arouse if the victim shows shock.
33. A “flasher” refers to someone who enjoys ________.
a. exhibitionism
b. machismo
c. frotteurism
d. voyeurism
Answer: A
Rationale:
Another name for an exhibitionist is a “flasher.”
34. Part of the arousal for Barry, who is an exhibitionist, is the ________ response of the
victim.
a. pleasure
b. shock
c. nond. humorous
Answer: B
Rationale:
Exhibitionists are aroused by the shock response of the victim.
35. ________ refers to the compulsion to rub one’s genitals against a nonconsenting person
for sexual arousal.

a. Exhibitionism
b. Pedophilia
c. Frotteurism
d. Voyeurism
Answer: C
Rationale:
Frotteurism is the compulsion to rub one’s genitals against a nonconsenting person for sexual
arousal.
36. If James is a frotteurist, he enjoys ________.
a. crowded subways
b. peering through windows
c. watching people make love
d. displaying his genitals
Answer: A
Rationale:
A frotteurist enjoys crowded places such as subways.
37. Daniel enjoys inflicting pain and humiliation for sexual gratification. His behavior would
be referred to as ________.
a. masochism
b. sexual sadism
c. sex play
d. discipline
Answer: B
Rationale:
Sexual sadism involves inflicting pain and humiliation for sexual gratification.
38. ________ refers to the exploitation of prepubescent children for an adult’s sexual
purposes.
a. Exhibitionism
b. Pedophilia
c. Frotteurism
d. Voyeurism

Answer: B
Rationale:
Pedophilia refers to the exploitation of prepubescent children for an adult’s sexual purposes.
39. Karen’s class is studying the issue of pedophiles. Some of the things she is likely to learn
include all of the following except that ________.
a. they are more often men
b. many are married
c. they themselves were sexually abused as children
d. they have a high sex drive
Answer: D
Rationale:
Pedophiles are often men, many are married, and many were sexually abused as children.
40. Approximately ________ of the victims of pedophiles are girls aged 8 to 11.
a. 25%
b. 45%
c. 65%
d. 85%
Answer: C
Rationale:
Approximately 65% of victims of pedophiles are girls aged 8-11.
41. Many paraphilias are ________, in that they are solitary activities or involve adults who
have given their consent to participate.
a. coercive
b. nonvictimizing
c. deviant
d. illegal
Answer: B
Rationale Nonvictimizing paraphilias can be solitary activities or involve adults who have
given their consent to participate.
42. Ian’s sexual arousal and gratification is associated with acts or fantasies of being hurt,
humiliated, or otherwise being made to suffer. This refers to ________.
a. bondage

b. sadism
c. masochism
d. physical abuse
Answer: C
Rationale:
Masochism is associated with acts or fantasies of being hurt, humiliated, or otherwise made
to suffer.
43. The difference between sexual sadism and sexual masochism is that in the latter
________.
a. the partners make agreements and ground rules
b. there is always a woman in the dominate position
c. bondage is not used
d. humiliation is not included
Answer: A
Rationale:
In sexual masochism partners make agreements and ground rules, whereas in sexual sadism
they do not.
44. The most dangerous of all the paraphilias mentioned in the text is ________.
a. sexual masochism
b. autoerotic asphyxiation
c. transvestism
d. frotteurism
Answer: B
Rationale:
Autoerotic asphyxiation is considered the most dangerous of all paraphilias.
45. Autoerotic asphyxiation involves ________.
a. binding the feet
b. torturing the victim by suffocation
c. depriving the brain of oxygen through some form of strangulation
d. masturbating to unconsciousness
Answer: C

Rationale:
Autoerotic asphyxiation involves depriving the brain of oxygen through some form of
strangulation.
46. It is thought that about ________ of all deaths due to strangulation among teens are due to
autoerotic asphyxiation.
a. 10%
b. 20%
c. 30%
d. 50%
Answer: C
Rationale:
About 30% of all deaths due to strangulation among teens are due to autoerotic asphyxiation.
47. Jeff can only become aroused when he is fondling or thinking about high heels. His
condition is called ________.
a. frotteurism
b. fetishism
c. transvestism
d. psychosis
Answer: B
Rationale:
A fetish might include a person who can only become aroused by fondling or thinking of
high heels.
48. The most common fetish objects include all of the following except ________.
a. shoes and boots
b. women’s underwear and lingerie
c. feet and toes
d. breasts
Answer: D
Rationale:
Common fetish objects include shoes and boots, women’s underwear or lingerie, and feet
and toes.
49. Ted has transvestic fetishism. Which of these statements is true about him?

a. He usually has homosexual tendencies.
b. He achieves sexual arousal by wearing female clothing.
c. He is confused about his gender identity.
d. He is tired of wearing pants all day.
Answer: B
Rationale:
A transvestic fetish involves a man becoming sexually aroused by wearing women’s
clothing.
50. Which of the following would a mental health worker consider to be a transvestite?
a. a male who dressed as Marilyn Monroe for Halloween
b. a male homosexual in drag
c. a man who experiences sexual satisfaction from wearing women’s underwear
d. a professional female impersonator
Answer: C
Rationale:
An example of a transvestite is a man who experiences sexual satisfaction from wearing
women’s underwear.
51. The motivation for seeking treatment that tends to have a higher likelihood of success is
________.
a. court-ordered
b. self-distress
c. social ostracism
d. distress due to sexual dysfunction
Answer: B
Rationale:
Treatment for a paraphilia is more likely to have success if it is motivated by self-distress.
52. According to the text, the reason why someone might seek some form of treatment for a
paraphilia may include all of the following except ________.
a. it was court-ordered
b. self-distress
c. relationship distress
d. a need to act out a fantasy

Answer: D
Rationale:
Treatment for a paraphilia may be because it is court-ordered, it is causing the person
distress, or it is causing distress in the relationship.
53. The treatment of paraphilic behavior ________.
a. is to extinguish the behavior completely
b. depends on what paraphilia is being treated
c. usually includes group therapy
d. does not work
Answer: B
Rationale:
Treatment for paraphilic behavior depends on what is being treated.
54. Sam is going through incorporation therapy as a treatment for his paraphila. All of the
following relate to this type of treatment except ________.
a. it is a compromise, in that the frequency of the paraphilic behavior will be decreased, but
not completely abolished
b. it is successful when the partner of the paraphile is distressed and unwilling to accept the
intensity of the behavior, but can endure milder forms
c. the couple may work together to reach a point where they can both accept a certain level of
the paraphilic behavior
d. it seeks to incorporate the behavior into lovemaking
Answer: D
Rationale:
Characterisitics of incorporation therapy include 1) it is a compromise, in that the frequency
of the paraphilic behavior will be decreased, but not completely abolished, 2) it is successful
when the partner of the paraphile is distressed and unwilling to accept the intensity of the
behavior, but can endure milder forms, and 3) the couple may work together to reach a point
where they can both accept a certain level of the paraphilic behavior.
55. Due to the ethical issues involved, psychotherapy is less likely to involve ________.
a. aversion therapy
b. covert sensitization therapy
c. group therapy
d. cognitive behavioral therapy
Answer: A

Rationale:
Psychotherapy for a paraphilia is less likely to include aversion therapy due to ethical issues.
56. ________ involves telling the client to masturbate using objects, fantasies, or images
related to his paraphilia, but as orgasm approaches, he is instructed to switch completely to
objects, fantasies, and images of more mainstream, socially acceptable sexual behaviors.
a. Masturbatory re-initiation
b. Orgasmic reconditioning
c. Aversion therapy
d. Social skills training
Answer: B
Rationale:
Orgasmic reconditioning involves telling the client to masturbate using objects, fantasies, or
images related to his paraphilia, but as orgasm approaches, he is instructed to switch
completely to objects, fantasies, and images of more mainstream, socially acceptable sexual
behaviors.
57. Historically, drug therapy for paraphilias consisted of medications that would reduce
________.
a. fantasies
b. appetite
c. testosterone
d. sensitivity
Answer: C
Historically, drug therapy for paraphilias consisted of medications that would reduce
testosterone.
58. The most recent class of medications to show promise in treating paraphilias is ________.
a. alcohol
b. SSRIs
c. hormone replacement
d. methadone
Answer: B
Rationale:
SSRIs show promise in treating paraphilias.
59. In terms of treatment effectiveness, all of the following are true except ________.

a. the primary source of statistics is the criminal justice system
b. studies seem to indicate that treatment is significantly better than no treatment
c. the success rate for most paraphilias is not terribly optimistic
d. most paraphilias are easily treated
Answer: D
Rationale:
In terms of treatment effectiveness we see: 1) the primary source of statistics is the criminal
justice system, 2) studies seem to indicate that treatment is significantly better than no
treatment, and 3) the success rate for most paraphilias is not terribly optimistic.
60. The most successful treatments appear to be all of the following except those who
________.
a. are treated early in their history
b. are the most motivated to stop
c. involve themselves in normal adult sexual relationships
d. have a history of being in counseling
Answer: D
Rationale:
The most successful treatments appear to be those who are treated early in their history, those
who are the most motivated to stop, and those who involve themselves in normal adult sexual
relationships.
TRUE-FALSE
1. Our knowledge of paraphilias is quite recent.
Answer: False
Rationale:
Our understanding of paraphilias dates back much further than recent times. The study of
atypical sexual behaviors and preferences has been documented throughout history, although
the conceptualization and classification of paraphilias have evolved over time.
2. Exactly what behaviors qualify as paraphilias has changed markedly throughout history.
Answer: True
Rationale:
The criteria for diagnosing paraphilias have indeed evolved over time, reflecting changes in
societal norms, cultural attitudes, and advancements in psychological understanding. What
was once considered a paraphilia may not necessarily meet current diagnostic criteria.

3. According to the text, it is fairly easy, using a few simple criteria, to analyze a particular
behavior to see if it is likely to be a paraphilia.
Answer: True
Rationale:
While diagnosing paraphilias involves specific criteria outlined in diagnostic manuals such
as the DSM, the process can be relatively straightforward with proper assessment tools and
professional expertise. Certain behaviors can be evaluated against established criteria to
determine if they align with the definition of a paraphilia.
4. A person who enjoys walking around the house naked when home alone is a good example
of a paraphilia called exhibitionism.
Answer: False
Rationale:
Exhibitionism refers specifically to the recurrent urge or behavior of exposing one's genitals
to unsuspecting strangers, not merely enjoying nudity in private settings. Enjoying nudity at
home alone would not meet the criteria for exhibitionism unless there is a compulsion to
expose oneself to others.
5. The compulsive component of Joe’s paraphilia is manifested in his inability to stop the
undesirable behavior.
Answer: True
Rationale:
Compulsivity is a common feature of paraphilias, wherein individuals feel driven to engage
in specific sexual behaviors despite adverse consequences or a desire to stop. Joe's inability to
control or stop his behavior despite it being undesirable aligns with the compulsive aspect
often seen in paraphilias.
6. The DSM-IV-TR allows for several of the victimizing paraphilias to be diagnosed as
disorders, if they are acted upon, even if they do not cause distress or interpersonal
difficulties for the person who engages in the behavior.
Answer: True
Rationale:
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) does indeed
classify certain paraphilias as disorders even if they do not cause distress or impairment to the
individual engaging in the behavior, particularly when the behavior involves harm to others.
7. Sara’s sexual fantasies are usually about being in control and dominating the man she is
with. This would qualify as a paraphilia.
Answer: False
Rationale:

Sara's sexual fantasies of dominance and control do not inherently qualify as paraphilias.
Paraphilias involve atypical sexual preferences or behaviors that cause distress, impairment,
or harm to oneself or others. Sara's fantasies may be within the realm of typical sexual
expression and may not meet the criteria for paraphilic disorders.
8. Ben’s paraphilia involves an attraction to elderly people. He has recently found a new job
in an elderly community and knows he may be at risk of acting on his paraphilia. If he did act
on his paraphilia, it would be referred to as gerontophilia.
Answer: True
Rationale:
Gerontophilia refers to a sexual preference for elderly individuals. If Ben were to act on his
attraction to elderly people, it would indeed be referred to as gerontophilia. The term
describes the target of his sexual preference rather than the behavior itself.
9. Jeff loves to call women who live alone and talk sexually to them. It is a turn on. His
paraphilia would be considered nonvictimizing since he is not technically hurting them.
Answer: False
Rationale:
Jeff's behavior of sexually harassing women over the phone constitutes a form of
victimization, even if it does not involve physical harm. Sexual harassment causes distress,
discomfort, and potential psychological harm to the recipients, making it a form of
victimizing paraphilia.
10. Stan has an obsessive preoccupation with and compulsive need for sex. His therapist says
this is what is typically referred to as sexual addiction.
Answer: True
Rationale:
Stan's obsessive preoccupation with sex and compulsive need for it align with the concept of
sexual addiction, also known as hypersexuality or compulsive sexual behavior. This condition
involves a persistent pattern of excessive sexual thoughts, urges, or behaviors that interfere
with daily functioning and relationships.
11. Carl enjoys dressing up as a woman in public but he is often made fun of and has even
been the target of violence. Because of the response, he knows his behavior is judged more
negatively by society.
Answer: True
Rationale:
Carl's experience of being ridiculed and targeted with violence highlights the societal stigma
and discrimination faced by individuals engaging in atypical sexual behaviors, such as crossdressing. This negative societal response reflects the cultural norms and attitudes that shape
perceptions of gender and sexuality.

12. If there is consent, then the behavior is not considered a paraphilia.
Answer: False
Rationale:
Paraphilic behaviors involve atypical sexual preferences or behaviors that may not align with
societal norms and can occur with or without consent. Consent does not determine whether a
behavior is considered a paraphilia; instead, paraphilias are characterized by the nature of the
sexual preference or behavior itself.
13. The reason most paraphilic behavior is attributed to men is because men have a stronger
sex drive than women.
Answer: False
Rationale:
Attributing paraphilic behavior to men solely based on presumed differences in sex drive is a
misconception. Paraphilias can affect individuals of any gender, and the etiology of paraphilic
disorders involves complex psychological, biological, and social factors beyond simple
differences in sex drive.
14. Some research has found that in cultures where sexual activity serves primarily as a
reproductive function, paraphilias are significantly less common.
Answer: True
Rationale:
Cultural attitudes towards sexuality can influence the prevalence and expression of
paraphilias. In cultures where sexuality is primarily viewed within the context of
reproduction and strict social norms govern sexual behavior, paraphilias may be less
prevalent due to societal constraints and taboos surrounding sexual expression.
15. What we now know is that people are born with particular sexual eccentricities.
Answer: False
Rationale:
The origins of paraphilias are not entirely understood, but research suggests that both genetic
and environmental factors contribute to the development of atypical sexual preferences or
behaviors. Paraphilias are not typically considered innate characteristics; rather, they emerge
through a complex interplay of biological and psychosocial factors.
16. Behavioral theories of the development of paraphilias suggest any behavior that occurs in
a particular setting and is followed by a rewarding event will be more likely to reoccur in the
future in a similar setting.
Answer: True
Rationale:

Behavioral theories posit that paraphilic behaviors can be learned and reinforced through
conditioning processes, wherein a behavior that is followed by a rewarding event is more
likely to be repeated in similar contexts. This process contributes to the persistence and
recurrence of paraphilic behaviors over time.
17. Little scientific research supports or even suggests a single, clear, definitive answer to the
causes of paraphilias.
Answer: True
Rationale:
The etiology of paraphilias is complex and multifaceted, involving a combination of
biological, psychological, and environmental factors. While various theories and hypotheses
exist, there is no singular, universally accepted explanation for the development of paraphilic
disorders.
18. Calvin is sexually aroused watching his partner undress prior to sex, going to clubs with
sex shows, or watching sexually explicit videos; this would qualify as voyeurism.
Answer: False
Rationale:
Voyeurism specifically involves the act of observing unsuspecting individuals who are
naked, disrobing, or engaging in sexual activity, for the purpose of sexual arousal. Calvin's
behaviors may involve elements of voyeurism, but they do not align with the specific criteria
for diagnosing voyeuristic disorder.
19. As with other coercive paraphilias, frotteurism is considered a form of sexual assault.
Answer: True
Rationale:
Frotteurism involves the non-consensual touching or rubbing against a non-consenting
individual for sexual arousal or gratification. This behavior constitutes a form of sexual
assault because it involves unwanted sexual contact without the other person's consent.
20. Damon is sexually aroused by bondage, which means he is a sexual sadist.
Answer: False
Rationale:
Bondage refers to consensual erotic practices involving the restraint of a partner for sexual
pleasure. Sexual sadism, on the other hand, involves deriving sexual arousal from inflicting
physical or psychological pain or suffering on others. Damon's arousal from bondage does
not necessarily indicate sexual sadism unless it involves the infliction of pain or suffering on
others for sexual gratification.
21. Sex play involving light bondage, spanking, and discipline appears to be quite popular
and fairly common when considering the number of websites and catalogs devoted to
products related to this activity.

Answer: True
Rationale:
Activities such as light bondage, spanking, and discipline, often referred to as BDSM
(Bondage and Discipline, Dominance and Submission, Sadism and Masochism), are indeed
popular and commonly practiced among consenting adults. The availability of related
products and resources reflects the widespread interest in these sexual practices.
22. The majority of pedophiles are strangers to their victims.
Answer: False
Rationale:
Contrary to popular belief, the majority of individuals who sexually abuse children are
known to them, such as family members, relatives, family friends, or authority figures.
Strangers perpetrating child sexual abuse are relatively rare compared to those who have
established relationships with the victims.
23. The number of Catholic priests who have been sexually involved with minors over the
past 50 years is estimated to be between 3,000 to 5,000 priests.
Answer: True
Rationale:
The sexual abuse scandal within the Catholic Church has led to numerous reports of clergy
members sexually abusing minors over several decades. Estimates suggest that thousands of
Catholic priests worldwide have been implicated in cases of child sexual abuse, highlighting
the extent of the issue.
24. Research estimates that 11,000 boys (now men) have been abused by priests.
Answer: True
Rationale:
Studies and investigations into the Catholic Church sexual abuse scandal have revealed
staggering numbers of victims, with estimates suggesting tens of thousands of individuals,
primarily boys, have been sexually abused by priests. These victims often suffer profound
and long-lasting psychological and emotional consequences as a result of the abuse.
25. According to research, two reasons for Catholic priest abuse is the church’s culture of
celibacy and its culture of homosexuality.
Answer: False
Rationale:
While celibacy and homosexuality within the priesthood have been cited in discussions
surrounding the sexual abuse scandal, research does not support them as direct causes of the
abuse. Instead, factors such as institutional secrecy, power dynamics, and inadequate
responses to allegations of abuse have been identified as significant contributors to the
problem.

26. Sexual masochism is typically not illegal.
Answer: True
Rationale:
Sexual masochism, which involves deriving sexual pleasure from experiencing pain or
humiliation, is not inherently illegal unless it involves non-consensual or harmful acts. In
consensual sexual encounters, individuals have the right to engage in various activities,
including those related to sexual masochism, without legal repercussions.
27. The belief by those who try autoerotic asphyxiation is that oxygen deprivation enhances
arousal and orgasm sensations during masturbation – but the reality is that there is no
connection.
Answer: True
Rationale:
Autoerotic asphyxiation involves deliberately restricting one's oxygen supply to enhance
sexual arousal or orgasm. However, this practice is extremely dangerous and can lead to
accidental death due to asphyxiation. Despite the belief among some individuals that it
enhances sexual sensations, there is no physiological connection between oxygen deprivation
and sexual arousal or pleasure.
28. The development of fetishes probably stems from experiences in childhood or early
adulthood in which some body part, article of clothing, or object is paired with sexual arousal
and orgasm.
Answer: True
Rationale:
The development of fetishes often involves a conditioning process wherein individuals
associate specific objects, body parts, or scenarios with sexual arousal or pleasure. These
associations can form during childhood or early adulthood through repeated exposure to
certain stimuli during sexual experiences, leading to the development of fetishistic
preferences.
29. Cross-dressing is the same thing as transvestism.
Answer: False
Rationale:
While both cross-dressing and transvestism involve wearing clothing typically associated
with the opposite gender, they are not synonymous. Cross-dressing refers to the act of
wearing clothing traditionally worn by the opposite sex, which may or may not be related to
one's gender identity. Transvestism, on the other hand, specifically refers to individuals who
derive sexual arousal or pleasure from cross-dressing.
30. Transgenderism is not a paraphilia.
Answer: True

Rationale:
Transgenderism refers to individuals whose gender identity does not align with the sex they
were assigned at birth. It is a diverse and complex aspect of human identity and is not
considered a paraphilia. Paraphilias involve atypical sexual preferences or behaviors that may
cause distress, impairment, or harm to oneself or others, whereas transgender identity relates
to one's deeply felt sense of being male, female, or another gender.
SHORT ANSWER
1. One of the first detailed accounts of paraphilic behavior was in a medical text written in
1886 called ________.
Answer: Psychopathia Sexualis
Rationale:
"Psychopathia Sexualis" written by Richard von Krafft-Ebing in 1886 is considered one of
the earliest and most influential texts on sexual disorders, including paraphilias. It provided
detailed descriptions and case studies of various atypical sexual behaviors, contributing to the
understanding and classification of paraphilias.
2. A ________ is one that controls the person instead of the other way around.
Answer: compulsive behavior
Rationale:
Compulsive behavior refers to actions that are driven by an irresistible urge or impulse, often
leading individuals to engage in repetitive behaviors despite adverse consequences. In the
context of paraphilias, compulsive behaviors can manifest in the uncontrollable urge to
engage in atypical sexual activities.
3. The ________ is the diagnostic manual used by mental health professionals for the
diagnosis of psychological disorders, including paraphilias.
Answer: DSM-IV-TR
Rationale:
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) is a widely used
classification system for mental health disorders, providing criteria and guidelines for
diagnosing various psychological conditions, including paraphilic disorders.
4. Examples of victimizing paraphilias include ________, ________, ________, and
________.
Answer: voyeurism, exhibitionism, frotteurism and pedophilia
Rationale:
Victimizing paraphilias involve behaviors that intrude upon or violate the privacy and
autonomy of others, often causing harm or distress to the victims. Voyeurism, exhibitionism,
frotteurism, and pedophilia are examples of paraphilias characterized by non-consensual or
harmful sexual acts towards others.

5. Zachary’s sexual attraction to a nonliving object or nonsexual body part would be
considered ________.
Answer: fetishism
Rationale:
Fetishism involves sexual arousal or gratification derived from nonliving objects or
nonsexual body parts. Individuals with fetishes may experience intense sexual desire or
arousal in response to specific objects or body parts, often incorporating them into sexual
fantasies or behaviors.
6. This paraphilia involves sexual attraction to insects or other small crawling creatures:
________.
Answer: formicophilia
Rationale:
Formicophilia is a paraphilic disorder characterized by sexual arousal or gratification derived
from insects or other small crawling creatures. Individuals with formicophilia may engage in
behaviors such as having insects crawl on their body or incorporating them into sexual
activities.
7. Jason’s paraphilic behavior involves self-strangulation during masturbation. His is known
as ________.
Answer: autoerotic asphyxiation
Rationale:
Autoerotic asphyxiation is a paraphilic practice involving self-strangulation or oxygen
deprivation during sexual arousal or masturbation. Individuals engage in this behavior to
enhance sexual pleasure, but it can lead to accidental death due to asphyxiation.
8. ________ refers to an obsessive preoccupation and compulsive need for sexual activity.
Answer: Hypersexual disorder
Rationale:
Hypersexual disorder, also known as compulsive sexual behavior or sex addiction, involves
an intense and uncontrollable urge to engage in sexual activity. Individuals with hypersexual
disorder may experience persistent thoughts about sex, engage in excessive sexual behaviors,
and have difficulty controlling their sexual impulses.
9. Three theories, ________, ________, and ________, have been suggested to account for
the development of a paraphilia.
Answer: psychodynamic, behavioral, and biological
Rationale:
Various theories have been proposed to explain the development of paraphilias, including
psychodynamic theories that focus on unconscious conflicts and early childhood experiences,

behavioral theories that emphasize learning and conditioning processes, and biological
theories that explore genetic, neurological, and hormonal factors influencing sexual behavior.
10. ________ propose that paraphilias begin with the pairing of a particular event with sexual
arousal.
Answer: Behavior theorists
Rationale:
Behavior theorists suggest that paraphilias develop through a process of associative learning,
wherein a specific event or stimulus becomes paired with sexual arousal or gratification. Over
time, this association strengthens, leading to the persistence and reinforcement of atypical
sexual preferences or behaviors.
11. “Peeping Tom” is to ________ as “flasher” is to ________.
Answer: voyeurism; exhibitionism
Rationale:
"Peeping Tom" refers to voyeurism, which involves surreptitiously observing others for
sexual arousal. "Flasher" refers to exhibitionism, which involves exposing one's genitals to
others for sexual arousal or gratification.
12. The vast majority of adults who sexually abuse children are ________.
Answer: heterosexual
Rationale:
Research indicates that the majority of individuals who sexually abuse children identify as
heterosexual. Sexual orientation is not a determining factor in the perpetration of child sexual
abuse, as perpetrators come from diverse backgrounds and sexual orientations.
13. Sexual sadism and sexual masochism both typically involve elements of humiliation and
pain, but the difference is that the latter includes ________.
Answer: consent and ground rules
Rationale:
While both sexual sadism and sexual masochism may involve elements of pain and
humiliation, sexual masochism includes the presence of consent and mutually agreed-upon
ground rules between partners. In sexual masochism, individuals derive sexual pleasure from
experiencing pain or humiliation within a consensual context.
14. ________ is the most personally dangerous of all the paraphilias.
Answer: Autoerotic asphyxiation
Rationale:
Autoerotic asphyxiation is considered one of the most personally dangerous paraphilias due
to the risk of accidental death from asphyxiation. Individuals who engage in this practice may
inadvertently cause severe injury or fatal consequences while seeking sexual gratification.

15. Shoes, lingerie, and typically nonsexual body parts are among the most common
________.
Answer: fetish objects
Rationale:
Fetish objects are items or body parts that elicit sexual arousal or gratification for individuals
with fetishes. Common fetish objects include shoes, lingerie, and nonsexual body parts such
as feet or hair, which may be incorporated into sexual fantasies or activities.
16. Most transvestites are ________ males.
Answer: heterosexual
Rationale:
Transvestism, also known as cross-dressing, refers to the practice of wearing clothing
typically associated with the opposite gender. Research suggests that most transvestites are
heterosexual males who derive sexual arousal or gratification from cross-dressing.
17. Treatment for paraphilias include: ________, ________, ________, and ________.
Answer: incorporation, psychotherapy, orgasmic reconditioning, and drug therapy
Rationale:
Treatment approaches for paraphilias vary but may include psychotherapy, such as cognitivebehavioral therapy (CBT) or psychoanalytic therapy, to address underlying issues and modify
harmful behaviors. Other interventions may include medication, such as antidepressants or
antiandrogens, to reduce sexual arousal and manage impulsivity. Incorporation therapy
involves integrating paraphilic interests into a healthy, consensual sexual relationship, while
orgasmic reconditioning aims to redirect sexual arousal towards more socially acceptable
stimuli.
ESSAY
1. Discuss the three basic criteria used to determine if something is a paraphilia or not.
A sexual activity may be considered a paraphilia if it meets all three of the following criteria:
1. The behavior is engaged in for the purpose of sexual arousal or gratification.
The first criterion is obvious: at least one of the primary reasons a person is engaging in the
behavior is because it is a sexual turn-on. If a man dresses up as a woman for a part in a play,
his cross-dressing is unconnected to sexual arousal or gratification and is unlikely to be
defined as a paraphilia (transvestism).
2. The behavior tends to be compulsive and recurrent.
The second criterion of paraphilias is that they tend to constitute compulsive behavior. Any
behavior, sexual or not, may for some people become compulsive. In essence, a compulsive
behavior is one that controls the person instead of the other way around. Usually, it is a
behavior that the person would like to stop doing but feels powerless to control.

3. A clear majority of people in a given cultural setting would consider the behavior to be
strange, deviant, pathological, or abnormal.
The third criterion of paraphilias is what sets them apart from other sexual behaviors (even
those that might meet the first two criteria). Paraphilias are sexual behaviors that would strike
most people in a particular cultural setting as strange or abnormal. This judgment sounds
subjective. You may be thinking, “What’s strange to one person is mainstream to another” or
“Who’s to say what’s abnormal anyway?” It is important to take into account the culture in
which the behavior occurs because societies are often surprisingly diverse in their social and
sexual customs.
2. Discuss the three most common theories on the origins of paraphilias.
Three theories—psychodynamic, behavioral, and biological—have been suggested to account
for the development of a paraphilia:
• Psychodynamic theories of human nature rest on the basic psychoanalytic ideas of Sigmund
Freud, who contended that all dysfunctional or problematic behaviors in adulthood, sexual or
otherwise, are caused by traumatic events that occurred in early childhood. The fundamental
assumption here is that major developmental traumas or conflicts you may have encountered
during your early formative years, from birth through about age 10, have been repressed into
your unconscious in order to protect you from their disturbing nature. Because you repressed
them into your unconscious, you are even now totally unaware that those conflicts exist.
However, later, in adulthood, the theory maintains, those repressed traumas may exert
powerful forces on your behavior and cause you to engage in socially unacceptable behaviors
as your unconscious tries to resolve the tension they create.
• The behavioral approach to explaining the origins of paraphilias rests on the various
components of classical and operant conditioning. If you have studied these learning theories
in other psychology classes, you’ll recall that in classical conditioning, a response to a
particular stimulus is learned (or conditioned) when that stimulus is paired in the brain with
another event that naturally produces a particular response.
• Biological theories of paraphilias derive from the assumption that something physiological
has malfunctioned and is leading to the person’s strange and compulsive behaviors. These
theories focus primarily on imbalances in two biochemical systems: hormones and
neurotransmitters. The hormone hypothesis suggests that compulsive sexual behavior may be
related to an overproduction of male hormones, mainly testosterone, but other hormones,
such as epinephrine (adrenaline) and norepinephrine, have been implicated as well. The
neurotransmitter serotonin, which is known to be involved in various psychological disorders,
especially depression, anxiety, and obsessive-compulsive disorder (OCD), has been
connected to paraphilias as well.
3. Describe the five most common victimizing paraphilias.
• Voyeurism refers to the paraphilia of a recurring urge to secretly watching others undress or
engage in sexual activities without their knowledge or consent.
• Exhibitionism is the flip side of voyeurism in that the focus for sexual arousal and
gratification is displaying one’s genitals to others without their consent. A common term for
someone who engages in this paraphilia is a “flasher.”

• Frotteurism is the recurring compulsion to rub one’s genitals against a nonconsenting person
for sexual arousal and, typically, orgasm.
• Sexual sadism, the recurring compulsive urge to inflict of pain and humiliation for sexual
gratification, is named for the Marquis de Sade, an eighteenth-century French author and
aristocrat who spent much of his adult life imprisoned for engaging in and writing about his
particularly violent form of sexual expression.
• Pedophilia refers to the pattern of exploitation of prepubescent children for an adult’s sexual
purposes.
4. Discuss what is known about the more common nonvictimizing paraphilias.
• Sexual masochism refers to sexual arousal and gratification that is associated with acts or
fantasies of being hurt, humiliated, or otherwise made to suffer. The masochist has a recurring
pattern of engaging in such acts voluntarily and often seeks them out.
• Autoerotic asphyxiation involves depriving the brain of oxygen, usually through some form
of strangulation or hanging, during masturbation. If this behavior is engaged in by a couple,
where one chokes the other, with consent) during sexual activity, it is usually called sexual
hypoxia or hypoxyphilia; but this is far less common than the autoerotic form.
• Fetish is when a sexual preference intensifies to the point that a person obsesses almost
exclusively on a nonhuman object or sometimes on a body part that most members of a
culture do not find sexy, such as feet or toes.
5. Describe treatment approaches for paraphilias discussed in the textbook.
• Incorporation therapy is, in a way, a compromise in that the frequency of the paraphilic
behavior will be decreased or modified but not completely abolished. This approach is often
successful when the partner of the paraphiliac is distressed and unwilling to accept the
intensity of the paraphilic behaviors but can learn to endure a milder form of them.
• Psychotherapy. The most successful approach appears to be cognitive-behavioral therapy,
which combines techniques designed to modify unwanted behaviors with altering the client’s
thinking patterns that lead to the unwanted behaviors
• Orgasmic Reconditioning. Sexual arousal and orgasm are very powerful reinforcements for
whatever behavior becomes associated with them. If a person who desires to modify his
paraphilic behavior could be conditioned to become aroused and have orgasms in settings that
bear no resemblance to the paraphilia, his maladaptive associations and behaviors might be
altered
• Drug Therapy. If an imbalance in brain and glandular chemicals is leading to unwanted,
inappropriate sexual behavior, it makes sense that it might be treated with medications that
alter, in some way, the production or effects of those chemicals.

Test Bank for Human Sexuality
Roger R. Hock
ISBN's: 9780205989409, 9780133971385, 9780134224961

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