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Lady with Erotic Preference for Diapers.

Zack Cernovsky1, Yves Bureau2

  • 1Department of Psychiatry, University of Western Ontario , London, Canada.

Mental Illness
|December 21, 2016
PubMed
Summary

This case study explores a patient with depression and suicidal ideation whose anorgasmia resolved with diapering, linking her erotic fixation to childhood maternal deprivation. Treatment focused on depression, not the sexual preference, as fetishism is not classified as an illness by DSM-5.

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Area of Science:

  • Psychology
  • Psychiatry
  • Behavioral Therapy

Background:

  • A patient in her 20s presented with depression and suicidal ideation.
  • She reported anorgasmia, which resolved only when diapered, indicating a specific paraphilic interest.

Observation:

  • Childhood history revealed maternal deprivation and a challenging family environment.
  • The patient's erotic fixation on diapers was noted, drawing parallels to attachment behaviors in infant monkeys.
  • Behavioral therapy concepts, specifically avoidance learning, were considered in the etiological hypotheses.

Findings:

  • The patient's anorgasmia was linked to her diaper fetish.
  • Fetishism is not considered a disorder by the DSM-5 if the individual does not wish to change it.
  • The patient required treatment for severe depression, suicidal ideation, and low self-esteem.
Keywords:
Diaper fetishanorgasmiaavoidant conditioningrepetition compulsionsuicidal ideation

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Implications:

  • This case highlights the complex interplay between early life experiences, sexual preferences, and mental health conditions.
  • It underscores the importance of a nuanced approach to paraphilias, distinguishing between non-pathological interests and those causing distress or harm.
  • Treatment should prioritize addressing co-occurring mental health issues like depression and suicidality, even when the paraphilia itself is not considered an illness.