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Efforts to Reify Other Specified Paraphilic Disorder (Nonconsent) and Their Implications
Brian Holoyda1, Austin W Blum2
1Dr. Holoyda is Chief Psychiatrist, Contra Costa County Detention Health Services, Martinez, CA and Forensic Psychiatrist, Portland, OR. Dr. Blum is a Resident Physician in the Department of Psychiatry and Behavioral Neuroscience, University of Chicago. holoyda@gmail.com.
The Journal of the American Academy of Psychiatry and the Law
|February 8, 2023
Summary
The diagnosis of other specified paraphilic disorder (nonconsent) lacks scientific validity and reliability, despite its use in legal contexts. This article examines the concept's history, flaws, and ethical implications.
Area of Science:
- Forensic Psychology
- Psychiatry
- Legal Medicine
Background:
- The concept of paraphilic interest in rape emerged in the 1970s and gained prominence with sexually violent predator laws in the 1990s.
- Currently diagnosed as other specified paraphilic disorder (nonconsent) (OSPD (nonconsent)), it is a common diagnosis for individuals committed as sexually violent predators.
Approach:
- This article reviews the historical development and scientific deficiencies of OSPD (nonconsent).
- It examines the persistent promotion of this diagnosis by some experts, despite its lack of empirical support.
- The ethical, legal, and evaluative ramifications of its continued use are considered.
Key Points:
- OSPD (nonconsent) lacks scientific validity and demonstrates consistently poor interrater reliability.
- The concept has been repeatedly rejected for inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM) over several decades.
- Experts continue to advocate for OSPD (nonconsent), utilizing unresearched and unvalidated assessment criteria.
Conclusions:
- The continued clinical and legal application of OSPD (nonconsent) is problematic due to its fundamental scientific flaws.
- The promotion of this diagnosis raises significant ethical and legal concerns regarding expert testimony and patient evaluation.
- Further research and critical evaluation are necessary to address the validity and implications of OSPD (nonconsent).
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