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Abstract: Paraphilic coercive disorder: Is it a distinct paraphilia?

The Diagnostic and Statistics Manual 5 (DSM 5) Paraphilias Sub-workgroup has proposed a new paraphilic diagnostic syndrome, Paraphilic Coercive Disorder (PCD). This presentation will discuss the empirical data on the validity of this proposed construct, reviewing evidence from penile plethysmographic (PPG) studies, from MIDSA self-report data, from taxometric studies of PCD and related constructs, and from clinical trials on reliability. New factor analytic, taxometric, and Item Response Theory analyses will be presented, and it will be argued that PCD does not constitute a separate disorder, but is rather part of an “Agonistic” dimension that ranges from PCD on the low end to sadism on the high end. The consequences for the DSM 5 PCD proposal and for the clinical importance of this dimension will be discussed.


Dr. Raymond Knight is the Mortimer Gryzmish Professor of Human Relations at Brandeis University. He has been doing research on sexual aggression for the last thirty-five years. He has developed and validated taxonomic models for rapists and child molesters and has completed a 25-year follow-up of sex offenders released from the Massachusetts Treatment Center. He is currently validating the Multidimensional Inventory of Development, Sex, and Aggression (the MIDSA), which is a computerized contingency-based inventory that provides a comprehensive assessment of multiple critical areas of adaptation for juvenile and adult sexual offenders. Recently he has been involved in taxometric analyses of psychopathy, hypersexuality, and the proposed psychopathic sexual taxon. He has served as president of both the Society for Research in Psychopathology and the Association for the Treatment of Sexual Abusers.