title: How unusual are the contents of paraphilias? Paraphilia-associated sexual arousal patterns in a community-based sample of men.
abstract: BACKGROUND
  This is a report of a cross-sectional study on paraphilia-associated sexual arousal patterns (PASAP) among men in a metropolitan city in Germany, EU.
  
  
  OBJECTIVE
  To determine the prevalence of PASAP during sexual fantasies, fantasies accompanying masturbation, and real-life sociosexual behavior.
  
  
  METHODS
  In a cross-sectional study, self-reported sexual history data were collected by questionnaire from 367 volunteers recruited from a community sample of 1,915 men aged 40-79 years.
  
  
  METHODS
  The Derogatis Symptom Checklist-Revised (SCL-90-R) and the Life Satisfaction Questionnaire (LSQ; German original, Fragebogen zur Lebenszufriedenheit, [FLZ]) were administered to obtain a general subjective health measure and a measure of general as well as sex life satisfaction. The Questionnaire on Sexual Experiences and Behaviour was administered to comprehensively assess all relevant sexo-medical data. Results.  The percent of men that reported at least one PASAP was 62.4%. In 1.7% of cases, PASAP were reported to have caused distress. The presence of PASAP was associated with a higher likelihood of being single (odds ratio [OR] 2.6; 95%; confidence interval [CI] 1.047-6.640), masturbating at least once per week (OR 4.4; 95%; CI 1.773-10.914), or having a low general subjective health score (OR 11.9; 95%; CI 2.601-54.553). Pedophilic PASAP in sexual fantasies and in real-life sociosexual behavior was reported by 9.5% and 3.8% of participants, respectively.
  
  
  CONCLUSIONS
  The findings suggest that paraphilia-related experience can not be regarded as unusual from a normative perspective. At the same time, many men experience PASAP without accompanying problem awareness or distress, even when PASAP contents are associated with potentially causing harm to others. In view of the relevance for sex life and relationship satisfaction, presence of PASAP should be assessed in all sexual medicine consultations. Future research should focus on conditions in which PASAP reach clinical significance in the sense of mental disorders.
authors.affiliation: Institute of Sexology and Sexual Medicine, Charité University Medical Center, Freie und Humboldt-Universität zu Berlin, Berlin, Germany. dr.ahlers@berlin.de
authors.forename: Christoph Joseph
authors.initials: CJ
authors.lastname: Ahlers
authors.forename: Gerard Alfons
authors.initials: GA
authors.lastname: Schaefer
authors.forename: Ingrid Annette
authors.initials: IA
authors.lastname: Mundt
authors.forename: Stephanie
authors.initials: S
authors.lastname: Roll
authors.forename: Heike
authors.initials: H
authors.lastname: Englert
authors.forename: Stefan N
authors.initials: SN
authors.lastname: Willich
authors.forename: Klaus Michael
authors.initials: KM
authors.lastname: Beier
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D010262:Paraphilic Disorders / Q000453:epidemiology / Q000523:psychology*; D011581:Psychological Tests; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires