DSM-5 distinguishes between a 'paraphilia' and a 'paraphilic disorder'. Which statement CORRECTLY describes this distinction?

• A A paraphilic disorder requires either personal distress or harm/potential harm to others; a paraphilia alone does not warrant diagnosis or treatment ✓
• B A paraphilia is always a disorder requiring treatment
• C All paraphilias involving non-consenting individuals are classified only as paraphilias, not disorders
• D The distinction was introduced in DSM-III and has remained unchanged

Explanation

DSM-5 introduced a conceptually important distinction: a paraphilia is an atypical, intense, persistent sexual interest that does not in itself constitute a disorder. A paraphilic disorder is diagnosed only when the paraphilia causes significant distress or functional impairment to the individual, OR when the sexual interest involves non-consenting individuals (e.g., pedophilic disorder, voyeuristic disorder, frotteuristic disorder) — in the latter, the disorder is diagnosable regardless of distress, because it involves potential harm. This prevents pathologising consensual atypical sexuality between adults.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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