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R. Karl Hanson’s theoretical paper argues for the dimensional classification of paraphilic disorders. In the article the argument is made that a scale should be established to distinguish varying degrees of paraphilia. Through a review of literature Hanson has discovered varying types of paraphilia, that have been distinguished from one another. This helps him make his case that there are dimensions at which we should measure sexual deviances. In his review he proposed 3 dimensions that may be relevant to the diagnosis of paraphillias. He also offers 3 ways to show what these dimensions present through diagnostic confidence, symptom strength, and latent dimensions.
Sexual -Self Regulation
His first dimension is sexual-self regulation, this is how a person manages their sexual thoughts. This also falls on its own scale varying from indiscriminate sexual behaviors to more intense and high risk sexual behaviors. Hanson believes that some self-regulation is normal, in terms that some people may manage a fleeting sexual urge. The management is also scaled by difficulty, meaning how well a person manages the urge to act on their deviance.
Atypical Sexual Interest
The second dimensions are atypical sexual interests, which he reiterates is a sensitive topic due to the fact that some people indulge in activities that they find “normal.” Most heterosexual and homosexual people are able to keep their sexual interest within the parameters of their sexuality. Hanson says that evidence shows that most people with paraphilic interests also find themselves interested in other paraphilic tendencies. Which he also argues should be a factor in differentiating levels and types deviances.
Intensity of Sexuality
The third and final dimension is the intensity of sexuality. Hanson suggests that the intensity be labeled on a low to high scale. This ensures that psychologists are able to appropriately label their patients by the degree of the sexual deviance. He goes on to mention the ways to measure intensity by numbers of orgasms to number of times that the deviances take up time devoted to other things; such as work, family time, and other hobbies. He believes that there should be a universal way that professionals in the mental health industry identify levels deviance.
Quality of Evidence
In my opinion I find all of Hanson’s work and arguments to be valid and necessary. He provides great reasoning behind each of his dimensions. He also understands that dimensions and scales will not be an easy thing to implement in the medical field. Although Hanson has very good ideas in his approach to paraphilic disorders I also have a few concerns with his citations. Though he cites many different articles he fails to give detailed information that those articles possess. This makes it difficult to understand exactly what he references and why it is pertinent to his argument. He also does not show a set method of implementation of his dimensions into the field.
Overall Hanson believes that these 3 dimensions can be used to scale levels of paraphilia, and the intensity of each. With symptom strength a medical professional may be able to label a patient on a scale from the number of sexual desires and the intensity at which they feel them. He also confronts the issues behind diagnostic confidence. The confidence at which a healthcare provider is able to diagnose a patient with a paraphilic disorder, without the opportunity for misdiagnoses.
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