Problems with the DSM-IV diagnosis of pedophilia.

This paper examines the taxonomic adequacy of the Diagnostic and Statistical Manual, 4th ed., DSM-IV (American Psychiatric Association, 1994) diagnostic category of pedophilia. This diagnosis, as well as the other sexual disorders, have been ignored in DSM field trials. There is no empirical information about the reliability or validity of this diagnosis. Moreover, because the vagueness of the diagnostic criteria, clinicians would need to make inferences that would likely lead to reliability problems in diagnosis. Further, the DSM diagnostic criteria include constructs that are not intersubjectively verifiable and for which there are no valid measures. This can also lead to lack of diagnostic reliability and accuracy. Most problematical however, there are aspects of the diagnostic criteria, most notably the presence of an "ego dystonic sexual attraction to children," that are incorrect exclusion criteria. Suggestions for improvement are provided.

Psychotherapy for male sexual dysfunction: a review.

There are nine major diagnostic categories of male sexual dysfunction in the DSM-IV. Psychotherapy outcome studies focusing on these problems are reviewed. Currently, there appears to be little evidence that effective psychological interventions exist for these problems. Reasons for this include numerous methodological problems of existing research, effect sizes that are not clearly clinically significant, lack of compelling follow-up data indicating durability of treatment gains, and lack of treatment manuals that allow replication. Also, some disorders have been ignored by researchers. Guidelines for sample selection and description, assessment and diagnosis, and research design are provided.