Table 1

DSM-IV-TR and DSM-5 Criterion Templates for the Paraphilic Disorders^1,12

DSM-5	DSM-IV-TR
Template for Paraphilic Disorders involving Nonconsenting Victims (i.e., Voyeuristic Disorder, Exhibitionistic Disorder, Frotteuristic Disorder, Sexual Sadism Disorder) except Pedophilic Disorder (see below). A. Over a period of at least 6 months, recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity [Voyeuristic Disorder] from the exposure of one's genitals to an unsuspecting person [Exhibitionistic Disorder] from touching or rubbing against a nonconsenting person [Frotteuristic Disorder] from the physical or psychological suffering of another person [Sexual Sadism Disorder] … as manifested by fantasies, urges, or behaviors. B. The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. C. [for Voyeuristic Disorder only]: The individual experiencing the arousal and/or acting on the urges is at least 18 years of age. For Exhibitionistic Disorder only: Specify whether: Sexually aroused by exposing genitals to prepubertal children Sexually aroused by exposing genitals to physically mature individuals Sexually aroused by exposing genitals to prepubertal children and to physically mature individuals Specify if: In a controlled environment: this specifier is primarily applicable to individuals living in institutional or other settings where opportunities to [engage in paraphilic behavior] are restricted. In full remission: The individual has not acted on the urges with a nonconsenting person, and there has been no distress or impairment in social, occupational, or other areas of functioning, for at least 5 years while in an uncontrolled environment.	Template for Paraphilias involving Nonconsenting Victims (i.e., Voyeurism, Exhibitionism, Frotteurism, Sexual Sadism) except Pedophilia (see below). A. Over a period of at least 6 months, recurrent intense sexually arousing fantasies, sexual urges, or behaviors … involving the act of observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity [Voyeurism]. involving the exposure of one's genitals to an unsuspecting person [Exhibitionism] involving touching or rubbing against a nonconsenting person [Frotteurism] involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person [Sexual Sadism]. B. The person has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulties.
Template for Paraphilic Disorders not involving nonconsenting victims (including Sexual Masochism, Fetishistic Disorder, and Transvestic Disorder) A. Over a period of at least 6 months, recurrent and intense sexual arousal … from the act of being humiliated, beaten, bound, or otherwise made to suffer … [Sexual Masochistic Disorder] … from the use of nonliving objects or a highly specific focus on nongenital body part(s) … [Fetishistic Disorder … from cross-dressing [Transvestic Disorder] … as manifested by fantasies, urges, or behaviors. B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.	Template for Paraphilic Disorders not involving nonconsenting victims (including Sexual Masochism, Fetishistic Disorder, and Transvestic Disorder) A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors … … involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer [Sexual Masochism] … involving the use of nonliving objects (e.g., female undergarments) [Fetishism] … involving cross-dressing in a heterosexual male [Transvestic Fetishism]. B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. [For Fetishistic Disorder only:] The fetish objects are not limited to articles of clothing used in cross-dressing (as in Transvestic Disorder) or devices specifically designed for the purpose of tactile genital stimulation (e.g., vibrator). For Transvestic Disorder only: Specify if: With fetishism: if sexually aroused by fabrics, materials, or garments. With autogynephilia: if sexually aroused by thoughts or images of self as female. For Sexual Masochism Disorder only: Specify if: With asphyxiophilia: If the individual engages in the practice of achieving sexual arousal related to restriction of breathing. For Fetishistic Disorder only: Specify: Body part(s) Nonliving object(s) Other Specify if: In a controlled environment: this specifier is primarily applicable to individuals living in institutional or other settings where opportunities to [engage in paraphilic behavior] are restricted. In full remission: there has been no distress or impairment in social, occupational, or other areas of functioning, for at least 5 years while in an uncontrolled environment.	C. [For Fetishism only:] The fetish objects are not limited to articles of female clothing used in cross-dressing (as in Transvestic Fetishism) or devices specifically designed for the purpose of tactile genital stimulation (e.g., vibrator). For Transvestic Fetishism only: Specify if: With Gender Dysphoria: if the person has persistent discomfort with gender role or identity
Template for Pedophilic Disorder A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger). B. The individual has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty. C. The individual is at least age 16 years and at least 5 years older than the child or children in Criterion A. Note: do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12- or 13-year-old. Specify whether: Exclusive type (attracted only to children) Nonexclusive type Specify if: Sexually attracted to males Sexually attracted to females Sexually attracted to both Specify if: Limited to incest	Template for Pedophilia A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger). B. The person has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty. C. The person is at least age 16 years and at least 5 years older than the child or children in Criterion A. Note: do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12- or 13-year-old. Specify type: Exclusive type (attracted only to children) Nonexclusive type Specify if: Sexually attracted to males Sexually attracted to females Sexually attracted to both Specify if: Limited to incest

Italics highlight the differences.