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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Historically voyeurism has been treated in a variety of ways. Psychoanalytic, group psychotherapy and shock aversion approaches have all been attempted with limited success. There is some evidence that shows that pornography can be used as a form of treatment for voyeurism. This is based on the idea that countries with pornography censorship have high amounts of voyeurism. Additionally shifting voyeurs from voyeuristic behavior, to looking at graphic pornography, to looking at the nudes in Playboy has been successfully used as a treatment. These studies show that pornography can be used as a means of satisfying voyeuristic desires without breaking the law.
Voyeurism has also been successfully treated with a mix of anti-psychotics and antidepressants. However the patient in this case study had a multitude of other mental health problems. Intense pharmaceutical treatment may not be required for most voyeurs.
There has also been success in treating voyeurism through using treatment methods for obsessive compulsive disorder. There have been multiple instances of successful treatment of voyeurism through putting patients on fluoxetine and treating their voyeuristic behavior as a compulsion.
Most psychologists believe that paraphilic sexual interests cannot be altered. Instead, the goal of therapy is normally to reduce the person's discomfort with their paraphilia and limit any criminal behavior. Both psychotherapeutic and pharmacological methods are available to these ends.
Cognitive behavioral therapy, at times, can help people with paraphilias develop strategies to avoid acting on their interests. Patients are taught to identify and cope with factors that make acting on their interests more likely, such as stress. It is currently the only form of psychotherapy for paraphilias supported by evidence.
The DSM-5 adds a distinction between "paraphilias" and "paraphilic disorders", stating that paraphilias do not require or justify psychiatric treatment in themselves, and defining "paraphilic disorder" as "a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others".
The DSM-5 Paraphilias Subworkgroup reached a "consensus that paraphilias are not "ipso facto" psychiatric disorders", and proposed "that the DSM-V make a distinction between "paraphilias" and paraphilic "disorders". [...] One would "ascertain" a paraphilia (according to the nature of the urges, fantasies, or behaviors) but "diagnose" a paraphilic disorder (on the basis of distress and impairment). In this conception, having a paraphilia would be a necessary but not a sufficient condition for having a paraphilic disorder." The 'Rationale' page of any paraphilia in the electronic DSM-5 draft continues: "This approach leaves intact the distinction between normative and non-normative sexual behavior, which could be important to researchers, but without automatically labeling non-normative sexual behavior as psychopathological. It also eliminates certain logical absurdities in the DSM-IV-TR. In that version, for example, a man cannot be classified as a transvestite—however much he cross-dresses and however sexually exciting that is to him—unless he is unhappy about this activity or impaired by it. This change in viewpoint would be reflected in the diagnostic criteria sets by the addition of the word "Disorder" to all the paraphilias. Thus, Sexual Sadism would become Sexual Sadism Disorder; Sexual Masochism would become Sexual Masochism Disorder, and so on."
Bioethics professor Alice Dreger interpreted these changes as "a subtle way of saying sexual kinks are basically okay – so okay, the sub-work group doesn’t actually bother to define paraphilia. But a paraphilic disorder is defined: that’s when an atypical sexual interest causes distress or impairment to the individual or harm to others." Interviewed by Dreger, Ray Blanchard, the Chair of the Paraphilias Sub-Work Group, explained: "We tried to go as far as we could in depathologizing mild and harmless paraphilias, while recognizing that severe paraphilias that distress or impair people or cause them to do harm to others are validly regarded as disorders."
Charles Allen Moser pointed out that this change is not really substantive as DSM-IV already acknowledged a difference between paraphilias and non-pathological but unusual sexual interests, a distinction that is virtually identical to what is being proposed for DSM-5, and it is a distinction that, in practice, has often been ignored. Linguist Andrew Clinton Hinderliter argued that "Including some sexual interests—but not others—in the DSM creates a fundamental asymmetry and communicates a negative value judgment against the sexual interests included," and leaves the paraphilias in a situation similar to ego-dystonic homosexuality, which was removed from the DSM because it was realized not to be a mental disorder.
The DSM-5 acknowledges that many dozens of paraphilias exist, but only has specific listings for eight that are forensically important and relatively common. These are voyeuristic disorder, exhibitionistic disorder, frotteuristic disorder, sexual masochism disorder, sexual sadism disorder, pedophilic disorder, fetishistic disorder, and transvestic disorder. Other paraphilias can be diagnosed under the Other Specified Paraphilic Disorder or Unspecified Paraphilic Disorder listings, if accompanied by distress or impairment.
Psychosexual disorders can vary greatly in severity and treatability. Medical professionals and licensed therapists are necessary in diagnosis and treatment plans. Treatment can vary from therapy to prescription medication. Sex therapy, behavioral therapy, and group therapy may be helpful to those suffering distress from sexual dysfunction. More serious sexual perversions may be treated with androgen blockers or selective serotonin reuptake inhibitors (SSRIs) to help restore hormonal and neurochemical balances.
In the DSM-5 all paraphilia disorders can be diagnosed by two main criteria that are referred to criteria A and criteria B respectively. The A and B criteria include a duration in which the behavior must be present for (typically 6 months) and specific details of actions or thoughts that are correlated specifically with the respective disorder being diagnosed.
Although small spy cameras had existed for decades, advances in miniaturization and electronics since the 1950s have greatly aided the ability to conceal miniature cameras, and the quality and affordability of tiny cameras (often called "spy cameras" or subminiature cameras) has greatly increased. Some consumer digital cameras are now so small that in previous decades they would have qualified as "spy cameras", and digital cameras of twenty megapixels or more are now being embedded in some mobile camera phones. The vast majority of mobile phones in use are camera phones.
Certain image capturing devices are capable of producing images through materials that are opaque to visible light, including clothing. These devices form images by using electromagnetic radiation outside the visible range. Infrared and terahertz-wave cameras are capable of creating images through clothing, though these images differ from what would be created with visible light.
Exhibitionism is the act of exposing in a public or semi-public context those parts of one's body that are not normally exposed – for example, the breasts, genitals or buttocks. The practice may arise from a desire or compulsion to expose themselves in such a manner to groups of friends or acquaintances, or to strangers for their amusement or sexual satisfaction or to shock the bystander. Exposing oneself only to an intimate partner is normally not regarded as exhibitionism. In law, the act of exhibitionism may be called indecent exposure, "exposing one's person", or other expressions.
Courtship disorder is a theoretical construct in sexology in which a certain set of paraphilias are seen as specific instances of anomalous courtship instincts in men. The specific paraphilias are biastophilia (paraphilic rape), exhibitionism, frotteurism, telephone scatologia, and voyeurism. According to the "courtship disorder hypothesis", there is a species-typical courtship process in human males consisting of four phases, and anomalies in different phases result in one of these paraphilic sexual interests. That is, instead of being independent paraphilias, this theory sees these sexual interests as individual symptoms of a single underlying disorder.
Public exhibitionism by women has been recorded since classical times, often in the context of women shaming groups of men into committing, or inciting them to commit, some public action. The ancient Greek historian Herodotus gives an account of exhibitionistic behaviors from the fifth century BC in "The Histories". Herodotus writes that: When people travel to Bubastis for the festival, this is what they do. Every "baris" carrying them there overflows with people, a huge crowd of them, men and women together. Some of the women have clappers, while some of the men have pipes which they play throughout the voyage. The rest of the men and women sing and clap their hands. When in the course of their journey they reach a community — not the city of their destination, but somewhere else — they steer the "bareis" close to the bank. Some of the women carry on doing what I have already described them as doing, but others shout out scornful remarks to the women in the town, or dance, or stand and pull up their clothes to expose themselves. Every riverside community receives this treatment.
A case of what appears to be exhibitionism in a clinical sense was recorded in a report by the Commission against Blasphemy in Venice in 1550.
In the UK the 4th draft of the revised Vagrancy Act of 1824 included an additional clause 'or openly and indecently exposing their persons' which gave rise to difficulties because of its ill-defined scope. During the course of a subsequent debate on the topic in Parliament, the then Home Secretary, Mr Peel, observed that 'there was not a more flagrant offence than that of indecently exposing the person which had been carried to an immense extent in the parks...wanton exposure was a very different thing from accidental exposure'. The development of new technologies such as smartphones and tablets has permitted some exhibitionists to reorient their methods such as with .
Candaulism is a sexual practice or fantasy in which a man exposes his female partner, or images of her, to other people for their voyeuristic pleasure.
The term may also be applied to the practice of undressing or otherwise exposing a female partner to others, or urging or forcing her to engage in sexual relations with a third person, such as during a swinging activity. Similarly, the term may also be applied to the posting of personal images of a female partner on the internet or urging or forcing her to wear clothing which reveals her physical attractiveness to others, such as by wearing very brief clothing, such as a microskirt, tight-fitting or see-through clothing or a low-cut top.
According to the "courtship disorder hypothesis", there is a species-typical courtship process in humans consisting of four phases. These phases are: "(1) looking for and appraising potential sexual partners; (2) pretactile interaction with those partners, such as by smiling at and talking to them; (3) tactile interaction with them, such as by embracing or petting; (4) and then sexual intercourse."
The associations between these phases and these paraphilias were first outlined by Kurt Freund, the originator of the theory: A disturbance of the search phase of courtship manifests as voyeurism, a disturbance of the pretactile interaction phase manifests as exhibitionism or telephone scatologia, a disturbance of the tactile interaction phase manifests as toucheurism or frotteurism, and the absence of the courtship behavior phases manifests as paraphilic rape (i.e., biastophilia). According to Freund, these paraphilias "can be conceptualized as a preference for a pattern of behavior or erotic fantasy in which one of these four phases of sexual interaction is intensified and distorted to such an extent that it appears to be a caricature of the normal, while the remaining phases are either omitted entirely or are retained only in a vestigial way."
Freund noted that "troilism" (a paraphilia for observing one’s sexual/romantic partner sexually interacting with a third party, usually unbeknownst to the third party) might also be a courtship disorder, troilism being a variant of voyeurism.
Appropriate behaviors depend on the social and cultural context, including time and place. Some behaviors that are unacceptable under most circumstances, such as public nudity or sexual contact between dancers, may be accepted or even encouraged during celebrations like Carnival or Mardi Gras. Where such cultural festivals alter normative courtship behaviors, the signs of courtship disorder may be masked or altered.
Until the 1990s, it tended to be described mostly as acrotomophilia, at the expense of other disabilities, or of the wish by some to pretend or acquire disability. Bruno (1997) systematised the attraction as factitious disability disorder. A decade on, others argue that erotic target location error is at play, classifying the attraction as an identity disorder. In the standard psychiatric reference "Diagnostic and Statistical Manual of Mental Disorders", text revision (DSM-IV-tr), the fetish falls under the general category of "Sexual and Gender Identity Disorders" and the more specific category of paraphilia, or sexual fetishes; this classification is preserved in DSM-5.
The World Health Organization's (WHO) "International Statistical Classification of Diseases and Related Health Problems", 10th Edition (ICD-10) lists narcissistic personality disorder under "Other specific personality disorders". It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
The formulation of narcissistic personality disorder in the American Psychiatric Association's (APA) "Diagnostic and Statistical Manual of Mental Disorders", 4th Edition, Text Revision (DSM-IV-TR) was criticised for failing to describe the range and complexity of the disorder. Critics said it focuses overly on "the narcissistic individual's external, symptomatic, or social interpersonal patterns—at the expense of ... internal complexity and individual suffering," which they argued reduced its clinical utility.
The Personality and Personality Disorders Work Group originally proposed the elimination of NPD as a distinct disorder in DSM-5 as part of a major revamping of the diagnostic criteria for personality disorders, replacing a categorical with a dimensional approach based on the severity of dysfunctional personality trait domains. Some clinicians objected to this, characterizing the new diagnostic system as an "unwieldy conglomeration of disparate models that cannot happily coexist" and may have limited usefulness in clinical practice. The general move towards a dimensional (personality trait-based) view of the Personality Disorders has been maintained despite the reintroduction of NPD.
Attraction to disability or devotism is a sexualised interest in the appearance, sensation and experience of disability. It may extend from normal human sexuality into a type of sexual fetishism. Sexologically, the pathological end of the attraction tends to be classified as a paraphilia. (Note, however, that the very concept "paraphilia" continues to elude satisfactory definition and remains a subject of ongoing debate in both professional and lay communities) Other researchers have approached it as a form of identity disorder. The most common interests are towards amputations, prosthesis, and crutches.
SPD can be first apparent in childhood and adolescence with solitariness, poor peer relationships, and underachievement in school. This may mark these children as different and make them subject to teasing.
Being a personality disorder, which are usually chronic and long-lasting mental conditions, schizoid personality disorder is not expected to improve with time without treatment; however, much remains unknown because it is rarely encountered in clinical settings.
Ralph Klein, Clinical Director of the Masterson Institute, delineates the following nine characteristics of the schizoid personality as described by Harry Guntrip:
The description of Guntrip's nine characteristics should clarify some differences between the traditional DSM portrait of SPD and the traditional informed object relations view. All nine characteristics are consistent. Most, if not all, must be present to diagnose a schizoid disorder.
"More details about each of the characteristics can be found in the Harry Guntrip (Psychologist) article."
Isidor Sadger hypothesized that the candaulist completely identifies with his partner's body, and deep in his mind is showing himself. Candaulism is also associated with voyeurism and exhibitionism. An alternative definition proposes it as a practice involving one person observing, often from concealment, two others having sexual relations.
There are several options for treatment of scopophobia. With one option, desensitization, the patient is stared at for a prolonged period and then describes their feelings. The hope is that the individual will either be desensitized to being stared at or will discover the root of their scopophobia.
Exposure therapy, another treatment commonly prescribed, has five steps:
- Evaluation
- Feedback
- Developing a fear hierarchy
- Exposure
- Building
In the evaluation stage, the scopophobic individual would describe their fear to the therapist and try to find out when and why this fear developed. The feedback stage is when the therapist offers a way of treating the phobia. A fear hierarchy is then developed, where the individual creates a list of scenarios involving their fear, with each one becoming worse and worse. Exposure involves the individual being exposed to the scenarios and situations in their fear hierarchy. Finally, building is when the patient, comfortable with one step, moves on to the next.
As with many human health problems support groups exist for scopophobic individuals. Being around other people who face the same issues can often create a more comfortable environment.
Other suggested treatments for scopophobia include hypnotherapy, neuro-linguistic programming (NLP), and energy psychology. In extreme cases of scopophobia, it is possible for the subject to be prescribed anti–anxiety medications. Medications may include benzodiazepines, antidepressants, or beta-blockers.
Scopophobia is unique among phobias in that the fear of being looked at is considered both a social phobia and a specific phobia, because it is a specific occurrence which takes place in a social setting. Most phobias typically fall in either one category or the other but scopophobia can be placed in both. On the other hand, as with most phobias, scopophobia generally arises from a traumatic event in the person's life. With scopophobia, it is likely that the person was subjected to public ridicule as a child. Additionally, a person suffering from scopophobia may often be the subject to public staring, possibly due to a deformity or physical ailment.
According to the Social Phobia/Social Anxiety Association, U.S. government data for 2012 suggests that social anxiety affects over 7% of the population at any given time. Stretched over a lifetime, the percentage increases to 13%.