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, 36 (4), 443-54

Use of DSM Paraphilia Diagnoses in Sexually Violent Predator Commitment Cases

  • PMID: 19092060

Use of DSM Paraphilia Diagnoses in Sexually Violent Predator Commitment Cases

Michael B First et al. J Am Acad Psychiatry Law.


There is legitimate concern in the psychiatric community about the constitutionality of sexually violent predator (SVP) commitment statutes. Such constitutionality depends on the requirement that a sexual offender have a mental abnormality that makes him commit violent predatory sex offenses and reflects almost exclusively a concern for public safety, with little regard for notions of clinical sensibility or diagnostic accuracy. However, given that mental health experts' diagnostic opinions are, and will continue to be, important to the triers of fact in regard to the application of the SVP statutes, we describe valid means of making a DSM-IV-TR paraphilic diagnosis. We also provide a three-step approach for the judicious application of the diagnosis in the context of SVP commitment evaluations that emphasizes the importance of not making a paraphilia diagnosis based solely on the sexual offenses themselves. Finally, we discuss the appropriate use of a paraphilia NOS diagnosis in SVP cases.

Comment in

  • Commentary: Muddy Diagnostic Waters in the SVP Courtroom
    RA Prentky et al. J Am Acad Psychiatry Law 36 (4), 455-8. PMID 19092061.
    In this brief commentary, we address several of the points raised by Drs. First and Halon on the abuses of DSM diagnoses (APA, 2000) in civil commitment hearings of sex o …

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