Abstract

Alcoholism has been related to a wide variety of crimes. Various authors have studied the prevalence of alcoholism in relationship to incest, rape and pedophilia. This study evaluates the co-morbidity of alcoholism and the specific paraphilias including sexual sadism, fetishism, incest, pedophilia, exhibitionism and transvestism. Rapists were included although by definition it is not strictly a paraphilic disorder. Seven hundred and twenty eight paraphilic individuals were evaluated. More than 50% of sexual sadists were alcoholics. Alcoholism in association with sexual sadists was statistically significant as compared to transvestites, rapists, pedophiles, and incest offenders. Transvestism had the lowest relative rate of alcoholism. The authors discuss these findings and the role alcoholism plays in causing violent sexual behavior in individuals with paraphilias.

References

1.
Bradford
J MW
,
Greenberg
D M
,
Motayne
G
.
Substance abuse in criminal behavior
.
Psychiatr Clin North Am
1992
;
15
(
3
):
605
-
22
.
2.
Rada
R T
.
Alcoholism and forcible rape
.
Am J Psychiatr
1975
;
132
(
4
):
444
-
46
.
3.
Murdoch
D
,
Pihl
R O
,
Ross
D .
Alcohol and crimes of violence: present issues
.
Int J Addictions
1990
;
25
:
1065
-
81
.
4.
Kessler
R C
,
McGonagle
K A
,
Zhao
S
,
Nelson
C B
,
Hughes
M
,
Eshleman
S
,
Wittchen
H
,
Kendler
K S
.
Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States
.
Arch Gen Psychiat
1994
;
51
:
8
-
19
.
5.
Wormith
J S
,
Bradford
J MW
,
Pawlak
A
,
Borzecki
M
,
Zohar
A
.
The assessment of deviant sexual arousal as a function of intelligence, instructional set and alcohol ingestion
.
Can J Psychiat
1988
;
33
:
800
-
07
.
6.
Swanson
D W
.
Adult sexual abuse of children: the man and circumstances
.
Dis Nervous Sys
1986
;
29
:
677
-
83
.
7.
Wormith
J S
.
A survey of incarcerated sexual offenders
.
Can J Criminol
1983
;
25
:
378
-
90
.
8.
Norris
J
,
Kerr
K L
.
Alcohol and violent pornography: responses to permissive and non-permissive cues
.
J Studies Alcohol
1993
;
11
:
118
-
27
.
9.
Abel
G G
,
Becker
J V
,
Skinner
L J
.
Aggressive behavior and sex
.
Psychiatr Clin North Am
1980
;
3
(
1
):
133
-
51
.
10.
Bradford
J MW
,
Gratzer
T
.
The physiological and psychological characteristics of sexual sadists: a controlled study
.
Submitted For Publication
,
1995
.
11.
Langevin
R
,
Hucker
S J
,
Handy
L
,
Purins
J E
,
Russon
A E
.
Erotic preference and aggression in pedophilia: a comparison of heterosexual, homosexual and bisexual types
.
Erotic preference, gender identity, and aggression in men: new research studies
,
Langevin
,
R.
, editor,
Lawrence Erlbaum and Associates
,
New Jersey
,
1985
,
137
-
60
.
12.
Langevin
R
,
Handy
L
,
Russon
A E
.
Are incestuous fathers pedophilic, aggressive, and alcoholic? Erotic preference, gender ideintity, and aggression in men: new research studies
.
Langevin
,
R
, editor,
Lawrence Erlbaum and Associates
,
New Jersey
,
1985
,
161
-
79
.
13.
Langevin
R
,
Lang
R A
.
Substance abuse among sex offenders
.
Ann Sex Res
1990
;
3
:
397
-
424
.
14.
American Psychiatric Association: Diagnostic and statistical manual of mental disorders
, 3rd Ed.,
American Psychiatric Association
,
Washington D. C.
,
1987
.
15.
Abel
G G
,
Barlow
D H
,
Blanchard
E B
,
Guild
D
.
The components of rapists and sexual arousal
.
Arch Gen Psychiatr
1977
;
34
(
8
):
895
-
903
.
16.
Abel
G G
.
Paraphilias
.
Comprehensive textbook of psychiatry
Kaplan
H I
,
Sadock
B J
, editors,
Williams and Wilkens
,
Maryland
,
1989
,
1069
-
85
.
17.
Abel
G G
,
Becker
J V
,
Cunningham-Rathner
J
,
Mittelman
N
,
Rouleau
J
.
Multiple paraphilic diagnoses among sex offenders
.
Bull Am Acad Psychiatr Law
1988
;
16
(
2
):
153
-
68
.
18.
Serin
R C
,
Malcolm
P B
,
Khanna
A
,
Barbaree
H E
.
Psychopathy and devient sexual behavior in incarcerated sexual offenders
.
J Interpersonal Violence
1994
;
9
(
1
):
3
-
11
.
19.
Bradford
J MW
,
Boulet
J
,
Pawlak
A
.
The paraphilias: a multiplicity of deviant behaviors
.
Can J Psychiatr
1992
;
37
(
2
):
104
-
08
.
20.
Brown
J RWC
.
Paraphilias: sadomasochism, fetishism, transvestitism, and transexuality
.
Br J Psychiatr
,
1983
;
143
:
227
-
31
.
21.
Freund
K
.
Courtship disorder. Handbook of sexual assault
,
Marshall
W L
,
Laws
D R
,
Barbaree
H E
, editors,
Plenum Press
,
New York and London
,
1990
,
195
-
207
.
22.
Steiner
B W
,
Langevin
R
,
Sanders
R M
.
Crossdressing, erotic preference, and aggression: a comparison of male transvestites and transsexuals
.
Erotic preference, gender identity, and aggression in men: new research studies
.
Langevin
R
, editor,
Lawrence Erlbaum and Associates
,
New Jersey
,
1985
;
261
-
75
.
23.
Gratzer
T
,
Bradford
J MW
.
Offender and offense characteristics of sexual sadists: a comparative study
.
J Forensic Sci
1995
;
40
(
3
):
450
-
55
.
24.
MacCulloch
M J
,
Snowden
P R
,
Wood
P JW
,
Mills
H E
.
Sadistic fantasy, sadistic behavior and offending
.
Br J Psychiatr
,
1983
;
143
:
20
-
29
.
25.
Hucker
S J
,
Stermac
L
.
The evaluation and treatment of sexual violence necrophilia and asphyxiophilia
.
Psychiatr Clin North Am
1990
;
15
(
3
):
703
-
19
.
26.
Dietz
P E
,
Hazelwood
R
,
Warren
J
.
The sexually sadistic criminal and his offences
.
Bull Am Acad Psych Law
1990
;
18
(
2
):
163
-
78
.
27.
Prentky
R A
,
Burgess
A W
,
Rokous
F
,
Lee
A
,
Hartman
C
,
Ressler
R
,
Douglas
J
.
The presumptive role of fantasy in serial sexual homocide
.
Am J Psych
1989
;
146
(
7
):
887
-
91
.
28.
Shukla
G D
,
Srivastava
O N
,
Katiyar
B C
.
Sexual disturbances in temporal lobe epilepsy: a controlled study
.
Br J Psychiatr
1979
;
134
:
288
-
92
.
29.
Wilson
D
,
Gosselin
C
.
Personality characteristics of fetishism, transvestitism, and sadomasochism
.
Personality and Individual Differences
 0191-8869,
1980
;
1
:
289
-
95
.
30.
Kolarsky
A
,
Freund
K
,
Machek
J
,
Polack
O
.
Male sexual deviation associated with early temporal lobe damage
.
Arch Gen Psychiatr
1967
;
17
:
735
-
43
.
31.
Selzer
M L
.
The Michigan alcoholism screening test: the quest for a new diagnostic instrument
.
Am J Psychiatr
1971
;
127
(
12
):
1653
-
58
.
32.
Magruder-Habib
K
,
Stevens
H A
,
Alling
W C
.
Relative performance of the mast, vast and cage versus DSM-III-R criteria for alcohol dependence
.
J Clin Epidemiol
1993
;
46
(
5
):
435
-
41
.
33.
Selzer
M L
,
Vinokur
A
,
van Rooijen
L
.
A self administered short Michigan alcoholism screening test (SMAST)
.
J Studies Alcohol
1975
;
36
(
1
):
117
-
26
.
34.
Magruder-Habib
K
,
Durand
A M
,
Frey
K A
.
Alcohol abuse and alcoholism in primary health care settings
.
J Fam Pract
1991
;
32
(
4
):
406
-
13
.
35.
Bushman
J B
,
Cooper
H M
.
Effects of alcohol on human aggression: an integrated research review
.
Psychologic Bull
1990
;
107
(
3
):
341
-
54
.
36.
Graham
K
.
Theories of intoxicated aggression
.
Can J Behav Sci
1990
;
12
(
2
):
141
-
58
.
37.
Van Woerkom
T CA
,
Teelken
A W
,
Minderhoud
J M
.
Differences in neurotransmittor metabolism in frontotemporal lobe contusions and diffuse cerebral contusions
.
The Lancet
1977
;
1
:
812
-
13
.
38.
Cummings
J L
.
Disturbances of sleep, appetite and sexual behavior
.
Clin Neuropsychiatr
234
-
50
.
Grune and Stratton Inc
,
New York
,
1985
.
39.
Bradford
J M
,
Greenberg
D
,
Gojer
J
,
Martindale
J J
,
Goldberg
M
.
Sertraline in the treatment of pedophilia: an open label study
. Presented at the
American Psychiatric Association Conference in Miami
,
Florida
,
1995
.
40.
Volavka
J
,
Martell
D
,
Convit
A
.
Psychobiology of the violent offender
.
J Forensic Sci
1992
;
37
(
1
):
237
-
51
.
41.
Langevin
R
.
Sexual anomalies and brain
.
Handbook of Sexual Assault
,
Marshal
W L
,
Laws
D R
,
Barbaree
H E
, editors,
Plenum Press
,
New York and London
,
1990
;
103
-
113
.
42.
Langevin
R
,
Ben-Aron
M H
,
Wright
P
,
Marchese
V
,
Handy
L
.
The sex killer
.
Ann Sex Res
1988
;
1
:
263
-
301
.
43.
Hucker
S
,
Langevin
R
,
Dickey
R
,
Handy
L
,
Chambers
J
,
Wright
S
.
Cerebral damage and dysfunction in sexually aggressive men
.
Ann Sex Res
1988
;
1
:
33
-
47
.
44.
Bradford
J MW
,
Reid
R
,
Greenberg
D M
,
Curry
S
.
HMPAO, SPECT, and sexual sadism
.
Submitted for Publication
,
1995
.
45.
Virkkunen
M
,
Linnoila
M
.
Brain serotonin, type II alcoholism and impulsive violence
.
J Studies Alcohol
1993
;
11
(Suppl):
163
-
69
.
46.
Linnoila
V M
,
Virkkunen
M
.
Aggression, suicidality, and serotonin
.
J Clin Psych
1992
;
53
(
10
):
46
-
51
.
47.
Virkkunen
M
,
Linnoila
M
.
Serotonin in early onset, male alcoholics with violent behavior
.
Ann Med
1990
;
22
:
327
-
31
.
48.
Clonninger
R C
,
Sigvardsson
S
,
von Knorring
A
,
Bohman
M
.
The Swedish sudies of adopted children of alcoholics: a reply to littrell
.
J Studies Alcohol
1988
;
49
(
6
):
500
-
09
.
49.
Moss
H B
,
Yao
J K
,
Panzak
G L
.
Serotonergic responsivity and behavioral dimension in antisocial personality disorder with substance abuse
.
Biological Psychiatry
 0006-3223
1990
;
28
:
325
-
38
.
50.
Zohar
J
,
Mueller
E A
,
Insel
T R
,
Zohar-Kadouch
R C
,
Murphy
D L
.
Serotonergic responsivity in obsessive-compulsive disorder
.
Arch Gen Psych
1987
;
44
:
946
-
95
.
51.
Åsberg
M
,
Träskman
L
,
Thoren
P
.
5-HIAA in the cerebral spinal fluid
.
Arch Gen Psych
1976
;
33
:
1193
-
97
.
52.
Tollefson
G D
.
Anxiety and alcoholism: a serotonin link
.
Br J Psych
1991
;
159
(Suppl.
12
):
34
-
39
.
53.
Bradford
J MW
,
Serotonin and the future of psychiatry
. Presented at the
25th Annual Meeting of the Academy of Psychiatry and the Law
,
Maui, Hawaii
,
1994
.
54.
Kafka
M P
.
Successful treatment of paraphilic coersive disorder (a rapist) with fluoxetine hydrochloride
.
Br J Psych
1991
;
158
:
844
-
47
.
55.
Kafka
M P
,
Prentky
R
.
Fluoxetine treatment of nonparaphilic sexual addictions and paraphilias in men
.
J Clin Psychiatr
1992
;
53
(
10
):
351
-
58
.
This content is only available via PDF.
You do not currently have access to this content.