Not Otherwise Specified (NOS) Paraphilic Disorder

Not Otherwise Specified (NOS) Paraphilic Disorder are sexually exciting fantasies, sexual impulses, or actions that include human and nonhuman things on a regular and intense basis. These paraphilias force the sufferer or the sufferer’s partner, children, or other nonconsenting people to suffer or be humiliated. Many symptoms involve more culturally acceptable practices (e.g., recurrent masturbation, Internet pornography); such highly sexual symptoms have been described as obsessive, addictive, or impulsive.

An increasing amount of available data suggests the presence of a distinct condition defined by frequent and strong sexually stimulating thoughts, sexual impulses, or actions involving patterns that do not fit the description of paraphilia. However, there is substantial comorbidity with paraphilia. Although these symptoms have been described as sexual compulsion or addiction, these words are not enough to describe this situation. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Illnesses, Fourth Edition (DSM-IV) classifies several sexual disorders as not otherwise specified (NOS) paraphilic disorder.

Not Otherwise Specified (NOS) Paraphilic Disorder

Not Otherwise Specified (NOS) Paraphilic Disorder

Types of Not Otherwise Specified (NOS) Paraphilic Disorder:

Nonparaphilic Compulsive Sexual Behaviors (CSB) can be impulsive, obsessive, and compulsive, as well as driven, out of control, and upsetting. There is no specific category in the DSM for this form of CSB, however an example is given under Sexual Disorder (Not Otherwise Specified (NOS) paraphilia). However, there are at least 7 subtypes of Non Paraphilic CSB

Subtypes of Non Paraphilic Compulsive Sexual Behavior

• Compulsive sexuality in a relationship
• Compulsive fixation on an unattainable partner
• Compulsive cruising and multiple partners
• Compulsive autoeroticism (masturbation)
• Compulsive use of the Internet for sexual purposes
• Compulsive use of erotica
• Compulsive multiple love relationships

Effects of Not Otherwise Specified (NOS) Paraphilic Disorder

There is a growing body of literature suggesting an association between Compulsive Sexual Behaviors and Human Immunodeficiency Virus and Sexually Transmitted Infection-related risk behaviors in those suffering from (NOS) Paraphilic Disorders. Whether paraphilic or Non Paraphilic Compulsive Sexual Behavior, these issues are connected to sexual health concerns, including sexually transmitted illnesses, sexual assault, and abuse. Individual psychological issues, in addition to cultural ones, can be responsible for a wide range of unfavorable sexual health outcomes.

Diagnosis of Not Otherwise Specified (NOS) Paraphilic Disorder


According to the DSM, criteria for the diagnosis of NOS Paraphilic Disorder comprises: 
• Sexual dysfunctions that do not match the criteria for any particular sexual dysfunction. 
• Despite apparently normal arousal and climax, there are no (or much reduced) subjective sensual emotions.
• Situations in which the doctor has determined that there is a sexual dysfunction but is unable to tell whether it is primary, secondary to a general medical problem, or drug-induced.

Treatment of Not Otherwise Specified (NOS) Paraphilic Disorder

Stress appears to play a significant impact on the emergence, aggravation, and persistence of sexual dysfunctions. Several evidence-based therapies, including systematic desensitization, couples therapy, and sensate focus, have been demonstrated to be beneficial with this group. Furthermore, pharmaceutical therapies have been shown to be effective in reducing the symptoms of sexual dysfunction.

Psychological Treatment

Cognitive-behavioral therapy in which the therapist assists the client in determining the underlying reason for the behavior and then works with the person to develop strategies for managing sexual desires in a healthier manner.

Aversion treatment and other sorts of imagery/desensitization, in which the person imagines himself in the setting and then experiences an unpleasant occurrence, may be used to lessen future desire in participating in sexual behaviors.

Thought-stopping strategies and cognitive restructuring (identifying and modifying the thoughts that drive the behavior) might also be utilized.

Medication for Not Otherwise Specified (NOS) Paraphilic Disorder

Specific types of medications are prescribed according to the type of sexual disorder. Nonetheless, further research is needed to continue to examine the role of stress in sexual dysfunctions and for the development of effective treatments to help prevent them.