Simulated Paraphilias: A Preliminary Study of Patients Who Imitate or Exaggerate Paraphilic Symptoms and Behaviors

Abstract

In a consecutive series of admissions to the Johns Hopkins Sexual Disorders Unit, 4 out of 20 patients appeared to have simulated paraphilic symptoms that further assessment indicated were either exaggerated or not present. The paper presents case histories of these 4 patients. A descriptive comparison is made between these patients and control groups of patients who admitted having paraphilic symptoms and a group of patients accused to having paraphilic symptoms but who denied them. Patients who simulated paraphilias tended to be self-referred (75%) and without current legal charges (100%). None of these patients was referred or sought treatment for pedophilia, in contrast to the other two patient groups, in which pedophilia accounted for 75% of the referrals. Several possible explanations for why patients might simulate paraphilias and implications for therapists who evaluate or treat sex offenders are discussed.

A Case of Factitious Pedophilia

“…However, Federoff et al. (9) present the only documented case of factitious paraphilias. Notably, these authors did not report a case of factitious pedophilia.…”

“…However, in 1992, Fedoroff et al (9) suggested an alternative explanation. It was possible, in some cases, that the research subjects had exaggerated the frequency and ⁄ or nature of their sexual behaviors.…”

“…Despite questions about the legitimacy of the category (10), an array of factitious disorders of a psychological nature has been reported, including alcohol dependence (11,12), posttraumatic stress disorder (13,14), bereavement (15,16), schizophrenia (17), suicidal ideation (18), and homicidal ideation (19), along with victimization such as rape (20). However, Federoff et al (9) present the only documented case of factitious paraphilias. Notably, these authors did not report a case of factitious pedophilia.…”