Voyeuristic Disorder: Causes, Symptoms, Treatments DSM-5 302.82 (F65.3)

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), voyeuristic disorder may be diagnosed if an individual continuously experiences strong sexual arousal from observing an unsuspecting person who is either naked, undressing, or engaging in sexual activity. Those diagnosed may be either disclosing individuals or nondisclosing individuals—disclosing individuals freely reveal and discuss this paraphilic interest while nondisclosing individuals deny it.

Diagnostic Criteria and Specifiers for Voyeuristic Disorder DSM-5 302.82 (F65.3)

The following diagnostic criteria for identifying whether one has voyeuristic disorder, as set forth by the DSM-5, can apply to both disclosing and nondisclosing individuals:

• Over a period of at least 6 months (as a general guideline), the individual receives persistent and intense sexual arousal from deliberately observing an unsuspecting person who is naked, in the process of undressing, or engaging in sexual activity.
• The individual has acted on these sexual impulses with a nonconsenting person, or the urges and/or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• The individual is at least 18 years of age.

The following two specifiers are important to tracking progress in controlling or recovering from the disorder:

• In a controlled environment: This specifier is primarily used to describe individuals living in settings where opportunities to engage in voyeuristic behavior is restricted.
• In full remission: This specifier is applicable to individuals that have not acted on their urges with a nonconsenting person, nor has there been any distress or impairment in any areas of functioning, for at least 5 years while in an uncontrolled environment.

Who Is at Risk of Developing Voyeuristic Disorder DSM-5 302.82 (F65.3)?

While voyeuristic disorder is very uncommon among females, the minimum age for a diagnosis of voyeuristic disorder in any individual is 18 years due to puberty and the corresponding age-appropriate sexual curiosity and activity. Therefore, it’s important to analyze the diagnostic criteria and contributing factors that may change over time or with age. Furthermore, childhood sexual abuse, substance misuse, and hypersexuality have all been suggested as risk factors.

Is There Treatment for the Disorder?

For treatment to be successful, an individual with voyeuristic disorder must want to modify existing patterns of behavior. This may be difficult, but if accomplished, a few treatments may prove successful:

• Behavioral therapy: The individual will learn to control the impulse to watch nonconsenting victims, as well as find more acceptable means to sexual gratification.
• Cognitive therapy: Without analyzing the why’s and how’s, this therapy will seek to change the patient’s behavior. While it is not able to change the individual’s sexual preference, it can suppress the resulting unwanted behavior
• Psychoanalysis: This form of therapy attempts to determine the traumatic unconscious experience that caused the voyeuristic behavior in the first place. Uncovering this unconscious knowledge enables the individual to sort out the trauma rationally and emotionally, therefore relieving his or her problems.

Voyeurism in Award-Winning Movie: Rear Window

Rear Window is a popular 1954 thriller film directed by Alfred Hitchock, based on Cornell Woolrich’s 1942 short story “It Had to Be Murder”. Jeff, the main character, is stuck in a wheelchair with a broken leg for the entirety of the movie. Bored, he resorts to peering into his neighbor’s windows and spying on their lives as a form of entertainment. This growing obsession is furthered when he surveys strange behavior and ultimately suspects one of his neighbors has committed murder.

• Does Jeff have voyeuristic disorder? No. While Jeff may have voyeuristic tendencies throughout the film, he is not portrayed to receive sexual arousal from watching his unsuspecting neighbors—remember the criteria as set forth by the DSM-5.
• Could his voyeurism lead to development of voyeuristic disorder? Yes. Voyeurism is a necessary precondition for voyeuristic disorder and risk factors for voyeurism also increase the rate of voyeuristic disorder. If Jeff still has the urge to spy on his neighbors when he is no longer bound to a wheelchair and stuck in his apartment, this may be a bad sign.

While Jeff does not meet the criteria to be diagnosed with voyeuristic disorder, his voyeurism would be something to keep an eye on. As humans, we are naturally curious of one another, but it’s important to identify and remember the fine line that separates this curiosity from intrusion.

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