Voyeuristic Disorder

Definition

Voyeuristic disorder is one of several psychiatric sexual disorders known as paraphilic disorders. Paraphilic refers to sexual interests, preferences, fantasies, urges, and behaviors outside the norm; these are considered symptoms of a disorder only if they are acted upon in ways that have the potential to cause distress or harm to oneself or others, especially others who have not given consent.

A person with voyeuristic disorder becomes sexually aroused by intentionally spying on unsuspecting people who are naked, getting undressed, or participating in sexual activities. In addition to observing these private acts directly, voyeurs may record them for later use. Inadvertently coming across and viewing someone in such a compromising position is not a disorder. Voyeurs are more commonly called “Peeping Toms,” because they tend to peer through peepholes and open windows and watch their targets with the aid of objects, such as binoculars, mirrors, and recording cameras.

Symptoms

To be diagnosed with voyeuristic disorder, a person must experience persistent and intense sexual arousal from the fantasy or act of watching an unsuspecting person who is naked, partially disrobed or sexually active, for at least six months. A subset of voyeurs derive sexual pleasure from watching people defecate or eavesdropping on highly erotic conversations. The viewer is likely to masturbate or have sexual fantasies while watching someone, but is not interested in having sex with the observed person. These behaviors must be causing severe distress or dysfunction in social, professional, or another significant area of the person’s day-to-day life. The viewer must be at least 18-years-old, and the viewing must occur without the other person’s consent. Males are more likely to engage in voyeuristic activities than females. Younger voyeurs are rarely arrested but adult voyeurism is a criminal act.

Causes

No specific cause has been determined for voyeuristic disorder. However, certain risk factors tend to coincide with a person becoming a voyeur, including substance abuse, sexual abuse, and being hypersexualized. Some experts suggest that, given the opportunity, many people have voyeuristic tendencies but are afraid to admit it or get caught. Voyeuristic disorder may stem from an accidental sighting of someone who is naked, disrobing, or participating in sexual activity. Continued viewing then reinforces and perpetuates the behavior to a point where it goes beyond what is considered culturally acceptable, or “normal,” and becomes pathological.

Treatments

Voyeurs rarely submit themselves for treatment but may be referred by a parent, spouse, or the legal system when they are caught breaking the law. Treatment for voyeuristic disorder typically involves psychotherapy, support groups, and medication. Early treatment may also include teaching the voyeur socially appropriate behaviors, such as respecting others’ privacy, and training them to avoid locations where they will be more tempted to engage in voyeurism.

Cognitive-behavioral therapy can help the individual learn to control the impulse to spy on others learn new and healthier ways to become sexually aroused. Antidepressants that balance brain chemicals and reduce impulsive behavior or anti-androgenic drugs that suppress sex drive may be used to treat sexual sadism disorder.

References

Brown, George R. Voyeuristic Disorder (Voyeurism). Merck Manual website. June 2015.

http://www.merckmanuals.com/professional/psychiatric-disorders/sexuality...

American Psychiatric Association. Understanding Mental Disorders: Your Guide to DSM-5. 2015. American Psychiatric Publishing.

Balon R. Voyeuristic Disorder. Practical Guide to Paraphilia and Paraphilic Disorders. 21 Dec 2016; 63-75. [Abstract]

https://link.springer.com/chapter/10.1007/978-3-319-42650-1_5

Yalcin O, Guney E, Saripinar EG. Dramatic improvement with sertraline in a male adolescent with voyeurism. Letter to the Editor. Bulletin of Clinical Psychopharmacology. 2014;24(3):292-294.

http://www.ejmanager.com/fulltextpdf.php?mno=44082

First MB. DSM-5 and Paraphilic Disorders. Journal of the American Academy of Psychiatry and the Law. 2014. 42:191-201

http://jaapl.org/content/jaapl/42/2/191.full.pdf

Last reviewed 03/06/2018