Exhibitionism - a review of research
DOI:
https://doi.org/10.12775/JEHS.2025.77.56926Keywords
exhibitionism, paraphilia, reviewAbstract
Introduction and Objective: Exhibitionism is a paraphilic behavior characterized by a persistent or recurrent tendency to expose one’s genitalia to strangers, typically without the intention of further interaction. The aim of this publication is to discuss various aspects of exhibitionism based on the latest literature.
Review Methods: A search was conducted in the PubMed database to identify scientific articles containing the term “exhibitionism” in their title, abstract, or keywords. The search focused on articles published between 2014 and 2024, with an emphasis on studies exploring the etiology, prevalence, and treatment of exhibitionism.
Brief Description of the State of Knowledge: While often linked to sexual excitement and followed by masturbation, exibitionism is more commonly observed in men. Research highlights several potential risk factors for exhibitionistic disorder, including childhood sexual or emotional abuse, hypersexuality, and sexual preoccupation. Neurobiological, cognitive, and social mechanisms are believed to underlie the development of these tendencies. Treatment of exhibitionistic disorder primarily involves cognitive behavioral therapy (CBT). Pharmacological approaches are also employed to manage symptoms by modulating serotonergic transmission.
Summary: Although relatively uncommon, exhibitionistic disorder has significant implications for individuals and society, underscoring the need for improved awareness, accurate prevalence estimates, and expanded access to effective treatment interventions. Further investigation into the true prevalence of exhibitionistic disorder is warranted, as current estimates may be imprecise.
References
Fisher KA, Marwaha R. Paraphilia. In StatPearls. StatPearls Publishing, 2023; (access 2024.10.15).
ICD-10 Version:2016. (n.d.). Icd.who.int. https://icd.who.int/browse10/2016/en#/F64 (access 2024.10.15).
Chatterjee S. Paraphilia: Concepts, Classifications, Epidemiology, Attributes and Management. Indian Journal of Health, Sexuality & Culture 2019; 5(2)
Mcmanus M, Hargreaves P, Lee R, et al. Paraphilias: Definition, diagnosis and treatment; F1000prime reports. 2013, 5. 36. 10.12703/P5-36.
Joyal, CC, Carpentier J. The Prevalence of Paraphilic Interests and Behaviors in the General Population: A Provincial Survey. Journal of sex research, 2017; 54(2), 161–171. https://doi.org/10.1080/00224499.2016.1139034
Konrad N, Welke J, Opitz-Welke A. Paraphilias. Current opinion in psychiatry, 2015; 28(6), 440–444. https://doi.org/10.1097/YCO.0000000000000202
Cengiz M, Cezayirli E, Bayoglu B, Asliyuksek H, Kocabasoglu N. Catechol-O-Methyltransferase Val158Met and brain-derived neurotrophic factor Val66Met gene polymorphisms in paraphilic sexual offenders. Indian journal of psychiatry, 2019; 61(3), 253–257. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_194_18
Kamenskov MY, Gurina OI. Neĭrotransmitternye mekhanizmy razvitiia parafil'nykh rasstroĭstv [Neurotransmitter mechanisms of paraphilic disorders]. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova, 2019; 119(8), 61–67. https://doi.org/10.17116/jnevro201911908161
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-5. American Psychiatric Association 2022; (access 2024.10.15).
10. ICD-11 for Mortality and Morbidity Statistics. (n.d.). Icd.who.int. https://icd.who.int/browse/2024-01/mms/en#2110604642 (access 2024.10.15).
Molen LV, Ronis ST, Benoit AA. Paraphilic Interests Versus Behaviors: Factors that Distinguish Individuals Who Act on Paraphilic Interests From Individuals Who Refrain. Sexual abuse : a journal of research and treatment, 2023; 35(4), 403–427. https://doi.org/10.1177/10790632221108949
Vayısoğlu S. Symptoms of exhibitionism that regress with bupropion: A case report. Frontiers in psychiatry, 2023; 13, 1079863. https://doi.org/10.3389/fpsyt.2022.1079863
Guay DR. Drug treatment of paraphilic and nonparaphilic sexual disorders. Clinical therapeutics, 2009; 31(1), 1–31. https://doi.org/10.1016/j.clinthera.2009.01.009
Zheng F, Lin Z, Ye X, et al. Unusual brain images of a boy with adolescent cerebral X-linked adrenoleukodystrophy presenting with exhibitionism: A CARE-compliant case report. Medicine, 2017; 96(51), e9481. https://doi.org/10.1097/MD.0000000000009481
Sedel F, Baumann N, Turpin JC, et al. Psychiatric manifestations revealing inborn errors of metabolism in adolescents and adults. Journal of inherited metabolic disease, 30(5), 2007; 631–641. https://doi.org/10.1007/s10545-007-0661-4
Beddows N, Brooks R. Inappropriate sexual behaviour in adolescents with autism spectrum disorder: what education is recommended and why. Early intervention in psychiatry, 2016; 10(4), 282–289. https://doi.org/10.1111/eip.12265
H K SP, Bhattacharjee D, H K TP. Paraphilia in Geriatric Patients: A Case Series From a General Hospital Setting. Cureus. 2024 Aug 6;16(8):e66260 https://doi.org/10.7759/cureus.66260
Joyal CC, Black DN, Dassylva B. The neuropsychology and neurology of sexual deviance: a review and pilot study. Sexual abuse : a journal of research and treatment, 2017; 19(2), 155–173. https://doi.org/10.1177/107906320701900206
Mokhber N, Streiner D, Prat S, et al. Neuroimaging in sexual offenses and paraphilia: A call to harmonize current clinical and imaging assessments in sexual offenses and paraphilia. Journal of Fundamentals of Mental Health, 2021; 23(2).
Frohman EM, Frohman TC, Moreault AM. Acquired sexual paraphilia in patients with multiple sclerosis. Archives of neurology, 2002; 59(6), 1006–1010. https://doi.org/10.1001/archneur.59.6.1006
Solla P, Bortolato M, Cannas A, et al. Paraphilias and paraphilic disorders in Parkinson's disease: A systematic review of the literature. Movement disorders : official journal of the Movement Disorder Society, 2015; 30(5), 604–613. https://doi.org/10.1002/mds.26157
Thomson SR, Patil N, Ommurugan B, et al. A Case of Hyper Sexuality Probably Associated with Clozapine. Psychopharmacology bulletin, 2018; 48(4), 20–24.
Costa AM, Lima MS, Mari JdeJ. A systematic review on clinical management of antipsychotic-induced sexual dysfunction in schizophrenia. Sao Paulo medical journal = Revista paulista de medicina, 2006; 124(5), 291–297. https://doi.org/10.1590/s1516-31802006000500012
Långström N, Hanson RK. High rates of sexual behavior in the general population: correlates and predictors. Archives of sexual behavior, 2006; 35(1), 37–52. https://doi.org/10.1007/s10508-006-8993-y
Thomas AG, Stone B, Bennett P, et al. Sex Differences in Voyeuristic and Exhibitionistic Interests: Exploring the Mediating Roles of Sociosexuality and Sexual Compulsivity from an Evolutionary Perspective. Archives of sexual behavior, 2021; 50(5), 2151–2162. https://doi.org/10.1007/s10508-021-01991-0
Dawson SJ, Bannerman BA, Lalumière ML. Paraphilic Interests: An Examination of Sex Differences in a Nonclinical Sample. Sexual abuse : a journal of research and treatment, 2016; 28(1), 20–45. https://doi.org/10.1177/1079063214525645
Thomas AG, Stewart-Williams S. Mating strategy flexibility in the laboratory: Preferences for long-and short-term mating change in response to evolutionarily relevant variables. Evolution and Human Behavior, 2018; 39(1), 82-93.
Albert G. Richardson GB, Arnocky S, et al. The Development and Psychometric Evaluation of a New Mating Effort Questionnaire. Archives of sexual behavior, 2021; 50(2), 511–530. https://doi.org/10.1007/s10508-020-01799-4
Dietzel C. The Three Dimensions of Unsolicited Dick Pics: Men Who have Sex with Men's Experiences of Sending and Receiving Unsolicited Dick Pics on Dating Apps. Sexuality & culture, 2022; 26(3), 834–852. https://doi.org/10.1007/s12119-021-09920-y
Ringrose J, Regehr K, Whitehead S. Teen Girls' Experiences Negotiating the Ubiquitous Dick Pic: Sexual Double Standards and the Normalization of Image Based Sexual Harassment. Sex roles, 2021; 85(9-10), 558–576. https://doi.org/10.1007/s11199-021-01236-3
Mandau MBH. ‘Directly in your face’: A qualitative study on the sending and receiving of unsolicited ‘dick pics’ among young adults. Sexuality & Culture, 2020; 24(1), 72-93.
March E, Wagstaff DL. Sending Nudes: Sex, Self-Rated Mate Value, and Trait Machiavellianism Predict Sending Unsolicited Explicit Images. Frontiers in psychology, 2017; 8, 2210. https://doi.org/10.3389/fpsyg.2017.02210
Oswald F, Lopes A, Skoda K, et al. I'll Show You Mine so You'll Show Me Yours: Motivations and Personality Variables in Photographic Exhibitionism. Journal of sex research, 2020; 57(5), 597–609. https://doi.org/10.1080/00224499.2019.1639036
Vitis L, Gilmour F. Dick pics on blast: A woman’s resistance to online sexual harassment using humour, art and Instagram. Crime, media, culture, 2017; 13(3), 335-355.
Hayes RM, Dragiewicz M. Unsolicited dick pics: Erotica, exhibitionism or entitlement?. In Women's Studies International Forum, 2018; 71, 114-120, Pergamon.
Marcotte AS, Gesselman AN, Fisher HE et al. Women's and Men's Reactions to Receiving Unsolicited Genital Images from Men. Journal of sex research, 2021; 58(4), 512–521. https://doi.org/10.1080/00224499.2020.1779171
Tziallas E. Gamified eroticism: Gay male “social networking” applications and self-pornography. Sexuality & Culture, 2015; 19, 759-775.
Smith M. Four in ten female millennials have been sent an unsolicited penis photo. YouGov, 2018; Retrieved July 7, 2020, from https://yougov.co.uk/topics/politics/articles-reports/2018/02/16/four-ten-female-millennials-been-sent-dick-pic
Chan HCO, Myers WC. Risky Sexual Behavior, Paraphilic Interest, and Sexual Offending: The Study of a Community Sample of Young Adults in Hong Kong. International journal of environmental research and public health, 2023; 20(5), 4279. https://doi.org/10.3390/ijerph20054279
Drury A, Heinrichs T, Elbert M, et al. Adverse childhood experiences, paraphilias, and serious criminal violence among federal sex offenders. Journal of criminal psychology, 2017; 7(2), 105-119.
Marshall WL, Marshall LE. Psychological Treatment of the Paraphilias: a Review and an Appraisal of Effectiveness. Current psychiatry reports, 2015; 17(6), 47. https://doi.org/10.1007/s11920-015-0580-2
Pang NTP, Masiran R, Alimuddin AS. Paraphilia without symptoms of primary psychiatric disorder: a case report. Journal of medical case reports, 2023; 17(1), 46. https://doi.org/10.1186/s13256-023-03774-8
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