690 Paraphilic Disorders
tasies about such sexual behavior and who re port that known episodes of exposure were
all accidental and nonsexual. Others may disclo se past episodes of sexual behavior involv-
ing genital exposure but refute any significant or sustained sexual interest in such behav-
ior. Since these individuals deny having urge s or fantasies involving genital exposure, it
follows that they would also deny feeling subjectively distressed or socially impaired by
such impulses. Such individuals may be diagnosed with exhibitionistic disorder despite
their negative self-report. Re current exhibitionistic behavior constitutes sufficient support
for exhibitionism (Criterion A)  and simultaneously demonstrat es that this paraphilically
motivated behavior is causing harm to others (Criterion B).
“Recurrent” genital exposure to unsuspecting others (i.e., multiple victims, each on a
separate occasion) may, as a ge neral rule, be interpreted as three or more victims on sep-
arate occasions. Fewer victims can be interpreted as satisfying this criterion if there were
multiple occasions of exposure to the same victim, or if th ere is corroborating evidence of
a strong or preferential interest in genital exposure to unsuspecting persons. Note that
multiple victims, as suggested earlier, are a sufficient but not a necessary condition for di-
agnosis, as criteria may be met by an indi vidual’s acknowledging intense exhibitionistic
sexual interest with distress and/or impairment.
The Criterion A time frame, indicating that signs or sy mptoms of exhibitionism must
have persisted for at least 6 months, should also be understo od as a general guideline, not
a strict threshold, to ensure that the sexual interest in exposing one’s genitals to unsuspect-
ing others is not merely transient. This migh t be expressed in clear evidence of repeated
behaviors or distress ov er a nontransient period  shorter than 6 months.