Frotteuristic Disorder 691
Hence, antisocial personality disorder, alco hol use disorder, and pedophilic interest may
be considered risk factors for exhibitionistic disorder in males with exhibitionistic sexual
preferences.
Environmental. Childhood sexual and emotional abus e and sexual preoccupation/hyper-
sexuality have been suggested as risk factor s for exhibitionism, al though the causal rela-
tionship to exhibitionism is unce rtain and the specificity unclear. 
Gender-Related Diagnostic Issues
Exhibitionistic disorder is highly unusual in females, whereas single sexually arousing ex-
hibitionistic acts might occur up to half as often among women compared with men.
Functional Consequences of  Exhibitionistic Disorder
The functional consequences of exhibitionisti c disorder have not been addressed in re-
search involving individuals who have not acte d out sexually by exposing their genitals to
unsuspecting strangers but who fulfill Criterio n B by experiencing intense emotional dis-
tress over these preferences.
Differential Diagnosis
Potential differential diagnose s for exhibitionistic disorder sometimes occur also as co-
morbid disorders. Therefore, it is generally necessary to evaluate the evidence for exhibi-
tionistic disorder and ot her possible conditions as separate questions. 
Conduct disorder and antisocial personality disorder. Conduct disorder in adolescents
and antisocial personality disorder would be characterized by additional norm-breaking and
antisocial behaviors, and the specific sexual interest in exposing the genitals should be lacking. 
Substance use disorders. Alcohol and substance use di sorders might involve single
exhibitionistic episodes by intoxicated individuals but should not involve the typical sex-
ual interest in exposing the genitals to unsusp ecting persons. Hence, recurrent exhibition-
istic sexual fantasies, urges, or behaviors that occur also when the individual is not
intoxicated suggest that exhibitionistic disorder might be present.
Comorbidity