one paraphilia is causing suffering to the individual or harm to others.
Because of the two-pronged nature of diag nosing paraphilic disorders, clinician-rated
or self-rated measures and se verity assessments could addre ss either the strength of the
paraphilia itself or the seriousness of its co nsequences. Although the distress and impair-
ment stipulated in the Criterio n B are special in being the im mediate or ultimate result of
the paraphilia and not primarily the result of some other factor, the phenomena of reactive
depression, anxiety, guilt, poor work history, impaired social relations, and so on are not
unique in themselves and may be quantified  with multipurpose measures of psychosocial
functioning or quality of life.
The most widely applicable framework for assessing the strength of a paraphilia itself
is one in which examinees’ paraphilic sexual fa ntasies, urges, or beha viors are evaluated in
relation to their normophilic sexual interests and behaviors. In a clinical interview or on
self-administered questionnair es, examinees can be asked whether their paraphilic sexual
fantasies, urges, or behaviors are weaker th an, approximately equal to, or stronger than
their normophilic sexual intere sts and behaviors. This same type of comparison can be,
and usually is, employed in psychophysiological  measures of sexual interest, such as pe-
nile plethysmography in males or viewing time in males and females.
Voyeuristic Disorder
Diagnostic Criteria 302.82 (F65.3)
A. Over a period of at least 6 months, recurrent and intense sexual arousal from observ-
ing an unsuspecting person who is naked, in the process of disrobing, or engaging in
sexual activity, as manifested by fantasies, urges, or behaviors.