686 Paraphilic Disorders
others. A paraphilia is a necessary but not a sufficient condition for having a paraphilic dis-
order, and a paraphilia by itself does not nece ssarily justify or require clinical intervention.
In the diagnostic criteria set for each of the listed paraphilic disorder s, Criterion A specifies
the qualitative nature of the paraphilia (e.g., an erotic focus on children or on exposing the gen-
itals to strangers), and Criterio n B specifies the negative conseq uences of the paraphilia (i.e.,
distress, impairment, or harm to  others). In keeping with the distinction between paraphilias
and paraphilic disorders, the term diagnosis  should be reserved for individuals who meet both
Criteria A and B (i.e., individuals who have a pa raphilic disorder). If an individual meets Cri-
terion A but not Criterion B for a particular paraphilia—a circumstance that might arise when
a benign paraphilia is discovered during the clinical investigation of some other condition—
then the individual may be said to have that paraphilia but not a paraphilic disorder.
It is not rare for an individual to manifest tw o or more paraphilias. In some cases, the para-
philic foci are closely related and the connectio n between the paraphilias is intuitively com-
prehensible (e.g., foot fetishism and shoe fetish ism). In other cases, th e connection between the
paraphilias is not obvious, and the presence of mu ltiple paraphilias may be coincidental or else
related to some generalized vulnerability to an omalies of psychosexual development. In any
event, comorbid diagnoses of separate paraphil ic disorders may be warranted if more than
one paraphilia is causing suffering to the individual or harm to others.