702 Paraphilic Disorders
unavailable during foreplay or  coitus. Some individuals with  fetishistic disorder may pre-
fer solitary sexual activity as sociated with their fetishistic preference (s) even while in-
volved in a meaningful reciprocal and affectionate relationship.
Although fetishistic disorder is relatively  uncommon among arrested sexual offenders
with paraphilias, males with fe tishistic disorder may steal an d collect their particular fe-
tishistic objects of desire. Such individuals have been arrested and charged for nonsexual
antisocial behaviors (e.g., breaking and enteri ng, theft, burglary) that are primarily moti-
vated by the fetishistic disorder.
Differential Diagnosis
Transvestic disorder. The nearest diagnostic neighbor of  fetishistic diso rder is transves-
tic disorder. As noted in the diagnostic criter ia, fetishistic disorder is not diagnosed when
fetish objects are limited to ar ticles of clothing exclusively worn during cross-dressing (as
in transvestic disorder), or when the object is genitally stimulating because it has been de-
signed for that purpose (e.g., a vibrator). 
Sexual masochism disorder or  other paraphilic disorders. Fetishes can co-occur with
other paraphilic disorders, especially “sad omasochism” and transvestic disorder. When
an individual fantasizes about or engages in “forced cross-dressing” and is primarily sex-
ually aroused by the domination or humiliation  associated with such fantasy or repetitive
activity, the diagnosis of sexual ma sochism disorder should be made.
Fetishistic behavior with out fetishistic disorder. Use of a fetish object for sexual arousal
without any associated distress or psychosoci al role impairment or  other adverse conse-
quence would not meet criteria for fetishisti c disorder, as the threshold required by Crite-