Disputed Paraphilia Diagnoses and Legal Decision Making: A Case Law Survey of Paraphilia NOS, Nonconsent

Paraphilia diagnoses applied in forensic settings are an ongoing subject of debate among psycholegal professionals and scholars. Disagreements pertain to both means-related issues having to do with issues of diagnostic reliability and validity, and ends-related issues regarding the consequences inherent to the legal contexts in which the diagnoses arise. To provide a fresh outlook on some of the issues, the present study entailed a systematic survey of U.S. case law to investigate the history, extent, and nature of forensic uses of a controversial paraphilia diagnosis, paraphilia not otherwise specified, nonconsent. Descriptive analyses revealed that use of the diagnosis, which occurred almost exclusively in adult sexually violent predator cases, increased substantially over the past decade, with cases in 3 states accounting for over 2/3 of the total observed prevalence rate. In the majority of cases examined in detail, the support that evaluators relied upon in making the diagnosis was either not clearly described or behaviorally inferential in nature, and the diagnosis was often accompanied by other mental and personality disorder diagnoses. An opposing expert was observed in more than half of the cases, approximately 1/3 of whom noted the debate surrounding the diagnosis and nearly 2/3 of whom opined that there was insufficient evidentiary support for the diagnosis in the case at bar. Finally, all courts that reached the issue of the admissibility of the diagnosis between 2008 and 2011 admitted it, and most courts also found it sufficient to support classifying an individual as a sexually violent predator