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So far, only very few studies have assessed hypersexual or paraphilic behaviors in individuals with ASD, and most of them are case reports reporting about ASD individuals showing excessive masturbation, 46 - 50 exhibitionistic behaviors, 51 pedophilic fantasies or behaviors, 52 , 53 fetishistic fantasies or behaviors, 54 , 55 sadomasochism, 50 or other forms of paraphilias. With regard to paraphilias, the DSM-5 now distinguishes between paraphilias and paraphilic disorders, thereby aiming at a destigmatization of nonnormative sexual interests and behaviors that do not cause distress or impairment to the individual or harm to others.
In this article, we will use the terms hypersexual behavior or hypersexuality referring to quantitatively relatively frequent sexual fantasies, sexual desire, and behaviors. Compulsive sexual behavior disorder is characterized by persistent and repetitive sexual impulses or urges that are experienced as irresistible or uncontrollable, leading to repetitive sexual behaviors, along with additional indicators such as sexual activities becoming a central focus of the person's life to the point of neglecting health and personal care or other activities, unsuccessful efforts to control or reduce sexual behaviors, or continuing to engage in repetitive sexual behavior despite adverse consequences eg, relationship disruption, occupational consequences, negative impact on health. Overview of paraphilic disorders included in current diagnostic manuals.
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