Causes and risk factors
Various theories have been put forth as a cause for this disorder. Biological theories – Increased susceptibility of males due to hormone testosterone, which influences the sexual drive. Learning theories – History of emotional abuse in childhood and family dysfunction increases the risk of development of exhibitionism. Psychoanalytical theories – It is thought that exhibitionists regard their mothers as rejecting them on the basis of their different genitals. Therefore, they grow up with the desire to force women to accept them by making women look at their genitals. Some evidence suggests of men becoming exhibitionists after head trauma without previous histories of alcohol abuse or sexual offenses.
Clinical presentation
Patients are usually men who expose in front of women or children. Symptoms of exhibitionism can be classified into mild, moderate, and severe. In mild form, the person has recurrent fantasies of exposing himself, but has rarely or never acted on them. In moderate exhibitionism, the person has occasionally exposed himself [three targets or fewer] and has difficulty controlling urges to do so. In severe form, the person has exposed himself to more than three people and has serious problems with control.
Investigation
Medical history by the patient and clinical examination by the psychiatrist or psychologist helps in diagnosis. The criteria that diagnose the disorder include – exhibitionistic behavior such as exhibitionistic fantasies or experience exhibitionistic urges over a period of at least 6 months. The person has acted on these sexual urges or the fantasies cause marked distress or interpersonal difficulty in the workplace or in everyday social situations.
Treatment
Treatment involves behavioral technique, cognitive behavioral techniques, and psychoanalytical techniques. Treatment involves psychotherapy. Medications such as antidepressants, antianxiety or antipsychotic drugs will also help in managing exhibitionism. Spiritual and religious approaches are also effective in treatment. If frontline treatment fails, doctor may prescribe medicine called as antiandrogens.
Other Modes of treatment
The other modes of treatment can also be effective in treating exhibitionism. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating exhibitionism.
