State of Research and Research Objectives
According to DSM-5, a paraphilia is a sexual interest that is not directed toward genital stimulation or toward foreplay for sexual acts with phenotypically normal, adult, consenting human partners. In DSM-5, paraphilic disorders are listed that refer to unusual behavioral preferences or unusual object preferences. A disorder exists if significant suffering or impairment in social, occupational, or other areas can be observed over a period of six months. Unusual behavioral preferences include voyeurism (the most common form), exhibitionism, frotteurism, sexual masochism, and sexual sadism. In relation to unusual object preferences, pedophilia, fetishism, and transvestism are mentioned. In addition, several other paraphilia are distinguished, such as necrophilia, zoophilia, or coprophilia.
Paraphilias manifest in fantasies, interests, urges, or behaviors. This means that a broad spectrum of manifestations must be considered when talking about paraphilias. Paraphilic behavior on the one side is a rather rare phenomenon, as a Swedish population-representative study showed (3.1% exhibitionism, 7.7% voyeurism). Men engage significantly more often than women in paraphilic behavior. On the other side, regarding paraphilic interests, it should first be emphasized that they should not be classified as disorders per se. Nevertheless, it is important to analyze these interests, as they can be associated with suffering and corresponding behavior, which in the final instance can also include criminal acts. Långström and Seto confirmed: “The two paraphilia-like behaviours were significantly, strongly, and positively associated with their corresponding fantasies. That is, respondents who acknowledged exhibitionistic behaviour were much more likely to also report fantasies about exhibitionistic behaviour compared to those who did not, and respondents who acknowledged any voyeuristic behaviour were more likely to report fantasies about voyeuristic behaviour.” Ahlers also stated that there is an obvious and empirically proven correlation between sexual experience (fantasies and thoughts) and sexual behavior (actions or deeds).
The aim of this study is not to examine paraphilic behavior and report corresponding diagnoses. Instead, it will focus on the area of paraphilic interests by means of a population-representative survey.
Paraphilic interest can be defined as sexual interest or “sexual desire,” that is, as arousal by an unusual behavior or object, whereby it is not relevant whether a corresponding behavior has already been performed or not. Paraphilic interests are therefore not problematic, but unusual, which does not imply that only a minority show such interests. As a representative survey study among adults in the province of Quebec, Canada, showed, various interests are quite common: 46.3% of respondents reported voyeuristic interest and 44.5% fetishistic interest. The results on other paraphilias were: frotteurism 26.7%, masochism 23.8%, sadism 7.1%, transvestism 6.3%, exhibitionism 4.5% and pedophilia 0.6%. Masochism and fetishism were reported more often by women, the other interests more often by men. A large survey study from the Czech Republic reported similar results: In the study, 31.3% of men and 13.6% of women reported at least one paraphilic interest. Except for beating/torture and humiliation/submission, almost all paraphilias were more common among men than among women.
Ahlers et al studied paraphilic interests in the form of “paraphilia-associated sexual arousal patterns.” This includes both fantasies (including masturbation fantasies) and actual behavior. Based on a sample of 367 men from Berlin, Germany, Ahlers et al reported that 62.4% of the respondents expressed at least one paraphilic arousal pattern. Voyeurism and fetishism were most frequently reported (38.7% and 35.7%, respectively), followed by sadism and masochism (24.8% and 18.5%, respectively). Frotteurism (15.0%), pedophilia (10.4%), transvestism (7.4%) and exhibitionism (4.1%) occurred less frequently. Fantasies were reported more frequently by the respondents than actual behavior. Impairments due to paraphilic arousal patterns were reported only by very few respondents, which could be an indication that these patterns alone are not to be classified as pathological; however, it remains to be asked to what extent affected people ultimately perceive possible impairments themselves. Correlation analyses indicated that pornography use increased arousal patterns, as does a worse subjective health.
Also worth mentioning is an online survey study based on a Canadian convenience sample. Various forms of paraphilic interest were measured; in the presentation of the results, gender differences were of particular interest, where 52% of male respondents and 26% of female respondents reported voyeuristic interest. Fetishism (28%) and frotteurism as well as sadism (19% each) were the next most common interests among men. For women, masochism (17%) and frotteurism followed. For some of the recorded interests, very low prevalence rates were found for both men and women (pedophilia, hebephilia, zoophilia, coprophilia).
In a systematic review, Brown et al examined BDSM (bondage and discipline, dominance and submission, sadism and masochism), considering interests as well as behaviors. It was shown that such interests are quite widespread. The prevalence rates range up to 70%, depending on the study. Gender differences seem to exist insofar as men more often show sadistic interests, women more often masochistic interests. The study by Holvoet et al on the basis of a Belgian representative sample also came to the conclusion that BDSM interests are quite widespread: 68.8% of the respondents stated that they had already carried out BDSM activities or had corresponding fantasies. Older persons report this less often than younger persons, men more often than women. In the same survey, fetishism was also asked about; here, too, the prevalence rates were significantly higher for male than for female respondents.
In another study among Italian students, voyeuristic interests were reported most frequently (men: 64.6%, women: 38.9%), and fetishistic interests second most frequently (37.9% and 34.4%, respectively). Pedophilic interests were reported least frequently (4.5% and 1.5%, respectively). In addition, the study again showed gender differences: men more often mentioned fantasies of voyeurism, exhibitionism, sadism, and frotteurism, whereas women mentioned masochism and transvestism.
The studies mentioned so far come from Europe. Beyond this, studies on paraphilic interests are also available from Asian and North American countries. For example, a study of 1,171 students from Hong Kong shows that voyeurism and biastophilia are most common among male respondents, while transvestic fetishism and masochism are most common among female students. A further study of 863 young people from Hong Kong confirms these findings, also reporting that, with the exception of transvestic fetishism, men exhibit all forms of paraphilic interests significantly more frequently than women. A study from Canada and the United States also shows that men exhibit highly stigmatized paraphilias (e.g., hebephilia, pedophilia) and non-consensual paraphilias (e.g., voyeurism, exhibitionism) significantly more often than women; however, there was no significant difference with regard to BDSM/fetish paraphilias.
In addition, research on paraphilias or paraphilic interests has produced at least three important findings. First, paraphilias sometimes occur together; that is, interest in one paraphilia correlates with increased interest in other paraphilias., The correlations between different paraphilic interests range from 0.03 to 0.42, with higher correlations between voyeurism and frotteurism, between masochism and sadism, and between fetishism and masochism (each above 0.30). In another study, even slightly higher correlations were reported. Second, paraphilic interests are related to various influencing factors. In addition to gender and age, these are factors of sexual activity, “including more sexual partners, greater sexual arousability, higher frequency of masturbation and pornography use.” In addition, alcohol and drug use increases paraphilic interests. Third, these interests are correlated with different consequences. Although it has already been pointed out that paraphilic interests are not pathological in themselves, there is increased risk of negative concomitant phenomena. Among other things, paraphilic interests are associated with a lower sense of well-being: “Respondents who reported exhibitionistic and/or voyeuristic behaviour reported more psychological problems, lower satisfaction with life in general, and a greater likelihood of a current mental disorder (voyeuristic behaviour only).”
Against the background of the outlined state of research and the continuing lack of epidemiological data on the topic, the present study pursues the following goals: (a) The prevalence of various paraphilic interests will be analyzed based on a representative population survey and will be compared for the sexes and age groups. (b) The correlations between different paraphilic interests will be addressed in the analyses. (c) In order to examine possible influencing factors and consequences of paraphilic interests, various correlates will be considered. An explorative approach is chosen for this purpose. As the survey was not designed to test theoretically derived or empirically proven variables—for example, hardly any personality traits (such as Big 5) and no sexuality-related assessments (such as hypersexuality, gender roles) were measured—different variables are included ad hoc in the analyses.
Method
Procedure
In order to investigate the prevalence of paraphilic interests, an additional module for measuring these interests was integrated into a survey on victimization experiences in the Canton of Zurich. The primary purpose of the survey was to analyze how the frequency of crime victimization experiences changed during the COVID-19 lockdown in spring 2020 compared to the period before. Beyond this, other topics were also addressed in the survey. The canton of Zurich is the most populous canton in Switzerland with 1.5 million inhabitants, containing metropolitan as well as urban and rural regions.
A postal online survey was conducted to collect the data; that is, the persons selected for the survey were invited by post to participate in an online survey. In order to obtain a representative sample, addresses were drawn at random. For this purpose, we cooperated with a company specialized in trading addresses for marketing purposes, among other things, which has address data for about three quarters of the inhabitants of Switzerland. The sample included 10,000 addresses/persons. Various age groups were excluded from the sample. On the one hand, this applied to persons under 18 years of age, whose surveying required parental consent (especially in the case of sensitive topics), which could not be obtained in the context of the study, and which would also have jeopardized the anonymity of the survey. On the other hand, persons over 50 years of age were not included in the study. This decision was made on the basis of crime data: According to police crime statistics, the various age groups of 18- to 50-year-olds have the highest victimization rates. For older persons, the victimization rate is significantly lower, which means that more persons would have to be included in a victimization survey in order to reach a victim. As the main question of the survey concerned possible crime changes during the lockdown (and not, for example, estimating prevalence rates for the entire population), a restriction to 18- to 50-year-olds and thus the primary victimization risk groups seemed justifiable. Another reason for excluding older persons from the survey was that an online survey was conducted, whereby it could not be assumed that all older persons had internet access.
A letter was sent by post to the selected persons with an invitation to take part in the online survey, which was sent so that it was delivered on May 11, 2020. Incentives were not used. Two weeks later, a reminder letter was sent, which was delivered to all selected persons on May 25, 2020.
Of the persons contacted, a total of 1,463 persons accessed the questionnaire. Of these, 139 people did not answer a single question. A further 61 persons answered less than one-fifth of the questions and did not answer a single victimization question (the main topic of the survey). Twenty-seven respondents indicated their age over 50 years. All these persons were deleted from the data set, so that in the end 1,236 respondents were available for analysis. The response rate was 13%.
Sample
The demographic composition of the sample can be seen in Table 1. Of all respondents, 49.8% were male and 50.0% female (0.2% diverse). This roughly corresponds to the proportions of the population: In the canton of Zurich, 50.9% of 18- to 50-year-olds are male, 49.1% female. However, there were major differences in the age distribution: In the sample, 25.3% were aged 18 to 34 years—in the population of the canton of Zurich, on the other hand, the proportion is 47.4%. Also, 74.7% of the respondents were between 35 and 50 years old (canton of Zurich: 52.6%). This means that proportionally too few younger respondents were reached or younger respondents participated less in the survey than older respondents. This problem can be dealt with by weighting the data, meaning that younger respondents are given a higher weight in the data analyses. In the presentation of the prevalences, such data weighting is used here; regarding the correlational analyses, however, no data weighting is used, insofar as gender and age are partialized out in these analyzes.
For the unweighted sample, socio-demographic characteristics are as follows: 27.2% of the respondents had a migration background; that is, they were not born in Switzerland or had a foreign nationality (possibly in addition to Swiss nationality). The largest migrant group was made up of respondents from Germany and southern European countries (mostly Italy). 56.4% of the respondents had a high education (high school diploma, university degree), 43.6% had a medium or low level of education. Unemployment or receipt of unemployment benefits and/or social assistance was reported by 5.0% of the respondents; 86.7% were employed full-time or part-time. In rural communities (comprising less than 5,000 inhabitants), 18.2% of the respondents lived; in urban communities (comprising 20,000 inhabitants and more), 44.7% (small towns: 37.1%). Also, 31.0% of the respondents belonged to the Protestant Church, 25.2% to the Roman Catholic Church (no affiliation: 34.6 %). This corresponds roughly to the proportions in the whole population of the canton.
Measurement of Paraphilic Interests
The measurement of paraphilic interests was based on the “Questionnaire on Sexual Experience and Behavior” (FSEV). This comprehensive questionnaire aims to record numerous sexual paraphilias. With the exception of pedophilia (“How much do you find childlike boys or prepubescent boys’ bodies (i.e. without pubic hair, childlike penis and scrotum)/childlike girls or prepubescent girls’ bodies (i.e. without pubic hair and without breasts) sexually arousing?”), all paraphilias were surveyed in our questionnaire, whereby the enumeration of examples was partly shortened. Not asking about pedophilic interests is undoubtedly a limitation; however, this was done because it was feared that corresponding items could lead to a dropout in the survey, insofar as this is an intensively discussed topic in Swiss society (cf., e.g., pedophilia initiative of 2014). The item “How much do you find adult men or sexually mature men’s bodies (i.e. male figure, fully developed pubic hair and genitals)/adult women or sexually mature women’s bodies (i.e. female figure, fully developed pubic hair and breasts) sexually arousing?” was not rated as paraphilic interest and is accordingly not reported below. Nevertheless, this item was presented to the respondents at the beginning of the enumeration of the various interests in order to create a certain acceptance for answering even more sensitive questions. In addition, as a first step, respondents were asked whether they knew a person in their personal environment who had corresponding interests. Only then should one’s own interests be reported. This lowers the inhibition threshold for reporting one’s own paraphilic interests. The exact wording of the individual paraphilia items is listed in the “Results” section.
The FSEV records paraphilias in a complex way: In relation to the past 12 months, five questions must be answered on three areas, namely, sexual fantasies, masturbatory fantasies, and sexual behavior. For these areas, first, the extent to which paraphilias (referred to as “sexual desires” in the questionnaire) are perceived as sexually arousing; second, since when have the paraphilias been perceived as sexually arousing; third, how often the “desires” occur; fourth, how much are the “desires” suffered; and fifth, how much do the “desires interfere with partnership, social or professional life.” This high level of complexity could not be adopted in the present study because the questions were at the end of the questionnaire, that is, after numerous questions on other topics had already been answered (which is why a high dropout rate would have been expected if the FSEV had been used in its entirety). It was therefore decided to ask only two questions about each paraphilia (in addition to the question about whether one knew a person with the interest in one’s environment): (a) “In the last 12 months, how much did you find yourself sexually aroused by these interests or desires?” The answers were: never, rarely, sometimes, frequently, very frequently, and always. (b) From the answer level “rarely” onward, the question was to be answered: “How much did you suffer from the interest or desire in the last 12 months?,” whereby the answer specifications were graded fourfold (not at all, slightly, moderately, very much).
In addition to the question on paraphilic interests, other constructs of influencing factors and consequences of paraphilic interests were measured in the survey. The measurement of these constructs is presented in the “Results” section.
Results
Table 2 reports various prevalence rates. It should first be noted that two paraphilic interests were measured with two items each: Regarding frotteurism, one item was rubbing/touching, and the other was touching strangers. In the case of hebephilia, questions were asked separately about interest in pubescent girls and interest in pubescent boys. For the analyses, the maximum value was coded, that is, the highest frequency reported for one of the items. All other paraphilic interests were measured with one item. For fetishistic transvestitism, also two items are listed in Table 2: In the analyses, for male respondents, only wearing typically female clothing was considered, and for female respondents, only wearing typically male clothing was considered. In addition, two indices were calculated: whether at least one paraphilic interest was reported or whether two or more interests were reported.
Table 2 shows three prevalence rates. The first rate reflects the proportion of respondents who had an interest at least “rarely” in the past 12 months. The second rate refers to those respondents who answered “frequently,” “very frequently,” or “always.” The third rate also refers to respondents with these stated frequencies; however, it is additionally considered whether at least a “slight” suffering regarding the interest was reported.
A total of 46.4% of the respondents reported that they had at least one of the paraphilic interests at least rarely in the last 12 months. The lowest prevalence was found for “special partners” and exhibitionism (0.7% and 0.9%, respectively), the highest prevalence for sexual sadism and masochism (18.7% and 18.0%, respectively). At least two paraphilic interests at least rarely were reported by 28.3% of the respondents. In addition to sadism and masochism, partialism, an interest in special characteristics, and fetishistic transvestitism were more common. Rather less common, apart from interest in special partners and exhibitionism, were urophilia/coprophilia, interest in unusual practices, frotteurism, hebephilia, and voyeurism.
If the proportion of respondents is considered who had a frequently to always interest and who reported at least a slight suffering, the rates are significantly reduced. Nevertheless, for every tenth respondent (10.7%), it is true that at least one paraphilic interest was experienced more frequently and was associated with suffering. This was most frequently the case regarding fetishistic transvestitism; regarding exhibitionism, no respondent was found for whom this was the case.
Table 3 presents analyses of prevalence rates differentiated for gender, on the one hand, and for age groups, on the other. The rates refer exclusively to respondents who at least rarely reported a paraphilic interest. Due to the low prevalence rates of respondents who reported interests more frequently and suffered at least slightly from it, analyses of subgroups would usually be based on only a few respondents and would therefore be unreliable. The comparison of the two genders shows that only for five paraphilic interests, there were no gender differences in prevalence rates. Only for two interests, higher rates were found for women than for men (masochism, special partners; both times not significant). For all other paraphilic interests, higher prevalence rates were found for men. The difference was strongest for hebephilia: men had a rate of 10.2%, that is, 15 times higher than women (0.7%). Differentiating analyses for the two corresponding items revealed a difference especially regarding interest in pubescent girls (8.9%–0.2%, chi-square = 47.713, p < .000). The rates in relation to pubescent boys were 2.5% (male respondents) and 0.7% (chi-square = 5.183, p < .05). Ultimately, 56.9% of male respondents and 35.4% of female respondents reported at least one paraphilic interest. Sexual sadism and partialism were most common among male respondents, masochism among female respondents.
The comparison of the two age groups showed somewhat less significant differences than in the gender comparison: For a total of seven paraphilic interests, no significant differences were found, whereby at the same time only for two paraphilic interests, 35- to 50-year-olds had a higher rate than 18- to 34-year-olds (urophilia/coprophilia, special partners; not significant). Regarding all other interests, younger respondents showed higher prevalence rates. Strong differences were found in masochism and sexual sadism: every fourth younger respondent reported such an interest. The highest prevalence rate for the older age group was for partialism (13.5%; younger respondents: 19.4%). At least one paraphilic interest was reported by 57.7% of 18- to 34-year-olds and 36.1% of 35- to 50-year-olds.
Table A1 in the appendix reports the correlations between the paraphilic interests. The analyses were based on the assessment of paraphilic interests in the last 12 months (interval-scaled from “never” to “always”). Of the 78 correlations, only 11 were found to be non-significant. Thus, our survey also showed that paraphilic interests are interrelated; the significant correlations ranged from r = 0.07 to r = 0.59. The least significant correlations were found for exhibitionism and hebephilia (5 out of 12 non-significant correlations).
In order to further analyze the correlations between the paraphilic interests, an explorative factor analysis (principal component analysis, Varimax rotation) was calculated; the results are shown in Table A2 in the appendix. The factor analysis examined the question, which paraphilic interests correlate particularly closely with each other? A total of five factors were extracted. Masochism, sexual sadism, and unusual practices formed the first factor. The second factor was formed by voyeurism and frotteurism, with exhibitionism and special partners also showing higher loadings (but loadings for both are also found in the fourth and fifth factor, respectively). Hebephilia and urophilia/coprophilia formed the third factor, partialism and special characteristics the fourth. The fifth factor was formed by fetishism and fetishistic transvestitism.
Table 4 presents correlations with various factors that can be rated as influencing factors but also as consequences of paraphilic interests. Partial correlations (controlling for gender and age) of the interval-scaled interest variables are reported in each case, whereby the presentation is limited to significant correlations (p < .05). The variables were measured as follows:
Consumption of alcohol (“beer, wine/sparkling wine, liquor”) as well as other drugs (“cannabis, ecstasy, LSD, cocaine”) was measured in relation to the six weeks of the lockdown (“mid-March to end of April 2020”) from “1—never” to “6—daily.” The mean was 3.44 (alcohol) and 1.20 (other drugs; unweighted data); 83.9% of respondents drank alcohol at least once or twice during this period, 8.1% consumed other drugs.
Online pornography consumption was also measured for the period “mid-March to end of April 2020,” with the response categories “1—never” to “8—daily over 3 hours.” The mean was 1.93; 32.2% of respondents had used online pornography at least once or twice.
Religiosity was measured via the question “How important is religion for you personally in everyday life?,” which could be answered from “1—completely unimportant” to “4—very important.” The mean was 1.83.
Authoritarianism was surveyed as a personality trait with three items (“We should be grateful for leaders who tell us exactly what we should do and not do,” “Children should conform to the ideas of their parents,” and “In order to preserve law and order, we should take tougher action against marginalized people (e.g., homeless people, drug addicts) and troublemakers”). The response categories ranged from “1—not at all true” to “6—completely true”; Cronbach’s alpha of the three-item scale was 0.50, the mean 2.66.
Satisfaction with life was surveyed with the question “How satisfied or dissatisfied are you currently with your life in general?,” which was to be answered from “1—not at all satisfied” to “10—very satisfied.” The mean was 7.50.
In addition, mental health was measured by the Patient Health Questionnaire-4 (PHQ-4). Two items were asked in each case about how often the respondents felt affected by symptoms of depression and anxiety in the last two weeks before the interview. A four-item response scale from “0—not at all” to “3—almost every day” was presented to rate the statements. The four-item scale had a high internal consistency (Cronbach’s alpha = 0.82). The four items were summed; the mean was 2.23 (unweighted data).
According to the results, alcohol consumption was only related to two paraphilic interests and to a low degree overall according to the conventions of Cohen: The more frequent alcohol consumption was, the more often masochism and partialism were reported. The consumption of other drugs correlated with more paraphilic interests, although only two correlations (sexual sadism and urophilia/coprophilia) could be classified as non-trivial. In general, however, the correlations were positive; that is, frequent use was associated with greater interest. This was also the case with pornography consumption. For this variable, the most correlations were found, which were almost always classified as non-trivial (r ≥ 0.10). Only with fetishistic transvestitism and exhibitionism, there was no correlation.
Religiosity and authoritarianism did not correlate significantly with paraphilic interests. In four out of five significant (and weak) correlations, the relationship was negative; that is, higher religiosity and more pronounced authoritarianism reduced the frequency of paraphilic interests.
For the variable satisfaction with life and mental health, too, there were only a few and mostly only weak, significant correlations. It should be noted, however, that the direction of the correlations was the same: the more frequently paraphilic interests were reported, the lower the life satisfaction and the worse the mental health was.
Discussion
Based on a representative survey of adults aged 18 to 50 in the canton of Zurich, various findings on prevalence rates and correlates of paraphilic interests in the Swiss population were presented in this study. In line with other studies,,, findings showed that masochism and sexual sadism are quite common: 18.7 resp. 18.0 % of the respondents stated that they at least rarely had such interests. Striking differences to other studies can be found in three paraphilic interests: In the present survey, voyeuristic, fetishistic, and frotteuristic interests were reported significantly less often (6.2%, 10.7%, and 4.7%, respectively) than in other surveys. Regarding fetishism, it should be noted that the rates for fetishistic transvestitism, which was also measured, were higher than in other studies,, so that the overall prevalence of both forms is less different from other studies. The differences in the other two forms (voyeurism, frotteurism) are less easy to interpret. Possibly, measurement plays a role, insofar as the items used describe these behaviors more deviantly than other instruments. Special features of the sample due to the low response rate may also be responsible for the findings.
Other paraphilic interests such as hebephilia (5.5%) or exhibitionism (0.9%) were rather rare, which has also been shown in other studies. Comparisons with other paraphilic interests measured in the present study are not possible because these were usually not measured (or reported) in other studies. However, the findings show that these interests should not be neglected. Thus, 14.3% of the respondents reported that they had an interest in special features, 4.3% in unusual practices. Overall, almost half of the respondents (46.4%) reported having any of the recorded interests at least rarely. This underlines that it is ultimately a fairly common phenomenon. Only in a minority, which is also consistent with existing findings, is the paraphilic interest associated with suffering. Only a small proportion of those who have paraphilic interests at least rarely state that this is more often to always the case and is associated with at least slight suffering—on average, this is the case for about one in eight people (e.g., masochism: 18.7% had this interest at least rarely; 2.3% stated that this was at least often the case and that they suffered at least slightly as a result of it).
The analyses presented on the correlations between paraphilic interests support findings from previous studies: People who have one interest tend to report stronger agreement with other interests. However, the correlations were mostly low. Particularly close overlaps were found for masochism and sexual sadism (r = 0.59) as well as for voyeurism and frotteurism (r = 0.41); beyond that, the correlations were mostly below r = 0.30.
Also in line with other studies are the findings on gender and age group differences. In the present study, there was not a single paraphilic interest that was reported significantly more often by women. Eight interests, on the other hand, had significantly higher rates for male respondents. These gender differences should be investigated further in future studies. Dawson et al discuss whether the variable “sex drive” could possibly explain the gender differences. Insofar as this refers to sexual fantasies and sexual behavior, among other things, and thus to very proximal factors in relation to the dependent variable paraphilic interest, this explanation seems of rather less importance; more distant explanatory factors, for example, regarding certain educational experiences in the family, could therefore be studied more intensively in the future. Regarding age, the analyses showed that for six paraphilic interests, older respondents (35- to 50-year-olds) reported significantly lower prevalences. A follow-up question to this finding would be whether these findings can be replicated in longitudinal surveys; that is, whether this is a phenomenon of ageing (as opposed to a generational phenomenon, according to which younger generations are more open to paraphilic interests). If this is the case, the question arises as to which factors are responsible for this age effect (e.g., starting a family). Studies that look at paraphilic interests on a longitudinal basis are not yet available. These would generally be helpful, also regarding the differentiation of influencing factors and consequences of paraphilic interests. Cross-sectional surveys like the present one can only look at correlations without actually being able to analyze causalities.
The correlation analyses on influencing factors and consequences presented here are similar to the results of other studies, whereby it is generally noticeable that a large part of the correlations were not significant and that in the case of significant correlations, rather small effects were found. An exception was pornography consumption, which correlated with many interests in a non-trivial way. Whether pornography consumption leads to the development of interests or whether, conversely, interests lead to pornography consumption cannot be examined here. However, a mutual reinforcement of both phenomena is again confirmed by the present study. Finally, two findings of the correlation analyses should be emphasized: First, more frequent use of drugs such as cannabis, ecstasy, etc. was accompanied by more frequent paraphilic interests. A question that follows on from this finding is whether drug use gives rise to corresponding ideas and fantasies or whether third-party factors such as lifestyle are responsible for the correlations. Second, paraphilic interests were associated with lower life satisfaction and poorer mental health. However, the correlations were again rather weak, which underlines that the interests are not harmful per se. This raises the question as to under which conditions or in which groups of people negative consequences occur more frequently. This finding also points to the need for further, at best representative, survey research.
Finally, the various limitations of the study presented here should be mentioned, which undoubtedly influence the significance of the findings. A first decisive limitation is the low response rate. Only 13% of the people invited to the survey took part. It is particularly problematic that younger people were reached much less frequently than their proportion in the population as a whole. Since various paraphilic interests occur more frequently in the younger age group, it can be assumed that the prevalence rates would have been even higher if younger respondents had been reached more. The results should therefore be checked using further samples with a higher response rate. However, it can be ruled out that the willingness to participate in the survey is related to the topic of paraphilic interests. The survey was primarily announced as a survey on victim’s experiences; although it was also mentioned in the invitation that other topics would be asked for, the decision to participate was probably primarily guided by whether one wanted to provide information about one’s own experiences of crime or not. Insofar as the survey focused on victimization, various variables relevant for correlation analyses with paraphilic interests were not measured—this is a second limitation of the study. In this respect, it could not be claimed that influencing factors and consequences were investigated in a comprehensive manner. The extent to which the survey of paraphilic interests in the context of a victimization survey has an impact on the results presented cannot be said at this point but can nevertheless be viewed as a further limitation. There is no doubt that asking about victimization in a survey is psychologically stressful. How this relates to the subsequent answering of questions about paraphilic interests has not yet been sufficiently analyzed. Corresponding methodological studies would therefore be desirable, as would studies for Switzerland that are primarily dedicated to the topic of paraphilic interests. A last limitation is the use of a reduced instrument compared to the original questionnaire to measure paraphilic interests. The survey does not allow to analyze arousal patterns, behavior, or even diagnoses of paraphilic disorders. In this context, it should be pointed out that an item on pedophilic interests was omitted because this may have led to more dropouts. Despite these various limitations, the findings presented are significant insofar as they provide an up-to-date inventory of the prevalence of paraphilic interests.
Declaration of Conflicting Interests The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Ethical Approval and Informed Consent Participation in the survey was voluntary. Any person could stop the survey at any time. The participants were informed about the content of the survey before the interview; the respondents were able to give their informed consent in this regard. An ethical approval statement was not required for the survey.
Funding The author received no financial support for the research, authorship, and/or publication of this article.
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