Rosh Psychiatry Board Practice Exam

A patient exposed his genitals to an adult woman at the beach. What is the most likely diagnosis for this behavior?

1. Exhibitionistic disorder

2. Frotteuristic disorder

3. Sexual masochism disorder

4. Voyeuristic disorder

The correct answer is: Exhibitionistic disorder

The behavior of exposing one's genitals to an unsuspecting person, such as an adult woman at the beach, aligns with exhibitionistic disorder. This condition is characterized by the act of exposing oneself to others for the purpose of sexual arousal and gratification. Individuals with this disorder often seek the shock or surprise of the victim, deriving pleasure from the non-consensual nature of the act. Exhibitionistic disorder is specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and involves recurring, intense sexual arousal from the exposure of one's genitals to an unsuspecting person, which must have occurred for at least six months and cause significant distress or impairment in functioning. This specific diagnostic criterion firmly supports the conclusion that the behavior described in this scenario is indicative of exhibitionistic disorder. In contrast, the other conditions mentioned do not apply to this scenario. Frotteuristic disorder involves the act of rubbing oneself against someone in a sexual manner without their consent, while sexual masochism disorder pertains to deriving sexual pleasure from one's own humiliation or suffering. Voyeuristic disorder involves observing unsuspecting individuals who are naked, disrobing, or engaging in sexual acts but does not involve the act of exposing oneself.