BETWEEN INTEREST AND DISORDER

WHAT DO INSTRUMENTS ACTUALLY MEASURE IN THE ASSESSMENT OF PARAPHILIAS? A SCOPING REVIEW

Abstract

Introduction: The distinction between paraphilia and paraphilic disorder, consolidated in the DSM-5, requires careful assessment to avoid both undue pathologization and clinical neglect. However, available instruments differ in terms of construct, context, and psychometric robustness. Objective: To map and characterize standardized instruments used in the assessment of paraphilias and paraphilic disorders in adults. Methods: A scoping review was conducted, guided by the PCC framework, with searches performed in the PubMed/MEDLINE and BVS platforms, without time restriction and including studies in Portuguese, English, and Spanish. Studies on the development, cross-cultural adaptation, or psychometric validation of standardized instruments focused on measuring paraphilias or paraphilic disorders in adults were eligible. Exclusively psychophysiological or indirect measures were excluded. Study selection was performed in two stages by independent reviewers, with descriptive synthesis organized by individual instrument. Results: Of the 1,696 records identified, 10 studies were included, all retrieved from PubMed/MEDLINE. Two main groups of instruments were identified: self-report measures focused on the dimensional assessment of interests and traits; and record-based scales, predominantly applied in forensic contexts. The most frequently reported psychometric evidence included internal structure analysis, measurement invariance, and criterion validity, with variability in the reporting of reliability and clinical applicability. No eligible instruments indexed in BVS were identified. Conclusion: The assessment