Tying it all together: Case of Autism Spectrum Disorder with paraphilic activities

ABSTRACT

@#Autism Spectrum Disorder (ASD) is a phenotypically heterogenous group of neurodevelopmental syndromes characterized by a wide range of impairments in socialcommunication and restricted and repetitive behaviors. (1) The majority of individualswith ASD go through puberty and experience the same physical and psychosexual aspectsof sexual development as their peers. However, there are notable problems with regardsto sexuality especially at the start of puberty when the development of social skillscannot keep up with the increasing social demands, and the difficulties of formingromantic and sexual relationships become evident. (2)The case presented here is a 26-year-old male with a history of engaging in paraphilicactivities that showed the complexities of ASD (Asperger Syndrome) in their sexualbehavior.PJPCASE REPORTTYING IT ALL TOGETHERCASE OF AUTISM SPECTRUM DISORDER WITH PARAPHILIC ACTIVITIESMELANIE TONGOL, MDTHE MEDICAL CITYDEPARTMENT OF PSYCHIATRY34 · PJP 2023 · Volume 4 (1-2) · ISSN 2980-4884CASE PRESENTATIONChief ComplaintJay was a 26-year-old Filipino male, Christian,single, seeking consult for intrusive thoughts withthemes of bondage & discipline, dominance& submission and sadism &masochism (BDSM).History of Present IllnessJay described himself as curious, ambitious, andpeculiar. Despite trying to be sociable andextroverted, he had difficulty connecting withfriends and he often ended up alone. This hasbeen a recurring experience since childhood.Five years prior to consult, Jay’s excitement washyped, as a female chatmate opened up thetopic of BDSM.He shared his long-term fantasies of tying up agirl and subjecting her to pain, humiliation andsexual stimulation, which was never realizedgiven his Christian belief that it was wrong.After meeting someone who shared his hiddendesires, he was able to muster the strength to liveout his fantasies and met with the said chatmate.They planned their BDSM roles and restrictions,with Jay as the dominant and the chatmate assubmissive. On the day of their meeting, Jaypacked ropes in his bag, as he remembered hispast fascination with them when he was still aboy scout. he met his chatmate at the deliveryarea of a mall and there began his string of novel sexual pursuits. He started binding herhands and legs behind her. Both lying on thefloor, fully clothed, he kept on tying her as if hewas in a trance. Merely having his partner