Supreme Court rulings supporting the constitutionality of sexually violent predator (SVP) statutes require that evaluators determine whether the rapist has a mental disorder (which justifies psychiatric commitment) or is just a common criminal (who cannot be preventively detained psychiatrically), but they offer no guidelines on making this crucial distinction. Until recently, state evaluators ignored the crucial fact that rape as a mental disorder has been roundly rejected by the Diagnostic and Statistical Manual of Mental Disorders (DSM) four times in the past 45 years (in DSM-III, DSM-III-R, DSM-IV, and DSM-5). The most common diagnosis in SVP cases was "other specified paraphilia, nonconsent," which was based on a misunderstanding and misuse of the DSM definition of "paraphilia." Sreenivasan and colleagues suggest antisocial personality disorder as an appropriate standalone diagnosis to replace "paraphilia" and report it has been allowable in 19 states, although it has been disallowed in New York state courts and in the federal courts. My contrasting view is that antisocial personality disorder is not an appropriate diagnosis in SVP cases because it overlaps almost completely with common criminality, holds only a very marginal place in psychiatric diagnosis, never serves as grounds for civil psychiatric commitment, and is never considered a valid psychiatric excuse to avoid prison for rape and therefore is not a legitimate psychiatric excuse for preventive incarceration after the criminal sentence has been served.

中文翻译：

---

在性暴力掠食者病例中误用诊断和统计手册诊断。

最高法院的裁决支持性暴力掠夺者（SVP）法规的合宪性，要求评估人员确定强奸犯是否患有精神疾病（证明有精神病学根据是正当的）或仅仅是普通罪犯（无法通过精神病学进行预防性拘留），但他们没有提供做出这一重要区分的指导原则。直到最近，国家评估人员还忽略了至关重要的事实，即在过去45年中，强奸作为一种精神障碍已被《精神障碍诊断和统计手册》（DSM）四次全面否决（在DSM-III，DSM-III-R， DSM-IV和DSM-5）。在SVP病例中，最常见的诊断是“其他指定的亲友性，不同意”，这是基于对DSM定义的“亲友性”的误解和误用。Sreenivasan和他的同事建议将反社会人格障碍作为一种适当的独立诊断，以取代“亲友关系”，并报告说，尽管在纽约州法院和联邦法院均不允许，但在19个州已允许使用。我的相反观点是，反社会人格障碍不适用于SVP病例，因为它与普通犯罪几乎完全重叠，在精神病诊断中仅占很小的地位，从不作为公民精神病承诺的依据，也从未被认为是有效的避免因强奸而入狱的精神科借口，因此在判刑后不是预防性监禁的合理精神科借口。并报告说，尽管在纽约州法院和联邦法院都不允许这样做，但在19个州中是允许的。我的相反观点是，反社会人格障碍不适用于SVP病例，因为它与普通犯罪几乎完全重叠，在精神病诊断中仅占很小的地位，从不作为公民精神病承诺的依据，也从未被认为是有效的避免因强奸而入狱的精神科借口，因此在判刑后不是预防性监禁的合理精神科借口。并报告说，尽管在纽约州法院和联邦法院都不允许这样做，但在19个州中是允许的。我的相反观点是，反社会人格障碍不适用于SVP病例，因为它与普通犯罪几乎完全重叠，在精神病诊断中仅占很小的地位，从不作为公民精神病承诺的依据，也从未被认为是有效的避免因强奸而入狱的精神科借口，因此在判刑后不是预防性监禁的合理精神科借口。