DSM-5 Case Studies Practice Test

Fetishistic disorder involves recurrent, intense sexual arousal from a nonliving object or a highly specific focus on a non-genital body part, lasting at least six months and causing distress or impairment. In this case, high-heeled shoes are the object of arousal, with the pattern persisting beyond six months and causing Sarah distress. That alignment with the object-based, persistent arousal is what makes fetishistic disorder the best fit. The other possibilities don’t fit as well. Transvestic disorder centers on cross-dressing as the primary source of arousal, usually involving wearing clothing of the opposite sex, which isn’t described here. Genito-pelvic pain/penetration disorder involves pain, difficulty, or distress with vaginal penetration, not a stimulus-driven arousal to an object. Exhibitionistic disorder involves arousal from exposing one’s genitals to others, which is not indicated in this scenario.