The DSM-5 differs significantly from the DSM-IV-TR in several ways. Under the new DSM-5, a patient's situation must satisfy at least one of two specific criteria in order to be diagnosed as having a paraphilic disorder. Those two criteria are:

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To be diagnosed with a paraphilic disorder, a patient must either (1) experience personal distress (not distress due to social disapproval), or (2) cause distress or harm to others (including involving individuals who are unwilling or unable to consent). Self-disgust is not a necessary criterion for this category of disorders. Examples of paraphilic disorders include exhibitionism, voyeurism, pedophilia, and sexual sadism.

The DSM-5 Differs Significantly from the DSM-IV-TR in Several Ways