New Research Distinguishes Clinical Profiles of Exhibitionism and Voyeurism

Exhibitionism and Voyeurism: Why Treating Them as One Condition May Be a Mistake

For nearly two centuries, exhibitionism and voyeurism have been studied side by side, sometimes treated as separate conditions and sometimes as two expressions of a single underlying disorder. A study published in Sexual Addiction and Compulsivity takes a closer, more data-driven look at this long-standing question, and the findings suggest that lumping these behaviors together may obscure important clinical differences.

The study, titled Varieties of Intrusion: Exhibitionism and Voyeurism, was conducted by Tiffany A. Hopkins and Bradley A. Green of the University of Southern Mississippi, Patrick J. Carnes of the American Foundation for Addiction Research, and Susan Campling of the Magnolia Creek Treatment Center for Eating Disorders.

A Question Two Centuries in the Making

The researchers note that exhibitionism and voyeurism have been examined as independent entities and as coexisting manifestations of the same disorder for roughly 200 years, without the field ever fully resolving the question. That kind of unresolved uncertainty has real consequences. If clinicians treat these behaviors as fundamentally the same, they may miss meaningful differences in risk, severity, and treatment needs between people who present with one behavior alone versus both together.

To address this gap, the research team turned to a large clinical sample and asked a more precise question than prior studies typically had: rather than simply asking whether these behaviors are related, they asked whether people who engage in exhibitionism alone, voyeurism alone, or both together look meaningfully different from one another.

Building Sex-Specific Clinical Profiles

Using a clinical sample, the researchers developed sex-specific profiles for three distinct groups: pure exhibitionists, pure voyeurs or covert intruders, and those who engaged in both behaviors. To build these profiles, the team drew on multiple validated measures, including specific sexual behavior patterns captured by the Sexual Dependency Inventory, general areas of psychological disturbance measured by the Sexual Addiction Screening Test, Revised, and established sexual addiction diagnostic criteria.

This multi-measure approach allowed the researchers to build a much richer picture than behavior alone could provide, capturing not just what people did, but the broader psychological and relational patterns associated with each behavior.

A Clear and Important Finding

The results offered real clarity to a question that had lingered for generations. Men and women displayed unique clinical profiles related to exhibitionism and voyeurism and covert intrusion, confirming that these are not interchangeable presentations of a single condition.

Perhaps the most clinically significant finding involved severity. Exhibitionists showed the least sexual pathology of the three groups, voyeurs and covert intruders showed a moderate degree of disturbance, and the group that engaged in both exhibitionism and voyeurism showed the greatest disturbance of all. In other words, the combination of both behaviors was not simply additive. It marked a meaningfully more severe clinical presentation than either behavior alone.

The researchers also gave particular attention to how each of these three groups related to more serious concerns, including rape, pedophilia, and legal consequences, an important consideration for clinicians assessing risk and safety.

Why This Distinction Matters for Treatment

These findings carry direct implications for how clinicians assess and treat these behaviors. A client who presents with exhibitionism alone may need a different treatment approach, and may carry a different risk profile, than a client who presents with both exhibitionism and voyeurism together. Treating every case the same way, without accounting for these documented differences in severity and associated risk, could mean missing warning signs in the clients who need the most careful attention.

This kind of differentiated understanding also matters for the field's broader diagnostic frameworks. Since its publication, this research has become a frequently cited reference point in later work on voyeurism, exhibitionism, and related paraphilic behaviors, reflecting how much clarity it brought to a previously murky area of study.

Supporting Research That Refines Clinical Understanding

AFAR is committed to supporting research that sharpens clinical understanding of sexual addiction and related conditions, helping clinicians move beyond broad categories toward the kind of nuanced, evidence-based distinctions that lead to safer and more effective treatment. Studies like this one make that kind of precision possible.

If you would like to support AFAR's continued investment in this kind of research, consider making a donation today.

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Source: Hopkins, T. A., Green, B. A., Carnes, P. J., & Campling, S. (2016). Varieties of Intrusion: Exhibitionism and Voyeurism. Sexual Addiction & Compulsivity, 23(1), 4-33.