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Psychology views sadism and masochism as interchangeable, with voyeurism and exhibitionism as their respective aspects.Devotees’ observation-based behavior and preference for display-minded partners seem to support explanations 2 to 4.Until the 1990s, it tended to be described mostly as acrotomophilia, at the expense of other disabilities, or of the wish by some to pretend or acquire disability.Bruno (1997) systematised the attraction as factitious disability disorder.Avowed "wannabes" seem to number not more than five percent of the devotee-wannabe population, though Nattress (1996) found 22 percent of his sample of 50 had wanted to become disabled.Accordingly, Bruno (1997) puts those afflicted with versions of the paraphilia under the broad heading of Devotees, Pretenders, and Wannabes (DPWs), as used here.Nattress (1993) found that 41 percent of a sample of 50 DPWs had, or were in, relationships with disabled partners.Relationships between DPWs and disabled people tend to be reported as being ordinary, the attraction being sated by the fact of the partner's disability.
However, it can be noted that the DSM-IV includes this paraphilia within the diagnostic criteria of psychiatric pathology.
In its middle pretending area is strong desire to reproduce the sensations of disability.
At its intense wannabe end is an imperative to acquire a disability which may prompt self-harm.
Those attracted often cherish early memories of a sexuoerotic tragedy (a "first sighting") involving an object of their future attention, often an older member of the opposite sex, as stereotypical in paraphilic etiology.
About a quarter report discovering the paraphilia in puberty and a few in maturity.