Paraphilia Scales From Kurt Freund’s Erotic Preferences Examination Scheme

Abstract

The Erotic Preferences Examination Scheme (EPES), originally known as Questionnaire III (Q-III), is a comprehensive self-report instrument developed by Dr. Kurt Freund and later compiled and described by Ray Blanchard. Developed primarily in the early 1970s at the Clarke Institute of Psychiatry (now the Centre for Addiction and Mental Health or CAMH) in Toronto, the EPES was designed to assess a wide range of sexual interests and preferences, particularly those related to paraphilias as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The instrument is specifically tailored for male populations, primarily those involved in the criminal justice system due to sexual offenses. While the EPES scales (such as the Pedo Admitter Scale and Hebe Admitter Scale) are highly valuable for research and clinical illustration, they rely on face validity and lack established cutting scores for formal individual diagnosis.

Keywords

Kurt Freund, Ray Blanchard, Erotic Preferences Examination Scheme, EPES, Q-III, Paraphilias, Sexual Deviance, Pedophilia, Hebephilia, Exhibitionism, Voyeurism, Phallometry, Sex Offenders, Self-Report Questionnaire.

Authors

Kurt Freund, Ray Blanchard.

Purpose

The primary purpose of the EPES is twofold: clinical illustration and scientific research. Clinically, the scales were intended to systematically canvass a patient’s sexual desires and actions, guiding experienced clinicians during interviews with potentially paraphilic individuals. The comprehensive content of the items themselves illustrates the key points an interviewer should cover, supplementing objective measures like penile plethysmography (phallometry).

For research, the computed scale totals provide quantitative data on the presence and intensity of various erotic interests, including specific paraphilias and related constructs such as parent-child relations, childhood gender identity, gynephilia, androphilia, and degree of heterosexual experience. Freund’s emphasis was on generating reliable research data, and as such, he did not establish standardized cutting scores for diagnostic classification based solely on the scale totals.

Construct

The EPES measures the presence and intensity of specific paraphilias, focusing on the conditions listed in the DSM. Freund’s initial scales focused on core paraphilias, including pedophilia, hebephilia, voyeurism, exhibitionism, sadism, masochism, fetishism, and transvestism. Later major additions in 1980 expanded the scope to include “courtship disorders” (e.g., toucheurism, frotteurism, telephone scatologia, and preferential rape) and autogynephilia.

Freund recognized that subjects, particularly those accused of criminal sexual behavior, might not be candid about their erotic interests. The items were therefore designed on the principle of strict face validity, directly asking about the specific erotic interests without attempts to mislead the patient. This recognition of potential non-candidacy led to the naming conventions for key scales, such as the Pedo Admitter Scale and the Hebe Admitter Scale, highlighting that scores reflected both the presence of the interest and the willingness to admit it.

Validity

Formal, comprehensive validity studies for the EPES in its entirety are limited. Freund designed the items based on the sole principle of face validity, which was deemed appropriate given the instrument’s role as a clinical aid and research tool used in conjunction with objective data (such as phallometric results) and detailed sexual offense histories. The scale contents are highly illustrative of the material necessary for a thorough clinical interview of a potentially paraphilic patient.

The instrument’s utility is confirmed by its extensive use in a large number of scholarly studies over several decades. While scores are influenced by a patient’s self-report bias, the instrument’s design ensured that it provided a starting point for measuring sexual desires rather than simply sexual actions.

Reliability

Psychometric data regarding the EPES are primarily limited to alpha reliability coefficients (internal consistency). Due to Freund’s clinical administration procedure—where only sections relevant to a patient’s presentation were administered—it was impossible to collect the necessary data set to conduct a comprehensive, omnibus factor analysis across all paraphilia measures on all subjects. Therefore, the available psychometric data focus on the internal consistency of the individual multi-item scales.

Factor Analysis

A grand, omnibus factor analysis spanning all sections of the EPES was never feasible or conducted. This limitation stems directly from Freund’s standard operating procedure: the EPES was physically divided into sections, and clinicians only administered the sections relevant to the patient’s clinical presentation (e.g., a patient presenting with exhibitionism would typically not receive the section on fetishism unless other interests were spontaneously disclosed). This selective administration prevented the compilation of a complete dataset required for a comprehensive factor analytic study of the entire scheme.

Instrument

Test Type: Self-Report Questionnaire/Clinical Interview Aid

Format: Multi-section questionnaire (Erotic Preferences Examination Scheme, EPES). Items are structured to assess specific paraphilic interests, with scoring weights applied to response options.

Language Available: English (developed as the first English-language version by Freund in Canada).

Population Group: Clinical and forensic samples; primarily male sex offenders.

Age Group: Adults (assessment of physically mature sexual preferences).

Population Details: The EPES is designed exclusively for men. Freund did not develop a parallel version for women, reflecting the demographic of his patient population, which overwhelmingly consisted of male sex offenders.

Test Methodology: The instrument uses direct questioning based on face validity. Items are sometimes repetitious, reflecting the monosymptomatic nature of many paraphilias. Clinicians often assisted patients in completing the questionnaire and used responses to key items (along with sexual offense histories and phallometric results) in making clinical diagnoses.

Keywords

Erotic Preferences, Kurt Freund, Q-III, Self-Report, Clinical Assessment, Sexual Offense History, CAMH, Admitter Scales, Gynephilia, Androphilia, Autogynephilia.

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: [email protected]

Correspondence Address: Ray Blanchard, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada.

Permissions & Fee and Test Year

The EPES scales are not copyrighted for commercial purposes. Clinicians or researchers are explicitly granted permission to use, quote, or modify the scales for their own research or clinical applications without requiring payment or formal permission. The primary version (Q-III) was finalized in 1974, with major additions related to courtship disorders and autogynephilia occurring around 1980.

A more complete description of these scales, including individual scales (with scoring weights in parentheses after each response option), references, and some psychometric data, may be found online at the following resource: http://www.routledge.com/textbooks/9780415801751.

Reference’s

The instrument itself is the culmination of pioneering research by Kurt Freund (1914–1996) on sexual orientation and paraphilias. Many of the multi-item scales comprising the EPES have been published in scholarly journals or book chapters, often appearing in appendices or tables related to specific research studies conducted by Freund, Blanchard, and their colleagues at the Centre for Addiction and Mental Health. The full, comprehensive list of references detailing the scale development and validation is available via the external academic resource provided in the Permissions section.

Items of the Paraphilia Scales From Kurt Freund’s Erotic Preferences Examination Scheme

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The specific items of the Erotic Preferences Examination Scheme (EPES) were not included in the provided source text. The EPES has never been published in its entirety, though many of its multi-item scales have been published in parts in scholarly literature. The full set of scales, along with scoring weights, is available through the external academic reference provided: http://www.routledge.com/textbooks/9780415801751.