User:Ckelly914/sandbox

Homosexual panic is a term defined by psychiatrist Edward J. Kempf as "panic due to the pressure of uncontrollable perverse sexual cravings". . The disorder was coined in 1920, and has also come to be known in the psychiatrist's honor as "Kempf's disease". He classified the disorder as an acute pernicious dissociative disorder. This meant that the condition involved in a disruption in typical perception and memory functions of an individual.

History of the Disorder
This disease was termed by Kempf after completing 19 case studies during and after World War I at a government mental institution. The case studies lasted months, in some cases, and consisted of extensive unstructured patient interviews. Kempf would, over the course of multiple sessions, investigate the personal history of the patient and the events that led up to hospitalization in order to diagnose them with homosexual panic. The disorder was included in Appendix C of the DSM-I as a supplementary term. Supplementary terms may be added on to an existing diagnosis to further explain the patient's condition. In order for mental health professionals to apply a diagnosis to a patient, the diagnosis must appear in the current edition of the DSM. The disorder has not appeared in any subsequent editions of the DSM, and thus is not considered a diagnosable condition

Etiology
Kempf cited possible reasons for the onset of the disease, including spending copious amounts of time with members of the same sex in a confined or limited atmosphere. Such environments included but were not limited to army camps, aboard ships, monasteries, schools, asylums, and prisons. Kempf asserted that individuals in these environments who had recently or were currently undergoing stress (due to fatigue, sickness, loss of a love interest, etc.) were more likely to have weak egos. According to the Freudian theory of psychoanalysis, the ego is the part of an individual's mind that mediates between the primitive unconscious and reality. When in such a position, sufferers would become “eccentric and irritable”, tending to feel inferior and weak amongst his or her companions. It is important to note that the onset of this condition was not attributed to unwanted homosexual advances. Rather, Kempf stated that it was caused by the individual’s own “aroused homosexual cravings" . The individual's homosexual feelings as a cause of his or her symptoms was what differentiated this diagnosis from any other stress-related disorder.

Symptoms
In his case studies, Kempf recorded a variety of symptoms that his patients presented with. Psychotic symptoms included hallucinations and delusions, especially those of persecution. Kempf cites Case PD-14, who insisted he had been framed for his behavior and accused his shipmates of conspiring to harm or kill him. Somatic symptoms were also common, including dizziness, nausea, and vomiting. In 1959, author Burton Glick documented mood-related symptoms, such as self-punishment, suicidal ideation, social withdrawal, and feelings of helplessness. Glick noted that patients appeared passive, and demonstrated an “inability to be aggressive”. Ultimately, patients became “unable to function at all”. Both Glick and Kempf emphasize their patients’ lack of aggression towards homosexual individuals. In a study of college aged-men, Henry Harper Hall found that men who exhibited symptoms in line with homosexual panic never acted out towards homosexual individuals; instead that they blamed themselves for their own cravings. . Kempf noted that the difference between patients who fared well after their diagnoses and those who did not was the patient's successful "transference" of such homosexual cravings. If a patient was able to transfer these impulses towards another, more socially appropriate target, the patient would begin to feel less inferior and thus recover

Differential Diagnosis
Homosexual panic disorder is a separate diagnosis from acute aggression panic disorder. Glick notes that the difference is explained by differing instinctual drives that motivate each disorder. Patients whose primary motivation is a sexual one are suffering from homosexual panic, whereas patients whose motivation is primarily aggression are suffering from acute aggression panic disorder. . As stated above, both Glick and Kempf noted in their accounts of patients that those with homosexual panic disorder were not aggressive toward others. Also in concordance with this, Hart’s study concluded that those individuals with homosexual panic who chose to satisfy homosexual urges experienced relief from their symptoms

Homosexual Panic and the HPD
Homosexual panic as a mental health disorder is distinct from the homosexual panic defense (HPD) within the legal system (also known as the gay panic defense). Whereas homosexual panic disorder was at one point considered a diagnosable medical condition, the homosexual panic defense implies only a temporary loss of self-control. . The homosexual panic defense is one used to reduce the sentence against the perpetrator of assault or murder of a homosexual individual. The HPD was used by defendant Brandon McInerny in the trial for the murder of Larry King. McInerny was convicted of voluntary manslaughter. In September 2014, California became the first state to abolish the HPD

Attitudes About Homosexuality
The absence of homosexual panic from the DSM 5 reflects changing attitudes about homosexuality. Homosexuality itself was removed from the DSM in 1973; a significant event in LGBT History. 60% of Americans now say that homosexuality should be accepted by society; this is up from 49% of Americans in 2007. Changing societal attitudes toward homosexuality have been influenced by LGBT movements in the United States.