Exhibitionism May Be Genetic Disorder, Study Finds

People arrested for exhibitionism may unknowingly suffer from Tourette Syndrome and can be helped with a drug that suppresses the compulsive behavior characteristic of the genetic disorder, a new study shows.

Clinical tests at City of Hope on Tourette victims showed that compulsive exhibitionist tendencies and obsessive thoughts associated with it were suppressed by the drug haloperidol.

The drug inhibits the desire for exhibitionism by decreasing cerebral spinal fluid levels of homovalinic acid--a breakdown product of dopamine, a chemical essential to normal brain function. It already was commonly used to control the facial tics and other compulsive behavior, and the study shows increased doses can suppress exhibitionism.

“We found that in some Tourette patients, the tics and other symptoms sometimes go away, leaving the exhibitionism as the only sign of the disease,” said medical geneticist Dr. David E. Comings, chief investigator for the study. “When this is the only way the disorder is expressed, people may not know they have Tourette Syndrome.”

“We estimate that exhibitionism occurs in about 10 to 15% of all patients who suffer with Tourette Syndrome, but the severest forms of exhibitionism are seen in only 1 to 2% of all Tourette patients,” Comings said.

A recent test of haloperidol on a non-Tourette exhibitionist at another research center reportedly suppressed the disorder. But a series of previous tests of haloperidol on non-Tourette exhibitionists has not been effective, Comings said.

“Tourette victims have a defective gene which causes chemical changes in the brain that respond to the drug. Other exhibitionists suffer psychiatric disturbances often seated in their confusion over sexuality,” Comings explained.

“There are different kinds of exhibitionism,” he said. “One kind is when Tourette patients are intact psychologically, they may have a family, a job and social standing in their communities, but then an urge will strike to expose themselves.”

Tourette Syndrome, named after French researcher Giles de la Tourette, is a neurological condition that usually manifests itself in early childhood and is characterized by uncontrollable eye blinking, grimacing, grunting, sniffing, shouting, barking and excessive repeating of words.

Although Tourette Syndrome occurs in both males and females, exhibitionist behavior occurs primarily in males and has been detected in children as young as 7 years old, Comings said.

“Compulsive exhibitionistic tendencies usually begin in puberty and peak between the ages of 15 and 30,” Comings said.

He suggests that people arrested repeatedly for exhibitionism should be tested for symptoms of Tourette Syndrome.

“Many patients we see in our clinic didn’t even know they had Tourette Syndrome until they heard about the condition on the news. Four years ago we assumed it to be very rare but now studies show that one in every 100 people may carry a gene for the disorder,” Comings said.

An estimated 300,000 to 400,000 Americans suffer the disorder in one degree or another, according to Comings.

“I would say it’s probably one of the most common genetic diseases known to man, but it is treatable,” he said.