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Dr. Richard Krueger, associate professor of psychiatry at Columbia University Medical Center, says some people who practice fetishes or alternative erotic lifestyles may be mentally ill, or have experienced trauma. But he says this is not a predictor.
Paraphilic infantilism, also known as autonepiophilia, psychosexual infantilism and adult baby syndrome, is a sexual fetish that involves role-playing a regression to an infant-like state. Behaviors may include drinking from a bottle or wearing diapers (diaper fetishism). Individuals may engage in gentle and nurturing experiences (an adult who engages only in infantile play is known as an adult baby) or be attracted to masochistic, coercive, punishing or humiliating experiences. Diaper fetishism involves "diaper lovers" wearing diapers for sexual or erotic reasons but may not involve infant-like behavior. Individuals who experience both of these things are referred to as adult baby/diaper lovers (AB/DL, also spelled ABDL). When wearing diapers, infantilists may urinate and/or defecate in them.
Meaningful information on the incidence or prevalence of any of the paraphilias are lacking due to the often clandestine nature of such practices. Similarly, it has been observed that infantilism is a closeted activity and it is not well documented in the medical literature. One study reported that 9% of Yahoo groups devoted to "fetishes" dealt with paraphilic infantilism, which was high in relation to other fetishes. If exceptional behaviors do not cause functional impairment, personal distress or distress to others, or have legal implications they can escape the purview of psychiatric awareness and knowledge. Additionally, infantilists may not consider themselves as suffering from a medical condition and may not want to change their behavior, a common occurrence among individuals with paraphilias. Individuals with paraphilic infantilism may seek therapy only for other issues, or be encouraged or coerced to seek treatment if discovered by others. Given these issues the potential of anonymous internet surveys for data collection on infantilist communities has been noted.
The conventional definition of infantilism means the persistence of childlike traits in adults and medically the failure to attain sexual maturity, and "sexual infantilism" is also used medically as a synonym for delayed puberty. The term "psychosexual infantilism" was used in Sigmund Freud's theory of psychosexual development to refer to individuals who had not matured through its hypothetical stages into heterosexuality. Psychologist Wilhelm Stekel used "psychosexual infantilism" as a category similar to paraphilia, including paraphilic infantilism and other paraphilias and sexual orientations.
Psychologists D. Richard Laws and William O'Donohue state that "Although infantilism is classified as a sexual masochism in the DSM-IV and DSM-IV-TR, it is questionable whether the criteria for sexual masochism are always met. For example, if the infantile role playing does not involve feelings of humiliation and suffering, then the diagnosis of sexual masochism would not be appropriate and a diagnosis of infantilism as a paraphilia [not otherwise specified] is warranted." Sexologist John Money, in his book Lovemaps describes paraphilic infantilism as a possible "...adjunctive to masochistic discipline and humiliation." Sexologist William B. Arndt considers paraphilic infantilism to combine forms of fetishism, transvestism and masochism. Wilhelm Stekel considered sado-masochistic practices to be variant behavior arising from psychosexual infantilism.
John Money distinguishes between infantilism or autonepiophilia and paraphilic diaper-wearing, stating that the latter is a paraphilic fetish that manifests as an erotic attraction to an article of clothing while the former is a non-fetishistic paraphilia directed at a change of status in terms of age identity.
Money thought that the lovemap was normally fully developed by the age of 8, serving as a kind of sexual template through to the end of one's adult life. Money believed all paraphilias were caused by the formation of abnormal lovemaps during the preadolescent years and that such abnormal lovemaps can be formed by any number of contributing factors or stressors during this developmental period. Money also coined the term "autonepiophilia" meaning a "diaperism" or diaper fetishism in 1984 to describe the condition. Nepon is Greek for infant.
The organization "Diaper Pail Friends" was established in San Francisco, growing to approximately 3,000 members in 1995 through magazine articles, books, talk shows and the Internet. The organization was studied in 1995 by a group of sexologists, though the results were not published. In 2001, the New York organization "Still in Diapers" was founded for diaper fetishists. In 2008, the Diaper Pail Friends had expanded to a national organization and claimed a membership of 15,000.
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