Which characteristic is often associated with paraphilic disorders?

The presence of clinically significant distress is a defining characteristic of paraphilic disorders as outlined in the DSM-5-TR. Paraphilic disorders are diagnosed when the sexual fantasies, sexual urges, or behaviors associated with atypical sexual interests lead to distress or impairment in social, occupational, or other important areas of functioning. This distress can manifest in various ways, such as anxiety, guilt, or feelings of isolation resulting from the individual's sexual interests.

In contrast, the absence of sexual fantasies would not typically be related to paraphilic disorders, as these disorders are directly tied to the presence of such fantasies or urges. A lack of sexual arousal is also contrary to the nature of paraphilic disorders, which fundamentally involve a deviation from normative sexual interests that still elicits arousal. Lastly, social acceptance of behavior is not a characteristic of paraphilic disorders; many of the behaviors in this category are socially stigmatized and not accepted, highlighting the distress experienced by individuals who engage in them.