Paraphilias are recurrent and intense sexual urges, fantasies or behaviors involving unusual objects, activities or situations that cause distress or impairment. Some common paraphilias described in the document include exhibitionism, fetishism, frotteurism, masochism, sadism and voyeurism. While the causes of paraphilias are not fully understood, psychological, biological and environmental factors are believed to play a role. Treatment options mentioned include psychotherapy, group therapy, medication and social skills training.