Science.gov

Sample records for pedophilia

  1. [Pedophilia].

    PubMed

    Farkas, Márta

    2013-01-01

    This article deals with the incidence, diagnosis and treatment of pedophilia as a conceptualized mental disorder. Pedophilia is a category of sexual deviation characterized by a sexual interest toward children under 13 years according to DSM-IV-TR or children under 14 years as determined by the law. Pedophilia is a distinguished form of child sexual abuse as a legal category. Today pedophilia patients are stigmatized and excluded from society not only in general, but also in prisons and forensic units. However, the phenomenon of pedophilia originates from the disorder of emotional, cognitive, sexual development as well as some social factors have also a significant role in this area, especially virtual social networks and the media. The combination of miscellaneous factors makes the social reintegration of patients in treatment very difficult and results in a high risk for relapse. The complexity of this topic can also be demonstrated by the high frequency of mental disorders among the victims.

  2. Pedophilia.

    PubMed

    Fagan, Peter J; Wise, Thomas N; Schmidt, Chester W; Berlin, Fred S

    2002-11-20

    This article addresses the risk factors associated with the psychiatric disorder pedophilia, its treatment, and treatment outcomes. It addresses physician responsibilities associated with case identification of victims and possible roles in the medical management of pedophilia. The essential feature of pedophilia is that an individual is sexually attracted exclusively or in part to prepubescent children. While pedophilia may be limited to fantasies and impulses, pedophilic behaviors are the primary concern of both the mental health and criminal justice systems. Remote risk factors for development of pedophilia often include the individual having been sexually abused as a child. Proximate risk factors for its behavioral expression are prevalence of comorbid psychiatric disorders and substance abuse disorders. Current treatment goals focus on stopping the behavior and achieving long-term behavioral control in the community. Common treatment methods are cognitive-behavioral, group therapy, and, when appropriate, medications such as androgen-lowering agents that can act as sexual appetite suppressants. Meta-analyses have established that treatment is more effective than nontreatment in preventing recidivism of sexual offenders in general, a finding that has a high probability of application to individuals with pedophilia. Pedophilia is a chronic psychiatric disorder, but it is treatable in terms of developing strategies for preventing behavioral expression. Ultimately, reducing the prevalence of pedophilic behavior requires further collaboration between the criminal justice system and the health care communities.

  3. Pedophilia.

    PubMed

    Seto, Michael C

    2009-01-01

    Pedophilia is defined as a sexual interest in prepubescent children. It is empirically linked with sexual offending against children: Child pornography offenders and sex offenders with child victims are more likely to be pedophiles based on self-report or objective measures of sexual interests. At the same time, some pedophiles have not had any known sexual contact with children, and perhaps half of sex offenders against children would not meet diagnostic criteria for pedophilia. Pedophilia can be diagnosed using a variety of methods and is an important factor to consider in the assessment of sex offenders because pedophilic offenders are more likely to sexually reoffend and require different interventions. There is no evidence to suggest that pedophilia can be changed. Instead, interventions are designed to increase voluntary control over sexual arousal, reduce sex drive, or teach self-management skills to individuals who are motivated to avoid acting upon their sexual interests.

  4. Phallometric Diagnosis of Pedophilia.

    ERIC Educational Resources Information Center

    Freund, Kurt; Blanchard, Ray

    1989-01-01

    Investigated sensitivity/specificity of phallometric test for pedophilia and hebephilia. Total samples were 154 men accused of sexual offenses against minors and 56 men accused of sexual offenses against adult women. Concluded that sensitivity of test in detecting pedophilia or hebephilia in complete nonadmitters is probably greater than or equal…

  5. [Pedophilia and its treatment].

    PubMed

    Knecht, T

    2001-11-01

    Pedophilia is a frequent cause of infringement of children's sexual integrity. It's a widely spread deviant pattern of sexual arousal and behavior, which seems to be deeply rooted in human nature, as shown by impressive ethological and cultural historical evidence. Aetiology and pathogenesis of pedophilia are still not clarified, but there is a number of interesting findings suggesting multifactorial developmental disorder as the basis of pedophilia. Regarding the treatment of pedophiles, there is usually drawn a distinction between somatic and non-somatic methods. The latter aim at relapse-prevention by augmentation of self-control. The former mean drive-reduction on a hormonal basis. Antiandrogens, progestogens and LHRH-agonists have proven themselves as having significant effects on sexual drive, whereas their side effects are quite tolerable on the whole.

  6. Pedophilia and deafness.

    PubMed

    Vernon, M; Rich, S

    1997-10-01

    Data from 22 cases of deaf individuals suffering from pedophilia are presented along with a tabular summary of recent articles from the deaf press, about deaf victims of pedophilia and deaf pedophiles. Results indicate a number of factors that distinguish deaf pedophiles from hearing pedophiles. First is the prevalence of Primitive Personality Disorder in the deaf group. Corollary to this, with a significant number of pedophiles, competence to stand trial is a major issue. Other significant differences include a high rate of brain damage, illiteracy, poor communication skills, and other psychiatric illnesses. Two of the 22 cases were deaf females with pedophilia. The mean performance IQ of the sample was 102.8 and the distribution of scores was bimodal. Case histories are presented and discussed, and legal issues, prevention, and punishment are addressed.

  7. Pedophilia and Deafness.

    ERIC Educational Resources Information Center

    Vernon, McCay; Rich, Steve

    1997-01-01

    Data from 22 cases of individuals with deafness suffering from pedophilia indicate a number of factors that distinguish them from hearing pedophiles. Differences include a prevalence of Primitive Personality Disorder, a high rate of brain damage, illiteracy, poorer communication skills, and psychiatric illnesses. Legal issues, prevention, and…

  8. Is pedophilia a sexual orientation?

    PubMed

    Seto, Michael C

    2012-02-01

    In this article, I address the question of whether pedophilia in men can be construed as a male sexual orientation, and the implications for thinking of it in this way for scientific research, clinical practice, and public policy. I begin by defining pedophilia and sexual orientation, and then compare pedophilia (as a potential sexual orientation with regard to age) to sexual orientations with regard to gender (heterosexuality, bisexuality, and homosexuality), on the bases of age of onset, correlations with sexual and romantic behavior, and stability over time. I conclude with comments about the potential social and legal implications of conceptualizing pedophilia as a type of sexual orientation in males.

  9. Neuroimaging in pedophilia.

    PubMed

    Wiebking, Christine; Northoff, Georg

    2013-04-01

    Paraphilia is a set of disorders characterized by abnormal sexual desires. Perhaps most discussed amongst them, pedophilia is a complex interaction of disturbances of the emotional, cognitive and sexual experience. Using new imaging techniques such as functional magnetic resonance imaging, neural correlates of emotional, sexual and cognitive abnormalities and interactions have been investigated. As described on the basis of current research, altered patterns of brain activity, especially in the frontal areas of the brain, are seen in pedophilia. Building on these results, the analysis of neural correlates of impaired psychological functions opens the opportunity to further explore sexual deviances, which may contribute ultimately to the development of tools for risk assessment, classification methods and new therapeutic approaches.

  10. [Pedophilia. Prevalence, etiology, and diagnostics].

    PubMed

    Mokros, A; Osterheider, M; Nitschke, J

    2012-03-01

    Pedophilia is a disorder of sexual preference that increases the risk for committing sexual offenses against children. Consequently, pedophilia is not only relevant in psychiatric therapy and prognostics, but also greatly influences the public attitude towards criminality. Public opinion seems to equate pedophilia with child sexual abuse and vice versa which leads to stigmatization of patients and may impede treatment. The present paper provides information on recent studies on the potential origins of the disorder and introduces new diagnostic methods. Moreover, the article presents estimates on the prevalence of pedophilic sexual interest.

  11. [Pedophilia: etiology, diagnostics and therapy].

    PubMed

    Fromberger, P; Jordan, K; Müller, J L

    2013-09-01

    Child sexual abuse is one of the most destructive events for healthy child development. Following psychiatric classification systems, pedophilia must be distinguished from child sexual abuse. Approximately only one half of all child abusers fulfill the diagnostic criteria for pedophilia which is defined as a persistent or dominating sexual preference for prepubescent children characterized by persistent thoughts, fantasies, urges, sexual arousal or behavior. This article describes the diagnostic criteria and potential differential diagnoses as well as epidemiological and etiological findings. From an etiological point of view multifactorial mechanisms are currently considered to be responsible especially genetic factors, learning theoretical and neurobiological factors. Psychotherapeutic and pharmaceutical treatment options will be discussed. According to the current state of knowledge cognitive-behavioral psychotherapy is the method of choice in the treatment of pedophilia and has demonstrated positive treatment effects in meta-analyses regarding relapse prevention. Medicinal treatment of pedophilia is only indicated for severe forms of pedophilia. Important aspects of risk management in the treatment of pedophilia and aspects which must be considered in the forensic psychiatric assessment are presented.

  12. Pedophilia and sexual offenses against children.

    PubMed

    Seto, Michael C

    2004-01-01

    This article reviews the definition and assessment of pedophilia, describes the relationship between pedophilia and sexual offenses against children, and provides an overview of our current theoretical understanding of the etiology of pedophilia. A great deal is known about the assessment of pedophilia--attributable to public and professional concerns regarding the empirical association between pedophilia and sexual offenses against children--but much remains to be learned about pedophilia, including its prevalence in the general population, cross-cultural manifestations, developmental trajectories, and causes. Recent research suggests that neurodevelopmental problems and childhood sexual abuse play a role in the etiology of pedophilia, but the mechanisms that are involved are unknown. Future directions for research on assessment methods and etiology are highlighted.

  13. Diffusion Tensor Imaging of Pedophilia.

    PubMed

    Cantor, James M; Lafaille, Sophie; Soh, Debra W; Moayedi, Massieh; Mikulis, David J; Girard, Todd A

    2015-11-01

    Pedophilia is a principal motivator of child molestation, incurring great emotional and financial burdens on victims and society. Even among pedophiles who never commit any offense,the condition requires lifelong suppression and control. Previous comparison using voxel-based morphometry (VBM)of MR images from a large sample of pedophiles and controls revealed group differences in white matter. The present study therefore sought to verify and characterize white matter involvement using diffusion tensor imaging (DTI), which better captures the microstructure of white matter than does VBM. Pedophilics ex offenders (n=24) were compared with healthy, age-matched controls with no criminal record and no indication of pedophilia (n=32). White matter microstructure was analyzed with Tract-Based Spatial Statistics, and the trajectories of implicated fiber bundles were identified by probabilistic tractography. Groups showed significant, highly focused differences in DTI parameters which related to participants’ genital responses to sexual depictions of children, but not to measures of psychopathy or to childhood histories of physical abuse, sexual abuse, or neglect. Some previously reported gray matter differences were suggested under highly liberal statistical conditions (p(uncorrected)<.005), but did not survive ordinary statistical correction (whole brain per voxel false discovery rate of 5%). These results confirm that pedophilia is characterized by neuroanatomical differences in white matter microstructure, over and above any neural characteristics attributable to psychopathy and childhood adversity, which show neuroanatomic footprints of their own. Although some gray matter structures were implicated previously, only few have emerged reliably.

  14. Intelligence, memory, and handedness in pedophilia.

    PubMed

    Cantor, James M; Blanchard, Ray; Christensen, Bruce K; Dickey, Robert; Klassen, Philip E; Beckstead, A Lee; Blak, Thomas; Kuban, Michael E

    2004-01-01

    A sample of 473 male patients with pedophilia (assessed by the patients' sexual history and penile response in the laboratory to standardized, erotic stimuli) or other problematic sexual interests or behaviors received brief neuropsychological assessments. Neuropsychological measures included a short form of the Wechsler Adult Intelligence Scale--Revised (D. Wechsler, 1981), the Hopkins Verbal Learning Test--Revised (R. H. B. Benedict, D. Schretlen. L. Groninger. & J. Brandt, 1998), the Brief Visuospatial Memory Test--Revised (R. H. B. Benedict, 1997), and the Edinburgh Handedness Inventory (S. M. Williams, 1986). Pedophilia showed significant negative correlations with IQ and immediate and delayed recall memory. Pedophilia was also related to non-right-handedness even after covarying age and IQ. These results suggest that pedophilia is linked to early neurodevelopmental perturbations. ((c) 2004 APA, all rights reserved)

  15. A case of factitious pedophilia.

    PubMed

    Porter, Theresa M; Feldman, Marc D

    2011-09-01

    Factitious disorder involves feigning, exaggerating, or self-inducing physical and/or psychological ailments with the goal of assuming the "sick" or "patient" role. In turn, the sick role entitles the factitious disorder patient to care, nurturance, and protection; it also exempts one from usual responsibilities. In this paper, we present the first reported case of factitious pedophilia. Although it seems counterintuitive, this middle-aged man has falsely claimed or exaggerated sexual desire for minors ostensibly to remain in a state hospital; indeed, he has remained in the same inpatient facility for more than 20 years as a result of his deceptions. At times, his reports have included disconfirmed claims of bizarre accidents and other physical travails. This case enlarges the literature on factitious psychological disorders and shows that some individuals may falsify paraphilic behaviors, although clearly minimization of these behaviors remains more common. © 2011 American Academy of Forensic Sciences.

  16. Handedness in pedophilia and hebephilia.

    PubMed

    Cantor, James M; Klassen, Philip E; Dickey, Robert; Christensen, Bruce K; Kuban, Michael E; Blak, Thomas; Williams, Natasha S; Blanchard, Ray

    2005-08-01

    A sample of 404 adult men underwent assessment following illegal or clinically significant sexual behaviors or interests. Patients' assessments included: administration of a modified version of the Edinburgh Handedness Inventory; recording of patients' phallometric (penile) responses to erotic stimuli depicting adults, pubescent children, and prepubescent children of both sexes; and a tabulation of the numbers of patients' victims, ages 0-11, 12-14, 15-16, and 17 and older, of both sexes. In Study 1, patients' right-handedness scores correlated negatively with their phallometric responses to stimuli depicting prepubescent children and positively with stimuli depicting adults, replicating the pattern described in a previous report (Cantor et al., 2004). Unlike the previous study, however, patients' handedness scores did not significantly correlate with their numbers of prepubescent victims. To explore this discrepancy, Study 2 combined the patients from this replication sample with those in the previously reported sample, categorizing them by the sex and age group of greatest erotic interest to them. The odds of non-right-handedness in men offending predominantly against prepubescent children were approximately two-fold higher than that in men offending predominantly against adults and three-fold higher after eliminating those men with intrafamilial (i.e., incest) offenses. Handedness differences between men erotically interested in males versus females were not statistically significant. These results indicate that the rates of non-right-handedness in pedophilia are much larger than previously suggested and are comparable to the rates observed in pervasive developmental disorders, such as autism, suggesting a neurological component to the development of pedophilia and hebephilia.

  17. [Pedophilia: contribution of neurology and neuroimaging techniques].

    PubMed

    Fonteille, V; Cazala, F; Moulier, V; Stoléru, S

    2012-12-01

    Pedophilia is characterized by a persistent sexual interest of an adult for prepubescent children. The development of neuroimaging techniques such as functional Magnetic Resonance Imaging (fMRI) is starting to clarify the cerebral basis of disorders of sexual behavior such as pedophilia, which had been previously suggested by case studies. To review structural and functional neuroimaging studies of pedophilia. An exhaustive consultation of PubMed and Ovid databases was conducted. We obtained 19 articles presented in the present review of the literature. Case studies have demonstrated various changes of sexual behavior in relation to brain lesions, including the late appearance in adults of a sexual attraction to prepubescent children. In most cases of pedophilia associated with brain lesions, these lesions were located in frontal or in temporal regions. Structural neuroimaging studies have compared pedophiles with healthy subjects and tried to relate pedophilia to anatomical differences between these two groups. The location of structural changes is inconsistent across studies. Recent functional neuroimaging studies have also attempted to investigate the cerebral correlates of pedophilia. Results suggest that the activation pattern found in pedophiles in response to pictures of prepubescent nude girls or boys is similar to the pattern observed in healthy subjects in response to pictures of adult nude women or men. However, regions that become more activated in patients than in healthy controls in response to the presentation of pictures of children vary across studies. Studies that have begun to investigate the cerebral correlates of pedophilia demonstrate that it is possible to explore them through neuroimaging techniques. These initial results have to be confirmed by new studies backed with objective measurements of sexual arousal such as phallometry. Copyright © 2012 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  18. The DSM diagnostic criteria for pedophilia.

    PubMed

    Blanchard, Ray

    2010-04-01

    This paper contains the author's report on pedophilia, submitted on June 2, 2008, to the work group charged with revising the diagnoses concerning sexual and gender identity disorders for the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). The author reviews the previously published criticisms and empirical research concerning the diagnostic criteria for pedophilia and presents criticism and relevant research of his own. The review shows that the DSM diagnostic criteria for pedophilia have repeatedly been criticized as unsatisfactory on logical or conceptual grounds, and that published empirical studies on the reliability and validity of these criteria have produced ambiguous results. It therefore seems that the current (i.e., DSM-IV-TR) diagnostic criteria need to be examined with an openness to major changes in the DSM-V.

  19. Abnormal amygdala activation profile in pedophilia.

    PubMed

    Sartorius, Alexander; Ruf, Matthias; Kief, Christine; Demirakca, Traute; Bailer, Josef; Ende, Gabriele; Henn, Fritz A; Meyer-Lindenberg, Andreas; Dressing, Harald

    2008-08-01

    Despite considerable public interest research in neurobiological correlates of pedophilia is scarce. Since amygdala activation is central for emotional valuation, arousal, and salience, we investigated the activation profile of this structure in 10 male subjects with pedophilia (exclusively attracted to boys), all convicted sex-offenders and sentenced to forensic psychiatric treatment along with ten male heterosexual matched controls. We used a sexually non-explicit functional Magnetic Resonance Imaging (fMRI) paradigm with images of men, women, boys or girls randomly embedded in neutral target/non-target geometrical symbols. We applied statistical parametric mapping (SPM2) and SPSS 14 for image processing and analysis. While controls activated significantly less to pictures of children compared to adults, the activation profile was reversed in subjects with pedophilia, who exhibited significantly more activation to children than adults. The highest activation was observed for boys in the patient group, and for women in control participants. Our data show enhanced activation to children's pictures even in an incidental context and suggest the provocative hypothesis that a normally present mechanism for reduced emotional arousal for children relative to adults is reversed in pedophilia, suggesting a neural substrate associated with deviant sexual preference in this condition. More extensive research in this field would be of benefit for both the victims and the offenders.

  20. Pedophilia: a diagnosis in search of a disorder.

    PubMed

    Malón, Agustin

    2012-10-01

    This article presents a critical review of the recent controversies concerning the diagnosis of pedophilia in the context of the preparation of the fifth edition of the DSM. The analysis focuses basically on the relationship between pedophilia and the current DSM-IV-TR's definition of mental disorder. Scholars appear not to share numerous basic assumptions ranging from their underlying ideas about what constitutes a mental disorder to the role of psychiatry in modern society, including irreconcilable theories about human sexuality, which interfere with reaching any kind of a consensus as to what the psychiatric status of pedophilia should be. It is questioned if the diagnosis of pedophilia contained in the DSM is more forensic than therapeutic, focusing rather on the dangers inherent in the condition of pedophilia (dangerous dysfunction) than on its negative effects for the subject (harmful dysfunction). The apparent necessity of the diagnosis of pedophilia in the DSM is supported, but the basis for this diagnosis is uncertain.

  1. [Forensic-psychiatric assessment of pedophilia].

    PubMed

    Nitschke, J; Osterheider, M; Mokros, A

    2011-09-01

    The present paper illustrates the approach of a forensic psychiatric expert witness regarding the assessment of pedophilia. In a first step it is inevitable to differentiate if the defendant is suffering from pedophilia or if the alleged crime might have been committed because of other motivations (antisociality, sexual activity as redirection, impulsivity). A sound diagnostic assessment is indispendable for this task. In a second step the level of severity needs to be gauged in order to clarify whether the requirement of the entry criteria of §§ 20, 21 of the German penal code are fulfilled. In a third step, significant impairments of self-control mechanisms need to be elucidated. The present article reviews indicators of such impairments regarding pedophilia. With respect to a mandatory treatment order (§ 63 German penal code) or preventive detention (§ 66 German penal code) the legal prognosis of the defendant needs to be considered. The present paper gives an overview of the current state of risk assessment research and discusses the transfer to an individual prognosis critically. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Stigmatization of people with pedophilia: two comparative surveys.

    PubMed

    Jahnke, Sara; Imhoff, Roland; Hoyer, Juergen

    2015-01-01

    Despite productive research on stigma and its impact on people's lives in the past 20 years, stigmatization of people with pedophilia has received little attention. We conducted two surveys estimating public stigma and determining predictors of social distance from this group. In both studies, pedophilia was defined as a "dominant sexual interest in children." The survey was comprised of items measuring agreement with stereotypes, emotions, and social distance (among others). Responses were compared with identical items referring to either people who abuse alcohol (Study 1), sexual sadists or people with antisocial tendencies (Study 2). Study 1 was conducted in two German cities (N = 854) and Study 2 sampled 201 English-speaking online participants. Both studies revealed that nearly all reactions to people with pedophilia were more negative than those to the other groups, including social distance. Fourteen percent (Study 1) and 28 % (Study 2) of the participants agreed that people with pedophilia should better be dead, even if they never had committed criminal acts. The strongest predictors of social distance towards people with pedophilia were affective reactions to this group (anger and, inversely, associated, pity) and the political attitude of right-wing authoritarianism (Study 1). Results strongly indicate that people with pedophilia are a stigmatized group who risk being the target of fierce discrimination. We discuss this particular form of stigmatization with respect to social isolation of persons with pedophilia and indirect negative consequences for child abuse prevention.

  3. Review of medical reports on pedophilia.

    PubMed

    Hughes, John R

    2007-10-01

    The present report is a review of all 554 papers published on Medline on pedophilia. The first discussion is the history of the disorder from ancient Greece to the present time, especially the influence of the liberal country of the Netherlands, the North American Man-Boy Love Association, and the sexual crisis in the Catholic Church. One important question is the relationship between homosexual pedophilia and adult homosexuality. Evidence for and against this relationship is presented. Next discussed are the characteristics of the victim and the long lasting serious effects of sexual abuse. Laboratory correlations are included, especially phallometric tests in order to objectively measure the physical responses to sexual stimuli. Electrophysiological and radiographic tests are also mentioned, including electroencephalography, computed tomography, magnetic resonance imaging, and positron emission tomography scans. An important section is the characterization of pedophiles with emphasis on their frequent previous sexual abuse, their past, their present, and their anticipated future. The final topic is treatment of this disorder with surgery, medication, behavioral therapy and the combination of medication and behavioral therapy.

  4. The Neurobiology and Psychology of Pedophilia: Recent Advances and Challenges.

    PubMed

    Tenbergen, Gilian; Wittfoth, Matthias; Frieling, Helge; Ponseti, Jorge; Walter, Martin; Walter, Henrik; Beier, Klaus M; Schiffer, Boris; Kruger, Tillmann H C

    2015-01-01

    A pedophilic disorder is recognized for its impairment to the individual and for the harm it may cause to others. Pedophilia is often considered a side issue and research into the nature of pedophilia is delayed in comparison to research into other psychiatric disorders. However, with the increasing use of neuroimaging techniques, such as functional and structural magnetic resonance imaging (sMRI, fMRI), together with neuropsychological studies, we are increasing our knowledge of predisposing and accompanying factors contributing to pedophilia development. At the same time, we are faced with methodological challenges, such as group differences between studies, including age, intelligence, and comorbidities, together with a lack of careful assessment and control of child sexual abuse. Having this in mind, this review highlights the most important studies investigating pedophilia, with a strong emphasis on (neuro-) biological studies, combined with a brief explanation of research into normal human sexuality. We focus on some of the recent theories on the etiology of pedophilia such as the concept of a general neurodevelopmental disorder and/or alterations of structure and function in frontal, temporal, and limbic brain areas. With this approach, we aim to not only provide an update and overview but also a framework for future research and to address one of the most significant questions of how pedophilia may be explained by neurobiological and developmental alterations.

  5. The Neurobiology and Psychology of Pedophilia: Recent Advances and Challenges

    PubMed Central

    Tenbergen, Gilian; Wittfoth, Matthias; Frieling, Helge; Ponseti, Jorge; Walter, Martin; Walter, Henrik; Beier, Klaus M.; Schiffer, Boris; Kruger, Tillmann H. C.

    2015-01-01

    A pedophilic disorder is recognized for its impairment to the individual and for the harm it may cause to others. Pedophilia is often considered a side issue and research into the nature of pedophilia is delayed in comparison to research into other psychiatric disorders. However, with the increasing use of neuroimaging techniques, such as functional and structural magnetic resonance imaging (sMRI, fMRI), together with neuropsychological studies, we are increasing our knowledge of predisposing and accompanying factors contributing to pedophilia development. At the same time, we are faced with methodological challenges, such as group differences between studies, including age, intelligence, and comorbidities, together with a lack of careful assessment and control of child sexual abuse. Having this in mind, this review highlights the most important studies investigating pedophilia, with a strong emphasis on (neuro-) biological studies, combined with a brief explanation of research into normal human sexuality. We focus on some of the recent theories on the etiology of pedophilia such as the concept of a general neurodevelopmental disorder and/or alterations of structure and function in frontal, temporal, and limbic brain areas. With this approach, we aim to not only provide an update and overview but also a framework for future research and to address one of the most significant questions of how pedophilia may be explained by neurobiological and developmental alterations. PMID:26157372

  6. Pedophilia, sexual orientation, and birth order.

    PubMed

    Bogaert, A F; Bezeau, S; Kuban, M; Blanchard, R

    1997-05-01

    This study extended research on birth order and erotic preferences by examining birth order in a sample of pedophiles. Charts of 338 pedophiles, assessed from 1980-1994 in the Behavioural Sexology Department of the Clarke Institute of Psychiatry in Toronto, were reviewed for family-demographic information. In total, 170 (57 heterosexual pedophiles, 68 homosexual pedophiles, and 45 bisexual pedophiles) of these men had sufficient sibling information to be included in the analyses. The results indicated that homosexual-bisexual pedophiles had a later birth order than heterosexual pedophiles and that this effect was primarily the result of the homosexual-bisexual group being born later among their brothers. The results extend previous findings that homosexual men, regardless of sample composition, have a later birth order than comparable groups of heterosexual men. The results also challenge some existing theories on the nature and origins of pedophilia.

  7. Pedophilia, hebephilia, and the DSM-V.

    PubMed

    Blanchard, Ray; Lykins, Amy D; Wherrett, Diane; Kuban, Michael E; Cantor, James M; Blak, Thomas; Dickey, Robert; Klassen, Philip E

    2009-06-01

    The term pedophilia denotes the erotic preference for prepubescent children. The term hebephilia has been proposed to denote the erotic preference for pubescent children (roughly, ages 11 or 12-14), but it has not become widely used. The present study sought to validate the concept of hebephilia by examining the agreement between self-reported sexual interests and objectively recorded penile responses in the laboratory. The participants were 881 men who were referred for clinical assessment because of paraphilic, criminal, or otherwise problematic sexual behavior. Within-group comparisons showed that men who verbally reported maximum sexual attraction to pubescent children had greater penile responses to depictions of pubescent children than to depictions of younger or older persons. Between-groups comparisons showed that penile responding distinguished such men from those who reported maximum attraction to prepubescent children and from those who reported maximum attraction to fully grown persons. These results indicated that hebephilia exists as a discriminable erotic age-preference. The authors recommend various ways in which the DSM might be altered to accommodate the present findings. One possibility would be to replace the diagnosis of Pedophilia with Pedohebephilia and allow the clinician to specify one of three subtypes: Sexually Attracted to Children Younger than 11 (Pedophilic Type), Sexually Attracted to Children Age 11-14 (Hebephilic Type), or Sexually Attracted to Both (Pedohebephilic Type). We further recommend that the DSM-V encourage users to record the typical age of children who most attract the patient sexually as well as the gender of children who most attract the patient sexually.

  8. Connectivity and functional profiling of abnormal brain structures in pedophilia

    PubMed Central

    Poeppl, Timm B.; Eickhoff, Simon B.; Fox, Peter T.; Laird, Angela R.; Rupprecht, Rainer; Langguth, Berthold; Bzdok, Danilo

    2015-01-01

    Despite its 0.5–1% lifetime prevalence in men and its general societal relevance, neuroimaging investigations in pedophilia are scarce. Preliminary findings indicate abnormal brain structure and function. However, no study has yet linked structural alterations in pedophiles to both connectional and functional properties of the aberrant hotspots. The relationship between morphological alterations and brain function in pedophilia as well as their contribution to its psychopathology thus remain unclear. First, we assessed bimodal connectivity of structurally altered candidate regions using meta-analytic connectivity modeling (MACM) and resting-state correlations employing openly accessible data. We compared the ensuing connectivity maps to the activation likelihood estimation (ALE) maps of a recent quantitative meta-analysis of brain activity during processing of sexual stimuli. Second, we functionally characterized the structurally altered regions employing meta-data of a large-scale neuroimaging database. Candidate regions were functionally connected to key areas for processing of sexual stimuli. Moreover, we found that the functional role of structurally altered brain regions in pedophilia relates to nonsexual emotional as well as neurocognitive and executive functions, previously reported to be impaired in pedophiles. Our results suggest that structural brain alterations affect neural networks for sexual processing by way of disrupted functional connectivity, which may entail abnormal sexual arousal patterns. The findings moreover indicate that structural alterations account for common affective and neurocognitive impairments in pedophilia. The present multi-modal integration of brain structure and function analyses links sexual and nonsexual psychopathology in pedophilia. PMID:25733379

  9. Connectivity and functional profiling of abnormal brain structures in pedophilia.

    PubMed

    Poeppl, Timm B; Eickhoff, Simon B; Fox, Peter T; Laird, Angela R; Rupprecht, Rainer; Langguth, Berthold; Bzdok, Danilo

    2015-06-01

    Despite its 0.5-1% lifetime prevalence in men and its general societal relevance, neuroimaging investigations in pedophilia are scarce. Preliminary findings indicate abnormal brain structure and function. However, no study has yet linked structural alterations in pedophiles to both connectional and functional properties of the aberrant hotspots. The relationship between morphological alterations and brain function in pedophilia as well as their contribution to its psychopathology thus remain unclear. First, we assessed bimodal connectivity of structurally altered candidate regions using meta-analytic connectivity modeling (MACM) and resting-state correlations employing openly accessible data. We compared the ensuing connectivity maps to the activation likelihood estimation (ALE) maps of a recent quantitative meta-analysis of brain activity during processing of sexual stimuli. Second, we functionally characterized the structurally altered regions employing meta-data of a large-scale neuroimaging database. Candidate regions were functionally connected to key areas for processing of sexual stimuli. Moreover, we found that the functional role of structurally altered brain regions in pedophilia relates to nonsexual emotional as well as neurocognitive and executive functions, previously reported to be impaired in pedophiles. Our results suggest that structural brain alterations affect neural networks for sexual processing by way of disrupted functional connectivity, which may entail abnormal sexual arousal patterns. The findings moreover indicate that structural alterations account for common affective and neurocognitive impairments in pedophilia. The present multimodal integration of brain structure and function analyses links sexual and nonsexual psychopathology in pedophilia. © 2015 Wiley Periodicals, Inc.

  10. Right orbitofrontal tumor with pedophilia symptom and constructional apraxia sign.

    PubMed

    Burns, Jeffrey M; Swerdlow, Russell H

    2003-03-01

    Orbitofrontal abnormalities are associated with poor impulse control, altered sexual behavior, and sociopathy. To describe a patient with acquired pedophilia and a right orbitofrontal tumor who was unable to inhibit sexual urges despite preserved moral knowledge. Case report. The patient displayed impulsive sexual behavior with pedophilia, marked constructional apraxia, and agraphia. The behavioral symptoms and constructional deficits, including agraphia, resolved following tumor resection. For patients with acquired sociopathy and paraphilia, an orbitofrontal localization requires consideration. This case further illustrates that constructional apraxia can arise from right prefrontal lobe dysfunction. Agraphia may represent a manifestation of constructional apraxia in the absence of aphasia and ideomotor apraxia.

  11. Child pornography offenses are a valid diagnostic indicator of pedophilia.

    PubMed

    Seto, Michael C; Cantor, James M; Blanchard, Ray

    2006-08-01

    This study investigated whether being charged with a child pornography offense is a valid diagnostic indicator of pedophilia, as represented by an index of phallometrically assessed sexual arousal to children. The sample of 685 male patients was referred between 1995 and 2004 for a sexological assessment of their sexual interests and behavior. As a group, child pornography offenders showed greater sexual arousal to children than to adults and differed from groups of sex offenders against children, sex offenders against adults, and general sexology patients. The results suggest child pornography offending is a stronger diagnostic indicator of pedophilia than is sexually offending against child victims. Theoretical and clinical implications are discussed.

  12. [A comparative evaluation of the biochemical and psychopathological characteristics in subjects with signs of pedophilia].

    PubMed

    Shostakovich, B V; Smirnova, L K; Tkachenko, A A; Ushakova, I M; Kartelishev, A V; Nikolaeva, T N

    1992-01-01

    RIA was employed to examine 54 test subjects who committed sexual crimes with regard to children of tender age. A syndrome of sexual perversions in the form of pedophilia was discovered in 42 persons. Different patients' groups manifested significant differences in the content of hypophyseal and sexual hormones in the blood serum. A significant lowering of testosterone was revealed in persons with heterosexual pedophilia and with pedophilia without any aggressive and sadistic disorders. They also demonstrated a high prolactin content.

  13. Executive Functioning in Pedophilia and Child Sexual Offending.

    PubMed

    Massau, Claudia; Tenbergen, Gilian; Kärgel, Christian; Weiß, Simone; Gerwinn, Hannah; Pohl, Alexander; Amelung, Till; Mohnke, Sebastian; Kneer, Jonas; Wittfoth, Matthias; Ristow, Inka; Schiltz, Kolja; Beier, Klaus M; Ponseti, Jorge; Walter, Martin; Kruger, Tillmann H C; Walter, Henrik; Schiffer, Boris

    2017-07-01

    Pedophilia (P) is a psychiatric disease associated with sexual attraction toward children and often accompanied by child sexual offending (CSO). Consequently, it is important to address the understanding of executive dysfunctions that may increase the probability of CSO. Moreover, this research field has been lacking to disentangle executive deficits associated with pedophilia (as a deviant sexual preference) from those associated with CSO (as a deviant sexual behavior). The German multi-sided research network NeMUP offers the opportunity to overcome these limitations. By applying the Cambridge Automated Neuropsychological Test Battery in four carefully matched groups of men: (1) pedophiles with (N=45) and (2) without (N=45) a history of sexual offending against children; (3) child molesters without pedophilia (N=19), and (4) non-offending controls (N=49), we were able to analyze executive functioning in pedophilia and CSO independently. Both CSO groups as compared to both non-CSO groups exhibited worsened response inhibition ability. However, only non-pedophilic offenders showed additionally disabled strategy use ability. Regarding set-shifting abilities, the P+CSO group showed the best performance. We also found that performances were affected by age: only in pedophiles, response inhibition worsened with age, while age-related deficits in set-shifting abilities were restricted to non-pedophilic participants. The latter also differentiated between both sexual preference groups. Our results are the first to demonstrate that executive dysfunctions are related to offense status rather than pedophilic preference. Furthermore, there was evidence for differentiating age and performance correlations between pedophiles and non-pedophiles, which warrants further investigation. (JINS, 2017, 23, 460-470).

  14. [Pedophilia--a review of literature, casuistics, doubts].

    PubMed

    Łucka, Izabela; Dziemian, Anna

    2014-01-01

    The main purpose of this article is presentation of several basic issues related to the phenomenon of child sexual molesters and recognition of pedophilia as a significant social problem. The article, supplemented by casuistic illustration showing adolescents with sexual behavior disorders is giving rise to the following question: do they progress in their inappropriate behaviors to grow into adult molesters or do they stop anywhere along the way of their development? Casuistry, in the intention of the authors, is the background for discussion about prevention of child sexual abuse. This article presents also a review of the current knowledge about child sexual molesters. The topics include: the definition of pedophilia itself, which varies in the literature depending on the types of activities, kinds of victims and the circumstances in which the perpetrator acts, through to the recognition of symptoms of pedophilia as well as its consequences. It includes both intra-familial and extra-familial child sexual abuse and their offenders. The more, that the history of child sexual abuse is associated with numerous long-term physical, psychological, behavioral, interpersonal and social effects on the victim. The examinations made among pedophilic molesters have shown structural and functional temporal-limbic abnormalities, including abnormalities in the amygdala and it is possible that the pedophilic inclinations are secondary to neurodevelopmental perturbations and other neuropsychiatric syndromes.

  15. Commentary on pedophilia diagnostic criteria in DSM-5.

    PubMed

    Berlin, Fred S

    2011-01-01

    Human beings differ in sexual makeup. Most adults are not sexually attracted to prepubescent children, but some are. Societal values can be of relevance in determining whether such a difference is considered to be a psychiatric condition. Were a society to believe that adult-child sexual interactions should not be prohibited, such a difference might not be viewed as a disorder. According to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), a difference in sexual makeup can be considered a disorder when it causes interpersonal difficulty or marked distress. In contemporary society, pedophilia can do both. According to DSM-IV-TR, for a diagnosis of pedophilia, there must be both a qualitative difference in sexual makeup (i.e., sexualized urges directed toward children) and a quantitative difference (i.e., the sexualized urges must be intense). However, just as a heterosexual man with low (i.e., nonintense) sexual urges is still heterosexual, DSM-5 should similarly allow that individuals with low sexual urges in response to children qualify for a diagnosis of pedophilia.

  16. Androgen deprivation therapy (castration therapy) and pedophilia: What's new.

    PubMed

    Silvani, Mauro; Mondaini, Nicola; Zucchi, Alessandro

    2015-09-30

    Andrology is a constantly evolving discipline, embracing social problems like pedophilia and its pharmacological treatment. With regard to chemical castration, the andrologist may perform an important role as part of a team of specialists. At present, no knowledge is available regarding hormonal, chromosomal or genetic alterations involved in pedophilia. International legislation primarily aims to defend childhood, but does not provide for compulsory treatment. We reviewed international literature that, at present, only comprises a few reports on research concerning androgen deprivation. Most of these refer to the use of leuprolide acetate, rather than medroxyprogesterone and cyproterone acetate, which present a larger number of side effects. Current opinions on chemical castration for pedophilia are discordant. Some surveys confirm that therapy reduces sexual thoughts and fantasies, especially in recidivism. On the other hand, some authors report that chemical castration does not modify the pedophile's personality. In our opinion, once existing legislation has changed, andrologists could play a significant role in the selection of patients to receive androgen deprivation therapy, due in part to their knowledge about its action and side effects.

  17. The utility of the diagnosis of pedophilia: a comparison of various classification procedures.

    PubMed

    Kingston, Drew A; Firestone, Philip; Moulden, Heather M; Bradford, John M

    2007-06-01

    This study examined the utility of the diagnosis of pedophilia in a sample of extra-familial child molesters assessed at a university teaching hospital between 1982 and 1992. Pedophilia was defined in one of four ways: (1) DSM diagnosis made by a psychiatrist; (2) deviant phallometric profile; (3) DSM diagnosis and a deviant phallometric profile; and, (4) high scores based on the Screening Scale for Pedophilic Interest (Seto & Lalumière, 2001). Demographic data, psychological tests, and offence history were obtained and group differences were analyzed along with the ability of certain variables to contribute uniquely to the classification of pedophilia. Results indicated that few significant differences existed on psychological measures between pedophilic and nonpedophilic extra-familial child molesters regardless of the classification system employed. Finally, results indicated that the procedures used to define pedophilia were not significantly related to one another. Results are discussed in terms of the utility of the diagnosis of pedophilia.

  18. Absolute versus relative ascertainment of pedophilia in men.

    PubMed

    Blanchard, Ray; Kuban, Michael E; Blak, Thomas; Cantor, James M; Klassen, Philip E; Dickey, Robert

    2009-12-01

    There are at least two different criteria for assessing pedophilia in men: absolute ascertainment (their sexual interest in children is intense) and relative ascertainment (their sexual interest in children is greater than their interest in adults). The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) used relative ascertainment in its diagnostic criteria for pedophilia; this was abandoned and replaced by absolute ascertainment in the DSM-III-R and all subsequent editions. The present study was conducted to demonstrate the continuing need for relative ascertainment, particularly in the laboratory assessment of pedophilia. A total of 402 heterosexual men were selected from a database of patients referred to a specialty clinic. These had undergone phallometric testing, a psychophysiological procedure in which their penile blood volume was monitored while they were presented with a standardized set of laboratory stimuli depicting male and female children, pubescents, and adults.The 130 men selected for the Teleiophilic Profile group responded substantially to prepubescent girls but even more to adult women; the 272 men selected for the Pedophilic Profile group responded weakly to prepubescent girls but even less to adult women. In terms of absolute magnitude, every patient in the Pedophilic Profile group had a lesser penile response to prepubescent girls than every patient in the Teleiophilic Profile group. Nevertheless, the Pedophilic Profile group had a significantly greater number of known sexual offenses against prepubescent girls, indicating that they contained a higher proportion of true pedophiles. These results dramatically demonstrate the utility-or perhaps necessity-of relative ascertainment in the laboratory assessment of erotic age-preference.

  19. Response inhibition in pedophilia: an FMRI pilot study.

    PubMed

    Habermeyer, Benedikt; Esposito, Fabrizio; Händel, Nadja; Lemoine, Patrick; Kuhl, Hans Christian; Klarhöfer, Markus; Mager, Ralph; Mokros, Andreas; Dittmann, Volker; Seifritz, Erich; Graf, Marc

    2013-01-01

    The failure to inhibit pleasurable but inappropriate urges is associated with frontal lobe pathology and has been suggested as a possible cause of pedophilic behavior. However, imaging and neuropsychological findings about frontal pathology in pedophilia are heterogeneous. In our study we therefore address inhibition behaviorally and by means of functional imaging, aiming to assess how inhibition in pedophilia is related to a differential recruitment of frontal brain areas. Eleven pedophilic subjects and 7 nonpedophilic controls underwent fMRI while performing a go/no-go task composed of neutral letters. Pedophilic subjects showed a slower reaction time and less accurate visual target discrimination. fMRI voxel-level ANOVA revealed as a main effect of the go/no-go task an activation of prefrontal and parietal brain regions in the no-go condition, while the left anterior cingulate, precuneus and gyrus angularis became more activated in the go condition. In addition, a group × task interaction was found in the left precuneus and gyrus angularis. This interaction was based on an attenuated deactivation of these brain regions in the pedophilic group during performance of the no-go condition. The positive correlation between blood oxygen level-dependent imaging signal and reaction time in these brain areas indicates that attenuated deactivation is related to the behavioral findings. Slower reaction time and less accurate visual target discrimination in pedophilia was accompanied by attenuated deactivation of brain areas belonging to the default mode network. Our findings thus support the notion that behavioral differences might also derive from self-related processes and not necessarily from frontal lobe pathology. © 2013 S. Karger AG, Basel.

  20. Pedophilia: neuropsychological evidence encouraging a brain network perspective.

    PubMed

    Tost, Heike; Vollmert, Christian; Brassen, Stefanie; Schmitt, Andrea; Dressing, Harald; Braus, Dieter F

    2004-01-01

    Although the vast majority of current pathogenetic theories support a neurobiological understanding of psychiatric disorders, the brain functional correlates of pedophilia are largely unknown. Based on prior behavior genetics research on human sexual orientation and phenomenology as well as the phenotypical intersection of pedophilia with other psychiatric spectrum disorders, we hypothesize the involvement of striato-thalamo-cortical processing loops in the formation of pedophilic urges and behaviors. Data from a current neuropsychological pilot study in four pedophiles encourage our brain functional perspective. As deduced from the network model, all four patients exhibited pronounced and circumscribed deficits in cognitive domains mediated by striato-thalamically controlled areas of the frontal cortex. All patients were especially impaired in neuropsychological functions associated with the prefrontal and motor processing loops (e.g., response inhibition, working memory and cognitive flexibility), with a performance level located up to five standard deviations below the normative data. Contrary to this, neuropsychological performances in cognitive domains without a comparable high frontal loading were in all participants unobtrusive. In future, studying gene by environment interactions in combination with functional neuroimaging and neuropsychological assessment is promising to elucidate the pathophysiological relationship of psychiatric disorders that are characterized by inadequate urges and poor behavioral inhibition. Copyright 2004 Elsevier Ltd.

  1. Association between brain structure and phenotypic characteristics in pedophilia.

    PubMed

    Poeppl, Timm B; Nitschke, Joachim; Santtila, Pekka; Schecklmann, Martin; Langguth, Berthold; Greenlee, Mark W; Osterheider, Michael; Mokros, Andreas

    2013-05-01

    Studies applying structural neuroimaging to pedophiles are scarce and have shown conflicting results. Although first findings suggested reduced volume of the amygdala, pronounced gray matter decreases in frontal regions were observed in another group of pedophilic offenders. When compared to non-sexual offenders instead of community controls, pedophiles revealed deficiencies in white matter only. The present study sought to test the hypotheses of structurally compromised prefrontal and limbic networks and whether structural brain abnormalities are related to phenotypic characteristics in pedophiles. We compared gray matter volume of male pedophilic offenders and non-sexual offenders from high-security forensic hospitals using voxel-based morphometry in cross-sectional and correlational whole-brain analyses. The significance threshold was set to p < .05, corrected for multiple comparisons. Compared to controls, pedophiles exhibited a volume reduction of the right amygdala (small volume corrected). Within the pedophilic group, pedosexual interest and sexual recidivism were correlated with gray matter decrease in the left dorsolateral prefrontal cortex (r = -.64) and insular cortex (r = -.45). Lower age of victims was strongly associated with gray matter reductions in the orbitofrontal cortex (r = .98) and angular gyri bilaterally (r = .70 and r = .93). Our findings of specifically impaired neural networks being related to certain phenotypic characteristics might account for the heterogeneous results in previous neuroimaging studies of pedophilia. The neuroanatomical abnormalities in pedophilia seem to be of a dimensional rather than a categorical nature, supporting the notion of a multifaceted disorder. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. IQ, handedness, and pedophilia in adult male patients stratified by referral source.

    PubMed

    Blanchard, Ray; Kolla, Nathan J; Cantor, James M; Klassen, Philip E; Dickey, Robert; Kuban, Michael E; Blak, Thomas

    2007-09-01

    This study investigated whether the previously observed association of pedophilia with lower IQs is an artifact of heterogeneity in referral source. The subjects were 832 adult male patients referred to a specialty clinic for evaluation of their sexual behavior. The patients' erotic preferences for prepubescent, pubescent, or adult partners were assessed with phallometric testing. Full scale IQ was estimated using six subtests from the WAIS-R. The results showed that the relations between pedophilia and lower IQ, lesser education, and increased rates of non-right-handedness were the same in homogeneous groups referred by lawyers or parole and probation officers as they were in a heterogeneous group referred by a miscellany of other sources. Those results, along with secondary analyses in the study, supported the conclusion that the relation between pedophilia and cognitive function is genuine and not artifactual. The findings were interpreted as evidence for the hypothesis that neurodevelopmental perturbations increase the risk of pedophilia in males.

  3. Impulsive personality traits in male pedophiles versus healthy controls: is pedophilia an impulsive-aggressive disorder?

    PubMed

    Cohen, Lisa J; Gans, Sniezyna Watras; McGeoch, Pamela G; Poznansky, Olga; Itskovich, Yelena; Murphy, Sean; Klein, Erik; Cullen, Ken; Galynker, Igor I

    2002-01-01

    Pedophilia is characterized by sexual attraction to prepubescent children. Despite the extensive literature documenting the pervasive and pernicious effects of childhood sexual abuse, there is surprisingly little psychiatric literature on pedophilia and its etiology remains enigmatic. In recent years, the psychiatric literature on the phenomenology, neurobiology, and treatment of impulsive-aggressive disorders has grown significantly. As some investigators have conceptualized pedophilia as an impulsive-aggressive disorder, it is of interest whether recent advances in the study of impulsive-aggressive disorders might shed light on pathological mechanisms underlying pedophilia. In the following study, 20 male subjects with a DSM-IV diagnosis of pedophilia, heterosexual type were recruited from an outpatient facility for sexual offenders and compared to 24 demographically similar control subjects. Groups were compared on three personality instruments--the Millon Clinical Multiaxial Inventory-II (MCMI-II), the Temperament and Character Inventory (TCI), and the Dimensional Assessment of Personality Impairment-Questionnaire (DAPI-Q)--to assess for select impairment in impulsive-aggressive personality traits. Pedophiles showed severe and pervasive personality impairment relative to controls. Although there was evidence of impulsivity, the findings do not suggest a predominance of impulsive-aggressive traits, and in fact provide evidence of inhibition, passive-aggression, and harm avoidance. The notion of "compulsive-aggression" in pedophilia is proposed.

  4. Lower omega-3 polyunsaturated fatty acids and lower docosahexaenoic acid in men with pedophilia.

    PubMed

    Mincke, Elda; Cosyns, Paul; Christophe, Armand B; De Vriese, Stephanie; Maes, Michael

    2006-12-01

    Previous studies have suggested that abnormalities in plasma phospholipid fatty acids may play a role in aggressive behavior. Recently, it was suggested that a dysfunctional serotonergic turnover in the brain may be involved in the etiopathology of pedophilia. Depletion of n-3 polyunsaturated fatty acids (PUFA) may cause alterations in the serotonergic system that may be related to pedophilia and aggression. This study examines the serum phospholipid n-3 and n-6 PUFA fractions in pedophilia. Twenty-seven pedophilic men and eighteen healthy volunteers participated in this study. In pedophilia there was a significant depletion of the C22:6n-3 (docosahexaenoic acid, DHA), total n-3 fractions and an increase in the total n-6/n-3 and C20:4n-6/C20:5n-3 (arachidonic acid/eicosapentaenoic acid) ratios. Using the NEO Personality Inventory, lower DHA in pedophiles is related to more impulsiveness and lower agreeableness (trust, altruism, straightforwardness, compliance) and conscientiousness (self-discipline). The results of this study suggest that a depletion of the serum phospholipid n-3 higher unsaturated fatty acids (HUFAs) and, in particular, of DHA may take part in the pathophysiology of pedophilia. One hypothesis is that a depletion of n-3 HUFAs and DHA may cause alterations in the serotonergic turnover, which are related to impulse discontrol and aggression-hostility, behaviors which are associated with pedophilia.

  5. Assessment of pedophilia using hemodynamic brain response to sexual stimuli.

    PubMed

    Ponseti, Jorge; Granert, Oliver; Jansen, Olav; Wolff, Stephan; Beier, Klaus; Neutze, Janina; Deuschl, Günther; Mehdorn, Hubertus; Siebner, Hartwig; Bosinski, Hartmut

    2012-02-01

    Accurately assessing sexual preference is important in the treatment of child sex offenders. Phallometry is the standard method to identify sexual preference; however, this measure has been criticized for its intrusiveness and limited reliability. To evaluate whether spatial response pattern to sexual stimuli as revealed by a change in the blood oxygen level-dependent signal facilitates the identification of pedophiles. During functional magnetic resonance imaging, pedophilic and nonpedophilic participants were briefly exposed to same- and opposite-sex images of nude children and adults. We calculated differences in blood oxygen level-dependent signals to child and adult sexual stimuli for each participant. The corresponding contrast images were entered into a group analysis to calculate whole-brain difference maps between groups. We calculated an expression value that corresponded to the group result for each participant. These expression values were submitted to 2 different classification algorithms: Fisher linear discriminant analysis and κ -nearest neighbor analysis. This classification procedure was cross-validated using the leave-one-out method. Section of Sexual Medicine, Medical School, Christian Albrechts University of Kiel, Kiel, Germany. We recruited 24 participants with pedophilia who were sexually attracted to either prepubescent girls (n = 11) or prepubescent boys (n = 13) and 32 healthy male controls who were sexually attracted to either adult women (n = 18) or adult men (n = 14). Sensitivity and specificity scores of the 2 classification algorithms. The highest classification accuracy was achieved by Fisher linear discriminant analysis, which showed a mean accuracy of 95% (100% specificity, 88% sensitivity). Functional brain response patterns to sexual stimuli contain sufficient information to identify pedophiles with high accuracy. The automatic classification of these patterns is a promising objective tool to clinically diagnose

  6. Diminished functional connectivity on the road to child sexual abuse in pedophilia.

    PubMed

    Kärgel, Christian; Massau, Claudia; Weiß, Simone; Walter, Martin; Kruger, Tillmann H C; Schiffer, Boris

    2015-03-01

    Pedophilia is a disorder recognized for its impairment to the individual and for the harm it may cause to others. However, the neurobiology of pedophilia and a possible propensity to sexually abuse children are not well understood. In this study, we thus aimed at providing new insights in how functional integration of brain regions may relate to pedophilia or child sexual abuse (CSA). By using functional magnetic resonance imaging (fMRI) technique, we compared functional connectivity at rest (RSFC) between pedophiles who engaged (P+CSA; N = 12) or did not engage (P-CSA; N = 14) in CSA and healthy controls (HCs; N = 14) within two networks: (i) the default mode network and (ii) the limbic network that has been linked to pedophilia before. Pedophiles who engaged in CSA show diminished RSFC in both networks compared with HC and P-CSA. Most importantly, they showed diminished RSFC between the left amygdala and orbitofrontal as well as anterior prefrontal regions. Though significant age differences between groups could not be avoided, correlation control analysis did not provide evidence for the assumption that the RSFC effects were related to age differences. We found significantly diminished RSFC in brain networks critically involved in widespread motivational and socio-emotional processes. These results extend existing models of the functional neuroanatomy of pedophilia and CSA as altered RSFC between these regions were related to CSA rather than pedophilia and thus may account for an increased propensity to engage in CSA in people suffering from pedophilia. © 2015 International Society for Sexual Medicine.

  7. [Pedophile, who are you? A study of pedophilia in the press].

    PubMed

    Landini, Tatiana Savoia

    2003-01-01

    This paper define the characteristics of pedophilia as it appears in the Brazilian newspaper Folha de São Paulo, including both the characteristics of the pedophile and the reasons given for such behavior. The research employs a technique called analysis by opposition which means that news coverage on other forms of sexual violence against children (sexual abuse, child pornography, rape, and incest) is used to help shed light on the characteristics of pedophilia itself. Some 384 articles were analyzed, of which 114 referred to pedophilia, all published between 1994 and 1999. News on sexual abuse of children was biased by concepts of class and violence/illness, reiterating the lay view that violence can be either a result of barbarianism and poverty or of psychological disorder, both depending on the aggressor's social class. The theoretical perspective adopted, that there is a correlation between media and reality, indicates that this bias is shared by Brazilian society as a whole.

  8. Structural brain abnormalities in the frontostriatal system and cerebellum in pedophilia.

    PubMed

    Schiffer, Boris; Peschel, Thomas; Paul, Thomas; Gizewski, Elke; Forsting, Michael; Leygraf, Norbert; Schedlowski, Manfred; Krueger, Tillmann H C

    2007-11-01

    Even though previous neuropsychological studies and clinical case reports have suggested an association between pedophilia and frontocortical dysfunction, our knowledge about the neurobiological mechanisms underlying pedophilia is still fragmentary. Specifically, the brain morphology of such disorders has not yet been investigated using MR imaging techniques. Whole brain structural T1-weighted MR images from 18 pedophile patients (9 attracted to males, 9 attracted to females) and 24 healthy age-matched control subjects (12 hetero- and 12 homosexual) from a comparable socioeconomic stratum were processed by using optimized automated voxel-based morphometry within multiple linear regression analyses. Compared to the homosexual and heterosexual control subjects, pedophiles showed decreased gray matter volume in the ventral striatum (also extending into the nucl. accumbens), the orbitofrontal cortex and the cerebellum. These observations further indicate an association between frontostriatal morphometric abnormalities and pedophilia. In this respect these findings may support the hypothesis that there is a shared etiopathological mechanism in all obsessive-compulsive spectrum disorders.

  9. Pedophilia: an evaluation of diagnostic and risk prediction methods.

    PubMed

    Wilson, Robin J; Abracen, Jeffrey; Looman, Jan; Picheca, Janice E; Ferguson, Meaghan

    2011-06-01

    One hundred thirty child sexual abusers were diagnosed using each of following four methods: (a) phallometric testing, (b) strict application of Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision [DSM-IV-TR]) criteria, (c) Rapid Risk Assessment of Sex Offender Recidivism (RRASOR) scores, and (d) "expert" diagnoses rendered by a seasoned clinician. Comparative utility and intermethod consistency of these methods are reported, along with recidivism data indicating predictive validity for risk management. Results suggest that inconsistency exists in diagnosing pedophilia, leading to diminished accuracy in risk assessment. Although the RRASOR and DSM-IV-TR methods were significantly correlated with expert ratings, RRASOR and DSM-IV-TR were unrelated to each other. Deviant arousal was not associated with any of the other methods. Only the expert ratings and RRASOR scores were predictive of sexual recidivism. Logistic regression analyses showed that expert diagnosis did not add to prediction of sexual offence recidivism over and above RRASOR alone. Findings are discussed within a context of encouragement of clinical consistency and evidence-based practice regarding treatment and risk management of those who sexually abuse children.

  10. Determinants of Punitive Attitudes Toward People with Pedophilia: Dissecting Effects of the Label and Intentionality Ascriptions.

    PubMed

    Imhoff, Roland; Jahnke, Sara

    2017-08-10

    Recent research has established marked punitive attitudes against people sexually interested in children. These negative attitudes are even more pronounced when such sexual interest is labeled as pedophilia, but are attenuated to the extent that such sexual interest is perceived as beyond one's own control (unintentional). We explored these effects in more detail by separately manipulating the label (pedophiles vs. people with sexual interest in prepubescent children) and degree of intentionality (pedophilia or sexual desire as malleable vs. not malleable). Participants recruited via an online platform (N = 423) were randomly assigned to the experimental conditions and asked to rate degree of intentionality, dangerousness, deviance, and punitive attitudes toward people sexually interested in children. As expected, participants expressed stronger punitive attitudes when the label was present. The manipulation of intentionality, however, was not successful. Further analyses explored whether participants found the notion that sexual interest cannot be altered at will more credible than the opposite, particularly in presence of the pedophilia label. The results are discussed with regard to the significance of and potential intervention against the markedly strong public stigma against people with pedophilia.

  11. Effects of Home Environment on the Development of Pedophilia: A Review of the Literature.

    ERIC Educational Resources Information Center

    Brown, James H.

    Pedophilia is the experience of recurrent intense sexual urges and sexually arousing fantasies involving sexual activity with a prepubescent child by a person (at least 16 years of age and 5 years older than the victim) who has acted on these urges. This research paper reviews research on the effects of parent-child relationships and home…

  12. A profile of pedophilia: definition, characteristics of offenders, recidivism, treatment outcomes, and forensic issues.

    PubMed

    Hall, Ryan C W; Hall, Richard C W

    2007-04-01

    Pedophilia has become a topic of increased interest, awareness, and concern for both the medical community and the public at large. Increased media exposure, new sexual offender disclosure laws, Web sites that list the names and addresses of convicted sexual offenders, politicians taking a 'get tough' stance on sexual offenders, and increased investigations of sexual acts with children have increased public awareness about pedophilia. Because of this increased awareness, it is important for physicians to understand pedophilia, its rate of occurrence, and the characteristics of pedophiles and sexually abused children. In this article, we address research that defines the various types and categories of pedophilia, review available federal data on child molestation and pornography, and briefly discuss the theories on what makes an individual develop a sexual orientation toward children. This article also examines how researchers determine if someone is a pedophile, potential treatments for pedophiles and sexually abused children, the risk of additional sexual offenses, the effect of mandatory reporting laws on both physicians and pedophiles, and limitations of the current pedophilic literature.

  13. Diagnostic accuracy of eye movements in assessing pedophilia.

    PubMed

    Fromberger, Peter; Jordan, Kirsten; Steinkrauss, Henrike; von Herder, Jakob; Witzel, Joachim; Stolpmann, Georg; Kröner-Herwig, Birgit; Müller, Jürgen Leo

    2012-07-01

    Given that recurrent sexual interest in prepubescent children is one of the strongest single predictors for pedosexual offense recidivism, valid and reliable diagnosis of pedophilia is of particular importance. Nevertheless, current assessment methods still fail to fulfill psychometric quality criteria. The aim of the study was to evaluate the diagnostic accuracy of eye-movement parameters in regard to pedophilic sexual preferences. Eye movements were measured while 22 pedophiles (according to ICD-10 F65.4 diagnosis), 8 non-pedophilic forensic controls, and 52 healthy controls simultaneously viewed the picture of a child and the picture of an adult. Fixation latency was assessed as a parameter for automatic attentional processes and relative fixation time to account for controlled attentional processes. Receiver operating characteristic (ROC) analyses, which are based on calculated age-preference indices, were carried out to determine the classifier performance. Cross-validation using the leave-one-out method was used to test the validity of classifiers. Pedophiles showed significantly shorter fixation latencies and significantly longer relative fixation times for child stimuli than either of the control groups. Classifier performance analysis revealed an area under the curve (AUC) = 0.902 for fixation latency and an AUC = 0.828 for relative fixation time. The eye-tracking method based on fixation latency discriminated between pedophiles and non-pedophiles with a sensitivity of 86.4% and a specificity of 90.0%. Cross-validation demonstrated good validity of eye-movement parameters. Despite some methodological limitations, measuring eye movements seems to be a promising approach to assess deviant pedophilic interests. Eye movements, which represent automatic attentional processes, demonstrated high diagnostic accuracy. © 2012 International Society for Sexual Medicine.

  14. Real-time functional magnetic imaging-brain-computer interface and virtual reality promising tools for the treatment of pedophilia.

    PubMed

    Renaud, Patrice; Joyal, Christian; Stoleru, Serge; Goyette, Mathieu; Weiskopf, Nikolaus; Birbaumer, Niels

    2011-01-01

    This chapter proposes a prospective view on using a real-time functional magnetic imaging (rt-fMRI) brain-computer interface (BCI) application as a new treatment for pedophilia. Neurofeedback mediated by interactive virtual stimuli is presented as the key process in this new BCI application. Results on the diagnostic discriminant power of virtual characters depicting sexual stimuli relevant to pedophilia are given. Finally, practical and ethical implications are briefly addressed. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Etiology of pedophilia from a neurodevelopmental perspective: markers and brain alterations.

    PubMed

    Becerra García, Juan Antonio

    2009-10-01

    Distinct signs have been associated with a wide range of neurodevelopmental disorders and warning signs of neural developmental problems have also been observed in pedophiles. Continuing this line of research, several neuroimaging studies have found neural alterations in this disorder. Pedophilia has been related to distinct indicators of neurodevelopmental alterations such as low intelligence quotient, left-handedness and smaller stature, among others. In addition, pedophiles show several neural alterations and a predominantly subcortical pattern of cerebral activation to sexual stimuli. The results of these studies suggest that the origin of pedophilia may partly lie in brain alterations due to problems during neural development, although these alterations do not absolve these persons of responsibility for their actions. Copyright © 2009 Sociedad Española de Psiquiatría and Sociedad Española de Psiquiatría Biológica. Published by Elsevier Espana. All rights reserved.

  16. Pedophilia: the problem with diagnosis and limitations of CBT in treatment.

    PubMed

    Studer, Lea H; Aylwin, A Scott

    2006-01-01

    This paper asserts two main points. First, there is little reason to include pedophilia among the mental disorders of the Diagnostic and Statistical Manual (DSM). The diagnostic criteria as specified in the DSM-IV-TR (2000) are both over-inclusive in that all acts of child molestation warrant diagnosis, and under-inclusive in that individuals who have not acted upon, and who are not distressed by their sexual interest in children do not meet diagnostic criteria. On both sides of this debate there are problems. A diagnosis of pedophilia seems to "medicalize" an illegal behavior, or "criminalize" fantasy; depending on the diagnostic criteria used, or the use made of the diagnosis. Secondly, the typical CBT-based relapse prevention treatment for pedophilia, which represents current best practice, is reviewed. It is suggested that this, as a stand alone therapy, is suboptimal. CBT components are necessary but not sufficient for comprehensive therapy. It is imperative that process issues are given primacy in treatment programs. The common factors literature makes it clear that the therapeutic relationship is at least as potent a factor promoting change as the system or techniques that clinicians employ. Diagnosis per se is not required for adequate treatment of these individuals. For the CBT components, some offence specific information is required but that is a far cry from true diagnosis.

  17. Stigmatizing attitudes towards people with pedophilia and their malleability among psychotherapists in training.

    PubMed

    Jahnke, Sara; Philipp, Kathleen; Hoyer, Juergen

    2015-02-01

    Offering counseling and psychotherapy to patients with pedophilia is considered an essential part of sexual abuse prevention by many experts in the field. Yet, professionals' willingness to offer treatment might be compromised by stigmatizing attitudes towards these patients. In the present study, we developed and tested a 10-min online intervention (including educational material and a video about a person with pedophilia) to reduce stigma and increase motivation to work with this particular patient group. Psychotherapists in training were either assigned to the anti-stigma intervention group (n=68) or the control group (n=69) that received information about violence-free parenting. In the anti-stigma condition, agreement with the stereotypes controllability and dangerousness, anger, reduced pity and social distance were significantly reduced after the intervention, compared to the control group, while motivation to work with this group remained unchanged. The effects persisted, though slightly reduced in size, for perceived controllability, anger and social distance at follow-up. Our results suggest that stigmatizing attitudes, negative affective responses and social distance regarding people with pedophilia among psychotherapists in training can be positively influenced by a low-cost intervention. Practical implications of these findings for high quality health care and child sexual abuse prevention are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Why Information Matters: Examining the Consequences of Suggesting That Pedophilia Is Immutable.

    PubMed

    Tozdan, Safiye; Kalt, Anna; Dekker, Arne; Keller, Livia B; Thiel, Stephanie; Müller, Jürgen L; Briken, Peer

    2016-11-18

    In this study, the impact of suggesting that pedophilia is immutable on a man's specific self-efficacy for modifying his sexual interest in children was examined in 94 men with a sexual interest in children. The participants were selected from differing contexts and included non-forensic patients, forensic patients, and participants from the Internet. Randomly distributed to two conditions, the mutable condition group received the information that experts consider pedophilia to be modifiable, whereas the immutable condition group received the information that experts consider pedophilia to be stable. Afterward, the participants' levels of specific self-efficacy for modifying their sexual interest in children were assessed. Non-forensic participants in the mutable condition reported higher levels of specific self-efficacy than those in the immutable condition. No differences in specific self-efficacy were revealed for the forensic and Internet participants when comparing the mutable and immutable conditions. It would appear appropriate to avoid generalized and absolute statements about the (im)mutability of sexual interest in children, as scientific research on this topic remains insufficient. Furthermore, given the present results, such statements might have serious consequences for an individual's belief in being able to change his sexual interest in children. © The Author(s) 2016.

  19. Prescription of medroxyprogesterone acetate to a patient with pedophilia, resulting in Cushing's syndrome and adrenal insufficiency.

    PubMed

    Krueger, Richard B; Hembree, Wylie; Hill, Michael

    2006-04-01

    This article provides a case report of a patient with pedophilia who was treated over a 4-year period with medroxyprogesterone acetate (MPA) at a dose of 300 mg/day and as a consequence developed Cushing's Syndrome and adrenal insufficiency, for which he was treated and from which he recovered. He also reported a hypersexual reaction to his own past cessation of MPA. Gonadotropin-releasing hormone agonists, which have a more benign side-effect profile than MPA, are suggested as an alternative to MPA.

  20. Minor Physical Anomalies as a Window into the Prenatal Origins of Pedophilia.

    PubMed

    Dyshniku, Fiona; Murray, Michelle E; Fazio, Rachel L; Lykins, Amy D; Cantor, James M

    2015-11-01

    Evidence is steadily accumulating to support a neurodevelopmental basis for pedophilia. This includes increased incidence of non-right-handedness, which is a result primarily of prenatal neural development and solidified very early in life. Minor physical anomalies (MPAs; superficial deviations from typical morphological development, such as un-detached earlobes) also develop only prenatally, suggesting them as another potential marker of atypical physiological development during the prenatal period among pedophiles. This study administered the Waldrop Physical Anomaly Scale to assess the prevalence of MPAs in a clinical sample of men referred for assessment following a sexual assault, or another illegal or clinically significant sexual behavior. Significant associations emerged between MPA indices and indicators of pedophilia, including penile responses to depictions of children, number of child victims, and possession of child pornography. Moreover, greater sexual attraction to children was associated with an elevated craniofacial-to-peripheral anomalies ratio. The overall sample demonstrated a greater number of MPAs relative to prior samples of individuals with schizophrenia as well as to healthy controls.

  1. The basis of the abused abuser theory of pedophilia: a further elaboration on an earlier study.

    PubMed

    Freund, K; Kuban, M

    1994-10-01

    The connection between the retrospective self-report of sexual abuse in childhood by an adult person, and (i) erotically preferred age bracket and (ii) type of offense, was investigated in 303 heterosexual males. This group consisted of 83 pedophilic sex offenders against female children, 52 sex offenders against female children who erotically preferred adult women, 34 sex offenders against adult women, and 134 volunteer controls. An earlier exploratory investigation with somewhat smaller numbers of individuals had rendered only ambiguous results. After regrouping of individuals and more precise analysis of results, the present study demonstrated that the self-report of having been sexually abused in childhood is mainly connected with pedophilia. Status as a sex offender in general was not related to childhood abuse.

  2. Pedophilia is linked to reduced activation in hypothalamus and lateral prefrontal cortex during visual erotic stimulation.

    PubMed

    Walter, Martin; Witzel, Joachim; Wiebking, Christine; Gubka, Udo; Rotte, Michael; Schiltz, Kolja; Bermpohl, Felix; Tempelmann, Claus; Bogerts, Bernhard; Heinze, Hans Jochen; Northoff, Georg

    2007-09-15

    Although pedophilia is of high public concern, little is known about underlying neural mechanisms. Although pedophilic patients are sexually attracted to prepubescent children, they show no sexual interest toward adults. This study aimed to investigate the neural correlates of deficits of sexual and emotional arousal in pedophiles. Thirteen pedophilic patients and 14 healthy control subjects were tested for differential neural activity during visual stimulation with emotional and erotic pictures with functional magnetic resonance imaging. Regions showing differential activations during the erotic condition comprised the hypothalamus, the periaqueductal gray, and dorsolateral prefrontal cortex, the latter correlating with a clinical measure. Alterations of emotional processing concerned the amygdala-hippocampus and dorsomedial prefrontal cortex. Hypothesized regions relevant for processing of erotic stimuli in healthy individuals showed reduced activations during visual erotic stimulation in pedophilic patients. This suggests an impaired recruitment of key structures that might contribute to an altered sexual interest of these patients toward adults.

  3. Leg Length Versus Torso Length in Pedophilia: Further Evidence of Atypical Physical Development Early in Life.

    PubMed

    Fazio, Rachel L; Dyshniku, Fiona; Lykins, Amy D; Cantor, James M

    2017-08-01

    Adult men's height results from an interaction among positive and negative influences, including genetic predisposition, conditions in utero, and influences during early development such as nutritional quality, pathogen exposure, and socioeconomic status. Decreased height, reflected specifically as a decreased leg length, is strongly associated with increased risk of poorer health outcomes. Although prior research has repeatedly shown that pedophiles are shorter than nonpedophiles, the largest study to date relied on self-reported height. In the present study, pedophiles demonstrated reduced measured height and reduced leg length as compared with teleiophiles. Given the prenatal and early childhood origins of height, these findings contribute additional evidence to a biological, developmental origin of pedophilia. In addition, the magnitude of this height difference was substantially larger than that found in children exposed to a variety of early environmental stressors, but similar to that seen in other biologically based neurodevelopmental disorders.

  4. The struggle to maintain neutrality in the treatment of patient with pedophilia.

    PubMed

    Lally, Matthew C; Freeman, Scott A

    2005-01-01

    This article explores the ethical concept of neutrality through use of a psychiatric clinical vignette. In this case a psychiatry resident is faced with the treatment of a patient who was found by the FBI to be in possession of child pornography. Although not accused of any other crimes, the patient was a fugitive from the law and requesting treatment for pedophilia. Faced with the pressures of limited resources and anxiety about the patient's dangerousness to others, the resident and his supervisor tried to strike a balance between the ethical principles of neutrality and beneficence. Through this vignette, the importance of neutrality, as well as how it can be compromised by other pressures such as expediency and anxiety, is explored.

  5. LH-RH agonists modulate amygdala response to visual sexual stimulation: a single case fMRI study in pedophilia.

    PubMed

    Habermeyer, Benedikt; Händel, Nadja; Lemoine, Patrick; Klarhöfer, Markus; Seifritz, Erich; Dittmann, Volker; Graf, Marc

    2012-01-01

    Pedophilia is characterized by a persistent sexual attraction to prepubescent children. Treatment with anti-androgen agents, such as luteinizing hormone-releasing hormone (LH-RH) agonists, reduces testosterone levels and thereby sexual drive and arousal. We used functional magnetic resonance imaging (fMRI) to compare visual erotic stimulation pre- and on-treatment with the LH-RH agonist leuprolide acetate in the case of homosexual pedophilia. The pre-treatment contrasts of the erotic pictures against the respective neutral pictures showed an activation of the right amygdala and adjacent parahippocampal gyrus that decreased significantly under treatment with leuprolide acetate. Our single case fMRI study supports the notion that anti-androgens may modify amygdala response to visual erotic stimulation, a hypothesis that should be further examined in larger studies.

  6. Potential implications of research on genetic or heritable contributions to pedophilia for the objectives of criminal law.

    PubMed

    Berryessa, Colleen M

    2014-01-01

    In recent years, there has been increasing scientific research on possible genetic or heritable influences to the etiology of pedophilia, driven by national and public concerns about better understanding the disorder in order to reduce children's vulnerabilities to pedophilic and child sex offenders. This research has corresponded to growing academic dialogue on how advances in genetic research, especially concerning the causes and development of particular mental disorders or behaviors, may affect traditional practices of criminal law and how the justice system views, manages, and adjudicates different types of criminal behavior and offenders. This paper strives to supplement this dialogue by exploring several of the many possible effects and implications of research surrounding genetic or heritable contributions to pedophilia for the five widely accepted objectives that enforce and regulate the punishment of criminal law. These include retribution, incapacitation, deterrence, rehabilitation, and restoration. Although still currently in early stages, genetic and heritability research on the etiology of pedophilia may have the potential moving forward to influence the current and established punitive methods and strategies of how the justice system perceives, adjudicates, regulates, and punishes pedophilic and sex offenders, as well as how to best prevent sexual offending against children by pedophilic offenders in the future.

  7. Potential Implications of Research on Genetic or Heritable Contributions to Pedophilia for the Objectives of Criminal Law

    PubMed Central

    Berryessa, Colleen M.

    2015-01-01

    In recent years, there has been increasing scientific research on possible genetic or heritable influences to the etiology of pedophilia, driven by national and public concerns about better understanding the disorder in order to reduce children’s vulnerabilities to pedophilic and child sex offenders. This research has corresponded to growing academic dialogue on how advances in genetic research, especially concerning the causes and development of particular mental disorders or behaviors, may affect traditional practices of criminal law and how the justice system views, manages, and adjudicates different types of criminal behavior and offenders. This paper strives to supplement this dialogue by exploring several of the many possible effects and implications of research surrounding genetic or heritable contributions to pedophilia for the five widely accepted objectives that enforce and regulate the punishment of criminal law. These include retribution, incapacitation, deterrence, rehabilitation, and restoration. Although still currently in early stages, genetic and heritability research on the etiology of pedophilia may have the potential moving forward to influence the current and established punitive methods and strategies of how the justice system perceives, adjudicates, regulates, and punishes pedophilic and sex offenders, as well as how to best prevent sexual offending against children by pedophilic offenders in the future. PMID:25557668

  8. The inclusion of child pornography in the DSM-5 diagnostic criteria for pedophilia: conceptual and practical problems.

    PubMed

    First, Michael B

    2011-01-01

    The proposal to add use of child pornography to Criterion B of pedophilia is in direct conflict with the newly proposed distinction between paraphilia and paraphilic disorder, muddying rather than clarifying the diagnostic definition of pedophilia. The proposal to distinguish paraphilic disorder from paraphilia derives from the fact that the diagnostic criteria for the paraphilias have two components: Criterion A, defining the presence of a paraphilic erotic interest, and Criterion B, requiring clinically significant distress, impairment, or acting out the paraphilia with a nonconsenting person. Meeting Criteria A and B is necessary for a diagnosis of paraphilic disorder; meeting only Criterion A indicates a paraphilia. Use of pornography is better placed within Criterion A, perhaps as an example of a behavioral manifestation of pedophilia. If the Sexual and Gender Identity Disorders Work Group's true intent was to add a third prong to Criterion B, then the criterion must be modified to restrict it to the use of illegal forms of pornography (i.e., visual depictions of real children), excluding written or aural forms or virtual images.

  9. Comparison of childhood sexual histories in subjects with pedophilia or opiate addiction and healthy controls: is childhood sexual abuse a risk factor for addictions?

    PubMed

    Cohen, Lisa J; Forman, Howard; Steinfeld, Matthew; Fradkin, Yuli; Frenda, Steven; Galynker, Igor

    2010-11-01

    Given the recent interest in the concept of sexual addictions, it is instructive to study subjects with pedophilia alongside chemically addicted individuals and non-addicted controls in order to help identify which factors may determine the objects of people's respective addictions, as well as any factors that may predispose people to developing an addictive disorder. In this study, we considered whether childhood sexual abuse (CSA) is a specific risk factor for pedophilia as opposed to other types of addictive disorders by comparing the childhood sexual histories of 48 pedophilic sex offenders, 25 subjects with opiate addiction in remission, and 61 healthy controls. CSA was assessed with The Sexual History Questionnaire and the Child Trauma Questionnaire (CTQ). Compared with both opiate addicted subjects and healthy controls, subjects with pedophilia were more likely to report experiencing adult sexual advances when they were children and a first sexual contact by age 13 with a partner at least 5 years older. Although both subjects with pedophilia and those with opiate addiction first had sex at a younger age than healthy controls, opiate addicted subjects, compared with healthy controls, reported neither increased reception of sexual advances as children nor increased rates of first sexual contact before age 13 with a partner at least 5 years older. Further, subjects with pedophilia but not those with opiate addiction scored significantly higher than healthy controls on the CTQ. Sexual abuse in childhood may be a specific risk factor for sexual addictions such as pedophilia but may not be a specific risk factor for chemical addictions.

  10. History of abuse and organic difficulties in a convenience sample of 46 ultra-orthodox males with pedophilia.

    PubMed

    Witztum, Eliezer; Daie, Netzer; Daie-Gabai, Ayala; Rosler, Ariel

    2012-01-01

    Evidence has started to accumulate that relates pedophilia to a history of being a victim of sexual abuse as well as to comorbidity with organic vulnerabilities. During a naturalistic study regarding treatment of pedophilia, the authors had access to clinical and psychodiagnostic evaluations of Israeli Jewish ultraorthodox male pedophiles outside the forensic system. Using psychiatric examination as well as a battery of psychological tests, presence of history of trauma as well as comorbidity with organic vulnerabilities among this unique sub-group was examined. This survey was part of a larger scale research on the effectiveness of Decapeptyl injections as treatment for pedophilia. All participants in the original research underwent comprehensive psychological assessment including an extensive clinical interview as well as psychological tests (Bender, Rorschach and TAT). Of the patients participating in the research, this survey focused on the group of 46 ultra-orthodox male pedophiles. Cross-tabs analyses were conducted in order to examine prevalence of history of trauma and organic vulnerabilities in this specific group. Based on self reports combined with corroborating reports (obtained from parents, educators and medical staff), together with indications in psychological tests, we found that 82.6% of participants were victims of sexual trauma as children and 87% suffer from some kind of organic vulnerability (learning disabilities, disinhibitions, etc.). LIMITATIONS of this small convenience sample that influence ability to generalize are discussed. The current survey indicates that in this sample, the ultra-orthodox male pedophile was frequently a victim of childhood sexual trauma, and exhibited indications of organic vulnerabilities. This is more pronounced than findings in previous studies, and calls for further research in order to understand the underlying causes.

  11. Comparison of personality traits in pedophiles, abstinent opiate addicts, and healthy controls: considering pedophilia as an addictive behavior.

    PubMed

    Cohen, Lisa J; Grebchenko, Yuli F; Steinfeld, Matthew; Frenda, Steven J; Galynker, Igor I

    2008-11-01

    To investigate the model of pedophilia as a disorder of addictive behavior, pedophiles and chemically addicted individuals were compared on personality traits potentially associated with impaired behavioral inhibition. Twenty-nine pedophiles, 25 opiate addicts (OA's), and 27 healthy controls were administered the Barratt Impulsivity Scale, Hare Psychopathy Checklist-Revised (PCL-R), and Structured Clinical Interview for DSM-V for Axis-II. OA's scored higher than either pedophiles or controls on the Barratt. Pedophiles and OA's scored higher than controls on all 3 Psychopathy Checklist-Revised scores but OA's scored marginally higher than pedophiles on factor 2 (behavioral) and total scores. On Structured Clinical Interview for DSM-V for Axis-II, pedophiles scored higher than controls on paranoid and schizoid scores whereas OA's did so on paranoid scores. Thus, both pedophiles and OA's may have elevated psychopathic traits and propensity toward cognitive distortions, as reflected in cluster A traits. Such similarities support the conceptualization of pedophilia as a behavioral addiction. Pedophiles may be less impulsive than OA's, however, and more prone toward cognitive distortions.

  12. Investigating the relationship between sexual and chemical addictions by comparing executive function in subjects with pedophilia or opiate addiction and healthy controls.

    PubMed

    Cohen, Lisa J; Nesci, Cristina; Steinfeld, Matthew; Haeri, Sophia; Galynker, Igor

    2010-11-01

    Disorders of driven sexual behavior have been conceptualized as sexual addictions. In the following study, we compared 51 subjects with pedophilia, 53 subjects with opiate addiction, and 84 healthy control subjects on neuropsychological tests that tap executive functions. The test battery included the Wisconsin Card Sorting Test (WCST), Stroop Color-Word Test, the Matching Familiar Figures Test (MFFT), Porteus Mazes, Controlled Word Association (COWA), and Trailmaking Test. The groups differed on tests of cognitive flexibility and set switching (WCST), sustained attention (Stroop), and impulsivity (MFFT and Porteus Mazes). There were no differences on verbal fluency (COWA). The subjects with pedophilia differed significantly from those with opiate addiction on several tests, with longer latency to response on MFFT and fewer completed mazes but also fewer errors on Porteus Mazes. Thus, while both subjects with pedophilia and those with opiate addiction show executive dysfunction, the nature of that dysfunction may differ between the two groups; specifically, opiate addicted subjects may be more prone to cognitive impulsivity.

  13. Lay theories of etiology and "cure" for four types of paraphilia: fetishism; pedophilia; sexual sadism; and voyeurism.

    PubMed

    Furnham, A; Haraldsen, E

    1998-08-01

    The current study set out to investigate the structure, determinants, and relationship between lay theories of the etiology and efficacy of "cures" for four types of paraphilia: fetishism, pedophilia, sexual sadism, and voyeurism. One hundred and five participants completed a four-part questionnaire, which was divided into (a) demographic details, (b) perceptions of the etiology, (c) ratings of cure for each paraphilia, and (d) the Eysenck Personality Questionnaire. Previous studies of lay theories have demonstrated a clear and interpretable factor structure similar to that of explicit academic theories, as well as a clear and logical relationship between perceived etiology and cure. A similar structure was expected to emerge in this study, together with positive correlations between the various factors and personality type. A factor analysis revealed a clear and logical factor structure for etiology and cure items. Further, etiology and cure factors correlated strongly with each other but only moderately with demographic details and personality differences. These findings are discussed in relation to growing literature in the field.

  14. Pedophilia-Themed Obsessive-Compulsive Disorder: Assessment, Differential Diagnosis, and Treatment with Exposure and Response Prevention.

    PubMed

    Bruce, Simone Leavell; Ching, Terence H W; Williams, Monnica T

    2017-08-18

    Fears of sexually harming children are fairly common among clients suffering from obsessive-compulsive disorder (OCD), yet these symptoms are largely unrecognized and frequently misdiagnosed by mental health professionals. Specifically, clients with pedophilia-themed OCD (P-OCD) experience excessive worries and distressing intrusive thoughts about being sexually attracted to, and sexually violating, children. Expressing these concerns may provoke misjudgments from uninformed mental health professionals that a client is presenting instead with pedophilic disorder. This misdiagnosis and subsequent improper interventions can then contribute to increased fear, anxiety, and in many cases, depression, in affected clients. Therefore, it is imperative that mental health professionals first possess a good understanding of this common manifestation of OCD. As such, in this article, we described obsessions and compulsions typical of P-OCD, in order to inform the reader of the distinctive differences between P-OCD and pedophilic disorder. Information about how to assess for P-OCD symptoms is then provided, followed by suggestions on how to tailor aspects of exposure and response prevention to treat this specific form of OCD.

  15. Functional cortical and subcortical abnormalities in pedophilia: a combined study using a choice reaction time task and fMRI.

    PubMed

    Poeppl, Timm B; Nitschke, Joachim; Dombert, Beate; Santtila, Pekka; Greenlee, Mark W; Osterheider, Michael; Mokros, Andreas

    2011-06-01

    Pedophiles show sexual interest in prepubescent children but not in adults. Research into the neurofunctional mechanisms of paraphilias has gathered momentum over the last years. To elucidate the underlying neural processing of sexual interest among pedophiles and to highlight the differences in comparison with nonparaphilic sexual interest in adults. Nine pedophilic patients and 11 nonpedophilic control subjects underwent functional magnetic resonance imaging (fMRI) while viewing pictures of nude (prepubescents, pubescents, and adults) and neutral content, as well as performing a concomitant choice reaction time task (CRTT). Brain blood oxygen level-dependent (BOLD) signals and response latencies in the CRTT during exposure to each picture category. Analysis of behavioral data showed group differences in reaction times regarding prepubescent and adult but not pubescent stimuli. During stimulation with pictures displaying nude prepubescents, pedophiles showed increased BOLD response in brain areas known to be involved in processing of visual sexual stimuli. Comparison of pedophilic patients with the control group discovered differences in BOLD responses with respect to prepubescent and adult but not to pubescent stimuli. Differential effects in particular occurred in the cingulate gyrus and insular region. The brain response of pedophiles to visual sexual stimulation by images of nude prepubescents is comparable with previously described neural patterns of sexual processing in nonpedophilic human males evoked by visual stimuli depicting nude adults. Nevertheless, group differences found in the cingulate gyrus and the insular region suggest an important role of these brain areas in pedophilic sexual interest. Furthermore, combining attention-based methods like CRTT with fMRI may be a viable option for future diagnostic procedures regarding pedophilia. © 2011 International Society for Sexual Medicine.

  16. A pilot study of the effects of gonadotropin-releasing hormone agonist therapy on brain activation pattern in a man with pedophilia.

    PubMed

    Moulier, Virginie; Fonteille, Véronique; Pélégrini-Issac, Mélanie; Cordier, Bernard; Baron-Laforêt, Sophie; Boriasse, Emeline; Durand, Emmanuel; Stoléru, Serge

    2012-02-01

    Gonadotropin-releasing hormone (GnRH) agonists, such as leuprorelin, are recommended in the patients with pedophilia at highest risk of offending. However, the cerebral mechanisms of the effects of these testosterone-decreasing drugs are poorly known. This study aimed to identify changes caused by leuprorelin in a pedophilic patient's brain responses to pictures representing children. Clinical, endocrine, and fMRI investigations were done of a man with pedophilia before leuprorelin therapy and 5 months into leuprorelin therapy. Patient was compared with an age-matched healthy control also assessed 5 months apart. Before therapy, pictures of boys elicited activation in the left calcarine fissure, left insula, anterior cingulate cortex, and left cerebellar vermis. Five months into therapy, all the above-mentioned activations had disappeared. No such activations and, consequently, no such decreases occurred in the healthy control. The results of this pilot study suggest that leuprorelin decreased activity in regions known to mediate the perceptual, motivational, and affective responses to visual sexual stimuli.

  17. Reliability and validity of the DSM-IV-TR and proposed DSM-5 criteria for pedophilia: Implications for the ICD-11 and the next DSM.

    PubMed

    Seto, Michael C; Fedoroff, J Paul; Bradford, John M; Knack, Natasha; Rodrigues, Nicole C; Curry, Susan; Booth, Brad; Gray, Jonathan; Cameron, Colin; Bourget, Dominique; Messina, Sarina; James, Elizabeth; Watson, Diane; Gulati, Sanjiv; Balmaceda, Rufino; Ahmed, Adekunle G

    We tested the inter-rater reliability and criterion-related validity of the DSM-IV-TR pedophilia diagnosis and proposed DSM-5 pedohebephilia diagnosis in a sample of 79 men who had committed child pornography offenses, contact sexual offenses against children, or who were referred because of concerns about whether they had a sexual interest in children. Participants were evaluated by two independent psychiatrists with an interview and questionnaire regarding demographic characteristics, sexual history, and self-reported sexual interests; they also completed phallometric and visual reaction time testing. Kappa was .59 for ever meeting DSM-IV-TR criteria for pedophilia and .52 for ever meeting the proposed DSM-5 criteria for pedohebephilia. Ever meeting DSM-IV-TR diagnosis was significantly related to self-reported index of sexual interest in children (highest AUC=.81, 95% CI=.70-.91, p<.001) and to indices of sexual interest in children from phallometric testing (AUC=.70; 95% CI=.52-.89; p<.05) or a computerized assessment based on visual reaction time and self-report (AUC=.75; 95% CI=.62-.88; p<.005). Ever meeting the proposed DSM-5 "diagnosis" was similarly related to self-report (AUC=.84, 95% CI=.74-.94, p<.001) and to the two objective indices, with AUCs of .69 (95% CI=.53-.85; p<.05) and .77 (95% CI=.64-.89; p<.001), respectively. Because the pDSM-5 criteria did not produce significantly better reliability or validity results and users are more familiar with the current DSM-5 criteria, we believe these results suggest the revision of DSM-5 and development of ICD-11 could benefit from drawing on the current DSM-5 criteria, which are essentially the same as DSM-IV-TR except for a distinction between having a paraphilia (the interest) and a paraphilic disorder (the paraphilia plus clinically significant distress or impairment).

  18. Pedophilia and the Culture Wars.

    ERIC Educational Resources Information Center

    Zuriff, G. E.

    2000-01-01

    Discusses reaction to research findings published in a journal of the American Psychological Association (APA) which concluded that classifying sexual behavior between adults and children as abuse merely because it is considered illegal or immoral, even in the absence of harm, is not scientifically valid. Notes the APA's stand on the study's…

  19. Erotic gender differentiation in pedophilia.

    PubMed

    Freund, K; Watson, R; Dickey, R; Rienzo, D

    1991-12-01

    Five groups of males were compared on penile volume changes elicited from viewing short movie strips and slides of nude children and adults of both genders. Subject groups were sex offenders against adult females, volunteer controls who erotically preferred adult females, volunteer controls who erotically preferred adult males, heterosexual pedophiles, and homosexual pedophiles. Pedophiles differentiated erotically between females and males less than males who erotically preferred physically mature partners.

  20. The Genesis of Pedophilia: Testing the "Abuse-to-Abuser" Hypothesis.

    ERIC Educational Resources Information Center

    Fedoroff, J. Paul; Pinkus, Shari

    1996-01-01

    This study tested three versions of the "abuse-to-abuser" hypothesis by comparing men with personal histories of sexual abuse and men without sexual abuse histories. There was a statistically non-significant trend for assaulted offenders to be more likely as adults to commit genital assaults on children. Implications for the abuse-to-abuser…

  1. The study of intergenerational intimacy in North America: beyond politics and pedophilia.

    PubMed

    Jones, G P

    1990-01-01

    Intergenerational intimacy, social as well as sexual, has been studied in the United States and abroad for some time. In recent years the general trend has been to label such behavior "child sexual abuse." Interest in this type of abuse has generated a considerable amount of more or less scientific literature, some of which seems to have been produced in a "rush to judgment" attempt to build a "professional" literature that supports popular beliefs. This tradition of child-abuse-defined literature, along with the work of investigative and helping agencies which some refer to as a "child abuse industry," has fostered a one-sided, simplistic picture of intergenerational intimacy. A close look at the empirical studies in this tradition reveals flaws associated with two problems: the studies nearly always (1) maintain a narrow focus on sexual contact, and (2) proceed from the related basic assumption that sexual contact in intergenerational relationships by definition constitutes abuse. While sexual abuse certainly occurs, those who apply this assumption to all situations are ignoring empirical findings that show otherwise. Research outside the "child sexual abuse" tradition reveals a broader range of intergenerational relationships outside the family, including a number of aspects which typically are not seen when the focus is on the sexual. Some studies show clearly that even when sexual contact is involved, negative outcomes are not inevitable. This indicates the need for a much broader approach. Further research in North American society and in other cultures would help us to understand more accurately the diversity and possible benefits of intergenerational intimacy.

  2. Toward a Testable Developmental Model of Pedophilia: The Development of Erotic Age Preference.

    ERIC Educational Resources Information Center

    Freund, Kurt; Kuban, Michael

    1993-01-01

    Analysis of retrospective self-reports about childhood curiosity to see persons in the nude, with heterosexual and homosexual pedophiles, gynephiles, and androphiles, suggests that establishment of erotic sex preference proceeded that of age preference, and a greater proportion of pedophiles than gynephiles or androphiles remembered childhood…

  3. Toward a Testable Developmental Model of Pedophilia: The Development of Erotic Age Preference.

    ERIC Educational Resources Information Center

    Freund, Kurt; Kuban, Michael

    1993-01-01

    Analysis of retrospective self-reports about childhood curiosity to see persons in the nude, with heterosexual and homosexual pedophiles, gynephiles, and androphiles, suggests that establishment of erotic sex preference proceeded that of age preference, and a greater proportion of pedophiles than gynephiles or androphiles remembered childhood…

  4. The relation between peak response magnitudes and agreement in diagnoses obtained from two different phallometric tests for pedophilia.

    PubMed

    Lykins, Amy D; Cantor, James M; Kuban, Michael E; Blak, Thomas; Dickey, Robert; Klassen, Philip E; Blanchard, Ray

    2010-03-01

    Phallometric testing is widely considered the best psychophysiological procedure for assessing erotic preferences in men. Researchers have differed, however, on the necessity of setting some minimum criterion of penile response for ascertaining the interpretability of a phallometric test result. Proponents of a minimum criterion have generally based their view on the intuitive notion that "more is better" rather than any formal demonstration of this. The present study was conducted to investigate whether there is any empirical evidence for this intuitive notion, by examining the relation between magnitude of penile response and the agreement in diagnoses obtained in two test sessions using different laboratory stimuli. The results showed that examinees with inconsistent diagnoses responded less on both tests and that examinees with inconsistent diagnoses responded less on the second test after controlling for their response on the first test. Results also indicated that at response levels less than 1 cm(3), diagnostic consistency was no better than chance, supporting the establishment of a minimum response level criterion.

  5. A skin on fire: the link between thermal metaphors and early trauma in a case of pedophilia.

    PubMed

    Houssier, Florian; Duchet, C; Chagnon, Jean-Yves; Robert, Philippe; Marty, Francois

    2011-03-01

    On the basis of excerpts from the psychoanalytic psychotherapy of an adult patient convicted of child abuse, the authors suggest the hypothesis that the thermal metaphors that repeatedly appear in the patient's discourse are the marks of early psycho-bodily trauma. These are traces of the patient's burning incestuous relationship with his mother, which led to early fusion of his physical and psychic skins. In this clinical work the authors include the dynamics of transference.

  6. Changed processing of visual sexual stimuli under GnRH-therapy--a single case study in pedophilia using eye tracking and fMRI.

    PubMed

    Jordan, Kirsten; Fromberger, Peter; Laubinger, Helge; Dechent, Peter; Müller, Jürgen L

    2014-05-17

    Antiandrogen therapy (ADT) has been used for 30 years to treat pedophilic patients. The aim of the treatment is a reduction in sexual drive and, in consequence, a reduced risk of recidivism. Yet the therapeutic success of antiandrogens is uncertain especially regarding recidivism. Meta-analyses and reviews report only moderate and often mutually inconsistent effects. Based on the case of a 47 year old exclusively pedophilic forensic inpatient, we examined the effectiveness of a new eye tracking method and a new functional magnetic resonance imaging (fMRI)-design in regard to the evaluation of ADT in pedophiles. We analyzed the potential of these methods in exploring the impact of ADT on automatic and controlled attentional processes in pedophiles. Eye tracking and fMRI measures were conducted before the initial ADT as well as four months after the onset of ADT. The patient simultaneously viewed an image of a child and an image of an adult while eye movements were measured. During the fMRI-measure the same stimuli were presented subliminally. Eye movements demonstrated that controlled attentional processes change under ADT, whereas automatic processes remained mostly unchanged. We assume that these results reflect either the increased ability of the patient to control his eye movements while viewing prepubertal stimuli or his better ability to manipulate his answer in a socially desirable manner. Unchanged automatic attentional processes could reflect the stable pedophilic preference of the patient. Using fMRI, the subliminal presentation of sexually relevant stimuli led to changed activation patterns under the influence of ADT in occipital and parietal brain regions, the hippocampus, and also in the orbitofrontal cortex. We suggest that even at an unconscious level ADT can lead to changed processing of sexually relevant stimuli, reflecting changes of cognitive and perceptive automatic processes. We are convinced that our experimental designs using eye tracking and fMRI could prospectively add additional and valuable information in the evaluation of ADT in paraphilic patients and sex offenders. But with respect to the limited significance of this single case study, these first results are preliminary and further studies have to be conducted with healthy subjects and patients.

  7. Changed processing of visual sexual stimuli under GnRH-therapy – a single case study in pedophilia using eye tracking and fMRI

    PubMed Central

    2014-01-01

    Background Antiandrogen therapy (ADT) has been used for 30 years to treat pedophilic patients. The aim of the treatment is a reduction in sexual drive and, in consequence, a reduced risk of recidivism. Yet the therapeutic success of antiandrogens is uncertain especially regarding recidivism. Meta-analyses and reviews report only moderate and often mutually inconsistent effects. Case presentation Based on the case of a 47 year old exclusively pedophilic forensic inpatient, we examined the effectiveness of a new eye tracking method and a new functional magnetic resonance imaging (fMRI)-design in regard to the evaluation of ADT in pedophiles. We analyzed the potential of these methods in exploring the impact of ADT on automatic and controlled attentional processes in pedophiles. Eye tracking and fMRI measures were conducted before the initial ADT as well as four months after the onset of ADT. The patient simultaneously viewed an image of a child and an image of an adult while eye movements were measured. During the fMRI-measure the same stimuli were presented subliminally. Eye movements demonstrated that controlled attentional processes change under ADT, whereas automatic processes remained mostly unchanged. We assume that these results reflect either the increased ability of the patient to control his eye movements while viewing prepubertal stimuli or his better ability to manipulate his answer in a socially desirable manner. Unchanged automatic attentional processes could reflect the stable pedophilic preference of the patient. Using fMRI, the subliminal presentation of sexually relevant stimuli led to changed activation patterns under the influence of ADT in occipital and parietal brain regions, the hippocampus, and also in the orbitofrontal cortex. We suggest that even at an unconscious level ADT can lead to changed processing of sexually relevant stimuli, reflecting changes of cognitive and perceptive automatic processes. Conclusion We are convinced that our experimental designs using eye tracking and fMRI could prospectively add additional and valuable information in the evaluation of ADT in paraphilic patients and sex offenders. But with respect to the limited significance of this single case study, these first results are preliminary and further studies have to be conducted with healthy subjects and patients. PMID:24885644

  8. Child Pornography. An Exploratory Study

    DTIC Science & Technology

    1990-01-01

    34 American Journal of OrthopsychLatry 55, no. 4 (October 1985): 530-541. Finkelhor, David and Sharon Araji. "Explanations of Pedophilia : A Four Factor Model...on Governmental Affairs, Permanent Subcommittee on Investigations. Child Pornoaraphy and Pedophilia . Report, 99th Cong., 2N.D. seas., 9 Oct. 1986...viii List of Tabls Table Page 2.1 Summary ofCauesof Pedophilia .....a......... *....... 25 2.2 Summary of Elements of Child Pornography Industry .... 33

  9. Cyberculture and Personnel Security: Report 1 - Orientation, Concerns, and Needs

    DTIC Science & Technology

    2011-05-01

    viii In general, those cyber activities involving the migration of known issues to new venues present relatively modest cause for deliberation...addiction or impulse control disorders. 3. Easy communication with foreign nationals. 4. Illegal activities such as gambling or simulated pedophilia ...Simulated pedophilia requires special attention because it has lead to widespread international concern. At one time, some adult Second Life users

  10. Child Pornography and Pedophillia. Report Made by the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs. United States Senate, Ninety-Ninth Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Governmental Affairs.

    This document contains an extensive overview of the topics of child pornography and pedophilia. Pedophilia is defined for this report as a condition in which an adult's primary sexual attraction is to prepubescent children roughly between the ages of 6 and 12. The introduction discusses the recent history of public awareness of the problem,…

  11. Reply to Goldberg.

    ERIC Educational Resources Information Center

    Money, John

    1994-01-01

    This rebuttal to Goldberg's criticism (EC 609 744) concerning Herzog and Money's 1993 paper on Klinefelter Syndrome supports the use of Depo-Provera as an adjunct to counseling in cases of pedophilia in men with Klinefelter's Syndrome. (DB)

  12. Sexual Abuse of Children: Current Concepts.

    ERIC Educational Resources Information Center

    Jones, Jerry G.

    1982-01-01

    Acts of pedophilia, rape, and incest are uncomfortable subjects that are underdiagnosed and underreported. Effective management involves a multidisciplinary approach that is difficult to achieve without a special program for sexually abused children. Journal availability: see EC 143 201. (Author)

  13. Reply to Goldberg.

    ERIC Educational Resources Information Center

    Money, John

    1994-01-01

    This rebuttal to Goldberg's criticism (EC 609 744) concerning Herzog and Money's 1993 paper on Klinefelter Syndrome supports the use of Depo-Provera as an adjunct to counseling in cases of pedophilia in men with Klinefelter's Syndrome. (DB)

  14. Gray matter anomalies in pedophiles with and without a history of child sexual offending

    PubMed Central

    Schiffer, B; Amelung, T; Pohl, A; Kaergel, C; Tenbergen, G; Gerwinn, H; Mohnke, S; Massau, C; Matthias, W; Weiß, S; Marr, V; Beier, K M; Walter, M; Ponseti, J; Krüger, T H C; Schiltz, K; Walter, H

    2017-01-01

    Pedophilia is a psychiatric disorder that is inter-related with but distinct from child sexual offending (CSO). Neural alterations reportedly contribute to both pedophilia and CSO, but until now, no study has distinguished the brain structural anomalies associated with pedophilia from those specifically associated with CSO in pedophilic men. Using high-resolution T1-weighted brain images and voxel-based morphometry, we analyzed the gray matter (GM) volume of the following 219 men recruited at four acquisition sites in Germany: 58 pedophiles with a history of CSO, 60 pedophiles without any history of CSO and 101 non-pedophilic, non-offending controls to control for the effects of age, education level, verbal IQ, sexual orientation and the acquisition site. Although there were no differences in the relative GM volume of the brain specifically associated with pedophilia, statistical parametric maps revealed a highly significant and CSO-related pattern of above vs below the ‘normal’ GM volume in the right temporal pole, with non-offending pedophiles exhibiting larger volumes than offending pedophiles. Moreover, regression analysis revealed that the lower GM volume of the dorsomedial prefrontal or anterior cingulate cortex was associated with a higher risk of re-offending in pedophilic child molesters. We believe our data provide the first evidence that CSO in pedophilia rather than pedophilia alone is associated with GM anomalies and thus shed new light on the results of previous studies on this topic. These results indicate the need for new neurobehavioral theories on pedophilia and CSO and may be potentially useful for treatment or prevention approaches that aim to reduce the risk of (re)offending in pedophilia. PMID:28509903

  15. Differences Between Black and White Military Offenders: A Study of Socioeconomic, Familial, Personality, and Military Characteristics of Inmates at the United States Disciplinary Barracks at Fort Leavenworth

    DTIC Science & Technology

    1993-09-01

    category of sex-related crimes only for sex crimes against minors ( pedophilia ) and included rape in the category of violent crimes against others. 8 rsi C...be involved in incest or pedophilia . The important point is that these preliminary personality data show a need for more research in this area. More...experiences of individuals regardless of race, such as a disadvantaged upbringing and disadvantaged education, that cause them to get into legal troubles. In

  16. Inventing the Pedophile in the Journal of Homosexuality.

    PubMed

    Zaborskis, Mary

    2016-01-01

    This article serves as one of the supplementary pieces of this special issue on "Mapping Queer Bioethics," in which we take a solipsistic turn to "map" the Journal of Homosexuality itself. Here, the author examines one of the most controversial moments in the history of the journal, whereby a contributor was subject to governmental and popular rebuke for his scholarship on pederasty, pedophilia, and underage queer sexuality. In a chronological and intellectual appraisal of this pedophilia-themed text, the author asks us to recalibrate the disquietude we posit when same-sex affection, youthful sexuality, and sexual abuse are in close proximity.

  17. Developmental risk factors for sexual offending.

    PubMed

    Lee, Joseph K P; Jackson, Henry J; Pattison, Pip; Ward, Tony

    2002-01-01

    The aim of the study was to identify the general, common, and specific developmental risk factors for pedophilia, exhibitionism, rape, and multiple paraphilia, and to address five methodological issues observed in this area of research. This study involved 64 sex offenders and 33 nonsex, nondrug-related, and nonviolent property offenders. The group of 64 sex offenders was further divided into eight subgroups, some of which overlapped in memberships because of multiple diagnoses. To overcome the methodological problem associated with overlapping group memberships, a special approach involving comparisons of sets of logistic regression analyses was adopted. Offenders were clinically assessed for evidence of paraphilias, and their adverse childhood experiences were measured by a battery of tests. Childhood Emotional Abuse and Family Dysfunction, Childhood Behavior Problems, and Childhood Sexual Abuse were found to be general developmental risk factors for paraphilias. Furthermore, Childhood Emotional Abuse and Family Dysfunction was found to be a common developmental risk factor for pedophilia, exhibitionism, rape, or multiple paraphilia. Additional analyses revealed that childhood emotional abuse contributed significantly as a common developmental risk factor compared to family dysfunction. Besides, Childhood Sexual Abuse was found to be a specific developmental risk factor for pedophilia. The study has supported the value of conceptualizing certain childhood adversities as developmental risk factors for paraphilic behaviors. The role of childhood emotional abuse as an important developmental risk contributor, and the relationship between childhood sexual abuse and pedophilia are of theoretical significance. Furthermore, the results have significant implications for the prevention of childhood abuse and treatment of sex offenders.

  18. Developing a Scale of Perception of Sexual Abuse in Youth Sports (SPSAYS)

    ERIC Educational Resources Information Center

    Baker, Thomas A., III.; Byon, Kevin K.

    2014-01-01

    A scale was developed to measure perceptions of sexual abuse in youth sports by assessing (a) the perceived prevalence of sexual abuse committed by pedophilic youth sport coaches, (b) the perceived likelihood that a coach is a pedophile, (c) perceptions on how youth sport organizations should manage the risk of pedophilia, and (d) media influence…

  19. Charter for the Protection of Children and Young People.

    ERIC Educational Resources Information Center

    Momentum, 2002

    2002-01-01

    Provides the text for United States Conference of Catholic Bishops Charter for the Protection of Children and Young People. This document is part of a special collection of resources in the journal that address sexual abuse and the growing number of both confirmed and alleged cases of pedophilia and sexual abuse within the Catholic Church. (RC)

  20. A Sacred Trust: The Safety of Our Children.

    ERIC Educational Resources Information Center

    Momentum, 2002

    2002-01-01

    Provides the text of the National Catholic Educational Association Statement on Child Abuse. This document, titled A Sacred Trust: The Safety of Our Children, was generated in response to the growing number of both confirmed and alleged cases of pedophilia and sexual abuse within the Catholic Church. (RC)

  1. Counseling Adult Sex Offenders: Unique Challenges and Treatment Paradigms.

    ERIC Educational Resources Information Center

    Priest, Ronnie; Smith, Annalee

    1992-01-01

    Reviews current definitions and research literature related to characteristics of adults who sexually victimize children. Presents discussion of pedophilia as a sexual deviation. Examines treatment issues that may confront counselors engaged in treating adults who sexually victimize children and discusses implications for practitioners. (Author/NB)

  2. The Latent Structure of Multiphasic Sex Inventory-Assessed Pedophilic Interest

    ERIC Educational Resources Information Center

    Mackaronis, Julia E.; Strassberg, Donald S.; Marcus, David K.

    2011-01-01

    The Multiphasic Sex Inventory (MSI; Nichols & Molinder, 1984) is a self-report measure frequently used in the assessment of sex offenders. Scores on the MSI are often used to assess levels of pedophilic interest. However, the question of whether men with pedophilia represent a unique group distinguished by their sexual interests, or whether they…

  3. The Latent Structure of Multiphasic Sex Inventory-Assessed Pedophilic Interest

    ERIC Educational Resources Information Center

    Mackaronis, Julia E.; Strassberg, Donald S.; Marcus, David K.

    2011-01-01

    The Multiphasic Sex Inventory (MSI; Nichols & Molinder, 1984) is a self-report measure frequently used in the assessment of sex offenders. Scores on the MSI are often used to assess levels of pedophilic interest. However, the question of whether men with pedophilia represent a unique group distinguished by their sexual interests, or whether they…

  4. Developmental Risk Factors for Sexual Offending.

    ERIC Educational Resources Information Center

    Lee, Joseph K. P.; Jackson, Henry J.; Pattison, Pip; Ward, Tony

    2002-01-01

    A study involving 64 Australian sex offenders and 33 non-sex offenders found childhood emotional abuse and family dysfunction, childhood behavior problems, and childhood sexual abuse were developmental risk factors for paraphilia. Emotional abuse and family dysfunction was found to be a risk factor for pedophilia, exhibitionism, rape, or multiple…

  5. Developmental Risk Factors for Sexual Offending.

    ERIC Educational Resources Information Center

    Lee, Joseph K. P.; Jackson, Henry J.; Pattison, Pip; Ward, Tony

    2002-01-01

    A study involving 64 Australian sex offenders and 33 non-sex offenders found childhood emotional abuse and family dysfunction, childhood behavior problems, and childhood sexual abuse were developmental risk factors for paraphilia. Emotional abuse and family dysfunction was found to be a risk factor for pedophilia, exhibitionism, rape, or multiple…

  6. Information on Child Abuse: A Selected Bibliography of Federal Government Publications. Research Guide.

    ERIC Educational Resources Information Center

    Dodge, Timothy

    The overall topic of this annotated bibliography, directed to users of the Auburn University libraries, is child abuse. It contains 63 federal government publications in 4 major areas: (1) definitions and prevalence of child abuse, including child pornography and pedophilia, family violence, abductions, and emotional abuse; (2) recent legislation,…

  7. Treatment of Sexual Offenses by Persons with Developmental Disabilities.

    ERIC Educational Resources Information Center

    Myers, Beverly A.

    1991-01-01

    A case history of a young man with mild mental retardation who had engaged in pedophilia and was successfully treated with medroxyprogesterone acetate is presented. The role of antiandrogen treatments of mentally retarded sexual offenders is discussed including issues of informed consent and ethical aspects of treatment. (Author/DB)

  8. 41 CFR 60-741.3 - Exceptions to the definitions of “individual with a disability” and “qualified individual with a...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., education and other job-related requirements of such position. (c) Contagious disease or infection—(1) In... individual satisfies the requisite skill, experience, education and other job-related requirements of such..., pedophilia, exhibitionism, voyeurism, gender identity disorders not resulting from physical impairments, or...

  9. Developing a Scale of Perception of Sexual Abuse in Youth Sports (SPSAYS)

    ERIC Educational Resources Information Center

    Baker, Thomas A., III.; Byon, Kevin K.

    2014-01-01

    A scale was developed to measure perceptions of sexual abuse in youth sports by assessing (a) the perceived prevalence of sexual abuse committed by pedophilic youth sport coaches, (b) the perceived likelihood that a coach is a pedophile, (c) perceptions on how youth sport organizations should manage the risk of pedophilia, and (d) media influence…

  10. 28 CFR 36.104 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... organs; cardiovascular; reproductive; digestive; genitourinary; hemic and lymphatic; skin; and endocrine... disability does not include— (i) Transvestism, transsexualism, pedophilia, exhibitionism, voyeurism, gender... “illegal use of drugs” does not include the use of a drug taken under supervision by a licensed health care...

  11. Treatment of Sexual Offenses by Persons with Developmental Disabilities.

    ERIC Educational Resources Information Center

    Myers, Beverly A.

    1991-01-01

    A case history of a young man with mild mental retardation who had engaged in pedophilia and was successfully treated with medroxyprogesterone acetate is presented. The role of antiandrogen treatments of mentally retarded sexual offenders is discussed including issues of informed consent and ethical aspects of treatment. (Author/DB)

  12. Cognitional Impairment: Is There a Role for Cognitive Assessment in the Treatment of Individuals Civilly Committed Pursuant to the Sexually Violent Predator Act?

    PubMed

    Azizian, Allen; Hutton, Shane; Hughes, Doriann; Sreenivasan, Shoba

    2016-12-01

    Sexually Violent Predator statutes allow the involuntary treatment of individuals who are found to pose a threat to public safety. Most sex offender treatment programs rely on cognitive interventions to reduce the risk of recidivism. The purpose of this study was to examine (a) whether individuals with paraphilia diagnoses have cognitive deficits compared with the general population; (b) whether individuals diagnosed with pedophilia differed on cognitive performance when compared with individuals diagnosed with paraphilia not otherwise specified (NOS), nonconsent; and (c) whether individuals with paraphilia plus antisocial personality disorder (ASPD) differed in cognitive performance when compared with individuals with a paraphilia diagnosis only. The sample consisted of 170 males (M age = 50.21; SD = 10.22) diagnosed with pedophilia or paraphilia NOS, nonconsent, who were detained or civilly committed to a forensic psychiatric hospital. Assessments included Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Wechsler Abbreviated Scale of Intelligence (WASI), and Wide Range Achievement Test 4 (WRAT4). Individuals diagnosed with pedophilia and paraphilia NOS, nonconsent, obtained lower scores than matched controls based on the RBANS Immediate Memory, Visuospatial/Constructional, Delayed Memory indices and Total Score. In comparison with individuals with paraphilia NOS, nonconsent, those with pedophilia diagnosis had lower scores on the RBANS Delayed Memory. Individuals diagnosed with a paraphilia disorder combined with ASPD demonstrated trends toward lower IQ scores than those with a paraphilia diagnosis only. Treatment programs can improve their chance of success by assessment of cognitive processes, and offer therapy in a style that is consistent with the cognitive abilities of their clients. © The Author(s) 2015.

  13. The Soldier’s Dilemma: Using Decision Theory to Explain American War Crimes

    DTIC Science & Technology

    2007-12-01

    and flashbacks, the audience becomes aware of Hearst’s failing marriage, his solicitation of prostitutes, his possible pedophilia , and his...professional. He is also a respected community leader, chosen to speak on behalf of hurricane victims and champion the cause of charity work in the...of the field. Table 6. Specialist Green’s Contributing Factors at Node H. Identity: Generally benefits society 0.7 Enemy: Avoid  causing

  14. Solving the Mystery of Insanity Law: Zealous Representation of Mentally Ill Servicemembers

    DTIC Science & Technology

    2005-04-01

    that the accused possessed sufficient mental capacity to stand trial. Prior to trial, a sanity board diagnosed the accused with both pedophilia and...to "events occurring after the trauma or disease that caused the condition." Id. Retrograde refers to "events that occurred before the trauma or...disease that caused the condition." Id. offenses charged.31 The defense asserted that the accused’s inability to remember the critical events

  15. The Child Sexual Abuse Offender: A Review of Current Research and Implications for Personnel Security

    DTIC Science & Technology

    1988-08-01

    These theories assume offenders have an emotional defect such that children are suitable sexual objects. Some theories of pedophilia (e.g., Howells...Trauma in early sexual experiences is seen as another possible cause for blockage. Related theories suggest that child molesters are timid, awkward...self-reported history of indecent exposure; and offenders who begin offending at a younger age. Future research will give more insight into the causes

  16. The Power to Raise and Support Armies: The Homosexual Exclusion Policy in Perspective

    DTIC Science & Technology

    1991-01-01

    overriding principle in military personnel policies is "the good of the service." This principle clearly cannot be relinquished, even though it may cause a...of sexual gratification, range over a spectrum that is limited only by one’s imagination. Non-homosexual 64 preferences, such as pedophilia ...homosexuals reporting median lifetime numbers of partners in excess of 1,000.3° While public health concerns may have caused some downward trend in

  17. Sensitivity and Specificity of the Phallometric Test for Hebephilia.

    PubMed

    Cantor, James M; McPhail, Ian V

    2015-09-01

    The phallometric test has been examined most widely in the literature with regard to its ability to detect pedophilia; however, it has become of increasing interest to clinicians and researchers to ascertain to what extent the test accurately detects hebephilia: Whereas pedophilia refers to an adult's sexual interest in prepubescent children (age 10 or younger, on average), hebephilia refers to an adult's sexual interest in pubescent children (ages 11-14, on average). The aim of this study was to estimate the accuracy of volumetric phallometry in distinguishing pedophilic men and hebephilic men from men who are teleiophilic (primarily sexually interested in adults, age 17 or older). A retrospective chart review was conducted on the cumulate database of a large phallometric laboratory and clinic to identify a group of 239 men who committed sexual offenses against extrafamilial adults age 17 or older and a group of 996 men who committed sexual offenses against extrafamilial children age 14 or younger, all of whom professed a greater sexual interest in adults over children. The sensitivity and specificity of the phallometric test is calculated for its accuracy in distinguishing sexual preferences for children spanning various age ranges. Receiver operator characteristic curves were highly significant for each classification decision: Using its previously established cut-point of +0.25 standard deviation (SD) units, the phallometric test detected hebephilia with a sensitivity and specificity of 70.0% and 90.7%, detected pedophilia with 46.9% and 100%, and detected pedohebephilia with 75.3% and 90.7%. At a new cut-point of +0.0 SD units, the sensitivity and specificity of the test for pedophilia was 71.9% and 95.3%. Volumetric phallometry significantly distinguishes teleiophilic sex offenders from each of pedophilic, hebephilic, and pedohebephilic sex offenders and can serve as a reliable diagnostic test of sexual age preference among men who deny sexual interest in

  18. Changes in sexual arousal as measured by penile plethysmography in men with pedophilic sexual interest.

    PubMed

    Müller, Karolina; Curry, Susan; Ranger, Rebekah; Briken, Peer; Bradford, John; Fedoroff, John Paul

    2014-05-01

    Although pedophilia is defined by a recurrent sexual interest in prepubescent children, little attention has been paid to the stability or fluidity of this sexual interest over time. The aim of the current study was to investigate if patterns of penile tumescence (as a proxy for sexual interest) measured by penile plethysmography testing (PPT) can change. In this retrospective chart review study, PPT results of 43 men diagnosed with pedophilia were collected and analyzed. All participants displayed a pedophilic sexual arousal pattern at the time of their first PPT. To test for change, we compared initial PPT results with subsequent PPT results measured at least 6 months later. Sexual arousal was assessed using PPT by measuring change in penile circumference induced by the presentation of standardized sexual audio stimuli. Approximately half of the sample (n = 21) displayed a change in PPT results. This change was characterized by a significant decrease of sexual arousal in response to pedophilic (child) stimuli and a significant increase of sexual arousal in response to nonpedophilic (adult) stimuli. No differences between sexual interest changers (ICs) and nonchangers (NC) were found for demographic data or for length of time between assessments. However, between-group comparisons revealed that ICs had significantly lower pedophilic indices at the initial assessment than NCs. Results from the current study indicate that relative pedophilic interest, as defined by increase in penile circumference in response to nonpedophilic stimuli as measured by PPT, changed in about 50% of men diagnosed with pedophilia who also had initial pedophilic PPT sexual responses. This represents a significant challenge to the hypothesis that sexual interest in men with pedophilia is unchangeable and should be the focus of future studies. © 2014 International Society for Sexual Medicine.

  19. Crime and hate in virtual worlds: a new playground for the ID?

    PubMed

    Gorrindo, Tristan; Groves, James E

    2010-01-01

    Virtual worlds offer the potential for friendship, compassionate listening and support, and even love for 15 million users worldwide. But virtual analogs of crimes such as rape, murder, and pedophilia also exist within these worlds. The writings of Freud and Winnicott provide one model for understanding what may motivate these virtual crimes and how to think about them clinically. Psychiatric treatment can potentially benefit if therapists discuss virtual world use with patients as a way of understanding their inner lives.

  20. Independent Component Analysis of Resting-State Functional Magnetic Resonance Imaging in Pedophiles.

    PubMed

    Cantor, J M; Lafaille, S J; Hannah, J; Kucyi, A; Soh, D W; Girard, T A; Mikulis, D J

    2016-10-01

    Neuroimaging and other studies have changed the common view that pedophilia is a result of childhood sexual abuse and instead is a neurologic phenomenon with prenatal origins. Previous research has identified differences in the structural connectivity of the brain in pedophilia. To identify analogous differences in functional connectivity. Functional magnetic resonance images were recorded from three groups of participants while they were at rest: pedophilic men with a history of sexual offenses against children (n = 37) and two control groups: non-pedophilic men who committed non-sexual offenses (n = 28) and non-pedophilic men with no criminal history (n = 39). Functional magnetic resonance imaging data were subjected to independent component analysis to identify known functional networks of the brain, and groups were compared to identify differences in connectivity with those networks (or "components"). The pedophilic group demonstrated wide-ranging increases in functional connectivity with the default mode network compared with controls and regional differences (increases and decreases) with the frontoparietal network. Of these brain regions (total = 23), 20 have been identified by meta-analytic studies to respond to sexually relevant stimuli. Conversely, of the brain areas known to be those that respond to sexual stimuli, nearly all emerged in the present data as significantly different in pedophiles. This study confirms the presence of significant differences in the functional connectivity of the brain in pedophilia consistent with previously reported differences in structural connectivity. The connectivity differences detected here and elsewhere are opposite in direction from those associated with anti-sociality, arguing against anti-sociality and for pedophilia as the source of the neuroanatomic differences detected. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  1. Age Diversity Among Victims of Hebephilic Sexual Offenders.

    PubMed

    Stephens, Skye; Seto, Michael C; Goodwill, Alasdair M; Cantor, James M

    2016-08-25

    Hebephilia refers to sexual interest in pubescent children who are beginning to show early signs of sexual development but are sexually immature. The present study examined the relationship between hebephilia and victim age choice in a sample of 2,238 adult male sexual offenders. On average, offenders were 39 years old at the time of their assessments, and approximately half (48%) were referred by probation or parole offices. Assessment data included self-report, sexual arousal measured by volumetric phallometry, and victims' ages. Results suggested that, similar to pedophilia, hebephilia had a medium sized association with a greater number of victims under age 11 and a small sized association with a greater number of victims ages 11 to 14. Unlike pedophilia, a small positive association was consistently found between hebephilia and a greater number of victims ages 15 or 16. Furthermore, a small positive association was observed between victim age polymorphism and hebephilia and pedophilia. The present results suggested that hebephilia was associated with a greater number of victims age 14 or younger and had similar victim age correlates to pedophiles.

  2. Evidence of Construct Validity in the Assessment of Hebephilia.

    PubMed

    Stephens, Skye; Seto, Michael C; Goodwill, Alasdair M; Cantor, James M

    2017-01-01

    Hebephilia refers to a persistent intense sexual interest in pubescent children. Although not as widely studied as pedophilia, studies of hebephilia have indicated convergence in self-report and sexual arousal. The present study expanded on previous work by examining convergent and divergent validity across indicators of hebephilia that included self-report, sexual behavior, and sexual arousal in a sample of 2238 men who had sexually offended. We included men who denied such interest and specifically examined the overlap between hebephilia and pedophilia and examined pedohebephilia (i.e., sexual interests in both prepubescent and pubescent children). Results indicated that there was considerable convergence across indicators of hebephilia. The results suggested poor divergent validity between hebephilia and pedophilia, as there was substantial overlap between the two constructs across analyses. Finally, a distinct pattern of sexual arousal was found in offenders with pedohebephilia. The results of the present study were discussed with a focus on implications for the assessment of sexual interest in children and the conceptualization of pedohebephilia.

  3. Suicide and the Publicly Exposed Pedophile

    PubMed Central

    Walter, Garry; Pridmore, Saxby

    2012-01-01

    Background: Current clinical wisdom is that the vast majority of those who complete suicide suffer from a mental disorder. Uncritical adherence to this belief may limit our understanding and restrict the full range of prevention activities. We aimed to examine the public record for accounts of suicide by men who had been, or were about to be, investigated or apprehended for “sex only” child sex offences, with a view to presenting a collection of case histories, and identifying examples of suicide in the apparent absence of mental disorder other than pedophilia. Methods: The public record (hard and electronic copy) was examined. Results: Twenty case histories were identified of men with no apparent mental disorder (other than pedophilia) who completed suicide shortly after exposure or threatened public exposure and/or early or potential legal punishment. Conclusion: This evidence strongly suggests that exposure or threatened public exposure of pedophilia and/or early or potential legal punishment creates a predicament, which may lead to completed suicide. PMID:23613648

  4. Investigating the Relationship between Sexual and Chemical Addictions by Comparing Executive Function in Pedophiles, Opiate Addicts and Healthy Controls

    PubMed Central

    Cohen, Lisa J.; Nesci, Cristina; Steinfeld, Matthew; Haeri, Sophia; Galynker, Igor

    2011-01-01

    Disorders of driven sexual behavior have been conceptualized as sexual addictions. In the following study, we compared 51 subjects with pedophilia, 53 subjects with opiate addiction, and 84 healthy control subjects on neuropsychological tests that tap executive functions. The test battery included the Wisconsin Card Sorting Test (WCST), Stroop Color-Word Test, the Matching Familiar Figures Test (MFFT), Porteus Mazes, Controlled Word Association (COWA), and Trailmaking Test. The groups differed on tests of cognitive flexibility and set switching (WCST), sustained attention (Stroop), and impulsivity (MFFT and Porteus Mazes). There were no differences on verbal fluency (COWA). The subjects with pedophilia differed significantly from those with opiate addiction on several tests, with longer latency to response on MFFT and fewer completed mazes but also fewer errors on Porteus Mazes. Thus, while both subjects with pedophilia and those with opiate addiction show executive dysfunction, the nature of that dysfunction may differ between the two groups; specifically, opiate addicted subjects may be more prone to cognitive impulsivity. PMID:21107145

  5. Punitive attitudes against pedophiles or persons with sexual interest in children: does the label matter?

    PubMed

    Imhoff, Roland

    2015-01-01

    In the present research, we addressed the question of whether people harbor punitive attitudes against individuals sexually interested in children even if no sexual offense is mentioned and whether this effect is amplified by the clinical label pedophilia. In two online studies (total N = 345), participants rated the extent to which they saw individuals sexually interested in children as necessarily committing child sexual abuse (dangerousness), responsible for their sexual interest (intentionality), and clinically disordered (deviance) before judging their endorsement of means of punishment (punitive attitudes). Participants were randomly assigned to one of two conditions in which either the "pedophilia" label or the descriptive term "sexual interest in (prepubescent) children" was included in all items. Across both studies, results showed high degrees of punitive attitudes against sexually deviant men, an effect that was particularly pronounced if the pedophilia label was present. Whereas this was only latently observable in Study 1 (concealed by a suppression effect of reduced ascriptions of intentionality), in Study 2 no such suppression was observed. Unlike any other stigma we know of, punitive attitudes against pedophiles were associated positively with social desirability, suggesting that participants saw it as particularly socially desirable to condemn someone based on their deviant sexual interest.

  6. [Crime prevention in high-functioning pervasive developmental disorders with paraphilia].

    PubMed

    Ueno, Chiho; Oda, Hiroyuki; Inoue, Masaharu; Ariki, Nagako; Hasaba, Miho; Kinoshita, Toshihiko

    2007-01-01

    Paraphilia refers to occasional concomitant disorders of pervasive developmental disorder (PDD). When a restricted interest of PDD is focused on a sexual object, paraphilia may be develop as a problematic symptom. However, having this concomitant disorder does not always result in criminal behavior. When the social interactivity of a particular patient with PDD is severely impaired, paraphilia could lead to a sex crime. Because pedophilia targets sacrifice innocent and defenseless children, it is critical to prevent such sex crimes by understanding the psychopathology of PDD with paraphilia, especially pedophilia. Two cases of male adolescents with high-functioning PDD and pedophilia were reported; one ended up committing a serious crime, and the other controlled his sexual impulse. The psychopathology of these two cases was similar; however, the outcome turned out to be quite different. The similarity and dissimilarity of these two cases were analyzed. We came to a conclusion that early intervention could be a key to prevent the development of criminal sexual behavior in PDD with paraphilia (pedophilia). Both patients became aware of pedophilia during adolescence and developed a depressive state at the time of consulting our clinic. In the first case, the patient stabbed a woman with a knife. He could not respect other people, including women he was sexually interested in and has always been preoccupied with his own peculiar ideas. He did not listen to other people's opinions and his abnormal thoughts had never been corrected because of his lack of ability to form interpersonal relationships. The second patient could control his sexual impulse. He has an ability to sympathize with the child he is sexually interested in and has confronted his sexual impulses. He could build interpersonal relationship with others and listen to other people's opinions. He made an effort to manage his sexual impulses positively through individual psychotherapy. He was diagnosed at the

  7. Self-reported head injuries before and after age 13 in pedophilic and nonpedophilic men referred for clinical assessment.

    PubMed

    Blanchard, Ray; Kuban, Michael E; Klassen, Philip; Dickey, Robert; Christensen, Bruce K; Cantor, James M; Blak, Thomas

    2003-12-01

    Previous research has found that pedophilic men referred for clinical assessment of their sexual behavior are more likely to report that they suffered head injuries before their 13th birthday than are nonpedophilic men referred for the same purpose. This study investigated whether pedophilic patients are also more likely to report head injuries after their 13th birthday. The 685 participants represented all patients with usable data from a consecutive series of men referred to a clinical laboratory specializing in phallometric assessment of erotic preferences. In addition to phallometric testing, participants were administered a brief neuropsychological test battery and a companion interview, which included questions on head injury, drug abuse, and childhood diagnosis of attention-deficit/hyperactivity disorder. The results showed that the pedophilic patients reported more head injuries before age 13 than did the nonpedophilic patients, but they did not report more head injuries after age 13. The association between pedophilia and childhood head injuries could mean either that subtle brain damage after birth increases a boy's risk of pedophilia, or that neurodevelopmental problems before birth increase a boy's accident-proneness along with his risk of pedophilia. Additional analyses showed that self-reported head injuries before age 13 were associated with attentional problems and with left-handedness; in contrast, head injuries after age 13 were associated with drug abuse and promiscuity. These analyses suggest that, among patients with primary presenting complaints of sexual rather than cognitive problems, childhood head injuries cluster with neuropsychological phenomena, whereas later head injuries cluster with lifestyle variables.

  8. Neurocognitive and personality factors in homo- and heterosexual pedophiles and controls.

    PubMed

    Kruger, Tillmann H C; Schiffer, Boris

    2011-06-01

    Several neuropsychological studies have suggested an association between pedophilia, neurocognitive disturbances, and specific personality profiles. However, inconsistencies in the findings have not been explained sufficiently, because many studies did not control for possible confounding factors, such as age, education level, or gender orientation. Therefore, the present investigation examined neurocognitive performance and personality profiles in pedophiles in dependence of sexual gender preferences and sexual deviance, as well as with regard to age and education level. Scores on the different neurocognitive tests, personality questionnaires, and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV (SCID) interviews. An extensive neurocognitive test battery (including a reduced version of the German Wechsler Adult Intelligence Scale, the Wisconsin card-sorting test, d2 Attention-Deficit Test, and the Corsi block-tapping test) as well as two personality questionnaires (Minnessota Multiphasic Personality Inventory [MMPI-2] and the Multiphasic Sex Inventory [MSI]) were used to examine a consecutive sample of 20 psychiatrically assessed (SCID I and II) pedophile inpatients (nine exclusively attracted to females and 11 to males) from two high security forensic hospitals and 28 healthy controls (14 heterosexual, 14 homosexual). Compared with controls, pedophiles showed neurocognitive impairments and personality specifics in the majority of tests and questionnaires, such as reduced values on the intelligence scale and weaker performances in information processing, together with high scores for psychopathy and paranoia, and signs of sexual obsessiveness and sexual dysfunction. In contrast to previous reports, some of these alterations were at least partly explained by factors other than pedophilia, such as education level or age. These alterations may be seen to be in line with the hypothesis of a perturbation of

  9. Double-blind, controlled, clinical trial planned in germany to investigate the efficacy of psychotherapy combined with triptorelin in adult male patients with severe pedophilic disorders: presentation of the study protocol.

    PubMed

    Briken, Peer; Berner, Wolfgang

    2012-01-01

    The treatment of paraphilias, especially of pedophilia, centers upon cognitive-behavioral psychotherapy and pharmacologic interventions. Two open, uncontrolled clinical studies using the synthetic LHRH-agonist triptorelin suggested that, combined with psychotherapy, antiandrogen treatment reduced deviant sexual fantasies, urges, and behaviors in paraphilic patients. There is a need for further research using controlled, randomized trials to examine the effectiveness of sexual offender treatment including psychotherapeutic and pharmacologic interventions. The aim of this pilot study is to evaluate the efficacy and tolerability of cognitive-behavioral psychotherapy together with intramuscular (IM) 3-monthly injections of triptorelin in adult men with severe pedophilia. In this multicenter, forensic psychiatric hospital-based, double-blind, controlled, parallel group phase IV trial conducted in Germany, convicted male sexual offenders aged ≥ 18 years with pedophilia, as defined by DSM-IV-TR criteria, will be randomized to receive study-specific psychotherapy together either with triptorelin or placebo for 12 months (total of 4 injections). This is a pilot study, therefore exploratory data analyses will be carried out of three different target parameters: 1. Changes in psychosexual characteristics using the Multiphasic Sex Inventory (scale: sexual abuse of children) 2. Changes in the risk of violent sexual behavior using the Sexual Violence Risk-20 total score 3. Changes in serum testosterone concentration Treatment effects will be assessed by comparing baseline values with those at the final examination (month 12). The absence of real-life stimulants to test for actual recidivism limits possible findings. The study will be conducted in agreement with the European GCP-guideline, all relevant legal requirements, and the legal framework for voluntary treatment of convicted sexual offenders in Germany.

  10. Developmental psychopathological perspectives on sexually compulsive behavior.

    PubMed

    Schwartz, Mark F

    2008-12-01

    Highly pernicious events can result in a variety of severe adult psychiatric manifestations, including pedophilia in select individuals with a history of prior "at-risk factors." Influences such as social isolation can either increase or decrease the outcome. This article reviews some of the other sequential developmental factors that might contribute to sexual compulsivity in such biographies, including temperament, early attachment, family influences, trauma re-enactments, affect dysregulation, social isolation, vandalized love maps, self-formation, sexualization in families, and addictive cycles.

  11. An Approach to Treatment of the Child Sexual Abuser in the Military.

    DTIC Science & Technology

    1987-04-20

    matter for a stuay cifferent from our purposes. What we wl! be ceasIng with in this paper is a treatise on incest ano pedophilia . These are sexual acts...sess.ons. where family memoers are allowed to partic;rate so tna nev: can better understand the origin and nature of the Or:er7. causing the offense. 4...readily admits to his offenses. ano aemonstrates remorse and guilt, and who desires treatment to or~nc about relief from the misery caused by his deviant

  12. Being Sexually Attracted to Minors: Sexual Development, Coping With Forbidden Feelings, and Relieving Sexual Arousal in Self-Identified Pedophiles.

    PubMed

    Houtepen, Jenny A B M; Sijtsema, Jelle J; Bogaerts, Stefan

    2016-01-02

    This article aims to provide more insight into pedophilic attraction and risk and protective factors for offending in nonclinical pedophiles. Fifteen participants were interviewed about sexuality, coping, and sexual self-regulation. Many participants struggled with acknowledging pedophilic interest in early puberty and experienced psychological difficulties as a result. Furthermore, many committed sex offenses during adolescence when they were still discovering their feelings. Early recognition of risk factors and early start of interventions seem vital in preventing offending. Moreover, results suggest that risk for offending can be diminished by creating more openness about pedophilia and by providing pedophiles with social support and control.

  13. [Multiple sex drive abnormalities in a patient with Klinefelter's syndrome].

    PubMed

    Lahl, R; Thomas, B; Zernahle, K

    1977-03-01

    The authors report various sexual instinct disturbances and, more specifically, exhibitionism and pedophilia of a 25-year-old patient with Klinefelter's syndrome. The patient had committed several punishable offenses and was referred to our specialty clinic for psychologic and psychiatric examinations. Aspects of psychopathology and causal etiopathogenetic relationships of the authors' own observations are discussed and compared with those reported in the literature. Environmental factors are considered to be primarily responsible for the development of sexual perversions. The Klinefelter syndrome as such may be regarded as being of predispositional importance only.

  14. Assessment of the paraphilias.

    PubMed

    Seto, Michael C; Kingston, Drew A; Bourget, Dominique

    2014-06-01

    Paraphilias are recurrent, persistent, and intense sexual interests in atypical objects or activities. The most commonly encountered paraphilias in sexological or forensic settings are pedophilia, sexual sadism, exhibitionism, and voyeurism. Paraphilias are often comorbid with other sexual, mood, and personality disorders. Assessment and diagnosis require an integration of multiple sources of clinical information, given the limits and biases of self-report (through clinical interview or questionnaires). Clinicians ideally have access to more objective assessment methods, such as phallometric testing of sexual arousal. The accurate assessment and diagnosis of paraphilias is essential to effective treatment and management.

  15. Stigma-Related Stress and Its Correlates Among Men with Pedophilic Sexual Interests.

    PubMed

    Jahnke, Sara; Schmidt, Alexander F; Geradt, Max; Hoyer, Jürgen

    2015-11-01

    Despite decades of research on the adverse consequences of stereotyping and discrimination for many stigmatized groups, little is known about how people with pedophilia perceive and react to stigma. In this article, we present a framework that outlines how stigma-related stress might negatively affect emotional and social areas of functioning, cognitive distortions, and the motivation to pursue therapy, all of which may contribute to an increased risk of sexual offending. We tested our hypotheses in an online survey among self-identified German-speaking people with pedophilia (N = 104) using a wide range of validated indicators of social and emotional functioning (Brief Symptom Inventory-53, UCLA Loneliness Scale, Emotion Subscale of the Coping Inventory for Stressful Situations, Fear of Negative Evaluation-5, Rosenberg Self-Esteem Scale). Specific risk factors such as self-efficacy, cognitive distortions, and the motivation to seek treatment were also assessed. In line with our hypotheses, fear of discovery generally predicted reduced social and emotional functioning. Contrary to our predictions, perceived social distance and fear of discovery were not linked to self-efficacy, cognitive distortions, or treatment motivation. Results were controlled for the effects of confounding variables (e.g., age, educational level, social desirability, relationship status). We critically evaluate the empirical contribution of this study to research on stigma and child sex offenses, including a discussion of the results in light of the potential indirect effects that public stigma may have on the overall risk for sexual offenses.

  16. Genetic Variants Associated With Male Pedophilic Sexual Interest.

    PubMed

    Alanko, Katarina; Gunst, Annika; Mokros, Andreas; Santtila, Pekka

    2016-05-01

    The etiology of sexual preference disorders (paraphilias) in general and pedophilia in particular remains unknown. There are some indications of biological factors related to pedophilic interest and pedophilic disorder. To examine single-nucleotide polymorphisms (SNPs) potentially associated with pedophilic sexual interest. The sample consisted of 1,672 men 18 to 45 years old from the Genetics of Sex and Aggression sample who had submitted saliva samples. Fifty-four SNPs were genotyped and relevant SNPs were analyzed. A self-report questionnaire designed specifically for the Genetics of Sex and Aggression sample was used to measure sexual interest in and sexual behavior toward children and adolescents. DNA extraction and genotyping were used to measure possible associations between male pedophilia and SNPs. Before controlling for multiple testing, statistically significant associations were found for SNPs linked to androgen, estrogen, prolactin, corticotrophin, serotonin, and oxytocin. No associations remained significant after controlling for multiple testing. The results of the present study suggest a complex biological mechanism affecting adult sexual interest in children. Very small effect sizes characterized the findings, and several polymorphisms related to different hormonal functioning were initially related to the phenotype. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  17. Male-on-male sexual assaults: an analysis of crime scene actions.

    PubMed

    Almond, Louise; McManus, Michelle A; Ward, Lydia

    2014-05-01

    While the concept of male victimization is not a new phenomenon, the sexual assault of a male is a relatively new notion, emerging over the last 30 years in social research literature. Studies of female rape, pedophilia, and juvenile sex offenders have suggested that different styles of offending are reflected in the different types of behaviors committed by offenders at the crime scene. These studies suggest that there are three distinct themes of behavior: Control, Hostility, and Involvement. Using the crime scene actions of 305 male-on-male sexual assault from a U.K. national police database, multidimensional analysis was carried out. The proposed framework was found to be a useful way of classifying male-on-male sexual assaulters with 74% displaying a dominant theme. These resulted in 42% classified as displaying hostility, 23% as control, and 9% as involvement. Implications and suggestions for future research are discussed.

  18. Integration initiatives for forensic services

    PubMed Central

    ARBOLEDA-FLÓREZ, JULIO

    2003-01-01

    Poorly implemented mental health reform policies are often given as reasons for the growth in demands for forensic psychiatric services and the steady increase of mental patients in prison systems. However, in this paper, additional reasons are advanced to explain the growth of forensic psychiatry, such as an expansion in the types of "psychiatric defences" in courts of law; public concerns about violent behaviour attributed to the mentally ill; the community management of paraphilias, especially pedophilia; the development of risk assessment methodologies and the halo of super-specialization. The net result of these developments is that patients who receive a label of "forensic" enter into a mental health ghetto with little connectivity or integration with the general mental health system. The forensic label increases the stigma and decreases opportunities for reintegration and full social recovery. The paper provides guidelines to reverse these trends. PMID:16946932

  19. Detecting and Teaching Desire: Phallometry, Freund, and Behaviorist Sexology.

    PubMed

    Ha, Nathan

    2015-01-01

    During the 1960s and 1970s, Kurt Freund and other researchers developed phallometry to demonstrate the effectiveness of behaviorism in the diagnosis and treatment of male homosexuality and pedophilia. Researchers used phallometers to segment different aspects of male arousal, to discern cryptic hierarchies of eroticism, and to monitor the effectiveness of treatments to change an individual's sexuality. Phallometry ended up challenging the expectations of behaviorist researchers by demonstrating that most men could not change their sexual preferences--no matter how hard they tried or how hard others tried to change them. This knowledge, combined with challenges mounted by gay political activists, eventually motivated Freund and other researchers to revise their ideas of what counted as therapy. Phallometric studies ultimately revealed the limitations of efforts to shape "abnormal" and "normal" masculinity and heralded the rise of biologically determinist theories of sexuality.

  20. Criminal diversity and paraphilic interests among adult males convicted of sexual offenses against children.

    PubMed

    Smallbone, Stephen W; Wortley, Richard K

    2004-04-01

    Official demographic and offense history data (n = 362) and confidential self-report data on paraphilic interests and behavior (n = 221) obtained on adult males convicted of sexual offenses against children were analyzed. Considerable criminal diversity was observed, with all standard categories of offenses represented in offenders' criminal histories. Most (86%) of the offenders' previous convictions were for nonsexual offenses, and most (92%) of the recidivist offenders had previously been convicted of at least one nonsexual offense. The prevalence of diagnosable paraphilias was low, with only 5% meeting formal diagnostic criteria for multiple (two or more) paraphilias other than pedophilia. Sexual offenders' paraphilic interests were unrelated to the extent of their sexual offense convictions but were significantly related to the extent of their nonsexual offense convictions. The results are better explained by a general theory of crime than by traditional clinical conceptions linking sexual offenses specifically with sexual psychopathology.

  1. Diagnostic profiles of civilly committed sexual offenders in Illinois and other reporting jurisdictions: what we know so far.

    PubMed

    Jumper, Shan; Babula, Mark; Casbon, Todd

    2012-09-01

    The records of 377 men civilly committed under Illinois' Sexually Violent Persons Act were compared with similar published samples from seven other states. Civilly committed sexual offenders in Illinois were more likely to be diagnosed with any personality disorder and more likely to exceed the cutoff score for psychopathy than similar offenders in other states. The authors then present a national composite of demographic, victim, and diagnostic information on men referred or pursued for civil commitment in eight states to better understand how these individuals differ from sex offender populations in correctional settings. Results suggest that there may be less victim specificity in sexually violent person (SVP) populations, as although nearly 50% of SVPs are diagnosed with pedophilia, 80% had committed at least one sexual offense against a child or adolescent victim. Across all samples, 72.7% of SVPs were diagnosed with a personality disorder, with antisocial personality disorder the most prevalent.

  2. Pedophilic brain potential responses to adult erotic stimuli.

    PubMed

    Knott, Verner; Impey, Danielle; Fisher, Derek; Delpero, Emily; Fedoroff, Paul

    2016-02-01

    Cognitive mechanisms associated with the relative lack of sexual interest in adults by pedophiles are poorly understood and may benefit from investigations examining how the brain processes adult erotic stimuli. The current study used event-related brain potentials (ERP) to investigate the time course of the explicit processing of erotic, emotional, and neutral pictures in 22 pedophilic patients and 22 healthy controls. Consistent with previous studies, early latency anterior ERP components were highly selective for erotic pictures. Although the ERPs elicited by emotional stimuli were similar in patients and controls, an early frontal positive (P2) component starting as early as 185 ms was significantly attenuated and slow to onset in pedophilia, and correlated with a clinical measure of cognitive distortions. Failure of rapid attentional capture by erotic stimuli suggests a relative reduction in early processing in pedophilic patients which may be associated with relatively diminished sexual interest in adults. Copyright © 2016. Published by Elsevier B.V.

  3. [Sexual development of the child and the onset of gender identity].

    PubMed

    Mauroy, M C

    2000-10-01

    In view of the numerous questions raised by the recently disclosed pedophilia, sexual abuses and prostitution of children, it appeared worthwhile to review the recent studies dealing with the child sexual development and the onset of the gender identity. These studies consist partly in retrospective analysis of pathological situations and partly in the analysis of normal development. It appears that the social and emotional surroundings of the child, provided that they were continuous and devoid of ambiguity, play a prominent role in this process. At present, numerous authors consider that gender identity is achieved at about 2 years of age when the child has a harmonious general development. The family physician and the paediatrician are on the first line to detect potential problems provided that they were aware of the main determinants and symptoms involved.

  4. Serial Murder of Four Victims, of Both Genders and Different Ethnicities, by an Ordained Baptist Minister

    PubMed Central

    Reavis, James A.

    2011-01-01

    A case of a 61-year-old African-American male who sexually assaulted and murdered four individuals, of different ethnicities and both genders, is reported. The subject additionally engaged in sexual activity with each victim postmortem. Each murder is reviewed in detail, and the subjective state of the offender during the murders is commented upon. Psychological test data are reviewed. The subject met criteria for several Axis I disorders, including Bipolar I Disorder, Pedophilia, and Sexual Sadism, and met criteria for Axis II diagnoses of Narcissistic and Antisocial Personality disorder. He was additionally classified as a Psychopath, which, in combination with his Sexual Sadism, general psychiatric state, and exquisite sensitivity to humiliation, led to his decision to murder. PMID:22937398

  5. Stability of Self-Reported Arousal to Sexual Fantasies Involving Children in a Clinical Sample of Pedophiles and Hebephiles.

    PubMed

    Grundmann, Dorit; Krupp, Jurian; Scherner, Gerold; Amelung, Till; Beier, Klaus M

    2016-07-01

    In forensic research, there is a controversial discussion concerning the changeability or stability of pedophilia. Seto (2012) conceptualized pedophilia as a sexual age orientation characterized by an early onset, correlations with sexual and romantic behavior, and stability over time. However, empirical data are sparse and are mostly based on samples of detected offenders. The present study examined self-reported arousal to sexual fantasies involving children in a clinical sample of pedo-/hebephiles. In Study 1, retrospective self-reports on the age of onset and duration of sexual interest in minors were examined. In Study 2, the stability and variability of self-reported arousal to sexual fantasies involving children were evaluated prospectively. Non-prosecuted self-identifying pedo-/hebephilic men seeking professional help were recruited within the Berlin Prevention Project Dunkelfeld. Between 2005 and 2013, 494 participants completed the intake assessment. Self-reported data were collected via questionnaire focusing on sexual arousal to fantasies during masturbation involving prepubescent and/or early pubescent minors. Subsequent assessments of sexual arousal were obtained for 121 of the participants. The average time between the first and last assessment was approximately 29 months. Spearman's correlation coefficients examined the between-group rank-order and Wilcoxon signed-rank tests examined the within-individual mean-level stability. The majority of subjects reported an early onset of their pedo-/hebephilic sexual arousal. The rank-order stability was medium to high. Over the investigated period, the majority of subjects showed no or only minimal decrease or increase of self-reported sexual arousal. These results suggested that sexual arousal to fantasies involving prepubescent and/or early pubescent children is stable. Furthermore, the results support the conceptualization of pedo-/hebephilia as a sexual age orientation in men.

  6. Brain response to visual sexual stimuli in homosexual pedophiles

    PubMed Central

    Schiffer, Boris; Krueger, Tillmann; Paul, Thomas; de Greiff, Armin; Forsting, Michael; Leygraf, Norbert; Schedlowski, Manfred; Gizewski, Elke

    2008-01-01

    Objective The neurobiological mechanisms of deviant sexual preferences such as pedophilia are largely unknown. The objective of this study was to analyze whether brain activation patterns of homosexual pedophiles differed from those of a nonpedophile homosexual control group during visual sexual stimulation. Method A consecutive sample of 11 pedophile forensic inpatients exclusively attracted to boys and 12 age-matched homosexual control participants from a comparable socioeconomic stratum underwent functional magnetic resonance imaging during a visual sexual stimulation procedure that used sexually stimulating and emotionally neutral photographs. Sexual arousal was assessed according to a subjective rating scale. Results In contrast to sexually neutral pictures, in both groups sexually arousing pictures having both homosexual and pedophile content activated brain areas known to be involved in processing visual stimuli containing emotional content, including the occipitotemporal and prefrontal cortices. However, during presentation of the respective sexual stimuli, the thalamus, globus pallidus and striatum, which correspond to the key areas of the brain involved in sexual arousal and behaviour, showed significant activation in pedophiles, but not in control subjects. Conclusions Central processing of visual sexual stimuli in homosexual pedophiles seems to be comparable to that in nonpedophile control subjects. However, compared with homosexual control subjects, activation patterns in pedophiles refer more strongly to subcortical regions, which have previously been discussed in the context of processing reward signals and also play an important role in addictive and stimulus-controlled behaviour. Thus future studies should further elucidate the specificity of these brain regions for the processing of sexual stimuli in pedophilia and should address the generally weaker activation pattern in homosexual men. PMID:18197269

  7. Executive dysfunctions in pedophilic and nonpedophilic child molesters.

    PubMed

    Schiffer, Boris; Vonlaufen, Corinne

    2011-07-01

    There is some evidence that child molesters show neuropsychological abnormalities which might reflect specific structural and/or functional brain alterations, but there are also inconsistencies in the existing findings which need to be clarified. Most of the different outcomes can either be explained by the fact that different types of child molesters were examined or by not having accounted for basically confounding factors such as age, education/intelligence, or criminality. The present study therefore sought to determine whether pedophilic and nonpedophilic child molesters, compared to relevant control groups, show different profiles of executive dysfunction when accounting for potentially confounding factors. The performance of 30 child molesters (15 pedophilic and 15 nonpedophilic) and 33 age- and education-matched controls (16 nonsexual offenders and 17 healthy controls) was assessed regarding several neuropsychological functions. Scores on different neurocognitive tests and semistructured diagnostical interviews. Results indicate that pedophilic child molesters exhibited less performance deficits in cognitive functioning than nonpedophilic child molesters. Compared to healthy controls and nonsexual offenders, the pedophilic child molesters only showed executive dysfunction concerning response inhibition, whereas the nonpedophilic child molesters revealed more severe dysfunction, especially on tasks associated with cognitive flexibility and verbal memory. These results enhance our knowledge about executive dysfunction associated with criminality and/or pedophilia, as they suggest different profiles of impairment between groups. In summary, data suggest that nonpedophilic child molesters showed more severe cognitive deficits than pedophilic child molesters. However, as response inhibition is associated with prefrontal (i.e., orbitofrontal) functioning, the deficits observed in both child molester groups indicate dysfunction in the orbitofrontal cortex. This

  8. Brain pathology in pedophilic offenders: evidence of volume reduction in the right amygdala and related diencephalic structures.

    PubMed

    Schiltz, Kolja; Witzel, Joachim; Northoff, Georg; Zierhut, Kathrin; Gubka, Udo; Fellmann, Hermann; Kaufmann, Jörn; Tempelmann, Claus; Wiebking, Christine; Bogerts, Bernhard

    2007-06-01

    Pedophilic crime causes considerable public concern, but no causative factor of pedophilia has yet been pinpointed. In the past, etiological theories postulated a major impact of the environment, but recent studies increasingly emphasize the role of neurobiological factors, as well. However, the role of alterations in brain structures that are crucial in the development of sexual behavior has not yet been systematically studied in pedophilic subjects. To examine whether pedophilic perpetrators show structural neuronal deficits in brain regions that are critical for sexual behavior and how these deficits relate to criminological characteristics. Amygdalar volume and gray matter of related structures that are critical for sexual development were compared in 15 nonviolent male pedophilic perpetrators (forensic inpatients) and 15 controls using complementary morphometric analyses (voxel-based morphometry and volumetry). Psychosocial adjustment and sexual offenses were also assessed. Pedophilic perpetrators showed a significant decrease of right amygdalar volume, compared with healthy controls (P = .001). We observed reduced gray matter in the right amygdala, hypothalamus (bilaterally), septal regions, substantia innominata, and bed nucleus of the striae terminalis. In 8 of the 15 perpetrators, enlargement of the anterior temporal horn of the right lateral ventricle that adjoins the amygdala could be recognized by routine qualitative clinical assessment. Smaller right amygdalar volumes were correlated with the propensity to commit uniform pedophilic sexual offenses exclusively (P = .006) but not with age (P = .89). Pedophilic perpetrators show structural impairments of brain regions critical for sexual development. These impairments are not related to age, and their extent predicts how focused the scope of sexual offenses is on uniform pedophilic activity. Subtle defects of the right amygdala and closely related structures might be implicated in the pathogenesis of

  9. Child rape: facets of a heinous crime.

    PubMed

    Gangrade, K D; Sooryamoorthy, R; Renjini, D

    1995-01-01

    This article discusses the extent of child rape in India, case studies of girl children in legal procedures, rape settings and perpetrators, public morality, and the nature of rape laws in India. It is concluded that there is no safe place for children. Currently, rapists are allowed to go free or are acquitted. Prevention and control of child rape must involve punishment of rapists. It is not appropriate that society ostracize the victim and her family. Victims should not remain silent. National Crime Records Bureau statistics reveal increases in rape during 1986-91. State figures are given for 1986-88. Madhya Pradesh had the highest reported incidence of rape in 1988. In 1993, Madhya Pradesh had a total of 2459 rapes. Nationally, 10,425 women were reported as raped in 1991. 51.7% were 16-30 years old. There were 1099 cases of pedophilia in 1991, which was an increase over 1990. Over 50% of the pedophilia cases were reported in Uttar Pradesh. The record of convictions shows very low figures. 1992 trial results of 276 rape cases indicated that only 46 persons were convicted. Victims suffer from psychological effects of embarrassment, disgust, depression, guilt, and even suicidal tendencies. There is police and prosecution indifference as well as social stigma and social ostracism of the victim and her family. Many cases go unreported. The case studies illustrate the difficulties for the victim of experiencing the rape and the social responses: police harassment, shame and fear, and occasionally public outrage. The case studies illustrate rape in familiar settings, such as schools, family homes, and neighbors and friends' homes; rape by policemen; and rape by political influentials. Most offenders are young, married, and socioeconomically poor. Mass media portrayals fuel the frustrations of poor and lonely men in cities. Rapists exhibit anti-social behavior or psychopathology. Sexual offenses are related to society's moral values.

  10. Pedophilic sexual interests and psychopathy in child sexual abusers working with children.

    PubMed

    Turner, Daniel; Rettenberger, Martin; Lohmann, Lena; Eher, Reinhard; Briken, Peer

    2014-02-01

    Research has identified stable and dynamic characteristics in child sexual abusers working with children (CSA-W) that may distinguish them from other child sexual abusers (CSA). However, in previous research CSA-W have usually been included in the group of extra-familial CSA (CSA-E). Two hundred and forty-eight forensic-sexological reports about CSA conducted by the Federal Evaluation Centre for Violent and Sexual Offenders in the Austrian Prison System were evaluated retrospectively. One hundred and nineteen intra-familial CSA (CSA-I), 66 CSA-E, and 38 CSA-W were compared with regard to static risk factors, indicators of psychopathy, and pedophilic sexual interests. CSA-E had the highest risk of recidivism as measured by the Static-99 total score, followed by CSA-W. Furthermore, CSA-E had more previous convictions than CSA-W. Both CSA-E and CSA-I had higher total scores on the Psychopathy Checklist-Revised than CSA-W. CSA-W had the highest prevalence of pedophilia diagnoses according to DSM-IV-TR criteria, as well as the highest rate of pedophilia with an orientation toward male children, and the highest frequency of male victims. CSA-W also had the highest total scores in the Screening Scale for Pedophilic Interests. CSA-W seem to constitute a group with particular risk factors and criminogenic needs, that is, they show more indicators of pedophilic sexual interests but less general antisociality and psychopathy, and would thus seem to be distinguishable from other CSA. Future research should focus in particular on evaluating differences in the grooming strategies used by CSA-W to commit and disclose child sexual abuse, as well as on the resources of this particular offender group. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Half of obsessive-compulsive disorder cases misdiagnosed: vignette-based survey of primary care physicians.

    PubMed

    Glazier, Kimberly; Swing, Matt; McGinn, Lata K

    2015-06-01

    Medical settings are the primary mode of care for mental health problems; physicians' abilities with regard to psychiatric diagnosis and treatment recommendations are therefore essential. While misdiagnosis can occur across all psychiatric conditions, the heterogeneous nature of obsessive-compulsive disorder (OCD) may make this condition at an elevated risk for misidentification. The study's aim was to assess primary care physicians' ability to identify OCD. The study was cross-sectional in design. An online, vignette-based survey was emailed to 1,172 physicians from 5 major medical hospitals in the Greater New York Area. The email included a link to the survey, which consisted of 1 of 8 randomized OCD vignettes; each vignette focused on one of the following common manifestations of OCD: obsessions regarding aggression, contamination, fear of saying things, homosexuality, pedophilia, religion, somatic concerns, or symmetry. Participants provided diagnostic impressions and treatment recommendations for the individual described in the vignette. Data collection took place from December 10, 2012, through January 18, 2013. Two hundred eight physicians completed the survey. The overall misidentification rate was 50.5%. Vignette type was the strongest predictor of a correct OCD response (Wald χ(2)7 = 40.58; P <.0001). Misidentification rates by vignette were homosexuality (84.6%), aggression (80.0%), saying certain things (73.9%), pedophilia (70.8%), somatic concerns (40.0%), religion (37.5%), contamination (32.3%), and symmetry (3.70%). Participants who misidentified the OCD vignette were less likely to recommend a first-line empirically supported treatment (cognitive-behavioral therapy [CBT] = 46.7%, selective serotonin reuptake inhibitor [SSRI] = 8.6%) compared to participants who correctly identified the OCD vignette (CBT = 66.0%, SSRI = 35.0%). Antipsychotic recommendation rates were elevated among incorrect versus correct responders (12.4% vs 1.9%). Elevated OCD

  12. Childhood sexual history of 20 male pedophiles vs. 24 male healthy control subjects.

    PubMed

    Cohen, Lisa J; McGeoch, Pamela G; Gans, Sniezyna Watras; Nikiforov, Konstantin; Cullen, Ken; Galynker, Igor I

    2002-11-01

    Despite the widespread incidence of childhood sexual abuse, there is insufficient investigation into the childhood sexual history of perpetrators. In addition, there is little published on the specific similarities between childhood and adult sexual histories. The present study investigates the incidence of childhood sexual abuse in a carefully characterized sample of male pedophiles compared with a demographically similar control group. Concordance between and cognitive distortions about characteristics of childhood abuse and pedophilic behavior are also studied. Twenty men with pedophilia, heterosexual type were compared with 24 demographically similar, healthy male control subjects on a questionnaire specifically designed to assess childhood sexual history in pedophiles. Sixty percent of pedophiles compared with 4% of control subjects reported adult sexual advances as a child. Seventy-five percent of pedophiles and 22% of control subjects reported a first sexual encounter before age 14 years. About 60% concordance was found between acts experienced as a child and perpetrated as an adult. Finally, numerous inconsistencies throughout the questionnaire add preliminary support for the role of cognitive distortions with regard to childhood and adult sexual history. The present findings replicate the elevated rate of childhood sexual abuse found among pedophiles and are consistent with the notion of a causative relationship between early childhood abuse and later pedophilic behavior.

  13. Undetected and detected child sexual abuse and child pornography offenders.

    PubMed

    Neutze, Janina; Grundmann, Dorit; Scherner, Gerold; Beier, Klaus Michael

    2012-01-01

    Current knowledge about risk factors for child sexual abuse and child pornography offenses is based on samples of convicted offenders, i.e., detected offenders. Only few studies focus on offenders not detected by the criminal justice system. In this study, a sample of 345 self-referred pedophiles and hebephiles was recruited from the community. All participants met DSM-IV-TR criteria for pedophilia or hebephilia (paraphilia not otherwise specified), were assured of confidentiality, and self-reported lifetime sexual offending against prepubescent and/or pubescent children. Two sets of group comparisons were conducted on self-report data of risk factors for sexual reoffending. Measures of risk factors address the following dimensions identified in samples of convicted offenders: sexual preferences (i.e. co-occurring paraphilias), sexual self-regulation problems, offense-supportive cognitions, diverse socio-affective deficits, and indicators of social functioning (e.g., education, employment). Men who admitted current or previous investigation or conviction by legal authorities (detected offenders) were compared with those who denied any detection for their sexual offenses against children (undetected offenders). Group comparisons (detected vs. undetected) were further conducted for each offense type separately (child pornography only offenders, child sexual abuse only offenders, mixed offenders). Although there were more similarities between undetected and detected offenders, selected measures of sexual-self regulation problems, socio-affective deficits, and social functioning data demonstrated group differences. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Sexual preferences and recidivism of sex offenders with mental retardation.

    PubMed

    Rice, Marnie E; Harris, Grant T; Lang, Carol; Chaplin, Terry C

    2008-12-01

    By some accounts, sex offenders with mental retardation commit sex offenses against children because the offenders lack sexual knowledge or are socially and intellectually immature rather than because of sexually deviant interests. By other accounts, these offenders exhibit pedophilic sexual interests. In this study, phallometrically determined sexual interests, recidivism, and choices of victims of 69 sex offenders with mental retardation are examined and compared with those of 69 sex offenders of average or higher IQ. Consistent with hypotheses, sex offenders with mental retardation exhibit more deviant preferences for prepubertal children, male children, and young children than do the comparison offenders. They are also more likely to have had a prepubertal victim, a prepubertal male victim, and a very young victim. They are no more likely than the comparison offenders to exhibit preferences for extremely coercive sex with children or to exhibit deviant adult activity preferences, nor are they more likely to recidivate violently. Results support the idea that pedophilia is a disorder of neurodevelopment and point to the importance of risk assessments that include assessing sexual preferences among sex offenders with mental retardation.

  15. The puzzle of intrafamilial child sexual abuse: a meta-analysis comparing intrafamilial and extrafamilial offenders with child victims.

    PubMed

    Seto, Michael C; Babchishin, Kelly M; Pullman, Lesleigh E; McPhail, Ian V

    2015-07-01

    Intrafamilial child sexual abuse is a serious social and health problem, yet explanations of sexual offending against children that emphasize antisocial tendencies and atypical sexual interests do not adequately explain intrafamilial offending. In this meta-analysis, we tested other explanations of intrafamilial child sexual abuse by examining 78 independent samples that compared a total of 6605 intrafamilial offenders to a total of 10,573 extrafamilial offenders, in studies disseminated between 1978 and 2013 (Mdn=2000). Intrafamilial offenders were significantly lower on variables reflecting antisocial tendencies (e.g., criminal history, juvenile delinquency, impulsivity, substance use, and psychopathy) and atypical sexual interests (e.g., pedophilia, other paraphilias, and excessive sexual preoccupation). Contrary to other explanations that have been proposed, intrafamilial offenders scored lower on offense-supportive attitudes and beliefs, emotional congruence with children, and interpersonal deficits; intrafamilial offenders also did not differ from extrafamilial offenders on most indicators of psychopathology. Intrafamilial offenders were, however, more likely to have experienced sexual abuse, family abuse or neglect, and poor parent-child attachments. There were too few studies to examine family dynamics - spousal relationship quality, parent-child victim relationship, and family functioning more generally - even though these factors have been frequently mentioned in the clinical and theoretical literatures. Implications for theories of intrafamilial sexual offending, treatment, and future directions for research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. A multimodal examination of sexual interest in children: a comparison of sex offenders and nonsex offenders.

    PubMed

    Babchishin, Kelly M; Nunes, Kevin L; Kessous, Nicolas

    2014-08-01

    Research and theoretical models have consistently identified sexual interest in children as a key factor involved in child sexual offending. However, there is only moderate agreement in the diagnosis of pedophilia and different assessment methods identify different offenders as pedophiles. The current study examined the discriminative and convergent validity of three different measures of sexual interest in children. Participants included sex offenders and nonsex offenders recruited from federal prisons (i.e., offenders serving sentences of more than 2 years) in Ontario, Canada. Child molesters' responses (n = 35) were not significantly different from nonsex offenders (n = 21) on an implicit measure of sexual interest in children (Sexual Attraction to Children Implicit Association Test [SAC-IAT] d = 0.44, 95% CI [-0.11, 0.99]), but differed on the self-report (Sexual Interest Profiling System; d = 0.83, 95% CI [0.27, 1.39]) and viewing time (d = 1.15, 95% CI [0.54, 1.75]) measures. Findings did not provide clear support for the superiority of a multimodal approach, possibly due to the relatively small sample. More often than not, convergence between the three measures was observed (n = 74). Findings from the present study are an important step toward understanding the relationship between different measures of sexual interest in children and establishing their validity.

  17. Considering the pedophile subculture online.

    PubMed

    Holt, Thomas J; Blevins, Kristie R; Burkert, Natasha

    2010-03-01

    The development of the Internet and computer-mediated communications has fostered the growth of a wide range of deviant sexual behaviors along with deviant subcultures that support and approve of these behaviors. Some of these practices pose little risk to public safety, though acts such as pedophilia and the creation and distribution of child pornography have significant negative ramifications for victims. A growing literature has examined the function of the Internet for child pornography distribution, social networks of pedophiles, and tactics of child solicitation. Few, however, have explored the utility of the Internet to develop a subculture of pedophiles and its role in fostering attitudes and justifications for relationships with children. This study will explore the subcultural norms and enculturation of the pedophile community using a qualitative analysis of five Web forums run by and for pedophiles. The findings suggest that the values of the pedophile culture support and encourage emotional and, in some cases, sexual relationships with boys and girls in virtual and real settings. Implications for the study of pedophiles and the role of the Internet are explored.

  18. Is Emotional Congruence With Children Associated With Sexual Offending in Pedophiles and Hebephiles From the Community?

    PubMed

    Konrad, Anna; Kuhle, Laura F; Amelung, Till; Beier, Klaus M

    2015-12-16

    Although emotional congruence with children (ECWC) is a risk factor for sexual offending against children, its conceptual validity has hardly been researched. This study aims to explore the construct of ECWC by evaluating the factor structure of the Child Identification Scale (CIS-R) and its relation to facets of sexual preference and child sexual abuse behaviors. It was hypothesized that the measure comprises consistent subscales that are differently associated with aspects of sexual preference and sexual offending against children. CIS-R data of a sample of 217 adult male pedophiles from the community were used for an exploratory principal component analysis (PCA). Group comparisons and a multinomial logistic regression analysis were conducted after including a non-pedophilic control group of 22 adult men. PCA revealed a three-factor solution for the CIS-R accounting for 30% of variance. Group comparisons found differences in overall scores and the factor labeled "Attachment to Children" between subgroups of sexual age and gender preference, but not between contact, online, and non-offenders. The regression analysis showed a pedophile sexual preference and the interaction between a hebephile sexual age preference and the factor "Attachment to Children" being associated with past offending behavior. The results indicate a wish to attach to children as core feature of the CIS-R measure assessing ECWC. It is discussed whether this is an inherent feature of pedophilia or rather an independent aspect being differently distinct in pedophiles. © The Author(s) 2015.

  19. Experimental studies of the etiology of genital exhibitionism.

    PubMed

    Langevin, R; Paitich, D; Ramsay, G; Anderson, C; Kamrad, J; Pope, S; Geller, G; Pearl, L; Newman, S

    1979-07-01

    Several studies are reported which examine the critical stimuli and responses as well as personality factors important in genital exhibitionism. Using penile volume measurement, sex history questionnaires, personality tests, and behavioral observations, it was found that (1) exhibitionists responded most to mature females and were comparable to normals in reactions to children and men; (2) while exhibitionists indicated narcissistic desires in exposing, in a laboratory study they did not differ from controls in reactions to exposing with various reactions of the female, from sexual arousal and admiration to fear and anger; (3) the only strong features distinguishing exhibitionists from controls and other sexually anomalous subjects were peeping associated with orgasm and outdoor solitary masturbation; (4) exhibitionists seemed to be less assertive and less feminine than controls, but results were weak and inconsistent; (5) exhibitionists and controls did not differ in separation and divorce or marital satisfaction; (6) blood testosterone and penile reactivity of exhibitionists were within normal limits. Overall, the results suggest that most major theories of genital exhibitionism are wanting. It is suggested that narcissism and pedophilia be examined further in connection with exhibitionism.

  20. Treatment of paraphilia in young adults with leuprolide acetate: a preliminary case report series.

    PubMed

    Saleh, Fabian M; Niel, Tracey; Fishman, Marc J

    2004-11-01

    Some juveniles who engage in sexual offenses may have a paraphilia, a psychiatric disorder characterized by a pervasive pattern of deviant and impairing sexual fantasies, thoughts, and/or behaviors. Though there is no known cure for these conditions, paraphilias can be effectively managed using a multimodal treatment approach. This may include the use of psychotherapeutic and pharmacological treatment interventions, including antiandrogen medications. One such agent, leuprolide acetate (leuprolide), a luteinizing hormone-releasing-hormone agonist, has been shown to be effective in reducing paraphilic symptoms in adult patients. To date, however, there is no published data on its use and effectiveness in adolescent and young adult paraphilic patients. This study consists of a case report series of six young adult patients treated with leuprolide. All subjects had been diagnosed with at least one paraphilia (i.e., Pedophilia, Sexual Sadism, Frotteurism, and Paraphilia Not Otherwise Specified). All subjects had been refractory to treatment in a residential program for adolescent sex offenders prior to initiation of leuprolide. All six subjects reported a reduction in sexually deviant symptoms following treatment with leuprolide. Clinicians rated four as much improved and two as moderately improved. The treatment was well tolerated in all six subjects. This preliminary case series supports the conclusion that leuprolide deserves further examination as a potentially safe and effective component in the treatment of young adult patients with paraphilia.

  1. Predictors of child pornography offenses and child sexual abuse in a community sample of pedophiles and hebephiles.

    PubMed

    Neutze, Janina; Seto, Michael C; Schaefer, Gerard A; Mundt, Ingrid A; Beier, Klaus M

    2011-06-01

    Little is known about factors that distinguish men who act upon their self-identified sexual interest in prepubescent or pubescent children from those who do not. Even less is known about pedophiles or hebephiles who are not involved with the criminal justice system. In this study, a sample of 155 self-referred pedophiles and hebephiles was recruited from the community. All participants met DSM-IV-TR criteria for pedophilia (or paraphilia not otherwise specified for those who were sexually attracted to pubescent children). Two sets of group comparisons were conducted on sociodemographic variables and measures of dynamic risk factors. The first set was based on recent activity and compared men who had committed child pornography only or child sexual abuse offenses in the past six months with men who remained offense-free during the same period. The second set was based on lifetime offense history (excluding the most recent six months) and compared child pornography offenders with child sexual abuse offenders and men who had committed both kinds of offenses. Overall, there were more similarities than differences between groups.

  2. The relationship between victim age and gender crossover among sex offenders.

    PubMed

    Levenson, Jill S; Becker, Jennifer; Morin, John W

    2008-03-01

    Some child molesters abuse children of both genders. The purpose of this study was to explore the relationship between gender crossover and victim age. The authors hypothesized that offenders who molested children of both genders would be more likely to have very young victims and that offenders who molested very young children would be more likely to abuse children of both sexes than offenders with older victims. The sample consisted of 362 sex offenders being considered for civil commitment as sexually violent predators in Florida. Data were collected from file reviews. The relationship between victim age and gender crossover was examined using chi-square and multivariate logistic regression analyses. The proportion of offenders with victims of both genders significantly increased as the victims' ages decreased, and sex offenders with preschool-age victims were most likely to have abused both boys and girls. A sex offender with a victim 6 years of age or younger had more than 3 times the odds of having perpetrated sex crimes against both genders than a sex offender with only older victims. Sex offenders with victims of both genders had more than 3 times the odds of having preschool victims. The presence of a major mental illness increased the odds of gender crossover more than threefold. Pedophilia increased the odds of having victims younger than 6 more than 11-fold. Implications for practice are discussed.

  3. When benefitting a patient increases the risk for harm for third persons - the case of treating pedophilic Parkinsonian patients with deep brain stimulation.

    PubMed

    Müller, Sabine; Walter, Henrik; Christen, Markus

    2014-01-01

    This paper investigates the question whether it is ethically justified to treat Parkinsonian patients with known or suspected pedophilia with deep brain stimulation - given increasing evidence that this treatment might cause impulse control disorders, disinhibition, and hypersexuality. This specific question is not as exotic as it looks at a first glance. First, the same issue is raised for all other types of sexual orientation or behavior which imply a high risk for harming other persons, e.g. sexual sadism. Second, there are also several (psychotropic) drugs as well as legal and illegal leisure drugs which bear severe risks for other persons. We show that Beauchamp and Childress' biomedical ethics fails to derive a veto against medical interventions which produce risks for third persons by making the patients dangerous to others. Therefore, our case discussion reveals a blind spot of the ethics of principles. Although the first intuition might be to forbid the application of deep brain stimulation to pedophilic patients, we argue against such a simple way out, since in some patients the reduction of dopaminergic drugs allowed by deep brain stimulation of the nucleus subthalamicus improves impulsive control disorders, including hypersexuality. Therefore, we propose a strategy consisting of three steps: (1) risk assessment, (2) shared decision-making, and (3) risk management and safeguards.

  4. Pathologizing sexual deviance: a history.

    PubMed

    De Block, Andreas; Adriaens, Pieter R

    2013-01-01

    This article provides a historical perspective on how both American and European psychiatrists have conceptualized and categorized sexual deviance throughout the past 150 years. During this time, quite a number of sexual preferences, desires, and behaviors have been pathologized and depathologized at will, thus revealing psychiatry's constant struggle to distinguish mental disorder--in other words, the "perversions," "sexual deviations," or "paraphilias"--from immoral, unethical, or illegal behavior. This struggle is apparent in the works of 19th- and early-20th-century psychiatrists and sexologists, but it is also present in the more recent psychiatric textbooks and diagnostic manuals, such as the consecutive editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). While much of the historical literature revolves around the controversy over homosexuality, this article also reviews the recent medicohistorical and sociohistorical work on other forms of sexual deviance, including the diagnostic categories listed in the latest edition, the DSM-IV-TR: exhibitionism, voyeurism, fetishism, frotteurism, pedophilia, sexual masochism, sexual sadism, and transvestic fetishism.

  5. Evidence for superior neurobiological and behavioral inhibitory control abilities in non-offending as compared to offending pedophiles.

    PubMed

    Kärgel, Christian; Massau, Claudia; Weiß, Simone; Walter, Martin; Borchardt, Viola; Krueger, Tillmann H C; Tenbergen, Gilian; Kneer, Jonas; Wittfoth, Matthias; Pohl, Alexander; Gerwinn, Hannah; Ponseti, Jorge; Amelung, Till; Beier, Klaus M; Mohnke, Sebastian; Walter, Henrik; Schiffer, Boris

    2017-02-01

    Neurobehavioral models of pedophilia and child sexual offending suggest a pattern of temporal and in particular prefrontal disturbances leading to inappropriate behavioral control and subsequently an increased propensity to sexually offend against children. However, clear empirical evidence for such mechanisms is still missing. Using a go/nogo paradigm in combination with functional magnetic resonance imaging (fMRI) we compared behavioral performance and neural response patterns among three groups of men matched for age and IQ: pedophiles with (N = 40) and without (N = 37) a history of hands-on sexual offences against children as well as healthy non-offending controls (N = 40). As compared to offending pedophiles, non-offending pedophiles exhibited superior inhibitory control as reflected by significantly lower rate of commission errors. Group-by-condition interaction analysis also revealed inhibition-related activation in the left posterior cingulate and the left superior frontal cortex that distinguished between offending and non-offending pedophiles, while no significant differences were found between pedophiles and healthy controls. Both areas showing distinct activation pattern among pedophiles play a critical role in linking neural networks that relate to effective cognitive functioning. Data therefore suggest that heightened inhibition-related recruitment of these areas as well as decreased amount of commission errors is related to better inhibitory control in pedophiles who successfully avoid committing hands-on sexual offences against children. Hum Brain Mapp 38:1092-1104, 2017. © 2016 Wiley Periodicals, Inc.

  6. Diagnosing and litigating hebephilia in sexually violent predator civil commitment proceedings.

    PubMed

    Fabian, John Matthew

    2011-01-01

    In recent years, state and federal legislative initiatives have heavily emphasized punitive laws to combat sexual crime. These statutes include indefinite civil commitment, which is the ultimate infringement on sexual offenders' civil liberties. Many of these committed offenders have repeatedly offended against prepubescent children (pedophiles), and many have committed nonconsensual sexual offenses against adults (rapists). A substantial number of sex offenders have offended against postpubescent adolescents and teenagers outside the age range of pedophilia (commonly referred to by some clinicians and researchers as hebephilia). The use of the term hebephilia has recently received heightened scrutiny in sexually violent predator civil commitment proceedings. Specifically, experts debate whether hebephilia is recognized within the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and whether it is a generally accepted diagnosis within the field of sexual offender assessment. Scholars and practitioners question how hebephilia pertains to sexual deviance and one's risk of reoffending and whether it ultimately meets the legal mental abnormality threshold of civil commitment through DSM diagnostic criteria. This article addresses these questions and provides recent federal case law that attends to hebephilia in sexually violent predator proceedings.

  7. Non-Homicidal and Homicidal Sexual Offenders: Prevalence of Maladaptive Personality Traits and Paraphilic Behaviors.

    PubMed

    Chan, Heng Choon Oliver; Beauregard, Eric

    2016-08-01

    This study aims to examine the psychopathological profile of non-homicidal sexual offenders (NHSOs) and homicidal sexual offenders (HSOs). Using an incarcerated sample of 96 NHSOs and 74 HSOs in a federal penitentiary in Canada, these offenders are compared in terms of their offending process, maladaptive personality traits, and paraphilic behaviors. A number of cross-tabular and sequential logistic regression analyses are performed. Relative to their counterpart, findings indicate that a higher percentage of HSOs select a victim of choice, report deviant sexual fantasies, mutilate their victim, and admit to their offense upon apprehension, whereas a higher percentage of NHSOs select victims with distinctive characteristics. In addition, a higher percentage of HSOs manifest paranoid, schizotypal, borderline, histrionic, narcissistic, obsessive-compulsive, and impulsive personality traits, and overall odd and eccentric personality traits compared with NHSOs. Similarly, a higher percentage of HSOs engage in exhibitionism, fetishism, frotteurism, homosexual pedophilia, sexual masochism, and partialism compared with NHSO. These findings are discussed with their implications for offender profiling. © The Author(s) 2015.

  8. The German Dunkelfeld project: a pilot study to prevent child sexual abuse and the use of child abusive images.

    PubMed

    Beier, Klaus M; Grundmann, Dorit; Kuhle, Laura F; Scherner, Gerold; Konrad, Anna; Amelung, Till

    2015-02-01

    Sexual interest toward prepubescents and pubescents (pedophilia and hebephilia) constitutes a major risk factor for child sexual abuse (CSA) and viewing of child abusive images, i.e., child pornography offenses (CPO). Most child sexual exploitation involving CSA and CPO are undetected and unprosecuted in the "Dunkelfeld" (German: "dark field"). This study assesses a treatment program to enhance behavioral control and reduce associated dynamic risk factors (DRF) in self-motivated pedophiles/hebephiles in the Dunkelfeld. Between 2005 and 2011, 319 undetected help-seeking pedophiles and hebephiles expressed interest in taking part in an anonymous and confidential 1-year-treatment program using broad cognitive behavioral methodology in the Prevention Project Dunkelfeld. Therapy was assessed using nonrandomized waiting list control design (n=53 treated group [TG]; n=22 untreated control group [CG]). Self-reported pre-/posttreatment DRF changes were assessed and compared with CG. Offending behavior characteristics were also assessed via self-reporting. No pre-/postassessment changes occurred in the control group. Emotional deficits and offense-supportive cognitions decreased in the TG; posttherapy sexual self-regulation increased. Treatment-related changes were distributed unequally across offender groups. None of the offending behavior reported for the TG was identified as such by the legal authorities. However, five of 25 CSA offenders and 29 of 32 CPO offenders reported ongoing behaviors under therapy. Therapy for pedophiles/hebephiles in the Dunkelfeld can alter child sexual offending DRF and reduce-related behaviors. Unidentified, unlawful child sexual exploitative behaviors are more prevalent in this population than in officially reported recidivism. Further research into factors predictive of problematic sexual behaviors in the Dunkelfeld is warranted. © 2014 International Society for Sexual Medicine.

  9. Childhood sexual victimization, pedophilic interest, and sexual recidivism.

    PubMed

    Nunes, Kevin L; Hermann, Chantal A; Renee Malcom, J; Lavoie, Kayla

    2013-09-01

    The goal of the current study was to examine the extent to which child sexual abuse (CSA) and particular characteristics of CSA are associated with pedophilic interest and sexual recidivism. Subjects were 462 adult male sexual offenders who had been incarcerated in Canadian federal prisons. Compared to sexual offenders who had not been sexually abused, those who had been sexually abused before age 16 sexually offended against significantly younger victims and had significantly more indicators of pedophilic interest. This was the case whether we examined self-reported or officially documented CSA. Offenders who had been sexually abused exclusively by a male had significantly more indicators of pedophilic interest than those who had been sexually abused exclusively by a female. These findings are consistent with past research and theory suggesting that CSA may play a role in pedophilia and sexual offending against children. CSA exclusively by a female abuser predicted higher rates of sexual recidivism than abuse by a male or both a male and female abuser. Among offenders with victims 15 years old or younger, a closer relationship between offender and abuser predicted higher rates of sexual recidivism. The relationship between CSA and sexual recidivism was significantly moderated by actuarial risk. More specifically, CSA predicted higher rates of sexual recidivism among higher risk offenders, but CSA did not predict sexual recidivism among lower risk offenders. This novel finding raises the possibility that CSA may play a role in sexual recidivism for some offenders. If future research replicates this CSA by risk interaction and identifies the constructs and processes involved, CSA may be worth considering in risk assessment and treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Understanding processing speed weaknesses among pedophilic child molesters: response style vs. neuropathology.

    PubMed

    Suchy, Yana; Eastvold, Angela D; Strassberg, Donald S; Franchow, Emilie I

    2014-02-01

    Research shows that pedophilic (PED) child molesters exhibit slower performance speed and greater performance accuracy when compared to nonpedophilic (N-PED) child molesters or other criminal and noncriminal controls. The purpose of the present study was to examine whether these differences reflect a slow/deliberate response style among PEDS (as we have previously hypothesized; Eastvold, Suchy, & Strassberg, 2011; Suchy, Whittaker, Strassberg, & Eastvold, 2009a, 2009b), or a fundamental neuropathological weakness in processing speed. Data came from a larger study examining neurocognition among sex offenders. Processing speed in three different domains (motor speed, visual-perceptual speed, and visual-motor integration) was examined in 20 phallometrically identified PEDs, 20 N-PEDs, and 20 nonsexual offenders, using both clinical (Finger Tapping, Symbol Search, Digit Symbol Coding) and experimental measures (Inspection Time Task [ITT]). The ITT assessed speed of visual-perceptual processing independent of response speed. On clinical measures, PEDs exhibited slower visual perception [F(2, 57) = 5.24, p = .008] and visual-motor integration [F(2, 57) = 5.02, p = .010] than the other groups, with no differences for simple motor speed. On the ITT, PEDs performed less accurately than the other groups [F(2, 57) = 3.95, p = .025], clearly indicating that slow processing speed cannot be explained by a deliberate response style. Group differences persisted after controlling for other potential confounds (age, estimate IQ, working memory, ethnicity, and substance use). PEDs' slower performance is due to a fundamental neurocognitive weakness, rather than a slow/deliberate response style. These results are consistent with Cantor et al.'s (2008) work identifying white matter abnormalities among PEDs and provide further support for a neurodevelopmental etiology of pedophilia.

  11. [Deviant sexual behaviors, paraphilias, perversions].

    PubMed

    Blachère, P; Cour, F

    2013-07-01

    To know the new concept of paraphilias, their clinical presentation and their link with a personality disorder as perversion, the French legislation concerning them and the different therapeutic options. Review of guidelines published on this subject in the Medline database and a reflexion from our own clinical experience, especially in the judicial expertise. Deviant sexual behavior is, in current classifications, known as paraphilia. This clinical entity corresponds to any sexual behavior considered "abnormal" compared with sexual acts in the society where the person lives. It means precisely, firstly, suffering caused by this disorder or deterioration of social, professional, or family life. Paraphilia such as pedophilia have strict age limits. The victim must be aged below 16 years, with an age difference of at least 5 years with the author of the act. Sexual acts which are illegal are crimes or offences according to the degree, and are sanctioned by the law. In ordinary terms, they are known as perverts, committing perversions. This concept is different from that of paraphilia, a pervert can have, or not have, paraphiliac behavior. In order to diagnose a personality disorder such as perversion, all the criteria must be included: narcissism, use of a person as an object for pleasure, with, primarily, mechanisms of denial and a split personality which removes any feeling of guilt from the perpetrator. Medical treatment of paraphilia alone is not satisfactory for the denial mechanism is such that only the sex drive is affected with a high risk of recurrence. Only psychotherapy can modify the pathological element of a perverted personality. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  12. Axis I psychiatric disorders, paraphilic sexual offending and implications for pharmacological treatment.

    PubMed

    Kafka, Martin

    2012-01-01

    Axis I non-sexual psychopathology, especially if associated with other manifestations of impulsivity, could be important to consider during the assessment and pharmacological treatment of paraphilic sexual offenders. The author performed a Medline literature search using combinations of the following terms "sexual offender," "paraphilia," "Axis I," and "comorbid." In addition, individual paraphilic disorders including "exhibitionism," "voyeurism," "frotteurism," "sexual sadism" and "pedophilia" were searched with the terms "Axis I" and "comorbid." From the literature retrieved, 18 relevant specific articles and additional references were reviewed that utilized either a comprehensive prospective methodology to ascertain Axis I psychopathology or a specific diagnosis not typically included in structured diagnostic instruments was ascertained with validated rating instruments. Unipolar and bipolar mood disorders, social anxiety disorder, attention deficit hyperactivity disorder and other neurodevelopmental conditions (mental retardation, fetal alcohol spectrum disorder, Asperger's disorder) are Axis I psychopathologies reported as co-associated with paraphilic sexual offending. The aforementioned Axis I psychiatric disorders typically manifest during childhood or adolescence, the same age of onset as paraphilic disorders. Alcohol abuse is prevalent among paraphilic offenders as well and its presence serves as an additional disinhibitor. Research supporting the concurrent pharmacological treatment of Axis I comorbidities is modest but offers support that such treatment could mitigate paraphilic behavior. This review was organized to emphasize positive findings. Studies reviewed varied in both sample types and settings as well as ascertainment and diagnostic methodologies. The literature reviewed is modest in size and additionally limited by small samples. A subset of males with Axis I diagnoses of mood disorders, social anxiety disorder, substance use disorders, and

  13. Sexual murderers with adult or child victims: are they different?

    PubMed

    Spehr, Aranke; Hill, Andreas; Habermann, Niels; Briken, Peer; Berner, Wolfgang

    2010-09-01

    This study investigates characteristics differentiating sexually motivated murderers targeting child victims (CV; n = 35) from those with only adult victims (AV; n = 100). In the initial phase, psychiatric court reports were evaluated using standardized instruments (SCID-II, PCL-R, HCR-20, SVR-20, Static-99). In the second phase, data on duration of detention and reconviction rates were obtained from German federal criminal records. The CV group showed more often diagnostic criteria of pedophilia (43% vs. 4%) and less often alcohol abuse and drug dependency (31% vs. 55%), sexual dysfunctions (9% vs. 29%) and narcissistic personality disorder (0% vs. 13%). No significant differences were found regarding PCL-R and total risk assessment scores. Child victim perpetrators were more likely to have committed acts of sexual child abuse before the sexual homicide (46% vs. 16%) but were less likely to have committed rape or sexual assault (17% vs. 42%) or caused bodily injury (26% vs. 50%). The CV group was detained more frequently in forensic psychiatric hospitals (59% vs. 26%), but the two groups showed the same rates of release and reconviction for sexual (22% for both groups), nonsexual violent (CV 25% vs. AV 15%) and nonviolent offenses (CV 63% vs. AV 59%). Although well-known differences between nonhomicidal sexual child abusers and rapists were replicated in this study on sexual homicide perpetrators, the groups showed more similarities than differences. The high prevalence of violence and antisocial personality disorder in both groups seem to be important risk factors for committing a (sexual) homicide and might have outweighed other differences.

  14. Evidence for heritability of adult men's sexual interest in youth under age 16 from a population-based extended twin design.

    PubMed

    Alanko, Katarina; Salo, Benny; Mokros, Andreas; Santtila, Pekka

    2013-04-01

    Sexual interest in children resembles sexual gender orientation in terms of early onset and stability across the life span. Although a genetic component to sexual interest in children seems possible, no research has addressed this question to date. Prior research showing familial transmission of pedophilia remains inconclusive about shared environmental or genetic factors. Studies from the domains of sexual orientation and sexually problematic behavior among children pointed toward genetic components. Adult men's sexual interest in youthfulness-related cues may be genetically influenced. The aim of the present study was to test whether male sexual interest in children and youth under age 16 involves a heritable component. The main outcome measure was responses in a confidential survey concerning sexual interest, fantasies, or activity pertaining to children under the age of 16 years during the previous 12 months. The present study used an extended family design within behavioral genetic modeling to estimate the contributions of genetic and environmental factors in the occurrence of adult men's sexual interest in children and youth under age 16. Participants were male twins and their male siblings from a population-based Finnish cohort sample aged 21-43 years (N = 3,967). The incidence of sexual interest in children under age was 3%. Twin correlations were higher for monozygotic than for dizygotic twins. Behavioral genetic model fitting indicated that a model including genetic effects as well as nonshared environmental influences (including measurement error), but not common environmental influences, fits the data best. The amount of variance attributable to nonadditive genetic influences (heritability) was estimated at 14.6%. The present study provides the first indication that genetic influences may play a role in shaping sexual interest toward children and adolescents among adult men. Compared with the variance attributable to nonshared environmental effects

  15. Homosexuality according to ancient Greek physicians.

    PubMed

    Laios, K; Moschos, M M; Koukaki, E; Kontaxaki, M-I; Androutsos, G

    2017-01-01

    Homosexuality and pedophilia in ancient Greece greatly concerned many researchers who were mainly interested in highlighting the social aspect of this phenomenon in ancient Greek society. An important source on the subject was the paintings of a man and his lover in attic black and red figured pottery, up to the end of the 5th century BC. Another main source was the information that derived from the texts of ancient Greek literature, especially poetry. Homosexuality was not only referring to relationships between males, but it was also manifested in lesbian love. It is believed that in the Homeric world homosexuality was not favored. In Greek society of the archaic period, the restriction of women at home, the satisfaction of sexual needs with courtesans, the marriage for the purpose of maintaining and managing the property, put women aside, marginalizing them in terms of social life, impeding the cultivation of emotional relationships between sexes. At the same time, in the society of those times, the aristocratic ideal, the constant communication of men during military training and the war, the male nudity in sports and the promotion of beauty and bravery in athletic contests, as well as the gatherings and the entertainment of men at the symposia, created a suitable substrate in which male homosexuality could develop. In this context, pedophile relationships were developed mainly during the archaic period, as recorded on vase paintings, where a mature man developed a special relationship with a teenager of the same social class. The mature man had the role of mentor for the juvenile, he would look after him and cover his living expenses and education cost. In this relationship, exhibiting predominantly the social dimension of an initiation process and introduction to adult life, the erotic homosexual intercourse could find a place to flourish. The above-mentioned relationship could not last forever, given that this would later transform into an emotional

  16. Pharmacology of sexually compulsive behavior.

    PubMed

    Codispoti, Victoria L

    2008-12-01

    In a meta-analysis on controlled outcomes evaluations of 22,000 sex offenders, Losel and Schmucker found 80 comparisons between treatment and control groups. The recidivism rate averaged 19% in treated groups, and 27% in controls. Most other reviews reported a lower rate of sexual recidivism in treated sexual offenders. Of 2039 citations in this study (including literature in five languages), 60 studies held independent comparisons. Problematic issues included the control groups; various hormonal, surgical, cognitive behavioral, and psychotherapeutic treatments; and sample sizes. In the 80 studies compared after the year 2000, 32% were reported after 2000, 45% originated in the United States, 45% were reported in journals, and 36% were unpublished. Treatment characteristics showed a significant lack of pharmacologic treatment (7.5%), whereas use cognitive and classical behavioral therapy was 64%. In 68% of the studies, no information was available on the integrity of the treatment implementation; 36% of the treatment settings were outpatient only, 31% were prison settings, and 12% were mixed settings (prison, hospital, and outpatient). Integrating research interpretations is complicated by the heterogeneity of sex offenders, with only 56% being adult men and 17.5% adolescents. Offense types reported included 74% child molestation, 48% incest, and 30% exhibitionism. Pedophilia was not singled out. Follow-up periods varied from 12 months to greater than 84 months. The definition of recidivism ran the gamut from arrest (24%), conviction (30%), charges (19%), and no indication (16%). Results were difficult to interpret because of the methodological problems with this type of study. Overall, a positive outcome was noted with sex offender treatment. Cognitive-behavioral and hormonal treatment were the most promising. Voluntary treatment led to a slightly better outcome than mandatory participation. When accounting for a low base rate of sexual recidivism, the reduction

  17. The role of testosterone in sexuality and paraphilia--a neurobiological approach. Part II: testosterone and paraphilia.

    PubMed

    Jordan, Kirsten; Fromberger, Peter; Stolpmann, Georg; Müller, Jürgen Leo

    2011-11-01

    Antiandrogen therapy has been used for 30 years to treat paraphilic patients and sexual offenders. Yet the therapeutic success of antiandrogens is uncertain. Furthermore, there is still a lack of comprehensive knowledge about the effects of androgen-lowering therapy in paraphilic patients. We discuss endocrinological, neurobiological, and therapeutic aspects of paraphilia with the aim of integrating these on the basis of the current neurobiological and clinical knowledge on testosterone that was set out in Part I of this review. Our review of the human literature comprises the current knowledge about the neurobiology of paraphilia and the known endocrinological, pathophysiological, and genetic aspects of this disorder. The role of testosterone is discussed. A survey of antiandrogen therapy and its outcome in paraphilic patients and sex offenders is provided. Although not all data are consistent, current imaging research suggests that structural and functional changes in pedophilia appear for the most part in brain regions also involved in sexual functions. Not exclusively testosterone but also some other endocrinological and neurochemical parameters could be disturbed in pedophilic patients and child molesters; these include changes in hypothalamic-pituitary function, prolactin levels, and dopaminergic or serotonergic functions. There appears to be a sex-steroid-related genetic influence on antisocial traits, externalizing behavior, and sexual behavior. Most of the studies in which antiandrogen therapy in paraphilic patients and sex offenders have been examined were case reports, or observational or open-label studies, and many did not include adequate control groups. Only a few placebo-controlled double-blind studies have been published with inconsistent results concerning treatment effects. Outcome measures differ between the studies and do not seem ideally suited to their purpose. On the basis of the current knowledge about testosterone and its effects on brain

  18. [Assessment of a new law for sex offenders implemented in France in 1998].

    PubMed

    Tesson, J; Cordier, B; Thibaut, F

    2012-04-01

    Most people recognize that incarceration alone will not solve sexual violence. Treating the offenders is critical in an approach to preventing sexual violence and reducing victimization. The Law of June 17, 1998, on the prevention and repression of sexual offences, as well as the protection of minors, makes a provision for the possibility of medical and psychological monitoring adapted to these particular individuals. Sex offenders may well be constrained, after their incarceration, to social and judicial follow-up, which may include coerced treatment in order to reduce the risk of recidivism. In order to control this follow-up, the legislature has created the position of medical coordinator, who acts as an interface between justice and care in conjunction with the treating physician. This study is the first attempt to evaluate the activity of physician coordinators conducted in France since the implementation in 2004 of the 1998 law on monitoring sex offenders. An interview of all the physician coordinators in Upper Normandy was conducted. The files of all sex offenders subjected to coerced treatment were studied. In our sample of 100 sex offenders who were subjected to coerced treatment (any kind of treatment) (99% men, 60% of sexual assaults on minors, 14% of cases of indecent exposure), minor victims of sexual assault were: 78% females; in 90% of cases the victim was aged under 14 years (under 10 in 52% of cases), 60% of cases were intrafamilial incest; the victim was an unknown aggressor in only one case out of 60. The constraint follow-up contributed to reducing the risk of recidivism (three cases of recidivism in 100 individuals over an average duration of follow-up of five years), although it remains difficult to assess the recidivism over a duration of time as short as five years. A diagnosis of paraphilia was only applied in 19% of cases (in 10 cases pedophilia, exhibitionism in nine cases). Only six subjects were receiving antiandrogen treatment. A