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Chronos A, Jahnke S, Blagden N. The Treatment Needs and Experiences of Pedohebephiles: A Systematic Review. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:3329-3346. [PMID: 39009743 PMCID: PMC11390808 DOI: 10.1007/s10508-024-02943-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 07/17/2024]
Abstract
People with a sexual interest in children face significant barriers to seeking and receiving mental health treatment. This review aims to bridge the gap between the treatment needs and experiences of pedohebephiles, and the services aiming to support them. Reviewers screened 1705 database hits and extracted findings from 22 qualitative, 15 quantitative, and 3 mixed-method studies on the treatment needs and experiences of pedohebephiles. Research suggests that this population experiences significant levels of distress, depression, and anxiety related to their sexual interest. Many individuals belonging to this population would seek (median = 42.3%), or have sought (median = 46.5%), treatment to cope with their sexual interest or with potential related mental health repercussions. Their experiences in treatment have been mixed, with some reporting positive experiences with empathic therapists and others reporting rejection. Most frequently, pedohebephiles report fear of exposure and rejection as barriers to seeking treatment, in addition to fear of the legal repercussions. The current study is the first to summarize and discuss previous findings on the treatment needs and experiences of pedohebephiles. The findings indicate that the treatment needs of pedohebephiles often remain unaddressed. Suggestions to increase the fit between treatment services and the needs of pedohebephiles are put forward.
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Affiliation(s)
- Agatha Chronos
- Department of Health Promotion and Development, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.
| | - Sara Jahnke
- Department of Health Promotion and Development, University of Bergen, Årstadveien 17, 5009, Bergen, Norway
| | - Nicholas Blagden
- School for Law and Social Sciences, University of Derby, Derby, UK
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2
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Jahnke S, Blagden N, McPhail IV, Antfolk J. Secret-keeping in therapy by clients who are sexually attracted to children. Psychother Res 2024; 34:941-956. [PMID: 37848189 DOI: 10.1080/10503307.2023.2265047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
Objective This study investigated the reasons why pedohebephilic clients disclose their sexual attraction to children in therapy and the experiences associated with this decision among English-speaking samples. Method: The pre-registered online survey combined (1) quantitative correlational data of self-reported improvement, alliance, therapist reaction to disclosure, and the belief that mandatory reporting laws were in place, and (2) qualitative data about reasons for disclosure or no disclosure as well as perceived consequences. The sample consisted of pedohebephilic people who have been clients in therapy and have disclosed (n = 96) or not disclosed (n = 40). Results: While the disclosure and no disclosure groups did not differ in improvement or beliefs about mandatory reporting, those who had disclosed reported a stronger alliance. Clients who did not perceive the therapist's reaction as supportive reported less improvement than the no disclosure group. Thematic analysis of qualitative data identified three themes concerning motives for disclosing or not disclosing and a fourth regarding differential impacts of disclosure. Discussion: This study indicates that disclosing pedohebephilia does not in and of itself lead to improvement but is contingent on a therapist's reaction.
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Affiliation(s)
- Sara Jahnke
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Nicholas Blagden
- School for Law and Social Sciences, University of Derby, Derby, UK
| | - Ian V McPhail
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jan Antfolk
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
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Levitan JA, Martijn FM, Santaguida M, Seto MC. Minor-Attracted Men's Lived Experiences of Romantic Attraction. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:811-824. [PMID: 39118553 DOI: 10.1080/0092623x.2024.2385909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Studies of minor-attracted persons have mainly focused on their sexual attractions, and little is known about their romantic attractions. This online qualitative survey study collected 74 self-identified minor-attracted men's anonymous accounts of romantic attraction to minors. Using reflexive thematic analysis, three themes were identified and interpreted: (1) Falling in Love; (2) Recognizing Limitations to Attraction and Relationship Development; (3) Making Sense and Meaning of Romantic Attraction to Minors. Overall, romantic attraction to minors resembles romantic attraction to adults. Findings have implications for how conceptualization, assessment, and treatment of minor attraction may each consider both sexual and romantic domains.
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Affiliation(s)
- Julia A Levitan
- Department of Psychology, McGill University, Montreal, Canada
| | | | - Maria Santaguida
- Department of Psychology, Concordia University, Montreal, Canada
| | - Michael C Seto
- University of Ottawa's Institute for Mental Health Research, Ottawa, Canada
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Zannoni R, Keil J, Ponseti J, Stirn AV, Holtfrerich SKC, Diekhof EK. Modulation of the attentional response to baby schema by testosterone in pedohebephilic men and its relation to the nurturing system. Sci Rep 2024; 14:16385. [PMID: 39013917 PMCID: PMC11252362 DOI: 10.1038/s41598-024-65572-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 06/21/2024] [Indexed: 07/18/2024] Open
Abstract
Previous fMRI research found increased brain responses in men with pedophilic interest to non-sexual pictures of child and animal faces. This raised the question of whether an aberrant nurturing system could be linked to pedophilia. To further explore this hypothesis, 20 pedohebephilic and 23 teleiophilic men performed a target detection task with adult versus infant human and animal faces, which measured selective attention towards the baby schema by comparing reaction times to infant versus adult targets that were presented amongst distractors of the other category. Since the response to baby schema can be influenced by steroid hormones, saliva samples were additionally collected to determine endogenous testosterone, progesterone, estradiol and cortisol. Contrary to expectations, all men did not react faster to infant than adult faces. Yet, pedohebephilic men were more distracted by infant's faces than teleiophilic men. Pedohebephilic men with higher testosterone were faster in orienting attention to infant targets in the context of adult distractors. This association was not observed in teleiophilic men. Our results support the idea of an overactive nurturing system in pedophilia, which may be influenced by the endogenous testosterone level.
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Affiliation(s)
- Ronja Zannoni
- Centre for Integrative Psychiatry, Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, UKSH, 24105, Kiel, Germany.
| | - Julian Keil
- Department of Psychology, Christian-Albrechts-University Kiel, 24118, Kiel, Germany
| | - Jorge Ponseti
- Centre for Integrative Psychiatry, Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, UKSH, 24105, Kiel, Germany
| | - Aglaja V Stirn
- Centre for Integrative Psychiatry, Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, UKSH, 24105, Kiel, Germany
| | - Sarah K C Holtfrerich
- Neuroendocrinology and Human Biology Unit, Institute of Cell and Systems Biology of Animals, University Hamburg, 20146, Hamburg, Germany
| | - Esther K Diekhof
- Neuroendocrinology and Human Biology Unit, Institute of Cell and Systems Biology of Animals, University Hamburg, 20146, Hamburg, Germany
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Amelung T, Konrad A, Beier KM, Lehmann RJB. The Viewing Reaction Time as a Diagnostic Tool of Pedohebephilia in the Dunkelfeld. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:25-42. [PMID: 37594679 PMCID: PMC10794365 DOI: 10.1007/s10508-023-02662-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 08/19/2023]
Abstract
Diagnosing pedohebephilia is fraught with obstacles given the tabooed nature of this sexual preference. The viewing reaction time effect (VRT) provides a non-intrusive indirect measure of sexual interest in minors. In forensic populations, the ability of the difference between the latencies while viewing child and adult sexual stimuli (VRT index) to discern child sexual offenders from a range of control groups has been ascertained meta-analytically. Given that the effect has been studied almost exclusively in forensic samples, its dependence or independence on prior overt (deviant) sexual behavior remains unclear. The present study sought to examine the relationship of prior sexual and non-sexual behaviors with the VRT in a sample of 282 self-referring, help-seeking men with and without pedohebephilia with and without a history of prior child sexual offenses (CSO) or a use of child sexual abuse materials (CSAM) recruited outside a forensic context. We found that (1) the clinical diagnosis of pedohebephilia but not prior CSO or CSAM showed a significant association with the VRT index; (2) the discriminatory ability of the VRT index did not differ significantly between samples with and without a history of prior overt sexual behavior with children; (3) the VRT index correlated positively with a behavioral marker of pedohebephilia in a subsample of individuals with prior judicially detected or undetected overt sexual behavior with children; and (4) in the same subsample, the VRT index correlated positively with markers of sexual interests in minors or hypersexuality but not of antisociality. Equivalence testing failed to refute a potential effect of prior sexual behavior on the VRT index. Our study showed that the VRT may provide an unintrusive diagnostic tool for pedohebephilia. The effect of prior overt sexual behavior with children needs further examination.
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Affiliation(s)
- Till Amelung
- Institut für Sexualwissenschaft und Sexualmedizin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Luisenstraße 57, 10117, Berlin, Germany.
- Klinik für Psychiatrie und Psychotherapie, CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and HumboldtUniversität zu Berlin, Klinik für Psychiatrie und Psychotherapie, CCM, Berlin, Germany.
| | - Anna Konrad
- Institut für Sexualwissenschaft und Sexualmedizin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Luisenstraße 57, 10117, Berlin, Germany
| | - Klaus M Beier
- Institut für Sexualwissenschaft und Sexualmedizin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Luisenstraße 57, 10117, Berlin, Germany
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Lievesley R, Harper CA, Woodward E, Tenbergen G. Fantasy Sexual Material Use by People with Attractions to Children. Curr Psychiatry Rep 2023; 25:395-404. [PMID: 37523114 PMCID: PMC10506952 DOI: 10.1007/s11920-023-01435-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE OF REVIEW With the Internet allowing consumers easy access to fantasy and fictional sexual materials (FSM), it is becoming increasingly important to understand the context of their use among specific populations. Of particular, social, clinical, and legal interest is FSM use by people who are attracted to children and whether this may have a risk-enhancing or protective impact on their likelihood of committing a contact or non-contact sexual offence. RECENT FINDINGS There is a lack of data currently available in relation to the use of FSM by those with sexual attractions to children. Evidence from allied areas appears to show no meaningful associations between FSM use and sexual aggression. We propose a novel research program and some initial research questions that provide a theoretical framework for more evidence-based inquiry on FSM use by people who experience attractions to children.
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Affiliation(s)
- Rebecca Lievesley
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Craig A Harper
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK.
| | - Ellie Woodward
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Gilian Tenbergen
- Department of Psychology, State University of New York at Oswego, Oswego, NY, 13126, USA
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Jahnke S, Schmidt AF, Hoyer J. Pedohebephilia and Perceived Non-coercive Childhood Sexual Experiences: Two Non-matched Case-Control Studies. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2023; 35:340-374. [PMID: 35549946 PMCID: PMC10041574 DOI: 10.1177/10790632221098341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Research on the link between childhood sexual abuse experiences (CSAE) and pedohebephilia is limited by its focus on events that the respondents rate as abusive. We asked 199 German-speaking (Study 1) and 632 English-speaking (Study 2) men with and without self-reported pedohebephilia to complete the Childhood Trauma Questionnaire (CTQ) and scales to assess perceived non-coercive childhood sexual experiences with adults (PNCSE-A), and peers (PNCSE-P, only Study 2). A substantial number of participants with PNCSE-A disagreed with all items of the CTQ Sexual Abuse subscale (e.g., 35% and 26% of pedohebephilic men in Studies 1 and 2, 38% of teleiophilic men in Study 2). While pedohebephilic men reported more CSAE than teleiophilic men, the effects for PNCSE-A did not consistently point in the expected direction. In Study 2, conviction status for sexual offenses among pedohebephilic men was linked to higher rates of CSAE, PNCSE-A, PNCSE-P, physical neglect, and physical abuse. Pedohebephilic men in Study 2 also reported more PNCSE-P than teleiophilic men. Our results highlight the importance of assessing different (positive or neutral) perceptions of CSAE. Better controlled designs (e.g., matched case-control studies) are needed to substantiate whether and how perceived non-coercive childhood sexual experiences relate to pedohebephilia and sexual offending.
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Affiliation(s)
- Sara Jahnke
- Department of Health Promotion and Development, University of Bergen, Norway
| | - Alexander F. Schmidt
- Institute of Psychology, Social & Legal Psychology, Johannes Gutenberg-Universität Mainz, Germany
| | - Jürgen Hoyer
- Institute for Clinical Psychology and Psychotherapy, Technische Universitä Dresden, Germany
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Jahnke S, Blagden N, Hill L. Pedophile, Child Lover, or Minor-Attracted Person? Attitudes Toward Labels Among People Who are Sexually Attracted to Children. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:4125-4139. [PMID: 36175817 PMCID: PMC9663395 DOI: 10.1007/s10508-022-02331-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 06/16/2023]
Abstract
The primary label for people who are sexually attracted to children ("pedophile") is conflated with sexual offending behavior and tainted with stigma. In the present pre-registered mixed-method study, we therefore investigated attitudes and preferences regarding "pedophile/hebephile" and other labels among 286 people who report a stronger or equally strong sexual attraction to prepubescent and pubescent children than to adults. Overall, quantitative data showed acceptance of "pedophile/hebephile" as well as a range of alternative labels in a personal (Labeling Oneself) and a professional context (Being Labeled by Others). "Minor-attracted person" and "pedophile/hebephile" received generally higher support than other terms and appeared to be least divisive across three major online fora. Qualitative data revealed four themes: "Contested self-labels," "Person-first language and pathologizing sexuality/identity," "Stigma and shame," and "Reclaiming the pedophile label." Our results allow deeper insight into reasons for adopting certain labels over others, as well as difficulties of finding a non-stigmatizing label. We discuss limitations of the study and practical implications for clinical and research contexts.
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Affiliation(s)
- Sara Jahnke
- Department of Health Promotion and Development, University of Bergen, Postboks 7807, 5020, Bergen, Norway.
- Department of Psychology, Åbo Akademi University, Turku, Finland.
| | - Nicholas Blagden
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Laura Hill
- Department of Psychology, Nottingham Trent University, Nottingham, UK
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Baltodano-Calle MJ, Onton-Díaz M, Gonzales GF. Androgens, brain and androgen deprivation therapy in paraphilic disorders: A narrative review. Andrologia 2022; 54:e14561. [PMID: 35995581 DOI: 10.1111/and.14561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/26/2022] [Accepted: 08/04/2022] [Indexed: 11/27/2022] Open
Abstract
Sexual delinquency is a global problem where those with paraphilic disorders, such as paedophiles, are more likely to commit and reoffend. Androgen deprivation therapy (ADT) has been suggested as a solution. The objective of this narrative review is to present current information on its risks, benefits and limitations as a treatment for paraphilias. The importance of testosterone in sexual function, the effect of its deficiency by age or by pharmacological treatment (anti-androgens, GnRH agonists and GnRH antagonists) and the effect of testosterone replacement therapy will be reviewed. The relationship between androgens, brain, sexual behaviour and pathophysiology of paraphilic disorders will also be explored. ADT reduces sexual urges, but has adverse effects and, because its reversible nature, it does not ensure less recidivism. Likewise, the research quality of ADT drugs is limited and not enough to support their use. Child sex offenders, and not paraphilic subjects who have not committed assaults, show signs of elevated prenatal exposure to androgens and a higher methylation state of the androgen receptor gene. Sexual behaviour is regulated by subcortical (hypothalamus, brainstem and spinal cord) and cortical structures of the brain, in addition to brain circuits (dopaminergic, serotonergic). Those with paraphilic disorders show abnormalities at these levels that could relate to the risk of sexual offences. In conclusion, androgens represent a significant part of the pathophysiology of paraphilias and therefore, ADT seems promising. Nonetheless, more studies are needed to make definite conclusions about the efficacy of long-term ADT in paraphilic patients.
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Affiliation(s)
| | - Melisa Onton-Díaz
- Faculty of Medicine, Cayetano Heredia Peruvian University., Lima, Peru
| | - Gustavo F Gonzales
- Laboratorio de Endocrinología y Reproducción, Laboratorios de Investigación y Desarrollo (LID), Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.,Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.,Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru
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