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Dewhurst K, Spenser K, Fido D. Romeo & Juliet Laws: Investigating UK Public Perceptions of Young Consensual Sex and the Effects of Age Gaps and Perpetrator and Respondent Gender. JOURNAL OF SEX RESEARCH 2024:1-13. [PMID: 38635356 DOI: 10.1080/00224499.2024.2332939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Public perception of regulated sexual behavior is a crucial factor in considering policy, particularly when UK sexual consent laws could criminalize the many young people who are increasingly engaging in underage sex. In contrast, other countries have progressively implemented consent age-spans to respect sexual autonomy while simultaneously protecting young people from sexual exploitation. This study investigated UK perceptions of consensual underage sex between similar-aged adolescents, with predominant focus on age-spans, as an adaptive alternative to dropping consent age. An online experimental survey of members of the UK public (n = 336) manipulated age-gaps, perpetrator gender, and respondent gender. Supporting the hypothesis, results showed more support (i.e., reduced condemnation of the situation, perpetrator, and victim) was given for sex with age gaps of up to 2 years than those larger. Gender differences were present only for age gaps of 3 and 4 years, where harsher situation and perpetrator judgments were elicited when the perpetrator was male. To our knowledge, this is the first UK-based study investigating perceptions of similar-aged consensual underage sex, and therefore forms a baseline for future research. Results are discussed in terms of acceptability of behavior and present important evidence for policymakers to consider reviewing UK consent laws in line with international legislation.
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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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3
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Storch M, Kanthack M, Amelung T, Beier KM, Krueger THC, Sinke C, Walter H, Walter M, Schiffer B, Schindler S, Schoenknecht P. Hypothalamic volume in pedophilia with or without child sexual offense. Eur Arch Psychiatry Clin Neurosci 2023; 273:1295-1306. [PMID: 36370175 PMCID: PMC10449687 DOI: 10.1007/s00406-022-01501-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/14/2022] [Indexed: 11/15/2022]
Abstract
The hypothalamus regulates sexual behavior and is simultaneously associated with aggression and violence. Consequently, this brain region is relevant in research of pedophilia and child sexual offenses (CSO). The distinction between these two phenomena is of great importance and was the object of consideration of this study. We analyzed exclusively men, including 73 pedophilic offenders who committed CSO, an equal number of people with pedophilia but without such offenses, and 133 non-pedophilic, non-offending subjects who formed the control group. All data were collected in a multicenter in vivo study and analyzed using a semi-automated segmentation algorithm for 3-Tesla magnetic resonance images. Men with pedophilia who committed CSO on average had a 47 mm3 smaller hypothalamus per side than people without committed CSO. This effect was driven by both the group of non-offending people with pedophilia and the control group. By contrast, the exploratory comparison of pedophilic persons without CSO with the control group showed no significant difference. The present study demonstrates a deviant hypothalamic structure as a neurobiological correlate of CSO in pedophiles, but not in people with pedophilia who have not committed CSO. Thus, it strengthens the argument to distinguish between sexual offending and paraphilic sexual preferences.
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Affiliation(s)
- Melanie Storch
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany.
- Department of Biology, University of Leipzig, 04103, Leipzig, Germany.
| | - Maria Kanthack
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany
| | - Till Amelung
- Institute of Sexology and Sexual Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany
- Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany
| | - Klaus M Beier
- Institute of Sexology and Sexual Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany
| | - Tillmann H C Krueger
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625, Hanover, Germany
- Center for Systems Neuroscience Hannover, Hanover, Germany
| | - Christopher Sinke
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625, Hanover, Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany
| | - Martin Walter
- Department of Psychiatry, Otto-Von Guericke-University Magdeburg, 39106, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Jena, 07743, Jena, Germany
| | - Boris Schiffer
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr University Bochum, LWL University Hospital, 44791, Bochum, Germany
| | - Stephanie Schindler
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany
| | - Peter Schoenknecht
- Medical Faculty, Department of Psychiatry and Psychotherapy, University Hospital Leipzig, 04103, Leipzig, Germany
- Out-Patient Department for Sexual-Therapeutic Prevention and Forensic Psychiatry, University Hospital Leipzig, 04103, Leipzig, Germany
- Academic Saxon State Hospital Arnsdorf, 01477, Arnsdorf, Germany
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Swaminath S, Simons RM, Hatwan ML. Understanding Pedophilia: A Theoretical Framework on the Development of Sexual Penchants. JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:732-748. [PMID: 37463124 DOI: 10.1080/10538712.2023.2236602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 05/08/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
Pedophilia is a significant public health problem. Despite its cost to society, little effort has been directed toward understanding idiographic differences in the development and maintenance of pedophilia. Extant literature emphasizes biological underpinnings and predictors of re-offense. In this article, we posit that pedophilic penchants in males originate due to language, cognition, emotions, and emotion regulation. Adverse childhood experiences, such as emotional and sexual abuse, are posited as a major contributor to the etiology of pedophilia. However, not all individuals attracted to minors present with similar childhood adversities. The development of pedophilia, in the absence of such direct training (childhood adversities), is difficult to comprehend. Relational frame theory, a comprehensive account of human language and cognition, aids in deciphering the idiographic underpinnings of pedophilia. The role of maladaptive emotion regulation in maintaining pedophilia is also described. This article presents examples of how relational frames are established and activated in distressing contexts. Finally, implications for future research are discussed.
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Vásquez-Amézquita M, Leongómez JD, Salvador A, Seto MC. What can the eyes tell us about atypical sexual preferences as a function of sex and age? Linking eye movements with child-related chronophilias. Forensic Sci Res 2023; 8:5-15. [PMID: 37712065 PMCID: PMC10498142 DOI: 10.1093/fsr/owad009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/14/2022] [Accepted: 10/13/2022] [Indexed: 09/16/2023] Open
Abstract
Visual attention plays a central role in current theories of sexual information processing and is key to informing the use of eye-tracking techniques in the study of typical sexual preferences and more recently, in the study of atypical preferences such as pedophilia (prepubescent children) and hebephilia (pubescent children). The aim of this theoretical-empirical review is to connect the concepts of a visual attention-based model of sexual arousal processing with eye movements as indicators of atypical sexual interests, to substantiate the use of eye-tracking as a useful indirect measure of sexual preferences according to sex and age of the stimuli. Implications for research are discussed in terms of recognizing the value, scope and limitations of eye-tracking in the study of pedophilia and other chronophilias in males and females, and the generation of new hypotheses using this type of indirect measure of human sexual response.
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Affiliation(s)
- Milena Vásquez-Amézquita
- Faculty of Psychology, Universidad El Bosque, Bogotá, Colombia
- Department of Psychobiology, Laboratory of Social Cognitive Neuroscience, IDOCAL, University of Valencia, Valencia, Spain
- Department of Social Sciences, Faculty of Human and Social Sciences, Universidad de la Costa, Barranquilla, Colombia
| | | | - Alicia Salvador
- Department of Psychobiology, Laboratory of Social Cognitive Neuroscience, IDOCAL, University of Valencia, Valencia, Spain
| | - Michael C Seto
- Forensic Research Unit, Royal Ottawa HealthCare Group, Ottawa, ON, Canada
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Schaefer A, Wittenberg A, Galynker I, Cohen LJ. Qualitative Analysis of Minor Attracted Persons' Subjective Experience: Implications for Treatment. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:391-411. [PMID: 36147026 DOI: 10.1080/0092623x.2022.2126808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Treatment for Minor Attracted Persons is inadequate and difficult to access. This qualitative study examined community-based MAPs' responses to narrative questions about their experiences and what they want society to understand, using an iterative thematic analysis. Notable responses from the participants included: 1) sexual attraction does not equal action; 2) minor attraction is immutable; 3) stigma leads to psychological burden; 4) therapy should aim to reduce distress, not change sexual feelings; and 5) sexual behavior can be controlled and remain within legal parameters. Further understanding of MAPs' experiences is key for developing more efficacious treatment modalities to help them live meaningful lives without endangering children.
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Affiliation(s)
- Adelle Schaefer
- Department of Psychiatry, Mount Sinai Beth Israel Hospital, New York, New York, USA
| | - Alexander Wittenberg
- Department of Psychiatry, Mount Sinai Beth Israel Hospital, New York, New York, USA
| | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel Hospital, New York, New York, USA
| | - Lisa J Cohen
- Department of Psychiatry, Mount Sinai Beth Israel Hospital, New York, New York, USA
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Stigmatisation of People with Deviant Sexual Interest: A Comparative Study. SEXES 2022. [DOI: 10.3390/sexes4010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Pedophilia is a deviant sexual interest subject to more public stigma and punitive attitudes than others. Pedophilia has received a disproportionate amount of scholarly attention in comparison to other deviant sexual interests. To address this, the present study offers a comparison of the public stigma and punitive attitudes associated with pedophilia, fetishism, and hypersexuality. Methods: Recruited in Australia, one-hundred and twelve individuals participated in an anonymous online survey. Stigmatising and punitive attitudes toward pedophilia, fetishism, and hypersexuality were assessed via sub-scales of perceived dangerousness, deviance, intentionality, and punitive attitudes. Results: Participants held harsher punitive attitudes toward people with pedophilia and thought them to be more deviant and dangerous than people with fetishism and hypersexuality. Participants perceived hypersexuality to be more dangerous and deviant than fetishism. No consistent combination of perceived dangerousness, deviance, and intentionality predicted punitive attitudes toward all conditions. Rather, combinations of punitive attitude predictors were unique across conditions. Conclusions: This research articulates the unparalleled public stigma and punitive attitudes faced by people with pedophilia, compared to people with fetishism and hypersexuality. Findings which suggest that public stigma is stronger for hypersexuality than it is for fetishism are relatively novel, as are the observed predictors of punitive attitudes toward each condition. Knowledge produced by this study contributes to an improved conceptualisation of how the public views individuals who experience deviant sexual interests.
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Lehmann RJB, Brouillette-Alarie S, Pedneault A, Knight RA. Validating the Screening Scale of Pedophilic Crime Scene Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:4085-4096. [PMID: 35896938 PMCID: PMC9663345 DOI: 10.1007/s10508-022-02354-z] [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: 10/18/2021] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
The Screening Scale of Pedophilic Crime Scene Behavior (SSPC) is a seven-item structured rating scale assessing pedophilic sexual arousal. In the current study, we cross-validated the scale's convergent validity using multiple measures of sexual interest in children (clinical diagnosis of pedophilia, the high fixation/low social competence type of the MTC:CM4, and phallometric assessment of sexual interests toward children) in two independent samples (USA and Canada). In both samples and in relation to all three criteria, the SSPC showed acceptable (phallometry) to excellent (clinical assessment) diagnostic accuracy. Furthermore, the SSPC showed incremental validity in relation to the Screening Scale for Pedophilic Interest and at times outperformed it in convergent validity analyses. The current study also provides psychometric information that can help users choose an appropriate SSPC cutoff score.
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Affiliation(s)
- Robert J B Lehmann
- Department of Psychology, MSB Medical School Berlin, Institute of Psychology, Rüdesheimer Str. 50, 14197, Berlin, Germany.
| | | | - Amelie Pedneault
- Department of Criminal Justice and Criminology, Washington State University, Pullman, WA, USA
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9
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Glina F, Carvalho J, Barroso R, Cardoso D. Lay People´s Myths Regarding Pedophilia and Child Sexual Abuse: A Systematic Review. Sex Med Rev 2022; 10:596-619. [PMID: 37051950 DOI: 10.1016/j.sxmr.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The term "paedophilia erotica" was first coined in 1886 by the psychiatrist Krafft-Ebing and it was considered a "psycho-sexual perversion." It was at the beginning of the twentieth century that the term "pedophilia" was adopted and it started to appear in medical dictionaries. Sexual abuse is legally defined as the engagement in sexual contact with a person below a specified age or who is incapable of giving consent. Both, pedophilia and child sexual abuse (CSA) are worldwide phenomena requiring deep scientific knowledge in order to improve prevention strategies. Individuals' misconceptions of pedophilia and CSA may legitimize sexual violence, which can influence prevention strategies and policies. OBJECTIVES This review aimed to summarize existing research to help answer the question: "What are laypeople´s myths regarding pedophilia and CSA?" METHODS This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify as many relevant articles as possible. A literature search was conducted using PubMed, Web of Science, Scopus, and EBSCOhost databases for articles published before January 2022. Sixty-one articles were included in the current review. RESULTS Overall, findings revealed a significant number of myths regarding pedophilia and CSA, organized into the following categories: (i) blame diffusion, (ii) denial of abusiveness, (iii) restrictive stereotypes, (iv) victim age and consequences, (v) social stigma, (vi) punitive attitudes, and (vii) treatment. CONCLUSION Findings suggested that laypeople's perceptions should be taken into account when devising prevention policies. Additionally, perceptions should also be a target of prevention since there is evidence of social stigma and prejudice involving individuals with pedophilia. Such phenomena can contribute to social, emotional, and cognitive problems, among said individuals as well as causing these individuals to exhibit a higher risk for abusive behavior and less help-seeking. Glina F, Barroso R, Cardoso D, et al. Lay People´s Myths Regarding Pedophilia and Child Sexual Abuse: A Systematic Review. Sex Med Rev 2022;XX:XXX-XXX.
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Affiliation(s)
- Flavia Glina
- Faculty of Psychology and Education Sciences University of Porto, Porto, Portugal
| | - Joana Carvalho
- Faculty of Psychology and Education Sciences University of Porto, Porto, Portugal
- CPUP: Center for Psychology of Porto University, Faculty of Psychology and Educational Sciences Porto University, Porto, Portugal
| | - Ricardo Barroso
- Department of Education and Psychology University of Tras-os-Montes and Alto Douro, Vila Real, Portugal
| | - Daniel Cardoso
- Sociology Department Manchester Metropolitan University, Manchester, UK
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10
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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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Media Coverage of Pedophilia and Its Impact on Help-Seeking Persons with Pedophilia in Germany—A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159356. [PMID: 35954714 PMCID: PMC9368625 DOI: 10.3390/ijerph19159356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
The public stigma associated with pedophilia, the sexual attraction to prepubescent children, is tremendous. Previous research indicates that undifferentiated media coverage plays an essential role in perpetuating the public stigma by falsely equating pedophilia and child sexual abuse (CSA) and thus may stop persons suffering from a pedophilic disorder from seeking professional help. Until now, a comprehensive examination of positive as well as negative media effects on affected individuals is missing. Therefore, the present study explores if and how media coverage impacts the lives of help-seeking persons with pedophilia by conducting four qualitative focus group discussions with a clinical sample (N = 20) from the German Prevention Network “Kein Täter werden”. Present results demonstrate that media coverage of pedophilia was perceived as mostly undifferentiated, even though participants observed an increase in fact-based reporting over the years. Moreover, it seems that media coverage has strong emotional and behavioral consequences for patients (e.g., negative reporting reduced self-esteem). In sum, our results highlight that differentiated media coverage could play a key role in supporting help-seeking persons with pedophilic disorder, while the impact of undifferentiated media coverage appears to be mostly negative. Therefore, our results point to the need to reframe pedophilia using differentiated media coverage to help affected persons receive treatment efficiently and thereby prevent CSA.
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12
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Richards K, Biron D. Framing Perpetrators of Sexual Violence Who Participate in Circles of Support and Accountability (CoSA): An Analysis of Global Print Media Reporting. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022:306624X221113536. [PMID: 35852435 DOI: 10.1177/0306624x221113536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Circles of Support and Accountability (CoSA) are now part of the criminal justice landscape in various parts of the world. While CoSA have received considerable media attention, it is not yet known how they are portrayed in the media. This study addressed this gap by analyzing newspaper coverage of CoSA from across the English-speaking world. Overall, it identified that representations of those convicted of sexual violence in print media accounts of CoSA differ substantially from those identified in previous scholarship. We argue therefore that the nature of CoSA as an intervention may allow for more sympathetic and humanistic representation. The findings provide a platform from which the international CoSA community can develop strategic approaches to interacting with the media.
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Affiliation(s)
- Kelly Richards
- Queensland University of Technology-Gardens Point Campus, Brisbane, Australia
| | - Dean Biron
- Queensland University of Technology-Gardens Point Campus, Brisbane, Australia
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13
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Lievesley R, Swaby H, Harper CA, Woodward E. Primary Health Professionals' Beliefs, Experiences, and Willingness to Treat Minor-Attracted Persons. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:923-943. [PMID: 35084616 PMCID: PMC8793822 DOI: 10.1007/s10508-021-02271-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 05/31/2023]
Abstract
There is a desire and need among minor-attracted persons (MAPs) to access support within the community, and this often begins with an approach to healthcare providers working in general medical/mental health settings. However, little is known about the experiences of these non-specialist professionals in relation to their beliefs, knowledge, and decision-making processes when working with patients who disclose sexual attractions to children. Using an online survey, this study explored the knowledge, comfort, competence, and treatment willingness of 220 non-specialist healthcare providers when faced with patients who disclose sexual attractions to children. We investigated how often such disclosures were made, clinician stigma, treatment priorities, and professionals' willingness to report MAPs to external agencies because of their sexual attractions. Some key differences were found when comparing primary medical vs. mental health professionals, including increased likelihood to view MAPs as dangerous, unable to control behaviors and that sexual attractions are an avoidable choice, in the former group. Both groups prioritized mental health treatment targets above controlling attractions and living with stigmatized attractions, although controlling or changing attractions were still relatively high priorities. Results indicated a need for further training, focusing on increasing comfort around working with MAPs, as this was associated with a greater willingness to work with this group. We identify current gaps in service provision for MAPs seeking professional support and discuss recommendations for professional training.
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Affiliation(s)
- Rebecca Lievesley
- Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK.
| | - Helen Swaby
- Department of Counselling, Bishop Grosseteste University, Lincoln, UK
| | - Craig A Harper
- Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Ellie Woodward
- Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
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Speer L, Schuler M, Keil J, Moran JK, Pantazidis P, Amelung T, Florack J, Beier KM, Senkowski D. Sexual preference for prepubescent children is associated with enhanced processing of child faces in juveniles. Eur Child Adolesc Psychiatry 2022; 31:261-274. [PMID: 33230608 PMCID: PMC8837509 DOI: 10.1007/s00787-020-01684-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022]
Abstract
Child sexual abuse offences (CSOs) represent a severe ethical and socioeconomic burden for society. Juveniles with a sexual preference for prepubescent children (PP) commit a large percentage of CSOs, but have been widely neglected in neuroscience research. Aberrant neural responses to face stimuli have been observed in men with pedophilic interest. Thus far, it is unknown whether such aberrations exist already in PP. A passive face-viewing paradigm, including the presentation of child and adult faces, was deployed and high-density electroencephalography data were recorded. The study group comprised 25 PP and the control group involved 22 juveniles with age-adequate sexual preference. Attractiveness ratings and evoked brain responses were obtained for the face stimuli. An aberrant pattern of attractiveness ratings for child vs. adult faces was found in the PP group. Moreover, elevated occipital P1 amplitudes were observed for adult vs. child faces in both groups. At longer latency (340-426 ms), a stronger negative deflection to child vs. adult faces, which was source localized in higher visual, parietal and frontal regions, was specifically observed in the PP group. Our study provides evidence for enhanced neural processing of child face stimuli in PP, which might reflect elevated attention capture of face stimuli depicting members from the sexually preferred age group. This study expands our understanding of the neural foundations underlying sexual interest in prepubescent children and provides a promising path for the uncovering of objective biomarkers of sexual responsiveness to childlike body schemes in juveniles.
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Affiliation(s)
- Lara Speer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Sexology and Sexual Medicine, Charitéplatz 1, 10117, Berlin, Germany.
| | - Miriam Schuler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Sexology and Sexual Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Julian Keil
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Biological Psychology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - James K Moran
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Pierre Pantazidis
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Sexology and Sexual Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Till Amelung
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Sexology and Sexual Medicine, Charitéplatz 1, 10117, Berlin, Germany
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jakob Florack
- Child and Adolescent Psychiatry, Vivantes Hospital Berlin, Berlin, Germany
| | - Klaus M Beier
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Sexology and Sexual Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Daniel Senkowski
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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15
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Tozdan S, Briken P, Schröder J. Women with Sexual Interest in Children - Results from an Online Survey Among a Non-Forensic Female Sample. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:444-460. [PMID: 34823438 DOI: 10.1080/0092623x.2021.2005208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Little research has examined adult women's sexual interest in children, particularly in non-forensic samples. We aimed to describe characteristics of women with sexual interest in children by recruiting 52 women (mean age: 33.2 years) who have a self-identified sexual interest in children under the age of 14 years into an anonymous online self-report study. Measures of interest referred to general characteristics (e.g., age, education level), general sexuality (e.g., sexual orientation, masturbation), and sexual interest in children (e.g., exclusivity, motivation to change). Results showed that women with sexual interest in children are similar to non-forensic samples of men with sexual interest in children in previous studies and rather differ from women from the general population regarding the investigated characteristics in this study. Our results clearly indicate that women with sexual interest in children need to be taken into account in future research and clinical practice. Treatment programs preventing sexual offenses against children or the consumption of abuse material need to explicitly address females as well.
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Affiliation(s)
- Safiye Tozdan
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johanna Schröder
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Warren JI, Reed J. Victim selection patterns of community-residing child molesters identified by a nationwide youth-serving organization. BEHAVIORAL SCIENCES & THE LAW 2021; 39:307-327. [PMID: 33786890 DOI: 10.1002/bsl.2507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/08/2021] [Accepted: 02/06/2021] [Indexed: 06/12/2023]
Abstract
The current study examines data extracted from revocation files of a national youth-serving organization (YSO) involving 7819 revoked individuals and 12,254 alleged child victims to better understand victim selection patterns of community-residing child molesters. These data demonstrate consistent patterns of victim selection based upon the age, gender, and YSO affiliation of each victim. We created two variables to explore whether the revoked individual was "likely pedophilic (LP)" or a "mixed offender (MO)" based upon their behaviors and patterns of victim selection. Compared with the non-LPs and non-MOs, LPs and MOs had more known victims, were more often involved in other YSOs, and were more likely to have had contact with law enforcement. We utilized a public health perspective to interpret these findings, suggesting that child sexual abuse in YSOs reflects a societal problem that is not a unique phenomenon specific to programs offering services to youth.
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Affiliation(s)
- Janet I Warren
- Department of Psychiatry and Neurobehavioral Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA
- Institute of Law, Psychiatry and Public Policy, University of Virginia, Charlottesville, VA, USA
| | - James Reed
- Department of Psychiatry and Neurobehavioral Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA
- Institute of Law, Psychiatry and Public Policy, University of Virginia, Charlottesville, VA, USA
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17
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Lehmann RJB, Schmidt AF, Jahnke S. Stigmatization of Paraphilias and Psychological Conditions Linked to Sexual Offending. JOURNAL OF SEX RESEARCH 2021; 58:438-447. [PMID: 32352329 DOI: 10.1080/00224499.2020.1754748] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Except for pedophilia, little is known about public attitudes toward paraphilias and psychological conditions that are considered risk factors for sexual offending. In the present study we sought to compare the stigma attached to pedophilia with attitudes toward sexual sadism and antisocial tendencies (Study 1, N = 720) and with attitudes toward necrophilia and zoophilia (Study 2, N = 210) in convenience samples of community individuals. When investigating social distance intentions both studies explicitly referred to people with paraphilic sexual interests or antisocial tendencies who had not committed any crimes. In both studies, people with pedophilia emerged as highly stigmatized even though most participants showed awareness that pedophilic interests cannot be chosen or changed at will. The present studies solidify the evidence that pedophilia occupies a place in the public consciousness as less deserving of acceptance than most other sexual offending risk-relevant conditions, including ones that compare in terms of rarity.
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Affiliation(s)
| | - Alexander F Schmidt
- Institute of Psychology, Social & Legal Psychology, Johannes Gutenberg-University of Mainz
| | - Sara Jahnke
- Department of Research Synthesis, Intervention, and Evaluation, Friedrich-Schiller-University Jena
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18
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Prado CSDC, Lopes PMG, Moll J, DeSalles A, de Oliveira-Souza R. A case of developmental pedophilia unmasked by frontotemporal dementia. Neurocase 2021; 27:129-137. [PMID: 33856971 DOI: 10.1080/13554794.2021.1886310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A 65-year-old right-handed man gradually became socially indifferent and less active. Four years later, he was indicted for molesting children on multiple occasions. Psychomotor slowness and executive impairment contrasted with sparing of language, semantic memory, visuospatial perception, construction praxis, and right-left orientation. Neuroimaging showed asymmetric atrophy of dorsomedial frontal and anterior temporal lobes, and hypoperfusion of medial prefrontal cortex consistent with a diagnosis of behavioral variant of frontotemporal dementia. Further information revealed that the patient exhibited pedophilic behavior several years prior to symptom onset. We conclude that preexisting developmental pedophilia was "unmasked" by the underlying progressive frontotemporal degeneration.
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Affiliation(s)
- Catarina Sodré de Castro Prado
- Department of Neurology, Gaffrée e Guinle University Hospital, the Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Pedro Maranhão Gomes Lopes
- Department of Neurology, Gaffrée e Guinle University Hospital, the Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jorge Moll
- Division of Clinical and Experimental Neurology, The D'Or Institute for Research & Education (Idor), Rio de Janeiro, RJ, Brazil
| | - Antonio DeSalles
- Professor Emeritus of Neurosurgery and Radiation Oncology, UCLA School of Medicine; and Department of Neurosurgery and Radiotherapy, Director of NeuroSapiens, Neurosurgery at the D'Or-São Luiz Hospitals Network, São Paulo, SP, Brazil
| | - Ricardo de Oliveira-Souza
- Department of Neurology, Gaffrée e Guinle University Hospital, the Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Division of Clinical and Experimental Neurology, The D'Or Institute for Research & Education (Idor), Rio de Janeiro, RJ, Brazil
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19
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Giles S, Alison L. Prioritizing Indecent Image Offenders: A Systematic Review and Economic Approach to Understand the Benefits of Evidence-Based Policing Strategies. Front Psychol 2021; 12:606731. [PMID: 33633637 PMCID: PMC7902032 DOI: 10.3389/fpsyg.2021.606731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/12/2021] [Indexed: 11/29/2022] Open
Abstract
In 2013, there were an estimated 50,000 individuals involved in downloading and sharing indecent images of children (IIOC) in the United Kingdom (UK). This poses challenges for limited police resources. We argue that police officers can make most effective use of limited resources by prioritizing those offenders who pose the greatest risk of contact offending, by nature of demonstrable pedophilia, hebephilia or dual offending status and thus, those at highest risk must be dealt with first. What is currently lacking is a clear idea of the potential scale of the problem in socio-economic terms and why, therefore, it is so important that evidence-based approaches to offender detection and investigation continue to be a top priority for funders and policy makers. A systematic literature review was undertaken to address two related questions. First, what is the scale of the problem in the UK, in terms of the number of pedophilic and hebephilic individuals who pose a risk of contact offending against a child? Second, what is the potential socio-economic burden generated by the national IIOC suspect pool if left unattended to by targeted police action? Applying population estimates of pedophilia and hebephilia to the male population (16–89 years), we estimate there are between 2,365–5,991 males with paedophila and 12,218–30,952 males with hebephilia who are likely contact offenders. Applying average prevalence and incidence based costing methods to a conservative estimate of one victim per offender, the combined socio-economic burden from these persons could amount to £236-£597 million (incident costs) increasing to £2.9-£7.3 billion (lifetime costs; £3.3-£8.3 billion including QALY measures). Applying the same costs to CEOP (2013) estimate of 50,000 IIOC offenders we estimate that between 6,000 and 27,500 dual offenders could have already committed past contact offenses, contributing an economic burden of between £97–£445 million (incident costs) increasing to £1.2–£5.4 billion (lifetime costs; £1.4–£6.2 billion including QALY measures). Future contact offenses could contribute a further burden of £16–£18.6 million (incident costs) increasing to £198–£227 million (lifetime costs; £226–£260 million including QALY measures). Drawing upon these findings, we argue for the benefits of a research-informed prioritization approach to target IIOC offenders.
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Affiliation(s)
- Susan Giles
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Laurence Alison
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
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20
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Stelzmann D, Jahnke S, Kuhle LF. Media Coverage of Pedophilia: Benefits and Risks from Healthcare Practitioners' Point of View. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165739. [PMID: 32784429 PMCID: PMC7460489 DOI: 10.3390/ijerph17165739] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/01/2020] [Accepted: 08/05/2020] [Indexed: 11/22/2022]
Abstract
The fierce stigma associated with pedophilia may interfere with attempts to prevent sexual offending. Prior research on the effects of media reports about pedophilia mostly focused on their role in perpetuating stigma in the general population. In order to better understand potential benefits and risks of the media coverage on people with pedophilia and specialized prevention and treatment efforts, we conducted semi-structured qualitative interviews with 11 healthcare practitioners of the German Prevention Network “Don’t offend”. Healthcare practitioners described positive (e.g., raising awareness for prevention offers) as well as negative (e.g., perpetuating the existing public stigma) effects of the media coverage and estimated that only about one-third of media coverage portrays pedophilia realistically. To destigmatize pedophilia and benefit the prevention of child sexual abuse, a fact box for journalists was developed based on practitioners’ expert knowledge.
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Affiliation(s)
- Daniela Stelzmann
- Institute of Sexology and Sexual Medicine, Charité – Universitätsmedizin Berlin, 10117 Berlin, Germany;
- Institute for Media and Communication Studies, Freie Universität Berlin, 14195 Berlin, Germany
- Correspondence:
| | - Sara Jahnke
- Department of Psychology, Friedrich-Schiller-Universität Jena, 07743 Jena, Germany;
| | - Laura F. Kuhle
- Institute of Sexology and Sexual Medicine, Charité – Universitätsmedizin Berlin, 10117 Berlin, Germany;
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21
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Thibaut F, Cosyns P, Fedoroff JP, Briken P, Goethals K, Bradford JMW. The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders. World J Biol Psychiatry 2020; 21:412-490. [PMID: 32452729 DOI: 10.1080/15622975.2020.1744723] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objectives: The primary aim of these guidelines is to evaluate the role of pharmacological agents in the treatment and management of patients with paraphilic disorders, with a focus on the treatment of adult males. Because such treatments are not delivered in isolation, the role of specific psychotherapeutic interventions is also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients, including sexual offenders, with paraphilic disorders. The aim of these guidelines is to bring together different views on the appropriate treatment of paraphilic disorders from experts representing different countries in order to aid physicians in clinical decisions and to improve the quality of care.Methods: An extensive literature search was conducted using the English-language-literature indexed on MEDLINE/PubMed (1990-2018 for SSRIs) (1969-2018 for hormonal treatments), supplemented by other sources, including published reviews.Results: Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. The type of medication used depends on the severity of the paraphilic disorder and the respective risk of behaviour endangering others. GnRH analogue treatment constitutes the most relevant treatment for patients with severe paraphilic disorders.Conclusions: An algorithm is proposed with different levels of treatment for different categories of paraphilic disorders accompanied by different risk levels.
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Affiliation(s)
- Florence Thibaut
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin, University of Paris, INSERM U1266, Institute of Psychiatry and Neurosciences, Paris, France
| | - Paul Cosyns
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - John Paul Fedoroff
- Division of Forensic Psychiatry, The Royal Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Kris Goethals
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp and University Forensic Centre, Antwerp University Hospital, Antwerp, Belgium
| | - John M W Bradford
- The Royal Institute of Mental Health Research, University of Ottawa, McMaster University, Ottawa & Hamilton, ON, Canada
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22
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Münch R, Walter H, Müller S. Should Behavior Harmful to Others Be a Sufficient Criterion of Mental Disorders? Conceptual Problems of the Diagnoses of Antisocial Personality Disorder and Pedophilic Disorder. Front Psychiatry 2020; 11:558655. [PMID: 33093836 PMCID: PMC7523554 DOI: 10.3389/fpsyt.2020.558655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 08/25/2020] [Indexed: 11/20/2022] Open
Abstract
Generally, diseases are primarily harmful to the individual herself; harm to others may or may not be a secondary effect of diseases (e.g., in case of infectious diseases). This is also true for mental disorders. However, both ICD-10 and DSM-5 contain two diagnoses which are primarily defined by behavior harmful to others, namely Pedophilic Disorder and Antisocial (or Dissocial) Personality Disorder (ASPD or DPD). Both diagnoses have severe conceptual problems in the light of general definitions of mental disorder, like the definition in DSM-5 or Wakefield's "harmful dysfunction" model. We argue that in the diagnoses of Pedophilic Disorder and ASPD the criterion of harm to the individual is substituted by the criterion of harm to others. Furthermore, the application of the criterion of dysfunction to these two diagnoses is problematic because both heavily depend on cultural and social norms. Therefore, these two diagnoses fall outside the general disease concept and even outside the general concept of mental disorders. We discuss whether diagnoses which primarily or exclusively ground on morally wrong, socially inacceptable, or criminal behavior should be eliminated from ICD and DSM. On the one side, if harming others is a sufficient criterion of a mental disorder, the "evil" is pathologized. On the other side, there are practical reasons for keeping these diagnoses: first for having an official research frame, second for organizing and financing treatment and prevention. We argue that the criteria set of Pedophilic Disorder should be reformulated in order to make it consistent with the general definition of mental disorder in DSM-5. This diagnosis should only be applicable to individuals that are distressed or impaired by it, but not solely based on behavior harmful to others. For ASPD, we conclude that the arguments for eliminating it from the diagnostic manuals overweigh the arguments for keeping it.
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Affiliation(s)
- Ricarda Münch
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Henrik Walter
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sabine Müller
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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23
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Stoll CB, Boillat C, Pflueger MO, Graf M, Rosburg T. Psychopathy, Neuroticism, and Abusive Behavior in Low Risk Child Sex Offenders. JOURNAL OF CHILD SEXUAL ABUSE 2019; 28:990-1006. [PMID: 31225780 DOI: 10.1080/10538712.2019.1630880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/27/2019] [Accepted: 06/01/2019] [Indexed: 06/09/2023]
Abstract
Personality traits are considered as an important aspect in the assessment of child sex offenders (CSOs). The current study sought to elucidate the association between neuroticism, psychopathy, and abusive behavior in low risk CSOs. 43 pedophilic CSOs and 21 controls (CTLs) completed the NEO-Personality Inventory-Revised (NEO-PI-R), Psychopathy Checklist: Screening Version (PCL:SV), and Multiphasic Sex Inventory (MSI). Our results revealed small differences in PCL scores between CSOs and CTLs, with comparatively low levels of psychopathy in both groups. Higher levels of neuroticism were associated with higher PCL scores, in both CSOs and CTLs. However, higher PCL scores in CSOs did not correlate with higher MSI total scores on the subscale child molest. These findings suggest an ambiguous role of psychopathy in CSOs: higher levels of psychopathy co-occur with higher levels of neuroticism, but psychopathy does apparently not modulate abusive behavior, at least not in low risk offenders, as currently investigated.
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Affiliation(s)
- Cedric B Stoll
- Forensics Department, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Coralie Boillat
- Forensics Department, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Marlon O Pflueger
- Forensics Department, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Marc Graf
- Forensics Department, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Timm Rosburg
- Forensics Department, University Psychiatric Clinics Basel, Basel, Switzerland
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Camperio Ciani AS, Scarpazza C, Covelli V, Battaglia U. Profiling acquired pedophilic behavior: Retrospective analysis of 66 Italian forensic cases of pedophilia. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 67:101508. [PMID: 31785728 DOI: 10.1016/j.ijlp.2019.101508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/06/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
Neurological disorders can be mis-diagnosed as psychiatric ones. This might happen to pedophilia emerging as a symptom of brain insult (i.e. acquired pedophilic behavior). This paper aims to delineate a behavioral profile that might help to identify defendants whose pedophilic behavior is likely to be the consequence of a neurological disorder. Through a systematic review of the literature, seventeen clinical and behavioral variables of the modus operandi and victimology that can distinguish between acquired and developmental pedophilic behavior have been collected. Seven of these were found to be consistent behavioral indicators (i.e. red flags) for acquired pedophilia. Cluster hierarchical analysis on the seventeen variables collected through the systematic review of the literature on cases of acquired pedophilic behavior was applied to a new dataset including 66 Italian closed cases of pedophilia. Stepwise regression and correlation analyses were carried out to further examine the differences between the clusters identified in the cluster analysis. Results revealed that the new sample was partitioned into two clusters. Individuals with ascertained acquired pedophilia were grouped together. The clusters widely differed for the prevalence of red flags (mean number of red flags in each cluster: 2.14 ± 0.79 vs 4.96 ± 0.93, p < 0.001), while no between cluster difference emerged for the other clinical and behavioral variables. Regression analysis provided a robust model that included the three most significant red flags that explain over 64.5% of the variance (absence of masking, spontaneous confession and offenders older age). An organic origin of pedophilic behavior should be suspected if red flags are present in a defendant charged with pedophilia. In those cases, an in depth trans-disciplinary neuroscientific investigation is advocated. The behavioral profile identified might help to provide a proper assessment of defendants.
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Affiliation(s)
- Andrea S Camperio Ciani
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy.
| | | | - Valeria Covelli
- Department of General Psychology, University of Padova, Padova, Italy
| | - Umberto Battaglia
- Department of General Psychology, University of Padova, Padova, Italy
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25
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Davis KA, Knight RA. Childhood maltreatment experiences and problematic sexual outcomes in adult males who have sexually offended: Further evidence of the potency of male caregiver psychological abuse. CHILD ABUSE & NEGLECT 2019; 96:104097. [PMID: 31437771 DOI: 10.1016/j.chiabu.2019.104097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 07/18/2019] [Accepted: 07/22/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Although research on the developmental antecedents of sexual offending has tended to focus on sexual abuse, recent research in juveniles and adults who have sexually offended suggests that psychological abuse perpetrated by a male caregiver may be a particularly important factor in the development of problematic sexual interests and behaviors. OBJECTIVE This study aimed to extend previous findings by investigating the association between psychological abuse by a male caregiver and problematic sexual outcomes in a sample of adult males who had sexually offended. PARTICIPANTS Participants were 529 adult males incarcerated for sexual offenses, 21% of whom were civilly committed. METHODS Childhood maltreatment and problematic sexual outcomes were assessed using the Multidimensional Assessment of Sex and Aggression, a contingency-based inventory that assesses domains related to sexual aggression. Hierarchical regressions were calculated examining the association between childhood abuse types and sexual outcomes. RESULTS Childhood sexual abuse was associated with child sexual (β = .247, p < .001) and other paraphilic interests (β = .189, p < .001). Male caregiver psychological abuse also emerged as marginally associated with child sexual interest (β = .100, p = .059), even after controlling for other abuse types. CONCLUSIONS These results partially replicate recent findings in a juvenile sample and challenge conventional developmental theories of sexual offending, by suggesting that male caregiver psychological abuse may play a role in the etiology of child sexual interest among males who have sexually offended. This study also suggests a possible gender symmetry effect moderating the developmental consequences of abuse.
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Affiliation(s)
- Kathryn A Davis
- Department of Psychology, Brandeis University, Waltham, MA, United States.
| | - Raymond A Knight
- Department of Psychology, Brandeis University, Waltham, MA, United States
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26
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Fuss J, Jais L, Grey BT, Guczka SR, Briken P, Biedermann SV. Self-Reported Childhood Maltreatment and Erotic Target Identity Inversions Among Men with Paraphilic Infantilism. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:781-795. [PMID: 31130086 DOI: 10.1080/0092623x.2019.1623355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Adults with paraphilic infantilism may desire to wear diapers or engage in infant-like role play. Erotic target identity inversions (ETII) and childhood maltreatment have been hypothesized to cause regressive interests. To evaluate these two etiological hypotheses, we surveyed the online adult baby/diaper lover community. Data from 1904 cis-gender men revealed a prevalence of pedophilic interests comparable with the general male population, arguing against ETIIs as common in paraphilic infantilism. In contrast, self-reported childhood neglect and abuse were highly prevalent, suggesting that infantilism might be correlated with childhood maltreatment. Additionally, some participants described repetition and/or sexualization of negative childhood experiences.
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Affiliation(s)
- Johannes Fuss
- Human Behavior Laboratory, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Laura Jais
- Human Behavior Laboratory, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | | | - Sascha R Guczka
- Psychological Methods and Statistics, Institute for Psychology, University of Hamburg , Hamburg , Germany
| | - Peer Briken
- Human Behavior Laboratory, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Sarah V Biedermann
- Human Behavior Laboratory, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
- Department of Psychiatry and Psychotherapy, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Jordan K, Wild TSN, Fromberger P, Müller I, Müller JL. Are There Any Biomarkers for Pedophilia and Sexual Child Abuse? A Review. Front Psychiatry 2019; 10:940. [PMID: 32038314 PMCID: PMC6985439 DOI: 10.3389/fpsyt.2019.00940] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/27/2019] [Indexed: 12/13/2022] Open
Abstract
The use of biomarkers in medicine is a common and valuable approach in several clinical fields. Understanding the relationship between measurable biological processes and clinical outcomes not only is indispensable in the face of understanding physiological processes in healthy as well as in diseased organisms but also for understanding and evaluating treatment effects. Therefore, also in the context of forensic psychiatry, biomarkers and their potentially beneficial effects are of growing interest. The objective of this review is to examine if there are biomarkers that may serve as a tool to support diagnostic process, treatment evaluation, and risk assessment of pedophilic individuals and child sexual offenders. In the first part, we present an overview of the current neurobiological, as well as physiological and psychophysiological approaches to characterize pedophilia and child sexual offending. Secondly, we discuss and evaluate the impact of these approaches on the development of biomarkers for diagnosis, therapy, and risk assessment in pedophilic subjects and child sexual offenders. We conclude that a lot of research has already enhanced our neurobiological knowledge about pedophilia and child sexual offending. Although there surely exist promising parameters and approaches, in our view currently none of these is ready yet to serve as a clinically applicable diagnostic, response, or predictive biomarker for pedophilia and child sexual offending. Therefore, further work remains to be done. The development of a composite diagnostic biomarker to assess deviant sexual interest, combining several measures like functional magnetic resonance imaging, electroencephalogram, eye tracking, and behavioral approaches seems to be most promising. A valid and reliable measurement of deviant sexual interest, insensitive to manipulations could significantly support clinical diagnostic process. Similarly, regarding therapy evaluation and risk assessment, a composite biomarker to assess inhibitory control functions seems to be promising. Furthermore, the application of the Research Domain Criteria-approach, a new approach for investigating and classifying mental disorders, offers the possibility to take research to a new level.
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Affiliation(s)
- Kirsten Jordan
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany
| | - Tamara Sheila Nadine Wild
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany
| | - Peter Fromberger
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany
| | - Isabel Müller
- Asklepios Forensic Psychiatric Hospital, Goettingen, Germany
| | - Jürgen Leo Müller
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany.,Asklepios Forensic Psychiatric Hospital, Goettingen, Germany
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Blagden NJ, Mann R, Webster S, Lee R, Williams F. "It's Not Something I Chose You Know": Making Sense of Pedophiles' Sexual Interest in Children and the Impact on Their Psychosexual Identity. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2018; 30:728-754. [PMID: 28366051 DOI: 10.1177/1079063217697132] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sexual interest in children is one of the most strongly predictive of the known risk factors for sexual reconviction. It is an important aspect of risk assessment to identify the presence of such interest, and an important task for treatment providers to address such a sexual interest where it is present. It has been argued that understanding pedophiles' deviant sexual interest in children can enhance risk assessment, management, and treatment planning. This research study aims to explore the phenomenology of deviant sexual interest in children, the impact it has on pedophilic offenders' identities, and their views on the treatability of that interest. The study used semistructured interviews and repertory grids to make sense of participants' experiences. The results revealed three superordinate themes: "'living' with a deviant sexual interest," "relational sexual self," and "possible and feared sexual self." The analysis unpacks these themes and repertory grid analysis is used to explore a subset of participants' identities in more detail. The results reveal that there needs to be an acceptance from both client and therapist that their sexual interest in children may never go away. Through this acceptance, clients could work on enhancing sexual self-regulation, recognizing their triggers, and so managing their sexual thoughts, feelings, and behavior. Implications for treatment are also discussed.
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Affiliation(s)
| | - Ruth Mann
- 2 The National Offender Management Service, England, UK
| | | | - Rachael Lee
- 2 The National Offender Management Service, England, UK
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29
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Abstract
PURPOSE OF REVIEW Risk assessment is one of the most ubiquitous tasks in the criminal justice system, informing virtually every decision made about offenders. This review, intended for researchers and practitioners, outlines some of the most important recent advances, emerging issues, and recommendations in sex offender risk assessment. RECENT FINDINGS The underlying nature and purpose of risk scales is reviewed, with implications for how we should evaluate them. Limits of recidivism probability estimates are discussed, and efforts to advance a common language for describing risk levels are highlighted. Advances in risk communication and field validity are summarized. The utility of protective risk factors in risk assessments is debated. Emerging areas in assessing offender change and assessments with child pornography offenders are discussed. Despite critical advances in the last few years, there are still important gaps in knowledge, particularly for risk communication, field implementation, offender change, and child pornography offenders.
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Affiliation(s)
- L Maaike Helmus
- Wandering Vagabond, 807-1189 Melville Street, Vancouver, BC, V6E 4T8, Canada.
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30
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Schmidt AF, Mann RE. Heraclitus’ River and Recent Advances in Criminal Psychology. EUROPEAN PSYCHOLOGIST 2018. [DOI: 10.1027/1016-9040/a000327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Alexander F. Schmidt
- Institute of Psychology, Social & Legal Psychology, Johannes Gutenberg University Mainz, Germany
- Department of Psychology, Medical School Hamburg, Germany
| | - Ruth E. Mann
- Her Majesty’s Prison & Probation Service, England and Wales, London, United Kingdom
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Gerwinn H, Weiß S, Tenbergen G, Amelung T, Födisch C, Pohl A, Massau C, Kneer J, Mohnke S, Kärgel C, Wittfoth M, Jung S, Drumkova K, Schiltz K, Walter M, Beier KM, Walter H, Ponseti J, Schiffer B, Kruger THC. Clinical characteristics associated with paedophilia and child sex offending - Differentiating sexual preference from offence status. Eur Psychiatry 2018; 51:74-85. [PMID: 29625377 DOI: 10.1016/j.eurpsy.2018.02.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 10/17/2022] Open
Abstract
Contrary to public perception, child sex offending (CSO) and paedophilia are not the same. Only half of all cases of CSO are motivated by paedophilic preference, and a paedophilic preference does not necessarily lead to CSO. However, studies that investigated clinical factors accompanying and contributing to paedophilia so far mainly relied on paedophiles with a history of CSO. The aim of this study was to distinguish between factors associated with sexual preference (paedophile versus non-paedophile) and offender status (with versus without CSO). Accordingly, a 2 (sexual preference) × 2 (offender status) factorial design was used for a comprehensive clinical assessment of paedophiles with and without a history of CSO (n = 83, n = 79 respectively), child sex offenders without paedophilia (n = 32) and healthy controls (n = 148). Results indicated that psychiatric comorbidities, sexual dysfunctions and adverse childhood experiences were more common among paedophiles and child sex offenders than controls. Offenders and non-offenders differed in age, intelligence, educational level and experience of childhood sexual abuse, whereas paedophiles and non-paedophiles mainly differed in sexual characteristics (e.g., additional paraphilias, onset and current level of sexual activity). Regression analyses were more powerful in segregating offender status than sexual preference (mean classification accuracy: 76% versus 68%). In differentiating between offence- and preference-related factors this study improves clinical understanding of both phenomena and may be used to develop scientifically grounded CSO prevention and treatment programmes. It also highlights that some deviations are not traceable to just one of these two factors, thus raising the issue of the mechanism underlying both phenomena.
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Affiliation(s)
- Hannah Gerwinn
- Department of Neurology, Medical School, Kiel University, Arnold-Heller-Str. 3, 24105 Kiel, Germany; Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Niemannsweg 147, 24105 Kiel, Germany
| | - Simone Weiß
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Forensic Psychiatry, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany; Institute of Forensic Psychiatry, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Gilian Tenbergen
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Department of Psychology, State University of New York at Oswego, 7060 State Route 104, 13126 Oswego, NY, USA
| | - Till Amelung
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Carina Födisch
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Alexander Pohl
- Department of Neurology, Medical School, Kiel University, Arnold-Heller-Str. 3, 24105 Kiel, Germany; Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Niemannsweg 147, 24105 Kiel, Germany
| | - Claudia Massau
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Forensic Psychiatry, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany; Institute of Forensic Psychiatry, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Jonas Kneer
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Sebastian Mohnke
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Christian Kärgel
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Forensic Psychiatry, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany; Institute of Forensic Psychiatry, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Matthias Wittfoth
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Stefanie Jung
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Krassimira Drumkova
- State Hospital for Forensic Psychiatry Uchtspringe, Schnöggersburger Weg 1, 39576 Stendal, Germany
| | - Kolja Schiltz
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany; Department of Forensic Psychiatry, Psychiatric Hospital, LMU Munich, Nußbaumstr. 7, 80336 München, Germany
| | - Martin Walter
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany; Department of General Psychiatry and Psychotherapy, University Hospital Tübingen, Osianderstr. 24, 72076 Tübingen, Germany
| | - Klaus M Beier
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Jorge Ponseti
- Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Niemannsweg 147, 24105 Kiel, Germany
| | - Boris Schiffer
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Forensic Psychiatry, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany; Institute of Forensic Psychiatry, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Tillmann H C Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
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32
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Tozdan S, Kalt A, Dekker A, Keller LB, Thiel S, Müller JL, Briken P. Why Information Matters: Examining the Consequences of Suggesting That Pedophilia Is Immutable. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:1241-1261. [PMID: 27864530 DOI: 10.1177/0306624x16676547] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
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.
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Affiliation(s)
- Safiye Tozdan
- 1 University Medical Center Hamburg-Eppendorf, Germany
| | - Anna Kalt
- 1 University Medical Center Hamburg-Eppendorf, Germany
| | - Arne Dekker
- 1 University Medical Center Hamburg-Eppendorf, Germany
| | | | | | | | - Peer Briken
- 1 University Medical Center Hamburg-Eppendorf, Germany
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33
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Hornor G, Zeno R. Child Sexual Abuse Perpetrators: What Forensic Nurses Need to Know. JOURNAL OF FORENSIC NURSING 2018; 14:206-213. [PMID: 30433909 DOI: 10.1097/jfn.0000000000000222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Child sexual abuse is a problem of epidemic proportions resulting in lifelong physical and mental health consequences for victims. Most child sexual abuse victims never disclose and do not receive needed treatment. Clearly, pediatric healthcare providers must understand the dynamics of child sexual abuse to better identify and protect potential victims. Forensic nurses are at the forefront of caring for victims of sexual abuse and are strong voices in the education of parents, community members, and other healthcare professionals regarding sexual abuse. Forensic nurses with a deeper understanding of child sexual abuse perpetrators will be better able to educate the public and advocate for children at risk for sexual abuse. In this article, specific types of child sexual abuse perpetration will be explored, and implications for forensic nursing will be discussed.
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Affiliation(s)
- Gail Hornor
- Center for Family Safety and Healing, Nationwide Children's Hospital
| | - Rosie Zeno
- The Ohio State University, Nationwide Children's Hospital
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34
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Wild TSN, Fromberger P, Jordan K, Müller I, Müller JL. Web-Based Health Services in Forensic Psychiatry: A Review of the Use of the Internet in the Treatment of Child Sexual Abusers and Child Sexual Exploitation Material Offenders. Front Psychiatry 2018; 9:763. [PMID: 30778306 PMCID: PMC6369176 DOI: 10.3389/fpsyt.2018.00763] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 12/20/2018] [Indexed: 11/13/2022] Open
Abstract
In recent years, web-based health services for a variety of mental disorders have been developed and evaluated. Evidence suggests that guided internet-based therapy can be as effective as conventional face-to-face therapy. In forensic psychiatric practice, few web-based treatments have been implemented up to now. However, to our knowledge, there do not yet exist guided internet-based treatments for child sexual abusers and child sexual exploitation material offenders. This review aims at examining under what conditions patients are most likely to benefit from internet-based treatments. In addition, some computer-based health services in forensic psychiatry will be summarized and their potentials and weaknesses will be discussed. Subsequently, the review focuses on the implications for the development of online treatments for child sexual abusers as well as on a variety of ethical and legal issues that practitioners may encounter during the development, evaluation and delivery of online health services. The review will conclude with proposed quality standards for the development and implementation of web-based interventions for child sexual abusers and child sexual exploitation material offenders. By virtue of the low number of psychotherapists offering therapy to this clientele as well as individual barriers to seeking treatment such as fear of stigmatization, feelings of shame, long access routes, or limited mobility due to physical handicaps, the development of mental eHealth services in this sector could close an important healthcare gap. By increasing the density of supply, more child sexual abusers and child sexual exploitation material offenders would have the chance to engage in treatment and, ultimately, more incidents of sexual assault against minors could be prevented.
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Affiliation(s)
- Tamara S N Wild
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, Human Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Peter Fromberger
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, Human Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Kirsten Jordan
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, Human Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Isabel Müller
- Prevention of Sexual Abuse (PsM), Asklepios Psychiatric Clinic Göttingen, Göttingen, Germany
| | - Jürgen L Müller
- Clinic for Psychiatry and Psychotherapy-Forensic Psychiatry, Human Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany
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35
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Dombert B, Antfolk J, Kallvik L, Zappalà A, Osterheider M, Mokros A, Santtila P. Identifying Pedophilic Interest in Sex Offenders Against Children With the Indirect Choice Reaction Time Task. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2017. [DOI: 10.1027/1015-5759/a000293] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Pedophilia – a disorder of sexual preference with primary sexual interest in prepubescent children – is forensically relevant yet difficult to detect using self-report methods. The present study evaluated the criterion validity of the Choice Reaction Time (CRT) task to differentiate between a sample of child sex offenders with a presumably high rate of pedophilic individuals and three control groups (other sex offenders, non-sex offenders, and community controls, all male; N = 233). The CRT task required locating a dot superimposed on images depicting men, women, girls, or boys and scrambled pictures as quickly as possible. We used two picture sets, the Not Real People (NRP) set and the Virtual People Set (VPS). We predicted sexually relevant pictures to elicit longer reaction times in interaction with the participant group. Both CRTs showed main effects of stimulus explicitness and preferred stimulus gender. The CRT-NRP also yielded an interaction effect of participant group and stimulus maturity while the CRT-VPS showed a tendency in this direction. The overall effect size was moderate. Results offer support for the usefulness of the CRT task in forensic assessment of child sex offenders.
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Affiliation(s)
- Beate Dombert
- Department of Forensic Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Jan Antfolk
- Department of Psychology and Logopedics, Åbo Akademi University, Finland
| | - Lisa Kallvik
- Department of Psychology and Logopedics, Åbo Akademi University, Finland
| | - Angelo Zappalà
- Department of Psychology and Logopedics, Åbo Akademi University, Finland
| | - Michael Osterheider
- Department of Forensic Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Andreas Mokros
- Department of Forensic Psychiatry and Psychotherapy, University of Regensburg, Germany
- Department for Forensic Psychiatry, University Hospital of Psychiatry Zurich, Switzerland
| | - Pekka Santtila
- Department of Psychology and Logopedics, Åbo Akademi University, Finland
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36
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Stolpmann G, Briken P, Müller JL. [Treatment structures for men with pedosexual problems]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 60:1055-1062. [PMID: 28752249 DOI: 10.1007/s00103-017-2604-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Pedophilia is defined as a persistent or dominating sexual preference for prepubescent children characterized by persistent thoughts, fantasies, urges, sexual arousal and behavior. Less than 50% of all child abusers fulfill the diagnostic criteria and an even smaller part exclusively has a preference for children. Following psychiatric classification systems, pedophilia must be distinguished from child sexual abuse. Outpatient treatment and treatment in forensic psychiatry clinics, sociotherapeutic facilities and in correction facilities are different aspects of prevention. So-called grey area projects (Dunkelfeldprojekte) are special facilities of primary and secondary prevention. The aim is to prevent sexual abuse by reducing and controlling of risk factors.
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Affiliation(s)
- Georg Stolpmann
- Schwerpunktprofessur für forensische Psychiatrie und Psychotherapie, Georg-August-Universität Göttingen, Rosdorfer Weg 70, 37081, Göttingen, Deutschland.
| | - Peer Briken
- Institut für Sexualforschung und Forensische Psychiatrie, Zentrum für Psychosoziale Medizin UKE Hamburg, Hamburg, Deutschland
| | - Jürgen L Müller
- Schwerpunktprofessur für forensische Psychiatrie und Psychotherapie, Georg-August-Universität Göttingen, Rosdorfer Weg 70, 37081, Göttingen, Deutschland.,Asklepios Klinik für forensische Psychiatrie und Psychotherapie, Göttingen, Deutschland
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37
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Schmidt AF, Babchishin KM, Lehmann RJB. A Meta-Analysis of Viewing Time Measures of Sexual Interest in Children. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:287-300. [PMID: 27543106 DOI: 10.1007/s10508-016-0806-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 05/26/2016] [Accepted: 06/28/2016] [Indexed: 05/24/2023]
Abstract
Due to unobtrusiveness and ease of implementation, viewing time (VT) measures of sexual interest in children have sparked increasing research interest in forensic contexts over the last two decades. The current study presents two meta-analyses of VT measures adapted to assess pedophilic interest to determine their discrimination between sexual offenders against children (SOC) and non-SOC groups as well as convergent validity (associations with other measures of sexual interest in children). On average, VT measures showed moderate discrimination between criterion groups (fixed-effect d = 0.60, 95 % CI [0.51, 0.68], N = 2705, k = 14) and significant convergent validity with self-reports, penile plethysmography, Implicit Association Tests, and offence behavioral measures ranging from r = .18 to r = .38. VT measures, however, provided better discrimination for adults (fixed-effect d = 0.78, 95 % CI [0.64, 0.92]) than adolescent samples (fixed-effect d = 0.50, 95 % CI [0.40, 0.61]), Q between = 9.37, p = .002. Moreover, compared to absolute scores, using pedophilic difference scores within adult samples substantially increased VT measures' validity (fixed-effect d = 1.03, 95 % CI [0.82, 1.25], N = 414, k = 7). Results are discussed in terms of their theoretical and applied implications for forensic contexts.
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Affiliation(s)
- Alexander F Schmidt
- Department of Psychology, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
| | - Kelly M Babchishin
- Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Robert J B Lehmann
- Institute of Forensic Psychiatry, Charité-University Medicine, Berlin, Germany
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38
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Seto MC. The Puzzle of Male Chronophilias. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:3-22. [PMID: 27549306 DOI: 10.1007/s10508-016-0799-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 06/15/2016] [Accepted: 06/22/2016] [Indexed: 05/24/2023]
Abstract
In this article, I return to the idea that pedophilia, a sexual interest in prepubescent children, can be considered a sexual orientation for age, in conjunction with the much more widely acknowledged and discussed sexual orientation for gender. Here, I broaden the scope to consider other chronophilias, referring to paraphilias for age/maturity categories other than young sexually mature adults. The puzzle of chronophilias includes questions about etiology and course, how chronophilias are related to each other, and what they can tell us about how human (male) sexuality is organized. In this article, I briefly review research on nepiophilia (infant/toddlers), pedophilia (prepubescent children), hebephilia (pubescent children), ephebophilia (postpubescent, sexually maturing adolescents), teleiophilia (young sexually mature adults, typically 20s and 30s), mesophilia (middle-aged adults, typically 40s and 50s), and gerontophilia (elderly adults, typically 60s and older) in the context of a multidimensional sexual orientations framework. Relevant research, limitations, and testable hypotheses for future work are identified.
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Affiliation(s)
- Michael C Seto
- Royal Ottawa Health Care Group, Ottawa, ON, K1Z 7K4, Canada.
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Schulz T, Palmer S, Stolpmann G, Wernicke M, Müller JL. Presenting a Treatment Concept for People with a Self-Reported Sexual Interest in Children in an Outpatient Setting. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojpsych.2017.71001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Nolet K, Rouleau JL, Benbouriche M, Carrier Emond F, Renaud P. How Ego Depletion Affects Sexual Self-Regulation: Is It More Than Resource Depletion? JOURNAL OF SEX RESEARCH 2016; 53:994-1007. [PMID: 26690094 DOI: 10.1080/00224499.2015.1096887] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Rational thinking and decision making are impacted when in a state of sexual arousal. The inability to self-regulate arousal can be linked to numerous problems, like sexual risk taking, infidelity, and sexual coercion. Studies have shown that most men are able to exert voluntary control over their sexual excitation with various levels of success. Both situational and dispositional factors can influence self-regulation achievement. The goal of this research was to investigate how ego depletion, a state of low self-control capacity, interacts with personality traits-propensities for sexual excitation and inhibition-and cognitive absorption, to cause sexual self-regulation failure. The sexual responses of 36 heterosexual males were assessed using penile plethysmography. They were asked to control their sexual arousal in two conditions, with and without ego depletion. Results suggest that ego depletion has opposite effects based on the trait sexual inhibition, as individuals moderately inhibited showed an increase in performance while highly inhibited ones showed a decrease. These results challenge the limited resource model of self-regulation and point to the importance of considering how people adapt to acute and high challenging conditions.
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Affiliation(s)
- Kevin Nolet
- a University of Montreal
- b Philippe Pinel Institute, ARVIPL
| | | | - Massil Benbouriche
- a University of Montreal
- b Philippe Pinel Institute, ARVIPL
- c European University of Britanny-Rennes 2
| | | | - Patrice Renaud
- b Philippe Pinel Institute, ARVIPL
- d Université du Québec en Outaouais
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Seto MC, Fedoroff JP, Bradford JM, Knack N, Rodrigues NC, Curry S, Booth B, Gray J, Cameron C, Bourget D, Messina S, James E, Watson D, Gulati S, Balmaceda R, Ahmed AG. Reliability and validity of the DSM-IV-TR and proposed DSM-5 criteria for pedophilia: Implications for the ICD-11 and the next DSM. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 49:98-106. [PMID: 27665026 DOI: 10.1016/j.ijlp.2016.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
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).
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Affiliation(s)
- Michael C Seto
- Forensic Research Unit, University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada; Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada.
| | - J Paul Fedoroff
- Forensic Research Unit, University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada; Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - John M Bradford
- Forensic Research Unit, University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada; Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Natasha Knack
- Forensic Research Unit, University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Nicole C Rodrigues
- Forensic Research Unit, University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada; Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Susan Curry
- Forensic Research Unit, University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Brad Booth
- Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Jonathan Gray
- Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Colin Cameron
- Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Dominique Bourget
- Forensic Research Unit, University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada; Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Sarina Messina
- Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Elizabeth James
- Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Diane Watson
- Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Sanjiv Gulati
- Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Rufino Balmaceda
- Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Adekunle G Ahmed
- Forensic Research Unit, University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada; Integrated Forensic Program, Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
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Sigre-Leirós V, Carvalho J, Nobre PJ. Early parenting styles and sexual offending behavior: A comparative study. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 46:103-109. [PMID: 27019974 DOI: 10.1016/j.ijlp.2016.02.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Sexual offenders, in general, report problematic rearing practices from their parents, lacking however more empirical research on this topic regarding particular subtypes of offenders. The current study examined the relationship between early parenting styles and different types of sexual offending. A total of 113 sexual offenders (rapists, pedophilic and nonpedophilic child molesters), and 51 nonsexual offenders completed the EMBU (My Memories of Upbringing), the Brief Symptom Inventory, and the Socially Desirable Response Set Measure. Results showed that rapists were less likely to remember their fathers as being emotionally warm compared with nonsexual offenders and pedophilic child molesters. In addition, compared with rapists, pedophilic offenders perceived their mothers as having been less emotionally warm to them. Overall, results showed that certain developmental experiences with parents were able to distinguish between subtypes of offenders supporting an association between distal interpersonal factors and sexual offending. These findings may have important implications for early intervention and prevention of sexual crimes. Further research using larger samples of pedophilic child molesters is recommended.
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Affiliation(s)
- Vera Sigre-Leirós
- Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal.
| | - Joana Carvalho
- Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal; Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal
| | - Pedro J Nobre
- Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal
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Beier KM, Oezdemir UC, Schlinzig E, Groll A, Hupp E, Hellenschmidt T. "Just dreaming of them": The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ). CHILD ABUSE & NEGLECT 2016; 52:1-10. [PMID: 26773897 DOI: 10.1016/j.chiabu.2015.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/14/2015] [Accepted: 12/16/2015] [Indexed: 06/05/2023]
Abstract
The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ) offers diagnostic and therapeutic help to 12-to-18-year-old juveniles with a sexual preference for the prepubescent and/or early pubescent body of children and who apply for treatment on a voluntary basis. The project goal is to prevent primary or recurrent child sexual abuse as well as primary or recurrent use of child abuse images. Treatment aims to enable affected juveniles to obtain control over their conflictual sexual behaviors. In the present article, the origin of the PPJ; its main approach, including the conception of a media campaign; as well as results from the first year of a three-year study are presented. Further, initial characterizations of juveniles taking part in the project for the first 12 months are provided. The results confirmed that the group of 12-to-18-year-old juveniles with a sexual preference for prepubescent and/or early pubescent minors exists as a target group for primary preventive measures and that they can be assessed for their sexual preferences.
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Affiliation(s)
- Klaus M Beier
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Umut C Oezdemir
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Eliza Schlinzig
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Groll
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Elena Hupp
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Hellenschmidt
- Department of Child and Adolescent Psychiatry at Vivantes Hospital in Friedrichshain, Berlin, Germany
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Knott V, Impey D, Fisher D, Delpero E, Fedoroff P. Pedophilic brain potential responses to adult erotic stimuli. Brain Res 2015; 1632:127-40. [PMID: 26683083 DOI: 10.1016/j.brainres.2015.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/27/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Verner Knott
- Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada.
| | - Danielle Impey
- Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Emily Delpero
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Paul Fedoroff
- Forensic Research Unit, University of Ottawa, Institute of Mental Health Research, Ottawa, ON, Canada
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Dombert B, Schmidt AF, Banse R, Briken P, Hoyer J, Neutze J, Osterheider M. How Common is Men's Self-Reported Sexual Interest in Prepubescent Children? JOURNAL OF SEX RESEARCH 2015; 53:214-23. [PMID: 26241201 DOI: 10.1080/00224499.2015.1020108] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Consistent evidence exists for sexual interest in children in nonclinical/nonforensic male populations. However, prevalences for community men's self-reported sexual interest in children have been based on indiscriminate definitions including postpubescent individuals, age-restricted samples, and/or small convenience samples. The present research assessed men's self-reported sexual interest in children (including child prostitution and child sex tourism) on the community level and examined the link between strictly defined sexual fantasies and behaviors involving prepubescent children. In an online survey of 8,718 German men, 4.1% reported sexual fantasies involving prepubescent children, 3.2% reported sexual offending against prepubescent children, and 0.1% reported a pedophilic sexual preference. Sexual fantasies involving prepubescent children were positively related to sexual offending against prepubescent children. Sexual interest in children was associated with subjectively perceived need for therapeutic help. In contrast to findings from forensic samples, men who reported child pornography use exclusively were identified as a subgroup differing from contact sexual offenders against prepubescent children and men who reported both child pornography use and contact sexual offenses against prepubescent children. The empirical link between child-related sexual fantasies and sexual victimization of prepubescent children and high levels of subjective distress from this inclination underscore the importance of evidence-based child sexual abuse prevention approaches in the community. Findings are discussed in terms of their relation to pedophilic disorder.
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Affiliation(s)
- Beate Dombert
- a Department of Forensic Psychiatry and Psychotherapy , University of Regensburg
| | - Alexander F Schmidt
- b Institute for Health and Behavior, Department of Health Promotion and Aggression Prevention , University of Luxembourg
- c Department of Psychology, Social and Legal Psychology , University of Bonn
| | - Rainer Banse
- c Department of Psychology, Social and Legal Psychology , University of Bonn
| | - Peer Briken
- d Institute for Sex Research and Forensic Psychiatry , University Medical Center Hamburg-Eppendorf
| | - Jürgen Hoyer
- e Institute of Clinical Psychology and Psychotherapy , Technische Universität Dresden
| | - Janina Neutze
- a Department of Forensic Psychiatry and Psychotherapy , University of Regensburg
| | - Michael Osterheider
- a Department of Forensic Psychiatry and Psychotherapy , University of Regensburg
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46
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Adult interpersonal features of subtypes of sexual offenders. J Forensic Leg Med 2015; 34:5-10. [DOI: 10.1016/j.jflm.2015.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/29/2015] [Indexed: 11/23/2022]
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Tozdan S, Briken P. The Earlier, the Worse? Age of Onset of Sexual Interest in Children. J Sex Med 2015; 12:1602-8. [DOI: 10.1111/jsm.12927] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tenbergen G, Wittfoth M, Frieling H, Ponseti J, Walter M, Walter H, Beier KM, Schiffer B, Kruger THC. The Neurobiology and Psychology of Pedophilia: Recent Advances and Challenges. Front Hum Neurosci 2015; 9:344. [PMID: 26157372 PMCID: PMC4478390 DOI: 10.3389/fnhum.2015.00344] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 05/29/2015] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- Gilian Tenbergen
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School , Hannover , Germany
| | - Matthias Wittfoth
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School , Hannover , Germany
| | - Helge Frieling
- Laboratory for Molecular Neuroscience, Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School , Hannover , Germany
| | - Jorge Ponseti
- Department of Sexual Medicine, University Hospital Schleswig-Holstein , Kiel , Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Medical Faculty University Hospital Magdeburg , Magdeburg , Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Charité - University Clinic Berlin , Berlin , Germany
| | - Klaus M Beier
- Institute of Sexology and Sexual Medicine, Charité - University Clinic Berlin , Berlin , Germany
| | - Boris Schiffer
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy, and Preventive Medicine, LWL-University Hospital Bochum , Bochum , Germany
| | - Tillmann H C Kruger
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School , Hannover , Germany
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Poeppl TB, Eickhoff SB, Fox PT, Laird AR, Rupprecht R, Langguth B, Bzdok D. Connectivity and functional profiling of abnormal brain structures in pedophilia. Hum Brain Mapp 2015; 36:2374-86. [PMID: 25733379 DOI: 10.1002/hbm.22777] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/24/2015] [Accepted: 02/17/2015] [Indexed: 12/25/2022] Open
Abstract
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.
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Affiliation(s)
- Timm B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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Beier KM, Grundmann D, Kuhle LF, Scherner G, Konrad A, Amelung T. The German Dunkelfeld Project: A Pilot Study to Prevent Child Sexual Abuse and the Use of Child Abusive Images. J Sex Med 2015; 12:529-42. [DOI: 10.1111/jsm.12785] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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