Pedophilia

Not to be confused with ephebophilia or podophilia.

The term pedophilia or paedophilia has a range of definitions as found in common usage, psychology, and law enforcement. As a medical diagnosis, it is defined as a psychological disorder in which an adult experiences a sexual preference for prepubescent children and may engage in child sexual abuse, also known as "pedophilic behavior". According to the DSM, pedophilia is a form of paraphilia in which a person either has acted on intense sexual urges towards children, or has sexual urges towards and fantasies about children that cause distress or interpersonal difficulty.

In common usage, the term pedophile or paedophile refers to an adult who is sexually attracted to children, whether or not the adult acts upon that attraction by sexually abusing a child. In law enforcement, the term "pedophile" is generally used to describe those accused or convicted of child sexual abuse under sociolegal definitions of child (including both prepubescent children and adolescents younger than the local age of consent); as can be seen for example in the name of the United Kingdom police agency, the Paedophile Unit. Some researchers have described this usage as improper and suggested it can confound two separate types of offenders, child molesters and rapists, thereby obscuring results of ongoing research.

The causes of pedophilia have not been determined, though there are a variety of theories ranging from biological to psychological, and research is ongoing. Most pedophiles are men, though pedophilia occurs in women as well. In psychology and law enforcement, there have been a variety of typologies suggested to categorize pedophiles according to behavior and motivations. There is no known treatment or cure for pedophilia, however there are therapies that can reduce the incidence of pedophilic behaviors that result in child sexual abuse.

History of the term

The word comes from the Greek paidophilia (παιδοφιλία): pais (παις, "child") and philia (φιλία, "love, friendship"). Paidophilia was coined by Greek poets either as a substitute for "paiderastia" (pederasty), or vice versa.

The classic Latinized spelling is with ae or æ, to avoid confusion with pedophilia, which etymologically means attraction to the ground (πέδον). The term should also not be confused with podophilia either, which is attraction to feet (πούς > octopus / ποδός / πηδόν > pedal).

Today the American (among others) pronunciation has changed into the more germanic English form using the "ped" as in "pediatrician," not as in "pedestrian" despite the fact the original Greek spelling contained an ai, which is pronounced as in "eye". English has not fully developed the sounds of the vowels in the original form due to the phonetics of the vastly different languages. The correct terminology of the modern word Paedophile uses the ae or æ, which is the Latinized form of the Greek original, this happened a lot in the adoption of more of the classical languages into modern English and other European languages as detailed below.

The term paedophilia erotica was coined in 1886 by the Viennese psychiatrist Richard von Krafft-Ebing in his writing Psychopathia Sexualis. He gave the following characteristics:

• The sexual interest is toward pre-pubescent youths only. This interest does not extend to the first signs of pubic hair.
• The sexual interest is toward pre-pubescent youths only and does not include teenagers.
• The sexual interest remains over time.

Adults sexually attracted to pre-pubescent youths were placed into three categories by Krafft-Ebing:

• a.) pedophile
• b.) surrogate (that is, the pre-pubescent youths are regarded as a substitute object for a preferred, non-available adult object)
• c.) sadistic

Other researchers used their own terms for the Krafft-Ebing categories:

• a.) preferential/structured/fixed (i. e. pedophile) type,
• b.) situational/opportunistic/regressed/incest (i. e. surrogate) type
• c.) sadistic (no change)

This three-type model as well as the fundamental mental and behavioural differences of the three types were empirically evidenced, among others, by Kinsey; Howells 1981; Abel, Mittleman & Becker 1985; Knight et al. 1985; McConaghy 1993; Ward et al. 1995; Hoffmann 1996; Seikowski 1999.

Diagnosis

The International Statistical Classification of Diseases and Related Health Problems (F65.4) defines pedophilia as "a sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age."

The APA's Diagnostic and Statistical Manual of Mental Disorders 4th edition, Text Revision gives the following as its "Diagnostic criteria for 302.2 Pedophilia":

• A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger);
• B. The person has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty;
• C. The person is at least age 16 years and at least 5 years older than the child or children in Criterion A.
• Specify if: Limited to incest
• Specify type: Exclusive Type (attracted only to children) Nonexclusive Type

Neither the ICD or the APA diagnostic criteria require actual sexual activity with a pre-pubescent youths. The diagnosis can therefore be made based on the presence of fantasies or sexual urges alone, provided the subject meets the remaining criteria. "For individuals in late adolescence with pedophilia, no precise age difference is specified, and clinical judgment must be used" (p. 527 DSM).

Nepiophilia, also called infantophilia, is used to refer to a sexual preference for toddlers and infants (usually ages 0–3).

Etiology

The cause or causes of pedophilia are not known. The experience of sexual abuse as a child was previously thought to be a strong risk factor, but research does not show a causal relationship, as the vast majority of sexually abused children do not grow up to be adult offenders, nor do the majority of adult offenders report childhood sexual abuse. The US Government Accountability Office concluded, "the existence of a cycle of sexual abuse was not established." Prior to 1996, there was greater belief in the theory of a "cycle of violence," because most of the research done was retrospective—abusers were asked if they had experienced past abuse. Even the majority of studies found that most adult sex offenders said they had not been sexually abused during childhood, but studies varied in terms of their estimates of the percentage of such offenders who had been abused, from 0 to 79 percent. More recent prospective longitudinal research—studying children with documented cases of sexual abuse over time to determine what percentage become adult offenders—has demonstrated that the cycle of violence theory is not an adequate explanation for why people molest children.

Biological findings

Several researchers have reported correlations between pedophilia and certain psychological characteristics, such as low self-esteem and poor social skills. Until recently, many pedophilia researchers believed that pedophilia was actually caused by those characteristics. Beginning in 2002, other researchers, most notably Canadian sexologists James Cantor and Ray Blanchard and their colleagues, began reporting a series of findings linking pedophilia with brain structure and function: Pedophilic (and hebephilic) men have lower IQs, poorer scores on memory tests, greater rates of non-right-handedness, greater rates of school grade failure over and above the IQ differences, lesser physical height, greater probability of having suffered childhood head injuries resulting in unconsciousness, and several differences in MRI-detected brain structures. They report that their findings suggest that there are one or more neurological characteristics present at birth that cause or increase the likelihood of being pedophilic. Evidence of familial transmittability "suggests, but does not prove that genetic factors are responsible" for the development of pedophilia.

Another study, using structural MRI, shows that pedophilic men have a lower volume of white matter than non-sexual criminals.

Functional magnetic resonance imaging (fMRI) has shown that child molesters diagnosed with pedophilia have reduced activation of the hypothalamus as compared with non-pedophilic individuals when viewing sexually arousing pictures of adults. A 2008 functional neuroimaging study notes that central processing of sexual stimuli in heterosexual "paedophile forensic inpatients" may be altered by a disturbance in the prefrontal networks, which "may be associated with stimulus-controlled behaviours, such as sexual compulsive behaviours." The findings may also suggest "a dysfunction at the cognitive stage of sexual arousal processing."

Blanchard, Cantor, and Robichaud (2006) reviewed the research that attempted to identify hormonal aspects of pedophiles. They concluded that there is some evidence that pedophilic men have less testosterone than controls, but that the research is of poor quality and that is it difficult to draw any firm conclusion from it.

While not causes of pedophilia itself, comorbid psychiatric illness—such as personality disorders and substance abuse—are risk factors for acting on pedophilic urges. Blanchard, Cantor, and Robichaud (2006) noted about comorbid psychiatric illnesses that, "The theoretical implications are not so clear. Do particular genes or noxious factors in the prenatal environment predispose a male to develop both affective disorders and pedophilia, or do the frustration, danger, and isolation engendered by unacceptable sexual desires—or their occasional furtive satisfaction—lead to anxiety and despair?" They indicated that because they previously found mothers of pedophiles to be more likely to have undergone psychiatric treatment, the genetic possibility is more likely.

Psychopathology and cognitive distortions

According to one theory, child sex offenders use cognitive distortions to justify their behaviours. This, according to some others can also be seen in the beliefs of pedophiles who have not necessarily offended. For example, the Encyclopedia of Psychology states that these defense mechanisms reflect one of the most salient features of the condition, with cognitive distortions being a hallmark feature of the pedophilia; used to maximize the pedophiles subjective self-regard, justify their thoughts and behavior, rarely have basis in objective reality as they're entirely self-serving.

Personality impairment in male pedophiles

This study states that pedophiles have impaired interpersonal functioning and elevated passive-aggressiveness, as well as impaired self-concept. Regarding disinhibitory traits, pedophiles demonstrate elevated sociopathy and propensity for cognitive distortions. Pathologic personality traits in pedophiles lend support to a hypothesis that such pathology is related to both motivation for and failure to inhibit pedophilic behavior.

Other texts

A review of qualitative research studies published between 1982 and 2001 concluded that pedophiles use cognitive distortions to meet personal needs, justifying abuse by making excuses, redefining their actions as love and mutuality, and exploiting the power imbalance inherent in all adult-child relationships. Other cognitive distortions include the idea of "children as sexual beings," "uncontrollability of sexuality," and "sexual entitlement-bias."

A United States Department of Justice manual lists five of these common psychological defenses commonly used by pedophiles to justify their actions. 1) Denial(is it wrong to hug a child?), 2) Minimization (it only happened once), 3) Justification (I'm a boy lover, not a child molester), 4) Fabrication (activities were for a scholarly research project), and 5) Attack (character attacks on child, accusers, and others.)

Criticism

Cognitive distortion theories have been criticised, sometimes on the basis of an "ideological bias" where the therapist is always right. For example, Agner Fog, Ph.D, writes that "The rationale behind cognitive therapy is that the world view of the therapist is believed to be right and when the world view of the patient is different he is said to suffer from cognitive distortion". Shadd and Mann (2006) cast doubt on whether cognitive distortions lead to offending or reoffending. They also argue that the pathologization of cognitive distortions is inappropriate. In their view, excuses are a normal and healthy aspect of human behavior. Gannon and Polaschek claim that "the popularity of the cognitive distortion hypothesis is due to factors other than its empirical validity."

Types

Exclusive vs. nonexclusive

Although defined as an exclusive sexual preference by some experts and sexologists, pedophilia may be better understood if separated into two categories. Exclusive pedophiles are attracted to children, and children only. They show little erotic interest in adults their own age and in some cases, can only become aroused while fantasizing or being in the presence of prepubescent children. Nonexclusive pedophiles are attracted to both children and adults, and can be sexually aroused by both. According to a U.S. study on 2429 adult male pedophiles, only 7% identified themselves as exclusive; indicating that many or most pedophiles fall into the nonexclusive category.

See Also: Child Sexual Offender Types

Prevalence among child sex offenders

A behavioral analysis report by the FBI states that most child molesters in general are pedophiles, and in particular, "A high percentage of acquaintance child molesters are preferential sex offenders who have a true sexual preference for children (i.e., pedophiles)." According to the Mayo Clinic, approximately 95% of child sexual abuse incidents are committed by the 88% of child molestation offenders who meet the diagnostic criteria for pedophilia; and pedophilic child molestors commit ten times more sexual acts against children than non-pedophilic child molestors. On the other hand, in papers by Paul Okami and Amy Goldberg (1992), and Kevin Howells (1981), the authors stated that most data they had reviewed suggests that pedophiles make up a minority of incarcerated child sex offenders.

The term pedophile is commonly used to describe all child sexual offenders, including those who do not meet the clinical diagnosis standards. This use is seen as problematic by some people. Some researchers, such as Howard E. Barbaree, have endorsed the use of actions as a sole criterion for the diagnosis of pedophilia as a means of taxonomic simplification, rebuking the American Psychiatric Association's standards as "unsatisfactory". Child sexual abuse, whether perpetrated by a clinically diagnosed pedophile or not, is illegal. According to the Association for the Treatment of Sexual Abusers,

"Although virtually all pedophiles are child molesters, not all child molesters are pedophiles. Pedophiles are men with a clear sexual preference for children rather than adults. Child molesters are described as individuals who have committed a sexual offense against a child victim. There are, however, no 'pure' types, and offenders are best conceptualized as closer to one end of the continuum or the other."

A perpetrator of child sexual abuse is commonly assumed to be and referred to as a pedophile; however, there may be other motivations for the crime (such as stress, marital problems, or the unavailability of an adult partner), Child sexual abuse may or may not be an indicator that its perpetrator is a pedophile; or a subtype of pedophile. Many terms have been used to disntiguish "true pedophiles" from nonpedophilic offenders, or to distinguish among types of pedophiles on a continuum according to strength and exclusivity of pedophilic interest. Some of the terms used to describe incest offenders are regressed, situational, and intrafamilial.

A review article in the British Journal of Psychiatry notes the overlap between extrafamilial and intrafamilial offenders:

Incest and paedophilia: Originally, the legal definition of incest applied to vaginal intercourse between a male and female whom the offender knew to be his daughter, granddaughter, sister or mother — and did not include stepfathers or adoptive fathers or actions other than vaginal intercourse (Smith & Bentovim, 1994). In clinical practice, the definition has been modified by including sexual contact which occurred within the nuclear family, giving rise to the dichotomy of intrafamilial abuse (incest) and extrafamilial abuse (paedophilia). Consequently, there was confusion about sexual abuse by stepparents and adoptive parent abusers. Paedophilia has been defined as a "perversion in which an adult has a sexual interest in children with paedophiliacs having certain fundamental features in common" (Glasser, 1990). However, just as incest does not imply homogeneity neither does paedophilia, and ambiguity in this term can lead to differences in usage. Another long-held belief is that incest and paedophile offenders are distinct (Cooper & Cormier, 1990; Glasser, 1990), together with an associated tendency to support community-based treatment for the incest offender but to view the paedophile as more dangerous. Conte (1991) contests this belief on the basis that about half of fathers and stepfathers, referred for treatment at clinics for having abused children outside the home, had at the same time been abusing their own children (Abel et al, 1988).

As noted by Abel, Mittleman, and Becker (1985) and Ward et al. (1995), there are generally large distinctions between the two types of offenders' characteristics. Situational offenders tend to offend at times of stress; have a later onset of offending; have fewer, often familial victims; and have a general preference for adult partners. Pedophilic offenders, however, often start offending at an early age; often have a large number of victims who are frequently extrafamilial; are more inwardly driven to offend; and have values or beliefs that strongly support an offense lifestyle. Research suggests that incest offenders recidivate at approximately half the rate of extrafamilial child molesters, and one study estimated that by the time of entry to treatment, nonincestuous pedophiles who molest boys had committed an average of 282 offenses against 150 victims.

Treatment

Although pedophilia is a chronic condition that has no cure at this time, various treatments are available that can help to reduce or prevent the expression of pedophilic behavior, thereby reducing the prevalence of child sexual abuse. Treatment of pedophilia is considered a form of primary prevention and often requires collaboration between law enforcement and health care professionals.

A number of proposed treatment techniques for pedophilia have been developed. In 1981, writer David Crawford reported that the success rate of these therapies was very low. Dr. Fred Berlin, founder of the Johns Hopkins Sexual Disorders Clinic, believed pedophilia could "indeed be successfully treated," if only the medical community would give it more attention.

Some psychologists, such as Dr. Fred S. Berlin, assert sexual attraction to pre-pubescent youths to be a sexual orientation in itself, but Berlin also states "The psychiatric profession still correctly considers pedophilia to be a mental disorder." In one article, Berlin writes "it is likely that no one would choose voluntarily to develop a pedophilic sexual orientation. Those with such an orientation have no more decided to have it than have any of us decided as children to be either heterosexual or homosexual." Berlin also defends the classification of pedophilia as a mental disorder, however, stating "In our society, to have a pedophilic sexual orientation can create both psychological burdens and impairments."

Medical therapies

Cognitive behavioral therapy has been shown to reduce recidivism in contact sex offenders. Applied behavior analysis is used with mentally disabled sex offenders. Some treatment programs use covert sensitization and odor aversion, which are both forms of aversion therapy. While such programs are effective in lowering recidivism by 15-18 percent, they do not represent a cure. A study by the Council on Scientific Affairs found that the success rate of aversion therapy was parallel to that of homosexual conversion therapy; that is to say, extremely low. This method is rarely used on pedophiles who have not offended.

Anti-androgenic medications such as Depo Provera may be used to lower testosterone levels in offending pedophiles. These treatments, commonly referred to as "chemical castration", are often used in conjunction with the non-medical approaches noted above. Gonadotropin-releasing hormone analogues, which last longer and have less side effects, are also effective in reducing libido and may be used. According the Association for the Treatment of Sexual Abusers, "Anti-androgen treatment should be coupled with appropriate monitoring and counseling within a comprehensive treatment plan." In a controlled Depo-Provera treatment study of forty sex offenders--including 23 pedophiles--who received Depo, and 21 sex offenders who received psychotherapy alone, outcome follow-up of the treated group v. the untreated group demonstrated that the reoffense rate for the Depo-treated group was significantly lower. Eighteen percent reoffended while receiving medication; 35 percent reoffended after stopping medication. In contrast, 58 percent of the control patients, who received psychotherapy alone reoffended. Patients defined as regressed were much more likely to reoffend off therapy than the patients defined as fixated.

Klaus M. Beier of the Institute of Sexology and Sexual Medicine at Charité , a university hospital in Berlin, reported success in a preliminary study using role-play therapy and "impulse-curbing drugs" to help pedophiles avoid sexually assaulting a child. According to researchers, contact child sex offenders were better able to control their urges once they understood the pre-pubescent youth's view. Although these results are relevant to the prevention of re-offending in contact child sex offenders, there is no empirical suggestion that such therapy is a cure for pedophilia.

Related activism

Pro-pedophile activism

Main article: Pro-pedophile activism

Some pro-pedophile activists aim to change legal, medical and social views of pedophilia. The highly controversial Rind et al. study has been quoted by numerous pedophile advocacy organizations.

Anti-pedophile activism

Main article: Anti-pedophile activism

Anti-pedophile activism encompasses opposition to pedophiles, pro-pedophile activism, and other phenomena that are seen as related to pedophilia, such as child pornography and child sexual abuse. Whilst much of the direct action classified as anti-pedophile involves demonstrations against sex offenders, groups advocating legalization of sexual activity between adults and children, and internet users who solicit sex from teens, there are some organizations, such as Absolute Zero, that explicitly target pedophiles.

See also

• Child sexual abuse
• Child pornography
• Ephebophilia
• Pederasty
• Roman Catholic sex abuse cases

Notes and references

References

• Abel GG: Behavioral treatment of child molesters, in Perspectives on Behavioral Medicine. Edited by Stunkard AJ, Baum A. New York, Lawrence Erlbaum, 1989, pp 223-242
• Abel GG, Blanchard EB: The role of fantasy in the treatment of sexual deviation. Arch Gen Psychiatry 30:467-475, 1974
• Abel GG, Osborn CA: Clinical syndromes of adult psychiatry: the paraphilias, in The Oxford Textbook of Psychiatry. New York, Oxford University Press, in press.
• Abel GG, Rouleau J-L: Male sex offenders, in Handbook of Outpatient Treatment of Adults. Edited by Thase ME, Edelstein BA, Hersen M. New York, Plenum, 1990, pp 271-290
• Levine, Judith. (2002). Harmful to Minors: The Perils of Protecting Children From Sex. Minneapolis: University of Minnesota Press. Discusses the perception and reality of pedophilia. ISBN 0-8166-4006-8.
• Pryor, Douglass, Unspeakable Acts: Why Men Sexually Abuse Children, New York Univ. Press, 1996.
• Rind et al. (1998). "A meta-analytic examination of assumed properties of child sexual abuse using college samples." Psychological Bulletin. 124 (1), 22-53.
• Scruton, Roger, Sexual Desire: A Moral Philosophy of the Erotic, Free, 1986.
• Wilson, Paul R. (1981). The Man They Called a Monster. Melbourne: Cassell Australia. ISBN 0-7269-9282-8. (Book about a court reporter who had sexual relationships with 2500 adolescent males; includes interviews with the later adults who reflect on these relationships.)

External links

• WebMd: Explaining Pedophillia - from a medical point of view
• Diagnostic criteria for Pedophilia in DSM-IV