B4U-ACT

Excerpt from Wilson, G. & Cox, D. (1983). The Child-Lovers: A Study of Paedophiles in Society. London: Peter Owen Publishers

This pedophile sample was drawn neither from medical case records nor from prison files. Rather, they were self-confessed pedophiles "at large" within the community.

In terms of personality, we found our group of pedophiles to be markedly introverted, but their scores on psychoticism and neuroticism were only slightly elevated compared with controls. There were indications of deficient social skill and confidence (e.g. shyness, sensitivity, loneliness and some depression) but the majority showed no sign of clinically significant psychopathy or thought disorder. The majority of pedophiles, however socially inappropriate, seem to be gentle and rational. We cannot rule out the possibility that some part of the social anxiety and withdrawal that has been so consistently observed in pedophile men is a reaction to experienced (or anticipated) social hostility.

Naive innocence (otherwise described as softness, simplicity, openness, and willingness to learn) was the quality of the child that was of primary attractiveness to the pedophiles. Certain other qualities of children that pedophiles find particularly attractive show that their sexual arousal mechanism is in many respects normal. The vitality, energy, playfulness and vivaciousness that was often cited as attractive to pedophiles is an important basis of attraction between adult partners, both heterosexual and homosexual.

Finally, our research revealed that the fantasies of pedophile men have a lot in common with those of normal men, e.g. the emphasis on group sex and compliant partners. Even the prime defining characteristic of pedophilia, the preference for extreme youth in a sex partner, can be seen as an extension of the normal tendency of men to seek partners younger than themselves. When all these factors are considered it is clear that the sexual preferences of the pedophile are not so far removed from those of the normal man as they might at first appear.

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Excerpt from "Pessimism about pedophilia." (2010). Harvard Mental Health Letter. July, 2010.

One challenge in the scientific literature is that most of the studies on pedophilia have involved men convicted of crimes against children, and experts estimate that only one in 20 cases of child sexual abuse is reported. It remains unclear how prevalent pedophilia is in the general population. Research on convicts may not apply to people with pedophilic tendencies who live without detection in the community or suffer silently while controlling their impulses.

There is more agreement on other issues. Co-occurring disorders, such as personality disorders or mood disorders, are common in people with pedophilic tendencies. And about 50% to 70% of people with pedophilic tendencies are also diagnosed with another paraphilia, such as exhibitionism, voyeurism, or sadism.

Several reports have concluded that most people with pedophilic tendencies eventually act on their sexual urges in some way. Typically this involves exposing themselves to children, watching naked children, masturbating in front of children, or touching children's genitals. Oral, anal, or vaginal penetration is less common.

Fears about predatory behavior are valid. Most pedophiles who act on their impulses do so by manipulating children and gradually desensitizing them to inappropriate behavior. Then they escalate it. Pedophiles are able to do this because in most cases they already know the children or have access to them.

Some researchers fear that the growth of Internet communities for people with pedophilic tendencies may encourage users to act on their sexual urges and share information about how to elude detection. But other commentators note that these online communities actually make it easier for law enforcement officials to lure and entrap potential offenders before they commit a sexual crime.

Most psychotherapies used to treat pedophilia incorporate the principles and techniques of cognitive behavioral therapy. The focus of therapy is to enable the patient to recognize and overcome rationalizations about his behavior. In addition, therapy may involve empathy training and techniques in sexual impulse control.

Aversive conditioning, a behavioral method directed at associating a pedophilic fantasy or desire with an unpleasant sensation such as nausea, an electric shock, or a bad smell, was once popular. Although a review concluded that aversive conditioning might increase someone's ability to control sexual attraction to children in the short term, there is no evidence that this approach is effective over time.

Drugs that suppress production of the male hormone testosterone are used to reduce the frequency or intensity of sexual desire. Although physical castration is another option, testosterone suppression offers advantages such as the need for follow-up visits (which aids in monitoring behavior).

State programs such as Megan's Law and the Adam Walsh Act seek to limit where convicted sex crime offenders may live and work. Meanwhile, school- and community-based educational programs offer advice about how to identify situations that may endanger children, how to recognize behaviors such as inappropriate touching that may desensitize children so that they are more easily victimized, and how children can protect themselves.

Until we know more, parents and others who want to protect children from pedophiles are best advised to watch for the subtle stalking behaviors that may precede physical contact — and to remember that most sex offenders of any type approach children they know.

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Excerpt from American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author, p. 571.

Individuals with pedophilia who act on their urges with children may limit their activity to undressing the child and looking, exposing themselves, masturbating in the presence of the child, or gentle touching and fondling of the child. Others, however, perform fellatio or cunnilingus on the child or penetrate the child's vagina, mouth, or anus with their fingers, foreign objects, or penis and use varying degrees of force to do so. These activities are commonly explained with excuses or rationalizations that they have "educational value" for the child, that the child derives "sexual pleasure" from them, or that the child was "sexually provocative"—themes that are also common in pedophilic pornography.

Individuals may limit their activities to their own children, stepchildren, or relatives or may victimize children outside their families. Some individuals with Pedophilia threaten the child to prevent disclosure. Others, particularly those who frequently victimize children, develop complicated techniques for obtaining access to children, which may include winning the trust of a child's mother, marrying a woman with an attractive child, trading children with other individuals with Pedophilia, or, in rare instances, taking in foster children from non-industrialized countries or abducting children from strangers. Except in cases in which the disorder is associated with Sexual Sadism, the person may be attentive to the child's needs in order to gain the child's affection, interest, and loyalty and to prevent the child from reporting the sexual activity. The disorder usually begins in adolescence, although some individuals with Pedophilia report that they did not become aroused by children until middle age. The frequency of pedophilic behavior often fluctuates with psychosocial stress. The course is usually chronic, especially in those attracted to males. The recidivism rate for individuals with Pedophilia involving a preference for males is roughly twice that for those who prefer females.

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Excerpt from Blanchard, R. (2010). The DSM diagnostic criteria for pedophilia. Archives of Sexual Behavior, 39, 304-16. (Passages here appear on pp. 306, 310-311.)

In clinical practice, the patient's history of sexual offenses against children is often the only basis for making a diagnosis of pedophilia. It is well established that self-report alone cannot be used to diagnose pedophilia in offenders against children. Offenders are not necessarily rewarded for being truthful about pedophilic impulses; they might experience even more severe consequences of their actions if they acknowledge being pedophiles.

The widespread clinical opinion that self-report is unreliable in pedophiles has been reinforced by laboratory studies. In these studies, sexual interest in children was measured with phallometric testing, a procedure in which blood volume in the examinee's penis is monitored while he is presented with a standardized set of laboratory stimuli including visual and auditory representations of children and adults. In a series of studies in my laboratory, my predecessor and I specifically studied men who had committed sexual offenses against children but who claimed that they were sexually attracted only to adults. The self-report of the majority was directly contradicted by their laboratory results.

The DSM-IV-TR excludes from diagnosis a sizable proportion of patients whose strongest sexual feelings are for physically immature persons. The modal age of victims of sexual offenses in the United States falls within the time-frame of puberty. In anonymous surveys of social organizations of persons who acknowledge having an erotic interest in children, attraction to children of pubescent ages is more frequently reported than is attraction to those of prepubescent ages. In samples of sexual offenders recruited from clinics and correctional facilities, men whose offense histories or assessment results suggest erotic interest in pubescents sometimes outnumber those whose data suggest erotic interest in prepubescent children.

Other studies have shown hebephiles to be intermediate between pedophiles and teleiophiles with regard to IQ, completed education, school grade failure and special education placement, head injuries before age 13, left-handedness, and stature.

The DSM-V should include hebephilia to recognize the clinical and scientific importance of patients preferentially attracted to children who have entered puberty but are still physically quite immature. This would systematize what is already happening unsystematically. Levenson has noted that practitioners evaluating patients for civil commitment under sexually violent predator statutes typically diagnose such patients with "Paraphilia NOS (Hebephilia)."

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