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Ray Blanchard - One of the best experts on this subject based on the ideXlab platform.

  • the dsm diagnostic criteria for Pedophilia
    Archives of Sexual Behavior, 2010
    Co-Authors: Ray Blanchard
    Abstract:

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

  • absolute versus relative ascertainment of Pedophilia in men
    Sexual Abuse: A Journal of Research and Treatment, 2009
    Co-Authors: Ray Blanchard, Michael E. Kuban, Thomas Blak, James M. Cantor, Philip E. Klassen, Robert Dickey
    Abstract:

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

  • Pedophilia hebephilia and the dsm v
    Archives of Sexual Behavior, 2009
    Co-Authors: Ray Blanchard, Michael E. Kuban, Thomas Blak, James M. Cantor, Amy D Lykins, Diane K Wherrett, Robert Dickey
    Abstract:

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

  • reply to letters regarding Pedophilia hebephilia and the dsm v
    Archives of Sexual Behavior, 2009
    Co-Authors: Ray Blanchard
    Abstract:

    The on-line publication of our article, ‘‘Pedophilia, Hebephilia, and the DSM-V’’ (Blanchard et al., 2008), quickly prompted the writing of several letters to the editor of this journal. I am writing this letter of reply as sole author, and any inadequacies or inaccuracies in it can be attributed to me alone. The letters by Tromovitch (2008) and DeClue (2008) focus on our recommendation that hebephilia (the erotic preference for pubescent children) be considered for inclusion in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Tromovitch and DeClue point out that we did not provide a definition of mental disorder, and we did not investigate whether hebephilia would satisfy the definition of mental disorder. That is true. We could and perhaps should have included a statement to this effect: ‘‘The clinical implications of this study depend on the DSM-V using a definition of mental disorder that is similar to the definition supplied in the DSM-IV-TR (American Psychiatric Association, 2000, pp. xxxi) and on the future interpretation of that definition as including the erotic preference for physically immature individuals. The sex-research implications of the study, however, do not depend on these outcomes.’’ There is a sense in which Tromovitch’s views accord with the implications of our study. Tromovitch writes that there is no basis for classifying Pedophilia (the erotic preference for prepubescent children) as a mental disorder, and that there has been no rationale for including Pedophilia in any edition of the DSM. Since Pedophilia should not be in the DSM, hebephilia should not be in it either. The clinical implications of our study are essentially the obverse: If Pedophilia is included in the DSM, then hebephilia should be included also. Thus, he and we appear to agree that clinical judgments regarding the one preference are relevant to the other. It is difficult to divine whether some of the other letterwriters share Tromovitch’s view, or whether they are willing to accept Pedophilia as a psychopathology but not hebephilia. Franklin supports one of her criticisms with a reference to Kleinplatz and Moser (2005), who argued in that paper and in similar papers published elsewhere that all paraphilias should be removed from the DSM. That suggests that Franklin might agree with Tromovitch that neither Pedophilia nor hebephilia belongs in the DSM. On the other hand, Franklin argues that erotic attractions to ‘‘young pubescent girls ... are evolutionarily adaptive,’’ which suggests that she might be making some distinction between sexual interest in prepubescent girls and sexual interest in pubescent girls on the basis of fecundity, or on the basis of males’ reproductive strategies for ensuring that they are the fathers of all their mates’ offspring. It is not clear how, or whether, she would apply this distinction to homosexual Pedophilia and hebephilia. DeClue registers no objection to the classification of Pedophilia as a psychopathology; he is willing to contemplate hebephilia as a psychopathology on the condition that this would produce no increase in the total number of men diagnosed as paraphilic by DSM criteria. He does not explain how this condition squares with his view that erotic preferences should be classified as mental disorders according to some previously stated definition of mental disorder. Zander (2008) appears not to agree with Tromovitch, since he begins his critique with an affirmation of the status quo: ‘‘DSM-IV-TR draws the distinction between pathological and non-pathological age-related sexual arousal at the onset of pubescence: adult arousal to prepubescents is considered R. Blanchard (&) Kurt Freund Laboratory, Law and Mental Health Program, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, Canada M5T 1R8 e-mail: ray_blanchard@camh.net

  • iq handedness and Pedophilia in adult male patients stratified by referral source
    Sexual Abuse: A Journal of Research and Treatment, 2007
    Co-Authors: Ray Blanchard, Robert Dickey, James M. Cantor, Philip E. Klassen, Nathan J Kolla, Michael E. Kuban
    Abstract:

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

Andreas Mokros - One of the best experts on this subject based on the ideXlab platform.

  • response inhibition in Pedophilia an fmri pilot study
    Neuropsychobiology, 2013
    Co-Authors: Benedikt Habermeyer, Andreas Mokros, Fabrizio Esposito, Nadja Handel, Patrick Lemoine, Hans Christian Kuhl, Markus Klarhofer, Ralph Mager, Volker Dittmann, Erich Seifritz
    Abstract:

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

  • association between brain structure and phenotypic characteristics in Pedophilia
    Journal of Psychiatric Research, 2013
    Co-Authors: Timm B Poeppl, Michael Osterheider, Joachim Nitschke, Pekka Santtila, Martin Schecklmann, Berthold Langguth, Mark W Greenlee, Andreas Mokros
    Abstract:

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

  • Pedophilia prevalence etiology and diagnostics
    Nervenarzt, 2012
    Co-Authors: Andreas Mokros, Michael Osterheider, Joachim Nitschke
    Abstract:

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

  • functional cortical and subcortical abnormalities in Pedophilia a combined study using a choice reaction time task and fmri
    The Journal of Sexual Medicine, 2011
    Co-Authors: Timm B Poeppl, Michael Osterheider, Joachim Nitschke, Pekka Santtila, Mark W Greenlee, Beate Dombert, Andreas Mokros
    Abstract:

    ABSTRACT Introduction Pedophiles show sexual interest in prepubescent children but not in adults. Research into the neurofunctional mechanisms of paraphilias has gathered momentum over the last years. Aim To elucidate the underlying neural processing of sexual interest among pedophiles and to highlight the differences in comparison with nonparaphilic sexual interest in adults. Methods Nine pedophilic patients and 11 nonpedophilic control subjects underwent functional magnetic resonance imaging (fMRI) while viewing pictures of nude (prepubescents, pubescents, and adults) and neutral content, as well as performing a concomitant choice reaction time task (CRTT). Main Outcome Measures Brain blood oxygen level-dependent (BOLD) signals and response latencies in the CRTT during exposure to each picture category. Results Analysis of behavioral data showed group differences in reaction times regarding prepubescent and adult but not pubescent stimuli. During stimulation with pictures displaying nude prepubescents, pedophiles showed increased BOLD response in brain areas known to be involved in processing of visual sexual stimuli. Comparison of pedophilic patients with the control group discovered differences in BOLD responses with respect to prepubescent and adult but not to pubescent stimuli. Differential effects in particular occurred in the cingulate gyrus and insular region. Conclusions The brain response of pedophiles to visual sexual stimulation by images of nude prepubescents is comparable with previously described neural patterns of sexual processing in nonpedophilic human males evoked by visual stimuli depicting nude adults. Nevertheless, group differences found in the cingulate gyrus and the insular region suggest an important role of these brain areas in pedophilic sexual interest. Furthermore, combining attention-based methods like CRTT with fMRI may be a viable option for future diagnostic procedures regarding Pedophilia. Poeppl TB, Nitschke J, Dombert B, Santtila P, Greenlee MW, Osterheider M, and Mokros A. Functional cortical and subcortical abnormalities in Pedophilia: A combined study using a choice reaction time task and fMRI.

  • functional cortical and subcortical abnormalities in Pedophilia a combined study using a choice reaction time task and fmri
    The Journal of Sexual Medicine, 2011
    Co-Authors: Timm B Poeppl, Michael Osterheider, Pekka Santtila, Mark W Greenlee, Beate Dombert, J Nitschke, Andreas Mokros
    Abstract:

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

Igor Galynker - One of the best experts on this subject based on the ideXlab platform.

  • comparison of childhood sexual histories in subjects with Pedophilia or opiate addiction and healthy controls is childhood sexual abuse a risk factor for addictions
    Journal of Psychiatric Practice, 2010
    Co-Authors: Lisa J Cohen, Howard Forman, Matthew Steinfeld, Yuli Fradkin, Steven J Frenda, Igor Galynker
    Abstract:

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

  • Investigating the relationship between sexual and chemical addictions by comparing executive function in subjects with Pedophilia or opiate addiction and healthy controls.
    Journal of psychiatric practice, 2010
    Co-Authors: Lisa J Cohen, Matthew Steinfeld, Cristina Nesci, Sophia Haeri, Igor Galynker
    Abstract:

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

  • Comparison of childhood sexual histories in subjects with Pedophilia or opiate addiction and healthy controls: is childhood sexual abuse a risk factor for addictions?
    Journal of psychiatric practice, 2010
    Co-Authors: Lisa J Cohen, Howard Forman, Matthew Steinfeld, Yuli Fradkin, Steven J Frenda, Igor Galynker
    Abstract:

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

  • clinical features of Pedophilia and implications for treatment
    Journal of Psychiatric Practice, 2002
    Co-Authors: Lisa J Cohen, Igor Galynker
    Abstract:

    The authors discuss the diagnostic criteria for Pedophilia and review the literature on its clinical features, including data on prevalence, gender, age of onset, number of victims, frequency and type of acts, violence, impulsivity, and insight. Findings concerning the characteristics of victims (e.g., sex, age, relationship to the pedophile) and research on pedophilic subtypes-exclusive versus nonexclusive; incestuous versus nonincestuous; heterosexual, homosexual, or bisexual-are reviewed. Studies have shown that pedophiles may share many psychiatric features beyond deviant sexual desire, including high rates of comorbid axis I disorders (affective disorders, substance use disorders, impulse control disorders, other paraphilias) as well as severe axis II psychopathology (especially antisocial and Cluster C personality disorders). The authors present several possible etiological models for Pedophilia and conclude that further research is needed concerning the etiological role of a childhood history of sexual abuse as well as the underlying neurobiology of deviant sexual arousal and decreased erotic differentiation. Finally, findings concerning pharmacological and cognitive-behavioral treatments for Pedophilia are briefly reviewed. Recidivism, drop-out, and noncompliance are significant problems in the treatment of Pedophilia. The authors review predictors of treatment outcome and conclude that Pedophilia is extremely difficult to treat and that effective treatment needs to be intensive, long-term, and comprehensive, possibly with lifetime follow-up.

  • impulsive personality traits in male pedophiles versus healthy controls is Pedophilia an impulsive aggressive disorder
    Comprehensive Psychiatry, 2002
    Co-Authors: Lisa J Cohen, Sniezyna Watras Gans, Pamela G Mcgeoch, Olga Poznansky, Yelena Itskovich, Sean Murphy, Erik Klein, Ken Cullen, Igor Galynker
    Abstract:

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

Timm B Poeppl - One of the best experts on this subject based on the ideXlab platform.

  • connectivity and functional profiling of abnormal brain structures in Pedophilia
    Human Brain Mapping, 2015
    Co-Authors: Timm B Poeppl, Berthold Langguth, Simon B Eickhoff, Peter T Fox, Angela R Laird, Rainer Rupprecht, Danilo Bzdok
    Abstract:

    Despite its 0.5-1% lifetime prevalence in men and its general societal relevance, neuroimag- ing 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 neuroi- maging 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 net- works 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. Hum Brain

  • association between brain structure and phenotypic characteristics in Pedophilia
    Journal of Psychiatric Research, 2013
    Co-Authors: Timm B Poeppl, Michael Osterheider, Joachim Nitschke, Pekka Santtila, Martin Schecklmann, Berthold Langguth, Mark W Greenlee, Andreas Mokros
    Abstract:

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

  • functional cortical and subcortical abnormalities in Pedophilia a combined study using a choice reaction time task and fmri
    The Journal of Sexual Medicine, 2011
    Co-Authors: Timm B Poeppl, Michael Osterheider, Joachim Nitschke, Pekka Santtila, Mark W Greenlee, Beate Dombert, Andreas Mokros
    Abstract:

    ABSTRACT Introduction Pedophiles show sexual interest in prepubescent children but not in adults. Research into the neurofunctional mechanisms of paraphilias has gathered momentum over the last years. Aim To elucidate the underlying neural processing of sexual interest among pedophiles and to highlight the differences in comparison with nonparaphilic sexual interest in adults. Methods Nine pedophilic patients and 11 nonpedophilic control subjects underwent functional magnetic resonance imaging (fMRI) while viewing pictures of nude (prepubescents, pubescents, and adults) and neutral content, as well as performing a concomitant choice reaction time task (CRTT). Main Outcome Measures Brain blood oxygen level-dependent (BOLD) signals and response latencies in the CRTT during exposure to each picture category. Results Analysis of behavioral data showed group differences in reaction times regarding prepubescent and adult but not pubescent stimuli. During stimulation with pictures displaying nude prepubescents, pedophiles showed increased BOLD response in brain areas known to be involved in processing of visual sexual stimuli. Comparison of pedophilic patients with the control group discovered differences in BOLD responses with respect to prepubescent and adult but not to pubescent stimuli. Differential effects in particular occurred in the cingulate gyrus and insular region. Conclusions The brain response of pedophiles to visual sexual stimulation by images of nude prepubescents is comparable with previously described neural patterns of sexual processing in nonpedophilic human males evoked by visual stimuli depicting nude adults. Nevertheless, group differences found in the cingulate gyrus and the insular region suggest an important role of these brain areas in pedophilic sexual interest. Furthermore, combining attention-based methods like CRTT with fMRI may be a viable option for future diagnostic procedures regarding Pedophilia. Poeppl TB, Nitschke J, Dombert B, Santtila P, Greenlee MW, Osterheider M, and Mokros A. Functional cortical and subcortical abnormalities in Pedophilia: A combined study using a choice reaction time task and fMRI.

  • functional cortical and subcortical abnormalities in Pedophilia a combined study using a choice reaction time task and fmri
    The Journal of Sexual Medicine, 2011
    Co-Authors: Timm B Poeppl, Michael Osterheider, Pekka Santtila, Mark W Greenlee, Beate Dombert, J Nitschke, Andreas Mokros
    Abstract:

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

Claudia Massau - One of the best experts on this subject based on the ideXlab platform.

  • Empathy in Pedophilia and sexual offending against children: A multifaceted approach.
    Journal of Abnormal Psychology, 2019
    Co-Authors: Miriam Schuler, Till Amelung, Benjamin Lemme, Viola Borchardt, Hannah Gerwinn, Jonas Kneer, Christian Kargel, Sebastian Mohnke, Isabel Dziobek, Claudia Massau
    Abstract:

    Empathy is regarded as dynamic risk factor of child sexual offending. However, empathy research in the context of child sexual abuse suffers from various problems. First, prior studies failed to differentiate between pedophilic and nonpedophilic sexual offenders. Second, there is no distinction made between cognitive and affective empathy. Third, cognitive and affective empathy toward emotional states of specific age groups (children and adults) has not been adequately addressed. The current study tackles these shortcomings investigating offending and nonoffending pedophiles and multiple aspects of empathy using self-reports and objective behavioral measures. Participants included 85 pedophilic men who committed hands-on child sexual offenses (P+CSO), 72 pedophilic men who never committed hands-on child sexual offenses (P-CSO), and 128 nonoffending teleiophilic male controls (TC). Several affective and cognitive aspects of empathy were assessed using the Multifaceted Empathy Test (MET) and the Interpersonal Reactivity Index (IRI). Whereas in self-reports (IRI) P+CSO scored lower than TC (P-CSO intermediate) in cognitive perspective-taking abilities, a performance-based measure (MET) revealed evidence for a better differentiation of emotional states in P-CSO as compared with P+CSO (TC intermediate). In addition, P+CSO and P-CSO showed significantly higher affective resonance while observing children (MET), which was paralleled by higher self-reported levels of personal distress in social situations (IRI). The results indicate evidence for higher general affective empathic resonance to children in pedophilic men but superior cognitive empathy abilities in nonoffending pedophiles only, which may act as a protective factor in the prevention of sexual offending. Together, these findings underline the importance of accounting for multiple facets of empathy when targeting Pedophilia and child sexual offending. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

  • neural correlates of moral judgment in Pedophilia
    Social Cognitive and Affective Neuroscience, 2017
    Co-Authors: Claudia Massau, Christian Kargel, Simone Weis, Jorge Ponseti, Martin Walter, Tillmann H C Krueger
    Abstract:

    Pedophilia is a sexual preference that is often associated with child sex offending (CSO). Sexual urges towards prepubescent children and specifically acting upon those urges are universally regarded as immoral. However, up until now, it is completely unknown whether moral processing of sexual offenses is altered in pedophiles. A total of 31 pedophilic men and 19 healthy controls were assessed by using functional magnetic resonance imaging (fMRI) in combination with a moral judgment paradigm consisting of 36 scenarios describing different types of offenses. Scenarios depicting sexual offenses against children compared to those depicting adults were associated with higher pattern of activation in the left temporo-parietal-junction (TPJ) and left posterior insular cortex, the posterior cingulate gyrus as well as the precuneus in controls relative to pedophiles, and vice versa. Moreover, brain activation in these areas were positively associated with ratings of moral reprehensibility and negatively associated with decision durations, but only in controls. Brain activation, found in key areas related to the broad network of moral judgment, theory of mind and (socio-)moral disgust - point to different moral processing of sexual offenses in Pedophilia in general. The lack of associations between brain activation and behavioral responses in pedophiles further suggest a biased response pattern or dissected implicit valuation processes.

  • executive functioning in Pedophilia and child sexual offending
    Journal of The International Neuropsychological Society, 2017
    Co-Authors: Claudia Massau, Till Amelung, Hannah Gerwinn, Jonas Kneer, Christian Kargel, Sebastian Mohnke, Gilian Tenbergen, Simone Weis, Alexander Pohl, Matthias Wittfoth
    Abstract:

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

  • diminished functional connectivity on the road to child sexual abuse in Pedophilia
    The Journal of Sexual Medicine, 2015
    Co-Authors: Christian Kargel, Claudia Massau, Simone Weis, Martin Walter, Boris Schiffer, Tillmann H C Kruger
    Abstract:

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