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BMJ (Clinical Research Ed.) Sep 1996
Topics: Behavior Control; California; Criminal Law; Humans; Male; Mandatory Programs; Medroxyprogesterone Acetate; Mentally Ill Persons; Orchiectomy; Pedophilia
PubMed: 8819434
DOI: 10.1136/bmj.313.7059.707a -
Clinical Neuropsychiatry Apr 2023Disgust is a basic emotion evolved to safeguard our omnivorous species from contagion. Although the factors eliciting disgust typically involve concerns related to...
OBJECTIVE
Disgust is a basic emotion evolved to safeguard our omnivorous species from contagion. Although the factors eliciting disgust typically involve concerns related to physical contamination, physical disgust responses are also prompted by moral transgressions, (i.e. cannibalism, pedophilia, betrayal). The link between the general propensity to experience disgust (i.e. "Disgust Sensitivity") and morality, in particular in the deontological domain, is supported by an increasing amount of data on clinical and non-clinical sample. Evolutionistic explanations of this link posit that disgust evolved to indicate the presence of a threat to the integrity of the individual not only in the physical domain but also in the social and moral domain.In addition to the evolutionary point of view, this link could also be better investigated in terms of individual development. To the best of our knowledge, literature is scarce regarding which early experiences are associated to high DS. Therefore, this study aims to explore the content of early memories associated with disgust. Based on the strict link between disgust and morality, we hypothesized an association between DS and early memories of moral criticism.
METHOD
60 non-clinical participants filled in measures of DS. They were then presented with an auditory disgust induction, after which they recalled early memories through the technique of the "affect bridge". 10 independent raters assessed the emotional content of the memories on visual-analogical scales.
RESULTS
Results showed a positive association between disgust sensitivity and the propensity to experience deontological guilt. There was also a significant positive association between disgust sensitivity and moral memories, in particular relating to early experiences of being the object of contempt, moral criticism, anger, and of being held responsible.
CONCLUSIONS
These data directly support the centrality of early morally-loaded interpersonal experiences in the development of DS, confirming the link between disgust and morality also at the level of individual historical development.
PubMed: 37234358
DOI: 10.36131/cnfioritieditore20230203 -
Tijdschrift Voor Psychiatrie 2021Androgen deprivation therapy (ADT) is a libido-inhibiting medication that may be necessary to reduce recidivism in the treatment of paraphilic disorders, especially in...
Androgen deprivation therapy (ADT) is a libido-inhibiting medication that may be necessary to reduce recidivism in the treatment of paraphilic disorders, especially in those with a pedophilic disorder. However, there is a significant risk to develop osteoporosis while using ADT and thereby an increased risk to develop fractures. These risks and benefits must be carefully weighed in the treatment of these patients. We describe a case in which this dilemma is further explained and clarified. We recommend to request a second opinion and a structured risk assessment. If the risk for recidivism remains increased, despite psychotherapeutic interventions, we advise to suspend further rehabilitation into society, and let the reduction of the risk of recidivism prevail over the wishes of the patient.
Topics: Androgen Antagonists; Androgens; Bone Density; Fractures, Bone; Humans; Male; Osteoporosis; Pedophilia; Recidivism
PubMed: 33537978
DOI: No ID Found -
Sexual Medicine Mar 2019Current discussions in the field of sex research concern the age at which sexual interest in children occurred or awareness emerged.
INTRODUCTION
Current discussions in the field of sex research concern the age at which sexual interest in children occurred or awareness emerged.
AIM
To investigate the age of onset (AOO) and its correlates in men with sexual interest in children.
METHODS
Using 2 samples (study 1, patients from an outpatient treatment center, n = 26; study 2, an online survey using 3 recruitment paths, n = 94), we assessed self-reported AOO of sexual interest in children, its flexibility, its exclusiveness, and individuals' motivation to change it. We further examined the interrelation between these variables.
MAIN OUTCOME MEASURE
AOO as the self-reported age at which participants retrospectively felt sexually attracted to children for the first time.
RESULTS
We found broad ranges in AOO (study 1: mean 20.0 ± 10.7; study 2: mean 17.0 ± 8.7), flexibility, and exclusiveness (in studies 1 and 2, 7.7% and 22.3%, respectively, reported that their sexual interest is exclusively in children). The earlier participants felt sexually attracted to children for the first time, the more they were attracted exclusively in children and the less they perceived it to be flexible. Participants who reported rather exclusive sexual interest in children were less likely to perceive it as flexible. The more participants reported on flexibility, the more they were motivated to change it. The earlier participants of study 2 felt sexually attracted to children for the first time, the less they were motivated to change.
CLINICAL IMPLICATIONS
The variety of our results indicates the contradiction of overall rules for individuals with sexual interest in children.
STRENGTH & LIMITATIONS
We included individuals with sexual interest in children from different contexts (eg, forensic vs non-forensic). Our results are in line with previous findings. However, both studies included rather small samples, limiting generalizability. There is not yet consent about how to operationalize AOO.
CONCLUSION
We recommend a differentiated perspective on individuals with sexual interest in children and on different forms of pedophilia in the diagnostic construct. Tozdan S, Briken P. Age of Onset and Its Correlates in Men with Sexual Interest in Children.Sex Med 2019;7:61-71.
PubMed: 30545789
DOI: 10.1016/j.esxm.2018.10.004 -
The Virtual Mentor : VM Oct 2013
Topics: Duty to Warn; Forensic Psychiatry; Humans; Mandatory Reporting; Pedophilia
PubMed: 24152773
DOI: 10.1001/virtualmentor.2013.15.10.ecas2-1310 -
Revista Brasileira de Psiquiatria (Sao... 2015High impulsiveness is a general problem that affects most criminal offenders and is associated with greater recidivism risk. A cluster analysis of impulsiveness measured...
OBJECTIVE
High impulsiveness is a general problem that affects most criminal offenders and is associated with greater recidivism risk. A cluster analysis of impulsiveness measured by the Barratt Impulsiveness Scale - Version 11 (BIS-11) was performed on a sample of hands-on child molesters.
METHODS
The sample consisted of 208 child molesters enrolled in two different sectional studies carried out in São Paulo, Brazil. Using three factors from the BIS-11, a k-means cluster analysis was performed using the average silhouette width to determine cluster number. Direct logistic regression was performed to analyze the association of criminological and clinical features with the resulting clusters.
RESULTS
Two clusters were delineated. The cluster characterized by higher impulsiveness showed higher scores on the Sexual Screening for Pedophilic Interests (SSPI), Static-99, and Sexual Addiction Screening Test.
CONCLUSIONS
Given that child molesters are an extremely heterogeneous population, the "number of victims" item of the SSPI should call attention to those offenders with the highest motor, attentional, and non-planning impulsiveness. Our findings could have implications in terms of differences in therapeutic management for these two groups, with the most impulsive cluster benefitting from psychosocial strategies combined with pharmacological interventions.
Topics: Adolescent; Adult; Brazil; Child Abuse, Sexual; Cluster Analysis; Epidemiologic Methods; Female; Humans; Impulsive Behavior; Male; Pedophilia; Prisoners; Recurrence; Socioeconomic Factors
PubMed: 25946400
DOI: 10.1590/1516-4446-2014-1568 -
Psychiatria Polska Feb 2021A pilot study was conducted in order to construct a Polish adaptation of emotional Stroop test in assessment of pedophilia.
OBJECTIVES
A pilot study was conducted in order to construct a Polish adaptation of emotional Stroop test in assessment of pedophilia.
METHODS
The study consisted of two stages. The first stage involved creating test material by ranking words in adequate lists by competent experts. The second stage consisted of empirical verification of the principle of emotional Stroop test in a non-clinical population.
RESULTS
Based on the assessment of five competent experts, words were ordered from the most to the least sexually arousing (Kendall's W from 0.368 to 0.693). Six ranked lists were obtained, and the competent experts were subsequently asked to assess whether these lists were suitable for the study (Lawshe's Content Validity Ratio from 0.6 to 1.0). Two categories of words were merged. Five ranked lists were obtained, and the competent experts were subsequently asked again to assess whether these lists were suitable for the study (Lawshe's Content Validity Ratio 1.0). The created lists of words were approved by allcompetent experts. Based on the experimental study conducted on a non-clinical population, it was shown that, in accordance with the principle of the test, the mean response time for sexually related words was longer that for neutral words. The mean response time for children-related words did not differ significantly from response time for neutral words.
CONCLUSIONS
Based on the study with competent experts and conducted experiments, an initial Polish adaptation of the emotional Stroop test for diagnosis of pedophilia has been created. Further studies with persons with pedophilia are needed to implement the test in clinical setting.
Topics: Humans; Pedophilia; Pilot Projects; Poland; Reproducibility of Results; Stroop Test
PubMed: 34021548
DOI: 10.12740/PP/111772 -
Cadernos de Saude Publica 2003This paper define the characteristics of pedophilia as it appears in the Brazilian newspaper Folha de São Paulo, including both the characteristics of the pedophile and...
This paper define the characteristics of pedophilia as it appears in the Brazilian newspaper Folha de São Paulo, including both the characteristics of the pedophile and the reasons given for such behavior. The research employs a technique called analysis by opposition which means that news coverage on other forms of sexual violence against children (sexual abuse, child pornography, rape, and incest) is used to help shed light on the characteristics of pedophilia itself. Some 384 articles were analyzed, of which 114 referred to pedophilia, all published between 1994 and 1999. News on sexual abuse of children was biased by concepts of class and violence/illness, reiterating the lay view that violence can be either a result of barbarianism and poverty or of psychological disorder, both depending on the aggressor's social class. The theoretical perspective adopted, that there is a correlation between media and reality, indicates that this bias is shared by Brazilian society as a whole.
Topics: Adolescent; Brazil; Child; Child Abuse, Sexual; Erotica; Humans; Incest; Mass Media; Newspapers as Topic; Pedophilia; Rape; Sex Offenses
PubMed: 15029347
DOI: 10.1590/s0102-311x2003000800009 -
The Israel Journal of Psychiatry and... 2012The treatment of paraphilias, especially of pedophilia, centers upon cognitive-behavioral psychotherapy and pharmacologic interventions. Two open, uncontrolled clinical... (Randomized Controlled Trial)
Randomized Controlled Trial
Double-blind, controlled, clinical trial planned in germany to investigate the efficacy of psychotherapy combined with triptorelin in adult male patients with severe pedophilic disorders: presentation of the study protocol.
BACKGROUND
The treatment of paraphilias, especially of pedophilia, centers upon cognitive-behavioral psychotherapy and pharmacologic interventions. Two open, uncontrolled clinical studies using the synthetic LHRH-agonist triptorelin suggested that, combined with psychotherapy, antiandrogen treatment reduced deviant sexual fantasies, urges, and behaviors in paraphilic patients. There is a need for further research using controlled, randomized trials to examine the effectiveness of sexual offender treatment including psychotherapeutic and pharmacologic interventions.
OBJECTIVE
The aim of this pilot study is to evaluate the efficacy and tolerability of cognitive-behavioral psychotherapy together with intramuscular (IM) 3-monthly injections of triptorelin in adult men with severe pedophilia.
STUDY DESIGN AND METHODS
In this multicenter, forensic psychiatric hospital-based, double-blind, controlled, parallel group phase IV trial conducted in Germany, convicted male sexual offenders aged ≥ 18 years with pedophilia, as defined by DSM-IV-TR criteria, will be randomized to receive study-specific psychotherapy together either with triptorelin or placebo for 12 months (total of 4 injections). This is a pilot study, therefore exploratory data analyses will be carried out of three different target parameters: 1. Changes in psychosexual characteristics using the Multiphasic Sex Inventory (scale: sexual abuse of children) 2. Changes in the risk of violent sexual behavior using the Sexual Violence Risk-20 total score 3. Changes in serum testosterone concentration Treatment effects will be assessed by comparing baseline values with those at the final examination (month 12).
LIMITATIONS
The absence of real-life stimulants to test for actual recidivism limits possible findings. The study will be conducted in agreement with the European GCP-guideline, all relevant legal requirements, and the legal framework for voluntary treatment of convicted sexual offenders in Germany.
Topics: Adult; Androgen Antagonists; Clinical Protocols; Combined Modality Therapy; Criminals; Double-Blind Method; Humans; Male; Pedophilia; Pilot Projects; Psychotherapy; Sex Offenses; Treatment Outcome; Triptorelin Pamoate
PubMed: 23585468
DOI: No ID Found -
Child Abuse & Neglect May 2008To establish the prevalence, typology and nature of attempted or completed incidents of stranger-perpetrated sexual abuse or abduction of children "away from home".
OBJECTIVE
To establish the prevalence, typology and nature of attempted or completed incidents of stranger-perpetrated sexual abuse or abduction of children "away from home".
METHODS
A questionnaire was completed by 2,420 children (83% response rate) aged 9-16 years in 26 elementary and high schools in North-West England.
RESULTS
Of these children, 19.0% (n=461) reported that they had been the victims of any attempted or completed sexual abuse or abduction incident away from home at some point in their lives. Of these children, 161 (6.7% of the original sample) reported that the "last" incident had been perpetrated by a stranger. Based upon these last incidents, four main types of attempted or completed CSA or abduction incident were identified: indecent exposure (40.8% of victims), touching (25.8%), and abduction (23.1%), each occurring on their own; and incidents involving multiple types of act (10.2%). The majority of these abductions (91.1%) and touching incidents (50.9%) were attempted as opposed to completed. Rates of victimization were generally higher among girls than boys (10.4% vs. 4.2%, p<.001). A sizeable minority of victims had experienced sexual abuse or abduction previously (28.8%). The large majority of incidents were carried out by males (88.2%). Most incidents occurred when children were accompanied by their peers (67.9%). Many victims were frightened by their experience (46.9% very frightened) and the large majority made a disclosure (79.9%). Only a minority of incidents were reported to the police (33.3%).
CONCLUSIONS
Incidents of attempted and completed stranger CSA and abduction are distinct from CSA and abduction by known persons, go against stereotypes, are complex, and give rise to a number of key issues that may have implications for prevention and intervention.
PRACTICE IMPLICATIONS
Professionals involved in child protection should undertake work to reduce the risk of existing victims of CSA or abduction becoming victims of stranger CSA or abduction, and the risk of attempted incidents becoming completed ones. They also need to encourage the disclosure and reporting of attempted and completed stranger CSA and abduction incidents.
Topics: Adolescent; Child; Child Abuse, Sexual; Crime; Crime Victims; Cross-Sectional Studies; Data Collection; Fear; Female; Humans; Incidence; Male; Pedophilia; Police; Self Disclosure; United Kingdom
PubMed: 18513796
DOI: 10.1016/j.chiabu.2008.02.002