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BJPsych International Nov 2021Phallometry is an objective method of assessing male sexual arousal. The main applications in forensic psychiatry concern the evaluation of men charged with or convicted... (Review)
Review
Phallometry is an objective method of assessing male sexual arousal. The main applications in forensic psychiatry concern the evaluation of men charged with or convicted of sexual offences, the evaluation of those with suspected paraphilias not subject to the criminal justice system, risk assessment and measurement of response to sex offender treatment. In some jurisdictions, phallometry is incorporated into legal decisions about release from custody or discharge from secure hospitals. This paper provides a brief overview of the international development of phallometry, considers challenges to its broader adoption and discusses future directions for research and clinical practice.
PubMed: 34747938
DOI: 10.1192/bji.2021.17 -
Psychiatria Danubina Dec 2019The aim of the study was to compare the characteristics of sex offenders today, and those who committed a sex crime fifteen years ago, in regard to their...
BACKGROUND
The aim of the study was to compare the characteristics of sex offenders today, and those who committed a sex crime fifteen years ago, in regard to their psychiatric-forensic aspects.
SUBJECTS AND METHODS
Data from the University psychiatric hospital Vrapče, Center for forensic psychiatry on court people sent for psychiatric and forensic evaluation, who were accused of sex offense in two time frames (1998-2001 and 2010-2016) were analysed. In total there were 50 and 57 male subjects sent for an evaluation.
RESULTS
In both groups rape was the most prevalent offence, and both groups had the same prevalence of abuse, earlier psychiatric treatment and the majority of offenders were diagnosed with dissocial personality disorder and other personality disorders. Paedophilia was diagnosed in only a minority (14% and 7% respectively) of cases. The latter group (2010-2016) committed more sex offences against children, more often were with no mental disorder and less often had alcohol dependence and mental retardation. Up to one third of the later group were not giving their defence, compared to 4% of the former group.
CONCLUSIONS
Changes in court case law and psychiatrists' usage of diagnostic criteria have influenced the prevalent diagnoses in sex offenders. Paraphilias are not often diagnosed in sex offenders because they do not confirm the act, and in recent years more often use not to give their defence (which makes reaching the diagnosis more challenging).
Topics: Adolescent; Adult; Aged; Alcoholism; Child; Criminals; Croatia; Female; Forensic Psychiatry; Humans; Intellectual Disability; Male; Mental Disorders; Middle Aged; Sex Offenses; Young Adult
PubMed: 32160179
DOI: No ID Found -
Neuropsychobiology 2013The failure to inhibit pleasurable but inappropriate urges is associated with frontal lobe pathology and has been suggested as a possible cause of pedophilic behavior....
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.
Topics: Adult; Aged; Brain; Case-Control Studies; Discrimination, Psychological; Functional Neuroimaging; Humans; Inhibition, Psychological; Magnetic Resonance Imaging; Male; Middle Aged; Pedophilia; Photic Stimulation; Pilot Projects; Psychomotor Performance; Reaction Time
PubMed: 24247250
DOI: 10.1159/000355295 -
Perspectives on Behavior Science Dec 2021This article provides an overview of highlights from 60 years of basic research on choice that are relevant to the assessment and treatment of clinical problems. The...
This article provides an overview of highlights from 60 years of basic research on choice that are relevant to the assessment and treatment of clinical problems. The quantitative relations developed in this research provide useful information about a variety of clinical problems including aggressive, antisocial, and delinquent behavior, attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, chronic pain syndrome, intellectual disabilities, pedophilia, and self-injurious behavior. A recent development in this field is an evolutionary theory of behavior dynamics that is used to animate artificial organisms (AOs). The behavior of AOs animated by the theory has been shown to conform to the quantitative relations that have been developed in the choice literature over the years, which means that the theory generates these relations as emergent outcomes, and therefore provides a theoretical basis for them. The theory has also been used to create AOs that exhibit specific psychopathological behavior, the assessment and treatment of which has been studied virtually. This modeling of psychopathological behavior has contributed to our understanding of the nature and treatment of the problems in humans.
PubMed: 35098025
DOI: 10.1007/s40614-021-00296-w -
Psychiatria Polska Jun 2020The issue of sexual abuse of minors in the Catholic Church is widely discussed in the media. Nevertheless, the term ‛priest-pedophile'has been used inaccurately to... (Review)
Review
The issue of sexual abuse of minors in the Catholic Church is widely discussed in the media. Nevertheless, the term ‛priest-pedophile'has been used inaccurately to identify perpetrators. There is very little research directly dealing with this group of offenders among Catholic clergy, and we do not yet have any theory that would adequately explain this type of behavior. Attempts to psychologically characterize priests who sexually abuse minors have brought limited success so far. The purpose of this article is to present the most important issues and clinical dilemmas related to the diagnosis and treatment of paraphilias among Catholic clergy, signifying similarities and differences between clergy and other perpetrators of sexual offenses against minors, present typology of sexual offenders among priests, and discuss therelationship of victims' gender with sexual orientation and celibacy of perpetrators. The author demonstrates that using the term ‛priest-pedophile' is not only misleading, but is sometimes used to deliberately mislead. On the one hand, to create a moral panic effect, suggesting that the Catholic clergy is at increased risk of this type of crime. On the other hand, indicating gender and age of the most of their victims, suggesting that people responsible for this kind of abuse among Catholic clergy are homosexual priests and thus select a scapegoat responsible for the problems of the Church institution.
Topics: Catholicism; Child; Child Abuse, Sexual; Clergy; Criminals; Humans; Male; Minors; Paraphilic Disorders; Pedophilia; Religion and Psychology
PubMed: 33038888
DOI: 10.12740/PP/118599 -
Psychiatria Polska 2016The paper discusses the governmental draft of the Act on counteracting threats of sexual offences. It assumes the creation of the Registry of Sex Offenders in a version... (Review)
Review
The paper discusses the governmental draft of the Act on counteracting threats of sexual offences. It assumes the creation of the Registry of Sex Offenders in a version with a limited access and a version available to the public. The registry is supplemented with a publically available map of sexual crime threats, which includes the places of sexual offences and the places of residence of offenders. Criticising the proposed solutions, the authors point out the lack of integration with other interventions conducted in Poland against sex offenders, noncompliance with the recommendations of the most important expert circles in the field, as well as the research results showing the lack of effectiveness of the planned measures to reduce sexual offences. Anumber of negative consequences of making the sex offenders'data available to the public was also highlighted in the form of a clear deterioration of social rehabilitation prognoses, additional stigmatisation, as well as social exclusion of the offenders themselves and the victims of sexual violence. The summary emphasises the need to counteract the problem of sexual offences in a systematic way and the need to diversify the interventions undertaken against the offenders, depending on the level of risk of sexual recidivism.
Topics: Attitude of Health Personnel; Crime Victims; Criminals; Forensic Medicine; Forensic Psychiatry; Health Policy; Humans; Pedophilia; Registries; Risk Assessment; Sex Offenses
PubMed: 27556108
DOI: 10.12740/PP/62903 -
World Psychiatry : Official Journal of... Oct 2003Poorly implemented mental health reform policies are often given as reasons for the growth in demands for forensic psychiatric services and the steady increase of mental...
Poorly implemented mental health reform policies are often given as reasons for the growth in demands for forensic psychiatric services and the steady increase of mental patients in prison systems. However, in this paper, additional reasons are advanced to explain the growth of forensic psychiatry, such as an expansion in the types of "psychiatric defences" in courts of law; public concerns about violent behaviour attributed to the mentally ill; the community management of paraphilias, especially pedophilia; the development of risk assessment methodologies and the halo of super-specialization. The net result of these developments is that patients who receive a label of "forensic" enter into a mental health ghetto with little connectivity or integration with the general mental health system. The forensic label increases the stigma and decreases opportunities for reintegration and full social recovery. The paper provides guidelines to reverse these trends.
PubMed: 16946932
DOI: No ID Found -
Child Abuse & Neglect Dec 2023Sexual violence is a major public health issue worldwide, with a high prevalence and extensive human and financial costs. Implementing prevention programs is complex,... (Review)
Review
BACKGROUND
Sexual violence is a major public health issue worldwide, with a high prevalence and extensive human and financial costs. Implementing prevention programs is complex, requiring not only evidence-based practices and high ethical standards, but also close collaboration with local governments and non-governmental organizations. In order to guide and support all stakeholders necessary to achieve large-scale prevention (e.g., politicians, decision-makers, in-field professionals), it is essential to establish international benchmarks for the prevention of sexual violence.
OBJECTIVE
The main goal of this collaborative study was to conduct a systematic review of the frameworks adopted by WHO, UN Women, UNESCO, and UNICEF to help prevent sexual violence worldwide, according to the PRISMA methodology. A secondary objective was to highlight the levels of prevention and determinants of health targeted by these organizations.
RESULTS
Overall, 1008 references were identified, of which 50 met the inclusion criteria. All international guidelines were limited to primary or tertiary prevention, and they were not specifically dedicated to sexual violence. In addition, each organization had developed idiosyncratic prevention strategies. Common primary prevention determinants of health were still found across organizations, including education, socio-economic inequalities, and life skills training. Tertiary prevention was poorly developed and polarized between victims and perpetrators. Secondary prevention was never addressed, however, despite the effectiveness of approaches such as helplines for people sexually attracted to children.
DISCUSSION
Given these results, an international French-speaking consortium of professional teams, all involved in the secondary prevention of sexual violence, was recently formed with a ratified charter presented here.
Topics: Child; Humans; Female; UNESCO; Sex Offenses; Sexual Behavior; Public Health; World Health Organization
PubMed: 37832246
DOI: 10.1016/j.chiabu.2023.106497 -
Sexual Abuse : a Journal of Research... Apr 2023Research on the link between childhood sexual abuse experiences (CSAE) and pedohebephilia is limited by its focus on events that the respondents rate as abusive. We...
Research on the link between childhood sexual abuse experiences (CSAE) and pedohebephilia is limited by its focus on events that the respondents rate as abusive. We asked 199 German-speaking (Study 1) and 632 English-speaking (Study 2) men with and without self-reported pedohebephilia to complete the Childhood Trauma Questionnaire (CTQ) and scales to assess perceived non-coercive childhood sexual experiences with adults (PNCSE-A), and peers (PNCSE-P, only Study 2). A substantial number of participants with PNCSE-A disagreed with all items of the CTQ Sexual Abuse subscale (e.g., 35% and 26% of pedohebephilic men in Studies 1 and 2, 38% of teleiophilic men in Study 2). While pedohebephilic men reported more CSAE than teleiophilic men, the effects for PNCSE-A did not consistently point in the expected direction. In Study 2, conviction status for sexual offenses among pedohebephilic men was linked to higher rates of CSAE, PNCSE-A, PNCSE-P, physical neglect, and physical abuse. Pedohebephilic men in Study 2 also reported more PNCSE-P than teleiophilic men. Our results highlight the importance of assessing different (positive or neutral) perceptions of CSAE. Better controlled designs (e.g., matched case-control studies) are needed to substantiate whether and how perceived non-coercive childhood sexual experiences relate to pedohebephilia and sexual offending.
Topics: Male; Adult; Humans; Child; Pedophilia; Sexual Behavior; Sex Offenses; Case-Control Studies; Surveys and Questionnaires; Child Abuse; Child Abuse, Sexual
PubMed: 35549946
DOI: 10.1177/10790632221098341 -
Archives of Sexual Behavior Nov 2022The primary label for people who are sexually attracted to children ("pedophile") is conflated with sexual offending behavior and tainted with stigma. In the present...
The primary label for people who are sexually attracted to children ("pedophile") is conflated with sexual offending behavior and tainted with stigma. In the present pre-registered mixed-method study, we therefore investigated attitudes and preferences regarding "pedophile/hebephile" and other labels among 286 people who report a stronger or equally strong sexual attraction to prepubescent and pubescent children than to adults. Overall, quantitative data showed acceptance of "pedophile/hebephile" as well as a range of alternative labels in a personal (Labeling Oneself) and a professional context (Being Labeled by Others). "Minor-attracted person" and "pedophile/hebephile" received generally higher support than other terms and appeared to be least divisive across three major online fora. Qualitative data revealed four themes: "Contested self-labels," "Person-first language and pathologizing sexuality/identity," "Stigma and shame," and "Reclaiming the pedophile label." Our results allow deeper insight into reasons for adopting certain labels over others, as well as difficulties of finding a non-stigmatizing label. We discuss limitations of the study and practical implications for clinical and research contexts.
Topics: Adult; Child; Humans; Pedophilia; Sexual Behavior; Sex Offenses; Attitude; Gender Identity
PubMed: 36175817
DOI: 10.1007/s10508-022-02331-6