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Journal of Psychiatry & Neuroscience :... Jan 2008The neurobiological mechanisms of deviant sexual preferences such as pedophilia are largely unknown. The objective of this study was to analyze whether brain activation...
OBJECTIVE
The neurobiological mechanisms of deviant sexual preferences such as pedophilia are largely unknown. The objective of this study was to analyze whether brain activation patterns of homosexual pedophiles differed from those of a nonpedophile homosexual control group during visual sexual stimulation.
METHOD
A consecutive sample of 11 pedophile forensic inpatients exclusively attracted to boys and 12 age-matched homosexual control participants from a comparable socioeconomic stratum underwent functional magnetic resonance imaging during a visual sexual stimulation procedure that used sexually stimulating and emotionally neutral photographs. Sexual arousal was assessed according to a subjective rating scale.
RESULTS
In contrast to sexually neutral pictures, in both groups sexually arousing pictures having both homosexual and pedophile content activated brain areas known to be involved in processing visual stimuli containing emotional content, including the occipitotemporal and prefrontal cortices. However, during presentation of the respective sexual stimuli, the thalamus, globus pallidus and striatum, which correspond to the key areas of the brain involved in sexual arousal and behaviour, showed significant activation in pedophiles, but not in control subjects.
CONCLUSIONS
Central processing of visual sexual stimuli in homosexual pedophiles seems to be comparable to that in nonpedophile control subjects. However, compared with homosexual control subjects, activation patterns in pedophiles refer more strongly to subcortical regions, which have previously been discussed in the context of processing reward signals and also play an important role in addictive and stimulus-controlled behaviour. Thus future studies should further elucidate the specificity of these brain regions for the processing of sexual stimuli in pedophilia and should address the generally weaker activation pattern in homosexual men.
Topics: Adult; Brain; Demography; Erotica; Homosexuality; Humans; Magnetic Resonance Imaging; Male; Pedophilia; Photic Stimulation
PubMed: 18197269
DOI: No ID Found -
International Journal of Surgery Case... 2016• Sexual problems are related to three components: physiology, sociocultural background, and neurological location of injury. • Studying the neural basis of sexual...
• Sexual problems are related to three components: physiology, sociocultural background, and neurological location of injury. • Studying the neural basis of sexual response and preference is crucial for exposing pathways involved in sexual disorders. • Literature case reports have shown that sexual disinhibition is associated with basal frontal lobe dysfunction.
PubMed: 27394398
DOI: 10.1016/j.ijscr.2016.06.035 -
NeuroImage. Clinical 2018A pedophilic disorder is characterised by abnormal sexual urges towards prepubescent children. Child abusive behavior is frequently a result of lack of behavioral...
A pedophilic disorder is characterised by abnormal sexual urges towards prepubescent children. Child abusive behavior is frequently a result of lack of behavioral inhibition and current treatment options entail, next to suppressing unchangeable sexual orientation, measures to increase cognitive and attentional control. We tested, if in brain regions subserving attentional control of behavior and perception of salient stimuli, such inhibition deficit can be observed also on the level of inhibitory neurotransmitters. We measured GABA concentration in the dorsal anterior cingulate cortex (dACC) and in a control region, the pregenual anterior cingulate cortex (pgACC) in pedophilic sex offenders ( = 13) and matched controls ( = 13) using a 7 Tesla STEAM magnetic resonance spectroscopy (MRS). In dACC but not in the control region pedophilic sex offenders showed reduced GABA/Cr concentrations compared to healthy controls. The reduction was robust after controlling for potential influence of age and gray matter proportion within the MRS voxel ( < 0.04). Importantly, reduced GABA/Cr in patients was correlated with lower self-control measured with the Barratt Impulsiveness Scale (p = 0.028, r = -0.689). In a region related to cognitive control and salience mapping, pedophilic sex offenders showed reduction of the inhibitory neurotransmitter GABA which may be seen as a neuronal correlate of inhibition and behavioral control.
Topics: Adult; Brain Mapping; Correlation of Data; Creatine; Gyrus Cinguli; Humans; Inhibition, Psychological; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Male; Middle Aged; Pedophilia; Sex Offenses; Young Adult; gamma-Aminobutyric Acid
PubMed: 29876253
DOI: 10.1016/j.nicl.2018.01.018 -
Medical History Oct 2015A scientific nomenclature of erotic age preferences informed the mid- through late nineteenth century joint appearance of homosexuality and sexual abuse of minors on the...
A scientific nomenclature of erotic age preferences informed the mid- through late nineteenth century joint appearance of homosexuality and sexual abuse of minors on the medico-legal scene. Yet, even in the twenty-first century, legal, psychiatric and culture-critical dimensions of related terms are rarely cleanly distinguished. Review of primary sources shows the ongoing Western suspension of notions of 'sick desire', alongside and beyond the medicalisation of homosexuality, between metaphor, legal interdiction and postulated psychopathology. Virtually all early attention to erotic age preference occurred in the context of emergent attention to erotic gender preference. Age of attraction and age difference centrally animate modern homosexuality's pre-modern past; its earliest psychiatric nomenclature and typologies (1844-69); its early aetiologies stipulating degrees of sexual differentiation (1890 s); its concomitant sub-classification (1896-1914); its earliest psychophysiological tests (1950s); and, finally, its post-psychiatric, social scientific typologies (1980s). Several identifications of 'paedophilia' were seen throughout the 1890 s but as a trope it gained cultural momentum only during, and as a seemingly intriguing corollary of, the progressive depsychiatricisation of homosexuality across the Anglo-European world (late 1950s through 1980s). Early twentieth century sources varied in having it denote (1) a distinct perversion, thus possible 'complication' of sexual inversion (2) a discrete corollary of psychosexual differentiation akin to gender preference (3) a distinct subtype of fetishism, thus a likely imprint of early seduction (4) a more intricate expression of erotic symbolism or psychosexual complex or (5) a taste answering to culture, a lack of it, or a libertine disregard for it.
Topics: Age Factors; Female; Forensic Psychiatry; History, 19th Century; History, 20th Century; History, 21st Century; History, Ancient; Homosexuality; Humans; Male; Pedophilia; Psychopathology
PubMed: 26352305
DOI: 10.1017/mdh.2015.47 -
The Linacre Quarterly Aug 2011Data on the age of the preferred partner of same-sex attracted men show that the abuse of minors by priests and deacons is primarily a question of "ordinary"...
Data on the age of the preferred partner of same-sex attracted men show that the abuse of minors by priests and deacons is primarily a question of "ordinary" homosexuality, and secondarily of homosexual pedophilia (not just unspecified "pedophilia"). This points to the substantial over-representation of homosexually inclined men among seminarians and priests, which in turn is related to a process of "homosexualization" (and feminization) in the Church. The general dissent from the moral doctrine on sexuality and marriage (as set forth in the encyclical Humanae vitae) has paved the way for this process. A few suggestions are discussed for the prevention of the abuses of the past decades: (a) improved screening of candidates for the priesthood as well as for the office of bishop on masculine personality maturity, which includes normal heterosexuality and fatherhood qualities; (b) a spiritual regime for seminary students and priests that is demanding on the self and directs the battle for holiness;
PubMed: 30082949
DOI: 10.1179/002436311803888294 -
Sexual Abuse : a Journal of Research... Aug 2023The Revised Screening Scale for Pedophilic Interests (SSPI-2) is a five-item measure that assesses for pedohebephilia (sexual attraction to prepubescent and pubescent...
The Revised Screening Scale for Pedophilic Interests (SSPI-2) is a five-item measure that assesses for pedohebephilia (sexual attraction to prepubescent and pubescent children) based on child victim characteristics. We aimed to replicate findings by Seto, Sandler et al. (2017) by examining the predictive validity of the SSPI-2 in an independent sample of 626 men referred for a sexological assessment because of sexual offending against children. SSPI-2 scores were associated with an increased likelihood of sexual recidivism but were not significantly associated with non-sexually violent or non-violent recidivism. When they were entered together, the SSPI-2 did not contribute additional variance to the Static-99R in the prediction of sexual recidivism. Results are consistent with the findings of Seto, Sandler et al. (2017) and suggest that higher scores on the SSPI-2 may be indicative of an increased risk for sexual recidivism in individuals who have sexually offended against children.
Topics: Male; Child; Humans; Pedophilia; Risk Factors; Sexual Behavior; Recidivism; Sex Offenses; Risk Assessment
PubMed: 36727957
DOI: 10.1177/10790632221149696 -
Archives of Sexual Behavior Jan 2024Diagnosing pedohebephilia is fraught with obstacles given the tabooed nature of this sexual preference. The viewing reaction time effect (VRT) provides a non-intrusive...
Diagnosing pedohebephilia is fraught with obstacles given the tabooed nature of this sexual preference. The viewing reaction time effect (VRT) provides a non-intrusive indirect measure of sexual interest in minors. In forensic populations, the ability of the difference between the latencies while viewing child and adult sexual stimuli (VRT index) to discern child sexual offenders from a range of control groups has been ascertained meta-analytically. Given that the effect has been studied almost exclusively in forensic samples, its dependence or independence on prior overt (deviant) sexual behavior remains unclear. The present study sought to examine the relationship of prior sexual and non-sexual behaviors with the VRT in a sample of 282 self-referring, help-seeking men with and without pedohebephilia with and without a history of prior child sexual offenses (CSO) or a use of child sexual abuse materials (CSAM) recruited outside a forensic context. We found that (1) the clinical diagnosis of pedohebephilia but not prior CSO or CSAM showed a significant association with the VRT index; (2) the discriminatory ability of the VRT index did not differ significantly between samples with and without a history of prior overt sexual behavior with children; (3) the VRT index correlated positively with a behavioral marker of pedohebephilia in a subsample of individuals with prior judicially detected or undetected overt sexual behavior with children; and (4) in the same subsample, the VRT index correlated positively with markers of sexual interests in minors or hypersexuality but not of antisociality. Equivalence testing failed to refute a potential effect of prior sexual behavior on the VRT index. Our study showed that the VRT may provide an unintrusive diagnostic tool for pedohebephilia. The effect of prior overt sexual behavior with children needs further examination.
Topics: Male; Adult; Child; Humans; Pedophilia; Reaction Time; Sexual Behavior; Sex Offenses; Child Abuse, Sexual; Paraphilic Disorders
PubMed: 37594679
DOI: 10.1007/s10508-023-02662-y -
The New England Journal of Medicine Feb 1998Men with deviant sexual behavior, or paraphilia, are usually treated with psychotherapy, antidepressant drugs, progestins, and antiandrogens, but these treatments are... (Clinical Trial)
Clinical Trial
BACKGROUND
Men with deviant sexual behavior, or paraphilia, are usually treated with psychotherapy, antidepressant drugs, progestins, and antiandrogens, but these treatments are often ineffective. Selective inhibition of pituitary-gonadal function with a long-acting agonist analogue of gonadotropin-releasing hormone may abolish the deviant sexual behavior by reducing testosterone secretion.
METHODS
In an uncontrolled observational study, we treated 30 men (mean age, 32 years) with severe long-standing paraphilia (25 with pedophilia and 5 with other types of abnormal behavior) with monthly injections of 3.75 mg of triptorelin and supportive psychotherapy for 8 to 42 months. The efficacy of therapy was evaluated monthly by the Intensity of Sexual Desire and Symptoms Scale and yearly by the Three Main Complaints questionnaire.
RESULTS
All the men had a decrease in the number of deviant sexual fantasies and desires, from a mean (+/-SD) of 48+/-10 per week before therapy to zero during therapy (P<0.001), and a decrease in the number of incidents of abnormal sexual behavior (from 5+/-2 per month to zero, P<0.001) while receiving triptorelin. These effects were evident after 3 to 10 months of therapy (P<0.001) and persisted in all 24 men who continued therapy for at least 1 year. The men's mean serum testosterone concentration fell from 545+/-196 ng per deciliter (18.9+/-6.8 nmol per liter) before therapy to 23+/-14 ng per deciliter (0.8+/-0.5 nmol per liter, P<0.001) after 42 months of triptorelin. The main side effects were erectile failure, hot flashes, and decrease in bone mineral density in some men.
CONCLUSIONS
Continuous administration of triptorelin, a long-acting agonist analogue of gonadotropin-releasing hormone, together with supportive psychotherapy, may be an effective treatment for men with severe paraphilia.
Topics: Adult; Bone Density; Erectile Dysfunction; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Luteinizing Hormone; Male; Paraphilic Disorders; Testis; Testosterone; Treatment Outcome; Triptorelin Pamoate
PubMed: 9459644
DOI: 10.1056/NEJM199802123380702 -
JMIR Mental Health Feb 2021Despite the high prevalence of child sexual offenses and the increasing amounts of available child sexual abuse material, there is a global shortage of preventive...
Characteristics of the Users of Troubled Desire, a Web-Based Self-management App for Individuals With Sexual Interest in Children: Descriptive Analysis of Self-assessment Data.
BACKGROUND
Despite the high prevalence of child sexual offenses and the increasing amounts of available child sexual abuse material, there is a global shortage of preventive interventions focusing on individuals at risk of sexual offending. The web-based app Troubled Desire aims to address this shortage by offering self-assessments and self-management training modules in different languages to individuals with sexual interests in prepubescent and early pubescent children (ie, those with pedophilic and hebephiliac sexual interest, respectively).
OBJECTIVE
The aim of this study was to describe the characteristics of the users of the Troubled Desire app.
METHODS
The fully completed self-assessment data gathered within the first 30 months of this study from October 25, 2017 to April 25, 2020 were investigated. The main outcome measures were (1) sociodemographic information and (2) sexual interests and sexual behaviors of the users of Troubled Desire.
RESULTS
The self-assessment was completed by 4161 users. User accesses were mainly from Germany (2277/4161, 54.7%) and the United States (474/4161, 11.4%). Approximately 78.9% (3281/4161) of the users reported sexual interest in children; these users were significantly more likely to report distress and trouble owing to their sexual interest. Further, child sexual offenses and consumption of child sexual abuse material were significantly more common among users with sexual interest in children than among users with no sexual interest in children. Additionally, the majority of the offenses were not known to legal authorities.
CONCLUSIONS
The Troubled Desire app is useful in reaching out to individuals with sexual interest in prepubescent and early pubescent children. However, future research is warranted to understand the prospective relevance of the Troubled Desire app in the prevention of child sexual offending.
PubMed: 33605895
DOI: 10.2196/22277 -
NeuroImage. Clinical 2019Although structural and functional neuroimaging techniques have recently been used to investigate the mechanisms of sexual attraction to children, a hallmark of...
Although structural and functional neuroimaging techniques have recently been used to investigate the mechanisms of sexual attraction to children, a hallmark of pedophilic disorder, the differences in the processing of child sexual stimuli between men attracted to children and those attracted to adults remain unclear. Here, our purpose was to identify through positron emission tomography the brain responses of 15 male outpatients with pedophilic disorder to validated visual sexual stimuli depicting children (VSSc) and to compare them with 15 male healthy controls matched for sexual orientation (to female or male adults), age, and handedness. The patients' sample comprised both offenders and non-offenders. In response to VSSc, the between-groups analysis showed that activation in the right inferior temporal cortex [Brodmann area (BA) 20] was lower in patients than in controls. Moreover, in patients but not in controls, the presentation of VSSc induced an activation in a more caudal region of the right inferior temporal gyrus (BA 37) and in the left middle occipital gyrus (BA 19). In addition, in patients the level of activation in the caudal right inferior temporal gyrus was positively correlated with ratings of sexual arousal elicited by VSSc, whereas this correlation was negative in BA 20. These results implicate the right inferior temporal gyrus as a possible candidate area mediating sexual arousal in patients with pedophilic disorder and suggest that two of its areas play opposite, i.e., activating and inhibitory, roles.
Topics: Adult; Brain; Child; Female; Humans; Male; Middle Aged; Pedophilia; Photic Stimulation; Positron-Emission Tomography; Temporal Lobe
PubMed: 30612938
DOI: 10.1016/j.nicl.2018.101647