Clinical characteristics associated with paedophilia and child sex offending – Differentiating sexual preference from offence status

Abstract

Child sex offending (CSO) has disastrous effects on children’s mental well-being and development that persist into adulthood [ 1 x [1] Kessler, R.C., McLaughlin, K.A., Green, J.G., Gruber, M.J., Sampson, N.A., Zaslavsky, A.M. et al. Childhood adversities and adult psychopathology in the WHO world mental health surveys. Br J Psychiatry. 2010; 197: 378–385 https://doi.org/10.1192/bjp.bp.110.080499 Crossref | PubMed | Scopus (565) | Google Scholar See all References 1 ] and may lead to structural and functional changes in children’s brains [ 2 x [2] Tomoda, A., Navalta, C.P., Polcari, A., Sadato, N., and Teicher, M.H. Childhood sexual abuse is associated with reduced gray matter volume in visual cortex of young women. Biol Psychiatry. 2009; 66: 642–648 https://doi.org/10.1016/j.biopsych.2009.04.021 Abstract | Full Text | Full Text PDF | PubMed | Scopus (78) | Google Scholar See all References , 3 x [3] Heim, C.M., Mayberg, H.S., Mletzko, T., Nemeroff, C.B., and Pruessner, J.C. Decreased cortical representation of genital somatosensory field after childhood sexual abuse. Am J Psychiatry. 2013; 170: 616–623 https://doi.org/10.1176/appi.ajp.2013.12070950 Crossref | PubMed | Scopus (75) | Google Scholar See all References ]. The average estimate of the prevalence of CSO is 12.7% in self-report studies, with female victims being more than twice as common as male victims [ 4 x [4] Stoltenborgh, M., van Ijzendoorn, M.H., Euser, E.M., and Bakermans-Kranenburg, M.J. A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreat. 2011; 16: 79–101 https://doi.org/10.1177/1077559511403920 Crossref | PubMed | Scopus (483) | Google Scholar See all References 4 ]. Paedophilia and CSO must not be considered synonymous [ 5 x [5] Seto, M.C. Pedophilia and sexual offending against children: theory, assessment, and intervention. 1st ed. American Psychological Association, Washington, DC; 2008 Crossref | Google Scholar See all References 5 ]; however paedophilic preference is a major contributing factor to CSO (present in about 50% of convicted offenders) [ 5 x [5] Seto, M.C. Pedophilia and sexual offending against children: theory, assessment, and intervention. 1st ed. American Psychological Association, Washington, DC; 2008 Crossref | Google Scholar See all References , 6 x [6] Whitaker, D.J., Le, B., Karl Hanson, R., Baker, C.K., McMahon, P.M., Ryan, G. et al. Risk factors for the perpetration of child sexual abuse: a review and meta-analysis. Child Abuse Negl. 2008; 32: 529–548 https://doi.org/10.1016/j.chiabu.2007.08.005 Crossref | PubMed | Scopus (113) | Google Scholar See all References ]. The ICD-10 defines paedophilia as “A sexual preference for children, boys or girls or both, usually of pre-pubertal or early pubertal age” that persists for at least six months [ 7, p. 171 x [7] World Health Organization. International statistical classification of diseases and related health problems. vol. 1. 10th rev. World Health Organization, Geneva, Switzerland; 1992 Google Scholar See all References 7, p. 171 ]. In the DSM-5, a diagnosis can only be made if a person with this preference has acted upon these urges or if they have caused ‘marked distress or interpersonal difficulty’ [ 8, p. 697 x [8] American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. American Psychiatric Association Publishing, Arlington, VA; 2013 Crossref | Google Scholar See all References 8, p. 697 ]. The prevalence of paedophilia or paedophilic disorder in the sense of these definitions is not known. However, some sexual interest in children (in the form of more or less frequent, intense and persistent sexual fantasies or thoughts involving children) is not rare in the general population. Based on extrapolation from large Finish and German surveys of convenience samples Seto estimated the upper limit for the prevalence of paedophilia in this latter sense at around 1% [ 9 x [9] Seto, M.C. The puzzle of male chronophilias. Arch Sex Behav. 2017; 46: 3–22 https://doi.org/10.1007/s10508-016-0799-y Crossref | PubMed | Scopus (25) | Google Scholar See all References 9 ].