Paedophilia

Question 1

DSM-5 criteria for pedophilic disorder

Answer 1

1. For at least 6 months, more or equal attraction to prepubescent or early prepubescent children than to adults as manifested by fantasies, urges or behaviours
2. Due to these sexual urges, the individual has:
   - Acted
   - Felt distress
   - Been impaired in social, occupational or other important areas of functioning
3. The individual is at least 18 years old and at least 5 years older than the children he is attracted to

Different types:

• Classic = Attracted to prepubescent children
• Hebephilic = Attracted to early prepubescent children
• Paedohebephilic = Attracted to both

Question 2

Issues with DSM-5 criteria

Answer 2

1. One could be diagnosed as paedophile even without having paedophilic feelings
2. Exclusively refers to prepubescent children
3. Difficult to diagnose ‘at least 6 months’

Question 3

Blanchard’s solutions to the definition

Answer 3

1. Paraphilias = Only criterion 1 (and 3) is met
2. Paraphilic disorders = All criteria are met
3. Hebephilic type = Attracted to children who entered puberty but are still physically immature

Question 4

Psychology of paedophilia

Answer 4

1. More deliberate and planned response style, greater self-monitoring and fewer deficits in cognitive functioning than non-paedophilic child molesters
2. Intimacy and social skills deficit
3. Deviant sexual patterns
4. Emotional and cognitive distortions
5. Deficits in executive functioning
6. Lower intelligence
7. High scores for psychopathy and paranoia

Question 5

Contributing factors

Answer 5

1. Sibling sex composition - Greater number of older brothers
2. Paternal and maternal age at birth - The younger the better
3. Fluctuating asymmetry of finger lengths and wrist widths
4. Left-handedness
5. Stressful events during childhood
6. Head injuries before the age of 13

Question 6

Online paedophiles

Answer 6

1. Two groups:
   - Contact-driven
   - Fantasy-driven
2. Compared to other paedophiles:
   - Greater self-control
   - Younger
   - More likely Caucasian
   - Greater empathy
   - Greater sexual deviancy
3. Only 1/8 had an official record of sexual abuse

Question 7

Treatment

Answer 7

1. Focused on the reduction of sexual interest and relapse prevention rather than actually modifying the sexual orientation = Can it even be modified?
2. Real-time fMRI = To train them to modulate activation levels in specific brain areas when facing sexual stimuli
3. Meditation = Lowering sexual impulses by interfering with the activity of testosterone
4. Leuprolelin = May decrease activity in regions known to mediate the perceptual, motivational and affective responses to visual sexual stimuli
5. Chemical castration = Use hormonal treatment to suppress testosterone levels = Not efficient if act is motivated by other reasons than sexual arousal

Question 8

How do you measure paedophilia?

Answer 8

1. Circumferential phallometry - Measures changes in penile grith with a wire band fixed at the base of the penis
2. Volumetric phallometry - Glass tube fixed around the penis, air output as the result of erection is measured
3. Viewing time paradigm - People will look for longer at stimuli they find sexually arousing
4. Pictorial Stroop task - Measures implicit sexual association - Better at differentiating between heterosexual v homosexual than between normal v paedophilic
5. Eye tracking and pupil dilatation
6. fMRI - Check neurobiology of paedophilia

Question 9

The neurobiology of paedophilia

Answer 9

1. Preference-specific brain activity in areas known to be involved in processing sexual stimuli:
   - Caudate nucleus
   - Cingulate cortex
   - Insula
   - Fusiform gyrus
   - Temporal cortex
   - Occipital cortex
   - Thalamus
   - Amygdala
   - Cerebellum
2. Orbitofrontal deactivation
3. Volume reduction of amygdala but increased activation when shown stimuli depicting children

Question 10

Theories of paedophilia

Answer 10

1. Frontal lobe theory - Orbitofrontal and dorsolateral prefrontal cortex = Responsible for behaviour control and inhibition of sexual behaviour
2. Temporal lobe theory = Disturbances in the temporal lobes can result in an increase in paedophilic behaviours
3. Dual lobe theory = Frontal lobe is responsible for committing the sexual offence and temporal lobe is responsible for the sexual preoccupation with children
4. Organisational-activational hypothesis - Due to masculinization of the brain = Temporary testosterone rise in prenatal and early post-natal stages shapes development by masculinizing and defeminizing neural networks in males