The cause or causes of pedophilia are not well understood. Personality problems may be evident, and the pedophile often shows little or no concern for the effects of his sexual behavior on the child. Researchers have reported that psychotherapy in conjunction with the use of testosterone-lowering drugs has substantially reduced the desire in male pedophiles to molest children. See also child abuse.
In law enforcement, the term "pedophile" is generally used to describe those accused or convicted of the sexual abuse of a minor (including both prepubescent children and adolescent minors younger than the local age of consent). An example of this use can be seen for example in the name of the United Kingdom police agency, the Paedophile Unit and in various forensic trainings manuals. Some researchers have described this usage as improper and suggested it can confound two separate types of offenders.
In common usage, the term refers to any adult who is sexually attracted to children or who sexually abuses a child.
The causes of pedophilia are not known; research is ongoing. Most pedophiles are men, though pedophilia occurs in women as well. In forensic psychology and law enforcement, there have been a variety of typologies suggested to categorize pedophiles according to behavior and motivations. No significant curative treatment for pedophilia has been found at this time. There are, however, certain therapies that can reduce the incidence of pedophilic behaviors that result in child sexual abuse.
Adults sexually attracted to pre-pubescent youths were placed into three categories by Krafft-Ebing:
These types have been expanded upon and updated over the years into a variety of typologies (see Child Sexual Offender Types)
The APA's Diagnostic and Statistical Manual of Mental Disorders 4th edition, Text Revision gives the following as its "Diagnostic criteria for 302.2 Pedophilia":
The diagnosis is further specified by the sex of the children the person is attracted to, and if the impulses or acts are limited to incest. It is also sometimes split further into two categories:
Exclusive pedophiles are attracted to children, and children only. They show little erotic interest in adults their own age and in some cases, can only become aroused while fantasizing or being in the presence of prepubescent children. Nonexclusive pedophiles are attracted to both children and adults, and can be sexually aroused by both. According to a U.S. study on 2429 adult male pedophile sex offenders, only 7% identified themselves as exclusive; indicating that many or most pedophiles fall into the nonexclusive category. Some systems further differentiate types of offender in more specific categories (see Child Sexual Offender Types).
Neither the ICD or the APA diagnostic criteria require actual sexual activity with a prepubescent youth. The diagnosis can therefore be made based on the presence of fantasies or sexual urges alone, provided the subject meets the remaining criteria. "For individuals in late adolescence with pedophilia, no precise age difference is specified, and clinical judgment must be used" (p. 527 DSM).
Functional magnetic resonance imaging (fMRI) has shown that child molesters diagnosed with pedophilia have reduced activation of the hypothalamus as compared with non-pedophilic individuals when viewing sexually arousing pictures of adults. A 2008 functional neuroimaging study notes that central processing of sexual stimuli in heterosexual "paedophile forensic inpatients" may be altered by a disturbance in the prefrontal networks, which "may be associated with stimulus-controlled behaviours, such as sexual compulsive behaviours." The findings may also suggest "a dysfunction at the cognitive stage of sexual arousal processing.
Blanchard, Cantor, and Robichaud (2006) reviewed the research that attempted to identify hormonal aspects of pedophiles. They concluded that there is some evidence that pedophilic men have less testosterone than controls, but that the research is of poor quality and that it is difficult to draw any firm conclusion from it.
While not causes of pedophilia itself, comorbid psychiatric illness—such as personality disorders and substance abuse—are risk factors for acting on pedophilic urges. Blanchard, Cantor, and Robichaud (2006) noted about comorbid psychiatric illnesses that, "The theoretical implications are not so clear. Do particular genes or noxious factors in the prenatal environment predispose a male to develop both affective disorders and pedophilia, or do the frustration, danger, and isolation engendered by unacceptable sexual desires—or their occasional furtive satisfaction—lead to anxiety and despair?" They indicated that because they previously found mothers of pedophiles to be more likely to have undergone psychiatric treatment, the genetic possibility is more likely.
According to Wilson and Cox (1983), "The paedophiles emerge as significantly higher on Psychoticism, Introversion and Neurotocism than age-matched controls. [But] there is a difficulty in untangling cause and effect. We cannot tell whether paedophiles gravitate towards children because, being highly introverted, they find the company of children less threatening than that of adults, or whether the social withdrawal implied by their introversion is a result of the isloation engendered by their preference (i.e., awareness of the social approbation and hostility that it evokes" (p. 324).
Studying child sex offenders, a review of qualitative research studies published between 1982 and 2001 concluded that pedophiles use cognitive distortions to meet personal needs, justifying abuse by making excuses, redefining their actions as love and mutuality, and exploiting the power imbalance inherent in all adult-child relationships. Other cognitive distortions include the idea of "children as sexual beings," "uncontrollability of sexuality," and "sexual entitlement-bias.
One review of the literature concludes that research on personality correlates and psychopathology in pedophiles is rarely methodologically correct, in part due to confusion between pedophiles and child sex offenders, as well as the difficulty of obtaining a representative, community sample of pedophiles. Seto (2004) points out that pedophiles who are available from a clinical setting are likely there because of distress over their sexual preference or pressure from others. This increases the likelihood that they will show psychological problems. Similarly, pedophiles recruited from a correctional setting have been convicted of a crime, making it more likely that they will show anti-social characteristics.
Some people with pedophilia threaten children to stop them from reporting their actions. Others, like those that often victimize children, can develop complex ways of getting access to children, like gaining the trust of a child's parent, trading children with other pedophiles or on infrequent occasions, get foster children from nonindustrialized nations or abduct child victims from strangers. Pedophiles may often act interested in the child, to gain the child's interest, loyalty and affection to keep the child from letting others know about the sexual activity.
A perpetrator of child sexual abuse is commonly assumed to be and referred to as a pedophile; however, there may be other motivations for the crime (such as stress, marital problems, or the unavailability of an adult partner). Child sexual abuse may or may not be an indicator that its perpetrator is a pedophile. Many terms have been used to distinguish "true pedophiles" from nonpedophilic offenders, or to distinguish among types of offenders on a continuum according to strength and exclusivity of pedophilic interest, and motivation for the offense (see Child Sexual Offender Types).
Perpetrators who meet the diagnostic criteria for pedophilia offend more often than non-pedophile perpetrators, and with a greater number of victims. According to the Mayo Clinic, approximately 95% of child sexual abuse incidents are committed by the 88% of child molestation offenders who meet the diagnostic criteria for pedophilia. A behavioral analysis report by the FBI states that a "high percentage of acquaintance child molesters are preferential sex offenders who have a true sexual preference for children (i.e., pedophiles)."
A review article in the British Journal of Psychiatry notes the overlap between extrafamilial and intrafamilial offenders. One study found that around half of the fathers and stepfathers in its sample who were referred for committing extrafamilial abuse had also been abusing their own children.
As noted by Abel, Mittleman, and Becker (1985) and Ward et al. (1995), there are generally large distinctions between the two types of offenders' characteristics. Situational offenders tend to offend at times of stress; have a later onset of offending; have fewer, often familial victims; and have a general preference for adult partners. Pedophilic offenders, however, often start offending at an early age; often have a large number of victims who are frequently extrafamilial; are more inwardly driven to offend; and have values or beliefs that strongly support an offense lifestyle. Research suggests that incest offenders recidivate at approximately half the rate of extrafamilial child molesters, and one study estimated that by the time of entry to treatment, nonincestuous pedophiles who molest boys had committed an average of 282 offenses against 150 victims.
According to Canadian sexologist Michael Seto, cognitive-behavioral treatments target attitudes, beliefs, and behaviors that are believed to increase the likelihood of sexual offenses against children, and "relapse prevention" is the most common type of cognitive-behavioral treatment. The techniques of relapse prevention are based on principles used for treating addictions.
Applied behavior analysis is used with mentally disabled sex offenders. This method is rarely used on pedophiles who have not offended.
Gonadotropin-releasing hormone analogues, which last longer and have less side effects, are also effective in reducing libido and may be used.
These treatments, commonly referred to as "chemical castration," are often used in conjunction with the non-medical approaches noted above. According the Association for the Treatment of Sexual Abusers, "Anti-androgen treatment should be coupled with appropriate monitoring and counseling within a comprehensive treatment plan.
In a controlled Depo-Provera treatment study of forty sex offenders – including 23 pedophiles – who received Depo, and 21 sex offenders who received psychotherapy alone, outcome follow-up of the treated group v. the untreated group demonstrated that the reoffense rate for the Depo-treated group was significantly lower. Eighteen percent reoffended while receiving medication; 35 percent reoffended after stopping medication. In contrast, 58 percent of the control patients, who received psychotherapy alone reoffended. Patients defined as regressed were much more likely to reoffend off therapy than the patients defined as fixated.
A Profile of Pedophilia: Definition, Characteristics of Offenders, Recidivism, Treatment Outcomes, and Forensic Issues
Apr 01, 2007; Pedophilia has become a topic of increased interest, awareness, and concern for both the medical community and the public...
Mental health's cold shoulder treatment of pedophilia: experts urge professionals to overcome the disorder's stigma to help reduce future victimization.
May 01, 2004; Emotions run high when discussing Pedophilia. The behavior is so disturbing that it's often attributed to a moral flaw...