Pedophilia

Pedophilia is termed pedophilic disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and the manual defines it as a paraphilia involving intense and recurrent sexual urges towards and fantasies about prepubescent children that have either been acted upon or which cause the person with the attraction distress or interpersonal difficulty. The International Classification of Diseases (ICD-11) defines it as a 'sustained, focused, and intense pattern of sexual arousal—as manifested by persistent sexual thoughts, fantasies, urges, or behaviours—involving pre-pubertal children.' In popular usage, the word pedophilia is often applied to any sexual interest in children or the act of child sexual abuse. This use conflates the sexual attraction to prepubescent children with the act of child sexual abuse and fails to distinguish between attraction to prepubescent and pubescent or post-pubescent minors. Researchers recommend that these imprecise uses be avoided, because although some people who commit child sexual abuse are pedophiles, child sexual abuse offenders are not pedophiles unless they have a primary or exclusive sexual interest in prepubescent children, and some pedophiles do not molest children. Pedophilia was first formally recognized and named in the late 19th century. A significant amount of research in the area has taken place since the 1980s. Although mostly documented in men, there are also women who exhibit the disorder, and researchers assume available estimates underrepresent the true number of female pedophiles. No cure for pedophilia has been developed, but there are therapies that can reduce the incidence of a person committing child sexual abuse. The exact causes of pedophilia have not been conclusively established. Some studies of pedophilia in child sex offenders have correlated it with various neurological abnormalities and psychological pathologies. In the United States, following Kansas v. Hendricks in 1997, sex offenders who are diagnosed with certain mental disorders, particularly pedophilia, can be subject to indefinite involuntary commitment. The word pedophilia comes from the Greek παῖς, παιδός (paîs, paidós), meaning 'child', and φιλία (philía), 'friendly love' or 'friendship'. Pedophilia is used for individuals with a primary or exclusive sexual interest in prepubescent children aged 13 or younger. Infantophilia is a sub-type of pedophilia; it is used to refer to a sexual preference for children under the age of 5 (especially infants and toddlers). This is sometimes referred to as nepiophilia (from the Greek: νήπιος (népios) meaning 'infant' or 'child,' which in turn derives from 'ne-' and 'epos' meaning 'not speaking'), though this term is rarely used in academic sources. Hebephilia is defined as individuals with a primary or exclusive sexual interest in 11- to 14-year-old pubescents. The DSM-5 does not list hebephilia among the diagnoses; while evidence suggests that hebephilia is separate from pedophilia, the ICD-10 includes early pubertal age (an aspect of hebephilia) in its pedophilia definition, covering the physical development overlap between the two philias. In addition to hebephilia, some clinicians have proposed other categories that are somewhat or completely distinguished from pedophilia; these include pedohebephilia (a combination of pedophilia and hebephilia) and ephebophilia (though ephebophilia is not considered pathological). Pedophilia emerges before or during puberty, and is stable over time. It is self-discovered, not chosen. For these reasons, pedophilia has been described as a disorder of sexual preference, phenomenologically similar to a heterosexual or homosexual sexual orientation. These observations, however, do not exclude pedophilia from the group of mental disorders because pedophilic acts cause harm, and mental health professionals can sometimes help pedophiles to refrain from harming children. In response to misinterpretations that the American Psychiatric Association considers pedophilia a sexual orientation because of wording in its printed DSM-5 manual, which distinguishes between paraphilia and what it calls 'paraphilic disorder', subsequently forming a division of 'pedophilia' and 'pedophilic disorder', the association commented: ''exual orientation' is not a term used in the diagnostic criteria for pedophilic disorder and its use in the DSM-5 text discussion is an error and should read 'sexual interest.'' They added, 'In fact, APA considers pedophilic disorder a 'paraphilia,' not a 'sexual orientation.' This error will be corrected in the electronic version of DSM-5 and the next printing of the manual.' They said they strongly support efforts to criminally prosecute those who sexually abuse and exploit children and adolescents, and 'also support continued efforts to develop treatments for those with pedophilic disorder with the goal of preventing future acts of abuse.' Studies of pedophilia in child sex offenders often report that it co-occurs with other psychopathologies, such as low self-esteem, depression, anxiety, and personality problems. It is not clear whether these are features of the disorder itself, artifacts of sampling bias, or consequences of being identified as a sex offender. One review of the literature concluded that research on personality correlates and psychopathology in pedophiles is rarely methodologically correct, in part owing 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. Impaired self-concept and interpersonal functioning were reported in a sample of child sex offenders who met the diagnostic criteria for pedophilia by Cohen et al. (2002), which the authors suggested could contribute to motivation for pedophilic acts. The pedophilic offenders in the study had elevated psychopathy and cognitive distortions compared to healthy community controls. This was interpreted as underlying their failure to inhibit their criminal behavior. Studies in 2009 and 2012 found that non-pedophilic child sex offenders exhibited psychopathy, but pedophiles did not.