J Psychiatry Neurosci. 2008 Jan; 33(1): 23-33
Schiffer B, Krueger T, Paul T, de Greiff A, Forsting M, Leygraf N, Schedlowski M, Gizewski E

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.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.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.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.

Sex Abuse. 2009 Dec; 21(4): 431-41
Blanchard R, Kuban ME, Blak T, Cantor JM, Klassen PE, Dickey R

There are at least two different criteria for assessing pedophilia in men: absolute ascertainment (their sexual interest in children is intense) and relative ascertainment (their sexual interest in children is greater than their interest in adults). The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) used relative ascertainment in its diagnostic criteria for pedophilia; this was abandoned and replaced by absolute ascertainment in the DSM-III-R and all subsequent editions. The present study was conducted to demonstrate the continuing need for relative ascertainment, particularly in the laboratory assessment of pedophilia. A total of 402 heterosexual men were selected from a database of patients referred to a specialty clinic. These had undergone phallometric testing, a psychophysiological procedure in which their penile blood volume was monitored while they were presented with a standardized set of laboratory stimuli depicting male and female children, pubescents, and adults.The 130 men selected for the Teleiophilic Profile group responded substantially to prepubescent girls but even more to adult women; the 272 men selected for the Pedophilic Profile group responded weakly to prepubescent girls but even less to adult women. In terms of absolute magnitude, every patient in the Pedophilic Profile group had a lesser penile response to prepubescent girls than every patient in the Teleiophilic Profile group. Nevertheless, the Pedophilic Profile group had a significantly greater number of known sexual offenses against prepubescent girls, indicating that they contained a higher proportion of true pedophiles. These results dramatically demonstrate the utility-or perhaps necessity-of relative ascertainment in the laboratory assessment of erotic age-preference.

Sex Abuse. 2010 Mar; 22(1): 3-24
Holt TJ, Blevins KR, Burkert N

The development of the Internet and computer-mediated communications has fostered the growth of a wide range of deviant sexual behaviors along with deviant subcultures that support and approve of these behaviors. Some of these practices pose little risk to public safety, though acts such as pedophilia and the creation and distribution of child pornography have significant negative ramifications for victims. A growing literature has examined the function of the Internet for child pornography distribution, social networks of pedophiles, and tactics of child solicitation. Few, however, have explored the utility of the Internet to develop a subculture of pedophiles and its role in fostering attitudes and justifications for relationships with children. This study will explore the subcultural norms and enculturation of the pedophile community using a qualitative analysis of five Web forums run by and for pedophiles. The findings suggest that the values of the pedophile culture support and encourage emotional and, in some cases, sexual relationships with boys and girls in virtual and real settings. Implications for the study of pedophiles and the role of the Internet are explored.

J Nerv Ment Dis. 2008 Nov; 196(11): 829-37
Cohen LJ, Grebchenko YF, Steinfeld M, Frenda SJ, Galynker II

To investigate the model of pedophilia as a disorder of addictive behavior, pedophiles and chemically addicted individuals were compared on personality traits potentially associated with impaired behavioral inhibition. Twenty-nine pedophiles, 25 opiate addicts (OA's), and 27 healthy controls were administered the Barratt Impulsivity Scale, Hare Psychopathy Checklist-Revised (PCL-R), and Structured Clinical Interview for DSM-V for Axis-II. OA's scored higher than either pedophiles or controls on the Barratt. Pedophiles and OA's scored higher than controls on all 3 Psychopathy Checklist-Revised scores but OA's scored marginally higher than pedophiles on factor 2 (behavioral) and total scores. On Structured Clinical Interview for DSM-V for Axis-II, pedophiles scored higher than controls on paranoid and schizoid scores whereas OA's did so on paranoid scores. Thus, both pedophiles and OA's may have elevated psychopathic traits and propensity toward cognitive distortions, as reflected in cluster A traits. Such similarities support the conceptualization of pedophilia as a behavioral addiction. Pedophiles may be less impulsive than OA's, however, and more prone toward cognitive distortions.

J Sex Med. 2011 Jun; 8(6): 1660-74
Poeppl TB, Nitschke J, Dombert B, Santtila P, Greenlee MW, Osterheider M, Mokros A

Pedophiles show sexual interest in prepubescent children but not in adults. Research into the neurofunctional mechanisms of paraphilias has gathered momentum over the last years.To elucidate the underlying neural processing of sexual interest among pedophiles and to highlight the differences in comparison with nonparaphilic sexual interest in adults.Nine pedophilic patients and 11 nonpedophilic control subjects underwent functional magnetic resonance imaging (fMRI) while viewing pictures of nude (prepubescents, pubescents, and adults) and neutral content, as well as performing a concomitant choice reaction time task (CRTT).Brain blood oxygen level-dependent (BOLD) signals and response latencies in the CRTT during exposure to each picture category.Analysis of behavioral data showed group differences in reaction times regarding prepubescent and adult but not pubescent stimuli. During stimulation with pictures displaying nude prepubescents, pedophiles showed increased BOLD response in brain areas known to be involved in processing of visual sexual stimuli. Comparison of pedophilic patients with the control group discovered differences in BOLD responses with respect to prepubescent and adult but not to pubescent stimuli. Differential effects in particular occurred in the cingulate gyrus and insular region.The brain response of pedophiles to visual sexual stimulation by images of nude prepubescents is comparable with previously described neural patterns of sexual processing in nonpedophilic human males evoked by visual stimuli depicting nude adults. Nevertheless, group differences found in the cingulate gyrus and the insular region suggest an important role of these brain areas in pedophilic sexual interest. Furthermore, combining attention-based methods like CRTT with fMRI may be a viable option for future diagnostic procedures regarding pedophilia.

Soc Sci Med. 2011 Jul 21;
Parikh SA

In 1990 women's rights activists in Uganda successfully lobbied to amend the Defilement Law, raising the age of sexual consent for adolescent females from fourteen to eighteen years old and increasing the maximum sentence to death by hanging. The amendment can be considered a macro-level intervention designed to address the social and health inequalities affecting young women and girls, particularly their disproportionately high rate of HIV as compared to their male counterparts. While the intention of the law and aggressive campaign was to prosecute "sugar daddies" and "pedophiles," the average age of men charged with defilement was twenty-one years old and many were believe to be "boyfriends" in consensual sexual liaisons with the alleged victims. This article uses court records, case studies, and longitudinal ethnographic data gathered in east-central Uganda to examine the impact of the age of consent law at national and local levels, and specifically what the disjunctures between national intentions and local uses reveal about conflicting views about sexual privilege and rights. I argue that existing class, gender, and age hierarchies have shaped how the Defilement Law has been applied locally, such that despite the stated aim of "protecting" young women, the law reinstates patriarchal privilege (especially against men of lower social class) while simultaneously increasing the regulation of adolescent female sexuality and undermining their autonomy. This paper demonstrates how ethnography and critical gender theory-which emphasizes the intersectionality of gender, age, and class in the (re)production of inequalities-can be used to examine consequences of macro-level interventions in ways that may be undetected in conventional public health evaluation techniques but that are crucial for designing and modifying effective interventions.

Future Child. 2009; 19(2): 169-94
Finkelhor D

David Finkelhor examines initiatives to prevent child sexual abuse, which have focused on two primary strategies--offender management and school-based educational programs. Recent major offender managment initiatives have included registering sex offenders, notifying communities about their presence, conducting background employment checks, controlling where offenders can live, and imposing longer prison sentences. Although these initiatives win approval from both the public and policy makers, little evidence exists that they are effective in preventing sexual abuse. Moreover, these initiatives, cautions Finkelhor, are based on an overly stereotyped characterization of sexual abusers as pedophiles, guileful strangers who prey on children in public and other easy-access environments and who are at high risk to re-offend once caught. In reality the population is much more diverse. Most sexual abusers are not strangers or pedophiles; many (about a third) are themselves juveniles. Many have relatively low risks for re-offending once caught. Perhaps the most serious shortcoming to offender management as a prevention strategy, Finkelhor argues, is that only a small percentage of new offenders have a prior sex offense record that would have involved them in the management system. He recommends using law enforcement resources to catch more undetected offenders and concentrating intensive management efforts on those at highest risk to re-offend. Finkelhor explains that school-based educational programs teach children such skills as how to identify dangerous situations, refuse an abuser's approach, break off an interaction, and summon help. The programs also aim to promote disclosure, reduce self-blame, and mobilize bystanders. Considerable evaluation research exists about these programs, suggesting that they achieve certain of their goals. Research shows, for example, that young people can and do acquire the concepts. The programs may promote disclosure and help children not to blame themselves. But studies are inconclusive about whether education programs reduce victimization. Finkelhor urges further research and development of this approach, in particular efforts to integrate it into comprehensive health and safety promotion curricula. Finkelhor also points to evidence that supports counseling strategies both for offenders, particularly juveniles, to reduce re-offending, and for victims, to prevent negative mental health and life course outcomes associated with abuse.

Leg Med (Tokyo). 2009 Apr; 11 Suppl 1: S368-9
Howes RJ

The use of phallometric testing to determine risk of sexual violence is becoming more widely recognized throughout the world. This technique involves the precise measurement of circumferential change in the penis from flaccidity to erection in response to both 'normal' and deviant sexual stimuli. Phallometric testing is the only pure measure of sexual arousal, and unlike other physiological measures such as heart rate and GSR it is not influenced by arousal states such as fear and anger. The current published research compares the phallometric testing profiles of incarcerated sexual offenders with those of incarcerated nonsexual offenders. Specifically, the sexual arousal of 100 convicted rapists, pedophiles, and nonsexual offenders is examined. This research identifies what differentiates these groups and what best predicts risk of sexual aggression. Implications of these results include the possibility of using phallometric testing as a screening tool for those who work with vulnerable populations (e.g., child care workers, teachers). The principal benefit of phallometric testing, however, lies in the identification of those incarcerated men who are at greatest risk to sexually reoffend and who should thus be denied release from jail.

Child Abuse Negl. 2009 Aug; 33(8): 545-9
Beier KM, Neutze J, Mundt IA, Ahlers CJ, Goecker D, Konrad A, Schaefer GA

Sex Abuse. 2011 Jun; 23(2): 212-42
Neutze J, Seto MC, Schaefer GA, Mundt IA, Beier KM

Little is known about factors that distinguish men who act upon their self-identified sexual interest in prepubescent or pubescent children from those who do not. Even less is known about pedophiles or hebephiles who are not involved with the criminal justice system. In this study, a sample of 155 self-referred pedophiles and hebephiles was recruited from the community. All participants met DSM-IV-TR criteria for pedophilia (or paraphilia not otherwise specified for those who were sexually attracted to pubescent children). Two sets of group comparisons were conducted on sociodemographic variables and measures of dynamic risk factors. The first set was based on recent activity and compared men who had committed child pornography only or child sexual abuse offenses in the past six months with men who remained offense-free during the same period. The second set was based on lifetime offense history (excluding the most recent six months) and compared child pornography offenders with child sexual abuse offenders and men who had committed both kinds of offenses. Overall, there were more similarities than differences between groups.

Annu Rev Clin Psychol. 2009; 5: 391-407
Seto MC

Pedophilia is defined as a sexual interest in prepubescent children. It is empirically linked with sexual offending against children: Child pornography offenders and sex offenders with child victims are more likely to be pedophiles based on self-report or objective measures of sexual interests. At the same time, some pedophiles have not had any known sexual contact with children, and perhaps half of sex offenders against children would not meet diagnostic criteria for pedophilia. Pedophilia can be diagnosed using a variety of methods and is an important factor to consider in the assessment of sex offenders because pedophilic offenders are more likely to sexually reoffend and require different interventions. There is no evidence to suggest that pedophilia can be changed. Instead, interventions are designed to increase voluntary control over sexual arousal, reduce sex drive, or teach self-management skills to individuals who are motivated to avoid acting upon their sexual interests.

J Int Neuropsychol Soc. 2011 Mar; 17(2): 295-307
Eastvold A, Suchy Y, Strassberg D

There is increasing evidence of neurocognitive dysfunction among child molesters, supporting the notion of brain anomalies among pedophiles. However, approximately half of child molesters are not pedophilic (i.e., are not primarily attracted to children), and neurocognitive differences between pedophilic (PED) and nonpedophilic (NPED) child molesters are not well understood. The purpose of this study was to assess neurocognition, specifically executive functioning (EF), among phallometrically defined PED and NPED child molesters, relative to nonsexual offenders (NSO). Participants (N = 89) were compared on seven EF domains. Results revealed that (a) child molesters exhibited an overall executive profile that was different from that of NSOs, with PEDs differing from NSOs but not from NPEDs; (b) child molesters on the whole performed better than NSOs on abstract reasoning and more poorly on inhibition; and (c) PEDs performed better than NPEDs on planning and exhibited better overall performance accuracy relative to NPEDs. These results suggest that PEDs exhibit a more deliberate, planful response style characterized by greater self-monitoring; whereas NPEDs appear to respond more impulsively. The current report further elucidates neurocognition among child molesters and highlights the need for future research examining subtypes of child molesters.

J Sex Med. 2011 Jun; 8(6): 1650-9
Kruger TH, Schiffer B

Several neuropsychological studies have suggested an association between pedophilia, neurocognitive disturbances, and specific personality profiles. However, inconsistencies in the findings have not been explained sufficiently, because many studies did not control for possible confounding factors, such as age, education level, or gender orientation.Therefore, the present investigation examined neurocognitive performance and personality profiles in pedophiles in dependence of sexual gender preferences and sexual deviance, as well as with regard to age and education level.Scores on the different neurocognitive tests, personality questionnaires, and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV (SCID) interviews.An extensive neurocognitive test battery (including a reduced version of the German Wechsler Adult Intelligence Scale, the Wisconsin card-sorting test, d2 Attention-Deficit Test, and the Corsi block-tapping test) as well as two personality questionnaires (Minnessota Multiphasic Personality Inventory [MMPI-2] and the Multiphasic Sex Inventory [MSI]) were used to examine a consecutive sample of 20 psychiatrically assessed (SCID I and II) pedophile inpatients (nine exclusively attracted to females and 11 to males) from two high security forensic hospitals and 28 healthy controls (14 heterosexual, 14 homosexual).Compared with controls, pedophiles showed neurocognitive impairments and personality specifics in the majority of tests and questionnaires, such as reduced values on the intelligence scale and weaker performances in information processing, together with high scores for psychopathy and paranoia, and signs of sexual obsessiveness and sexual dysfunction. In contrast to previous reports, some of these alterations were at least partly explained by factors other than pedophilia, such as education level or age.These alterations may be seen to be in line with the hypothesis of a perturbation of neurodevelopment in early life. These results enhance our knowledge about pedophilia-associated impairment in neurocognitive functioning and personality structure insofar as they allow a more detailed description of, and insight into, modulatory factors.

Emotion. 2011 Jun; 11(3): 637-46
Russell PS, Giner-Sorolla R

In the present research, we tested the unreasoning disgust hypothesis: moral disgust, in particular in response to a violation of a bodily norm, is less likely than moral anger to be justified with cognitively elaborated reasons. In Experiment 1, participants were asked to explain why they felt anger and disgust toward pedophiles. Participants were more likely to invoke elaborated reasons, versus merely evaluative responses, when explaining their anger, versus disgust. Experiment 2 used a between-participants design; participants explained why they felt either anger or disgust toward seven groups that either violated a sexual or nonsexual norm. Again, elaborated reasons were less prevalent when explaining their disgust versus anger and, in particular, when explaining disgust toward a group that violated a sexual norm. Experiment 3 further established that these findings are due to a lower accessibility of elaborated reasons for bodily disgust, rather than inhibition in using them when provided. From these findings, it can be concluded that communicating external reasons for moral disgust at bodily violations is made more difficult due to the unavailability of those reasons to people.

J Clin Psychol. 2008 Jan; 64(1): 1-16
Ryan GP, Baerwald JP, McGlone G

This study was designed to examine hypothesized differences between sex offending and nonoffending Roman Catholic clergy on cognitive mediation abilities as measured by the Rorschach Inkblot Test (H. Rorschach, 1921/1942). This study compared 78 priest pedophiles and 77 priest ephebophiles with 80 nonoffending priest controls on the Inkblot test using J. E. Exner's (2003) Comprehensive System. The three groups were compared on seven variables that constitute Exner's Cognitive Mediation cluster. Additionally, the groups' coping styles were compared to examine the interaction of coping style and cognitive mediational abilities. We found interactions between coping style and offending status across most of the cognitive variables indicating impairment in the mild to pathological ranges. Moreover, significantly higher unusual thinking styles (Xu%) and significantly lower conventional thinking styles (X+%) in offenders compared to nonoffenders. Those with an Extratensive style (n=31) showed significantly higher distorted thinking when compared to the Introversive (n=81), Ambitent (n=73), and Avoidant (n=50) coping styles. This study suggests that offenders display significantly higher distorted thinking styles than do nonoffenders. Possible reasons for these discrepancies and the role of coping styles in abusive behaviors were discussed.

Nonlinear Dynamics Psychol Life Sci. 2010 Oct; 14(4): 463-89
Renaud P, Goyette M, Chartier S, Zhornitski S, Trottier D, Rouleau JL, Proulx J, Fedoroff P, Bradford JP, Dassylva B, Bouchard S

Sexual arousal and gaze behavior dynamics are used to characterize deviant sexual interests in male subjects. Pedophile patients and non-deviant subjects are immersed with virtual characters depicting relevant sexual features. Gaze behavior dynamics as indexed from correlation dimensions (D2) appears to be fractal in nature and significantly different from colored noise (surrogate data tests and recurrence plot analyses were performed). This perceptual-motor fractal dynamics parallels sexual arousal and differs from pedophiles to non-deviant subjects when critical sexual information is processed. Results are interpreted in terms of sexual affordance, perceptual invariance extraction and intentional nonlinear dynamics.

Clin Ther. 2009 Jan; 31(1): 1-31
Guay DR

Paraphilias are characterized by recurrent, intense, sexually arousing fantasies, urges, or behaviors, over a period of > or =6 months, generally involving nonhuman objects, suffering or humiliation of oneself or one's partner, or children or other nonconsenting persons. These fantasies, urges, and behaviors produce clinically significant distress or impairments in social, occupational, and other important areas of functioning.The goal of this article was to provide an in-depth review of the clinical pharmacology of the main antiandrogens (cyproterone acetate, medroxyprogesterone acetate [MPA], and the luteinizing hormone-releasing hormone [LHRH] agonists) used in the treatment of the paraphilias, as well as a discussion of the relevant clinical case reports, case series, and controlled trials. Treatment recommendations are also provided.Relevant publications were identified through a search of the English-language literature indexed on MEDLINE/PubMed (1966-September 2008) using the search terms paraphilia, sex offender, hypersexuality, sexual behaviors, fetish, transvestic fetishism, sexual addiction, sexual compulsivism, selective serotonin reuptake inhibitors, tricyclic antidepressants, antiandrogens, cyproterone acetate, medroxyprogesterone acetate, LHRH agonists, and estrogens. Additional publications were identified from the bibliographies of retrieved publications.In vitro and in vivo (animal) studies have revealed that serotonin and prolactin inhibit sexual arousal, while norepinephrine (via alpha(1)-adrenoceptor activation), dopamine, acetylcholine (via muscarinic receptor activation), enkephalins, oxytocin, gonadotropin-releasing hormone, follicle-stimulating hormone, luteinizing hormone, testosterone/dihydrotestosterone, and estrogen/progesterone stimulate it. Most of the currently used pharmacologic treatments of the paraphilias have serotonin and testosterone/dihydrotestosterone as their targets. Cognitive-behavioral psychotherapy should be initiated in all offenders. In those at the highest risk of reoffending, psychotherapy should be initiated at the same time as drug therapy because their combination is associated with better results compared with either as monotherapy (especially in pedophiles). In offenders committing non-"hands-on" or violent paraphilias and those at low risk of reoffending, serotoninergic monotherapies (selective serotonin reuptake inhibitors [SSRIs] or tricyclic antidepressants) are reasonable choices (SSRIs are preferred). In other offenders, initial dual combination therapy (serotoninergic plus antiandrogenic) is recommended. Progestogens should be used before LHRH agonists or estrogens. Cyproterone acetate and MPA are preferred as oral and IM progestogens, respectively. Failure of dual combination serotoninergic/ progestogen therapy should prompt a change in one or both of the components (eg, SSRI to tricyclic antidepressants or vice versa, or cyproterone acetate to MPA or vice versa) or the addition or substitution of an LHRH agonist (leuprolide or triptorelin) for the progestogen. Estrogens are second- or third-line agents. Rarely, triple combination therapy is necessary (serotoninergic plus LHRH agonist or progestogen plus estrogen). It appears that recidivism rates are reduced by the use of psychotherapy alone, drug therapy alone, and more so by their combination.Although some progress has been made in the therapy of paraphilic and nonparaphilic sexual disorders, much work remains to be done. The development of more specific, more effective, and better-tolerated medications for these disorders should be recognized as a program worthy of greater support from government and pharmaceutical industry sources. Clinical studies performed to date have largely been of poor design, making the recommendations provided in this review tentative at best.

Arch Gen Psychiatry. 2011 Oct 3;
Ponseti J, Granert O, Jansen O, Wolff S, Beier K, Neutze J, Deuschl G, Mehdorn H, Siebner H, Bosinski H

CONTEXT: Accurately assessing sexual preference is important in the treatment of child sex offenders. Phallometry is the standard method to identify sexual preference; however, this measure has been criticized for its intrusiveness and limited reliability. OBJECTIVE: To evaluate whether spatial response pattern to sexual stimuli as revealed by a change in the blood oxygen level-dependent signal facilitates the identification of pedophiles. DESIGN: During functional magnetic resonance imaging, pedophilic and nonpedophilic participants were briefly exposed to same- and opposite-sex images of nude children and adults. We calculated differences in blood oxygen level-dependent signals to child and adult sexual stimuli for each participant. The corresponding contrast images were entered into a group analysis to calculate whole-brain difference maps between groups. We calculated an expression value that corresponded to the group result for each participant. These expression values were submitted to 2 different classification algorithms: Fisher linear discriminant analysis and κ-nearest neighbor analysis. This classification procedure was cross-validated using the leave-one-out method. SETTING: Section of Sexual Medicine, Medical School, Christian Albrechts University of Kiel, Kiel, Germany. PARTICIPANTS: We recruited 24 participants with pedophilia who were sexually attracted to either prepubescent girls (n = 11) or prepubescent boys (n = 13) and 32 healthy male controls who were sexually attracted to either adult women (n = 18) or adult men (n = 14). MAIN OUTCOME MEASURES: Sensitivity and specificity scores of the 2 classification algorithms. RESULTS: The highest classification accuracy was achieved by Fisher linear discriminant analysis, which showed a mean accuracy of 95% (100% specificity, 88% sensitivity). CONCLUSIONS: Functional brain response patterns to sexual stimuli contain sufficient information to identify pedophiles with high accuracy. The automatic classification of these patterns is a promising objective tool to clinically diagnose pedophilia.

J Am Acad Psychiatry Law. 2011; 39(4): 496-505
Fabian JM

In recent years, state and federal legislative initiatives have heavily emphasized punitive laws to combat sexual crime. These statutes include indefinite civil commitment, which is the ultimate infringement on sexual offenders' civil liberties. Many of these committed offenders have repeatedly offended against prepubescent children (pedophiles), and many have committed nonconsensual sexual offenses against adults (rapists). A substantial number of sex offenders have offended against postpubescent adolescents and teenagers outside the age range of pedophilia (commonly referred to by some clinicians and researchers as hebephilia). The use of the term hebephilia has recently received heightened scrutiny in sexually violent predator civil commitment proceedings. Specifically, experts debate whether hebephilia is recognized within the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and whether it is a generally accepted diagnosis within the field of sexual offender assessment. Scholars and practitioners question how hebephilia pertains to sexual deviance and one's risk of reoffending and whether it ultimately meets the legal mental abnormality threshold of civil commitment through DSM diagnostic criteria. This article addresses these questions and provides recent federal case law that attends to hebephilia in sexually violent predator proceedings.

Arch Sex Behav. 2010 Sep 17;
Blanchard R, Kuban ME, Blak T, Klassen PE, Dickey R, Cantor JM

The penile response profiles of homosexual and heterosexual pedophiles, hebephiles, and teleiophiles to laboratory stimuli depicting male and female children and adults may be conceptualized as a series of overlapping stimulus generalization gradients. This study used such profile data to compare two models of alloerotic responding (sexual responding to other people) in men. The first model was based on the notion that men respond to a potential sexual object as a compound stimulus made up of an age component and a gender component. The second model was based on the notion that men respond to a potential sexual object as a gestalt, which they evaluate in terms of global similarity to other potential sexual objects. The analytic strategy was to compare the accuracy of these models in predicting a man's penile response to each of his less arousing (nonpreferred) stimulus categories from his response to his most arousing (preferred) stimulus category. Both models based their predictions on the degree of dissimilarity between the preferred stimulus category and a given nonpreferred stimulus category, but each model used its own measure of dissimilarity. According to the first model ("summation model"), penile response should vary inversely as the sum of stimulus differences on separate dimensions of age and gender. According to the second model ("bipolar model"), penile response should vary inversely as the distance between stimulus categories on a single, bipolar dimension of morphological similarity-a dimension on which children are located near the middle, and adult men and women are located at opposite ends. The subjects were 2,278 male patients referred to a specialty clinic for phallometric assessment of their erotic preferences. Comparisons of goodness of fit to the observed data favored the unidimensional bipolar model.

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