Michael E. Kuban

Pedophilia, hebephilia, and the DSM-V.

The term pedophilia denotes the erotic preference for prepubescent children. The term hebephilia has been proposed to denote the erotic preference for pubescent children (roughly, ages 11 or 12–14), but it has not become widely used. The present study sought to validate the concept of hebephilia by examining the agreement between self-reported sexual interests and objectively recorded penile responses in the laboratory. The participants were 881 men who were referred for clinical assessment because of paraphilic, criminal, or otherwise problematic sexual behavior. Within-group comparisons showed that men who verbally reported maximum sexual attraction to pubescent children had greater penile responses to depictions of pubescent children than to depictions of younger or older persons. Between-groups comparisons showed that penile responding distinguished such men from those who reported maximum attraction to prepubescent children and from those who reported maximum attraction to fully grown persons. These results indicated that hebephilia exists as a discriminable erotic age-preference. The authors recommend various ways in which the DSM might be altered to accommodate the present findings. One possibility would be to replace the diagnosis of Pedophilia with Pedohebephilia and allow the clinician to specify one of three subtypes: Sexually Attracted to Children Younger than 11 (Pedophilic Type), Sexually Attracted to Children Age 11–14 (Hebephilic Type), or Sexually Attracted to Both (Pedohebephilic Type). We further recommend that the DSM-V encourage users to record the typical age of children who most attract the patient sexually as well as the gender of children who most attract the patient sexually.

Pedophiles: mental retardation, maternal age, and sexual orientation.

Intellectual functioning, parental age, andsexual orientation in 991 male sexual offenders wereinvestigated. Sources of data included semistructuredinterviews, clinical charts, phallometric tests, and self-administered questionnaires. The resultssuggest two main conclusions: (i) Among pedophiles ingeneral, erotic preference moves away from adult womenalong two dimensions: age and sex. The extent ofthis movementis greater, along both dimensions,forpedophiles with lower levels of intellectualfunctioning. (ii) High maternal age (or some factor itrepresents) increases the likelihood of exclusive sexual interest in boys. Intellectual deficiency (orsome factor it represents) decreases the likelihood ofexclusive sexual interest in girls. These two factorssummate, so that a pedophile with both factors is more likely to be sexually interested inboys than a pedophile with only one.

Self-Reported Head Injuries Before and After Age 13 in Pedophilic and Nonpedophilic Men Referred for Clinical Assessment

Previous research has found that pedophilic men referred for clinical assessment of their sexual behavior are more likely to report that they suffered head injuries before their 13th birthday than are nonpedophilic men referred for the same purpose. This study investigated whether pedophilic patients are also more likely to report head injuries after their 13th birthday. The 685 participants represented all patients with usable data from a consecutive series of men referred to a clinical laboratory specializing in phallometric assessment of erotic preferences. In addition to phallometric testing, participants were administered a brief neuropsychological test battery and a companion interview, which included questions on head injury, drug abuse, and childhood diagnosis of attention-deficit/hyperactivity disorder. The results showed that the pedophilic patients reported more head injuries before age 13 than did the nonpedophilic patients, but they did not report more head injuries after age 13. The association between pedophilia and childhood head injuries could mean either that subtle brain damage after birth increases a boys risk of pedophilia, or that neurodevelopmental problems before birth increase a boys accident-proneness along with his risk of pedophilia. Additional analyses showed that self-reported head injuries before age 13 were associated with attentional problems and with left-handedness; in contrast, head injuries after age 13 were associated with drug abuse and promiscuity. These analyses suggest that, among patients with primary presenting complaints of sexual rather than cognitive problems, childhood head injuries cluster with neuropsychological phenomena, whereas later head injuries cluster with lifestyle variables.

A comparison of volume and circumference phallometry: response magnitude and method agreement.

Penile circumference and penile volumephallometry are laboratory methods of assessing sexualarousal. Volume phallometry is reportedly more sensitiveto responses, but comparative studies have beeninconclusive and beset with methodological problems. In thisstudy, 42 self-professed heterosexual volunteers wereassessed with both methods simultaneously, employing astandard test for erotic partner preference. Pearson correlations between test outcomeprofiles were very high (r > .80) for subjects whosecircumferential increase was >2.5 mm [10% of a fullerection (FE)]. However, among lower responders the agreement dropped precipitously (mean r =–.15). Moreover, as a group higher respondersdifferentiated adult and pubescent age female stimulifrom each other and all other categories with eithermethod, but lower responders made this differentiationonly with the volume method. We conclude that (1) athigh levels of response both methods are equally good,(2) at low levels of response volumetric phallometry is a more accurate measure of arousal, and (3)10% FE, or a 2.5-mm circumference increase, should bethe minimum response criterion for the circumferentialmeasure.

Retrospective self-reports of childhood accidents causing unconsciousness in phallometrically diagnosed pedophiles.

The present study investigated whether head injuries in childhood might increase the risk of pedophilia in males. The subjects were 1206 patients referred to a clinical sexology service for assessment of their erotic preferences. These were classified, on the basis of phallometric test results, as pedophilic (n = 413) or nonpedophilic (n = 793). Information regarding early head injuries, other signs of possible neurodevelopmental problems, and parental histories of psychiatric treatment were collected with self-administered questionnaires. The results showed that childhood accidents that resulted in unconsciousness were associated with pedophilia and with lower levels of intelligence and education. These associations were statistically significant for accidents that occurred before the age of 6, but not for accidents that occurred between the ages of 6 and 12. These results are compatible with the hypothesis that neurodevelopmental perturbations in early childhood may increase the risk of pedophilia. They are also, however, compatible with the alternative explanation that prior neurodevelopmental problems lead to accident-proneness and head injury, on the one hand, and to pedophilia, on the other, and that head injury has no causal influence on pedophilia. A secondary finding was that the pedophiles were more likely to report that their mothers had undergone psychiatric treatment. This finding suggests that pedophilia may be influenced by genetic factors, which are manifested in women as an increased risk of psychiatric problems, and in their sons, as an increased risk of erotic interest in children.

Fraternal Birth Order and Sexual Orientation in Pedophiles

Whether homosexual pedophiles have more older brothers (a higher fraternal birth order) than do heterosexual pedophiles was investigated. Subjects were 260 sex offenders (against children age 14 or younger) and 260 matched volunteer controls. The subjects relative attraction to male and female children was assessed by phallometric testing in one analysis, and by his offense history in another. Both methods showed that fraternal birth order correlates with homosexuality in pedophiles, just as it does in men attracted to physically mature partners. Results suggest that fraternal birth order (or the underlying variable it represents) may prove the first identified universal factor in homosexual development. Results also argue against a previous explanation of the high prevalence of homosexuality in pedophiles (25% in this study), namely, that the factors that determine sexual preference in pedophiles are different from those that determine sexual preference in men attracted to adults. An alternative explanation in terms of canalization of development is suggested.

Criterion-related validity of a phallometric test for paraphilic rape and sadism

Eight men admitting to sadistic fantasies or urges (fantasizers), 7 sadistic rapists (sadists), 14 nonsadistic rapists, 31 courtship-disordered men (men displaying exhibitionism, voyeurism, frotteurism, or a combination of these paraphilias), and 20 community controls were compared on their relative phallometric responses to stimuli depicting rape, violent rape, and nonsexual violence. This study extended previous research by including a group of men who admitted to having sadistic fantasies or urges, in contrast to rapists who are likely to deny any such interests because of possible legal or social sanctions, and by including a large comparison group of men with a paraphilia other than sadism. Criterion-related validity was greater after combining the sadistic and nonsadistic rapists: fantasizers, sadists, and rapists did not differ from each other; fantasizers differed from community controls in their relative responses to rape, violent rape, and nonsexual violence; rapists differed from community controls in their relative responses to violent rape and nonsexual violence; and courtship-disordered men differed from community controls in their relative responses to nonsexual violence.

The basis of the abused abuser theory of pedophilia: a further elaboration on an earlier study

The connection between the retrospective self-report of sexual abuse in child-hood by an adult person, and (i) erotically preferred age bracket and (ii) type of offense, was investigated in 303 heterosexual males. This group consisted of 83 pedophilic sex offenders against female children, 52 sex offenders against female children who erotically preferred adult women, 34 sex offenders against adult women, and 134 volunteer controls. An earlier exploratory investigation with somewhat smaller numbers of individuals had rendered only ambiguous results. After regrouping of individuals and more precise analysis of results, the present study demonstrated that the self-report of having been sexually abused in childhood is mainly connected with pedophilia. Status as a sex offender in general was not related to childhood abuse.

Sexual Arousal to Female Children in Gynephilic Men

Phallometric assessments of single-victim sexual offenders against children have suggested that only about 50% of these men are more attracted to children than they are to adults. This has raised the question of what motivates the other 50% of men to approach young girls for sex. Freund et al. showed that gynephilic men (i.e., men preferentially attracted to adult women) evidenced greater arousal to images of prepubescent girls than to images of males of any age or to nonerotic images, arguing that gynephilic men may approach prepubescent girls as a “surrogate” for their preferred erotic targets (i.e., adult women). One might argue that these phallometric results are artifactual, given that they were obtained in a time period during which images of nudity were far less common than they are today (thus any female nudity might have elicited arousal). To address this issue, the authors examined the sexual arousal patterns of 214 contemporary men who, based on self-report, offense history, and phallometric responses, were purely gynephilic. Results showed the “classical control profile”: the greatest arousal to adult women, systematically decreasing arousal as the female stimuli became younger, and essentially no arousal to any age categories of males or to neutral (nonerotic) stimuli. Arousal to both pubescent and prepubescent girls was significantly greater than to neutral stimuli (p < .001 for both). Thus, Freund et al.’s results still appear to be valid, and the explanation for child molesting that they suggest still seems to be feasible.

Toward a Testable Developmental Model of Pedophilia: The Development of Erotic Age Preference.

Retrospective self-reports about childhood curiosity to see persons in the nude were used to compare the development of erotic sex and age preferences among four groups of males; 46 heterosexual pedophiles, 30 homosexual pedophiles, 462 gynephiles (who erotically prefer physically mature females), and 51 androphiles (who erotically prefer physically mature males). The results suggest (a) throughout this erotic developmental process among males, the establishment of erotic sex preference precedes that of erotic age preference, and (b) a greater proportion of pedophiles than of individuals who prefer physically mature partners remembers curiosity in their own childhood to see nude children without remembering such curiosity in regard to adults. This suggests that in a substantial proportion of pedophiles the occurrence of this paraphilia is predetermined at a very early developmental phase. A further set of retrospective self-reports, obtained from a group of 78 gynephilic university students suggests that at least in gynephiles the erotic appeal of children of the preferred sex ceases by about the time of puberty. This may be an indication that there exists a process of active devaluation of the nonpreferred age bracket, culminating at puberty.