Pedophilia

Pedophilia (alternatively spelled paedophilia or pædophilia) is the paraphilia, or sexual deviation, of being sexually attracted, primarily or exclusively, to prepubescent children. A person who exhibits such an attraction is called a pedophile. As with most paraphilias, the majority of those affected by the condition are men. Pedophilia is acknowledged to be a complex psychiatric disorder; however, acting on pedophilic urges is considered morally and criminally wrong in almost all cases. There are treatments available for the disorder, but the rates of success have been mixed. Nevertheless, public opinion, as well as that of both the legal and mental health professions, supports continued efforts to uncover the causes and effective treatments in the hope of protecting children from suffering abuse as a result of those acting on pedophilic impulses.

Definitions

The word pedophilia comes from the Greek paidophilia (παιδοφιλια)—pais (παις, "child") and philia (φιλια, "love, friendship"). Paidophilia was coined by Greek poets as a substitute for "paiderastia" (pederasty) (Liddell and Scott 1959).

The term paedophilia erotica was coined in 1886 by the Austro-German psychiatrist Richard von Krafft-Ebing in his writing Psychopathia Sexualis (1886). He described the following characteristics:

the sexual interest is toward children, either prepubescent or at the beginning of puberty
the sexual interest is the primary one, that is, exclusively or mainly toward children
the sexual interest remains over time

Strictly speaking, this definition would include many adolescents and prepubescents for whom such an interest might be normal. Thus, some experts add the criterion that the interest be toward children at least five years younger than the subject. However, according to other experts, a diagnosis of pedophilia can also be appropriate for a post-pubescent adolescent (Janssen 2003).

In the United States and several other countries, the term "pedophile" is also used to denote significantly older adults who are sexually attracted to adolescents, as well as those who have sexually abused a child (Ames and Houston 1990).

Debate over definitions

The use of the term "pedophile" to describe all child sexual offenders is problematic, especially when seen from a medical standpoint, as the majority of sex crimes against children are perpetrated by situational offenders rather than people sexually preferring prepubertal children (DiLorenzo1981). Nevertheless, some researchers, such as Barbaree and Seto (1997), have endorsed the use of actions as the sole criterion for the diagnosis of pedophilia, as a means of taxonomic simplification, rebuking the American Psychiatric Association's standards as "unsatisfactory."

Others have suggested that sexual attraction to children may be considered a sexual orientation in itself (Berlin 2000), arguing that "sexual orientation is defined as a lifelong attraction, which pedophilia obviously is" (Flanagan 2004). However, this is at odds with the current popular acceptance of the term "sexual orientation" as distinguishing attraction to the opposite sex (heterosexual), the same sex (homosexual), or both (bisexual).

Related terms

Ephebophilia, also known as hebephilia, is the condition of being sexually attracted primarily or exclusively to adolescents. These terms are used in contrast with pedophilia. However, pedophilia is sometimes used more broadly in the western world to describe both ephebophilia and attraction to younger children, that is, any person younger than the legal age of consent.
Pederasty, or the Shotaro complex, generally refers to an attraction toward adolescent, or older, underage males.
Lolita syndrome or Lolita complex are terms sometimes used to refer to an attraction to adolescent, or older, underage females.
Nepiophilia, also called infantophilia, is the attraction to toddlers and infants (usually aged 0-3 years). Some researchers have suggested a distinction between pedophilia and nepiophilia, as it is unusual for pedophiles to prefer toddlers.

Diagnosis

The International Statistical Classification of Diseases and Related Health Problems (F65.4) defines pedophilia as "a sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age."

The American Psychiatric Association (APA)'s Diagnostic and Statistical Manual of Mental Disorders 4th edition (2000), Text Revision gives the following as its "Diagnostic criteria for 302.2 Pedophilia":

Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).
The person has acted on these urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.
The person is at least age 16 years and at least 5 years older than the child or children in Criterion A.
Note: Does not include an individual in late adolescence involved in an ongoing sexual relationship with a 12 or 13-year-old.

The APA diagnostic criteria do not require actual sexual activity with a child. The diagnosis can therefore be made based on the presence of "fantasies" or "sexual urges" alone, provided the subject meets the remaining criteria.

The actual boundaries between childhood and adolescence may vary in individual cases and are difficult to define in rigid terms of age. The World Health Organization, for instance, defines adolescence as the period of life between 10 and 19 years of age (Goodburn and Ross 1995), though it is most often defined as the period of life between the ages of 13 and 18.

Law

Pedophilia itself is not a crime, since it does not describe behavior, but a psychological state (Feierman 1990). It is, generally speaking, not illegal to be sexually attracted to a child, and not all pedophiles sexually molest children (Fagan et al. 2002). Acting on such sexual attraction, however, may involve criminal behavior.

Sexual activity between adults and prepubescent children is almost always considered child sexual abuse, and is illegal in most countries. The matter can be complicated, however, by varying laws concerning youth marriage, emancipation of minors, and the age of consent, all of which can affect the legality of child sex in certain jurisdictions. Sexual intercourse is typically permitted at the ages of 16 to 18, but can range as high as 21 or as low as 12 depending on the country or area. In countries where the legal age of consent is lower, such as France or Brazil, the mainstream media avoid using the terms pedophilia or pedophile to refer to consensual relationships between adults and adolescents.

Child pornography, child prostitution, and recruiting or meeting children for sex using the Internet may also be illegal, depending on the jurisdiction. Some people with a history of sexual activity with children may be prevented, by court order or by legislation, from associating with children or being employed in a position that may bring them into contact with children, even from owning mobile phones or computers or having the ability to use the Internet or own childrens' toys.

Prevalence

The extent to which pedophilia occurs is not known with any certainty, due to the fact that even those who act on their attraction are often not reported since the encounter may stop short of intercourse and young victims may be unable or afraid to report the abuse. However, considerable research has been carried out, both on those who have been identified as perpetrators of sexual abuse against children and on samples of normal adults.

John Bradford, a psychiatrist with two decades of experience studying pedophilia, estimated that 4 percent of the population meet the criteria for diagnosis (Cloud 2002). Others have concluded that at least a quarter of all adult men may have some feelings of sexual arousal in connection with children (Hall et al. 1995, Freund and Costell 1970, Quinsey et al. 1975). Hall's study, for example, found that approximately 30 percent of their sample—consisting of 80 adult males—exhibited sexual arousal to heterosexual pedophilic stimuli that equaled or exceeded their arousal to the adult stimuli. Further studies indicated that even men erotically fixated on adult females are generally prone to react sexually when exposed to nude female children (Freund et al. 1972). A significant proportion (one-third) of undergraduate students who acknowledged sexual attraction to small children also conceded some probability of actually having sex with a child if they could avoid detection and punishment (Briere and Runtz 1989).

Child sex offenders

A perpetrator of child sexual abuse is, despite all medical definitions, commonly assumed to be a pedophile, and referred to as such by the general public. However, there are often other motivations for the crime (Barbaree and Seto 1997). These can include stress, marital problems, or the unavailability of an adult partner (Howells 1981), much as adult rape can have non-sexual reasons. Thus, child sexual abuse alone may or may not be an indicator that its perpetrator is a pedophile, since a significant number of perpetrators are in fact not primarily interested in children (Lanning 2001).

Those who have committed sexual crimes against children, but do not meet the normal diagnosis criteria for pedophilia, are referred to as "situational," "opportunistic," or "regressed" offenders, whereas offenders primarily attracted toward children are called "structured," "preferential," or "fixated" pedophiles, reflecting the understanding that their attraction is fixed by the structure of their personality. There are generally large characteristic distinctions between the two types of offenders (Abel et al. 1985). 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 extra-familiar; are more appositively driven to offend; and have values or beliefs that strongly support an offensive lifestyle. For example, pedophiles who abuse children often delude themselves that their actions are beneficial to the child's development or self-esteem, or that the child is enjoying the acts (Psychology Today's Diagnosis Dictionary).

Most cases of father-daughter incest are believed to involve fathers who are situational offenders, rather than pedophiles (Quinsey 1977). In fact, nearly 70 percent of all child sexual abusers are relatives of the victims (Cloud 2002). Such abuse within families is generally more difficult to detect than non-family abusers, who may be identified by the uncommon attention they show towards children.

Causes

There are many theories about the etiology of paraphilias in general, but the cause or causes of pedophilia are still not yet fully known. Theories range from chemical imbalances in the brain, to choromosomal abnormalities, to learned behaviors.

Early research studying pedophiles' brains showed differences in the way they react to changes in hormone levels, although nothing was clearly proven. However, it has been found that levels of male sexual hormones and of the brain chemical serotonin affect pedophilic urges and behaviors, although the connection between the two remains unclear.

Another theory that has been put forth is that sexual abuse as a child can cause a person to become a pedophile themselves (Psychology Today). More specifically, learned behavior explanations for pedophilic behavior posit that the imitation and reinforcement of inappropriate sexual behaviors can be consequences of childhood abuse. However, only one-third of pedophiles reported abuse as children (Cloud 2002), which would make this theory at best a partial explanation.

A variety of other risk factors for pedophilia have been suggested, including chromosomal abnormalities, psychological problems during childhood or puberty, as well as a lack of socially acceptable sexual outlets. It has even been suggested that "a gap of several years between brothers might deprive the pedophile of companionship in formative years of sexual behavior development" (Cloud 2002).

The controversy surrounding the subject often makes research into the causes of pedophilia very difficult. Nevertheless, understanding pedophilia is necessary to help those with the disorder, to support their victims, and also to prevent future abuse.

Treatment

In 2000, the U.S. Department of Justice reported that the number of substantiated cases of child sexual abuse had been decreasing due to vigorous incarceration of offenders. However, sending offenders to prison is neither permanent nor the best solution, as the average sentence for child sex abusers is only eleven years. In fact, acting pedophiles completing a treatment program are less likely to repeat abusive behaviors than those who serve prison terms and are not given access to treatment (Cloud 2002).

Treatment strategies for pedophilia include a "12 step support system," parallel to addiction therapy, and anti-androgenic medications that can be used to lower testosterone or medicines that increase serotonin levels. Such medications have met with success when combined with other treatments.

The most favored counseling approach is cognitive-behavioral therapy, in which the subject is taught to associate "pedophilic behavior" with various unpleasantries. Usually, this is done by telling the pedophile to fantasize of "deviant sexual activity," and then, once aroused, they are given instructions to imagine the assumed legal and social consequences of such an action. Empathy and social skills training is also often included in cognitive-behavioral therapy. Other programs induce an association of illegal behavior with pain, by means of more controversial aversion therapy in which the pedophile is subjected to an electric shock while fantasizing ("Can pedophiles be treated?").

There has been much debate in the medical and scientific communities over the effectiveness of treatments for pedophilia. Many experts regard pedophilia as highly resistant to psychological interference and have dismissed as ineffective most "reparative strategies" (Crawford 1981). Supporting this position, a 1987 study by the Council on Scientific Affairs found that the success rate of aversion therapy was parallel to that of homosexual reparative therapy. Others, such as Fred Berlin, believe pedophilia can "indeed be successfully treated," if only the medical community would give it more attention. Indeed, combinations of drugs and counseling have been showing increasing effectiveness in treating pedophiles. However, without a complete understanding of the causes of pedophilia, treatment cannot be expected to be completely effective.

Pedophile activism

The pedophile activism movement began as far back as the 1970s. Referred to by supporters as the "childlove" movement, it is a social movement which encompasses a wide variety of views. However, members of the movement generally advocate one or more of the following: social acceptance of adults' romantic or sexual attraction to children, acceptance of adults' sexual activity with children, and changes in institutions of concern to pedophiles, such as changing age-of-consent laws and declassifying pedophilia as a mental illness.

Most activists claim that they do not support the abuse of children, but rather mutual relationships between children and adults. However, experts and the public alike are skeptical towards this claim, as the general view is that children cannot consent to relationships with adults. Thus, the pedophile activism movement has always been extremely controversial, and has made little progress toward its goals.

Conclusion

Although the precise prevalence of pedophilia in the population is not known, the devastating effects of this mental illness are clear. Treatments have typically shown mixed levels of success, and there has been continued controversy over whether it is actually a treatable disorder, with some claiming that pedophilia should be considered an "orientation," similar to homosexuality, rather than a disease. In this context, it should be noted that there are those who regard homosexuality as a treatable perversion, and so would agree that pedophilia should be addressed in a similar fashion.

Such debate notwithstanding, public opinion, legal opinion, and the majority of mental health professionals agree that child sexual abuse, the inevitable consequence of acting on pedophilic tendencies, is destructive to the minors involved and is an unacceptable outcome. With continued research and efforts to understand the underlying causes of this problem, there is hope that treatments for pedophilia will improve in their effectiveness, and consequently that incidences of sexual abuse of children will decline.

References
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