Pedophilia

Overview
Pedophilia or paedophilia (Commonwealth usage) is the primary or exclusive sexual attraction by adults to prepubescent children. A person with this attraction is called a pedophile or paedophile. The ICD-10 and DSM IV, which are standard medical diagnosis manuals, describe pedophilia as a paraphilia and mental disorder of adults or older adolescents, if it causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The term pedophile is also used colloquially to denote an adult who is sexually attracted to young adolescents, especially younger than the local age of consent, as well as those accused or convicted of child sexual abuse or child pornography related offences.

Definitions
The word comes from the Greek paidophilia (παιδοφιλία): pais (παις, "child") and philia (φιλία, "love, friendship"). Paidophilia was coined by Greek poets either as a substitute for "paiderastia" (pederasty), or vice versa.

The classic spelling with ae or æ, pedophilia etymologically means attraction to the ground (πέδον). It should not be confused with podophilia either, which is attraction to the feet (πούς > octopus / ποδός / πηδόν > pedal). It is correctly pronounced using the "ped" as in "pediatrician," not as in "pedestrian" (as the original spelling contained an æ, which is pronounced as a long e).

The term paedophilia erotica was coined in 1886 by the Viennese psychiatrist Richard von Krafft-Ebing in his writing Psychopathia Sexualis. He gave the following characteristics:


 * The sexual interest is toward pre-pubescent youths only. This interest does not extend to the first signs of pubic hair.
 * The sexual interest is toward pre-pubescent youths only and does not include teenagers.
 * The sexual interest remains over time.

As people who have this interest would include many adolescents and pre-pubescents, some experts who theorize that attraction to minors is more common among youth, specify that the interest must be toward pre-pubescent youths at least five years younger than the subject.

Adults sexually attracted to pre-pubescent youths were placed into three categories by Krafft-Ebing:
 * a.) pedophile
 * b.) surrogate (that is, the pre-pubescent youths are regarded as a substitute object for a preferred, non-available adult object)
 * c.) sadistic

Other researchers used their own terms for the Krafft-Ebing categories:
 * a.) preferential/structured/fixed (i. e. pedophile) type,
 * b.) situational/opportunistic/regressed/incest (i. e. surrogate) type
 * c.) sadistic (no change)

This three-type model as well as the fundamental mental and behavioural differences of the three types were empirically evidenced, among others, by Kinsey; Howells 1981; Abel, Mittleman & Becker 1985; Knight et al. 1985; Brongersma 1990; McConaghy 1993; Ward et al. 1995; Hoffmann 1996; Seikowski 1999.

The term pedophile is commonly used to describe all child sexual offenders, including those who do not meet the clinical diagnosis standards. This use is seen as problematic by some people. Some researchers, such as Howard E. Barbaree, have endorsed the use of actions as a sole criterion for the diagnosis of pedophilia as a means of taxonomic simplification, rebuking the American Psychiatric Association's standards as "unsatisfactory". Child sexual abuse, whether perpetrated by a clinically diagnosed pedophile or a situational offender, is illegal in most jurisdictions.

Some psychologists, such as Dr. Fred S. Berlin, assert sexual attraction to pre-pubescent youths to be a sexual orientation in itself. In one article, Berlin writes "it is likely that no one would choose voluntarily to develop a pedophilic sexual orientation. Those with such an orientation have no more decided to have it than have any of us decided as children to be either heterosexual or homosexual." Berlin also defends the classification of pedophilia as a mental disorder, however, stating "In our society, to have a pedophilic sexual orientation can create both psychological burdens and impairments."

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 APA's Diagnostic and Statistical Manual of Mental Disorders 4th edition, Text Revision gives the following as its "Diagnostic criteria for 302.2 Pedophilia":


 * A. 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);
 * B. The person has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty;
 * C. The person is at least age 16 years and at least 5 years older than the child or children in Criterion A.

Neither the ICD or the APA diagnostic criteria require actual sexual activity with a pre-pubescent youths. 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).

Causes
The cause or causes of pedophilia are not well understood. German psychologist Michael Griesemer theorizes that pedophiles miss the switch of sexual interest from prepubescent to postpubescent partners (so-called sex-dimorphic maturation of the frontal brain) that usually occurs with the onset of puberty, so that pedophilia is a developmental disability. Noted American sexologist John Money differentiated between affectional and sadistic pedophilia. He believed that affectional pedophilia was caused by a surplus of parental love that became erotic.

There are indications of a familial transmittability, though it is unclear whether this stems from genetics or learned behavior. Other factors such as abnormalities in male sexual hormones or the brain chemical serotonin have not been proven as factors in the development of paraphilias such as pedophilia. A history of childhood sexual abuse is also a potential factor in the development of pedophilia, but this also has not been proven. Behavioral learning models suggest, however, that a child who is the victim or observer of inappropriate sexual behaviors learns to imitate and is later reinforced for the behavior.

Extent of occurrence
The extent to which pedophilia occurs is not known with any certainty. Historically, sexual contacts between older pre-pubescents and adults were relatively common and accepted in many places, including the United States and England, where the legal age of consent typically ranged from seven to 12 years until the end of the 19th century. Some studies have concluded that at least a quarter of all adult men may have some feelings of sexual arousal in connection with pre-pubescent youths. Freund et al. (1972) remarked that "with males who have no deviant object preferences, clearly positive sexual reactions occur to [nude] 6- to 8-year old female children."

In 1989 Briere and Runtz conducted a study on 193 male undergraduate students concerning pedophilia. Of the sample, 21 percent acknowledged sexual attraction to some small children; nine percent reported sexual fantasies involving children; five percent admitted masturbating to these fantasies; and seven percent conceded some probability of actually having sex with a child if they could avoid detection and punishment. The authors also noted that "given the probable social undesirability of such admissions, [one could] hypothesize that the actual rates ... were even higher.".

A study by Hall et al. of Kent State University found that, of their sample of 80 adult male volunteers, 20 percent reported some attraction to prepubescent girls and 32.5 percent exhibited sexual arousal to heterosexual pedophilic stimuli that equaled or exceeded their arousal to the adult stimuli.

Less research is available regarding pedophilia's occurrence in females. In a 1996 study of a university sample, 2.6 percent of surveyed females self-reported at least some sexual interest in children.

Occurrence in child sex offenders
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), much as adult rape can have non-sexual impetus. Child sexual abuse may or may not be an indicator that its perpetrator is a pedophile.

Some research indicates that most perpetrators of child sexual abuse are not primarily interested in pre-pubescent youths. In two studies designed to measure sexual preferences using phallometric data, it was found that "30% of the [child sex] offenders tested did not show sufficient arousal [to children] to derive a usable score."

Sociology professor Rüdiger Lautmann, stated in his book on pedophilia, "In this book I am concerned exclusively with the first type [the true pedophile who "has a general interest in social contact with children, including a sexual dimension"], which constitutes approximately five percent of all pedosexually active men."

A survey of cases of father-daughter incest concluded that most involve fathers who are situational offenders, rather than pedophiles.

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.

Attempts have been made to use offender profiling to identify pedophiles, however, these methods have come under criticism for making claims that are in excess of what the evidence supports. '''

Treatment
A number of proposed treatment techniques for pedophilia have been developed. In 1981, writer David Crawford reported that the success rate of these therapies was very low. Dr. Fred Berlin, founder of the Johns Hopkins Sexual Disorders Clinic, believed pedophilia could "indeed be successfully treated," if only the medical community would give it more attention. More recently, Dr. Berlin has concluded that, as a sexuality, pedophilia cannot be cured.

Although there are no known therapies for treating pedophilia, many therapies are available for treating the behavior of offending pedophiles. Such therapies do not affect a person's sexual attraction to children, but some are very effective at preventing re-offending behavior.

Medical therapies
Behavior modification programs have been shown to reduce recidivism in contact sex offenders. Often such programs use principles of applied behavior analysis such as the use of reward and punishment to train new behavior such as problem solving. Many of the programs use covert sensitization and odor aversion, which are both forms of aversion therapy. While such programs are effective in lowering recidivism by 15-18 percent, they do not represent a cure.

Anti-androgenic medications such as Depo Provera may be used to lower testosterone levels in offending pedophiles, and are often used in conjunction with the non-medical approaches above. (This is commonly referred to as "chemical castration.") Gonadotropin-releasing hormone analogues, which last longer and have less side effects, are also effective in reducing libido and may be used.

A study by the Council on Scientific Affairs found that the success rate of aversion therapy was parallel to that of homosexual reparative therapy; that is to say, extremely low. This method is rarely used on pedophiles who have not offended.

Convicted sex offenders, including many pedophiles, have been treated by the psychosurgical procedure commonly known as lobotomization. Psychosurgery has long been controversial, particularly the historical use of surgical intervention on homosexuals given that homosexuality is no longer considered a mental illness by the psychiatric community (see for instance Rieber et al. 1976; Sigusch 1977; Rieber & Sigusch 1979; Schorsch & Schmidt 1979) Lobotomies are generally no longer practiced and are prohibited in a number of countries.

Thalamotomy is an alternative surgical treatment of sex offenders in practice since the problems with leucotomy have been commonly known (see Greist 1990; Diering & Bell 1991; Hay & Sachdev 1992; Rappaport 1992; de la Porte 1993; Poynton 1993; Bridges et al. 1994; Cummings et al. 1995) and is increasingly advertised as an "effective therapy" for sex offenders (as well as for some children suffering from symptoms of child sexual abuse, since the 1980s (see for instance Andy 1970; Bradford 1988a; Wyre & Swift 1991; Abel et al. 1992; Bridges et al. 1994; Cummings et al. 1995). As Levey and Curfman have noted, however, given the availability of psychopharmacological treatment options, psychosurgical interventions are not likely to be employed given their extreme side effects and irreversible nature. See the same article for an in depth review of treatment options and diagnostic criteria.

Additionally, Reid writes that neurosurgery for sex offenders is "essentially unavailable" in the United States and that data on its use is sparse.

Many proponents of therapy for "pedophiles" cite the research of Klaus M. Beier of the Institute of Sexology and Sexual Medicine at Charité, a large university hospital in Berlin, Germany, which reported success in a preliminary study using role-play therapy and medicine. According to researchers, contact child sex offenders were better able to control their urges once they understood the pre-pubescent youth's view. Although these results are relevant to the prevention of re-offending in contact child sex offenders, there is no empirical suggestion that such therapy is a cure for pedophilia.

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, in jurisdictions where the legal age of consent is higher (like USA and Britain), pedophilia is sometimes used more broadly in a non-medical sense to describe both ephebophilia and attraction to younger children; in effect, any person younger than the legal age of consent. Ephebophilia does not have broad academic acceptance as constituting a paraphilia.


 * Pederasty has historically been given sharply different meanings, sometimes referring to male homosexual interactions in general, sometimes to anal sex in general, and sometimes specifically to sex between men and boys. In academic usage the word has still a fourth meaning, referring specifically to the age-structured homosexual interactions practiced in classical Greece between older men and adolescent boys, and by extension to age-structured homosexual interactions in other cultures.


 * Lolita syndrome is sometimes used to refer to the attraction to preadolescent females. The term Lolicon is a corrupted abridgment of Lolita complex, it refers to manga-style pornography depicting neotonous female characters. A male equivilent called shotacon was later adapted.


 * Nepiophilia, also called infantophilia, is the attraction to toddlers and infants (usually ages 0–3). Some researchers have suggested a distinction between pedophilia and nepiophilia, especially for same-sex pedophilia (see for example Bernard 1975, 1982; Lautmann 1994), as it is unusual for pedophiles to prefer toddlers. According to Howells 1981; Bernard 1982; McConaghy 1993; Lautmann 1994, male-oriented pedophilia more prevalently blends in with ephebophilia, while female-oriented pedophilia more prevalently blends in with nepiophilia.

Pro-pedophile activism
Some pro-pedophile activists aim to change legal, medical and social views of pedophilia. This advocacy movement gained public attention in 1948 with Alfred Kinsey's publication of the Kinsey Reports including his interviews with pedophiles, and increased momentum in the late 1990s with the highly controversial Rind et al. study, that has since been quoted by numerous pedophile advocacy organizations.

Anti-pedophile activism
Anti-pedophile activism encompasses opposition to pedophiles, pro-pedophile activism, and other phenomena that are seen as related to pedophilia, such as child pornography and child sexual abuse. Whilst much of the direct action classified as anti-pedophile involves demonstrations against sex offenders, groups advocating legalization of sexual activity between adults and children, and internet users who solicit sex from teens, there are some organizations, such as Absolute Zero, that explicitly target pedophiles.