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{{Infobox disease| |
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ICD9 = {{ICD9|302.2}} | |
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ICD10 = {{ICD10|F|65|4|f|60}} | |
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MeshID = D010378 |
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'''Pedophilia''' or '''paedophilia''' is a ] in which an adult or older adolescent experiences a primary or exclusive ] to prepubescent children, generally age 11 years or younger.<ref name="DSM 5">{{Cite web| title = Diagnostic and Statistical Manual of Mental Disorders, 5th Edition|publisher = ]|url=http://dsm.psychiatryonline.org/book.aspx?bookid=556|year=2013|accessdate=July 25, 2013}}</ref><ref name=ICD-10>See section F65.4 Paedophilia. {{Cite web |title=The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic criteria for research World|publisher=]/]|year=1993|accessdate=2012-10-10|url=http://www.who.int/classifications/icd/en/GRNBOOK.pdf|quote=B. A persistent or a predominant preference for ] with a prepubescent child or children. C. The person is at least 16 years old and at least five years older than the child or children in B.}}</ref> As a medical ], specific criteria for the disorder extend the cut-off point for prepubescence to age 13.<ref name="DSM 5" /> A person who is diagnosed with pedophilia must be at least 16 years of age; adolescents must be at least five years older than the prepubescent child for the attraction to be diagnosed as pedophilia.<ref name="DSM 5"/><ref name=ICD-10/> |
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] of ] |
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The ] (ICD) defines it as a sexual preference for children of prepubertal or early ] age.<ref name="WHOPaedophilia">See section F65.4 Paedophilia. {{Cite web|title=International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) Version for 2010|publisher=]|accessdate=November 17, 2012|url=http://apps.who.int/classifications/icd10/browse/2010/en#/F65.4}}</ref> It is termed ''pedophilic disorder'' in the '']'' (]), and the manual defines it as a ] in which adults or adolescents 16 years of age or older have intense and recurrent sexual urges towards and ] about prepubescent children that they have either acted on or which cause them distress or ] difficulty.<ref name="DSM 5"/> |
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In popular usage, the word ''pedophilia'' is often applied to any sexual interest in children or the act of ].<ref name="setovii">{{cite book |last= Seto |first= Michael |date= 2008|title= Pedophilia and Sexual Offending Against Children |location= Washington, DC |publisher= American Psychological Association|page= vii}}</ref><ref name=faganJAMA/> This use conflates the sexual preference (pedophilia) with the act of abuse (child molestation), and does not distinguish between attraction to prepubescent and pubescent ].<ref name=ames>{{cite journal | author = Ames MA, Houston DA | title = Legal, social, and biological definitions of pedophilia | journal = Arch Sex Behav | volume = 19 | issue = 4 | pages = 333–42 | date = August 1990 | pmid = 2205170 | doi = 10.1007/BF01541928 }}</ref><ref name=lanning3e/> Researchers recommend that these imprecise uses be avoided because although people who commit child sexual abuse sometimes exhibit the disorder,<ref name=faganJAMA/><ref name=mayoclinic>{{cite journal | author = Hall RC, Hall RC | title = A profile of pedophilia: definition, characteristics of offenders, recidivism, treatment outcomes, and forensic issues | journal = Mayo Clin. Proc. | volume = 82 | issue = 4 | pages = 457–71 | year = 2007 | pmid = 17418075 | doi = 10.4065/82.4.457 | url = }}</ref> many child sexual abuse offenders do not have a sexual preference for preprepubescent children,<ref name="ames"/><ref name=Oxford>{{Cite book| last1 = Blaney | first1 = Paul H. | last2 = Millon | first2 = Theodore | title = Oxford Textbook of Psychopathology (Oxford Series in Clinical Psychology) |edition= 2nd | year= 2009 | publisher = Oxford University Press, USA | quote = Some cases of child molestation, especially those involving incest, are committed in the absence of any identifiable deviant erotic age preference.| isbn = 0-19-537421-5 | pages = 528}}</ref><ref name="Edwards">Edwards, M. (1997) "Treatment for Paedophiles; Treatment for Sex Offenders". ''Paedophile Policy and Prevention, Australian Institute of Criminology Research and Public Policy Series'' (12), 74-75.</ref> and not all people with such a preference molest children.<ref name=faganJAMA/><ref name="feelgood">{{cite journal | author = Feelgood S, Hoyer J | year = 2008 | title = Child molester or paedophile? Sociolegal versus psychopathological classification of sexual offenders against children | journal = Journal of Sexual Aggression | volume = 14 | issue = 1 | pages = 33–43 | doi=10.1080/13552600802133860}}</ref><ref name="setovii" /><ref name="SetoReview" /> |
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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,<ref name="setowomen">{{cite book |last= Seto |first= Michael |date= 2008|title= Pedophilia and Sexual Offending Against Children |location= Washington, DC |publisher= American Psychological Association|page= 72-74}}</ref><ref name=genpsych>{{Cite book|title=Review of General Psychiatry |first=Howard H. |last=Goldman|year=2000|publisher=McGraw-Hill Professional Psychiatry |isbn=0-8385-8434-9 |page=374}}</ref> and researchers assume available estimates underrepresent the true number of female pedophiles.<ref name="psychiatrictimes.com">{{cite web|author=Lisa J. Cohen, PhD and ], MD, PhD|title=Psychopathology and Personality Traits of Pedophiles |publisher='']'' |date= June 8, 2009|accessdate=March 7, 2014 |url=http://www.psychiatrictimes.com/articles/psychopathology-and-personality-traits-pedophiles}}</ref> No cure for pedophilia has been developed, but there are therapies that can reduce the incidence of a person committing child sexual abuse.<ref name=faganJAMA/><ref name=fullerJAMA/> In the United States, following '']'', sex offenders who are diagnosed with certain mental disorders, particularly pedophilia, can be subject to indefinite ].<ref name="setocivil">{{cite book |last= Seto |first= Michael |date= 2008|title= Pedophilia and Sexual Offending Against Children |location= Washington, DC |publisher= American Psychological Association|page= xii}}</ref> At present, the exact causes of pedophilia have not been conclusively established.<ref name=psychtoday2008>{{Cite web|url=http://www.psychologytoday.com/conditions/pedophilia?tab=Causes |title=Pedophilia (Causes) |publisher= Sussex Publishers, LLC |work=Psychology Today |date=7 September 2006}}</ref> Some studies of pedophilia in child sex offenders have correlated it with various neurological abnormalities and psychological pathologies. |
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==Etymology and definitions== |
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The word comes from the {{lang-el|παῖς}} (''paîs''), meaning "child", and φιλία ('']''), "friendly love" or "friendship".<ref name="Liddell, H.G. 1959">Liddell, H.G., and Scott, Robert (1959). ''Intermediate Greek-English Lexicon''. ISBN 0-19-910206-6.</ref> As ''pedophilia'' denotes sexual attraction, the term's Greek meaning is not employed by medical authorities; further, the terms ''child love'' and ''child lover'' are used by pedophiles who use symbols and codes to identify their sexual preference toward prepubescent children.<ref name="slate.com">FBI's January 2007 "intelligence bulletin" on "symbols and logos used by pedophiles to identify sexual preferences". The document (see pages 2–4), was prepared and distributed to FBI divisions and field offices in 2007 by the Cyber Division's Innocent Images National Initiative. {{cite web|first=Bonnie|last=Goldstein |title=The Pedophile's Secret Code |work=] |date=2007-12-03|accessdate=2011-01-01|url=http://www.slate.com/id/2179052/entry/2179054/}}</ref><ref name="Philbin">{{cite book|title =The Killer Book of True Crime: Incredible Stories, Facts and Trivia from the World of Murder and Mayhem|isbn = 1-4022-0829-4|publisher=], Inc. |year=2007 |page=175 |accessdate=2011-01-01 |url=http://books.google.com/?id=V1BaLv_0AaAC&pg=PA175&dq=Pedophilia+%22child+love%22#v=onepage&q&f=false | author =Tom Philbin, Michael Philbin}}</ref> |
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''Pedophilia'' is used for individuals with a primary or exclusive sexual interest in prepubescent children aged 13 or younger.<ref name="DSM 5"/><ref name=ICD-10/> ''Nepiophilia (Infantophilia)'' is pedophilia,<ref name=mayoclinic/> but is used to refer to a sexual preference for ]s and ]s (ages 0–3 or those under age 5).<ref name=mayoclinic/><ref>{{Cite book|title=Sexual Deviance: Theory, Assessment, and Treatment |last= Laws|first= D. Richard |author2=William T. O'Donohue |year=2008 |publisher=Guilford Press |isbn= 1-59385-605-9 |page=176}}</ref> '']'' is defined as individuals with a primary or exclusive sexual interest in 11-14 year old pubescents.<ref>{{cite journal | author = Blanchard R, Lykins AD, Wherrett D, Kuban ME, Cantor JM, Blak T, Dickey R, Klassen PE | title = Pedophilia, hebephilia, and the DSM-V | journal = Arch Sex Behav | volume = 38 | issue = 3 | pages = 335–50 | date = June 2009 | pmid = 18686026 | doi = 10.1007/s10508-008-9399-9 }}</ref> 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.<ref name=SetoReview>Seto MC. (2009) . Annual Review of Clinical Psychology 5:391–407.</ref> 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 '']'' (though ephebophilia is not considered pathological).<ref name="dsm5.org"></ref><ref name="www.usccb.org">{{Cite web|first=Frederick|last=S. Berlin|title=Interview with Frederick S. Berlin, M.D., Ph.D| publisher=Office of Media Relations |accessdate=2008-06-27|url=http://web.archive.org/web/20110623130406/http://www.usccb.org/comm/kit6.shtml}}</ref> |
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===History=== |
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Like many psychiatric disorders, pedophilia is believed to have occurred in humans throughout history, but was not formally named, defined or studied until the late 19th century. The term '''''paedophilia erotica''''' was coined in 1886 by the ] psychiatrist ] in his writing '']''.<ref name=Krafft-Ebing>{{Cite book| last1 = Von Krafft-Ebing | first1 = Richard |others= Translated to English by Francis Joseph Rebman| title = Psychopathia Sexualis | year = 1922 | publisher = Medical Art Agency | location = | pages = 552–560| isbn = 1-871592-55-0 }}</ref> The term appears in a section titled "Violation of Individuals Under the Age of Fourteen", which focuses on the ] aspect of ] in general. Krafft-Ebing describes several typologies of offender, dividing them into ] and non-psychopathological origins, and hypothesizes several apparent causal factors that may lead to the sexual abuse of children.<ref name=Krafft-Ebing/> |
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Krafft-Ebing mentioned ''paedophilia erotica'' in a typology of "psycho-sexual perversion". He wrote that he had only encountered it four times in his career and gave brief descriptions of each case, listing three common traits: |
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# The individual is tainted (''hereditär belastete'')<ref name="Roudinesco">Roudinesco, Élisabeth (2009). ''Our dark side: a history of perversion,'' Polity, ISBN 978-0-7456-4593-3</ref> |
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# The subject's primary attraction is to children, rather than adults. |
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# The acts committed by the subject are typically not intercourse, but rather involve inappropriate touching or manipulating the child into performing an act on the subject. |
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He mentions several cases of pedophilia among adult women (provided by another physician), and also considered the ] to be extremely rare.<ref name=Krafft-Ebing/> Further clarifying this point, he indicated that cases of adult men who have some medical or ] disorder and abuse a male child are not true pedophilia and that, in his observation, victims of such men tended to be older and pubescent. He also lists ''pseudopaedophilia'' as a related condition wherein "individuals who have lost ] for the adult through masturbation and subsequently turn to children for the gratification of their sexual appetite" and claimed this is much more common.<ref name=Krafft-Ebing/> |
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Austrian neurologist ] briefly wrote about the topic in his 1905 book '']'' in a section titled ''The Sexually immature and Animals as Sexual objects.'' He wrote that exclusive pedophilia was rare and only occasionally were prepubescent children exclusive objects. He wrote that they usually were the subject of desire when a weak person "makes use of such substitutes" or when an uncontrollable instinct which will not allow delay seeks immediate gratification and cannot find a more appropriate object.<ref>Freud, Sigmund Three Contributions to the Theory of Sex Mobi Classics pages 18-20</ref> |
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In 1908, ] ] and psychiatrist ] wrote of the phenomenon, proposing that it be referred to it as "Pederosis", the "Sexual Appetite for Children". Similar to Krafft-Ebing's work, Forel made the distinction between incidental sexual abuse by persons with ] and other organic brain conditions, and the truly preferential and sometimes exclusive sexual desire for children. However, he disagreed with Krafft-Ebing in that he felt the condition of the latter was largely ingrained and unchangeable.<ref name=Forel>{{Cite book| last1 = Forel | first1 = Auguste |others= Translated to English by C.F. Marshall, MD| title = The Sexual Question: A scientific, psychological, hygienic and sociological study for the cultured classes | year = 1908 | publisher = Rebman | location = | pages = 254–255 }}</ref> |
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The term ''pedophilia'' became the generally accepted term for the condition and saw widespread adoption in the early 20th century, appearing in many popular ] such as the 5th Edition of ''Stedman's'' in 1918. In 1952, it was included in the first edition of the '']''.<ref>{{Cite book|title=Diagnostic and statistical manual of mental disorders |author= American Psychiatric Association Committee on Nomenclature and Statistics |year=1952 |edition= 1st|publisher=The Association |location=Washington, D.C |page=39 }}</ref> This edition and the subsequent DSM-II listed the disorder as one subtype of the classification "Sexual Deviation", but no diagnostic criteria were provided. The DSM-III, published in 1980, contained a full description of the disorder and provided a set of guidelines for diagnosis.<ref>{{Cite book|title=Diagnostic and statistical manual of mental disorders |author= American Psychiatric Association: Committee on Nomenclature and Statistics |year=1980 |edition= 3rd|publisher=American Psychiatric Association |location=Washington, D.C |page=271}}</ref> The revision in 1987, the DSM-III-R, kept the description largely the same, but updated and expanded the diagnostic criteria.<ref>{{Cite book| title = Diagnostic and statistical manual of mental disorders: DSM-III-R | year = 1987 | publisher = American Psychiatric Association | location = Washington, DC | isbn = 0-89042-018-1 | pages = }}</ref> |
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===Diagnostic criteria=== |
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====ICD-10 and DSM==== |
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The '']'' defines pedophilia as "a sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age".<ref name="WHOPaedophilia"/> Under this system's criteria, a person 16 years of age or older meets the definition if they have a persistent or predominant sexual preference for prepubescent children at least five years younger than them.<ref name=ICD-10/> |
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The ''Diagnostic and Statistical Manual of Mental Disorders'' 5th edition (DSM-5) has a significantly larger diagnostic features section for pedophilia than the previous DSM version, the ], and states, "The diagnostic criteria for pedophilic disorder are intended to apply both to individuals who freely disclose this paraphilia and to individuals who deny any sexual attraction to prepubertal children (generally age 13 years or younger), despite substantial objective evidence to the contrary."<ref name="DSM 5"/> Like the DSM-IV-TR, the manual outlines specific criteria for use in the diagnosis of this disorder. These include the presence of sexually arousing fantasies, behaviors or urges that involve some kind of sexual activity with a prepubescent child (with the diagnostic criteria for the disorder extending the cut-off point for prepubescence to age 13) for six months or more, or that the subject has acted on these urges or suffers from distress as a result of having these feelings. The criteria also indicate that the subject should be 16 or older and that the child or children they fantasize about are at least five years younger than them, though ongoing sexual relationships between a 12–13 year old and a late adolescent are advised to be excluded. A diagnosis is further specified by the sex of the children the person is attracted to, if the impulses or acts are limited to ], and if the attraction is "exclusive" or "nonexclusive".<ref name="DSM 5"/> |
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Many terms have been used to distinguish "true pedophiles" from non-pedophilic and non-exclusive offenders, or to distinguish among types of offenders on a continuum according to strength and exclusivity of pedophilic interest, and motivation for the offense (see ]). Exclusive pedophiles are sometimes referred to as ''true pedophiles.'' They are sexually attracted to prepubescent children, and prepubescent children only. Showing no erotic interest in adults, they can only become sexually aroused while fantasizing about or being in the presence of prepubescent children, or both.<ref name=psychiatrictimes.com/> Non-exclusive offenders—or "non-exclusive pedophiles"—may at times be referred to as ''non-pedophilic'' offenders, but the two terms are not always synonymous. Non-exclusive offenders are sexually attracted to both children and adults, and can be sexually aroused by both, though a sexual preference for one over the other in this case may also exist. If the attraction is a sexual preference for prepubescent children, such offenders are considered pedophiles in the same vein as exclusive offenders.<ref name=psychiatrictimes.com/><ref name="WHOPaedophilia"/> |
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Neither the ICD nor the DSM diagnostic criteria require actual sexual activity with a prepubescent youth. The diagnosis can therefore be made based on the presence of fantasies or sexual urges even if they have never been acted upon. On the other hand, a person who acts upon these urges yet experiences no distress about their fantasies or urges can also qualify for the diagnosis. ''Acting'' on sexual urges is not limited to overt sex acts for purposes of this diagnosis, and can sometimes include ], ] or ] behaviors,<ref name="DSM 5"/> or masturbating to ].<ref>{{cite journal | author = Seto MC, Cantor JM, Blanchard R | title = Child pornography offenses are a valid diagnostic indicator of pedophilia | journal = J Abnorm Psychol | volume = 115 | issue = 3 | pages = 610–5 | date = August 2006 | pmid = 16866601 | doi = 10.1037/0021-843X.115.3.610 | quote = The results suggest child pornography offending is a stronger diagnostic indicator of pedophilia than is sexually offending against child victims }}</ref> Often, these behaviors need to be considered in-context with an element of clinical judgment before a diagnosis is made. Likewise, when the patient is in late adolescence, the age difference is not specified in hard numbers and instead requires careful consideration of the situation.<ref name=DSMmedem> DSM at the Medem Online Medical Library</ref> |
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] ({{ICD10|F|66|1|f|60}}) includes people who acknowledge that they have a sexual preference for prepubertal children, but wish to change it due to the associated psychological or behavioral problems (or both). |
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====Debate regarding the DSM criteria==== |
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The DSM-IV-TR criteria was criticized simultaneously for being over-inclusive, as well as under-inclusive.<ref name=Studer>{{cite journal | author = Studer LH, Aylwin AS | title = Pedophilia: The problem with diagnosis and limitations of CBT in treatment | journal = Medical Hypotheses | volume = 67 | issue = 4 | pages = 774–781 | year = 2006 | pmid = 16766133 | doi = 10.1016/j.mehy.2006.04.030 | url = }}</ref> Though most researchers distinguish between child molesters and pedophiles,<ref name=Oxford/><ref name="Edwards"/><ref name=SetoReview/><ref name=Studer/> Studer and Aylwin argue that the DSM criteria are over-inclusive because all acts of child molestation warrant the diagnosis. A child molester satisfies criteria A because of the behavior involving sexual activity with prepubescent children and criteria B because the individual has acted on those urges.<ref name=Studer/> Furthermore, they argue that it also is under-inclusive in the case of individuals who do not act upon it and are not distressed by it.<ref name=Studer/> The latter point has also been made by several other researchers who have remarked that a so-called "contented pedophile"—an individual who fantasizes about having sex with a child and masturbates to these fantasies, but does not commit child sexual abuse, and who does not feel subjectively distressed afterward—does not meet the DSM-IV-TR criteria for pedophilia, because this person does not meet Criterion B.<ref name=SetoReview/><ref>{{cite journal | author = O'Donohue W, Regev LG, Hagstrom A | title = Problems with the DSM-IV diagnosis of pedophilia | journal = Sex Abuse | volume = 12 | issue = 2 | pages = 95–105 | year = 2000| pmid = 10872239 | doi = 10.1023/A:1009586023326 }}</ref><ref name="greenpedo">{{cite journal | author = Green R | year = 2002 | title = Is pedophilia a mental disorder? | url = http://www2.hu-berlin.de/sexology/BIB/pedophilia.htm | journal = ] | volume = 31 | issue = | page = 2002 }}</ref><ref name=DiagnosticCompare>{{cite journal | author = Moulden HM, Firestone P, Kingston D, Bradford J | year = 2009 | title = Recidivism in pedophiles: an investigation using different diagnostic methods | journal = Journal of Forensic Psychiatry & Psychology | volume = 20 | issue = 5 | pages = 680–701 | doi=10.1080/14789940903174055}}</ref> A large-scale survey about usage of different classification systems showed that the DSM classification is only rarely used. As an explanation, it was suggested that the under-inclusiveness, as well as a lack of validity, reliability and clarity might have led to the rejection of the DSM classification.<ref>{{cite journal | author = Feelgood S, Hoyer J | year = 2008 | title = Child molester or paedophile? Sociolegal versus psychopathological classification of sexual offenders against children | journal = Journal of Sexual Aggression | volume = 14 | issue = 1 | pages = 33–43 | doi=10.1080/13552600802133860}}</ref> |
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], an ] ] known for his research studies on pedophilia, addressed (in his literature review for the DSM-5) the aforementioned objections to the DSM-IV-TR, and proposed a general solution applicable to all paraphilias. This meant namely a distinction between ''paraphilia'' and ''paraphilic disorder''. The latter term is proposed to identify the diagnosable mental disorder which meets Criterion A and B, whereas an individual who does not meet Criterion B can be ascertained but ''not'' diagnosed as having a paraphilia.<ref name="pmid19757012">{{cite journal | author = Blanchard R | title = The DSM diagnostic criteria for pedophilia | journal = Arch Sex Behav | volume = 39 | issue = 2 | pages = 304–16 |date=April 2010 | pmid = 19757012 | doi = 10.1007/s10508-009-9536-0 | url = }}</ref> Blanchard and a number of his colleagues also proposed that hebephilia become a diagnosable mental disorder under the DSM-5 to resolve the physical development overlap between pedophilia and hebephilia by combining the categories under ''pedophilic disorder'', but with specifiers on which age range (or both) is the primary interest.<ref name="dsm5.org"/><ref name=Blanchard>{{cite journal | author = Blanchard R, Lykins AD, Wherrett D, Kuban ME, Cantor JM, Blak T, Dickey R, Klassen PE | title = Pedophilia, Hebephilia, and the DSM-V | journal = Archives of Sexual Behavior | volume = 38 | issue = 3 | pages = 335–350 | year = 2009 | pmid = 18686026 | doi = 10.1007/s10508-008-9399-9 | url = http://link.springer.com/content/pdf/10.1007%2Fs10508-008-9399-9 | format = pdf }}</ref> The proposal for hebephilia was rejected by the ],<ref name=prnsdhebephilia>{{cite web |url=http://www.psychologytoday.com/blog/witness/201212/psychiatry-rejects-novel-sexual-disorder-hebephilia |title=Psychiatry Rejects Novel Sexual Disorder "Hebephilia" |author=Karen Franklin |authorlink=Karen Franklin |date=2 December 2012 |publisher=Psychology Today |location=USA }}</ref> but the distinction between ''paraphilia'' and ''paraphilic disorder'' was implemented.<ref name="DSM 5"/><ref name= "dsm5.org Fact Sheet">{{cite web|title=Paraphilic Disorders|year=2013|accessdate=July 8, 2013|publisher=]|url=http://www.dsm5.org/Documents/Paraphilic%20Disorders%20Fact%20Sheet.pdf}}</ref> |
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The American Psychiatric Association stated that "n the case of pedophilic disorder, the notable detail is what wasn't revised in the new manual. Although proposals were discussed throughout the DSM-5 development process, diagnostic criteria ultimately remained the same as in DSM-IV TR" and that "nly the disorder name will be changed from pedophilia to pedophilic disorder to maintain consistency with the chapter’s other listings."<ref name= "dsm5.org Fact Sheet"/> If hebephilia had been accepted as a DSM-5 diagnosable disorder, it would have been similar to the ICD-10 definition of pedophilia that already includes early pubescents,<ref name=SetoReview/> and would have raised the minimum age required for a person to be able to be diagnosed with pedophilia from 16 years to 18 years (with the individual needing to be at least 5 years older than the minor).<ref name="dsm5.org"/> |
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O'Donohue, however, suggests that the diagnostic criteria for pedophilia be simplified to the attraction to children alone if ascertained by self-report, laboratory findings, or past behavior. He states that any sexual attraction to children is pathological and that distress is irrelevant, noting "this sexual attraction has the potential to cause significant harm to others and is also not in the best interests of the individual."<ref>{{cite journal | author = O'Donohue W | title = A critique of the proposed DSM-V diagnosis of pedophilia | journal = Arch Sex Behav | volume = 39 | issue = 3 | pages = 587–90 | date = Jun 2010 | pmid = 20204487 | doi = 10.1007/s10508-010-9604-5 }}</ref> Also arguing for behavioral criteria in defining pedophilia, Howard E. Barbaree and ] disagreed with the American Psychiatric Association's approach in 1997 and instead recommended the use of actions as the sole criterion for the diagnosis of pedophilia, as a means of ] simplification.<ref name="barbaree-seto">Barbaree, H. E., and Seto, M. C. (1997). Pedophilia: Assessment and Treatment. ''Sexual Deviance: Theory, Assessment, and Treatment''. 175-193.</ref> |
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====Other uses==== |
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In a 1993 review of research on child sexual abuse, Sharon Araji and ] stated that because this field of research was underdeveloped at that time, there are "definitional problems" resulting from lack of standardization among researchers in their use of the term ''pedophilia''. They described two definitions, a "restrictive" form referring to individuals with strong and exclusive sexual interest in children, and an "inclusive" definition, expanding the term to include offenders who engaged in sexual contact with a child, including incest. They stated that they used the wider definition in their review paper because behavioral criteria are easier to identify and do not require complex analysis of an individual's motivations.<ref name= Finkelhor/> |
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==Development and sexual orientation== |
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Pedophilia has been described as a disorder of sexual preference, phenomenologically similar to a ] or ] ] because it emerges before or during puberty, and because it is stable over time.<ref>Brian L. Cutler, ''Encyclopedia of Psychology and Law'', SAGE, 2008, ISBN 978-1-4129-5189-0, p. 549</ref> These observations, however, do not exclude pedophilia from the group of mental disorders because pedophilic acts cause harm, and pedophiles can sometimes be helped by mental health professionals to refrain from acting on their impulses which cause harm to children.<ref name="Berlin">{{cite web|first=Fred S.|last=Berlin|title=Treatments to Change Sexual Orientation|publisher=psychiatryonline.org/]|date= May 1, 2000|accessdate=December 10, 2014|url=http://ajp.psychiatryonline.org/article.aspx?articleID=174135}}</ref> |
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==Psychopathology and personality traits== |
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Several researchers have reported correlations between pedophilia and certain psychological characteristics, such as low ]<ref>{{cite journal | author = Marshall WL | title = The relationship between self-esteem and deviant sexual arousal in nonfamilial child molesters | journal = Behavior Modification | volume = 21 | issue = 1 | pages = 86–96 | year = 1997 | pmid = 8995044 | doi = 10.1177/01454455970211005 | url = }}</ref><ref>{{cite journal | author = Marshall W., Cripps E., Anderson D., Cortoni F. A. | year = 1999 | title = Self-esteem and coping strategies in child molesters | url = | journal = Journal of Interpersonal Violence | volume = 14 | issue = 9| pages = 955–962 | doi = 10.1177/088626099014009003 }}</ref> and poor social skills.<ref>{{cite journal | author = Emmers-Sommer T. M. | year = 2004 | title = A meta-analysis of the relationship between social skills and sexual offenders | url = | journal = Communication Reports | volume = 17 | issue = | pages = 1–10 | doi = 10.1080/08934210409389369 }}</ref> 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 criminal behavior.<ref>{{cite journal | author = Cohen LJ, McGeoch PG, Watras-Gans S, Acker S, Poznansky O, Cullen K, Itskovich Y, Galynker I | title = Personality impairment in male pedophiles | journal = Journal of Clinical Psychiatry | volume = 63 | issue = 10 | pages = 912–9 | date = October 2002 | pmid = 12416601 | doi = 10.4088/JCP.v63n1009 | url = http://www.psychiatrist.com/privatepdf/2002/v63n10/v63n1009.pdf | format = PDF }}</ref> Studies in 2009 and 2012 found that non-pedophilic child molesters exhibited psychopathy, but pedophiles did not.<ref>{{cite journal | author = Strassberg, Donald S., Eastvold, Angela, Kenney, J. Wilson, Suchy, Yana | title = Psychopathy among pedophilic and nonpedophilic child molesters | journal = Child Abuse & Neglect | volume = 36 | | pages = 379–382 | year = 2012}}</ref><ref>{{cite journal | author = Suchy, Yana; Whittaker, Wilson J.; Strassberg, Donald S.; Eastvold, Angela | title = Facial and prosodic affect recognition among pedophilic and nonpedophilic criminal child molesters | journal = Sexual Abuse: A Journal of Research and Treatment | volume = 21 | issue = 1 | pages = 93-110 | year = 2009}}</ref> |
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According to Wilson and Cox (1983), "The paedophiles emerge as significantly higher on Psychoticism, Introversion and Neurotocism than age-matched controls. there is a difficulty in untangling cause and effect. We cannot tell whether paedophiles gravitate towards children because, being highly introverted, they find the company of children less threatening than that of adults, or whether the social withdrawal implied by their introversion is a result of the isolation engendered by their preference i.e., awareness of the social approbation and hostility that it evokes" (p. 324).<ref>{{cite journal | author = Wilson G. D., Cox D. N. | year = 1983 | title = Personality of paedophile club members | url = | journal = Personality and Individual Differences | volume = 4 | issue = 3| pages = 323–329 | doi = 10.1016/0191-8869(83)90154-X }}</ref> |
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Studying child sex offenders, a review of qualitative research studies published between 1982 and 2001 concluded that pedophiles use ]s to meet personal needs, justifying abuse by making excuses, redefining their actions as love and mutuality, and exploiting the power imbalance inherent in all adult–child relationships.<ref>{{cite journal | author = Lawson L | title = Isolation, gratification, justification: offenders' explanations of child molesting | journal = Issues Ment Health Nurs | volume = (6-7): | issue = 24 | pages = 695–705 | date = 2003 September–November; | pmid = 12907384 | doi=10.1080/01612840305328}}</ref> Other cognitive distortions include the idea of "children as sexual beings", "uncontrollability of sexuality", and "sexual entitlement-bias".<ref>{{cite journal | author = Mihailides S, Devilly GJ, Ward T | title = Implicit cognitive distortions and sexual offending | journal = Sex Abuse | volume = 16 | issue = (4): | pages = 333–50 | date = October 2004 | pmid = 15560415 | doi = 10.1177/107906320401600406 }}</ref> |
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One review of the literature concludes that research on personality correlates and ] 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.<ref>Okami, P. & Goldberg, A. (1992). "Personality Correlates of Pedophilia: Are They Reliable Indicators?", ''Journal of Sex Research'', Vol. 29, No. 3, pp. 297–328. "For example, because an unknown percentage of true pedophiles may never act on their impulses or may never be arrested, forensic samples of sex offenders against minors clearly do not represent the population of "pedophiles", and many such persons apparently do not even belong to the population of "pedophiles"."</ref> 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.<ref name="seto2004" /> |
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==Prevalence and child molestation== |
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The prevalence of pedophilia in the general population is not known,<ref name=SetoReview/><ref name="seto2004">{{cite journal | author = Seto MC | title = Pedophilia and sexual offenses against children | journal = Annu Rev Sex Res | volume = 15 | issue = | pages = 321–61 | year = 2004 | pmid = 16913283 | doi = }}</ref> but is estimated to be lower than 5% among adult men.<ref name=SetoReview/> "Most sexual offenders against children are male, although female offenders may account for 0.4% to 4% of convicted sexual offenders. On the basis of a range of published reports, McConaghy estimates a 10 to 1 ratio of male-to-female child molesters."<ref name=psychiatrictimes.com/> It is believed that the true number of female pedophiles is underrepresented by available estimates, and that reasons for this may include a "societal tendency to dismiss the negative impact of sexual relationships between young boys and adult women, as well as women’s greater access to very young children who cannot report their abuse", among other explanations.<ref name=psychiatrictimes.com/> |
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The term ''pedophile'' is commonly used in the mainstream to describe all ] offenders, including those who do not meet the clinical diagnosis standards, which is seen as problematic by researchers<ref name="ames"/><ref name="Edwards"/> as most of them distinguish between child molesters and pedophiles.<ref name=Oxford/><ref name="Edwards"/><ref name=SetoReview/><ref name=Studer/> There are motives for child sexual abuse that are unrelated to pedophilia<ref name="barbaree-seto" /> (such as stress, marital problems, or the unavailability of an adult partner).<ref>Howells, K. (1981). "Adult sexual interest in children: Considerations relevant to theories of aetiology", ''Adult sexual interest in children.'' 55-94.</ref> As child sexual abuse is not automatically an indicator that its perpetrator is a pedophile, offenders might be separated into two types: Exclusive (i.e., "true pedophiles") and non-exclusive (or, in some cases, "non-pedophilic").<ref name=psychiatrictimes.com/><ref name=mayoclinic/> According to a U.S. study on 2429 adult male sex offenders who were categorized as "pedophiles", only 7% identified themselves as exclusive; indicating that many or most child sexual abusers may fall into the non-exclusive category.<ref name=mayoclinic/> However, the ] reports perpetrators who meet the diagnostic criteria for pedophilia offend more often than non-pedophile perpetrators, and with a greater number of victims. They state that approximately 95% of child sexual abuse incidents are committed by the 88% of child molestation offenders who meet the diagnostic criteria for pedophilia.<ref name="mayoclinic"/> A behavioral analysis report by the ] states that a "high percentage of acquaintance child molesters are preferential sex offenders who have a true sexual preference for children (i.e., true pedophiles)".<ref name=lanning3e>{{Cite web|title=Child Molesters: A Behavioral Analysis (Third Edition)|url=http://www.missingkids.com/en_US/publications/NC70.pdf |author=Lanning, Kenneth |year=2001 |publisher=National Center for Missing & Exploited Children |pages=25, 27, 29|format=PDF}}</ref> |
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A review article in the '']'' notes the overlap between extrafamilial and intrafamilial offenders. One study found that around half of the fathers and stepfathers in its sample who were referred for committing extrafamilial abuse had also been abusing their own children.<ref>{{Cite web|title=Cycle of child sexual abuse: links between being a victim and becoming a perpetrator|author=M. GLASSER, FRCPsych and I. KOLVIN, FRCPsych |url=http://bjp.rcpsych.org/cgi/content/full/bjprcpsych;179/6/482|work=British Journal of Psychiatry|year=2001}}</ref> |
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As stated by Abel, Mittleman, and Becker<ref>Abel, G. G., Mittleman, M. S., & Becker, J. V. (1985). "Sex offenders: Results of assessment and recommendations for treatment". In M. H. Ben-Aron, S. J. Hucker, & C. D. Webster (Eds.), ''Clinical criminology: The assessment and treatment of criminal behavior'' (pp. 207–220). Toronto, Canada: M & M Graphics.</ref> (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. Research suggests that incest offenders recidivate at approximately half the rate of extrafamilial child molesters, and one study estimated that by the time of entry to treatment, nonincestuous pedophiles who molest boys had committed an average of 282 offenses against 150 victims.<ref name=grossman>{{cite journal | author = Grossman LS, Martis B, Fichtner CG | title = Are Sex Offenders Treatable? A Research Overview | journal = Psychiatric Services | volume = 50 | issue = 3 | pages = 349–361 | date = 1 March 1999 | pmid = 10096639 | url = http://psychservices.psychiatryonline.org/cgi/content/full/50/3/349 }}</ref> |
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Some child molesters—pedophiles or not—threaten their victims to stop them from reporting their actions.<ref name="DSM 5"/> Others, like those who often victimize children, can develop complex ways of getting access to children, like gaining the trust of a child's parent, trading children with other pedophiles or, infrequently, get foster children from non-industrialized nations or abduct child victims from strangers.<ref name="DSM 5"/> Offending pedophiles may often act interested in the child, to gain the child's interest, loyalty and affection to keep the child from letting others know about the abuse.<ref name="DSM 5"/> |
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==Child pornography== |
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] is commonly collected by pedophiles who use the images for a variety of purposes, ranging from private sexual uses, trading with other pedophiles, preparing children for sexual abuse as part of the ] process, or enticement leading to entrapment for sexual exploitation such as production of new child pornography or ].<ref name=CrossonTower208>{{cite book|title=Understanding child abuse and neglect |first=Cynthia |last=Crosson-Tower |isbn=0-205-40183-X |publisher=Allyn & Bacon |year=2005|page=208}}</ref><ref name=Wortley14>{{cite journal|title=Child Pornography on the Internet |author=Richard Wortley, Stephen Smallbone |journal=Problem-Oriented Guides for Police |volume=No. 41|pages=p14–16}}</ref><ref name= Levesque64>{{cite book |title=Sexual Abuse of Children: A Human Rights Perspective |first=Roger J. R. |last=Levesque |year=1999 |pages=p64|publisher=Indiana University |isbn= 0-253-33471-3}}</ref> |
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Pedophile viewers of child pornography are often obsessive about collecting, organizing, categorizing, and labeling their child pornography collection according to age, gender, sex act and fantasy.<ref name=CrossonTower200>{{cite book|title=Understanding child abuse and neglect |first=Cynthia |last=Crosson-Tower |isbn=0-205-40183-X |publisher=Allyn & Bacon |year=2005|pages=198–200}}</ref><ref name= Lanning/> According to FBI agent Ken Lanning, "collecting" pornography does not mean that they merely view pornography, but that they save it, and "it comes to define, fuel, and validate their most cherished sexual fantasies". An extensive collection indicates a strong sexual preference for children and the owned collection is the single best indicator of what he or she wants to do.<ref name= Lanning>{{cite journal|title=Child Molesters: A Behavioral Analysis 4th ed|first=Kenneth V. |last=Lanning |year=2001 |publisher=National Center for Missing and Exploited Children|volume=86}}</ref> Researchers Taylor and Quayle reported that pedophile collectors of child pornography are often involved in anonymous internet communities dedicated to extending their collections.<ref name= NSPCC>{{cite web|title=Child pornography: images of the abuse of children|year=2003 |url=http://www.nspcc.org.uk/Inform/research/Briefings/imagesofchildabuse_wda48219.html|publisher=National Society for the Prevention of Cruelty to Children}}</ref> Pedophile online community bulletin boards (such as the defunct Dreamboard, taken down in ]), often include technical advice regarding ] and other measures from experienced child pornographers to assist new perpetrators from detection from ].<ref name= Lanning/> |
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==Causes and biological associations== |
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Although what causes pedophilia is not yet known, beginning in 2002, researchers began reporting a series of findings ] pedophilia with brain structure and function. Testing individuals from a variety of referral sources inside and outside the criminal justice system as well as ], these studies found associations between pedophilia and lower ],<ref name=Blanchard2007>{{cite journal | author = Blanchard R., Kolla N. J., Cantor J. M., Klassen P. E., Dickey R., Kuban M. E., Blak T. | year = 2007 | title = IQ, handedness, and pedophilia in adult male patients stratified by referral source | url = | journal = Sexual Abuse: A Journal of Research and Treatment | volume = 19 | issue = 3| pages = 285–309 | doi = 10.1177/107906320701900307 }}</ref><ref name = Cantor2004>{{cite journal | author = Cantor JM, Blanchard R, Christensen BK, Dickey R, Klassen PE, Beckstead AL, Blak T, Kuban ME | title = Intelligence, memory, and handedness in pedophilia | journal = Neuropsychology | volume = 18 | issue = 1 | pages = 3–14 | year = 2004 | pmid = 14744183 | doi = 10.1037/0894-4105.18.1.3 | url = }}</ref><ref name = Cantor2005>{{cite journal | author = Cantor JM, Blanchard R, Robichaud LK, Christensen BK | title = Quantitative reanalysis of aggregate data on IQ in sexual offenders | journal = Psychological Bulletin | volume = 131 | issue = 4 | pages = 555–568 | year = 2005 | pmid = 16060802 | doi = 10.1037/0033-2909.131.4.555 | url = }}</ref> poorer scores on memory tests,<ref name = Cantor2004/> greater rates of non-right-handedness,<ref name = Blanchard2007/><ref name = Cantor2004/><ref>{{cite journal | author = Cantor JM, Klassen PE, Dickey R, Christensen BK, Kuban ME, Blak T, Williams NS, Blanchard R | title = Handedness in pedophilia and hebephilia | journal = Archives of Sexual Behavior | volume = 34 | issue = 4 | pages = 447–459 | year = 2005 | pmid = 16010467 | doi = 10.1007/s10508-005-4344-7 | url = }}</ref><ref>{{cite journal | author = Bogaert AF | title = Handedness, criminality, and sexual offending | journal = Neuropsychologia | volume = 39 | issue = 5 | pages = 465–469 | year = 2001 | pmid = 11254928 | doi = 10.1016/S0028-3932(00)00134-2 | url = }}</ref> greater rates of school grade failure over and above the IQ differences,<ref>{{cite journal | author = Cantor JM, Kuban ME, Blak T, Klassen PE, Dickey R, Blanchard R | title = Grade failure and special education placement in sexual offenders' educational histories | journal = Archives of Sexual Behavior | volume = 35 | issue = 6 | pages = 743–751 | year = 2006 | pmid = 16708284 | doi = 10.1007/s10508-006-9018-6 | url = }}</ref> lesser physical height,<ref name="pmid17952597">{{cite journal | author = Cantor JM, Kuban ME, Blak T, Klassen PE, Dickey R, Blanchard R | title = Physical height in pedophilic and hebephilic sexual offenders | journal = Sex Abuse | volume = 19 | issue = 4 | pages = 395–407 | year = 2007 | pmid = 17952597 | doi = 10.1007/s11194-007-9060-5 }}</ref> greater probability of having suffered childhood head injuries resulting in unconsciousness,<ref name = Blanchard2002/><ref>{{cite journal | author = Blanchard R, Kuban ME, Klassen P, Dickey R, Christensen BK, Cantor JM, Blak T | title = Self-reported injuries before and after age 13 in pedophilic and non-pedophilic men referred for clinical assessment | journal = Archives of Sexual Behavior | volume = 32 | issue = 6 | pages = 573–581 | year = 2003 | pmid = 14574100 | doi = 10.1023/A:1026093612434 | url = }}</ref> and several differences in ]-detected brain structures.<ref name = Cantor2008>{{cite journal | author = Cantor JM, Kabani N, Christensen BK, Zipursky RB, Barbaree HE, Dickey R, Klassen PE, Mikulis DJ, Kuban ME, Blak T, Richards BA, Hanratty MK, Blanchard R | title = Cerebral white matter deficiencies in pedophilic men | journal = Journal of Psychiatric Research | volume = 42 | issue = 3 | pages = 167–183 | year = 2008 | pmid = 18039544 | doi = 10.1016/j.jpsychires.2007.10.013 }}</ref><ref name="pmid16876824">{{cite journal | author = Schiffer B, Peschel T, Paul T, Gizewski E, Forsting M, Leygraf N, Schedlowski M, Krueger TH | title = Structural brain abnormalities in the frontostriatal system and cerebellum in pedophilia | journal = J Psychiatr Res | volume = 41 | issue = 9 | pages = 753–62 | year = 2007 | pmid = 16876824 | doi = 10.1016/j.jpsychires.2006.06.003 }}</ref><ref>{{cite journal | author = Schiltz K, Witzel J, Northoff G, Zierhut K, Gubka U, Fellmann H, Kaufmann J, Tempelmann C, Wiebking C, Bogerts B | title = Brain pathology in pedophilic offenders: Evidence of volume reduction in the right amygdala and related diencephalic structures | journal = Archives of General Psychiatry | volume = 64 | issue = 6 | pages = 737–746 | year = 2007 | pmid = 17548755 | doi = 10.1001/archpsyc.64.6.737 }}</ref> They report that their findings suggest that there are one or more neurological characteristics present at birth that cause or increase the likelihood of being pedophilic. Other studies have found that pedophiles are less cognitively impaired than non-pedophilic child molesters.<ref>{{cite journal | author = Joyal, CC, Plante-Beaulieu, J. & De Chanterac, A. | title = The neuropsychology of sexual offenders: A meta-analysis. | journal = Journal of Sexual Abuse | volume = 26 | | pages = 149-177 | year = 2014 | quote = The distinction between nonpedophilic child molesters and exclusive pedophile child molesters, for instance, could be crucial in neuropsychology because the latter seem to be less cognitively impaired (Eastvold et al., 2011; Schiffer & Vonlaufen, 2011; Suchy et al., 2009). Pedophilic child molesters might perform as well as controls (and better than nonpedophilic child molesters) on a wide variety of neuropsychological measures when mean IQ and other socioeconomic factors are similar (Schiffer & Vonlaufen, 2011). In fact, some pedophiles have higher IQ levels and more years of education compared with the general population (Langevin et al., 2000; Lothstein, 1999; Plante & Aldridge, 2005).}}</ref> A 2011 study found that pedophilic child molesters had deficits in response inhibition, but no deficits in IQ, memory or cognitive flexibility.<ref>{{cite journal | author = Schiffer, B., & Vonlaufen, C. | title = Executive dysfunctions in pedophilic and nonpedophilic child molesters. | journal = Journal of Sexual Medicine | volume = 8 | | pages = 1975-1984 | year = 2011}}</ref> Evidence of familial transmittability "suggests, but does not prove that genetic factors are responsible" for the development of pedophilia.<ref>{{cite journal | author = Gaffney GR, Lurie SF, Berlin FS | title = Is there familial transmission of pedophilia? | journal = J. Nerv. Ment. Dis. | volume = 172 | issue = 9 | pages = 546–8 | date = September 1984 | pmid = 6470698 | doi = 10.1097/00005053-198409000-00006 }}</ref> |
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Another study, using structural ], shows that male pedophiles have a lower volume of ] than a ].<ref name = Cantor2008/> Functional magnetic resonance imaging (]) has shown that child molesters diagnosed with pedophilia have reduced activation of the ] as compared with non-pedophilic persons when viewing sexually arousing pictures of adults.<ref>Walter ''et al.'' (2007). "Pedophilia Is Linked to Reduced Activation in Hypothalamus and Lateral Prefrontal Cortex During Visual Erotic Stimulation". ''Biological Psychiatry.'' '''62'''.</ref> A 2008 functional ] study notes that central processing of sexual stimuli in heterosexual "paedophile forensic inpatients" may be altered by a disturbance in the prefrontal networks, which "may be associated with stimulus-controlled behaviours, such as sexual compulsive behaviours". The findings may also suggest "a dysfunction at the ] stage of ] processing".<ref>{{cite journal | author = Schiffer B, Paul T, Gizewski E, Forsting M, Leygraf N, Schedlowski M, Kruger TH | title = Functional brain correlates of heterosexual paedophilia | journal = Neuroimage | volume = 41 | issue = 1 | pages = 80–91 | date = May 2008 | pmid = 18358744 | doi = 10.1016/j.neuroimage.2008.02.008 }}</ref> |
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Blanchard, Cantor, and Robichaud (2006) reviewed the research that attempted to identify ] aspects of pedophiles.<ref name = Blanchard2006>Blanchard, R., Cantor, J. M., & Robichaud, L. K. (2006). Biological factors in the development of sexual deviance and aggression in males. In H. E. Barbaree & W. L. Marshall (Eds.), ''The juvenile sex offender'' (2nd ed., pp. 77–104). New York: Guilford.</ref> They concluded that there is some evidence that pedophilic men have less ] than controls, but that the research is of poor quality and that it is difficult to draw any firm conclusion from it. |
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While not causes of pedophilia themselves, ] by adults or ] psychiatric illnesses—such as ]s and ]—are risk factors for acting on pedophilic urges.<ref name=faganJAMA>{{cite journal | author = Fagan PJ, Wise TN, Schmidt CW, Berlin FS | title = Pedophilia | journal = JAMA | volume = 288 | issue = 19 | pages = 2458–65 | date = November 2002 | pmid = 12435259 | doi = 10.1001/jama.288.19.2458 | url = http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=12435259 }}</ref> Blanchard, Cantor, and Robichaud addressed comorbid psychiatric illnesses that, "The theoretical implications are not so clear. Do particular genes or noxious factors in the prenatal environment predispose a male to develop both affective disorders and pedophilia, or do the frustration, danger, and isolation engendered by unacceptable sexual desires—or their occasional furtive satisfaction—lead to anxiety and despair?"<ref name = Blanchard2006/> They indicated that, because they previously found mothers of pedophiles to be more likely to have undergone psychiatric treatment,<ref name = Blanchard2002>{{cite journal | author = Blanchard R, Christensen BK, Strong SM, Cantor JM, Kuban ME, Klassen P, Dickey R, Blak T | title = Retrospective self-reports of childhood accidents causing unconsciousness in phallometrically diagnosed pedophiles | journal = Archives of Sexual Behavior | volume = 31 | issue = 6 | pages = 511–526 | year = 2002 | pmid = 12462478 | doi = 10.1023/A:1020659331965 | url = }}</ref> the genetic possibility is more likely. |
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A study analyzing the sexual fantasies of 200 heterosexual men by using the Wilson Sex Fantasy Questionnaire exam determined that males with a pronounced degree of ] interest (including pedophilia) had a greater number of older brothers, a high 2D:4D ] (which would indicate excessive prenatal estrogen exposure), and an elevated probability of being ], suggesting that disturbed hemispheric ] may play a role in deviant attractions.<ref>{{cite journal | author = Rahman Q, Symeonides DJ | title = Neurodevelopmental Correlates of Paraphilic Sexual Interests in Men | journal = ] | volume = 37 | issue = 1 | pages = 166–172 | date = February 2007 | pmid = 18074220 | doi = 10.1007/s10508-007-9255-3 }}</ref> |
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==Treatment== |
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Although no cure has been found for pedophilia, various treatments are available that are aimed at reducing or preventing the expression of pedophilic behavior, reducing the prevalence of child sexual abuse.<ref name=fullerJAMA>{{cite journal | author = Fuller AK | title = Child molestation and pedophilia. An overview for the physician | journal = JAMA | volume = 261 | issue = 4 | pages = 602–6 | date = January 1989 | pmid = 2642565 | doi = 10.1001/jama.261.4.602 }}</ref><ref></ref> Treatment of pedophilia often requires collaboration between law enforcement and health care professionals.<ref name=faganJAMA/><ref name=fullerJAMA/> A number of proposed treatment techniques for pedophilia have been developed, though the success rate of these therapies has been very low.<ref name="crawfordd">Crawford, David (1981). "Treatment approaches with pedophiles". ''Adult sexual interest in children''. 181–217.</ref> |
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===Cognitive behavioral therapy=== |
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], also known as relapse prevention, has been shown to reduce recidivism in contact sex offenders.<ref>{{cite journal | author = Marshall W.L., Jones R., Ward T., Johnston P., Bambaree H.E. | year = 1991 | title = Treatment of sex offenders | url = | journal = Clinical Psychology Review | volume = 11 | issue = 4| pages = 465–485 | doi = 10.1016/0272-7358(91)90119-F }}</ref> |
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According to Canadian ] ], cognitive-behavioral treatments target attitudes, beliefs, and behaviors that are believed to increase the likelihood of sexual offenses against children, and "relapse prevention" is the most common type of cognitive behavioral treatment.<ref name = Seto2008>Seto, M. C. (2008). ''Pedophilia and sexual offending against children: Theory, assessment, and intervention.'' Washington, D.C.: American Psychological Association.</ref> The techniques of relapse prevention are based on principles used for treating addictions.<ref name="pn.psychiatryonline.org"></ref> Other scientists have also done some research that indicates that recidivism rates of pedophiles in therapy are lower than pedophiles who eschew therapy.<ref name="pn.psychiatryonline.org"/> |
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===Behavioral interventions=== |
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Behavioral treatments target sexual arousal to children, using satiation and aversion techniques to suppress sexual arousal to children and ] (or ] reconditioning) to increase sexual arousal to adults.<ref name = Seto2008/> Behavioral treatments appear to have an effect on sexual arousal patterns on phallometric testing, but it is not known whether the test changes represent changes in sexual interests or changes in the ability to control genital arousal during testing.<ref>Barbaree, H. E., Bogaert, A. F., & Seto, M. C. (1995). Sexual reorientation therapy for pedophiles: Practices and controversies. In L. Diamant & R. D. McAnulty (Eds.), ''The psychology of sexual orientation, behavior, and identity: A handbook'' (pp. 357–383). Westport, CT: Greenwood Press.</ref><ref>Barbaree, H. C., & Seto, M. C. (1997). Pedophilia: Assessment and treatment. In D. R. Laws & W. T. O'Donohue (eds.), ''Sexual deviance: Theory, assessment and treatment'' (pp. 175–193). New York: Guildford Press.</ref> For sex offenders with mental disabilities, ] has been used.<ref>{{cite journal | author = Maguth Nezu C., Fiore A. A., Nezu A. M | year = 2006 | title = Problem Solving Treatment for Intellectually Disabled Sex Offenders | url = | journal = International Journal of Behavioral Consultation and Therapy | volume = 2 | issue = | pages = 266–275 | doi=10.1002/9780470713488.ch6}}</ref> |
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===Pharmacological interventions=== |
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Medications are used to lower sex drive in pedophiles by interfering with the activity of testosterone, such as with ] (medroxyprogesterone acetate), ] (cyproterone acetate), and ] (leuprolide acetate). |
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]s, which last longer and have fewer side-effects, are also effective in reducing libido and may be used.<ref name="pmid15985890">{{cite journal | author = Cohen LJ, Galynker II | title = Clinical features of pedophilia and implications for treatment | journal = J Psychiatr Pract | volume = 8 | issue = 5 | pages = 276–89 | year = 2002 | pmid = 15985890 | doi = 10.1097/00131746-200209000-00004}}</ref> |
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These treatments, commonly referred to as "]", are often used in conjunction with the non-medical approaches noted above. According the ], "Anti-androgen treatment should be coupled with appropriate monitoring and counseling within a comprehensive treatment plan."<ref>{{Cite web|title=Ant-androgen therapy and surgical castration|work=Association for the Treatment of Sexual Abusers|url=http://www.atsa.com/ppantiandro.html|year=1997}}</ref> |
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===Limitations of treatment=== |
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Although these results are relevant to the prevention of reoffending in contact child sex offenders, there is no ] suggestion that such therapy is a cure for pedophilia. Dr. ], founder of the ] Sexual Disorders Clinic, believes that pedophilia could be successfully treated if the medical community would give it more attention.<ref name="berlin">{{Cite journal|url=http://www.paraphilias.com/publications/pdfs/Peer%20Comment.pdf|title=Peer Commentaries on Green (2002) and Schmidt (2002) - Pedophilia: When Is a Difference a Disorder?|first==Fred S. |last=Berlin, M.D., Ph.D.|journal=Archives of Sexual Behavior|volume=31|issue=6|date=December 2002|pages=479–480|doi=10.1023/A:1020603214218|format=PDF|accessdate=2009-12-17}}</ref> Castration, either physical or chemical, appears to be highly effective in removing such sexual impulses when offending is driven by the libido, but this method is not recommended when the drive is an expression of anger or the need for power and control (e.g., violent/] offenders).<ref>{{Cite news| url=http://www.washingtonpost.com/wp-dyn/content/article/2006/07/04/AR2006070400960_pf.html | work=The Washington Post | title=Can Castration Be a Solution for Sex Offenders? | first=Candace | last=Rondeaux | accessdate=2010-05-22}}</ref> Chemical and surgical castration has been used in several European countries since ], although not to the extent it was employed in ]. The program in ] was terminated after 2000, while ] is now seeking to introduce chemical castration.<ref></ref> The Council of Europe works to bring the practice to an end in Eastern European countries where it is still applied through the courts.<ref></ref> |
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==In law and forensic psychology== |
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===Definitions=== |
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In law enforcement circles, the term ''pedophile'' is sometimes used in a broad manner to encompass a person who commits one or more sexually-based crimes that relate to ] victims. These crimes may include ], ], offenses involving ], ], ], and ]. One unit of the United Kingdom's ] is known as the "Paedophile Unit" and specializes in online investigations and enforcement work.<ref>{{Cite web | last = | first = | title = Child abuse investigation impact | publisher =] (met.police.uk) | accessdate = April 18, 2014| url =http://www.met.police.uk/foi/pdfs/policies/child_abuse_investigation_eia2012.pdf}}</ref> Some forensic science texts, such as Holmes (2008), use the term to refer to a class of psychological offender typologies that target child victims, even when such children are not the primary sexual interest of the offender.<ref>{{Cite book | last1 = Holmes | first1 = Ronald M. | title = Profiling Violent Crimes: An Investigative Tool | publisher = Sage Pubns| location = | isbn = 1-4129-5998-5 | pages = }}</ref> The ], however, makes a point of acknowledging sex offenders who have a true sexual preference for prepubescent children.<ref name=lanning3e/> |
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===Civil and legal commitment=== |
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In the United States, following '']'', sex offenders who have certain mental disorders, including pedophilia, can be subject to indefinite ]<ref name="setocivil" /> under various state laws (generically called ]<ref>http://www.jaapl.org/cgi/reprint/30/4/556.pdf</ref><ref>{{Cite journal | url = http://books.google.com/books?id=V-jrT7yjiwgC&pg=PA483 | title = Public health behind bars: From prisons to communities | isbn = 978-0-387-71694-7 | author1 = Greifinger | first1 = Robert B | date = 2007-10-05}}</ref><ref>http://www.jaapl.org/cgi/reprint/36/4/443.pdf</ref>) and the federal ] of 2006.<ref name=apabc>Jesse J. Holland, , ]. Retrieved 5-16-2010.</ref> In ''Kansas v. Hendricks'', the ] upheld as constitutional a Kansas law, the ] (SVPA), under which Hendricks, a pedophile, was found to have a "mental abnormality" defined as a "congenital or acquired condition affecting the emotional or volitional capacity which predisposes the person to commit sexually violent offenses to the degree that such person is a menace to the health and safety of others", which allowed the State to ] Hendricks indefinitely irrespective of whether the State provided any treatment to Hendricks.<ref name=guilford>{{cite web |
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|url=http://www.guilford.com/cgi-bin/cartscript.cgi?page=etc/courts_updates.html&cart_id=#part_two |
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|title=Psychological Evaluation for the Courts, Second Edition - A Handbook for Mental Health Professionals and Lawyers - 9.04 Special Sentencing Provisions (b) Sexual Offender Statutes|publisher=Guilford.com|accessdate=2007-10-19}}</ref><ref>{{Cite journal | url = http://books.google.com/books?id=6MQj-mjHgBIC&pg=PA248 | title = Legal aspects of corrections management | isbn = 978-0-7637-2545-7 | author1 = Cripe | first1 = Clair A | last2 = Pearlman | first2 = Michael G | year = 2005}}</ref><ref>{{Cite journal | url = http://books.google.com/books?id=gngG9zPmNKMC&pg=PA159 | title = Inside the minds of sexual predators | isbn = 978-0-313-37960-4 | author1 = Ramsland | first1 = Katherine M | last2 = McGrain | first2 = Patrick Norman | year = 2010}}</ref> In '']'', this type of indefinite confinement was upheld for someone previously convicted on child pornography charges; this time a federal law was involved—the ].<ref name=apabc/><ref>{{cite news| url=http://www.nytimes.com/2010/05/18/us/politics/18offenders.html | work=The New York Times | first=Adam | last=Liptak | title=Extended Civil Commitment of Sex Offenders Is Upheld | date=2010-05-17}}</ref> The Walsh Act does not require a conviction on a sex offense charge, but only that the person be a ], and one who "has engaged or attempted to engage in sexually violent conduct or child molestation and who is sexually dangerous to others", and who "would have serious difficulty in refraining from sexually violent conduct or child molestation if released". Neither sexually violent conduct nor child molestation is defined by the Act.<ref name="papers.ssrn.com">Barker, The Adam Walsh Act: Un-civil Commitment, available at http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1496934#</ref> |
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In 2012, ] reacted to an increase of Western European and United States citizens traveling to the country for the purpose of ] with minors.<ref>http://www.thecuttingedgenews.com/index.php?article=72398&pageid=89&pagename=Features</ref> The ] enacted law that would mandate chemical castration for those who have sex with persons under the age of 15. Additionally, rapists would face castration on a case-by-case basis. The '']'' also reported that Moldovans had a perception that their country had become a sex tourism destination and that every five of the nine convicted child sex offenders in the country over the past two years were foreigners.<ref>{{cite news| url=http://www.bbc.co.uk/news/world-europe-17278225 | work=BBC News | title=Moldova introduces chemical castration for paedophiles | date=2012-03-06}}</ref> |
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In Egypt, ]s are forbidden by law, but the government does little to enforce the ban. |
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Meanwhile, the United Nations estimates some two million children are trafficked each year.<ref>http://www.catholic.org/international/international_story.php?id=51989</ref> |
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==Societal views== |
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===General=== |
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Pedophilia and child sexual abuse are generally seen as morally wrong and abnormal by society.<ref name="Smith">{{cite book | author =Christian Smith| title =What Is a Person?: Rethinking Humanity, Social Life, and the Moral Good from the Person Up |publisher= University of Chicago Press|year=2010|page=419|accessdate=2010-10-15|isbn =0-226-76591-1| url =http://books.google.com/?id=sT9r_h8X8I4C&pg=PA419&dq=Pedophilia+morally+wrong#v=onepage&q=Pedophilia%20morally%20wrong&f=false}}</ref><ref name="Hickey">{{cite book | author = Eric W. Hickey | title = Sex crimes and paraphilia |publisher= Pearson Education (Digitized October 30, 2008)|year=2006|pages=537 pages|accessdate=2010-10-15|isbn =0-13-170350-1| url =http://books.google.com/?id=xBUEAQAAIAAJ&q=Pedophilia+morally+wrong&dq=Pedophilia+morally+wrong|quote=Pedophilia is one sexual disorder that is widely looked upon as legally, socially, and morally wrong.}}</ref><ref name="informaworld.com">{{Cite journal | author=Ben Spieckera; Jan Steutela | title = Paedophilia, Sexual Desire and Perversity | journal = Journal of Moral Education| volume = 26 | issue = 3 | pages = 331–342|date=September 1997 | doi = 10.1080/0305724970260307 | pmid = |url=http://www.informaworld.com/smpp/content~db=all~content=a746543224}}</ref> Research at the close of the 1980s showed that there was a great deal of misunderstanding and unrealistic perceptions in the general public about pedophilia (La Fontaine, 1990; Leberg, 1997). However, a 2004 study indicated that the public's perception has gradually become more well-informed on the subject.<ref>{{cite journal | author = McCartan K | title = 'Here There Be Monsters': the public's perception of paedophiles with particular reference to Belfast and Leicester | journal = Med Sci Law | volume = 44 | issue = 4 | pages = 327–42 | date = Oct 2004 | pmid = 15573972 | doi = 10.1258/rsmmsl.44.4.327 }}</ref> |
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===Misuse of medical terminology=== |
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The words ''pedophile'' and ''pedophilia'' are sometimes used informally to describe an adult's sexual interest or attraction to pubescent or post-pubescent teenagers and to other situations that do not fit within the clinical definitions. The terms '']'' or '']'' may be more accurate in these cases.<ref name=britannica/><ref name=mayoclinic/><ref name="www.usccb.org"/> This was especially seen in the case of ] during the ]. Most of the media labeled Foley a pedophile, which led David Tuller of '']'' magazine to state that Foley was not a pedophile but rather an ephebophile.<ref name="www.slate.com">{{cite news|first=David |last=Tuller|title=What To Call Foley. The congressman isn't a pedophile. He's an ephebophile|publisher='']''|date=2006-10-04|accessdate=2010-10-17|url=http://www.slate.com/id/2151018/}}</ref> |
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Another common usage of ''pedophilia'' is to refer to the ] itself (that is, interchangeably with ''sexual abuse'')<ref name=britannica>{{Cite web|title=pedophilia|url=http://www.britannica.com/eb/article-9058932 |publisher=]}}</ref><ref name="psychtoday"/><ref name="burgess"/><ref name=americanheritage2>{{Cite web|url=http://dictionary.reference.com/browse/pedophilia |title="pedophilia" (n.d.) |work=The American Heritage Stedman's Medical Dictionary |date=May 6, 2008|quote=The act or fantasy on the part of an adult of engaging in sexual activity with a child or children.}}</ref> rather than the medical meaning, which is a ''preference'' for that age group on the part of the older individual.<ref name="ames" /><ref name=lanning3e/> There are also situations where the terms are misused to refer to relationships where the younger person is an adult of legal age, but is either perceived socially as being too young in comparison to their older partner, or the older partner occupies a position of authority over them.<ref name="www.huffingtonpost.com">{{Cite news| last = Guzzardi| first = Will| title = Andy Martin, GOP Senate Candidate, Calls Opponent Mark Kirk A "De Facto Pedophile" | url = http://www.huffingtonpost.com/2010/01/06/andy-martin-gop-senate-ca_n_413624.html | publisher = | date = 2010-01-06| accessdate = 15 January 2010 | work=Huffington Post}}</ref><ref>Seligman, M. (1993). ''What you can change and what you can't'', page 235. New York: Fawcett Columbine.</ref> Researchers state that the above uses for the term ''pedophilia'' are imprecise or suggest that they are best avoided.<ref name="ames"/><ref name="www.usccb.org"/> The ] states that ''pedophilia'' "is not a criminal or legal term".<ref name=mayoclinic/> |
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==={{anchor|Pedophile advocacy groups}}Pedophile advocacy groups=== |
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{{category see also|Pedophile activism}} |
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From the late 1950s to early 1990s, several pedophile membership organizations advocated ] to lower or abolish ] laws,<ref name=jenkins2006>{{Cite book|title=Decade of Nightmares: The End of the Sixties and the Making of Eighties America |first=Philip |last=Jenkins |year=2006 |publisher=Oxford University Press |page=120|isbn=0-19-517866-1}}</ref><ref name="spiegel">{{Cite book|title=Sexual Abuse of Males: The Sam Model of Theory and Practice |last= Spiegel |first=Josef |year=2003 |pages=5, p9 |publisher=Routledge |isbn= 1-56032-403-1}}</ref><ref name="Eichewald4">{{Cite news|author=Eichewald, Kurt |title=From Their Own Online World, Pedophiles Extend Their Reach|publisher=New York Times|date=August 21, 2006|url=http://www.nytimes.com/2006/08/21/technology/21pedo.html}}</ref> as well as for the acceptance of pedophilia as a ] rather than a ],<ref name="Bernard">{{Cite journal|title=The Dutch Paedophile Emancipation Movement |author= Dr. Frits Bernard, |journal=Paidika: the Journal of Paedophilia |volume= 1| issue = 2, (Autumn 1987), p. 35–4 |quote=Heterosexuality, homosexuality, bisexuality and paedophilia should be considered equally valuable forms of human behavior.}}</ref> and for the legalization of child pornography.<ref name="Eichewald4"/> The efforts of pedophile advocacy groups did not gain any public support<ref name=jenkins2006/><ref name="Eichewald4"/><ref name=jenkins1992>{{Cite book|title=Intimate Enemies: Moral Panics in Contemporary Great Britain |first=Philip |last=Jenkins |year=1992 |publisher=Aldine Transaction |page=75 |isbn=0-202-30436-1 |quote=In the 1970s, the pedophile movement was one of several fringe groups whose cause was to some extent espoused in the name of gay liberation.}}</ref><ref name=stanton>{{Cite book|title=Discourses of Sexuality: From Aristotle to AIDS |first=Domna C. |last=Stanton |year=1992 |publisher=University of Michigan Press |page=405|isbn= 0-472-06513-0}}</ref><ref name=hagan>{{Cite book|title=Deviance and the family |first=Domna C. |last= Hagan |author2=Marvin B. Sussman |year= 1988 |publisher=Haworth Press|page=131|isbn= 0-86656-726-7}}</ref> and today those few groups that have not dissolved have only minimal membership and have ceased their activities other than through a few websites.<ref name="Eichewald4"/><ref name=hagan/><ref>] (2001). "", Boston Magazine.</ref><ref>Trembaly, Pierre (2002). .</ref> |
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===Anti-pedophile activism=== |
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{{Main|Anti-pedophile activism}} |
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Anti-pedophile activism encompasses opposition against pedophiles, against pedophile advocacy groups, and against other phenomena that are seen as related to pedophilia, such as child pornography and child sexual abuse.<ref></ref> Much of the direct action classified as anti-pedophile involves demonstrations against sex offenders, against pedophiles advocating for the legalization of sexual activity between adults and children, and against Internet users who solicit sex from minors.<ref name="bbc"> August 9, 2000. Retrieved January 24, 2008.</ref><ref>, May 30, 2006. Retrieved Jan2008.</ref><ref>{{cite web|url=http://www.pjfi.org/ |title=The Perverted Justice Foundation Incorporated - A note from our foundation to you |publisher=]|accessdate=March 16, 2012}}</ref><ref name="NYT06Dec">{{cite news |first=Allen |last=Salkin |authorlink=Allen Salkin |author2=Happy Blitt |title=Web Site Hunts Pedophiles and TV Goes Along |url=http://query.nytimes.com/gst/fullpage.html?res=9D07E2DB1531F930A25751C1A9609C8B63&sec=&spon=&pagewanted=all |work=] |location=New York, New York |date=2006-12-13 |accessdate=March 16, 2012|quote='Every waking minute he's on that computer,' said his mother, Mary Erck-Heard, 46, who raised her son after they fled his father, whom she described as alcoholic. Mr. Von Erck legally changed his name from Phillip John Eide, taking his maternal grandfather's family name, Erck, and adding the Von.}}</ref> |
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High-profile media attention to pedophilia has led to incidents of ], particularly following reports of pedophilia associated with ] and ].<ref name = Jewkes1>{{Cite book|author=Jewkes Y |title=Media and crime |publisher=Sage |location=Thousand Oaks, Calif |year=2004 |pages= |isbn=0-7619-4765-5 |oclc= |doi= |accessdate=}}</ref> Instances of ] have also been reported in response to public attention on convicted or suspected child sex offenders. In 2000, following a media campaign of "]" suspected pedophiles in the UK, hundreds of residents took to the streets in protest against suspected pedophiles, eventually escalating to violent conduct requiring police intervention.<ref name="bbc" /> The Catholic church's ] estimated in 2014 that 2% of the clergy were pedophiles which was like "leprosy" infecting the church, and he promised to address the problem.<ref> 13 July 2014, BBC News, , Accessed July 13, 2014</ref> |
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==In culture== |
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* The ] novel '']'' was controversial because of its theme featuring an adult man with a 12-year-old "]" (a term he was said to have coined). |
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* The television series '']'' covers the topic of pedophilia.{{Citation needed|date=December 2013}} |
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* '']'', starring ], chronicles the journey of a child molester towards understanding the impact of his actions. |
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* '']'' covers the topic of pedophilia and the misuse of medical terminology. |
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==See also== |
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* ] |
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*] |
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*] |
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* ] |
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* ] |
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* ] |
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* ] |
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* ] |
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* ] |
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* ] |
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==References== |
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{{Reflist|35em}} |
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==Further reading== |
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*]. "." ("] and the Mind of a Pedophile") '']''. September 24, 2012. |
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*Philby, Charlotte. "." '']''. Saturday August 8, 2009. |
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*Bleyer, Jennifer. "" '']''. Monday September 24, 2012. |
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*Fong, Diana. Editor: Nancy Isenson. "." '']''. May 29, 2013. |
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==External links== |
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{{Wiktionary|pedophilia}} |
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{{Commons|Pedophilia}} |
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* |
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*"" () |
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* |
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