Pedophilia is defined as an ongoing sexual attraction to pre-pubertal children.
Pedophilia is considered a paraphilia, a condition in which a person's sexual arousal and gratification depend on fantasizing about and engaging in sexual behavior that is
Pedophilia is defined as an ongoing sexual attraction to pre-pubertal children.
Pedophilia is considered a paraphilia, a condition in which a person's sexual arousal and gratification depend on fantasizing about and engaging in sexual behavior that is atypical and extreme. Pedophilia is defined as the fantasy or act of sexual activity with children who are generally age 13 years or younger. Pedophiles are usually men and can be attracted to either or both sexes. How well they relate to adults of the opposite sex varies.
Pedophilic disorder can be diagnosed in people who are willing to disclose this paraphilia as well as in people who deny any sexual attraction to children, despite objective evidence of pedophilia. For the condition to be diagnosed, an individual must either act on their sexual urges or experience significant distress as a result of their urges or fantasies. Without these two criteria, a person may have a pedophilic sexual orientation but not pedophilic disorder.
The prevalence of pedophilic disorder is unknown, but the highest possible prevalence in the male population is approximately three to five percent. The prevalence in the female population is thought to be a small fraction of the prevalence in males.
An estimated 20 percent of American children have been sexually molested, making pedophilia a common paraphilia. Offenders are usually family friends or relatives. Types of activities vary and may include just looking at a child or undressing and touching a child. However, acts often do involve oral sex or touching of genitals of the child or offender. Studies suggest that children who feel uncared for or lonely may be at higher risk for sexual abuse.
For pedophilic disorder to be diagnosed, the following criteria must be met:
Additionally, a diagnosis of pedophilic disorder should specify whether the individual is exclusively attracted to children or not, the gender that the individual is attracted to, and whether the sexual urges are limited to incest.
There are a number of difficulties with the diagnosis of pedophilia. People who have this condition rarely seek help voluntarily—counseling and treatment are often the result of a court order. Interviews, surveillance, or internet records obtained through a criminal investigation can be helpful evidence in diagnosing the disorder. Extensive use of child pornography is a useful diagnostic indicator of pedophilic disorder. Additionally, genital sexual arousal can be measured in a laboratory setting through sexual stimuli and is based on the relative change in penile response.
Paraphilias as a group have a high rate of comorbidity with one another and an equally high rate of comorbidity with anxiety, major depression or mood disorders, and substance abuse disorders.
The causes of pedophilia (and other paraphilias) are not known. There is some evidence that pedophilia may run in families, 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 or pedophilia. A history of childhood sexual abuse is also a potential factor in the development of pedophilias but this, too, has not been proven.
Behavioral learning models suggest that a child who is the victim or observer of inappropriate sexual behaviors learns to imitate and is later reinforced for these same behaviors. These individuals are deprived of normal social and sexual contacts and thus seek gratification through less socially acceptable means. Physiological models focus on the relationship between hormones, behavior, and the central nervous system with a particular interest in the role of aggression and male sexual hormones.
Individuals may become aware of their sexual interest in children around the time of puberty. Pedophilia may be a lifelong condition, but pedophilic disorder includes elements that may change over time (distress, psychosocial impairment, tendency to act on urges).
Medications may be used in conjunction with psychotherapy to treat pedophilic disorder. Such medications include antiandrogens to lower sex drive, medroxyprogesterone acetate (Provera) and leuprolide acetate (Lupron). Selective serotonin reuptake inhibitors (SSRIs) may be prescribed to treat associated compulsive sexual disorders and/or to gain benefit from libido-lowering sexual side effects. Higher doses than are typically administered for depression are usually used. These include sertraline (Zoloft), fluoxetine (Prozac), fluvoxamine (Luvox), citalopram (Celexa), and paroxetine (Paxil).
Intensity of sex drive is not consistently related to the behavior of paraphiliacs and high levels of circulating testosterone do not predispose a male to paraphilias. Hormones such as medroxyprogesterone acetate and cyproterone acetate decrease the level of circulating testosterone, thereby reducing sex drive and aggression. These hormones reduce the frequency of erections, sexual fantasies, and initiation of sexual behaviors, including masturbation and intercourse. Hormones are typically used in tandem with behavioral and cognitive treatments. Antidepressants such as fluoxetine have also successfully decreased sex drive but have not effectively targeted sexual fan