antisocial personality disorder may be consid ered a risk factor for pedophilic disorder in
males with pedophilia. 
Environmental. Adult males with pedophilia often repo rt that they were sexually abused
as children. It is unclear, however, whether this correlation reflects a causal influence of
childhood sexual abuse on adult pedophilia.
Genetic and physiological. Since pedophilia is a necessary condition for pedophilic dis-
order, any factor that increase s the probability of pedophilia al so increases the risk of pe-
dophilic disorder. There is some  evidence that neurodevelopme ntal perturbation in utero
increases the probability of develo pment of a pedoph ilic interest.
Gender-Related Diagnostic Issues
Psychophysiological laboratory measures of sexu al interest, which are sometimes useful in di-
agnosing pedophilic disorder in males, are not necessarily useful in diagnosing this disorder in
females, even when an identical procedure (e.g., viewing time) or anal ogous procedures (e.g.,
penile plethysmography and vaginal photoplethysmography) are available.
Diagnostic Markers
Psychophysiological measures of sexual interest  may sometimes be useful when an indi-
vidual’s history suggests the possible presence  of pedophilic disorder but the individual
denies strong or preferential  attraction to children. The most thoroughly researched and
longest used of such measures is penile plethysmography, although the sensitivity and spec-
ificity of diagnosis may vary from one site to another. Viewing time,  using photographs of
nude or minimally clothed person s as visual stimuli, is also used to diagnose pedophilic
disorder, especially in combination with self-report measures. Mental health professionals
in the United States, however, should be aware that possession of such visual stimuli, even