Thursday, October 23, 2014

Pedophilia

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Pedophilia
Pedophilia or paedophilia is a psychiatric disorder in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children, generally age 11 years or younger. As a medical diagnosis, specific criteria for the disorder extends the cut-off point for prepubescence to age 13. 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.

Pedophilia has a range of definitions, as found in psychiatry, psychology, the vernacular, and law enforcement. The International Classification of Diseases (ICD) defines it as a "disorder of adult personality and behaviour" in which there is a sexual preference for children of prepubertal or early pubertal age. It is termed pedophilic disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and the manual defines it as a paraphilia in which adults or adolescents 16 years of age or older have intense and recurrent sexual urges towards and fantasies about prepubescent children that they have either acted on or which cause them distress or interpersonal difficulty.

In popular usage, the word pedophilia is often used to mean any sexual interest in children or the act of child sexual abuse. For example, The American Heritage Stedman's Medical Dictionary states, "Pedophilia is the act or fantasy on the part of an adult of engaging in sexual activity with a child or children." This common use sometimes conflates the sexual interest in and sexual contact with pubescent or post-pubescent minors. Researchers recommend that these imprecise uses be avoided because although people who commit child sexual abuse sometimes exhibit the disorder, many child sexual abuse offenders do not meet the clinical diagnosis standards for pedophilia and these standards pertain to prepubescents.

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, and researchers assume available estimates under represent the true number of female pedophiles. No cure for pedophilia has been developed, but there are therapies that can reduce the incidence of a person committing child sexual abuse. In the United States, following Kansas v. Hendricks, sex offenders who are diagnosed with certain mental disorders, particularly pedophilia, can be subject to indefinite civil commitment, under various state laws (generically called SVP laws) and the federal Adam Walsh Child Protection and Safety Act of 2006. At present, the exact causes of pedophilia have not been conclusively established. Research suggests that pedophilia may be correlated with several different neurological abnormalities, and often co-exists with other personality disorders and psychological pathologies. In the contexts of forensic psychology and law enforcement, a variety of typologies have been suggested to categorize pedophiles according to behavior and motivations.

Pedophilia can sometimes be a taboo topic. But it's often in the headlines. What is pedophilia? Who are pedophiles? How is it treated by the medical community? Here are answers from sexologist Ray Blanchard, PhD, adjunct psychiatry professor at the University of Toronto.

What is a pedophile?
A pedophile is a person who has a sustained sexual orientation toward children, generally aged 13 or younger, Blanchard says.

Not all pedophiles are child molesters (or vice versa). "Child molesters are defined by their acts; pedophiles are defined by their desires," Blanchard says. "Some pedophiles refrain from sexually approaching any child for their entire lives." But it's not clear how common that is.

Does the medical community consider pedophilia to be a mental disorder?
Yes. The American Psychiatric Association (APA) has included pedophilia in its Diagnostic and Statistical Manual of Mental Disorderssince 1968.

In the DSM, which is updated periodically, pedophilia has been grouped with other paraphilias -- which the APA defines as "recurrent, intense sexually arousing fantasies, sexual urges, or behaviors that involve children, nonhuman subjects, or other non-consenting adults, or the suffering or humiliation of oneself or one's partner."

But the next edition of the DSM -- the DSM 5 -- may instead refer to "pedophilic disorder."
"[Pedophiles] would be diagnosed with pedophilic disorder either if their attractions toward children are causing them guilt, anxiety, alienation, or difficulty in pursuing other personal goals, or else if their urges cause them to approach children for sexual gratification in real life," Blanchard says.

Can pedophilia be treated?
Yes. Although most experts do not think a person's feelings of pedophilia are curable, therapy may help them manage those feelings and not act on them.

Some patients at high risk of committing sexual offenses may needmedications to reduce their sex drive, Blanchard says.

Are pedophiles only attracted to children?
Some pedophiles may be as attracted to adults as they are to children, but it's hard to know how common that is. That's because most pedophilia research is based on people who were arrested for sexual offenses against children, and they may tend to exaggerate their sexual interest in adults to seem more "normal," Blanchard says.

Is pedophilia more common among men or women?
Pedophilic disorder is far more common among men than women, Blanchard says.
Can pedophilia develop in an adult who had been attracted to adults?

That's very unlikely, although some people may become adults "before they become fully aware that their strongest sexual attractions are still toward children and not toward their peers," Blanchard says.

Are pedophiles typically attracted to children of the opposite sex, same sex, or is there no particular pattern?
Most pedophiles have a definite preference for one sex or the other. But it's tough to estimate the percentage of pedophiles who are heterosexual, bisexual, and homosexual in their attraction to children, Blanchard says.

What would you want people to know about the stereotypes about pedophiles?
"People do not choose to be attracted to children or adults any more than they choose to be attracted to males or females," Blanchard says. "If there is any choice in the situation, it is in how pedophiles manage their lives once they become fully aware of the direction of their sexual interests and the societal prohibitions against expressing them."

How do pedophiles typically deal with those feelings?
Some pedophiles embrace and try to justify their sexual orientation. Others recognize that the idea of approaching a child in real life is morally wrong; they can be frustrated, isolated, lonely, depressed, and anxious, Blanchard says.

"It seems conceivable that the stress of living with pedophilic disorder may lead to various secondary psychological problems," Blanchard says. "There are, however, some resilient individuals who manage to lead productive and successful lives, even though their sexuality remains a source of frustration."

If a man or woman has feelings that may be within the range of pedophilia -- even if they've never acted upon those feelings -- what should they do?
Get help. "People who are troubled by their sexual attraction to children should seek professional help rather than try to deal with this problem on their own," Blanchard says. He suggests starting with a family practitioner, although it may take several rounds of referrals. Or search for a sex therapist in your city.

Most areas of North America have mandatory reporting laws that override patient confidentiality. "These require the clinician to report instances of child sexual abuse (or probable imminent abuse) to designated authorities," Blanchard says.

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