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Abstract

The stigmatization of people with pedophilic sexual interests is a topic of growing academic and professional consideration, owing to its potential role in moderating pedophiles’ emotional well-being, and motivation and engagement in child abuse prevention schemes. Thus, improving attitudes and reducing stigmatization toward this group is of paramount importance. 

Prior research has suggested that narrative humanization — presenting personal stories of self-identified non-offending pedophiles — could be one route to doing this. However, this work has only been conducted with students or trainee psychotherapists, meaning the public generalizability of this method is still unknown. 

In this study, we compared two stigma interventions to test whether narratives reduce stigma toward people with pedophilic interests more effectively than an informative alternative (scientific information about pedophilia). 

Using a longitudinal experimental design with a lack of non-intervention control (initial N = 950; final N = 539), we found that 

• narratives had consistently positive effects on all measured aspects of stigmatization (dangerousness, intentionality), whereas 
• an informative alternative had mixed results, and actually increased perceptions of pedophiles’ levels of deviance. 

These effects were still present four months after the initial presentation. 

We discuss these data in relation to ongoing debates about treating pedophilia as a public health issue requiring a broad societal approach to well-being and child abuse prevention.

Introduction

Many researchers have begun to explore sexual interests in children via sexual abuse prevention and well-being perspectives 

• (see Elchuk et al., 2021; Lievesley & Harper, 2021; Lievesley et al., 2020; Seto, 2018). 

However, there is an acknowledgement within the literature that the effective treatment
of individuals with such sexual interests is contingent on the availability of suitable services, the willingness of professionals to work with this client group, and the client
group feeling comfortable in seeking support that is made available 

• (Grady et al., 2019; Jahnke, 2018a, 2018b; Levenson & Grady, 2019; Lievesley & Harper, 2021). 

As such, finding methods of effective stigma reduction is becoming an important topic of study in relation to this client group 

• (Harper et al., 2018; Jahnke, 2018a, 2018b). 

In this paper, we ask whether previously observed effects of narrative humanization — the process by which stigma toward people with pedophilic sexual interests is reduced by presenting personal stories from the perspective of people within this community — 
are observable at scale within a large community sample, and whether they are persistent over time.

Defining pedophilia

Pedophilia is defined as a persistent and recurrent sexual interest in prepubertal children 

• (Finkelhor, 1984; Schmidt et al., 2013; Seto, 2018). 

In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) further defines pedophilic disorder as a persistent sexual interest in prepubescent children, which manifests itself in thoughts, fantasies, urges, sexual arousal, or sexual behavior, and is accompanied by either 
acting on or experiencing distress because of this interest. 

Pedophilia is not synonymous with sexual offending against children, though it is often conflated with child sexual abuse in popular and academic discourses (Feelgood & Hoyer, 2008). 
Seto (2018) emphasized that most men who sexually abuse children are not pedophiles, nor do all pedophiles sexually abuse children. Empirically, among child sexual abusers
across multiple assessment approaches, a subgroup of between 20 and 50% can be classified as pedophilic (Schmidt et al., 2013).
[... ... ...]

Stigmatization of pedophilia

A number of researchers have recently begun to study the social stigmatization of people with sexual interests in minors. 
For example, a series of studies have examined how stigmatization of this population is reflected in 

• (cognitively oriented) perceptions of the controllability and willful choice over having pedophilic sexual interests (Imhoff, 2015; Imhoff & Jahnke, 2018; Jahnke, 2018a, 2018b), and 
• attributions of psychopathic or predatory offending behavior (Jahnke et al., 2015a, 2015b, 2015c). 

Stigmatizing attitudes may be related to the popular conflation between pedophilia 
and child sexual abuse (Feelgood & Hoyer, 2008; Harrison et al., 2010).
[... ... ...]

At the core of the stigmatization of people with pedophilic sexual interests may be mental processes related to dehumanization. A number of research teams have examined
dehumanization within the context of media representations of sexual crime, which is often dominated by offenses committed against children and subsequently conflated
with “pedophilia” (Feelgood & Hoyer, 2008).

For example, Harper and Hogue (2015, 2017) reported how tabloid readers express more negative attitudes toward people convicted of sexual offenders than do broadsheet readers. However, the only differences in how these types of newspaper reported
on sexual crime was in the headlines. 

• Tabloids were more overtly hostile and dehumanizing in their descriptors of those convicted of sexual crimes (e.g., “beast,” “monster,” and “fiend”), whereas 
• broadsheets were more descriptive, typically using the crime type or the perpetrators’ prior occupations.

In addition to this work, Viki et al. (2012) reported how the dehumanization of people convicted of sexual offenses 

• by the public is associated with lower levels of support for rehabilitation and reintegration, and higher levels of support for punitive public policy. 
• Within the professional context, dehumanization by clinicians was associated with lower ratings of therapeutic alliance, which is in turn predictive of worse therapeutic outcomes (Beech & Hamilton-Giachritsis, 2005).

The Importance of Addressing Stigmatization

It is not only in social attitudes, public policy, and treatment settings that the stigmatization of people with pedophilic sexual interests has negative effects. According to Jahnke et al. (2015a, 2015b, 2015c), pedophiles may self-stigmatize, with this having profound effects on well-being. [... ... ...]

From a well-being perspective, people with sexual interests in children have reported  that professionals working with them appear to focus more on risk reduction (e.g., controlling sexual urges), despite them preferring to be supported in relation to the more general psychological well-being issues mentioned above (B4U-ACT, 2011; Blagden et al., 2018). 

This in turn leads many people with pedophilic sexual interests to be unwilling to come forward to access mental health support because of doubts over whether those professionals offering such services will act in non-judgmental ways 

• (B4U-ACT, 2011; Jahnke, 2018a; Levenson & Grady, 2019). 

Indeed, evidence suggests that the stigma experienced by those who have a dominant sexual interest in children impairs help-seeking behaviors due to both perceived and anticipated rejection 

• (Goode, 2010; Grady et al., 2019; Levenson & Grady, 2019).

Instead, these individuals may seek out a range of online fora (e.g., Virtuous Pedophiles and B4U-ACT ) wherein they can communicate with and be supported by other non-offending people with pedophilic interests in a safe environment. [... ...]

Existing Methods of Stigma Reduction

[...] Prejudice and stigma reduction interventions appear to fall into three main theoretical groupings.

[1] The largest of these is rooted in the contact hypothesis [...], which proposes that prejudices can be reduced by exposing individuals to positive encounters to representative examples of out-groups.
In contemporary research, such interventions are typically based on secondhand or imagined contact [...] This involves the presentation of written or video vignettes that depict a member of an out-group, with these designed to mentally bring about the impression of a positive encounter. Prejudice is thus reduced in these studies through positive emotional responses to outgroup members.

[2] The second cluster of stigma reduction interventions focus on cognitive and emotional understanding of out-groups. This method may be thought of as a traditional 
psychoeducation approach, wherein stereotypes are directly challenged by the presentation of information about an outgroup, its characteristics, and its experiences [...].

[3] The final cluster of stigma reduction interventions relate to social categorization. Instead of challenging stereotypes or emotional responses to an out-group, this third type of intervention challenges the very classification of people as an “out-group” at all [...]. They do this in one of two different ways.

[3a] The first stresses the overlaps between a perceiver (typically a study participant) and an ostensible out-group (attempting to bring the out-group into the sphere of the in-group; e.g., Hall et al., 2009).

[3b] The second approach asks study participants to consider the diversity of thought and experience within an out-group (attempting to break down the homogeneous view
of a collective out-group; e.g., Brauer & Er-Rafiy, 2011).

The effectiveness of each type of prejudice and stigma reduction intervention appears to be relatively similar, with changes in stigma that typically correspond to a Cohen’s d
effect size of between 0.35 and 0.40 [...] These are not small effects, but their relatively modest size may offer an explanation as to why any observed changes in stigma tend to be limited to the study population, to the laboratory setting, or to the immediate time frame of the intervention study [...]. 
That is, the standard effect size reported in much of the meta-analytic existing work on stigma and prejudice reduction reflect “light touch interventions, the long-term impact of which remains unclear” [...].

Nonetheless, the evidence appears to suggest that the largest changes in stigma and prejudicial attitudes stem from interventions that involve personal contact with members of out-groups [...] 
This has implications for the current study, which adopts the narrative humanization design described in Harper et al. (2018).

Narrative humanization can be defined as the process by which (typically, media-driven) stereotypes about a particular social group can be broken down and replaced with more accurate messages by presenting personal stories from people who form a part of the social group under consideration. [...] 

Narrative humanization in this context combines indirect contact (via the presentation of first-person stories) with an individual with pedophilic sexual interests with an informative psychoeducation angle through a discussion of both the unchosen nature of pedophilic sexual interests and the barriers to support services. 
As such, we believe that this approach has the potential to offer both immediate and longer-lasting attitude change when considering public views about people with pedophilic sexual interests. 

The present study 

Owing to the widespread social condemnation and hostility directed toward people with pedophilic sexual interests, but the potential of mental health and abuse prevention schemes for reducing risk factors associated with sexual offending, it is important to establish methods to bring about changes in the responses of the general public toward this group in order to encourage people with such interests to seek help before committing a sexual offense. 

Previous studies have demonstrated how narrative humanization can improve the
views of students [...] and clinical professionals [...] by reversing the processes of dehumanization described previously. [...]

 However, these participant groups may be naturally more receptive to progressive
information about people with pedophilic sexual interests and the improvement of their treatment within society (possibly due to higher levels of openness, liberalism,  professional experience, or general education [...]. 

As such, this prior work may not reflect how this type of information presentation would be received in the general lay population. Further, no studies have examined how we 
might improve public attitudes toward people with pedophilic sexual interests using large samples or longitudinal designs. 
This is the gap in the literature that we fill with the present study.

We replicated the procedure used by Harper et al. (2018) with two key alterations. 

[1] In the first deviation from this original work, we used a large public sample with an equal sex split (as compared to student participants with a heavy female skew). 

[2] Second, we deviated from the single testing procedure to incorporate a follow-up survey after a period of four months to establish whether any effects held beyond the initial testing time point. 

These adaptations allowed us to overcome the limitations of existing stigma reduction 
research in relation to pedophilia, as well as adhering to good practice within the broader field of prejudice reduction [...].

We hypothesized that both types of presentation (humanization and scientific information) would lead to reductions in negative evaluations (related to dangerousness, the perception that pedophilia is a choice, and ascriptions of deviance) and punitiveness toward pedophiles at the policy level (Hypothesis 1a). 

However, we predicted that these reductions would be greater in the narrative humanization condition (Hypothesis 1b). 

If these interventions do work in the ways previously reported, we might also expect that
participants assigned to the narrative humanization video would demonstrate less negative implicit associations about pedophilia than those assigned to watch the expert-delivered scientific information (Hypothesis 2). 

Due to the exploratory nature of the follow-up survey, we did not make any specific predictions about whether the initial effects would still be present after four months.

Method

Participants [... ... ...] [Table 1]

Attitudes to Sex Offenders Scale [... ... ...]  
Masures [... ... ...]
- Demographics [... ... ...]
- Stigma and Punitive Attitudes Scale (SPS) [... ... ...] [Table 2] 
Video mamipulation [... ... ...]
Untreported questions [... ... ...]
Procedure [... ... ...]
Planned analysis [... ... ...]

Results

[... ... ... Table 3 ... ... ... Figure 1 ... ... ...]

To summarize the key findings, we find similar immediate reductions in stigma, followed by gradual increases during the four-month follow-up period, in relation to perceptions of dangerousness and punitive attitudes, respectively. 
For intentionality (perceptions of choice over pedophilic sexual interests), although both presentations led to immediate reductions in stigma, the effect was larger for those in the
informative condition. 
However, there was a significant difference in stigma change during the follow-up period, with a significant rebound effect being observed among those in the informative condition, but not the narrative condition. 
In relation to perceptions of deviance (the view that pedophilia is pathological and in need of treatment), there was a significant difference in stigma change between the two conditions, with stigma increasing in the informative condition, and reducing in the narrative condition. 
There was also a significant difference in rebound effects for deviance perceptions, with
scores in the informative condition returning to baseline, and reductions remaining stable among those presented with the narrative stimulus.

Discussion

In this study, we sought to replicate the findings of Harper et al. (2018) by testing the effects of [a] first-person narrative humanization and [b] expert-delivered informative presentations of evidence on public attitudes toward people with pedophilic
sexual interests. 

Consistent with this earlier work, we found that dangerousness perceptions and punitive attitudes toward pedophiles significantly reduced following the presentation of a video. Extending prior work, these significant effects were still present (though to a lesser degree) after four months. The persistence of these attitudinal improvements is consistent with data reported by Jahnke et al. (2015a, 2015b, 2015c), who found that narrative-based presentations led to long-term reductions in stigmatization among German psychotherapists in training.

Inconsistent with Harper et al. (2018), there was no significant difference in these effects between the two experimental conditions, suggesting that both narrative and informative presentations are equally effective in reducing perceptions of pedophiles’ dangerousness, and punitive attitudes toward them. 

Where our data further deviated from Harper et al. (2018) related to [1] intentionality and [2] deviance judgments. 

[1] In terms of intentionality (i.e., the view that pedophilic sexual interests are a choice on the part of the individual experiencing them), we found that while both conditions reduced such attitudes (both immediately and at the end of the four-month followup), these effects were much more volatile in the informative condition. 

That is, while 
[a] the narrative presentation slightly decreased these views immediately (and this effect endured over the follow-up period), 
[b] the informative presentation led to a larger immediate reduction in intentionality judgments, followed by a significant increase in them during the follow-up. 

[2] With regard to deviance judgments, we also saw diverging trends between the conditions. While 
[a] the narrative presentation reduced these views immediately (and this effect endured throughout the follow-up), 
[b] the informative condition led to an immediate increase in deviance judgments, followed by a subsequent decrease to bring these attitudes back to their baseline level. 

These data are generally consistent (though with some minor deviations) with Hypothesis 1a [*], but not with Hypothesis 1b [**]. We observed no effect of our experimental manipulation on implicit valence associations with the “pedophile” label, which was not consistent with Hypothesis 2 [***].

[As stated here above:

• [*] = that both types of presentation (humanization and scientific information) would lead to reductions in negative evaluations (related to dangerousness, the perception that pedophilia is a choice, and ascriptions of deviance) and punitiveness toward pedophiles at the policy level.
• [**] = that these reductions would be greater in the narrative humanization condition.
• [***] = that participants assigned to the narrative humanization video would demonstrate less negative implicit associations about pedophilia than those assigned to watch the expert-delivered scientific information.]

Interpretation of Findings

How Does Narrative Humanization Work?

As indicated in the introduction to this paper, the stigmatization of people with pedophilic sexual interests may be based in processes related to dehumanization. That is, media representations of the perpetrators of child sexual abuse (and, by extension, “pedophiles,” such is the language used by many media outlets [...] are accompanied by descriptors that depict them as monstrous and predatory. 

In doing so, media outlets create a dichotomy of “us” (non-pedophiles) vs. “them” (pedophiles), wherein there are differences in the core moral characters, personality traits, and behavioral dispositions between the two groups. 

This leads to a sense of moral outrage related to pedophiles’ sexual interests in children and the behavioral connotations that are linked to these interests, which is characterized by feelings of fear, hatred, loathing, and disgust [...] 
These feelings make it much easier for those experiencing them to sanction retributive
and punitive policies, such as preventative incarceration and lay suggestions for mandated chemical castration [...].

What these presentations do is remove the sense of humanity from people with pedophilic sexual interests and reduces them to these interests and the associated behavioral implications. 

A narrative presentation reverses this process by presenting these individuals as people with sexual interests in children, rather than media-constructed predators driven
by them. 

There is a substantial body of social psychological literature suggesting that being able to take the perspective of particular [groups of] individuals can decrease levels of stigmatization toward these groups [...].

Taking the perspective of another individual is an important skill that places the perceiver “in the shoes” of those they are judging. In relation to pedophilia, there are some moves to see this form of sexual attraction as a sexual orientation (Seto, 2012). 
By humanizing those individuals as struggling with such preferences, perceivers may be able to identify with them on a range of indices (e.g., sexual interest choice, and control of sexual behavior) by comparing these issues with their own experience of having a non-pedophilic sexual orientation that they themselves did not choose. At its core, processes of humanization instigate this type of perspective taking and interpersonal identification. 

Pedophiles as “Doomed to Deviance” by Informative Presentations?

Possibly the most interesting and important finding in the present dataset is that related to the different effects of narrative and informative presentations on deviance judgments
made about people with pedophilic sexual interests. While 

• the narrative presentation had the expected positive effects on such ascriptions, 
• the informative video had an immediate negative effect (i.e., perceptions of deviance increased), before this effect subsiding through the follow-up period.

One possible explanation for this is that while 

• a narrative presentation allowed our participants to see other parts of the personality and behavior of the individual depicted in the experimental video, 
• the informative video stressed facts about pedophilic sexual interests from a medical perspective. In doing so, the biological medicalization of these interests [...] makes
  these interests appear fixed and unmalleable. [...]

We tentatively suggest that informative presentations about pedophilia may have negative effects on perceptions of the levels of deviance within this population. [...]
This medicalized view has the potential to produce an attitude in lay observers that people with pedophilic sexual interests are in some way “doomed to deviance” by an unchosen and unchangeable sexual interests. 

Promoting attributional shifts away from this fatalistic notion could bring about not only changes to social attitudes to people with pedophilic sexual interests and promote the
prevention of child sexual abuse, but also could have secondary effects in terms of lowering self-stigmatization in this population [...]. 
That is, this shift in attribution is not unlike the self-narrative changes in the desistance literature where people with convictions construed new selves as “good people who have done bad things” rather than “bad people who do bad things” [...]

In light of the existing literature on the stigmatization of people with pedophilic interests [...], there is a risk that even this well-meaning scientific communication could translate
into internalized stigma, with people with pedophilic sexual interests either taking on this “doomed to deviance” script, or enhancing the feeling that professionals are likely to view them through the lens of their sexual interests first, and not address broader treatment needs (B4U-ACT, 2011). 
A subsequent risk in this process is that people with pedophilic sexual interests avoid experiencing this stigma and decline to access the mental health support that they may require. [...]

Different Approaches, But Similar Effects?

[...] For intentionality judgments (i.e., whether pedophiles choose their sexual interests) we found interesting effects. Both presentations significantly reduced stigma, though informative presentations did so to a greater degree. 

However, there was a significant bounce-back effect in this condition that was not
observed after the narrative presentation, leading to comparative stigma changes at follow-up when compared to the initial baseline measurement. 
In relation to perceptions of pedophiles’ levels of deviance, the informative presentation 
initially increased stigma (to a small degree) before these perceptions returned to baseline after four months. However, the narrative presentation led to a significant reduction in deviance perceptions that was still present at the four-month
follow-up point (albeit to a reduced degree). 

What we see in these data are similar (small) effects for both types of presentation, but a more gradual return toward baseline attitudes in the narrative condition — particularly
in relation to perceptions of having control or choice over sexual interests. [...]

It is perhaps testament to the power of humanizing presentations that any significant effects (comparative to baseline views) were still present after four months following just a five-minute intervention. The effectiveness of such a narrative delivery may be rooted in how this method operates at a cognitive level. [...]
Haidt (2001) suggests that speaking to somebody’s intuitions, and then allowing them to rationalize their own subtle attitudinal shifts, represents a more effective route to long-term attitude change.
Humanizing presentations achieve this by not only presenting educational messages, but also by stressing the similarities between the participant and individuals with
pedophilic sexual interests. [...]

With the brief narrative intervention used in the present study resulting in lasting attitude change (again, albeit limited in effect), we might expect further repeated exposures to
such humanizing messaging to have more profound and lasting effects in a way that informative presentations may not.

More fundamentally, using narrative-based presentations is consistent with moves currently afoot within the sexological and forensic psychological research fields. That is, there is an emerging movement to adopt person-first language (see Willis, 2018) and to view individuals as whole identities, rather than being viewed purely on the basis of their sexual interests or offense histories. [...]

The narrative humanization approach potentially offers a more effective method to change attitudes in a profound and long-term manner, and is consistent with the philosophical direction of the field.

Possible Implications of Humanizing People with Pedophilic Sexual Interests

Although not directly related to the data at hand, a move toward first-person language and the humanization of people with pedophilic sexual interests is consistent with ongoing efforts to both treat and manage the emotional health of people with these sexual preferences, and also to prevent them from advancing on to acts of sexual abuse [...].
That is, by seeing people with such interests as individuals at different stages of their
journeys toward understanding and living with their sexual preferences, and creating services within which practitioners allow them to feel safe, it is possible to encourage active and open engagement with preventative support services [...]. 
As a subsequent effect of such engagement, these services afford the opportunity to work through treatment priorities that people with pedophilic sexual interests self-report as wanting to address, such as general mental health concerns (B4U-ACT, 2011).

Consistent with this, there have been some suggestions within the applied literature that a move toward therapies that are focused around principles of acceptance offer a 
promising means of engaging and helping those with pedophilic sexual interests [...]. Humanization is one step toward this, and we would urge future work to look at the effects of social humanization efforts on levels of well-being among people with pedophilic sexual interests, alongside related outcomes such as comfort with seeking support (if required or desired) and levels of engagement with treatment.

From Attitudes to Behavior?

One conclusion that we cannot draw from these data is that using humanizing (or informative) presentations of pedophilia as a stigma reduction technique leads to reductions in actual experiences of discrimination. Our data demonstrate that participants were somewhat more likely to express lower levels of stigma after being exposed to psychoeducational about pedophilia, or after hearing a narrative from somebody with sexual interests in children.
The nature of the outcomes (self-reported beliefs using the SPS; Imhoff, 2015) represent
cognitive and emotional facets of stigma. However, we know that stigmatization and discrimination are also expressed at the behavioral level [...]. Our data cannot
speak to this facet of stigmatization. [...]

It may be fruitful to explore whether changes in self-reported stigma translate into support for community-based prevention schemes (e.g., treatment units located in local areas, or differential contributions to charities with preventative vs. punitive aims).

Limitations and Future Directions

[... ... ... ... ...]

Conclusions

In this study, we replicated and extended previous work that found a significant positive effect of narrative humanization on attitudes and stigmatization of people with pedophilic sexual interests. 
We found that giving members of the lay public information of pedophilia — from both the perspective of somebody with such sexual interests and evidence delivered by an expert — had positive effects on perceptions of dangerousness, and the endorsement of punitive attitudes toward this group. 

However, on more nuanced indices of stigmatization— particularly perceptions of pedophiles’ deviance — only a narrative-driven presentation had consistently positive effects. 

We suggest that academics, activists, and policymakers might look to embed such narrative presentations about pedophilia when communicating about the important public health issue in a bid to improve the psychological well-being of people with pedophilic sexual interests and reduce the incidence of child sexual abuse.

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