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Pedophilia Often in Headlines, But Not in Research Labs 

Joan Arehart-Treichel; Clinical & Research News, May 19, 2006 
Volume 41, Number 10, page 37

Many researchers and research funding sources have been loath to have anything to do with pedophiles. This situation, however, may be changing now that Americans are pressuring elected officials to safe-guard children from sexual molestation.

Whether it is media reports about the Catholic priest pedophile scandal; child molester Joseph Edward Duncan III; or Richard Allen Davis, who abducted, then killed 12-year-old Polly Klaas, one gets the impression that pedophilia is a pervasive and pernicious problem in the United States.

And while there are no hard epidemiologic data to confirm this perception, pedophilia experts tend to agree that the assumption reflects reality. 

"Pedophilia is endemic in our society and affects not only the afflicted individual, but many, many others in the community as well," Fred Berlin, M.D., a Johns Hopkins University associate professor of psychiatry and a leading authority on pedophilia, told
Psychiatric News. 

"If you had a child who had been molested, you would certainly say that it is a significant problem," Howard Zonana, M.D., told Psychiatric News. Zonana, a Yale University professor of psychiatry,
chaired APA's Task Force on Sexual Offenders a few years ago.

"We are seeing a huge increase in arrests for possession of child pornography over the Internet or for solicitation and enticement of children over the Internet," Richard Krueger, M.D., medical director
of New York State Psychiatric Institute's sexual behavior clinic, attested.

Nonetheless, the causes of pedophilia, which DSM-IV defines as "recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child," are elusive. 

"Certain individuals who have suffered insults to their brain engage in pedophilic behaviors," said Fabian Saleh, M.D., an assistant professor of psychiatry at the University of Massachusetts and
director of research at the National Institute for the Study, Prevention, and Treatment of Sexual Trauma. 
"There, you can say the injury caused pedophilia in that individual... But if we take all the individuals with pedophilia, and we wanted to look for a cause, we would have to say that, in most cases, it is unknown." 

One reason that more is not known about the origins of pedophilia is that many American researchers have been loath to have anything to do with pedophiles. The same for American research funding agencies.

In Krueger's opinion, 

"The primary rate-limiting factor has been lack of government or private funding for research in this area." 

Still, during the past few years some intrepid American
investigators have attempted to better understand the disorder and to identify factors that might set the stage for it. So have some Canadian scientists. 

Both groups have come up with some valuable discoveries. Among them: 

Pedophiles' sexual interests vary. 

Although all pedophiles have a sexual interest in children, their specific sexual interests vary considerably. For example, some are attracted to boys, others to girls, and others to both. Some are sexually drawn to adults as well as children. Some molest children only outside their families,
others only within their families, and yet others both within and without. These findings come from Gene Abel, M.D., medical director of the Behavioral Medicine Institute of Atlanta. 

Sex drive and arousal may vary. 

What may come as a surprise to many people, 

"there is no difference in sex drive between a person with pedophilia and a person with normal sexual interest," J. Paul Fedoroff, M.D., co-director of the sexual behaviors clinic at the Royal Ottawa Hospital 
in Canada, attested. "I have seen people with very high sex drives who have perfectly normal sexual interest, and I have also seen people with pedophilia 
who have extremely low sex drives." 

One study suggests that pedophiles are easily aroused sexually. Igor Galynker, M.D., Ph.D., associate chair of psychiatry at Beth Israel Medical Center in New York City, along with Lisa Cohen, Ph.D., an associate professor of clinical psychiatry there, exposed male pedophiles attracted to girls aged 13 or younger, as well as control subjects, to three tapes. One contained neutral words, a second
described a sexual encounter between a man and a woman, and a third related a sexual encounter between a man and an 8-year-old girl. The pedophiles were found to experience much higher sexual arousal to all three tapes than did the controls, but especially to the tape with the girl. 

Distorted thinking is frequent. 

Pedophiles often have schizotypal personality disorder -- that is, a way of distorting reality, Galynker and Cohen have found in their studies.  

"And that is interesting," Cohen told Psychiatric News, "because one of the things that pedophiles are known for is rationalizing what they do with children. For instance, they might say, `I'm not abusing children; they need to know about sex,' or `I didn't molest her; she seduced me.' " 

Some are sociopaths, others not. 

In addition to having a high rate of schizotypal personality disorder, pedophiles have a high rate of antisocial personality disorder, Galynker and Cohen's studies show. But not all pedophiles are sociopaths. Two pedophiles with whom Galynker dealt a few years ago underscore this 

One was admitted to Galynker's psychiatric unit following a child pornography arrest. The pornography that the patient had enjoyed was so obscene, Galynker reported, that it literally made his defense lawyer sick to her stomach. 

"He turned out to be a sociopathic liar," Galynker said. 

The other patient, in contrast, came to see Galynker because, 
as Galynker pointed out, he 

"felt himself attracted to children and was very upset about it." 

Pedophiles Often Victims. 

On the basis of his research over the years, Abel has found that some 30 percent of pedophiles were sexually abused themselves as children. In their studies, Galynker and Cohen have come up with an even higher percentage -- 60 percent--versus only 4 percent of controls. Also, Cohen pointed out, 

"Of those who had been sexually abused as children, 30 percent reported having been sexually abused by women, which was interesting."

Age divide between being molested and molesting is thin. 

Although most people would probably guess that the average age of child molesters in the United States is around 25 or 30 years, it is actually 13, Abel told Psychiatric News. Thus, many pedophiles, it appears, were first sexually molested as children, then embarked on their own child-molestation careers as soon as they became adolescents. 

Some Progress Being Made 

Just as societal aversion to pedophilia has slowed efforts to
understand the condition, so has it retarded efforts to find
effective treatments for it. Still, some progress toward this end has been achieved.

The most robust data are for agents that lower sex hormones, Saleh reported. 

"There is a lot of data going back to the beginning of the last century showing that castration or lowering sex hormones in pedophilia decreases sexual offending behavior, decreases their urges, and decreases their sexual thoughts and fantasies." 

"With cognitive behavioral therapy, it is hard to do long-term studies," Zonana said. "But some studies show that pedophiles in treatment seem to have a lower recidivism rate than those who are not."  

Nonetheless, cognitive-behavioral therapy works only with pedophiles who "understand that having pedophilia urges is inappropriate," Saleh pointed out.

Some progress on how to approach pedophilia treatment has also been made during the past decade or so, Berlin reported. 

"We now see pedophilia as a chronic behavioral disorder, a craving disorder, similar to drug addiction and alcoholism, and recognize that,
although we can successfully treat it, we cannot cure it, and part of the successful treatment is to help these folks make the necessary changes in lifestyle so that they are not putting themselves in a situation of temptation they may not be able to handle." 

Yet more insights into pedophilia and better treatments for it may well emerge during the next five or 10 years, especially as the American public is increasingly pressuring elected officials to protect children from pedophiles.

For instance, Saleh and Berlin have found that endogenous opiates are released in the human brain during sexual arousal. They would like to investigate whether pedophiles produce an abnormally large number of these opiates, and if so, whether that might be related to their sexual fantasies, arousal, or behavior. 

"I think we will have a confirmation of something we already know, which is that there is almost certainly more than one type of pedophilia and therefore more than one cause," Fedoroff predicted. "We know, for example, that, of incest offenders who sexually
assault children, probably about a third of them have pedophilic tendencies. Most don't. So clearly, incestuous pedophiles are acting on the basis of something quite different from non-incestuous

Prevention Not Unrealistic Goal

Some tools to prevent pedophilia may even become available during the next decade or so.

Abel and his coworkers are in their second year of testing a
screening tool to identify adults who are at high risk of molesting children. The test takes about half an hour and can be used with both men and women. Also, since the average age of child molesters in the United States is 13 years, helping families identify adolescents who have fantasies about sexually molesting children might help keep those adolescents from acting on their fantasies, Abel believes. 

Fedoroff and his colleagues recently applied for a grant to use a new branch of mathematics called chaos theory to find better ways of identifying pedophiles who are going to reoffend. 

"What we'd like to do," Fedoroff explained, "is look at large numbers and pick out the instances that don't fit the pattern, which in a way is the way that sexual offenders tend to present." 

Also, if treatment were offered to pedophiles before they commit offenses, it could help prevent such offenses, Federoff believes. 

"I think the way to do that is to publicize that there are effective treatments." 

But would such advertising really bear fruit? 

"Huge numbers of people are being arrested for possession of child pornography," Fedoroff replied. 
Many of these individuals, he said, are pedophiles who have not yet victimized children, and many, he is convinced, do not want to be sexual criminals. So if they are given the option of treatment, "maybe they will take it," he said. 

And if they take it, he added, chances are good that they can be helped. 

"People who come into our pedophile treatment program say it actually changes their lives."

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