Norbert Konrad; Justus Welke; Annette Opitz-Welke

Disclosures

Curr Opin Psychiatry. 2015;28(6):440-444. 

In This Article

Paedophilia

From what we know today, paedophilia affects around 1% of the male population. Nevertheless, paedophilia is the paraphilia that gets virtually all media coverage, although human sexual interest can become fixated on a wide variety of targets.[17] After a century of broad clinical discussion about paraphilia in the western world, only paedophilia is to be excluded from the 'fun-and games, plug and play laundry list of healthy kink interests'.[18] Hence, it is not surprising that most research on the prevalence of paedophilia involves samples of individuals in forensic settings. As a result, almost nothing is known about ways of living with that sexual interest without causing harm.[17]

The DSM-5 diagnostic criteria for paedophilia and paedophilic disorder have been criticized by numerous experts for a variety of reasons. There has been a controversial discussion about the fact that no diagnostic category for individuals with a preference for pubertal adolescents – so-called hebephilia – was created.[19] Criticism has also been expressed that according to DSM-5, paedophilia is the only paraphilic disorder without an 'in remission' and an 'in controlled environment' specifier.[20] The latter is noteworthy because recent research has challenged the assumption that paedophilic interest is unchangeable,[20] and scientific evidence on the immutability of paedophilic disorder is lacking.[5]

Some results of neuropsychological research and neuroimaging provide evidence of brain abnormalities in individuals with paedophilia.[21] Nevertheless, functional neuroimaging has been able to support neither the association of paedophilic behaviour with frontal lobe disorder,[22] nor the hypothesis that paedophilic individuals show deficits in cognitive or perceptual categorization of sexual stimuli.[21]

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