Patterns of sexual arousal and history in a "normal" sample of young men

Peeping Wang: A Bird's Eye View on Video Voyeurism among Chinese Men Attracted to Men

Developments in technology and the Internet have made modern lives more convenient, yet they also created new mediums and means for sexual offending. Video voyeurism, for one, gained increasing research attention; however, most research focused on male-on-female perpetration, where heterosexual men take photos of female victims' private parts in public places without consent or acknowledgment (e.g., "up-skirting" and "down-blousing"). This study was the first to examine male-on-male video voyeurism in the Global South. Postings (N = 226) were collected from a large web forum dedicated to Chinese men attracted to men and its sub-section on non-consensual voyeuristic images. Neutralization theory was used to guide the data analyses. Preliminary findings suggested that 1) perpetrators obtained voyeuristic images largely through taking photos of strangers' private body parts in public restrooms; 2) perpetrators justified their behaviors most commonly by denial of victim, such as victim-shaming, victim-blaming, claiming that the victim "had fun," the illusion of domination, and objectification; 3) perpetrators also used metaphor of the ledger, by claiming relative inexperience or that they had become a different person since the perpetration.

"We Do Exist": The Experiences of Women Living with a Sexual Interest in Minors

The current body of the literature studying minor-attracted persons (MAPs) predominantly focuses on the experiences of men who experience sexual attractions to children. To shed more light on the experiences of women within this population, we conducted anonymous semi-structured interviews with six self-identified female MAPs, who were recruited through online support forums for individuals with sexual attractions to children. Interpretative phenomenological analysis (IPA) was used to analyze the interview transcripts. Two superordinate themes were identified from the dataset that highlighted the uniqueness of the experience of being a woman within the MAP community ("A minority within a minority") and themes of social isolation and the effects of this on identity ("A lonely secret existence"). The findings reported here highlight how the experiences of female MAPs both converge with and diverge from their male counterparts in important ways. We discuss the implications of these experiences in relation to more effective service provision for women who are sexually attracted to children.

Prevalence and correlates of individuals with sexual interest in children: A systematic review

BACKGROUND

Despite debates on what should constitute sexual interest in children in terms of definition and diagnostic criteria and its strong association with individuals who commit sexual offences against children, research in this area has shown that sexual interest in children is also commonly seen in the general population. Studies in this field have investigated its prevalence and its correlates. However, most research on this topic has focused on men and most particularly sex offender populations. When investigating the general population, again the vast majority of studies used male samples and students.

OBJECTIVE

This systematic review aimed to critically evaluate previous research on the prevalence of sexual interest in children across populations and to examine its correlates.

METHODS

A search of relevant databases was conducted as well as a hand search of selected journals to identify eligible papers. Studies meeting the inclusion criteria had their data extracted and were assessed for risk of bias, with a second rater to establish inter-rater reliability.

RESULTS

A total of 30 studies were reviewed and results indicated a mean prevalence rate of sexual interest in children between 2 %-24 %. Findings also indicated correlates such as the presence of mental health problems and adverse childhood experiences. Most studies showed poor external validity, with the majority of them scoring high on risk of bias.

CONCLUSION

Overall, the findings indicate inconsistencies in terms of methodology and definition/diagnostic criteria of sexual interest in children. Further research in this area using recommended methodology to avoid biases is recommended.

Preventing Child Sexual Abuse: Screening for Hidden Child Molesters Seeking Jobs in Organizations That Care for Children

Approximately 10% of children and adolescents are sexually abused by adults caring for them outside the home. The current study tested the validity and reliability of a child protection screen to identify job applicants who pose a sexual risk to children. The screen uses three separate measures. In combination, they attempt to identify two types of sexually problematic job applicants: hidden abusers and people with cognitive distortions that encourage child sexual boundary violations by themselves or tolerate them by others. The high specificity (97.8% for males and 98.7% for females) favored the high number of job applicants and volunteers who have not crossed sexual boundaries with children. The study included over 19,000 participants, and the screen correctly identified 77% of the men and over 72% of the women who posed a sexual risk. The test-retest correlation was statistically significant at r(121) = .83, and the screening methodology is valid and reliable. By identifying most of the job applicants who are hiding their history of sexually abusing a child or hiding their belief that adult-child sex causes no harm from the organizations they are attempting to join, this new preemployment screen methodology can help child-centered organizations protect children and adolescents in their care.

Psychiatric aspects of the assessment and treatment of sex offenders

Training in general and forensic psychiatry in the assessment and treatment of sex offenders is in need of considerable improvement. Although most sex offenders are not mentally ill, many are subject to substance misuse, abnormal personality traits, personality disorder, learning disability or dysphoric mood, and in some organic factors will be involved. Comprehensive assessment of sex offenders includes a full history and mental state evaluation, obtaining a collateral history from other sources, observation, psychometric testing, and psychophysiological methods of assessment, including penile plethysmography. Trials of the use of the polygraph are also under way. The treatment of sex offenders, especially those with paraphilias, may include medication with selective serotonin reuptake inhibitors or anti-libidinal agents. Ethical considerations can be problematic, but a balance can often be found between the welfare of the offender and the safety of the public.

Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11)

The World Health Organization is currently developing the 11th revision of the International Classifications of Diseases and Related Health Problems (ICD-11), with approval of the ICD-11 by the World Health Assembly anticipated in 2018. The Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH) was created and charged with reviewing and making recommendations for categories related to sexuality that are contained in the chapter of Mental and Behavioural Disorders in ICD-10 (World Health Organization 1992a). Among these categories was the ICD-10 grouping F65, Disorders of sexual preference, which describes conditions now widely referred to as Paraphilic Disorders. This article reviews the evidence base, rationale, and recommendations for the proposed revisions in this area for ICD-11 and compares them with DSM-5. The WGSDSH recommended that the grouping, Disorders of sexual preference, be renamed to Paraphilic Disorders and be limited to disorders that involve sexual arousal patterns that focus on non-consenting others or are associated with substantial distress or direct risk of injury or death. Consistent with this framework, the WGSDSH also recommended that the ICD-10 categories of Fetishism, Fetishistic Transvestism, and Sadomasochism be removed from the classification and new categories of Coercive Sexual Sadism Disorder, Frotteuristic Disorder, Other Paraphilic Disorder Involving Non-Consenting Individuals, and Other Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals be added. The WGSDSH's proposals for Paraphilic Disorders in ICD-11 are based on the WHO's role as a global public health agency and the ICD's function as a public health reporting tool.

Adults with Pedophilic Interests in the United States: Current Practices and Suggestions for Future Policy and Research

Adults with pedophilic interests are often viewed by the public as a homogenous subgroup based on what we know from those who sexually offend against children. The stigma associated with child sexual abuse may serve to deter such behaviors but may also interfere with the person's stability and willingness to seek assistance in managing pedophilic interests. This article contrasts the sex offender response and prevention efforts typically employed in the U.S. (i.e., containment, registration, and notification policies and public education programs) with treatment programs aimed at preventing child sexual abuse in Germany, Belgium, and Canada. Five major areas are identified that should be further examined with regard to implementing preventative outreach and treatment programs in the U.S.: barriers to outreach and treatment programs, how to expand or reframe current preventative educational programs, implementation of such programs in light of current mandating reporting policies, promising treatment approaches for pedophilic interests among non-offenders, and ethical concerns relevant to preventative psychological interventions.

Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations

In the World Health Organization's forthcoming eleventh revision of the International Classification of Diseases and Related Health Problems (ICD-11), substantial changes have been proposed to the ICD-10 classification of mental and behavioural disorders related to sexuality and gender identity. These concern the following ICD-10 disorder groupings: F52 Sexual dysfunctions, not caused by organic disorder or disease; F64 Gender identity disorders; F65 Disorders of sexual preference; and F66 Psychological and behavioural disorders associated with sexual development and orientation. Changes have been proposed based on advances in research and clinical practice, and major shifts in social attitudes and in relevant policies, laws, and human rights standards. This paper describes the main recommended changes, the rationale and evidence considered, and important differences from the DSM-5. An integrated classification of sexual dysfunctions has been proposed for a new chapter on Conditions Related to Sexual Health, overcoming the mind/body separation that is inherent in ICD-10. Gender identity disorders in ICD-10 have been reconceptualized as Gender incongruence, and also proposed to be moved to the new chapter on sexual health. The proposed classification of Paraphilic disorders distinguishes between conditions that are relevant to public health and clinical psychopathology and those that merely reflect private behaviour. ICD-10 categories related to sexual orientation have been recommended for deletion from the ICD-11.

How Common is Men's Self-Reported Sexual Interest in Prepubescent Children?

Consistent evidence exists for sexual interest in children in nonclinical/nonforensic male populations. However, prevalences for community men's self-reported sexual interest in children have been based on indiscriminate definitions including postpubescent individuals, age-restricted samples, and/or small convenience samples. The present research assessed men's self-reported sexual interest in children (including child prostitution and child sex tourism) on the community level and examined the link between strictly defined sexual fantasies and behaviors involving prepubescent children. In an online survey of 8,718 German men, 4.1% reported sexual fantasies involving prepubescent children, 3.2% reported sexual offending against prepubescent children, and 0.1% reported a pedophilic sexual preference. Sexual fantasies involving prepubescent children were positively related to sexual offending against prepubescent children. Sexual interest in children was associated with subjectively perceived need for therapeutic help. In contrast to findings from forensic samples, men who reported child pornography use exclusively were identified as a subgroup differing from contact sexual offenders against prepubescent children and men who reported both child pornography use and contact sexual offenses against prepubescent children. The empirical link between child-related sexual fantasies and sexual victimization of prepubescent children and high levels of subjective distress from this inclination underscore the importance of evidence-based child sexual abuse prevention approaches in the community. Findings are discussed in terms of their relation to pedophilic disorder.

Sexual interest in children among an online sample of men and women: prevalence and correlates

The purpose of the present study was to explore the extent to which men and women in the general population report sexual interest in children and to examine distinct developmental experiences associated with self-reported sexual interest. Participants (262 females and 173 males) were recruited online and completed a questionnaire assessing sexual interest and adverse childhood experiences. Among men, 6% indicated some likelihood of having sex with a child if they were guaranteed they would not be caught or punished, as did 2% of women. Nine percent of males and 3% of females indicated some likelihood of viewing child pornography on the Internet. Overall, nearly 10% of males and 4% of females reported some likelihood of having sex with children or viewing child pornography. Males and females with any sexual interest in children reported higher likelihoods of engaging in other antisocial or criminal behaviors and also reported more dysfunctional childhoods (i.e., histories of sexual abuse, insecure parent-child attachments). Theoretical implications of the findings and suggestions for preventing the sexual victimization of children are provided.

The Function of Sexual Fantasies for Sexual Offenders: A Preliminary Model

Although the content of sexual fantasy has been extensively researched, very little contemporary research has investigated the function of sexual fantasy within the context of offending. In this study, a qualitative analysis was used to develop a descriptive model of the phenomena of sexual fantasy during the offence process. Twenty-four adult males convicted of sexual offences provided detailed retrospective descriptions of their thoughts, emotions and behaviours before, during and after their offences. A data-driven approach to model development (grounded theory) was undertaken to analyse the interview transcripts. A preliminary model was developed to elucidate the function of sexual fantasy in the process of sexual offending, as well as the physiological and psychological variables associated with it. The sexual fantasy function model (SFFM) comprises four categories that describe the various functions of sexual fantasy in the offence process. These categories are affect regulation, sexual arousal, coping, and modelling. The strengths of the SFFM are discussed and its clinical implications are reviewed. Finally, the limitations of the study are presented, and future research directions discussed.

The DSM diagnostic criteria for exhibitionism, voyeurism, and frotteurism

I reviewed the empirical literature for 1980-2008 on exhibitionism, voyeurism, and frotteurism for the American Psychiatric Association's Sexual and Gender Identity Disorders Work Group in preparation for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Very limited empirical support was found for major changes of the current DSM-IV-TR criteria sets for these paraphilias. Some of the criticism of current criteria and the balancing of false negatives and false positive diagnoses are examined. The report concludes with suggestions for possible diagnostic criteria changes for the DSM-V.

Pedophilia

Pedophilia is defined as a sexual interest in prepubescent children. It is empirically linked with sexual offending against children: Child pornography offenders and sex offenders with child victims are more likely to be pedophiles based on self-report or objective measures of sexual interests. At the same time, some pedophiles have not had any known sexual contact with children, and perhaps half of sex offenders against children would not meet diagnostic criteria for pedophilia. Pedophilia can be diagnosed using a variety of methods and is an important factor to consider in the assessment of sex offenders because pedophilic offenders are more likely to sexually reoffend and require different interventions. There is no evidence to suggest that pedophilia can be changed. Instead, interventions are designed to increase voluntary control over sexual arousal, reduce sex drive, or teach self-management skills to individuals who are motivated to avoid acting upon their sexual interests.

[Paraphilia, sexual preference disorders. Diagnosis, etiology, epidemiology, treatment and prevention]

Hostility towards relationships is one prominent characteristic symptom for disorders of sexual preference (ICD-10) and paraphilias (DSM-IV). Paraphilic symptoms sometimes progress to obsessive or addictive- like forms leading to a loss of self-control but can occur also as single incidents or as episodic events. Besides constitutional aspects, problems in the development of close relationships to primary caregivers (attachment) play an important role in the development of these disorders. Actual relationship- and self-confidence problems often trigger the severity of disturbance, especially in the episodic forms of paraphilia. For patients who are in conflict with the law, cognitive-behavioral therapeutic approaches with the aim to minimize self-deception regarding the effects of the paraphilic behavior have become more and more relevant. Regarding the medical treatment, anti-hormonal therapy plays an important role, but also treatment with serotonergic agents and naltrexone are used. Only little can be advised in terms of prevention; general psycho-hygiene (regarding the parent-child relationship) is recommended. Beside these general measures, institutions which offer special treatment for people in danger to become delinquents may be able to prevent serious harm for possible victims of abuse.

The content of sexual fantasies for sexual offenders

Although the phenomenon of sexual fantasy has been extensively researched, little contemporary inquiry has investigated the content of sexual fantasy within the context of sexual offending. In this study, a qualitative analysis was used to develop a descriptive model of the phenomena of sexual fantasy during the offence process. Twenty-four adult males convicted of sexual offences provided detailed retrospective descriptions of their thoughts, emotions, and behaviors before, during, and after their offences. Using Grounded Theory, a model was developed to elucidate the content and themes of sexual fantasy for sexual offenders, as well as the way fantasy content was used in the process of sexual offending. The Sexual Fantasy Content Model (SFCM) comprises of three higher-order (level 1) and five second-order (level 2) categories that describe the content of sexual fantasy across the offence process. The level 1 categories are general sexual fantasy, nonspecific offence fantasy, and offence-specific fantasy, whereas the level 2 categories included demographic, behavioral, relational, situational, and self-perceptual considerations. The strengths of the SFCM are discussed and its clinical implications are reviewed.

Criminal diversity and paraphilic interests among adult males convicted of sexual offenses against children

Official demographic and offense history data (n = 362) and confidential self-report data on paraphilic interests and behavior (n = 221) obtained on adult males convicted of sexual offenses against children were analyzed. Considerable criminal diversity was observed, with all standard categories of offenses represented in offenders' criminal histories. Most (86%) of the offenders' previous convictions were for nonsexual offenses, and most (92%) of the recidivist offenders had previously been convicted of at least one nonsexual offense. The prevalence of diagnosable paraphilias was low, with only 5% meeting formal diagnostic criteria for multiple (two or more) paraphilias other than pedophilia. Sexual offenders' paraphilic interests were unrelated to the extent of their sexual offense convictions but were significantly related to the extent of their nonsexual offense convictions. The results are better explained by a general theory of crime than by traditional clinical conceptions linking sexual offenses specifically with sexual psychopathology.

Practical considerations in the interview and evaluation of sexual offenders

The evaluation and assessment of sexual offenders is different than any other type of evaluation, and most clinicians are not properly trained to interview this population. This article addresses the clinical and ethical issues particular to the interview, assessment, and evaluation of these types of offenders. It offers both practical information regarding the interview itself, along with an overview of classification systems, paraphilias, and assessment techniques used with this population. In addition, issues related to risk assessment and risk management are also addressed, and an introduction to the use of actuarial risk assessment instruments is provided.

A Brunswikian evolutionary-developmental theory of adolescent sex offending

A Brunswikian Evolutionary-Developmental model was developed to relate the sex offending behavior of adolescents to other forms of social deviance, tracing a history of repeated frustration and failure in various competitive sexual strategies and escalation to more extreme means of obtaining sexual gratification. Four hypothetical constructs were proposed as stages in the development of sexual criminality: (1) Psycho-Social Deficiency (PSD); (2) Non-Criminal Sexuality (NCS); (3) Non-Sexual Criminality (NSC); and (4) Sexual Criminality (SC). Significant direct and indirect pathways led from PSD to SC through both NCS and NSC, each time facilitated by an interaction with PSD. Although the causal orders between stages remain equivocal, the current results are consistent with our theory and establish the heuristic value of our theoretical approach, providing empirical support for otherwise counterintuitive predictions. This interpretation also offers hope for focusing preventative intervention at one major root cause of this unfortunate cascade of consequences, Psycho-Social Deficiency.

Child and adolescent sex abuse perpetrators: a review of the research literature

This paper reviews the existing literature on selected issues in relation to child and adolescent sex abuse perpetrators. The relatively recent recognition of this phenomenon and the multiple problems of definition in this field may have affected the figures for incidence and prevalence. Among known cases a high proportion of young sex abuse perpetrators have suffered earlier adversities such as sexual and physical victimisation, dysfunctional family relationships and peer isolation. Despite a slender research data base on which to draw, treatment programmes for this client group have proliferated and many of these have not been adequately evaluated. There is a pressing need for the adoption of agreed definitions of outcome targets and measures and establishing longterm outcome studies with this group of children and adolescents.