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Ristow I, Kärgel C. The Role of Atypical Sexual Preference and Behavior in Neuroelectrophysiological Research of Human Sexual Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:607-610. [PMID: 33575945 PMCID: PMC9886628 DOI: 10.1007/s10508-021-01927-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Inka Ristow
- Clinical Affective Neuroimaging Laboratory, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Christian Kärgel
- Division of Forensic Psychiatry, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
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Scarpazza C, Costa C, Battaglia U, Berryessa C, Bianchetti ML, Caggiu I, Devinsky O, Ferracuti S, Focquaert F, Forgione A, Gilbert F, Pennati A, Pietrini P, Rainero I, Sartori G, Swerdlow R, Camperio Ciani AS. Acquired Pedophilia: international Delphi-method-based consensus guidelines. Transl Psychiatry 2023; 13:11. [PMID: 36653356 PMCID: PMC9849353 DOI: 10.1038/s41398-023-02314-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 12/22/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
Idiopathic and acquired pedophilia are two different disorders with two different etiologies. However, the differential diagnosis is still very difficult, as the behavioral indicators used to discriminate the two forms of pedophilia are underexplored, and clinicians are still devoid of clear guidelines describing the clinical and neuroscientific investigations suggested to help them with this difficult task. Furthermore, the consequences of misdiagnosis are not known, and a consensus regarding the legal consequences for the two kinds of offenders is still lacking. The present study used the Delphi method to reach a global consensus on the following six topics: behavioral indicators/red flags helpful for differential diagnosis; neurological conditions potentially leading to acquired pedophilia; neuroscientific investigations important for a correct understanding of the case; consequences of misdiagnosis; legal consequences; and issues and future perspectives. An international and multidisciplinary board of scientists and clinicians took part in the consensus statements as Delphi members. The Delphi panel comprised 52 raters with interdisciplinary competencies, including neurologists, psychiatrists, neuropsychologists, forensic psychologists, expert in ethics, etc. The final recommendations consisted of 63 statements covering the six different topics. The current study is the first expert consensus on a delicate topic such as pedophilia. Important exploitable consensual recommendations that can ultimately be of immediate use by clinicians to help with differential diagnosis and plan and guide therapeutic interventions are described, as well as future perspectives for researchers.
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Affiliation(s)
- Cristina Scarpazza
- Department of General Psychology, University of Padova, Padova, Italy. .,Padova Neuroscience Center (PNC), University of Padova, Padova, Italy. .,IRCCS S. Camillo Hospital, Venezia, Italy.
| | - Cristiano Costa
- grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padova, Padova, Italy ,grid.5608.b0000 0004 1757 3470Department of Neuroscience, University of Padova, Padova, Italy
| | - Umberto Battaglia
- grid.5608.b0000 0004 1757 3470Department of Applied Psychology, FISPPA – University of Padova, Padova, Italy
| | - Colleen Berryessa
- grid.430387.b0000 0004 1936 8796School of Criminal Justice, Rutgers University, Newark, NJ USA
| | - Maria Lucia Bianchetti
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Padova, Italy
| | - Ilenia Caggiu
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Padova, Italy
| | - Orrin Devinsky
- grid.137628.90000 0004 1936 8753Epilepsy Center, NYU School of Medicine, New York, USA
| | - Stefano Ferracuti
- grid.7841.aDepartment of Human Neurosciences Sapienza Università di Roma, Rome, Italy
| | - Farah Focquaert
- grid.5342.00000 0001 2069 7798Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Ghent, Belgium
| | - Arianna Forgione
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Padova, Italy
| | - Fredric Gilbert
- grid.1009.80000 0004 1936 826XEthics, Policy & Public Engagement (EPPE) ARC Centre of Excellence for Electromaterials Science (ACES), Faculty of Arts, University of Tasmania, Hobart, Australia
| | | | - Pietro Pietrini
- grid.462365.00000 0004 1790 9464IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Innocenzo Rainero
- grid.7605.40000 0001 2336 6580Neurology I, Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Turin, Italy
| | - Giuseppe Sartori
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Padova, Italy
| | - Russell Swerdlow
- grid.412016.00000 0001 2177 6375University of Kansas Medical Center, Kansas City, KS USA
| | - Andrea S. Camperio Ciani
- grid.5608.b0000 0004 1757 3470Department of Applied Psychology, FISPPA – University of Padova, Padova, Italy
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Boschetti A, Camperio Ciani A, Scarpazza C. Sexual offenses and the brain. HANDBOOK OF CLINICAL NEUROLOGY 2023; 197:161-179. [PMID: 37633708 DOI: 10.1016/b978-0-12-821375-9.00017-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2023]
Abstract
Sexual offenses are a great concern worldwide due to the devastating physical and psychological consequences the victims of such crimes often experience. It is an important task to investigate potential mechanisms that may underlie sexual offending and predispose an individual for such antisocial behavior. Advanced techniques in neuroscience are increasingly used to uncover biomarkers in psychiatric disorders and organic brain disease. As this type of research is flourishing, preliminary studies with the aim to explore the neural basis of sex offenders have started to appear. To this purpose, researchers began to study the brain's structural and functional changes and the neurocognitive profiles of sex offenders, in comparison to nonoffenders and nonsex offenders, or among different subtypes of sex offenders. Most of the research to date has focused on pedophilia, with some inconsistent findings, which hampers the translation of the results into the forensic and clinical context. Any attempt to increase convergent evidence may profit from the harmonization of data analysis and avoidance of methodological inconsistencies, which can account for the different results across studies. Today, uncovering the neural basis of sex offences has to become a priority, not only for clinical interventions, but might also be important knowledge for crime prevention.
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Affiliation(s)
- Angela Boschetti
- Department of General Psychology, University of Padova, Padova, Italy
| | - Andrea Camperio Ciani
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Cristina Scarpazza
- Department of General Psychology, University of Padova, Padova, Italy; Translational Cognitive and NeuroImaging Lab, IRCCS Camillo Hospital, Venice, Italy.
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Szczypiński J, Wypych M, Krasowska A, Wiśniewski P, Kopera M, Suszek H, Marchewka A, Jakubczyk A, Wojnar M. Abnormal behavioral and neural responses in the right dorsolateral prefrontal cortex during emotional interference for cognitive control in pedophilic sex offenders. J Psychiatr Res 2022; 151:131-135. [PMID: 35477077 DOI: 10.1016/j.jpsychires.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/17/2022] [Accepted: 04/18/2022] [Indexed: 11/16/2022]
Abstract
Studies within the last decade have reported neural and behavioral differences in cognitive control between men with the pedophilic disorder who commit (CSO+) and do not commit (CSO-) child sexual abuse. Prior studies reported a higher number of errors in Go/Nogo task and lower activity of the prefrontal cortex in NoGo trials, in CSO+ compared with CSO-. Moreover, negative mood was reported as a risk factor for child sexual abuse in pedophilic men. We aimed to examine differences in brain function and behavior between CSO+ and CSO- patients regarding emotional interference on cognitive processes and inhibition. We recruited CSO+ (n = 11) and CSO- (n = 14) patients as well as matched healthy controls (HC) (n = 17). Participants performed the affective Go/NoGo task in a block-design functional magnetic resonance imaging experiment. The task comprised the following four conditions: Negative Go, including only Go stimuli and negatively valenced pictures; Negative NoGo, including 50% of Go and 50% of NoGo trials as well as negatively valenced pictures; and two corresponding conditions with neutral pictures. Brain analysis was restricted to the dorsolateral prefrontal (DLPFC), orbitofrontal, and anterior cingulate cortices. The HC and CSO- groups, but not the CSO+ group, showed significantly slower reactions in negative blocks compared with neutral blocks. Brain analysis revealed increased activation in the right DLPFC during emotional interference contrast (Negative > Neutral) in the HC and CSO- groups; however, there was decreased activation in the CSO+ group. In the CSO+ group, negative distractors did not increase cognitive control processes, which was observed in the CSO- and HC groups at the behavioral and neural levels. These results support previous reports indicating offender status is associated with cognitive and emotional impairments.
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Affiliation(s)
- Jan Szczypiński
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665, Warsaw, Poland; Laboratory of Brain Imaging, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Pasteur 3, 02-093, Warsaw, Poland.
| | - Marek Wypych
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Pasteur 3, 02-093, Warsaw, Poland
| | - Aleksandra Krasowska
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665, Warsaw, Poland
| | - Paweł Wiśniewski
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665, Warsaw, Poland
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665, Warsaw, Poland
| | - Hubert Suszek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland
| | - Artur Marchewka
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Pasteur 3, 02-093, Warsaw, Poland
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665, Warsaw, Poland
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665, Warsaw, Poland; Department of Psychiatry, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA.
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Altered Neural and Behavioral Response to Sexually Implicit Stimuli During a Pictorial-Modified Stroop Task in Pedophilic Disorder. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 3:292-300. [PMID: 37124357 PMCID: PMC10140453 DOI: 10.1016/j.bpsgos.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/15/2022] [Accepted: 02/03/2022] [Indexed: 11/21/2022] Open
Abstract
Background Pedophilic disorder (PD) entails sexual attraction to prepubertal children. A risk factor for committing child sexual abuse in PD is impaired cognitive control. However, the underlying neurocognitive mechanisms remain unclear. Methods We performed a case-control study including 51 self-identified and help-seeking males with PD and 55 matched healthy control subjects. Functional magnetic resonance imaging and a pictorial-modified Stroop task involving computer-generated sexually implicit images were used to measure response time and brain activation. Increases in response time during the pictorial-modified Stroop task are presumably due to image-induced interference in executive functions required for task performance. Results In PD, during the presentation of images of children compared with adults, we found increased response time (p = .005; 848 ± 92 ms vs. 826 ± 88 ms), and compared with healthy control subjects, we found increased activation in the occipital, temporal (bilateral hippocampus), parietal, frontal, cingulate, and left insular cortices; caudate (bilaterally); thalamus (mediodorsal); and cerebellum. Conclusions Presentation of child images was associated with response interference in PD and increased engagement of brain regions involved in the processing of sexual stimuli, visual perception, self-referential thought, and executive function. We conclude that processing of child images is associated with functional and behavioral alterations in PD.
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Klöckner MS, Jordan K, Kiehl KA, Nyalakanti PK, Harenski CL, Müller JL. Widespread and interrelated gray matter reductions in child sexual offenders with and without pedophilia: Evidence from a multivariate structural MRI study. Psychiatry Clin Neurosci 2021; 75:331-340. [PMID: 34346537 DOI: 10.1111/pcn.13292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 06/30/2021] [Accepted: 07/19/2021] [Indexed: 11/27/2022]
Abstract
AIM To further investigate the neuroanatomical correlates of child sexual offending and disentangle them from the neural correlates of pedophilia, using a multivariate analytical approach in order to minimize loss of statistical power. METHODS This study presents structural MRI data on gray matter in an incarcerated, male population of 22 pedophilic and 21 non-pedophilic child sexual offenders, and 20 violent non-sexual offender controls, based on a multivariate whole-brain approach using source-based morphometry. RESULTS We identify a network of several neuroanatomical regions exhibiting interrelated reduced gray matter in both child sexual offender groups relative to controls, comprising extensive clusters in the bilateral cerebellum and frontal lobe, as well as smaller clusters in the bilateral parietal, temporal, and occipital lobes, the bilateral basal ganglia, the medial cingulate and the hippocampus. CONCLUSION Our results speak to the interpretation that there are inter- and possibly connectivity-related brain structural abnormalities in child sexual offenders that are not (only) pertaining to pedophilia per se. Interpretations and limitations of the present data are discussed and recommendations for future works are given.
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Affiliation(s)
- Mona S Klöckner
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Göttingen, Göttingen, Germany.,Research Department Transnational Politics, Peace Research Institute Frankfurt, Frankfurt, Germany
| | - Kirsten Jordan
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Göttingen, Göttingen, Germany
| | - Kent A Kiehl
- The Mind Research Network & Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico, USA.,Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Prashanth K Nyalakanti
- The Mind Research Network & Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico, USA
| | - Carla L Harenski
- The Mind Research Network & Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico, USA
| | - Jürgen L Müller
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Göttingen, Göttingen, Germany
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7
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Bochkarev VK, Vasiliev NG, Kirenskaya AV, Tkachenko AA. [Neurophysiological correlates of pedophilia: a study of EEG evoked oscillations]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:52-58. [PMID: 34283530 DOI: 10.17116/jnevro202112106152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To study the changes of evoked EEG oscillations in response to erotic visual stimuli to identify specific patterns in subjects with different variants of pedophilia. MATERIAL AND METHODS Forty-eight right-handed male offenders who have committed sexual acts against children participated in the study. Seventeen subjects without paraphilic disorders were included in group 1, 17 subjects with heterosexual pedophilia were included in group 2, and 13 subjects with homosexual pedophilia were included in group 3. The stimuli were colored pictures of neutral, heterosexual normative, hetero- and homosexual pedophilic content shortly demonstrated with backward masking. Spectral power of delta, theta, alpha, and beta evoked oscillations (EO) was analyzed. Further, the number of significant changes of EO power in response to erotic stimuli relative to neutral ones was calculated, and topography changes of EO power in response to specific erotic pictures compared to neutral ones were analyzed for each group. RESULTS The diminished number of significant reactions to specific stimuli was found in the pedophilia groups (18 and 4 in groups 2 and 3, respectively) in comparison with the group without paraphilia (25). The specific changes of EO power in response to specific erotic visual pictures were found for each group. Increased power of delta, theta and alpha EO in the 104-164 ms time window, and decreased power of alpha EO in the 344-920 ms time window were found in group 1. In group 2, specific stimulation elicited decline of delta and theta EO power, possibly related to impaired motivational and emotional aspects of erotic stimuli perception. The weak changes were found in group 3 - increased power of beta EO in the frontal area. CONCLUSION The obtained frequency and spatial patterns of EO changes in response to erotic visual pictures are related to specificity of hetero- and homosexual pedophilia.
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Affiliation(s)
- V K Bochkarev
- Serbsky National Medical Research Centre for Psychiatry and Narcology, Moscow, Russia
| | - N G Vasiliev
- Serbsky National Medical Research Centre for Psychiatry and Narcology, Moscow, Russia
| | - A V Kirenskaya
- Serbsky National Medical Research Centre for Psychiatry and Narcology, Moscow, Russia
| | - A A Tkachenko
- Serbsky National Medical Research Centre for Psychiatry and Narcology, Moscow, Russia.,Sechenov First Moscow State Medical University, Moscow, Russia
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Dugré JR, Potvin S. Impaired attentional and socio-affective networks in subjects with antisocial behaviors: a meta-analysis of resting-state functional connectivity studies. Psychol Med 2021; 51:1249-1259. [PMID: 33902772 DOI: 10.1017/s0033291721001525] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In the past decade, there has been a growing interest in examining resting-state functional connectivity deficits in subjects with conduct and antisocial personality disorder. Through meta-analyses and literature reviews, extensive work has been done to characterize their abnormalities in brain activation during a wide range of functional magnetic resonance imaging (fMRI) tasks. However, there is currently no meta-analytical evidence regarding neural connectivity patterns during resting-state fMRI. Therefore, we conducted a coordinate-based meta-analysis of resting-state fMRI studies on individuals exhibiting antisocial behaviors. Of the retrieved studies, 18 used a seed-based connectivity approach (513 cases v. 488 controls), 20 employed a non-seed-based approach (453 cases v. 460 controls) and 20 included a correlational analysis between the severity of antisocial behaviors and connectivity patterns (3462 subjects). Meta-analysis on seed-based studies revealed significant connectivity deficits in the amygdala, middle cingulate cortex, ventral posterior cingulate cortex-precuneus, ventromedial and dorsomedial prefrontal cortex, premotor cortex, and superior parietal lobule. Additionally, non-seed-based meta-analysis showed increased connectivity in the ventral posterior cingulate cortex and decreased connectivity in the parietal operculum, calcarine cortex, and cuneus. Finally, we found meta-analytical evidence for negative relationship between the severity of antisocial behaviors and connectivity with the ventromedial prefrontal cortex. Functional characterization and meta-analytical connectivity modeling indicated that these findings overlapped with socio-affective and attentional processes. This further underscores the importance of these functions in the pathophysiology of conduct and antisocial personality disorders.
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Affiliation(s)
- Jules Roger Dugré
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Stéphane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
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Scarpazza C, Finos L, Genon S, Masiero L, Bortolato E, Cavaliere C, Pezzaioli J, Monaro M, Navarin N, Battaglia U, Pietrini P, Ferracuti S, Sartori G, Camperio Ciani AS. Idiopathic and acquired pedophilia as two distinct disorders: an insight from neuroimaging. Brain Imaging Behav 2021; 15:2681-2692. [PMID: 33507519 PMCID: PMC8500885 DOI: 10.1007/s11682-020-00442-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 02/05/2023]
Abstract
Pedophilia is a disorder of public concern because of its association with child sexual offense and recidivism. Previous neuroimaging studies of potential brain abnormalities underlying pedophilic behavior, either in idiopathic or acquired (i.e., emerging following brain damages) pedophilia, led to inconsistent results. This study sought to explore the neural underpinnings of pedophilic behavior and to determine the extent to which brain alterations may be related to distinct psychopathological features in pedophilia. To this aim, we run a coordinate based meta-analysis on previously published papers reporting whole brain analysis and a lesion network analysis, using brain lesions as seeds in a resting state connectivity analysis. The behavioral profiling approach was applied to link identified regions with the corresponding psychological processes. While no consistent neuroanatomical alterations were identified in idiopathic pedophilia, the current results support that all the lesions causing acquired pedophilia are localized within a shared resting state network that included posterior midlines structures, right inferior temporal gyrus and bilateral orbitofrontal cortex. These regions are associated with action inhibition and social cognition, abilities that are consistently and severely impaired in acquired pedophiles. This study suggests that idiopathic and acquired pedophilia may be two distinct disorders, in line with their distinctive clinical features, including age of onset, reversibility and modus operandi. Understanding the neurobiological underpinnings of pedophilic behavior may contribute to a more comprehensive characterization of these individuals on a clinical ground, a pivotal step forward for the development of more efficient therapeutic rehabilitation strategies.
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Affiliation(s)
- Cristina Scarpazza
- Department of General Psychology, University of Padova, Via Venezia 8, 25131, Padova, PD, Italy. .,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Livio Finos
- Department of Developmental Psychology and Socialisation, University of Padova, Padova, Italy
| | - Sarah Genon
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Laura Masiero
- Department of Statistical Sciences, University of Padova, Padova, Italy
| | - Elena Bortolato
- Department of Statistical Sciences, University of Padova, Padova, Italy
| | - Camilla Cavaliere
- Department of Statistical Sciences, University of Padova, Padova, Italy
| | - Jessica Pezzaioli
- Department of Statistical Sciences, University of Padova, Padova, Italy
| | - Merylin Monaro
- Department of General Psychology, University of Padova, Via Venezia 8, 25131, Padova, PD, Italy
| | - Nicolò Navarin
- Department of Mathematics "Tullio Levi-Civita", University of Padova, Padova, Italy
| | - Umberto Battaglia
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Pietro Pietrini
- Molecular Mind Lab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Stefano Ferracuti
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Giuseppe Sartori
- Department of General Psychology, University of Padova, Via Venezia 8, 25131, Padova, PD, Italy
| | - Andrea S Camperio Ciani
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
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Is there an "antisocial" cerebellum? Evidence from disorders other than autism characterized by abnormal social behaviours. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:1-8. [PMID: 30153496 DOI: 10.1016/j.pnpbp.2018.08.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 12/13/2022]
Abstract
The cerebellum is a hindbrain structure which involvement in functions not related to motor control and planning is being increasingly recognized in the last decades. Studies on Autism Spectrum Disorders (ASD) have reported cerebellar involvement on these conditions characterized by social deficits and repetitive motor behavior patterns. Although such an involvement hints at a possible cerebellar participation in the social domain, the fact that ASD patients present both social and motor deficits impedes drawing any firm conclusion regarding cerebellar involvement in pathological social behaviours, probably influenced by the classical view of the cerebellum as a purely "motor" brain structure. Here, we suggest the cerebellum can be a key node for the production and control of normal and particularly aberrant social behaviours, as indicated by its involvement in other neuropsychiatric disorders which main symptom is deregulated social behaviour. Therefore, in this work, we briefly review cerebellar involvement in social behavior in rodent models, followed by discussing the findings linking the cerebellum to those other psychiatric conditions characterized by defective social behaviours. Finally, possible commonalities between the studies and putative underlying impaired functions will be discussed and experimental approaches both in patients and experimental animals will also be proposed, aimed at stimulating research on the role of the cerebellum in social behaviours and disorders characterized by social impairments, which, if successful, will definitely help reinforcing the proposed cerebellar involvement in the social domain.
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11
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Jordan K, Wild TSN, Fromberger P, Müller I, Müller JL. Are There Any Biomarkers for Pedophilia and Sexual Child Abuse? A Review. Front Psychiatry 2019; 10:940. [PMID: 32038314 PMCID: PMC6985439 DOI: 10.3389/fpsyt.2019.00940] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/27/2019] [Indexed: 12/13/2022] Open
Abstract
The use of biomarkers in medicine is a common and valuable approach in several clinical fields. Understanding the relationship between measurable biological processes and clinical outcomes not only is indispensable in the face of understanding physiological processes in healthy as well as in diseased organisms but also for understanding and evaluating treatment effects. Therefore, also in the context of forensic psychiatry, biomarkers and their potentially beneficial effects are of growing interest. The objective of this review is to examine if there are biomarkers that may serve as a tool to support diagnostic process, treatment evaluation, and risk assessment of pedophilic individuals and child sexual offenders. In the first part, we present an overview of the current neurobiological, as well as physiological and psychophysiological approaches to characterize pedophilia and child sexual offending. Secondly, we discuss and evaluate the impact of these approaches on the development of biomarkers for diagnosis, therapy, and risk assessment in pedophilic subjects and child sexual offenders. We conclude that a lot of research has already enhanced our neurobiological knowledge about pedophilia and child sexual offending. Although there surely exist promising parameters and approaches, in our view currently none of these is ready yet to serve as a clinically applicable diagnostic, response, or predictive biomarker for pedophilia and child sexual offending. Therefore, further work remains to be done. The development of a composite diagnostic biomarker to assess deviant sexual interest, combining several measures like functional magnetic resonance imaging, electroencephalogram, eye tracking, and behavioral approaches seems to be most promising. A valid and reliable measurement of deviant sexual interest, insensitive to manipulations could significantly support clinical diagnostic process. Similarly, regarding therapy evaluation and risk assessment, a composite biomarker to assess inhibitory control functions seems to be promising. Furthermore, the application of the Research Domain Criteria-approach, a new approach for investigating and classifying mental disorders, offers the possibility to take research to a new level.
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Affiliation(s)
- Kirsten Jordan
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany
| | - Tamara Sheila Nadine Wild
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany
| | - Peter Fromberger
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany
| | - Isabel Müller
- Asklepios Forensic Psychiatric Hospital, Goettingen, Germany
| | - Jürgen Leo Müller
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany.,Asklepios Forensic Psychiatric Hospital, Goettingen, Germany
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12
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Abstract
PURPOSE OF REVIEW This paper reviews recent research into four different approaches to the assessment of offense-related sexual deviance. RECENT FINDINGS Two of these approaches, structured rating scales and phallometry, have a sufficient basis in research for clinical use but have undergone significant refinements in recent years. One approach, the use of cognitive tasks to indirectly assess sexual deviance, is approaching the point where it has a sound research basis for clinical use though too many promising tasks have yet to make the transition from laboratory to clinical practice. This approach has however begun to map the earlier stages of sexual response including preconscious processes. The final approach, assessment through neuroimaging, is at the earliest stage of development with research findings having yet to reach sufficient stability for clinical application. Existing assessment technologies, despite their limitations, allow professionals to assess offense-related sexual deviance. New approaches, currently being developed, potentially allow a better understanding of underlying processes and, when sufficiently mature, will be more therapeutically useful.
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Affiliation(s)
- David Thornton
- Sand Ridge Research Unit, 301 Troy Dr - Bldg 14, Madison, WI, 53704, USA.
| | - Gina Ambroziak
- Sand Ridge Research Unit, 301 Troy Dr - Bldg 14, Madison, WI, 53704, USA
| | - Rachel E Kahn
- Sand Ridge Research Unit, 301 Troy Dr - Bldg 14, Madison, WI, 53704, USA
| | - James Mundt
- Sand Ridge Research Unit, 301 Troy Dr - Bldg 14, Madison, WI, 53704, USA
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Multimodal neuroimaging measures and intelligence influence pedophile child sexual offense behavior. Eur Neuropsychopharmacol 2018; 28:818-827. [PMID: 29880336 DOI: 10.1016/j.euroneuro.2018.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 02/22/2018] [Accepted: 05/17/2018] [Indexed: 12/17/2022]
Abstract
Pedophilia is a heterogeneous disorder for which the neurobiological correlates are not well established. In particular, there are no biological markers identifying individuals with high risk to commit child sexual offense (CSO). Pedophiles with CSO (P+CSO; N = 73), pedophiles without CSO (P-CSO; N = 77), and non-pedophilic controls (NPC; N = 133) were assessed using multimodal structural neuroimaging measures including: cortical thickness (CT), surface area (SA), and white matter fractional anisotropy (FA), as well as full scale IQ (FSIQ) performance. Cortex-wise mediation analyses were used to assess the relationships among brain structure, FSIQ and CSO behavior. Lower FSIQ performance was strongly predict with P+CSO (Wald Chi2 = 13.0, p = 3.1 × 10-5). P+CSO had lower CT in the right motor cortex and pronounced reductions in SA spanning the bilateral frontal, temporal, cingulate, and insular regions (PFWE-corrected < 0.05). P+CSO also had lower FA particularly in the corpus callosum (PFWE-corrected < 0.05). The relationship between SA and P+CSO was significantly mediated by FSIQ, particularly in the prefrontal and anterior insular cortices (PFWE-corrected < 0.05). Within P+CSO, left prefrontal and right anterior cingulate SA negatively correlated with number of CSOs (PFWE-corrected < 0.05). This study demonstrates converging neurobiological findings in which P+CSO had lower FSIQ performance, reduced CT, reduced SA, and reduced FA, compared to P-CSO as well as NPC. Further, FSIQ potentially mediates abuse by pedophiles via aberrant SA, whereas the CT and FA associations were independent of FSIQ differences. These findings suggest aberrant neuroanatomy and lower intelligence as a potential core feature underlying child sexual abuse behavior by pedophiles.
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14
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Gerwinn H, Weiß S, Tenbergen G, Amelung T, Födisch C, Pohl A, Massau C, Kneer J, Mohnke S, Kärgel C, Wittfoth M, Jung S, Drumkova K, Schiltz K, Walter M, Beier KM, Walter H, Ponseti J, Schiffer B, Kruger THC. Clinical characteristics associated with paedophilia and child sex offending - Differentiating sexual preference from offence status. Eur Psychiatry 2018; 51:74-85. [PMID: 29625377 DOI: 10.1016/j.eurpsy.2018.02.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 10/17/2022] Open
Abstract
Contrary to public perception, child sex offending (CSO) and paedophilia are not the same. Only half of all cases of CSO are motivated by paedophilic preference, and a paedophilic preference does not necessarily lead to CSO. However, studies that investigated clinical factors accompanying and contributing to paedophilia so far mainly relied on paedophiles with a history of CSO. The aim of this study was to distinguish between factors associated with sexual preference (paedophile versus non-paedophile) and offender status (with versus without CSO). Accordingly, a 2 (sexual preference) × 2 (offender status) factorial design was used for a comprehensive clinical assessment of paedophiles with and without a history of CSO (n = 83, n = 79 respectively), child sex offenders without paedophilia (n = 32) and healthy controls (n = 148). Results indicated that psychiatric comorbidities, sexual dysfunctions and adverse childhood experiences were more common among paedophiles and child sex offenders than controls. Offenders and non-offenders differed in age, intelligence, educational level and experience of childhood sexual abuse, whereas paedophiles and non-paedophiles mainly differed in sexual characteristics (e.g., additional paraphilias, onset and current level of sexual activity). Regression analyses were more powerful in segregating offender status than sexual preference (mean classification accuracy: 76% versus 68%). In differentiating between offence- and preference-related factors this study improves clinical understanding of both phenomena and may be used to develop scientifically grounded CSO prevention and treatment programmes. It also highlights that some deviations are not traceable to just one of these two factors, thus raising the issue of the mechanism underlying both phenomena.
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Affiliation(s)
- Hannah Gerwinn
- Department of Neurology, Medical School, Kiel University, Arnold-Heller-Str. 3, 24105 Kiel, Germany; Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Niemannsweg 147, 24105 Kiel, Germany
| | - Simone Weiß
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Forensic Psychiatry, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany; Institute of Forensic Psychiatry, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Gilian Tenbergen
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Department of Psychology, State University of New York at Oswego, 7060 State Route 104, 13126 Oswego, NY, USA
| | - Till Amelung
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Carina Födisch
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Alexander Pohl
- Department of Neurology, Medical School, Kiel University, Arnold-Heller-Str. 3, 24105 Kiel, Germany; Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Niemannsweg 147, 24105 Kiel, Germany
| | - Claudia Massau
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Forensic Psychiatry, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany; Institute of Forensic Psychiatry, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Jonas Kneer
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Sebastian Mohnke
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Christian Kärgel
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Forensic Psychiatry, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany; Institute of Forensic Psychiatry, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Matthias Wittfoth
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Stefanie Jung
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Krassimira Drumkova
- State Hospital for Forensic Psychiatry Uchtspringe, Schnöggersburger Weg 1, 39576 Stendal, Germany
| | - Kolja Schiltz
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany; Department of Forensic Psychiatry, Psychiatric Hospital, LMU Munich, Nußbaumstr. 7, 80336 München, Germany
| | - Martin Walter
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany; Department of General Psychiatry and Psychotherapy, University Hospital Tübingen, Osianderstr. 24, 72076 Tübingen, Germany
| | - Klaus M Beier
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Jorge Ponseti
- Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Niemannsweg 147, 24105 Kiel, Germany
| | - Boris Schiffer
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Forensic Psychiatry, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany; Institute of Forensic Psychiatry, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Tillmann H C Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
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