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Lassche MM, Lasogga L, de Roos MS, Leeflang A, Ajazi V, Axioti M, Rassin E, van Dongen JDM. Dark Tetrad personality traits, paraphilic interests, and the role of impulsivity: an EEG-study using a Go/No-Go paradigm. Sci Rep 2024; 14:10884. [PMID: 38740864 DOI: 10.1038/s41598-024-61214-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 05/01/2024] [Indexed: 05/16/2024] Open
Abstract
Maladaptive personality traits, such as 'dark personalities' are found to result in a diverse set of negative outcomes, including paraphilic interests and associated (illegal) behaviors. It is however unclear how these are exactly related, and if related, if then only those individuals higher on dark personality traits and higher impulsivity engage in paraphilic behaviors. In the current study, 50 participants were recruited to investigate the relationship between Dark Tetrad personality traits (i.e., narcissism, psychopathy, Machiavellianism and everyday sadism), paraphilic interests (arousal and behavior) and the moderating role of impulsivity. Personality and paraphilic interests were investigated through self-report questionnaires. Impulsivity was measured both through self-reported dysfunctional impulsivity and the P3 event related potential using electroencephalography during the Go/No-Go task (i.e. response inhibition). The results showed that there was a positive association between psychopathy, sadism and paraphilic interests. Whereas everyday sadism was associated with paraphilic (self-reported) arousal, psychopathy was associated with paraphilic behavior. Although P3 amplitude was not associated with paraphilic interests, self-reported dysfunctional impulsivity was associated with paraphilic behavior specifically. However, there was no moderating role of dysfunctional impulsivity and response inhibition (P3) in the relationship between psychopathy and paraphilic behavior. Findings indicate that the relation between specific dark personalities and paraphilic interests may be more complex than initially thought. Nevertheless, risk assessment and intervention approaches for paraphilia and related behavior both may benefit from incorporating Dark Tetrad and impulsivity measurements.
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Affiliation(s)
- Maria M Lassche
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Luca Lasogga
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen, Aachen, Germany
| | - Melissa S de Roos
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Amber Leeflang
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Vanesa Ajazi
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
- Department of General Psychology, University of Padua, Padua, Italy
| | - Magda Axioti
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Eric Rassin
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Josanne D M van Dongen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.
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Mbiydzenyuy NE, Joanna Hemmings SM, Shabangu TW, Qulu-Appiah L. Exploring the influence of stress on aggressive behavior and sexual function: Role of neuromodulator pathways and epigenetics. Heliyon 2024; 10:e27501. [PMID: 38486749 PMCID: PMC10937706 DOI: 10.1016/j.heliyon.2024.e27501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/17/2024] Open
Abstract
Stress is a complex and multifaceted phenomenon that can significantly influence both aggressive behavior and sexual function. This review explores the intricate relationship between stress, neuromodulator pathways, and epigenetics, shedding light on the various mechanisms that underlie these connections. While the role of stress in both aggression and sexual behavior is well-documented, the mechanisms through which it exerts its effects are multifarious and not yet fully understood. The review begins by delving into the potential influence of stress on the Hypothalamic-Pituitary-Adrenal (HPA) axis, glucocorticoids, and the neuromodulators involved in the stress response. The intricate interplay between these systems, which encompasses the regulation of stress hormones, is central to understanding how stress may contribute to aggressive behavior and sexual function. Several neuromodulator pathways are implicated in both stress and behavior regulation. We explore the roles of norepinephrine, serotonin, oxytocin, and androgens in mediating the effects of stress on aggression and sexual function. It is important to distinguish between general sexual behavior, sexual motivation, and the distinct category of "sexual aggression" as separate constructs, each necessitating specific examination. Additionally, epigenetic mechanisms emerge as crucial factors that link stress to changes in gene expression patterns and, subsequently, to behavior. We then discuss how epigenetic modifications can occur in response to stress exposure, altering the regulation of genes associated with stress, aggression, and sexual function. While numerous studies support the association between epigenetic changes and stress-induced behavior, more research is necessary to establish definitive links. Throughout this exploration, it becomes increasingly clear that the relationship between stress, neuromodulator pathways, and epigenetics is intricate and multifaceted. The review emphasizes the need for further research, particularly in the context of human studies, to provide clinical significance and to validate the existing findings from animal models. By better understanding how stress influences aggressive behavior and sexual function through neuromodulator pathways and epigenetic modifications, this research aims to contribute to the development of innovative protocols of precision medicine and more effective strategies for managing the consequences of stress on human behavior. This may also pave way for further research into risk factors and underlying mechanisms that may associate stress with sexual aggression which finds application not only in neuroscience, but also law, ethics, and the humanities in general.
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Affiliation(s)
- Ngala Elvis Mbiydzenyuy
- Basic Science Department, School of Medicine, Copperbelt University, P.O Box 71191, Ndola, Zambia
- Division of Medical Physiology, Biomedical Science Research Institute, Stellenbosch University, Private Bag X1, Matieland, 7602, Cape Town South Africa
| | - Sian Megan Joanna Hemmings
- Division of Molecular Biology & Human Genetics, Biomedical Science Research Institute, Stellenbosch University, Private Bag X1, Matieland, 7602, Cape Town South Africa
| | - Thando W. Shabangu
- Division of Medical Physiology, Biomedical Science Research Institute, Stellenbosch University, Private Bag X1, Matieland, 7602, Cape Town South Africa
| | - Lihle Qulu-Appiah
- Division of Medical Physiology, Biomedical Science Research Institute, Stellenbosch University, Private Bag X1, Matieland, 7602, Cape Town South Africa
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Storch M, Kanthack M, Amelung T, Beier KM, Krueger THC, Sinke C, Walter H, Walter M, Schiffer B, Schindler S, Schoenknecht P. Hypothalamic volume in pedophilia with or without child sexual offense. Eur Arch Psychiatry Clin Neurosci 2023; 273:1295-1306. [PMID: 36370175 PMCID: PMC10449687 DOI: 10.1007/s00406-022-01501-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/14/2022] [Indexed: 11/15/2022]
Abstract
The hypothalamus regulates sexual behavior and is simultaneously associated with aggression and violence. Consequently, this brain region is relevant in research of pedophilia and child sexual offenses (CSO). The distinction between these two phenomena is of great importance and was the object of consideration of this study. We analyzed exclusively men, including 73 pedophilic offenders who committed CSO, an equal number of people with pedophilia but without such offenses, and 133 non-pedophilic, non-offending subjects who formed the control group. All data were collected in a multicenter in vivo study and analyzed using a semi-automated segmentation algorithm for 3-Tesla magnetic resonance images. Men with pedophilia who committed CSO on average had a 47 mm3 smaller hypothalamus per side than people without committed CSO. This effect was driven by both the group of non-offending people with pedophilia and the control group. By contrast, the exploratory comparison of pedophilic persons without CSO with the control group showed no significant difference. The present study demonstrates a deviant hypothalamic structure as a neurobiological correlate of CSO in pedophiles, but not in people with pedophilia who have not committed CSO. Thus, it strengthens the argument to distinguish between sexual offending and paraphilic sexual preferences.
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Affiliation(s)
- Melanie Storch
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany.
- Department of Biology, University of Leipzig, 04103, Leipzig, Germany.
| | - Maria Kanthack
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany
| | - 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, 10117, Berlin, Germany
- Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, 10117, Berlin, 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, 10117, Berlin, Germany
| | - Tillmann H C Krueger
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625, Hanover, Germany
- Center for Systems Neuroscience Hannover, Hanover, Germany
| | - Christopher Sinke
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625, Hanover, 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, 10117, Berlin, Germany
| | - Martin Walter
- Department of Psychiatry, Otto-Von Guericke-University Magdeburg, 39106, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Jena, 07743, Jena, Germany
| | - Boris Schiffer
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr University Bochum, LWL University Hospital, 44791, Bochum, Germany
| | - Stephanie Schindler
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany
| | - Peter Schoenknecht
- Medical Faculty, Department of Psychiatry and Psychotherapy, University Hospital Leipzig, 04103, Leipzig, Germany
- Out-Patient Department for Sexual-Therapeutic Prevention and Forensic Psychiatry, University Hospital Leipzig, 04103, Leipzig, Germany
- Academic Saxon State Hospital Arnsdorf, 01477, Arnsdorf, Germany
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Swaminath S, Simons RM, Hatwan ML. Understanding Pedophilia: A Theoretical Framework on the Development of Sexual Penchants. JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:732-748. [PMID: 37463124 DOI: 10.1080/10538712.2023.2236602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 05/08/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
Pedophilia is a significant public health problem. Despite its cost to society, little effort has been directed toward understanding idiographic differences in the development and maintenance of pedophilia. Extant literature emphasizes biological underpinnings and predictors of re-offense. In this article, we posit that pedophilic penchants in males originate due to language, cognition, emotions, and emotion regulation. Adverse childhood experiences, such as emotional and sexual abuse, are posited as a major contributor to the etiology of pedophilia. However, not all individuals attracted to minors present with similar childhood adversities. The development of pedophilia, in the absence of such direct training (childhood adversities), is difficult to comprehend. Relational frame theory, a comprehensive account of human language and cognition, aids in deciphering the idiographic underpinnings of pedophilia. The role of maladaptive emotion regulation in maintaining pedophilia is also described. This article presents examples of how relational frames are established and activated in distressing contexts. Finally, implications for future research are discussed.
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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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Manral IT, Panjrattan C, Saini RK, Roy S, Singh A. A multi-speciality approach to the protection of children from sexual offences act: A review. Ind Psychiatry J 2023; 32:4-8. [PMID: 37274576 PMCID: PMC10236663 DOI: 10.4103/ipj.ipj_169_21] [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: 07/26/2021] [Revised: 07/07/2022] [Accepted: 08/09/2022] [Indexed: 11/11/2022] Open
Abstract
Children constitute vulnerable section of the society, and governments have moral responsibility to safeguard their interests and safety. It does so by enacting various laws and providing framework for its implementation. Child sexual abuse (CSA) is widely prevalent in all societies and World Health Organization has promulgated broad guidelines against such practices. There are enough provisions against such perpetrators in India and suitable amendments have been provisioned based on inputs from various sections of the society. This article delves into the provisions of the act, its medicolegal application, and psychodynamics of such behaviors among the perpetrators.
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Affiliation(s)
- Ishita T. Manral
- Department of Forensic Medicine, Command Hospital (EC), Kolkata, West Bengal, India
| | - Carol Panjrattan
- Department of Psychiatry, Command Hospital (EC), Kolkata, West Bengal, India
| | - Rajiv K. Saini
- Department of Psychiatry, Command Hospital (EC), Kolkata, West Bengal, India
| | - Shuvendu Roy
- Department of Paediatrics, Command Hospital (EC), Kolkata, West Bengal, India
| | - Avinash Singh
- Department of Paediatrics, Command Hospital (EC), Kolkata, West Bengal, India
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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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Popovic D, Wertz M, Geisler C, Kaufmann J, Lähteenvuo M, Lieslehto J, Witzel J, Bogerts B, Walter M, Falkai P, Koutsouleris N, Schiltz K. Patterns of risk-Using machine learning and structural neuroimaging to identify pedophilic offenders. Front Psychiatry 2023; 14:1001085. [PMID: 37151966 PMCID: PMC10157073 DOI: 10.3389/fpsyt.2023.1001085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/27/2023] [Indexed: 05/09/2023] Open
Abstract
Background Child sexual abuse (CSA) has become a focal point for lawmakers, law enforcement, and mental health professionals. With high prevalence rates around the world and far-reaching, often chronic, individual, and societal implications, CSA and its leading risk factor, pedophilia, have been well investigated. This has led to a wide range of clinical tools and actuarial instruments for diagnosis and risk assessment regarding CSA. However, the neurobiological underpinnings of pedosexual behavior, specifically regarding hands-on pedophilic offenders (PO), remain elusive. Such biomarkers for PO individuals could potentially improve the early detection of high-risk PO individuals and enhance efforts to prevent future CSA. Aim To use machine learning and MRI data to identify PO individuals. Methods From a single-center male cohort of 14 PO individuals and 15 matched healthy control (HC) individuals, we acquired diffusion tensor imaging data (anisotropy, diffusivity, and fiber tracking) in literature-based regions of interest (prefrontal cortex, anterior cingulate cortex, amygdala, and corpus callosum). We trained a linear support vector machine to discriminate between PO and HC individuals using these WM microstructure data. Post hoc, we investigated the PO model decision scores with respect to sociodemographic (age, education, and IQ) and forensic characteristics (psychopathy, sexual deviance, and future risk of sexual violence) in the PO subpopulation. We assessed model specificity in an external cohort of 53 HC individuals. Results The classifier discriminated PO from HC individuals with a balanced accuracy of 75.5% (sensitivity = 64.3%, specificity = 86.7%, P 5000 = 0.018) and an out-of-sample specificity to correctly identify HC individuals of 94.3%. The predictive brain pattern contained bilateral fractional anisotropy in the anterior cingulate cortex, diffusivity in the left amygdala, and structural prefrontal cortex-amygdala connectivity in both hemispheres. This brain pattern was associated with the number of previous child victims, the current stance on sexuality, and the professionally assessed risk of future sexual violent reoffending. Conclusion Aberrant white matter microstructure in the prefronto-temporo-limbic circuit could be a potential neurobiological correlate for PO individuals at high-risk of reoffending with CSA. Although preliminary and exploratory at this point, our findings highlight the general potential of MRI-based biomarkers and particularly WM microstructure patterns for future CSA risk assessment and preventive efforts.
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Affiliation(s)
- David Popovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- Department of Forensic Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- *Correspondence: David Popovic,
| | - Maximilian Wertz
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- Department of Forensic Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Carolin Geisler
- Department of Dermatology, Venereology, and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Joern Kaufmann
- Department of Neurology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - Johannes Lieslehto
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
| | - Joachim Witzel
- Central State Forensic Psychiatric Hospital of Saxony-Anhalt, Uchtspringe, Germany
| | - Bernhard Bogerts
- Salus Institut, Salus gGmbH, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Kolja Schiltz
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- Department of Forensic Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany
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Dynamic Changes in Plasma Metabolic Profiles Reveal a Potential Metabolite Panel for Interpretation of Fatal Intoxication by Chlorpromazine or Olanzapine in Mice. Metabolites 2022; 12:metabo12121184. [PMID: 36557223 PMCID: PMC9782175 DOI: 10.3390/metabo12121184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/11/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Diagnosing the cause of fatal intoxication by antipsychotic agents is an important task in forensic practice. In the 2020 Annual Report of the American Association of Poison Control Centers, among 40 deaths caused by antipsychotics, 21 cases were diagnosed as "probably responsible", thereby indicating that more objective diagnostic tools are needed. We used liquid chromatography-mass spectrometry-based integrated metabolomics analysis to measure changes in metabolic profiles in the plasma of mice that died from fatal intoxication due to chlorpromazine (CPZ) or olanzapine (OLA). These results were used to construct a stable discriminative classification model (DCM) comprising L-acetylcarnitine, succinic acid, and propionylcarnitine between fatal intoxication caused by CPZ/OLA and cervical dislocation (control). Performance evaluation of the classification model in mice that suffered fatal intoxication showed relative specificity for different pharmacodynamic drugs and relative sensitivity in different life states (normal, intoxication, fatal intoxication). A stable level of L-acetylcarnitine and variable levels of succinic acid and propionylcarnitine between fatal-intoxication and intoxication groups revealed procedural perturbations in metabolic pathways related to fatal intoxication by CPZ/OLA. Additional stability studies revealed that decomposition of succinic acid in fatal-intoxication samples (especially in the OLA group) could weaken the prediction performance of the binary-classification model; however, levels of these three potential metabolites measured within 6 days in fresh samples kept at 4 °C revealed a good performance of our model. Our findings suggest that metabolomics analysis can be used to explore metabolic alterations during fatal intoxication due to use of antipsychotic agents and provide evidence for the cause of death.
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Miljkovitch R, Danner-Touati C, Gery I, Bernier A, Sirparanta A, Deborde AS. The role of multiple attachments in intergenerational transmission of child sexual abuse among male victims. CHILD ABUSE & NEGLECT 2022; 128:104864. [PMID: 33358280 DOI: 10.1016/j.chiabu.2020.104864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND According to Finkelhor (1984), difficulties child sexual abusers have in establishing adaptive adult relationships are a consequence of attachment problems with parents. Research shows that insecure attachment is associated with both the experience of child sexual abuse (CSA) as a victim and perpetration of CSA as an adult. Attachment may thus be a key factor in intergenerational transmission (IT) of CSA. OBJECTIVE The study aims to examine the direct, interactive, and mediated effects linking attachment in different relationships (mother, father, romantic partner) to IT of CSA among male victims. PARTICIPANTS AND SETTING Thirty-two abusing and 27 non-abusing male CSA survivors were recruited, respectively, in a prison and via networks of former foster children or CSA victims. METHOD All participants completed the Attachment Multiple Model Interview to assess attachment along four dimensions (security, deactivation, hyperactivation, and disorganization) in the relationship with mother, father, and partner. RESULTS Partial least square modeling suggests that the partner carries forward (mediates) the increased risk of committing sexual abuse associated with insecure/disorganized attachment with the father. A significant partner-mother interaction also suggests that the deleterious effects of attachment to the mother in terms of committing CSA are countered by more secure/organized attachment to the partner. CONCLUSIONS Findings highlight the pivotal role of the romantic partner in IT of CSA. Beyond early intervention, therapy in adulthood aimed at fostering adaptive ways of finding emotional security in the relationship with an adult could thus be encouraged.
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Affiliation(s)
- Raphaële Miljkovitch
- Laboratoire Paragraphe EA 349, Paris 8 University, 2 Rue de la Liberté, 93200, Saint-Denis, France.
| | - Camille Danner-Touati
- Laboratoire Paragraphe EA 349, Paris 8 University, 2 Rue de la Liberté, 93200, Saint-Denis, France.
| | - Isabelle Gery
- Penitentiary Center Poitiers-Divonne, Champ des Grolles - RD742, CS 80029, 86370, Vivonne, France.
| | - Annie Bernier
- Department of Psychology, University of Montreal, C.P. 6128, Succ. Centre-Ville, Montréal, Qc H3C 3J7, Canada.
| | - Aino Sirparanta
- Laboratoire Paragraphe EA 349, Paris 8 University, 2 Rue de la Liberté, 93200, Saint-Denis, France.
| | - Anne-Sophie Deborde
- Laboratoire Paragraphe EA 349, Paris 8 University, 2 Rue de la Liberté, 93200, Saint-Denis, France.
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Landgren V, Savard J, Dhejne C, Jokinen J, Arver S, Seto MC, Rahm C. Pharmacological Treatment for Pedophilic Disorder and Compulsive Sexual Behavior Disorder: A Review. Drugs 2022; 82:663-681. [PMID: 35414050 PMCID: PMC9064854 DOI: 10.1007/s40265-022-01696-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 01/21/2023]
Abstract
Guidelines for the pharmacological treatment of paraphilic disorders have historically been based on data from forensic settings and on risk levels for sexual crime. However, emerging treatment options are being evaluated for individuals experiencing distress because of their sexual urges and preferences, targeting both paraphilic disorders such as pedophilic disorder (PeD) and the new diagnosis of compulsive sexual behavior disorder (CSBD) included in the International Classification of Diseases, 11th Revision (ICD-11). As in other mental disorders, this may enable individualized pharmacological treatment plans, taking into account components of sexuality (e.g. high libido, compulsivity, anxiety-driven/sex as coping), medical and psychiatric comorbidity, adverse effects and patient preferences. In order to expand on previous reviews, we conducted a literature search focusing on randomized controlled trials of pharmacological treatment for persons likely to have PeD or CSBD. Our search was not restricted to studies involving forensic or criminal samples. Twelve studies conducted between 1974 and 2021 were identified regardless of setting (outpatient or inpatient), with only one study conducted during the last decade. Of a total of 213 participants included in these studies, 122 (57%) were likely to have PeD, 34 (16%) were likely to have a CSBD, and the remainder had unspecified paraphilias (40, 21%) or sexual offense (17, 8%) as the treatment indication. The diagnostic procedure for PeD and/or CSBD, as well as comorbid psychiatric symptoms, has been described in seven studies. The studies provide some empirical evidence that testosterone-lowering drugs reduce sexual activity for patients with PeD or CSBD, but the body of evidence is meager. There is a need for studies using larger samples, specific criteria for inclusion, longer follow-up periods, and standardized outcome measures with adherence to international reporting guidelines.
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Affiliation(s)
- Valdemar Landgren
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Josephine Savard
- Anova, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
| | - Cecilia Dhejne
- Anova, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jussi Jokinen
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden.,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Stefan Arver
- Anova, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Christoffer Rahm
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
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Jahnke S, Schmidt AF, Klöckner A, Hoyer J. Neurodevelopmental Differences, Pedohebephilia, and Sexual Offending: Findings from Two Online Surveys. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:849-866. [PMID: 34993718 PMCID: PMC8888371 DOI: 10.1007/s10508-021-02228-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 06/14/2023]
Abstract
The neurodevelopmental theory of pedohebephilia states that sexual interests in children arise from early neurodevelopmental perturbations, as, for example, evidenced by increased non-right-handedness, more childhood head injuries, and reduced intelligence and height. As corroborating evidence largely rests on samples of convicted men, we conducted online surveys among German-speaking (Study 1, N = 199) and English-speaking men (Study 2, N = 632), specifically targeting community members with pedohebephilic or teleiophilic interests. Although we detected theoretically meaningful sexual interest patterns in an embedded viewing time task, we could not detect expected neurodevelopmental differences between teleiophilic and pedohebephilic men in either of the two studies. Strikingly, pedohebephilic men who reported convictions for sexual offenses emerged as shorter and less intelligent than pedohebephilic men without convictions in Study 2. While elucidating possible third variable confounds, results have to be interpreted cautiously because of the methodological problems inherent to non-matched case control designs.
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Affiliation(s)
- Sara Jahnke
- Department of Health Promotion and Development, University of Bergen, 5020, Bergen, Norway.
| | - Alexander F Schmidt
- Department of Psychology, Social & Legal Psychology, Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Andrea Klöckner
- Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Hoyer
- Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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13
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Speer L, Schuler M, Keil J, Moran JK, Pantazidis P, Amelung T, Florack J, Beier KM, Senkowski D. Sexual preference for prepubescent children is associated with enhanced processing of child faces in juveniles. Eur Child Adolesc Psychiatry 2022; 31:261-274. [PMID: 33230608 PMCID: PMC8837509 DOI: 10.1007/s00787-020-01684-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022]
Abstract
Child sexual abuse offences (CSOs) represent a severe ethical and socioeconomic burden for society. Juveniles with a sexual preference for prepubescent children (PP) commit a large percentage of CSOs, but have been widely neglected in neuroscience research. Aberrant neural responses to face stimuli have been observed in men with pedophilic interest. Thus far, it is unknown whether such aberrations exist already in PP. A passive face-viewing paradigm, including the presentation of child and adult faces, was deployed and high-density electroencephalography data were recorded. The study group comprised 25 PP and the control group involved 22 juveniles with age-adequate sexual preference. Attractiveness ratings and evoked brain responses were obtained for the face stimuli. An aberrant pattern of attractiveness ratings for child vs. adult faces was found in the PP group. Moreover, elevated occipital P1 amplitudes were observed for adult vs. child faces in both groups. At longer latency (340-426 ms), a stronger negative deflection to child vs. adult faces, which was source localized in higher visual, parietal and frontal regions, was specifically observed in the PP group. Our study provides evidence for enhanced neural processing of child face stimuli in PP, which might reflect elevated attention capture of face stimuli depicting members from the sexually preferred age group. This study expands our understanding of the neural foundations underlying sexual interest in prepubescent children and provides a promising path for the uncovering of objective biomarkers of sexual responsiveness to childlike body schemes in juveniles.
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Affiliation(s)
- Lara Speer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Sexology and Sexual Medicine, Charitéplatz 1, 10117, Berlin, Germany.
| | - Miriam Schuler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Sexology and Sexual Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Julian Keil
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Biological Psychology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - James K Moran
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Pierre Pantazidis
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Sexology and Sexual Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Till Amelung
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Sexology and Sexual Medicine, Charitéplatz 1, 10117, Berlin, Germany
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jakob Florack
- Child and Adolescent Psychiatry, Vivantes Hospital Berlin, Berlin, Germany
| | - Klaus M Beier
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Sexology and Sexual Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Daniel Senkowski
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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14
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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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