A psychiatrist recounts a case of a man presenting with severe depression who claimed to have abused children and his pet dog. Clinical management of the case hinged on whether this claim was true, a lie or delusional. The uncertainty over this raised complex ethical dilemmas regarding confidentiality and protection of the public (and animals). (+info)
Lower baseline plasma cortisol and prolactin together with increased body temperature and higher mCPP-induced cortisol responses in men with pedophilia.
There is some evidence that hormonal and serotonergic alterations may play a role in the pathophysiology of paraphilias. The aims of the present study were to examine: 1) baseline plasma cortisol, plasma prolactin, and body temperature; and 2) cortisol, prolactin, body temperature, as well as behavioral responses to meta-chlorophenylpiperazine (mCPP) and placebo in pedophiles and normal men. Pedophiles showed significantly lower baseline plasma cortisol and prolactin concentrations and a higher body temperature than normal volunteers. The mCPP-induced cortisol responses were significantly greater in pedophiles than in normal volunteers. In normal volunteers, mCPP-induced a hyperthermic response, whereas in pedophiles no such response was observed. mCPP induced different behavioral responses in pedophiles than in normal men. In pedophiles, but not in normal men, mCPP increased the sensations "feeling dizzy, " "restless," and "strange" and decreased the sensation "feeling hungry". The results suggest that there are several serotonergic disturbances in pedophiles. It is hypothesized that the results are compatible with a decreased activity of the serotonergic presynaptic neuron and a 5-HT2 postsynaptic receptor hyperresponsivity. (+info)
Penile tumescence assessment used for a diagnosis of paraphilia: a pedophilia case report.
We report on the use of penile tumescence assessment to diagnose a paraphiliac client who was in denial about his problem. An 18-year-old male was accused of sexually assaulting a 4-year-old girl using physical restraint and vaginal penetration with a finger. During a psychiatric evaluation requested by the court, a comprehensive psychosexual assessment revealed that the subject was in denial about clarification of the paraphiliac experience. Penile tumescence under distinct visual stimulus was evaluated with electrobioimpedence volumetric assessment using child and adult female pictures in separate time frames. Both types of stimuli evoked arousal responses. However, child female stimuli demonstrated stronger responses than did adult female ones. Deviant sexual interest in children as well as a diagnosis of pedophilia was implied. Paraphiliac clients tend to be in denial toward psychosexual assessment which limits the interpretation of its results. Penile tumescence assessment may be more reliable than psychosexual assessment alone for detecting and diagnosing paraphilia. Further study is warranted in order to aid in more accurate diagnoses of paraphilia. (+info)
Paedophilia on the Internet--a study of 33 convicted offenders in the Canton of Lucerne.
BACKGROUND: The connection between the consumption of pornography and "contact-crimes" is unclear. The Internet has facilitated the mass consumption of pornography in general and specifically illegal pornography such as child-pornography. In 1999, the owners of "Landslide Production Inc.", an international provider of child-pornography in the USA were arrested and the credit-card-numbers of their clients were put at the disposal of the law enforcement agencies of the countries concerned. METHODS: Roughly 1300 Swiss citizens were subsequently arrested in the course of the nationwide action "Genesis". In the canton of Lucerne 33 men were identified. The police-files of these men were screened for psychosocial, criminological and psychosexual data. RESULTS: Most of these middle-aged men held comparatively elevated professional positions, only ten were married, eleven had never had an intimate relationship to a woman, and only thirteen of them had children. Only one of them had a relevant criminal record. The level of abuse depicted in the illegal material was high, all but one consumed pornography from other fields of sexual deviation. The personal statements of the offenders in general were hardly reliable, in three cases, however, the diagnosis of sexual deviation could be established from the files. The estimated time some of the offenders must have spent online in order to retrieve the material allows the diagnosis of Pathological Internet-Use. CONCLUSIONS: Deviant sexual fantasies seem to be widespread also among men otherwise not registered for any offences. The consumption of even particularly disgusting material may not be a specific risk factor for "contact" crimes. (+info)
Brain response to visual sexual stimuli in homosexual pedophiles.
OBJECTIVE: The neurobiological mechanisms of deviant sexual preferences such as pedophilia are largely unknown. The objective of this study was to analyze whether brain activation patterns of homosexual pedophiles differed from those of a nonpedophile homosexual control group during visual sexual stimulation. METHOD: A consecutive sample of 11 pedophile forensic inpatients exclusively attracted to boys and 12 age-matched homosexual control participants from a comparable socioeconomic stratum underwent functional magnetic resonance imaging during a visual sexual stimulation procedure that used sexually stimulating and emotionally neutral photographs. Sexual arousal was assessed according to a subjective rating scale. RESULTS: In contrast to sexually neutral pictures, in both groups sexually arousing pictures having both homosexual and pedophile content activated brain areas known to be involved in processing visual stimuli containing emotional content, including the occipitotemporal and prefrontal cortices. However, during presentation of the respective sexual stimuli, the thalamus, globus pallidus and striatum, which correspond to the key areas of the brain involved in sexual arousal and behaviour, showed significant activation in pedophiles, but not in control subjects. CONCLUSIONS: Central processing of visual sexual stimuli in homosexual pedophiles seems to be comparable to that in nonpedophile control subjects. However, compared with homosexual control subjects, activation patterns in pedophiles refer more strongly to subcortical regions, which have previously been discussed in the context of processing reward signals and also play an important role in addictive and stimulus-controlled behaviour. Thus future studies should further elucidate the specificity of these brain regions for the processing of sexual stimuli in pedophilia and should address the generally weaker activation pattern in homosexual men. (+info)
The consumption of Internet child pornography and violent and sex offending.