Pedophilia--The Definition

 

REPORT SUSPECTED CHILD ABUSE

A few weeks ago I wrote something about this (no, not the Praying Mantis post, something more serious) and took it down within the hour. I wasn’t in a good place, wasn't thinking like an academic, relied upon my memory for definitions and realize that's probably not a great idea. 

So I thought I’d take the topic in small, manageable bites, differentiate between sociopathy and pedophilia. Because a person can assault a child sexually and have no sexual interest in children at all, and a person can have intense sexual interest in children and never act upon his or her desires. 

Health professionals rely upon ICD 10 and 11 and the ICD relies upon the DSM-5 for mental health codes, so this discussion will stay within those parameters excepting the World Health Organization. 

The ICD-10-11 defines pedophilia as a "sustained, focused, and intense pattern of sexual arousal—as manifested by persistent sexual thoughts, fantasies, urges, or behaviours—involving pre-pubertal children.' 

The DSM-5 goes on to require that harm to the self or others is implicit in pedophilia as a disorder, but not as a condition or a state. But before we go over the DSM-5 criterion note that the World Health Organization's definition includes wider social ramifications:

Pedophilia refers to the sexual preference for children and poses a primary motivator for child molestation, which can incur great emotional and financial burdens on victims and on society, as well as on the pedophilic individuals themselves.  

Let's look at a bit of history, why don't we.

For over seventy years pedophilia has been classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders of by the American Psychiatric Associations. The DSM is upgraded every few decades and pedophilia has traditionally been classified as either a Psychosexual Disorder or a Paraphilic Disorder. The latest version of the DSM, the DSM-5, classifies it as a paraphilic disorder. There are dozens of these, but only 8 are chosen for the DSM primarily ‘because they are relatively common and some also entail actions for their satisfaction that, because of their noxiousness or potential harm to others, are classed as criminal offenses.’

 The 8 DSM-5 paraphilic disorders: 

voyeuristic disorder (spying on others in private activities)

exhibitionistic disorder (exposing the genitals)

frotteuristic disorder (touching or rubbing against a nonconsenting individual) 

sexual masochism disorder (undergoing humiliation, bondage, or suffering)

sexual sadism disorder (inflicting humiliation, bondage, or suffering)

pedophilic disorder (sexual focus on children)

 

fetishistic disorder (using nonliving objects or having a highly specific focus on nongenital parts of the body, and 

transvestic disorder (engaging in sexually arousing cross-dressing).  

Pedophilic disorder is considered an anomalous target preference disorder. Anomalous means that it deviates from the norm, from what is expected.

The label paraphilia denotes any intense or persistent  sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners. The DSM takes into accountability that the interest may be less intense or persistent as among the very ill or elderly. 

Note: children cannot legally consent to sexual relationships. 

For a paraphilia to be a disorder it must cause intense distress to the one who has it or personal harm or risk of harm to the target. Having a paraphilia, according to the manual, does not justify or require treatment. 

The DSM-5* criterion for Pedophilic Disorder F65.4 (302.2)   

A.     A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger)

B.     B. The individual has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty

C.     C. The individual is at least 16 years old and at least 5 years older than the child or children in Criterion A.

Note: Do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12 or 13 year old. 

Specify whether:

Exclusive type (attracted only to children)

Nonexclusive type

Specify if: 

Sexually attracted to males

Sexually attracted to females

Sexually attracted to both

 

Pedophilic sexual orientation is not the same thing, according the DSM—5. Here: the individual is not distressed or suffering any guilt, shame or anxiety about a sexual attraction to children, reports never having acted upon these impulses, and is not otherwise functionally limited by the paraphilic impulses and has not acted upon them.

 A person with pedophilia has an attraction to children that begins at puberty and doesn’t abate over time. What might change over time are feelings of distress, i.e. guilt and shame, feelings of isolation, or the propensity to act upon the desire. 

 The prevalence is not known, but is estimated to be approximately between 3-5% of the male population, unknown for females at the time the DSM-5 published in 2013. There is new data on women and I am waiting for the research to be delivered to my mailbox, hopefully soon. It suggests there is no difference between males and females.

 One is more likely to act on sexual impulses if diagnosed with antisocial personality disorder so the personality disorder is a risk factor. This explains my vitriol in the post that I took down, my screaming that a school pedophile who likely harmed a dozen or so children should be reported to police because this is NOT A NICE GUY, rather is a sociopath and should be in jail. 

So I wasn’t so off the mark on that one. 

But to be clear. One not have a diagnosable antisocial personality disorder to be a pedophile who acts upon his impulses. Pedophilia itself is the risk factor, a condition, a disorder that can cause emotional, psychological, social and financial harm to children.

One not have a diagnosable antisocial personality disorder to commit sexual crimes with children, nor need one be a pedophile to commit sexual crimes against children. 

 When we refer to the association between antisocial personality disorder and child sexual assault, it is about an adult with the personality disorder using the child for sex on the basis of accessibility. The child is available. A pedophile who works in a school and seduces children is harming them. He may not have antisocial personality disorder but intentionally harming children is sociopathy, a legal parlance. This is why I so strongly suggest that law enforcement be the judge regarding criminality, not school authorities. 

That and all school personnel are mandated reporters in most states. They must report to state departments of protective services. In Illinois, for example, mandated reporters must call the Department of Child and Family Services Child Abuse Hotline.

24-hours 800-25-ABUSE (800-252-2873)    Mandated means that if you have a suspicion of child abuse of any kind, you are required by law to call that number.  Mandated reporters include:

physicians physician assistants psychiatrists, surgeons residents interns dentists dental hygienists medical examiners pathologists osteopaths coroners Christian Science practitioners chiropractors podiatrists registered and licensed practical nurses emergency medical technicians hospital administrators and other personnel involved in the examination care or treatment of patients

teachers school personnel educational advocates assigned to a child pursuant to the School Code directors and staff assistants of day care centers and nursery schools child care workers truant officers probation officers law enforcement officers animal control officers field personnel of the Departments of Children and Family Services, Public Health, Public Aid, Human Services (acting as successor to the Department of Mental Health and Developmental Disabilities Rehabilitation Services, or Public Aid), Corrections and Human Rights

Bottom line: Not everyone who assaults children sexually is a pedophile, and not every individual diagnosed with pedophilia is dangerous to children. 

And anyone who suspects a child is being abused or sexually assaulted, molested, should report it. You don't need a mandate. 

therapydoc

*Note: The DSM-5 TR (text revised) is out and mine is due to arrive in early December. This post will have a refresh after that.