Pedophilic disorder pertains to both individuals who freely disclose this paraphilic interest and individuals who deny any sexual attraction to prepubescent children—or those 13 years and younger—despite substantial evidence of the attraction. For example, an individual who openly acknowledges that their sexual interest in children is real and greater than their sexual interest in older, mature individuals, is someone who discloses this paraphilia. If this same individual complains that this interest is causing psychosocial difficulties, only then may they be diagnosed with pedophilic disorder. If they do not feel guilt, shame, or anxiety related to these interests and have never acted on these impulses, they can be characterized as having pedophilic sexual orientation but not pedophilic disorder. And an individual who denies their interest in children but clearly seeks them out and does foster this interest may still be diagnosed with pedophilic disorder.
Diagnostic Criteria for Pedophilic Disorder DSM-5 302.2 (F65.4)
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), outlines diagnostic criteria that must be met in order for a diagnosis of pedophilic disorder to be made. The criteria are as follows:
The individual experiences intense sexually arousing fantasies or urges involving sexual activity
- with prepubescent children, over a period of at least 6 months.
- The individual has acted on these sexual urges, or the urges have caused serious distress.
- He or she is at least 16 years of age and at least 5 years older than his or her victim. Note: This does not pertain to individuals in late adolescence who are involved in ongoing sexual relationships with, say, 12 or 13-year-olds.
If the individual meets the criteria for pedophilic disorder, it should also be evaluated and specified if the disorder is:
- Exclusive type, whereas the individual is only attracted to children
- Nonexclusive type, whereas the individual is attracted to children in addition to mature individuals.
- Limited to incest
And if the individual is:
- Sexually attracted to males
- Sexually attracted to females
- Sexually attracted to both
Who Is at Risk of Developing Pedophilic Disorder DSM-5 302.2 (F65.4)?
There are, indeed, a few individuals at greater risk of developing pedophilic disorder. First, there appears to be a correlation between pedophilia and antisociality, as males with both traits are more likely to engage in sexual behavior with children. Therefore, antisocial personality disorder may also be a risk factor for pedophilic disorder. Secondly, many adult males with pedophilia report a history of being sexually abused in their childhood; this may or may not reflect a causal relationship. And lastly, any factor that increases the risk of pedophilia similarly increases the risk of pedophilic disorder. One of these factors may be neurodevelopmental perturbation in utero.
Development and Course
Adult males with pedophilic disorder have reported noticing their sexual interest in children during or around puberty, which is the same time that males become aware of their sexual orientation or whether they’re interested in women or men. However, it’s difficult to diagnose pedophilic disorder at such a young age due to differences in adolescent development and factors such as age-appropriate sexual interest and sexual curiosity. This accounts for why an individual must be at least 16 years of age and 5 years older than the child to be diagnosed with the disorder.
The elements of pedophilic disorder may change over time, whether n individual undergoes or forgoes treatment. These elements include subjective distress (e.g., guilt or shame), psychosocial impairment, or the inclination to engage in sexual behaviors with children. Additionally, the older an individual is the less likely he or she is to engage in sexual behavior with children.
Is There Treatment for Pedophilic Disorder?
Those who suffer from pedophilic disorder are not left alone to deal with their illness. There are a couple effective treatment options available to them:
Psychotherapy: Cognitive-behavioral models have proven to successfully treat individuals with pedophilic disorder. These models utilize victim empathy, assertiveness training, relapse prevention, and also involve confronting the individual’s cognitive distortions as well as teaching lifelong maintenance. Ultimately, this form of therapy will work to correct a pedophile’s thoughts and beliefs that children wish to be involved in the activity and help the offender identify with the victim as well.
Medication: Medication is often used simultaneously with psychotherapy. These medications include:
- Antiandrogens, such as Provera and Lupron, which lower sex drive
- Selective serotonin reuptake inhibitors, which treat associated compulsive sexual disorders