Skip to main content
Erschienen in: Current Sexual Health Reports 4/2018

20.08.2018 | Current Controversies (PJ Kleinplatz and C Moser, Section Editors)

“Can People with Pedophilia Change?: Yes they can!”

verfasst von: J. Paul Fedoroff

Erschienen in: Current Sexual Health Reports | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

This review is written in response to an invitation to explain why clinicians should reconsider the statement: “Once a pedophile always a pedophile”.

Recent Findings

Reviewed in this paper are challenges to the concept that pedophilia is “hard-wired” during a “critical period”, the idea that all people with pedophilia reoffend, the idea that people with pedophilia are like “boiling pots”, and that high-risk sex offenders are always high risk. The idea that pedophilia is an orientation is also redefined. Together, these observations and studies support a paradigm shift in favor of pedophilia being viewed as treatable condition characterized by a persistent sexual interest in children and a failure to develop adult sexual interests.

Summary

The available evidence suggests that sexual interests are subject to the same range of influences as other interests. In the absence of any evidence to the contrary, clinicians should inform patients that there is no evidence that paraphilias, including pedophilia, cannot change. This therapeutic perspective is evidence based and increases the responsibility that people with pedophilia take for their actions and enhances their motivation and optimism for healthy change in both sexual interests and actions. This perspective enhances the prospect of successful treatment outcomes for people with pedophilia (and other) paraphilias.
Literatur
1.
Zurück zum Zitat Fedoroff JP, Wisner-Carlson R, Dean S, Berlin FS. Rate of relapse in paraphilic men treated in psychotherapy for at least five years with or without medroxyprogesterone acetate. In: Coleman EE, Dwyer SW, Pullone NJ, editors. Sex offender treatment: psychological and medical approaches. New York: The Hamilton Press; 1992. p. 109–23. Fedoroff JP, Wisner-Carlson R, Dean S, Berlin FS. Rate of relapse in paraphilic men treated in psychotherapy for at least five years with or without medroxyprogesterone acetate. In: Coleman EE, Dwyer SW, Pullone NJ, editors. Sex offender treatment: psychological and medical approaches. New York: The Hamilton Press; 1992. p. 109–23.
2.
Zurück zum Zitat Money, J Lovemaps (p. 290) Buffalo NY, Prometheus Books, 1986. Money, J Lovemaps (p. 290) Buffalo NY, Prometheus Books, 1986.
3.
Zurück zum Zitat Ansaldo AI, Marcotte K, Scherer L, Raboyeau G. Language therapy and bilingual aphasia: clinical implications of psycholinguistic and neuroimaging research. J Neurolinguistics. 2008;21:539–57.CrossRef Ansaldo AI, Marcotte K, Scherer L, Raboyeau G. Language therapy and bilingual aphasia: clinical implications of psycholinguistic and neuroimaging research. J Neurolinguistics. 2008;21:539–57.CrossRef
4.
Zurück zum Zitat Fedoroff JP. Paraphilic worlds. In: Levine SB, editor. Handbook of clinical sexuality for mental health professionals. New York: Routledge; 2010. p. 401–24. Fedoroff JP. Paraphilic worlds. In: Levine SB, editor. Handbook of clinical sexuality for mental health professionals. New York: Routledge; 2010. p. 401–24.
5.
Zurück zum Zitat American Psychiatric Association: DSM-5. Arlington, VA. American Psychiatric Association, 2013. American Psychiatric Association: DSM-5. Arlington, VA. American Psychiatric Association, 2013.
6.
Zurück zum Zitat World Health Organization: International classification of diseases-10, WHO, 1999. World Health Organization: International classification of diseases-10, WHO, 1999.
7.
Zurück zum Zitat • Mcphail IV. Age of onset in pedohebophilic interests. Arch Sex Behav. 2018; https://doi.org/10.1007/s10508-018-1198-3. A recent article discussing the self-reported age of onset of sexual interest in people with and without pedophilia. It is comprehensive but omits discussion of the age of onset of sexual interest in adults. CrossRef • Mcphail IV. Age of onset in pedohebophilic interests. Arch Sex Behav. 2018; https://​doi.​org/​10.​1007/​s10508-018-1198-3. A recent article discussing the self-reported age of onset of sexual interest in people with and without pedophilia. It is comprehensive but omits discussion of the age of onset of sexual interest in adults. CrossRef
8.
Zurück zum Zitat Doidge N. The brain that changes itself : stories of personal triumph from the frontiers of brain science. Carlton North: Scribe Publications; 2010. Doidge N. The brain that changes itself : stories of personal triumph from the frontiers of brain science. Carlton North: Scribe Publications; 2010.
9.
Zurück zum Zitat Kuhn TS. The Structure of Scientific Revolutions. Chicago: University of Chicago Press; 1962. ISBN 0-226-45808-3 Kuhn TS. The Structure of Scientific Revolutions. Chicago: University of Chicago Press; 1962. ISBN 0-226-45808-3
10.
Zurück zum Zitat •• Shields M, Tonmyr L, Hovdestad. Is child sexual abuse declining in Canada? Results from nationally representaive retrospective surveys. Health Promot Chronic Dis Prev Can. 2016;36(11):252–60. One of the most recent reviews of the declining incidence of reported child sexual abuse. CrossRef •• Shields M, Tonmyr L, Hovdestad. Is child sexual abuse declining in Canada? Results from nationally representaive retrospective surveys. Health Promot Chronic Dis Prev Can. 2016;36(11):252–60. One of the most recent reviews of the declining incidence of reported child sexual abuse. CrossRef
11.
Zurück zum Zitat Finkelhor D, Jones LM. Explanations for the decline in child abuse cases. Juvenile justice bulletin – NCJ199298 (pp 1–12). Washington DC: US Government Printing Office; 2004. Finkelhor D, Jones LM. Explanations for the decline in child abuse cases. Juvenile justice bulletin – NCJ199298 (pp 1–12). Washington DC: US Government Printing Office; 2004.
12.
Zurück zum Zitat Hanson KR, Morton-Bourgon K. “Predictors of sexual recidivism” an updated meta-analysis 2004–02. Ottawa: Public Safety and Emergency Preparedness; 2004. Hanson KR, Morton-Bourgon K. “Predictors of sexual recidivism” an updated meta-analysis 2004–02. Ottawa: Public Safety and Emergency Preparedness; 2004.
15.
Zurück zum Zitat Fedoroff JP. The paraphilias. In: Gelder MG, Andereasen NC, Lopez-Iber Jr JJ, Beddes JR, editors. The new Oxford textbook of psychiatry. 2nd ed. Oxford: Oxford University Press; 2009. p. 832–42. Fedoroff JP. The paraphilias. In: Gelder MG, Andereasen NC, Lopez-Iber Jr JJ, Beddes JR, editors. The new Oxford textbook of psychiatry. 2nd ed. Oxford: Oxford University Press; 2009. p. 832–42.
16.
Zurück zum Zitat Diamond M. Pornography, public acceptance and sex related crime: a review. Int J Law Psychiatry. 2009;32:304–14.CrossRef Diamond M. Pornography, public acceptance and sex related crime: a review. Int J Law Psychiatry. 2009;32:304–14.CrossRef
17.
Zurück zum Zitat Murphy L, Bradford JB, Fedoroff JP. Paraphilia and paraphilic disorders. In: Gabbard GO, editor. Gabbard’s treatments of psychiatric disorders. Washington, DC: American Psychiatric Publishing; 2014. p. 669–94. Murphy L, Bradford JB, Fedoroff JP. Paraphilia and paraphilic disorders. In: Gabbard GO, editor. Gabbard’s treatments of psychiatric disorders. Washington, DC: American Psychiatric Publishing; 2014. p. 669–94.
18.
Zurück zum Zitat Waldram, JE. Hound Pound narrative: sexual offender habilitation and the anthology of therapeutic intervention. Berkeley: University of California Press; 2012. Waldram, JE. Hound Pound narrative: sexual offender habilitation and the anthology of therapeutic intervention. Berkeley: University of California Press; 2012.
19.
Zurück zum Zitat • Fedoroff P, Curry S, Ranger RC, Bradford JMW. Regression to the mean or the Semmelweis reflex? Invited Commentary. Arch Sex Behav. 2016;45(7):1869–70. https://doi.org/10.1007/s10508-016-0786-3. This is a response to a series of criticisms of a retrospective study that reported both a decrease in penile tumescence in response to pedophilic stimuli and an increase in penile tumescence in response to adult sexual stimuli in a group of men diagnosed with pedophilia. CrossRefPubMed • Fedoroff P, Curry S, Ranger RC, Bradford JMW. Regression to the mean or the Semmelweis reflex? Invited Commentary. Arch Sex Behav. 2016;45(7):1869–70. https://​doi.​org/​10.​1007/​s10508-016-0786-3. This is a response to a series of criticisms of a retrospective study that reported both a decrease in penile tumescence in response to pedophilic stimuli and an increase in penile tumescence in response to adult sexual stimuli in a group of men diagnosed with pedophilia. CrossRefPubMed
20.
Zurück zum Zitat •• CBC Ideas “Born that way?” (May) Expert commentator and interview http://www.cbc.ca/ideas/episodes/2017/04/11/born-that-way/ (accessed April 2, 2018). This hour long program presents a “debate” between Drs. Cantor and Fedoroff of the treatability of pedophilia and includes statements from a man who thinks his pedophilic interests will never change and one of Dr. Fedoroff’s patients who reports his pedophilic interest have changed. To date, Dr. Fedoroff’s patient continues to report he no longer has sexual thoughts about children and has not been re-charged or arrested. •• CBC Ideas “Born that way?” (May) Expert commentator and interview http://​www.​cbc.​ca/​ideas/​episodes/​2017/​04/​11/​born-that-way/​ (accessed April 2, 2018). This hour long program presents a “debate” between Drs. Cantor and Fedoroff of the treatability of pedophilia and includes statements from a man who thinks his pedophilic interests will never change and one of Dr. Fedoroff’s patients who reports his pedophilic interest have changed. To date, Dr. Fedoroff’s patient continues to report he no longer has sexual thoughts about children and has not been re-charged or arrested.
Metadaten
Titel
“Can People with Pedophilia Change?: Yes they can!”
verfasst von
J. Paul Fedoroff
Publikationsdatum
20.08.2018
Verlag
Springer US
Erschienen in
Current Sexual Health Reports / Ausgabe 4/2018
Print ISSN: 1548-3584
Elektronische ISSN: 1548-3592
DOI
https://doi.org/10.1007/s11930-018-0166-1

Weitere Artikel der Ausgabe 4/2018

Current Sexual Health Reports 4/2018 Zur Ausgabe

Female Sexual Dysfunction and Disorders (T Lorenz and R Nappi, Section Editors)

Hormonal Contraception and Sexuality

Male Sexual Dysfunction and Disorders (A Pastuszak and N Gupta, Section Editors)

Contemporary Review of BPH Medical and Surgical Treatments on Sexual Function

Current Controversies (PJ Kleinplatz and C Moser, Section Editors)

Can Pedophiles Change? Response to Opening Arguments and Conclusions

Sexual Orientation and Identity (E Coleman and J Vencill, Section Editors)

Improving Clinical Education and Training on Sexual and Gender Minority Health

Female Sexual Dysfunction and Disorders (T Lorenz and R Nappi, Section Editors)

Impact of Infertility on the Sexuality of Couples: an Overview

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.