Combining cognitive-behavioral therapy and pharmacotherapy in the treatment of pedophilic incest offenders

Treatment programs for incest offenders traditionally do not differentiate between pedophilic and nonpedophilic perpetrators. This oversight has failed to meet the specialized needs of pedophilic incest offenders, who differ from other incest as well as nonfamilial sex offenders in important ways. This paper describes a treatment intervention combining cognitive-behavioral therapy and pharmacotherapy for the specialized treatment needs of the pedophilic incest offender. A case report is presented to illustrate the use of combined treatment and to highlight indicators for this strategy.     

The sexual preferences of incest offenders.

Inclusive fitness theory suggests that discriminative solicitude and inbreeding avoidance are important mechanisms regulating parent-children interactions. From an inclusive fitness perspective, sex with one's biological children is paradoxical. The authors hypothesized that incest can occur when these mechanisms are not activated (e.g., if a father is uninvolved in child rearing) or are overwhelmed by another factor, such as pedophilic interest. They predicted that biological fathers, who presumably have been the most involved in the rearing of their victims, would show greater phallometrically measured pedophilic interest than would other incest offenders against children (e.g., grandfathers, uncles, stepfathers). The prediction was not supported. A testable alternative hypothesis to explain biological father incest is presented and the importance of assessing pedophilic interest among incest offenders is discussed.     

Parent-child relations in offenders who commit violent sexual crimes against children

One hundred eighty-one men were compared on parent–child relations, using the Clarke Parent–Child Relations Questionnaire. The sample included 66 heterosexual pedophiles, 29 homosexual pedophiles, 36 incest offenders and 50 controls. The offender groups were further divided into those who used force (20%) versus those who did not; into those sexually victimized as children themselves (53.2%) versus those not victimized; and into those physically abused as children (47.5%) versus those not abused. Results showed that the offender groups had more disturbances than controls in father–son relations, contrary to earlier findings showing disturbances in mother–son relations among individuals who interact sexually with minors. The offenders who used force in their offenses differed only in being more aggressive to their fathers as children, but otherwise did not differ from offenders who did not use force in their offenses. Offenders both sexually and physically abused as children showed more disturbances in father relationships than offenders who were not abused during their childhoods. Disturbed parent-child relations undoubtedly leave residual difficulties in sex offenders in later life, but in the present sample, they did not play the expected critical role in explaining the use of force by perpetrators who coerce children into sex.     

An implicit test of the associations between children and sex in pedophiles

Pedophiles are motivated to disguise their thoughts and feelings about their sexual beliefs and attraction toward children. New developments using implicit measures of associations have been successful in accessing socially stigmatic beliefs, even in cases in which the participant is resistant to this disclosure. Using an implicit measure, the authors show that pedophiles have an association between children and sex, whereas nonpedophilic offenders have an association between adults and sex. The task can therefore identify a core cognitive abnormality that may underpin some pedophilic deviant sexual behavior.     

Sensitivity and specificity of the phallometric test for pedophilia in nonadmitting sex offenders

The specificity of phallometric testing for pedophilia has been calculated using sex offenders against adult women. Does the offender's actual number of prior sexual contacts with women affect such estimates? To answer this, the authors' studied 82 male sex offenders against adult women, 172 offenders against unrelated children, and 70 offenders against their own biological children or stepchildren. Phallometric testing included visual and auditory depictions of prepubescent, pubescent, and adult males and females. The results for offenders against women showed that those who had had sexual contact with the greatest number of women (consenting or nonconsenting) had the lowest probability of being diagnosed as pedophilic. Specificity, calculated for those who had sexual contact with the most women and thus the most evidence of attraction to them, was 96%. Sensitivity, calculated analogously for men with the most offenses against children, was 61%.     

Psychological treatment of pedophiles

The main treatment problem of pedophilia is motivating the offender to change. Reasons for the perpetrator's resistance to therapy and strategies for motivating them to change are discussed. Current assumptions about the etiology of this sexual anomaly are examined. Results from a databank of sex offenders are reviewed to show that it is uncommon for pedophiles to be victims of sexual abuse, including incest, and few need pornography as stimulants. Therapeutic difficulties include the egocentric, egosyntonic, and erotically gratifying nature of pedophilia to the perpetrator, his unwillingness to give up his behavior, his tendency to rationalize his acts, and to see the child as consenting. Group therapy and a variety of clinical imagery procedures with case examples are discussed as ways of overcoming the poor motivational state of pedophiles for treatment.     

Parental identification of rapists and pedophiles.

It is well documented that sex offenders experience a higher incidence of sexual abuse and are more likely to have been reared in dysfunctional families than are individuals in most comparison groups. It is unclear, however, whether growing up in an abusive or dysfunctional family affects the extent to which the potential sex offender would subsequently identify with his parents. Sixteen rapists, 18 pedophiles, 9 general offenders, and 11 college students completed the Parental Identification Scale to assess their parental identification. It was predicted that the rapists and pedophiles would identify less with their parents than would college students or general offenders. Analysis indicated a strong and significant correlation between group membership and parental identification. Rapists and pedophiles identified less with their mothers and fathers than did members of corresponding control groups.     

The discriminative validity of a phallometric test for pedophilic interests among adolescent sex offenders against children

The authors examined the responses of adolescent sex offenders against children on a phallometric test of pedophilic interests. Participants were 40 adolescent sex offenders against children, 75 young adult sex offenders against children, and 39 young adult comparison participants. The responses of adolescents with female victims resembled those of comparison participants; adolescents with any male victims had larger relative responses to child stimuli than comparison participants. Young adult offenders, regardless of victim sex, had larger relative responses to child stimuli than comparison participants. Using a cut score of 0 (indicating equal or greater arousal to children than to adults), sensitivity was 42% for adolescents with any male victims, and specificity was 92% for the comparison participants. Results suggest phallometric testing can identify pedophilic interests among these adolescent sex offenders.     

Trends in the Treatment of Men Who Commit Violence against Women

Violence committed by men against women has a long history. At this time its prevalence is being increasingly documented and questioned in our society. Mental health workers have not had sufficient knowledge of the problem and, therefore, have not provided adequate treatment or devised preventive strategies. This article reviews the available literature regarding characteristics and treatment of three types of abusive men (rapists, incest offenders, wife batterers) and discusses the generalizability of common treatment approaches and counselor roles in treating these men.     

Differences in Self-Report Among Incest Family Members

A questionnaire study was conducted among incest families to study their perceptions of social background factors, how long the incest relationship lasted, who was involved, the history of incest in the family, emotional and psychological factors, and the consequences of the incest for the family. It was hypothesized that incest offenders, their spouses and incest victims all tend to report the above in a manner that reflect positively upon their own role in the incest relationship. The results showed clear differences in the reposts of the three groups. The paper concludes that such differences in perceptions must be incorporated in family therapy strategies as well as in our knowledge base of incest families.     

Family perception of rapists and pedophiles.

Previous research indicates that sex offenders were more likely to have been reared in dysfunctional families and to have identified less with their parents than were individuals in most comparison groups. It is unclear whether such failure to identify may be related to the perceived parenting styles and attitudes of the sex offenders' parents. 16 rapists, 18 pedophiles, 9 general offenders, and 11 college students completed the Children's Report of Parental Behavior Inventory to assess perceived parental communication patterns and attitudes. It was predicted that rapists and pedophiles would perceive their parents as (1) having been more rejecting, (2) as having exerted more control while encouraging less autonomy, and (3) as having provided harsher discipline than would individuals in comparison groups. Results supported the first two predictions.     

Gender identity and family relationships: Perspectives from incestuous fathers

The purpose of this study was to understand how incestuous fathers constructed their gender identities and family relationships and to determine how these perceptions were linked to incest. Analysis of intensive interviews with 20 incest offenders suggested that incest occurred in context of entitlement stemming from masculine gender constructions and family experiences which lead to conflicts regarding control and intimacy and a build up of failure. Case illustrations and implications for clinical practice are addressed.     

Quantitative reanalysis of aggregate data on IQ in sexual offenders

General intelligence has been the most commonly studied neuropsychological characteristic of sexual offenders for over 70 years. Results, however, have been highly inconsistent. To assess whether sexual offenders score lower in IQ than nonsexual offenders and to explore which sexual offense characteristics relate to IQ, the authors reanalyzed all reports providing sufficient information. Data spanned 236 samples, comprising 25,146 sexual offenders and controls. The literature contained sufficient information to permit comparison of adult versus juvenile sexual offenders, offenders targeting children versus adults, offenders targeting their own versus unrelated children, and offenders targeting boys versus girls. Results confirm the association between IQ and sexual offending and suggest that previous discrepancies are attributable to how many pedophilic individuals were in each sample.     

Die Screening Skala Pädophilen Tatverhaltens

The importance of including crime scene information into the diagnostic process and into risk assessment is emphasized throughout the literature. Therefore, the purpose of the current study was to investigate the feasibility of identifying pedophilic interest in child molesters using crime scene information. The development sample consisted of 113 expert opinions in forensic cases of sexual child abuse. The sample covered 50 pedophilic and 63 non-pedophilic offenders. Based on theoretical and empirical considerations it was concluded that the study should capture 6 content areas including 24 variables. Multivariate analyses revealed that the seven items that comprise the screening scale of pedophilic criminal behavior (SSPC) showed high predictive accuracy for the diagnosis of pedophilia (area under the curve AUC?=?0.91, standard error SE?=?0.03) and had incremental validity above and beyond the screening scale for pedophilic interest (SSPI).     

Counseling the incest offender

The Center Against Sexual Assault in Phoenix, Arizona is currently treating 50 incest offenders in its Offender Group treatment program. The average age range is 31–45 years old, and 80 percent were sexually or physically abused as children. These men have been found to be extremely self-centered, exhibit poor impulse control, and possess a strong denial of reality. The treatment program includes several intake sessions to ascertain suitability of the offender to this type of therapeutic approach and a stated self-admission of at least the possibility of incestuous involvement. The offenders work in groups, as well as individual sessions.     

Pedophilia,Height, and the Magnitude of the Association: A Research Note

Physical height is a manifestation of in utero and childhood conditions, and pedophilic individuals have generally been reported to be of lesser height. Jung, Klaver, and Pham (2014), however, report findings that fail to support an association between pedophilia and height. In the present note, we examine the methodology and findings of Jung et al. To estimate the magnitude of the pedophilia–height association, we conducted a meta-analysis of the published literature and found a significant effect size. Our findings suggest pedophiles may experience conditions during in utero and childhood development that are capable of influencing their physical development.     

The Relationship between Sex Offender Height and Pedophilic Interest

The current study examined the relationship between offender height and pedophilic interest (as measured by having a victim under 13 years old) in a sample of 22,228 registered sex offenders in the United States. Results revealed that offenders with victims age 12 and under were, on average, nearly one-quarter inch shorter than offenders of adults, and .18 inches shorter than those with minor teen victims. Implications for future research about the biological etiology of child sexual abuse perpetration are discussed, including the role of adverse childhood experiences in the neurodevelopment of offenders.