| 1. |
- Abé, Christoph, et al.
(författare)
-
Brain structure and clinical profile point to neurodevelopmental factors involved in pedophilic disorder
- 2021
-
Ingår i: Acta Psychiatrica Scandinavica. - : John Wiley & Sons. - 0001-690X .- 1600-0447. ; 143:4, s. 363-374
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Pedophilic disorder (PD) is characterized bypersistent, intense sexual attraction to prepubertal children that the individual has acted on, or causes marked distress or interpersonal difficulty. Although prior research suggests that PD has neurodevelopmental underpinnings, the evidence remains sparse. To aid the understanding of etiology and treatment development, we quantified neurobiological and clinical correlates of PD.Method: We compared 55 self-referred, help-seeking, non-forensic male patients with DSM-5 PD with 57 age-matched, healthy male controls (HC) on clinical, neuropsychological, and structural brain imaging measures (cortical thickness and surface area, subcortical and white matter volumes). Structural brain measures were related to markers for aberrant neurodevelopment including IQ, and the 2nd to 4th digit ratio (2D:4D).Results: PD was associated with psychiatric disorder comorbidity and ADHD and autism spectrum disorder symptoms. PD patients had lower total IQ than HC. PD individuals exhibited cortical surface area abnormalities in regions belonging to the brain's default mode network and showed abnormal volume of white matter underlying those regions. PD subjects had smaller hippocampi and nuclei accumbens than HC. Findings were not related to history of child-related sexual offending. IQ correlated negatively with global expression of PD-related brain features and 2D:4D correlated with surface area in PD.Conclusions: In the largest single-center study to date, we delineate psychiatric comorbidity, neurobiological and cognitive correlates of PD. Our morphometric findings, their associations with markers of aberrant neurodevelopment, and psychiatric comorbidities suggest that neurodevelopmental mechanisms are involved in PD. The findings may need consideration in future development of clinical management of PD patients.
|
|
| 2. |
- Bayram, Gökçe, et al.
(författare)
-
Health care professionals’ view on pedophilic disorder : a qualitative study
- 2021
-
Ingår i: Sexual and Relationship Therapy. - : Taylor & Francis Group. - 1468-1994 .- 1468-1749. ; 38:4, s. 684-695
-
Tidskriftsartikel (refereegranskat)abstract
- In the last few years there has been a shift in the view on pedophilia and its treatment in international diagnostic manuals and expert consensus documents. This study seeks to investigate the approach of health care professionals’ on some of the topics that are mostly debated: whether pedophilia without distress or acting out should be considered a mental disorder, whether there can be a changeability of pedophilic sexual interest over life and what the main aim of treatment should be. Qualitative content analysis was used to analyze the responses in semi-structured interviews of eight Swedish health care professionals with significant clinical experience from this patient category. These results suggest that there is a lack of consensus regarding all three topics, and that the opinions of the experienced health care professionals did not fully comply with the international experts agreements. This might lead to differences in clinical practice depending on who meets the patient, it can make the patients unsure about how they will be treated if they seek help, and it demonstrates a gap between published international research and clinical practice.
|
|
| 3. |
- Savard, Josephine, et al.
(författare)
-
Impulsivity in Compulsive Sexual Behavior Disorder and Pedophilic Disorder
- 2021
-
Ingår i: Journal of Behavioral Addictions. - : Akademiai Kiado. - 2062-5871 .- 2063-5303. ; 10:3, s. 839-847
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Impulsivity is regarded as a risk factor for sexual crime reoffending, and a suggested core feature in Compulsive Sexual Behavior Disorder. The aim of this study was to explore clinical (e.g. neurodevelopmental disorders), behavioral and neurocognitive dimensions of impulsivity in disorders of problematic sexuality, and the possible correlation between sexual compulsivity and impulsivity.Methods: Men with Compulsive Sexual Behavior Disorder (n = 20), and Pedophilic Disorder (n = 55), enrolled in two separate drug trials in a specialized Swedish sexual medicine outpatient clinic, as well as healthy male controls (n = 57) were assessed with the Hypersexual Behavior Inventory (HBI) for sexual compulsivity, and with the Barratt Impulsiveness Scale (BIS) and Connors' Continuous Performance Test-II (CPT-II) for impulsivity. Psychiatric comorbidity information was extracted from interviews and patient case files.Results: Approximately a quarter of the clinical groups had Attention-Deficit/Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder. Both clinical groups reported more compulsive sexuality (r = 0.73-0.75) and attentional impulsivity (r = 0.36-0.38) than controls (P < 0.05). Based on results on univariate correlation analysis, BIS attentional score, ADHD, and Commissions T-score from CPT-II were entered in a multiple linear regression model, which accounted for 15% of the variance in HBI score (P < 0.0001). BIS attentional score was the only independent positive predictor of HBI (P = 0.001).Discussion: Self-rated attentional impulsivity is an important associated factor of compulsive sexuality, even after controlling for ADHD. Psychiatric comorbidity and compulsive sexuality are common in Pedophilic Disorder.Conclusion: Neurodevelopmental disorders and attentional impulsivity - including suitable interventions - should be further investigated in both disorders.
|
|
