Phallometric testing, or penile plethysmography (PPG), is an objective measure of sexual arousal for males. While extensive research on the reliability and validity of PPG has promoted its reputation as the "gold standard" of objective measurement of sexual arousal, there is a lack of standardization of stimulus sets and interpretation of results between sites. This article describes the laboratory protocol employed for PPG at the Royal Ottawa Mental Health Centre's Sexual Behaviours Clinic (SBC) in Ottawa, Ontario, as well as those used by the Sexual Behaviors Clinic and Lab (SBCL) in the Community and Public Safety Psychiatry Division (CPSPD) of the Department of Psychiatry and Behavioral Sciences at Medical University of South Carolina (MUSC) in Charleston, South Carolina. The need for standardization in both testing protocol and stimuli use across sites are highlighted.
Penile plethysmography (PPG) is an objective measure of sexual arousal for men, commonly used to assess sexual arousal to both abnormal (i.e., paraphilic) and normal stimuli. While PPG has become a standard measure in the assessment and treatment of male sex offenders and men with paraphilic interests in both Canada and the United States, there is a lack of standardization of stimulus sets and interpretation of results between sites. The current article critically reviews the current state of the art while highlighting clinical and research efforts that may be undertaken in an attempt to reduce issues arising from lack of standardization across sites. Types and themes of stimulus sets, assessment apparatuses, laboratory preparation, and testing procedures are discussed. The continued development of standardized testing protocol and procedures across multiple international sites continues to be encouraged to promote unified PPG administration and interpretation, thus further enhancing the practical utility of the measurements and decreasing inter-rater discrepancies and error.
Introduction Although pedophilia is defined by a recurrent sexual interest in prepubescent children, little attention has been paid to the stability or fluidity of this sexual interest over time. Aim The aim of the current study was to investigate if patterns of penile tumescence (as a proxy for sexual interest) measured by penile plethysmography testing (PPT) can change. Methods In this retrospective chart review study, PPT results of 43 men diagnosed with pedophilia were collected and analyzed. All participants displayed a pedophilic sexual arousal pattern at the time of their first PPT. To test for change, we compared initial PPT results with subsequent PPT results measured at least 6 months later. Main Outcome Measure Sexual arousal was assessed using PPT by measuring change in penile circumference induced by the presentation of standardized sexual audio stimuli. Results Approximately half of the sample (n = 21) displayed a change in PPT results. This change was characterized by a significant decrease of sexual arousal in response to pedophilic (child) stimuli and a significant increase of sexual arousal in response to nonpedophilic (adult) stimuli. No differences between sexual interest changers (ICs) and nonchangers (NC) were found for demographic data or for length of time between assessments. However, between-group comparisons revealed that ICs had significantly lower pedophilic indices at the initial assessment than NCs. Conclusions Results from the current study indicate that relative pedophilic interest, as defined by increase in penile circumference in response to nonpedophilic stimuli as measured by PPT, changed in about 50% of men diagnosed with pedophilia who also had initial pedophilic PPT sexual responses. This represents a significant challenge to the hypothesis that sexual interest in men with pedophilia is unchangeable and should be the focus of future studies.
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