Pedophilia: A Diagnosis in Search of a Disorder

Malón, Agustín

doi:10.1007/s10508-012-9919-5

Cited by 16 publications

(11 citation statements)

References 48 publications

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“…The authors conclude that the HDdiagnose could provide a well-tuned tool for differential diagnostics, which in turn may facilitate the choice of treatment with higher resolution when the set of criminogenic factors is complex. This discussion also taps into the sociological analysis of the DSM nosology, in which there are two distinct perspectives on the role of psychiatry and psychiatric nomenclature, the "Hippocratic" and the "Lombrosian" (Malon, 2012). The first perspective is grounded on the concept that psychiatric nosology supplies clinicians and healthcare professionals with tools for improved understanding and increased capacity to make qualified assumptions in the assessment and treatment of patients.…”

Section: The Diagnostic Controversymentioning

confidence: 99%

A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men

Hallberg

Kaldo

Arver

et al. 2019

The Journal of Sexual Medicine

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Background Hypersexual disorder (HD) is defined as a condition in which the individual loses control over engagement in sexual behaviors, leading to distress and negative effects on key life areas. Cognitive behavioral therapy (CBT) has been proven to reduce symptoms of hypersexual behavior; however, no randomized controlled study of CBT interventions for HD has been reported previously. Aim To investigate the efficacy of group-administered CBT for HD. Methods Male participants (n = 137) diagnosed with HD, were randomized between 7 weeks of group-administered CBT (n = 70) and a waitlist control receiving the intervention after 8 weeks (n = 67). Measurements were administered at pre-, mid-, and posttreatment, with follow-up after 3 and 6 months. Outcomes The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS), and secondary outcomes were the Sexual Compulsivity Scale (SCS) and measures of depression (Montgomery–Åsberg Depression Rating Scale (MADRS-S), psychological distress (Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), and treatment satisfaction (CSQ-8). Results A significantly greater decrease in HD symptoms and sexual compulsivity, as well as significantly greater improvements in psychiatric well-being, were found for the treatment condition compared with the waitlist. These effects remained stable at 3 and 6 months after treatment. Clinical Implications CBT can ameliorate HD symptoms and psychiatric distress, suggesting that the CBT program may serve as a first-line treatment in clinical settings. Strengths & Limitations This is the first randomized controlled study evaluating the efficacy of a CBT program in a rather large sample of HD-specific diagnosed men. The long-term treatment effects are vague due to the low response rate on follow-up measurements, and the efficacy of this program for hypersexual women remains unknown. Conclusion This study supports the efficacy of a group-administered CBT program as a treatment option for HD; however, future studies should include women, comprise dismantling analysis of the constituting interventions, and evaluate other treatment formats, for example, administration via the Internet.

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Section: The Diagnostic Controversymentioning

confidence: 99%

A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men

Hallberg

Kaldo

Arver

et al. 2019

The Journal of Sexual Medicine

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“…It is true that concepts such as perversion and obscenity have been swept out of contemporary moral and scientific language, but this does not mean that they are not still present. Current paraphilias seem to be attempts to reinterpret long-standing perversions in a more clinical language (Wakefield, 2011;Malón, 2012). Something similar occurs with a large part of the emerging discussions on abuse and sexual violence.…”

Section: The Science Of Abuse and Moral Beliefsmentioning

confidence: 93%

“…Scientific controversy in this field, such as arguments over whether the expression "child sexual abuse" can be used as a scientific construct (Ondersma et. al, 2001;Rind, Bauserman, & Tromovitch, 2000) or the idea of pedophilia and hebephilia being mental disorders (Malón, 2012), inevitably have a 6 complex moral dimension, being scientific debates that often prove to be unintelligible and without solution if various ethical points of view are not clarified.…”

Section: Introductionmentioning

confidence: 99%

Adult-Child Sex and the Demands of Virtuous Sexual Morality

Malón

2016

Sexuality & Culture

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This article is the continuation of a previous analysis of the usual arguments-lack of consent, exploitation and harmused to evaluate sexual experiences between adults and children from general moral principles. It has been suggested that those arguments were insufficient to condemn all adult-child sexual experiences, and that it would be of interest to study others that come from a specific sexual morality based on a more complex and transcendent conception of human eroticism and sexual conduct. This paper develops three different arguments against adult-child sex from this perspective, a view which, while not rejecting the Kantian and utilitarian approaches, complements and transforms them with a virtue ethic that questions not only the permissibility of certain acts but also their moral desirability under this frame of reference. This helps us to clarify the scientific discourse on adult-child sex and directs us to the importance of attending to the educational dimension of this moral problem.

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“…Apart from the fundamental question whether there's such a thing as "mental disorders" at all (7), and hence, whether psychiatry is a part of medicine at all, the nature and definition of mental disorders in general have been discussed (4,8,9). Other controversies concern the disorder status of specific mental conditions, the most famous example probably being the removal of homosexuality from DSM in 1973 (10,11). A still missing stringent scientific basis and the important role of values (12) bring psychiatry into a position to constantly question its own presumptions about the concept of mental disorder.…”

Section: Mental Disorders and Their Diagnostic Manualsmentioning

confidence: 99%

Should Behavior Harmful to Others Be a Sufficient Criterion of Mental Disorders? Conceptual Problems of the Diagnoses of Antisocial Personality Disorder and Pedophilic Disorder

2020

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Generally, diseases are primarily harmful to the individual herself; harm to others may or may not be a secondary effect of diseases (e.g., in case of infectious diseases). This is also true for mental disorders. However, both ICD-10 and DSM-5 contain two diagnoses which are primarily defined by behavior harmful to others, namely Pedophilic Disorder and Antisocial (or Dissocial) Personality Disorder (ASPD or DPD). Both diagnoses have severe conceptual problems in the light of general definitions of mental disorder, like the definition in DSM-5 or Wakefield's "harmful dysfunction" model. We argue that in the diagnoses of Pedophilic Disorder and ASPD the criterion of harm to the individual is substituted by the criterion of harm to others. Furthermore, the application of the criterion of dysfunction to these two diagnoses is problematic because both heavily depend on cultural and social norms. Therefore, these two diagnoses fall outside the general disease concept and even outside the general concept of mental disorders. We discuss whether diagnoses which primarily or exclusively ground on morally wrong, socially inacceptable, or criminal behavior should be eliminated from ICD and DSM. On the one side, if harming others is a sufficient criterion of a mental disorder, the "evil" is pathologized. On the other side, there are practical reasons for keeping these diagnoses: first for having an official research frame, second for organizing and financing treatment and prevention. We argue that the criteria set of Pedophilic Disorder should be reformulated in order to make it consistent with the general definition of mental disorder in DSM-5. This diagnosis should only be applicable to individuals that are distressed or impaired by it, but not solely based on behavior harmful to others. For ASPD, we conclude that the arguments for eliminating it from the diagnostic manuals overweigh the arguments for keeping it.

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Pedophilia: A Diagnosis in Search of a Disorder

Cited by 16 publications

References 48 publications

A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men

A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men

Adult-Child Sex and the Demands of Virtuous Sexual Morality

Should Behavior Harmful to Others Be a Sufficient Criterion of Mental Disorders? Conceptual Problems of the Diagnoses of Antisocial Personality Disorder and Pedophilic Disorder

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