Problems with the DSM-IV Diagnosis of Pedophilia

Abstract

This paper examines the taxonomic adequacy of the Diagnostic and Statistical Manual, 4th ed., DSM-IV (American Psychiatric Association, 1994) diagnostic category of pedophilia. This diagnosis, as well as the other sexual disorders, have been ignored in DSM field trials. There is no empirical information about the reliability or validity of this diagnosis. Moreover, because the vagueness of the diagnostic criteria, clinicians would need to make inferences that would likely lead to reliability problems in diagnosis. Further, the DSM diagnostic criteria include constructs that are not intersubjectively verifiable and for which there are no valid measures. This can also lead to lack of diagnostic reliability and accuracy. Most problematical however, there are aspects of the diagnostic criteria, most notably the presence of an "ego dystonic sexual attraction to children," that are incorrect exclusion criteria. Suggestions for improvement are provided.

Hebephilia as Mental Disorder? A Historical, Cross-Cultural, Sociological, Cross-Species, Non-Clinical Empirical, and Evolutionary Review

“…Brülde (2007) cited pedophilia as a model instance of mental health professionals' use of the harmful-forFootnote 5 continued opposed to being ignored or dismissed in favor of Western patterns (Henrich et al, 2010). others criterion (see also O'Donohue, Regev, & Hagstrom, 2000;Spitzer & Wakefield, 2002). This criterion, however, is problematic.ManyNazisandKlansmen,forexample,whohabituallycommitted great harm to others, were mentally normal.…”

Multiplex Versus Multiple Taxonomy of Paraphilia: Case Example

“…This case illustrates some of the taxonomic problems that O'Donohue and his associates have discussed related to DSM-IV diagnosis of pedophilia (O'Donohue, Regev, & Hagstrom, 2000). The case violates temporal consistency of diagnosis, in that the subject would meet diagnostic criteria for different paraphilias at different times, even though there apparently was no other change in the individual.…”

The Utility of the Diagnosis of Pedophilia: A Comparison of Various Classification Procedures

“…As a result, the terms "pedophile" and "child molester" have been used interchangeably, which can create conceptual confusion (Barbaree & Seto, 1997). In the literature on sexual offending, a child molester is described as an individual who has engaged in a sexually motivated act against a prepubescent child, without an indication of preference, whereas a pedophile is described as an individual who has displayed a preference for sexual behavior against a child (O'Donohue, Regev, & Hagstrom, 2000). This distinction is important, as not all child molesters are pedophiles, and some pedophiles may not have committed a sexual offence against a child (Konopasky & Konopasky, 2000).…”