Sensitivity and Specificity of the Phallometric Test for Hebephilia

Abstract

Introduction The phallometric test has been examined most widely in the literature with regard to its ability to detect pedophilia; however, it has become of increasing interest to clinicians and researchers to ascertain to what extent the test accurately detects hebephilia: Whereas pedophilia refers to an adult's sexual interest in prepubescent children (age 10 or younger, on average), hebephilia refers to an adult's sexual interest in pubescent children (ages 11–14, on average). Aim The aim of this study was to estimate the accuracy of volumetric phallometry in distinguishing pedophilic men and hebephilic men from men who are teleiophilic (primarily sexually interested in adults, age 17 or older). Methods A retrospective chart review was conducted on the cumulate database of a large phallometric laboratory and clinic to identify a group of 239 men who committed sexual offenses against extrafamilial adults age 17 or older and a group of 996 men who committed sexual offenses against extrafamilial children age 14 or younger, all of whom professed a greater sexual interest in adults over children. Main Outcome Measures The sensitivity and specificity of the phallometric test is calculated for its accuracy in distinguishing sexual preferences for children spanning various age ranges. Results Receiver operator characteristic curves were highly significant for each classification decision: Using its previously established cut-point of +0.25 standard deviation (SD) units, the phallometric test detected hebephilia with a sensitivity and specificity of 70.0% and 90.7%, detected pedophilia with 46.9% and 100%, and detected pedohebephilia with 75.3% and 90.7%. At a new cut-point of +0.0 SD units, the sensitivity and specificity of the test for pedophilia was 71.9% and 95.3%. Conclusions Volumetric phallometry significantly distinguishes teleiophilic sex offenders from each of pedophilic, hebephilic, and pedohebephilic sex offenders and can serve as a reliable diagnostic test of sexual age preference among men who deny sexual interest in children.

Editorial Comment on “Sensitivity and Specificity of the Phallometric Test for Hebephilia”

“…There are several reasons to be cautious. The first is that the reported sensitivity in the current study (accurate classification as pedophilic) is as low as 21.2% for men with two child victims (table 3 in [2]). Kurt Freud wrote that phallometry should be used only as a “confirmatory test” [1] as it is not a measure of “guilt or innocence.”…”

Interventions for Pedohebephilic Arousal in Men Convicted for Sexual Offenses Against Children: A Meta-Analytic Review

“…Studies were included in the present meta-analysis if the research (a) included a sample of adult or adolescent males who had sexually offended against children, defined as men who had committed a sexual offense against a child below 15 years of age (Cantor & McPhail, 2015)—samples that had offended against related children, unrelated children, female children, or male children were included; (b) reported data from a phallometric assessment of pedohebephilic interests; (c) provided an intervention targeting pedohebephilic interests in a sample of sexual offenders against children; (d) included sufficient statistical information to calculate a within-subjects, pre–posttreatment change effect size (ES) in a treatment group.…”

“…Phallometric tests for pedohebephilic interest differentiate men who sexually offend against children from other groups based (Cantor & McPhail, 2015; McPhail et al, 2019), are robust predictors of sexual recidivism, and have adequate reliability (see below). In the present study, the age of persons depicted in stimuli used during phallometric testing was coded.…”

“…Two age categories were used to identify child stimuli: prepubescent stimuli (aged 10 years and younger) were coded as pedophilic and pubescent stimuli (aged 11–14 years) were coded as hebephilic. These age ranges were adopted because these age ranges reflect when pubertal changes occur for children, which is typically before or around age 11 (see Cantor & McPhail, 2015). Some studies describe child stimuli without providing specific ages for the children, complicating the classification of the age of the subjects depicted in the stimuli.…”

In His Own Words: Response to Moser

“…In our article, my co-author and I wrote this sentence: "There has been a vocal group of advocates arguing variously that sexually preferring 11-to 14-year-old children is normal, albeit illegal to actualize (e.g., [24]), and that no sexual interest, even pedophilia, should be diagnosed as a mental illness [25]" (p. 1948) [1]. Moser, the author of the cited Reference 25, contests this description of his publication, Accuracy is important [2].…”