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Neural mechanisms underlying pedophilia and sexual offending against children - first results of a multicenter study

Kneer, J1Engel, J1; Veit, M1; Ponseti, J2; Walter, M3; Beier, KM4; Walter, H4; Schiffer, B5; Schiltz, K6; Krueger, THC1

1: Hannover Medical School, Germany; 2: University Hospital Schleswig-Holstein, Germany; 3: Otto von Guericke University Magdeburg, Germany; 4: Charité – Universitaetsmedizin Berlin, Germany; 5: LWL-University Hospital Bochum, Germany; 6: Medical Center of the University of Munich, Germany

Objective(s): Child sexual offending (CSO) is an extensive problem all over the world. The estimates vary widely depending on the definitions and the type of CSO studied but even the lowest prevalence includes an alarming number of victims. Even if pedophilia is considered as a major risk factor for committing CSO, CSO and pedophilia are not the same. Both terms are often used interchangeably not only in the media but also in the field of pedophilia research. The vast majority of studies investigating pedophilia were carried out on (incarcerated) pedophilic CSO. The results were often erroneously interpreted as being pedophilia-specific. Under the acronym NeMUP – 5 study centres in Germany recruited more than 400 subjects between 2012 and 2016 to investigate the neural mechanisms underlying pedophilia and child sexual offending.

Material and Method(s): To disentangle pedophilia and offense-related effects a 2 x 2 factorial design was used. Four groups of men: (1) pedophiles with a history of hands-on sexual offending against children (P+CSO), (2) pedophiles who did not engage in hands-on child sexual offending (P-CSO), (3) non-pedophiles who engaged in hands-on child sexual offending (CSO-P) and (4) controls without any criminal conviction (C) were compared. With the use of an extensive clinical assessment, a wide range of neuroimaging techniques, such as functional and structural magnetic resonance imaging (sMRI, fMRI), together with a neuropsychological assessment we investigated predisposing and accompanying factors contributing to pedophilia and CSO.

Result(s): All experimental groups show increased levels of psychiatric axis 1 and axis 2 disorders. There is no broad disturbance of executive function in pedophilia per se. Alterations of impulsivity and inhibition are rather distinct or even better in pedophiles without CSO. VBM, DTI and fMRI highlight specific target regions which are associated with CSO but not pedophilia. Preliminary data of genetic and epigenetic analyses are in line with these findings and indicate a role for the androgen system in CSO.

Conclusion(s): NeMUP is the largest neurobiological data set in pedophilia and CSO and revises a number of previous theories and assumptions. In summary, we find several signatures for offense status but not pedophilia.

Disclosure:

Work supported by industry: no.

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