Acquired Pedophilia: international Delphi-method-based consensus guidelines.

Idiopathic and acquired pedophilia are two different disorders with two different etiologies. However, the differential diagnosis is still very difficult, as the behavioral indicators used to discriminate the two forms of pedophilia are underexplored, and clinicians are still devoid of clear guidelines describing the clinical and neuroscientific investigations suggested to help them with this difficult task. Furthermore, the consequences of misdiagnosis are not known, and a consensus regarding the legal consequences for the two kinds of offenders is still lacking. The present study used the Delphi method to reach a global consensus on the following six topics: behavioral indicators/red flags helpful for differential diagnosis; neurological conditions potentially leading to acquired pedophilia; neuroscientific investigations important for a correct understanding of the case; consequences of misdiagnosis; legal consequences; and issues and future perspectives. An international and multidisciplinary board of scientists and clinicians took part in the consensus statements as Delphi members. The Delphi panel comprised 52 raters with interdisciplinary competencies, including neurologists, psychiatrists, neuropsychologists, forensic psychologists, expert in ethics, etc. The final recommendations consisted of 63 statements covering the six different topics. The current study is the first expert consensus on a delicate topic such as pedophilia. Important exploitable consensual recommendations that can ultimately be of immediate use by clinicians to help with differential diagnosis and plan and guide therapeutic interventions are described, as well as future perspectives for researchers.

Idiopathic and acquired pedophilia as two distinct disorders: an insight from neuroimaging.

Pedophilia is a disorder of public concern because of its association with child sexual offense and recidivism. Previous neuroimaging studies of potential brain abnormalities underlying pedophilic behavior, either in idiopathic or acquired (i.e., emerging following brain damages) pedophilia, led to inconsistent results. This study sought to explore the neural underpinnings of pedophilic behavior and to determine the extent to which brain alterations may be related to distinct psychopathological features in pedophilia. To this aim, we run a coordinate based meta-analysis on previously published papers reporting whole brain analysis and a lesion network analysis, using brain lesions as seeds in a resting state connectivity analysis. The behavioral profiling approach was applied to link identified regions with the corresponding psychological processes. While no consistent neuroanatomical alterations were identified in idiopathic pedophilia, the current results support that all the lesions causing acquired pedophilia are localized within a shared resting state network that included posterior midlines structures, right inferior temporal gyrus and bilateral orbitofrontal cortex. These regions are associated with action inhibition and social cognition, abilities that are consistently and severely impaired in acquired pedophiles. This study suggests that idiopathic and acquired pedophilia may be two distinct disorders, in line with their distinctive clinical features, including age of onset, reversibility and modus operandi. Understanding the neurobiological underpinnings of pedophilic behavior may contribute to a more comprehensive characterization of these individuals on a clinical ground, a pivotal step forward for the development of more efficient therapeutic rehabilitation strategies.

Profiling acquired pedophilic behavior: Retrospective analysis of 66 Italian forensic cases of pedophilia.

Neurological disorders can be mis-diagnosed as psychiatric ones. This might happen to pedophilia emerging as a symptom of brain insult (i.e. acquired pedophilic behavior). This paper aims to delineate a behavioral profile that might help to identify defendants whose pedophilic behavior is likely to be the consequence of a neurological disorder. Through a systematic review of the literature, seventeen clinical and behavioral variables of the modus operandi and victimology that can distinguish between acquired and developmental pedophilic behavior have been collected. Seven of these were found to be consistent behavioral indicators (i.e. red flags) for acquired pedophilia. Cluster hierarchical analysis on the seventeen variables collected through the systematic review of the literature on cases of acquired pedophilic behavior was applied to a new dataset including 66 Italian closed cases of pedophilia. Stepwise regression and correlation analyses were carried out to further examine the differences between the clusters identified in the cluster analysis. Results revealed that the new sample was partitioned into two clusters. Individuals with ascertained acquired pedophilia were grouped together. The clusters widely differed for the prevalence of red flags (mean number of red flags in each cluster: 2.14 ±â€¯0.79 vs 4.96 ±â€¯0.93, p < 0.001), while no between cluster difference emerged for the other clinical and behavioral variables. Regression analysis provided a robust model that included the three most significant red flags that explain over 64.5% of the variance (absence of masking, spontaneous confession and offenders older age). An organic origin of pedophilic behavior should be suspected if red flags are present in a defendant charged with pedophilia. In those cases, an in depth trans-disciplinary neuroscientific investigation is advocated. The behavioral profile identified might help to provide a proper assessment of defendants.

Response: Avuncularity and Kin Selection in Homosexuals: A Problematic Test or a Problematic Hypothesis?

Here we respond to Vasey et al.'s critical comments regarding our article, "Societal norms rather than sexual orientation influence kin altruism and avuncularity in tribal Urak-Lawoi, Italian, and Spanish adult males" (Camperio Ciani, Battaglia, & Liotta, 2015 , JSR doi:10.1080/00224499.2014.993748). The first regards the selection of the Urak-Lawoi population of Ko Lipeh, which is considered too modern and touristic to be adequate to test the kin selection and avuncular hypothesis for homosexuality. We provide historical evidence of the contrary, and show that the population at the inception of our 10 years research was indeed primitive and tribal, and probands actually grew and lived in such a society. Only a few years after the 2004 tsunami, the island was developed and invaded by mass tourism. The second comment regarded the statistical analysis and interpretation of data. We show that we consistently and conservatively considered the effects of all confounding variables, both with comparative tests, and by a series of multivariate regression analyses. This was the orthodox procedure approved by all other reviewers. In conclusion, even addressing these comments, we maintain that the kin selection and avuncularity hypothesis for homosexuality is not supported by empirical data even in this primitive and tribal society.

Mothers who kill their offspring: testing evolutionary hypothesis in a 110-case Italian sample.

OBJECTIVES: This research aimed to identify incidents of mothers in Italy killing their own children and to test an adaptive evolutionary hypothesis to explain their occurrence. METHODS: 110 cases of mothers killing 123 of their own offspring from 1976 to 2010 were analyzed. Each case was classified using 13 dichotomic variables. Descriptive statistics and hierarchical cluster analysis were performed both for cases and variables, and significant differences between clusters were analyzed. RESULTS: The Italian sample of neonaticides (killings of children within the first day of life) was found to satisfy all evolutionary predictions for an evolved behavioral, emotional and motivational pattern to increase fitness, showing a consistent profile for offending mothers. Relatively young, poor women with no partner kill their offspring non-violently, either directly or through abandonment, and they attempt to conceal the body. These women have no psychopathologies and never attempt suicide after killing their children. All neonaticide cases fall in a single cluster that is distinct from all other offspring killings by mothers. Infanticide (killing of children within the first year of life) and filicide (killing of children after the first year of life) do not significantly differ according to any of the variables measured. The common profile of mothers who have committed infanticide or filicide includes psychopathology, suicide or attempted suicide after killing their children, violent killing of their victims, and no attempt to conceal the victims' bodies. These results suggest that maternal infanticide and filicide represent an improper functioning of adaptation, and their profile are much more variable than those of neonaticide offenders. CONCLUSION: Our study confirms that only neonaticide is an adaptive reproductive disinvestment, possibly evolved in the remote past, to increase the biological fitness of the mother by eliminating an unwanted newborn and saving resources for future offspring born in better conditions. Neonaticide is shown to be clearly distinct from infanticide and filicide and therefore should be approached, prevented, and judged differently.

Factors associated with higher fecundity in female maternal relatives of homosexual men.

INTRODUCTION: Recent evidence suggests that sexually antagonistic genetic factors in the maternal line promote homosexuality in men and fecundity in female relatives. However, it is not clear if and how these genetic factors are phenotypically expressed to simultaneously induce homosexuality in men and increased fecundity in their mothers and maternal aunts. AIMS: The aim of the present study was to investigate the phenotypic expression of genetic factors that could explain increased fecundity in the putative female carriers. METHODS: Using a questionnaire-based approach, which included also the Big Five Questionnaire personality inventory based on the Big Five theory, we investigated fecundity in 161 female European subjects and scrutinized possible influences, including physiological, behavioral, and personality factors. We compared 61 female probands who were either mothers or maternal aunts of homosexual men. One hundred females who were mothers or aunts of heterosexual men were used as controls. MAIN OUTCOME MEASURES: Personality traits, retrospective physiological and clinical data, behavior and opinions on fecundity-related issues were assessed and analyzed to illustrate possible effects on fecundity between probands and control females. RESULTS: Our analysis showed that both mothers and maternal aunts of homosexual men show increased fecundity compared with corresponding maternal female relatives of heterosexual men. A two-step statistical analysis, which was based on t-tests and multiple logistic regression analysis, showed that mothers and maternal aunts of homosexual men (i) had fewer gynecological disorders; (ii) had fewer complicated pregnancies; (iii) had less interest in having children; (iv) placed less emphasis on romantic love within couples; (v) placed less importance on their social life; (vi) showed reduced family stability; (vii) were more extraverted; and (viii) had divorced or separated from their spouses more frequently. CONCLUSIONS: Our findings are based on a small sample and would benefit from a larger replication, however they suggest that if sexually antagonistic genetic factors that induce homosexuality in males exist, the factors might be maintained in the population by contributing to increased fecundity greater reproductive health, extraversion, and a generally relaxed attitude toward family and social values in females of the maternal line of homosexual men.