Development and Initial Validation of Measures of Proximal Stigmas and Experiences of Discrimination for Minor Attracted People.

Stigma-related stressors are central to understanding psychopathology, distress, and coping in stigmatized groups; individuals who experience attractions to children are a highly stigmatized group. Currently, few validated self-report measures exist to assess stigma-related stressors in minor attracted people (MAPs) and the current research describes the development and initial validation of two measures of internalized stigma and experiences of discrimination. A sample of MAPs (n = 289; mean age = 31.8 years, SD = 12.2) was recruited online and completed a set of self-report measures assessing stigma-related stress, negative mental health outcomes, substance use, and coping. Exploratory factor analyses of the two newly developed stigma-related stress measures were conducted and convergent associations with other constructs were examined for validity evidence. Exploratory factor analyses indicated a two-factor solution to both the measure of internalized stigma and experiences of discrimination. The total scale scores and factors scores generally demonstrated the anticipated patterns of correlations with mental health concerns, distress, coping, and substance use. Clinical intervention with MAPs may benefit from an exploration of stigma-related stressors in clients' lives to improve mental health outcomes. The relatively large sample that was recruited from multiple online forums is a strength of the current study. The use of a self-report measurement modality for all measures used in the study weakens that strength of the validation evidence presented here. These results provide initial validity evidence for the measures of stigma-related stress in MAPs and the promise of stigma processes in understanding negative outcomes in this population.

Secret-keeping in therapy by clients who are sexually attracted to children.

Objective This study investigated the reasons why pedohebephilic clients disclose their sexual attraction to children in therapy and the experiences associated with this decision among English-speaking samples. Method: The pre-registered online survey combined (1) quantitative correlational data of self-reported improvement, alliance, therapist reaction to disclosure, and the belief that mandatory reporting laws were in place, and (2) qualitative data about reasons for disclosure or no disclosure as well as perceived consequences. The sample consisted of pedohebephilic people who have been clients in therapy and have disclosed (n = 96) or not disclosed (n = 40). Results: While the disclosure and no disclosure groups did not differ in improvement or beliefs about mandatory reporting, those who had disclosed reported a stronger alliance. Clients who did not perceive the therapist's reaction as supportive reported less improvement than the no disclosure group. Thematic analysis of qualitative data identified three themes concerning motives for disclosing or not disclosing and a fourth regarding differential impacts of disclosure. Discussion: This study indicates that disclosing pedohebephilia does not in and of itself lead to improvement but is contingent on a therapist's reaction.

Examining the 4-D Model in Persons Enrolled in the Top DD Internet Intervention.

The 4-dimensional (4-D) model of trauma-related dissociation differentiates between dissociative experiences involving trauma-related altered states of consciousness and symptoms of distress that do not appear to involve alterations in normal waking consciousness across four phenomenological dimensions (i.e., our experience of time, thought, body, and emotions). The current study evaluated hypotheses associated with the 4-D model using analyses of variance and correlation analyses in individuals with a primary diagnosis of a trauma-related dissociative disorder who were participating in the TOP DD internet study involving a combination of in-person psychotherapy and an online psychoeducational program (n = 111). Intrusive memories of traumatic events were more frequently endorsed than flashbacks, but emotional numbing was more frequently endorsed than other forms of affect dysregulation. Negative thoughts and emotion dysregulation were more strongly intercorrelated than were voice hearing and emotional numbing. Distress symptoms were more strongly associated with PTSD symptoms and difficulties in emotion regulation, whereas experiences of depersonalization were more strongly associated with dissociative self-states. Greater reduction in distress symptoms was also seen in comparison with trauma-related altered states of consciousness over the course of the combined psychotherapy and internet-based psychoeducational intervention. Overall, results continue to suggest that measures of distress and dissociative experiences can be distinguished by measures of symptom frequency, co-occurrence, and convergence with other measures of distress vs. dissociation albeit that results varied across the four phenomenological dimensions that were surveyed.

A preliminary examination of sexual interest in children in a non-representative community sample of females.

There are few empirical studies examining sexological features of sexual interest in children among females. A non-representative sample of 20 females and 208 males who self-identified as having a sexual interest in children completed an anonymous survey. The primary purpose of the present study was to examine sexological features of sexual interest in children among females. Most females reported interest in prepubescent and pubescent children and rated their interest in different age categories similarly. Most females reported an interest in boys. Females first experienced sexual attractions during childhood, but awareness of sexual interest in children occurred later in their adolescence.

The Association between Maladaptive Coping and Treatment Motivation in Individuals who are Sexually Attracted to Children Living in the Community.

There is a need for community treatment programs for people who are sexually attracted to children, but individuals report difficulty accessing services. Individuals who are sexually attracted to children (n = 293) completed an online anonymous survey that revealed a significant positive association between maladaptive coping and two factors of the treatment motivation measure. The association between maladaptive coping and treatment motivation was attenuated at higher levels of ego dystonic distress/aversion. Results highlight the importance of targeting stigma toward those who are sexually attracted to children to increase treatment seeking behavior.

Convergent and Predictive Associations of Three Measures of Pedophilic Interest.

Pedophilic interest is a central risk factor for sexual offending against children. Multiple measures exist to assess pedophilic interest, and the present study aims to provide validity evidence for three of these measures in a sample of men convicted of sexual offenses. The association between a phallometric test for pedophilic interest, the Screening Scale for Pedophilic Interest (SSPI), and the sexual deviance factor of the Violence Risk Scale-Sexual Offense (VRS-SO) version was examined in a sample of 261 men who participated in sexual violence reduction services. The association between these measures and sexual recidivism, both as sole predictors and while controlling for static risk, was also assessed. The second aim of the study was to examine the validity of different methods for modeling the distribution of pedophilic interests, using phallometric test scores, based on the findings in recent taxometric research. The measures generally showed a positive and moderate relationship with each other and predicted sexual recidivism. However, the SSPI did not significantly predict sexual recidivism, and when controlling for static risk, only the VRS-SO Sexual Deviance factor significantly predicted this outcome. Modeling phallometric test scores continuously and trichotomously produced significant associations with sexual recidivism; however, only a trichotomous model with two levels remained predictive after controlling for static risk. The results are broadly supportive of measures of pedophilic interest and underscore the importance of appropriately modeling the latent structure of pedophilic interest.

Construction and preliminary validation of the Cognitive and Emotional Congruence with Children (C-ECWC) Scale.

Emotional congruence with children is central in understanding why some adults pursue sexual contact with children. Although self-report scales have been developed to assess for emotional congruence with children, these scales have equivocal latent structure and less than desirable performance in validation research. Further, these scales were not developed to assess emotional congruence with children in individuals who commit Internet-facilitated offenses. In the current study, a sample of men with histories of Internet-facilitated sexual offenses, contact sexual offenses against children, and nonsexual offenses was used to examine factor structure, internal consistency, convergent and divergent validity, and known-group validity of the newly developed Cognitive and Emotional Congruence with Children (C-ECWC) scale. The scale had a three-factor latent structure, adequate internal consistency and adequately captured the nomological network of correlates and group differences anticipated for a measure of emotional congruence with children. Implications for scale validation and use in future research into emotional congruence with children are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Validity in Phallometric Testing for Sexual Interests in Children: A Meta-Analytic Review.

Valid assessment of pedohebephilic interests (i.e., sexual interest in children) is fundamental to forensic clinical practice. Phallometric testing-which measures changes in penile circumference or volume, while stimuli depicting different ages and sexual activities are presented-is widely used in clinical and research settings to detect such interests. This meta-analysis summarizes studies comparing sexual offenders against children and various types of controls on phallometric tests for pedohebephilic interests (37 samples; N = 6,785) and studies examining the relationship between phallometric test scores and sexual reoffending (16 samples; N = 2,709). The findings suggest that several phallometric testing procedures are valid indicators of pedohebephilic interest. Certain methodological features of phallometric tests were associated with greater validity, such as, slide or audio-plus-slide stimuli and z-score-based indices. In addition, phallometric tests for pedohebephilic, pedophilic, and hebephilic interests predicted sexual reoffending which provides further evidence that phallometric test scores are valid indicators of sexual interest in children. In general, the interpretation of phallometric test scores as indicators of pedohebephilic interests is supported.

Emotional Congruence with Children: Are Implicit and Explicit Child-Like Self-Concept and Attitude Toward Children Associated with Sexual Offending Against Children?

Some men convicted of sexual offences against children express an exaggerated affiliation with childhood, ascribe child-like characteristics to themselves, experience strong non-sexual liking of children, and hold positive views of children and childhood. These features are generally called emotional congruence with children. The present study examined child-like self-concept, which is an association of self with children and child-like characteristics, attitude toward children, and general emotional congruence with children as correlates of sexual offending against children and pedophilia. Male participants (18 sexual offenders against unrelated children; 7 incest offenders; 22 non-sexual offenders; 54 students) completed newly developed implicit and explicit measures of child-like self-concept and attitude toward children, as well as more established self-report measures of emotional congruence with children. Assessments of pedophilic interest and sexual recidivism risk were obtained from official file information. Sexual offenders against unrelated children reported higher levels of implicit child-like self-concept and self-reported emotional congruence with children when compared to the other three groups. Implicit child-like self-concept showed a small correlation with emotional congruence measures, whereas implicit attitude toward children was moderately correlated with the emotional congruence measures. Implicit child-like self-concept, implicit attitude toward children, and the emotional congruence measures were associated with greater pedophilic interest and sexual recidivism risk. The present findings provide a nuanced understanding of the emotional congruence with children construct and have implications for theory, research, and treatment of sexual offenders against children.

Taxometric Analysis of the Latent Structure of Pedophilic Interest.

The present study examined the latent structure of pedophilic interest. Using data from phallometric tests for pedophilic interest across four samples of offenders (ns = 805, 632, 531, 261), taxometric analyses were conducted to identify whether pedophilic interest is best characterized as taxonic or dimensional. Across the samples, the majority of analyses supported taxonic latent structure in pedophilic interest. Visual inspection of taxometric curves indicated trichotomous latent structure (i.e., three-ordered classes) may characterize pedophilic interest in these samples. In a second step of taxometric analysis, the results supported trichotomous latent structure, indicating the presence of a complement taxon and two pedophilic taxa. In comparison with the complement taxon, the men in the first pedophilic taxon were non-exclusively pedophilic and had similar rates of sexual recidivism and sexual compulsivity. The men in the second pedophilic taxon were exclusively pedophilic, had more child victims and total victims, sexually re-offended at a higher rate, and were more sexually compulsive. The finding of trichotomous latent structure in pedophilic interest is both consistent and inconsistent with previous taxometric studies and has implications for research, assessment, and treatment of pedophilic interest.

Emotional Congruence With Children Is Associated With Sexual Deviancy in Sexual Offenders Against Children.

Emotional congruence with children is a psychologically meaningful risk factor for sexual offending against children. The present study examines the correlates of emotional congruence with children in a sample of 424 adult male sexual offenders who started a period of community supervision in Canada, Alaska, and Iowa between 2001 and 2005. Consistent with previous work, we found sexual offenders against children high in emotional congruence with children were more likely to be sexually deviant, have poor sexual self-regulation, experience social loneliness, and have more distorted cognitions about sex with children. Overall, our findings are most consistent with a sexual deviancy model, with some support for a blockage model.

Sensitivity and Specificity of the Phallometric Test for Hebephilia.

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.

The puzzle of intrafamilial child sexual abuse: a meta-analysis comparing intrafamilial and extrafamilial offenders with child victims.

Intrafamilial child sexual abuse is a serious social and health problem, yet explanations of sexual offending against children that emphasize antisocial tendencies and atypical sexual interests do not adequately explain intrafamilial offending. In this meta-analysis, we tested other explanations of intrafamilial child sexual abuse by examining 78 independent samples that compared a total of 6605 intrafamilial offenders to a total of 10,573 extrafamilial offenders, in studies disseminated between 1978 and 2013 (Mdn=2000). Intrafamilial offenders were significantly lower on variables reflecting antisocial tendencies (e.g., criminal history, juvenile delinquency, impulsivity, substance use, and psychopathy) and atypical sexual interests (e.g., pedophilia, other paraphilias, and excessive sexual preoccupation). Contrary to other explanations that have been proposed, intrafamilial offenders scored lower on offense-supportive attitudes and beliefs, emotional congruence with children, and interpersonal deficits; intrafamilial offenders also did not differ from extrafamilial offenders on most indicators of psychopathology. Intrafamilial offenders were, however, more likely to have experienced sexual abuse, family abuse or neglect, and poor parent-child attachments. There were too few studies to examine family dynamics - spousal relationship quality, parent-child victim relationship, and family functioning more generally - even though these factors have been frequently mentioned in the clinical and theoretical literatures. Implications for theories of intrafamilial sexual offending, treatment, and future directions for research are discussed.

Correlates of emotional congruence with children in sexual offenders against children: a test of theoretical models in an incarcerated sample.

Emotional congruence with children is a psychological construct theoretically involved in the etiology and maintenance of sexual offending against children. Research conducted to date has not examined the relationship between emotional congruence with children and other psychological meaningful risk factors for sexual offending against children. The current study derived potential correlates of emotional congruence with children from the published literature and proposed three models of emotional congruence with children that contain relatively unique sets of correlates: the blockage, sexual deviance, and psychological immaturity models. Using Area under the Curve analysis, we assessed the relationship between emotional congruence with children and offense characteristics, victim demographics, and psychologically meaningful risk factors in a sample of incarcerated sexual offenders against children (n=221). The sexual deviance model received the most support: emotional congruence with children was significantly associated with deviant sexual interests, sexual self-regulation problems, and cognition that condones and supports child molestation. The blockage model received partial support, and the immaturity model received the least support. Based on the results, we propose a set of further predictions regarding the relationships between emotional congruence with children and other psychologically meaningful risk factors to be examined in future research.

Emotional congruence with children and sexual offending against children: a meta-analytic review.

OBJECTIVE: Emotional congruence with children is an exaggerated affective and cognitive affiliation with children that is posited to be involved in the initiation and maintenance of sexual offending against children. The current meta-analysis examined the relationship between emotional congruence with children and sexual offending against children, sexual recidivism, and change following sexual offender treatment. METHOD: A systematic literature review of online academic databases, conference proceedings, governmental agency websites, and article, book chapter, and book reference lists was performed. Thirty studies on emotional congruence with children in sexual offenders against children (SOC) were included in a random-effects meta-analysis. RESULTS: Extrafamilial SOC-especially those with male victims--evidenced higher emotional congruence with children than most non--SOC comparison groups and intrafamilial SOC. In contrast, intrafamilial SOC evidenced less emotional congruence with children than many of the non-SOC comparison groups. Higher levels of emotional congruence with children were associated with moderately higher rates of sexual recidivism. The association between emotional congruence with children and sexual recidivism was significantly stronger in extrafamilial SOC samples (d = 0.58, 95% CI [0.31, 0.85]) compared with intrafamilial SOC samples (d = -0.15, 95% CI [-0.58, 0.27]). Similarly, emotional congruence with children showed a significant reduction from pre- to posttreatment for extrafamilial SOC (d = 0.41, 95% CI [0.33, 0.85]), but not for intrafamilial SOC (d = 0.06, 95% CI [-0.10, 0.22]). CONCLUSIONS: Emotional congruence with children is a characteristic of extrafamilial SOC, is moderately predictive of sexual recidivism, and is potentially amenable through treatment efforts.