The Psychoanalytic Act in the Preschool Space, or How to Be Useful Instead of Right.

This contribution examines the position of expert knowledge in the institutional context of an American preschool and a consulting psychoanalyst's refusal to join in its unquestioned dynamic. It interrogates the shift, both theoretical and clinical, occurring if and when the authority of knowledge is supplanted by attention to transference. By arguing that a classroom is the space for the psychoanalytic act and by making a distinction between what it means to be useful rather than right, the author opens a perspective for psychoanalysis in extension that the cared-for children may welcome more than the caring adults.

Personality impairment in male pedophiles.

BACKGROUND: Despite the large body of literature on the psychological sequelae of childhood sexual abuse, the literature on the psychopathology of pedophiles is surprisingly underdeveloped. The present article explores the hypothesis that pedophiles evidence deficits in interpersonal functioning (lack of assertiveness and empathy, passive-aggressiveness) and in self-concept, which might contribute to the motivation for pedophilic acts, as well as elevated sociopathy, impulsivity, and propensity for cognitive distortions, which might underlie the inhibitory failure. METHOD: Twenty male heterosexual pedophiles (DSM-IV criteria) recruited from an outpatient clinic for sex offenders were compared with 24 demographically similar, healthy male controls using 3 personality instruments: the Millon Clinical Multiaxial Inventory-II, the Dimensional Assessment of Personality Impairment-Questionnaire, and the Temperament and Character Inventory. RESULTS: The data suggested that pedophiles have impaired interpersonal functioning, specifically, reduced assertiveness and elevated passive-aggressiveness, as well as impaired self-concept. Regarding disinhibitory traits, pedophiles demonstrated elevated sociopathy and propensity for cognitive distortions. CONCLUSION: Our data are consistent with previous reports of pathologic personality traits in pedophiles and lend support to a hypothesis that such pathology is related to both motivation for and failure to inhibit pedophilic behavior. Such information could potentially have important treatment implications.

Heterosexual male perpetrators of childhood sexual abuse: a preliminary neuropsychiatric model.

This paper presents data from a series of preliminary neuropsychiatric studies, including neuropsychological, personality, sexual history, plethysmographic and neuroimaging investigations, on a sample of 22 male, heterosexual, nonexclusive pedophiles and 24 demographically similar healthy controls. A psychobiological model of pedophilia is proposed, positing that early childhood sexual abuse leads to neurodevelopmental abnormalities in the temporal regions mediating sexual arousal and erotic discrimination and the frontal regions mediating the cognitive aspects of sexual desire and behavioral inhibition. In this way, pedophiles develop deviant pedophilic arousal. Subsequently, if there is comorbid personality pathology, specifically sociopathy and cognitive distortions, there will be failure to inhibit pedophilic behavior.

Impulsive personality traits in male pedophiles versus healthy controls: is pedophilia an impulsive-aggressive disorder?

Pedophilia is characterized by sexual attraction to prepubescent children. Despite the extensive literature documenting the pervasive and pernicious effects of childhood sexual abuse, there is surprisingly little psychiatric literature on pedophilia and its etiology remains enigmatic. In recent years, the psychiatric literature on the phenomenology, neurobiology, and treatment of impulsive-aggressive disorders has grown significantly. As some investigators have conceptualized pedophilia as an impulsive-aggressive disorder, it is of interest whether recent advances in the study of impulsive-aggressive disorders might shed light on pathological mechanisms underlying pedophilia. In the following study, 20 male subjects with a DSM-IV diagnosis of pedophilia, heterosexual type were recruited from an outpatient facility for sexual offenders and compared to 24 demographically similar control subjects. Groups were compared on three personality instruments--the Millon Clinical Multiaxial Inventory-II (MCMI-II), the Temperament and Character Inventory (TCI), and the Dimensional Assessment of Personality Impairment-Questionnaire (DAPI-Q)--to assess for select impairment in impulsive-aggressive personality traits. Pedophiles showed severe and pervasive personality impairment relative to controls. Although there was evidence of impulsivity, the findings do not suggest a predominance of impulsive-aggressive traits, and in fact provide evidence of inhibition, passive-aggression, and harm avoidance. The notion of "compulsive-aggression" in pedophilia is proposed.