Hebephilia as a sexual disorder.

BACKGROUND: The term "hebephilia" describes the sexual preference for minors at an early pubertal body age. For most clinicians the definition of hebephilia is not obvious and not integrated as a separate category in the DSM-5. METHOD: N = 222 self-motivated applicants from the community for the therapy program of the Prevention Project Dunkelfeld in Berlin were assessed concerning their sexual preference towards minors. RESULTS: Approximately two-thirds (n = 153) showed a sexual interest in early pubertal minors (15 % exclusively; 85 % non-exclusively). Approximately 95 % reported having sexually abused children and/or having used child abusive images at least once in their lifetime. Hebephiles reported a significantly higher level of clinically relevant distress and personality characteristics, as well as more offense-supportive attitudes compared to normative samples. CONCLUSION: Hebephilia can be differentiated from pedophilia in terms of sexual interest for the body age of the minor. Associated personal distress, deviant personality characteristics as well as sexual behavior problems suggest that hebephilia can fulfill the criteria of a sexual disorder which should be considered in classification systems (DSM, ICD).

[Hebephilia as a sexual disorder]. / Hebephilie als sexuelle Störung.

BACKGROUND: The term "hebephilia" describes the sexual preference for the body scheme of pubescent minors (Tanner stages 2 and 3). For most clinicians the definition of hebephilia as a sexual disorder is not obvious. METHOD: In all assessed males included in the Prevention Project Dunkelfeld at the Institute for Sexual Medicine at the Charité between 2005 and 2011, who met the inclusion criteria and showed no evidence for exclusion criteria (n=222), the existence of a hebephilia was examined. RESULTS: Approximately two thirds of the present sample (n=153) showed responsiveness for the body scheme of pubescent minors. Of these, only 15% were exclusively attracted by the pubescent body scheme and 85% were cases of mixed types. Concerning the clinical aspects of the sexual preference disorder, about 95% reported child sexual abuse and/or having used child abusive images at least once in their lifetime. Additionally, hebephiles reported a higher level of clinical/psychological stress and more distinct personality characteristics in relation to a comparative sample. In terms of risk factors, hebephiles showed more offense-supportive attitudes compared to a male comparative sample. CONCLUSION: Hebephilia is a sexual disorder, but cannot be independently coded in the presently valid classification systems (DSM-IV-TR and ICD-10). Plans to separately include this in future in the DSM-5 represent an important step from a sexological point of view.

Tumor necrosis factor alpha in the pathogenesis of human and murine fulminant hepatic failure.

BACKGROUND & AIMS: The tumor necrosis factor (TNF)-alpha/TNF receptor system is critical for liver development because hepatocytes undergo apoptosis if the antiapoptotic cascades resulting in RelA NF-kappaB activation are not effective. Therefore, we studied the role of TNF-alpha in fulminant hepatic failure (FHF) and developed a new therapeutic strategy. METHODS: Serum levels and hepatic expression of TNF-alpha and both TNF receptors were determined by enzyme-linked immunosorbent assay and immunohistochemistry. Adenoviral vectors were constructed expressing dominant-negative proteins interfering with intracellular TNF-alpha-dependent pathways. The relevance of these constructs was studied in primary mouse hepatocytes and in a murine model of FHF. RESULTS: Serum levels of TNF-alpha and TNF receptors are significantly increased in FHF; this increase correlates with patient prognosis. In livers of patients with FHF, infiltrating mononuclear cells express high amounts of TNF-alpha and hepatocytes overexpress TNF receptor 1 (TNF-R1). Apoptotic hepatocytes are significantly increased in FHF, and there is a strong correlation with TNF-alpha expression, which is even more pronounced in areas of mononuclear infiltrates. In an in vivo FHF model, the Fas-associated death domain (FADD), adenovirus selectively blocked the intracellular pathway, leading to mitochondrial cytochrome c release, caspase-3 activation, and, thus, apoptosis of hepatocytes. CONCLUSIONS: The results show that the TNF-alpha/TNF-R1 system is involved in the pathogenesis of FHF in humans. Studies in this animal model indicate that FADD may serve as a molecular target to prevent liver cell death in vivo.