Necesidades de Intervención en Prisión con Internos con Pedofilia / Intervention Needs in Prison With Pedophile Inmates

En prisión existen programas específicos de tratamiento para condenados por agresión sexual a menores; sin embargo, quienes además tienen pedofilia, requieren una atención específica. El objetivo del presente estudio es doble: primero, ofrecer una propuesta de intervención específica para pedofilia en el entorno penitenciario basada en la evidencia científica disponible y complementaria al Programa de Control de la Agresión Sexual y después, justificar dicha propuesta a través del caso de un interno con pedofilia. En concreto, proponemos una intervención individual y centrada en personas con pedofilia; trabajando la baja autoestima, evaluando la ideación suicida y reestructurando las distorsiones cognitivas con menores, facilitando la creación de relaciones personales funcionales con adultos, evaluando la polivictimización pasada y su posible influencia sobre la conducta sexual posterior, proporcionar a los internos psicoeducación sobre pedofilia; atender de forma específica las fantasías sexuales con menores, evitando las conductas disexuales y la eliminación del consumo de material abusivo.(AU)

There are specific treatment programs in prisons for those convicted of sexually assaulting minors; however, those who also have pedophilia require specific attention. The aim of this study is twofold: first, to offer a specific intervention proposal for pedophilia in the prison setting based on the available scientific evidence, and complementary to the Sexual Assault Control Program, and second, to justify this proposal through the case of an inmate with pedophilia. Specifically, we propose an individual intervention focused on people with pedophilia; working on low self-esteem, assessing suicidal ideation and restructuring cognitive distortions with minors, facilitating the creation of functional personal relationships with adults, assessing past polyvictimization and its possible influence on subsequent sexual behavior, providing inmates with psychoeducation on pedophilia; specifically addressing sexual fantasies with minors, avoiding dyssexual behavior, and eliminating the consumption of abusive material.(AU)

Lay People´s Myths Regarding Pedophilia and Child Sexual Abuse: A Systematic Review.

INTRODUCTION: The term "paedophilia erotica" was first coined in 1886 by the psychiatrist Krafft-Ebing and it was considered a "psycho-sexual perversion." It was at the beginning of the twentieth century that the term "pedophilia" was adopted and it started to appear in medical dictionaries. Sexual abuse is legally defined as the engagement in sexual contact with a person below a specified age or who is incapable of giving consent. Both, pedophilia and child sexual abuse (CSA) are worldwide phenomena requiring deep scientific knowledge in order to improve prevention strategies. Individuals' misconceptions of pedophilia and CSA may legitimize sexual violence, which can influence prevention strategies and policies. OBJECTIVES: This review aimed to summarize existing research to help answer the question: "What are laypeople´s myths regarding pedophilia and CSA?" METHODS: This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify as many relevant articles as possible. A literature search was conducted using PubMed, Web of Science, Scopus, and EBSCOhost databases for articles published before January 2022. Sixty-one articles were included in the current review. RESULTS: Overall, findings revealed a significant number of myths regarding pedophilia and CSA, organized into the following categories: (i) blame diffusion, (ii) denial of abusiveness, (iii) restrictive stereotypes, (iv) victim age and consequences, (v) social stigma, (vi) punitive attitudes, and (vii) treatment. CONCLUSION: Findings suggested that laypeople's perceptions should be taken into account when devising prevention policies. Additionally, perceptions should also be a target of prevention since there is evidence of social stigma and prejudice involving individuals with pedophilia. Such phenomena can contribute to social, emotional, and cognitive problems, among said individuals as well as causing these individuals to exhibit a higher risk for abusive behavior and less help-seeking. Glina F, Barroso R, Cardoso D, et al. Lay People´s Myths Regarding Pedophilia and Child Sexual Abuse: A Systematic Review. Sex Med Rev 2022;10:596-619.

Challenges and Solutions to Implementing a Community-Based Wellness Program for Non-Offending Minor Attracted Persons.

Child sexual abuse is a significant public health concern that has long-lasting consequences for victims and their families and poses a significant financial cost to the public. Prevention efforts, including sex offender treatment programs, are intended to prevent further instances of sexual abuse. Most sexual offenses, however, are committed by individuals who are not yet known as sexual offenders, and therefore traditional sex offender treatment programs fall short of this goal. It is crucial to provide services to people who may be at risk for committing a sexual offense and those who have not offended, including those individuals who are attracted to children. While primary prevention programs such as Prevention Project Dunkelfeld and Talking for Change have begun to address this issue internationally, there are significant barriers to providing preventive services of this nature to non-offending minor attracted persons (NOMAPs) in the United States. Barriers include concerns about mandated reporting laws, stigmatization, and lack of knowledge by therapists about MAPs. This paper explores these barriers and provides solutions for practitioners to offer services to this population. This paper includes the development of specific programming for non-offenders and specialized training for clinicians who work with non-offenders as used by The Global Prevention Project.

Lay People´s Myths Regarding Pedophilia and Child Sexual Abuse: A Systematic Review.

INTRODUCTION: The term "paedophilia erotica" was first coined in 1886 by the psychiatrist Krafft-Ebing and it was considered a "psycho-sexual perversion." It was at the beginning of the twentieth century that the term "pedophilia" was adopted and it started to appear in medical dictionaries. Sexual abuse is legally defined as the engagement in sexual contact with a person below a specified age or who is incapable of giving consent. Both, pedophilia and child sexual abuse (CSA) are worldwide phenomena requiring deep scientific knowledge in order to improve prevention strategies. Individuals' misconceptions of pedophilia and CSA may legitimize sexual violence, which can influence prevention strategies and policies. OBJECTIVES: This review aimed to summarize existing research to help answer the question: "What are laypeople´s myths regarding pedophilia and CSA?" METHODS: This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify as many relevant articles as possible. A literature search was conducted using PubMed, Web of Science, Scopus, and EBSCOhost databases for articles published before January 2022. Sixty-one articles were included in the current review. RESULTS: Overall, findings revealed a significant number of myths regarding pedophilia and CSA, organized into the following categories: (i) blame diffusion, (ii) denial of abusiveness, (iii) restrictive stereotypes, (iv) victim age and consequences, (v) social stigma, (vi) punitive attitudes, and (vii) treatment. CONCLUSION: Findings suggested that laypeople's perceptions should be taken into account when devising prevention policies. Additionally, perceptions should also be a target of prevention since there is evidence of social stigma and prejudice involving individuals with pedophilia. Such phenomena can contribute to social, emotional, and cognitive problems, among said individuals as well as causing these individuals to exhibit a higher risk for abusive behavior and less help-seeking.

Humanizing Pedophilia as Stigma Reduction: A Large-Scale Intervention Study.

The stigmatization of people with pedophilic sexual interests is a topic of growing academic and professional consideration, owing to its potential role in moderating pedophiles' emotional well-being, and motivation and engagement in child abuse prevention schemes. Thus, improving attitudes and reducing stigmatization toward this group is of paramount importance. Prior research has suggested that narrative humanization-presenting personal stories of self-identified non-offending pedophiles-could be one route to doing this. However, this work has only been conducted with students or trainee psychotherapists, meaning the public generalizability of this method is still unknown. In this study, we compared two stigma interventions to test whether narratives reduce stigma toward people with pedophilic interests more effectively than an informative alternative (scientific information about pedophilia). Using a longitudinal experimental design with a lack of non-intervention control (initial N = 950; final N = 539), we found that narratives had consistently positive effects on all measured aspects of stigmatization (dangerousness, intentionality), whereas an informative alternative had mixed results, and actually increased perceptions of pedophiles' levels of deviance. These effects were still present four months after the initial presentation. We discuss these data in relation to ongoing debates about treating pedophilia as a public health issue requiring a broad societal approach to well-being and child abuse prevention.

Child Sexual Abuse: The Need for a Perpetration Prevention Focus.

In the evolution of efforts to reduce child sexual abuse (CSA) rates in the United States, there has been a gradual shift to add preventive measures to after-the-fact interventions (i.e., interventions and policies implemented after the abuse has already happened, such as services and treatment for victims and punishment, treatment, and management of offenders). Prevention of CSA perpetration, however, is often missing from these efforts, despite decades of experts calling for broader prevention solutions. The current paper describes the scope of the problem of CSA, highlights problems with an over-reliance on after-the-fact interventions, and describes promising perpetration-focused CSA prevention interventions. While most existing preventive efforts focus on teaching children to protect themselves from incurring sexual harm, perpetration prevention efforts may hold more promise by addressing the onset of harmful behavior. As such, perpetration prevention efforts can contribute to a more robust and comprehensive approach to CSA - an approach that focuses on prevention of harm from occurring in the first place, as well as responding once harm has occurred.

Características del abuso sexual infantil por representantes de la Iglesia católica en España / Characteristics of Child Sexual Abuse by Representatives of the Catholic Church in Spain / Característiques de l'abús sexual infantil per representants de l'Església catòlica a Espanya

Este es el primer estudio nacional en España en el que se evalúan las características diferenciales de la victimización sexual contra niños, niñas y adolescentes por parte de representantes de la Iglesia católica. Participaron 38 adultos (25 varones y 13 mujeres), a quienes se llegó mediante muestreo no probabilístico de conveniencia y bola de nieve. Se evaluaron las características de la victimización sexual y del victimario, la revelación y notificación y la vivencia de otras formas de victimización por parte de personas no pertenecientes al clero. Los resultados sugieren que las organizaciones religiosas deberían adquirir el compromiso de colaborar en el proceso de superación de las graves experiencias de victimización infantojuvenil acontecidas en su seno por parte de aquellos niños, niñas y adolescentes más vulnerables y victimizados

This is the first national study in Spain in which the differential characteristics of sexual victimization against children and adolescents by representatives of the Catholic Church are evaluated. Thirty-eight adults (25 men and 13 women) reached by non-probabilistic sampling of convenience and snowball participated in the study. The characteristics of the sexual victimization and the perpetrator, the disclosure and notification and the experience of other forms of victimization by people not belonging to the clergy were evaluated. The results suggests that religious organizations should acquire the commitment to collaborate in the process of overcoming the serious experiences of victimization by those most vulnerable and victimized children and adolescents

Aquest és el primer estudi nacional a Espanya en el qual s'avaluen les característiques diferencials de la victimització sexual contra nens, nenes I adolescents per part de representants de l'Església catòlica. Van participar-hi 38 adults (25 homes I 13 dones), als qui es va arribar mitjançant mostreig no probabilístic de conveniència I bola de neu. Es van avaluar les característiques de la victimització sexual I del victimari, la revelació I notificació ila vivència d'altres formes de victimització per part de persones no pertanyents al clergat. Els resultats suggereixen que les organitzacions religioses haurien d'adquirir el compromís de col·laborar en el procés de superació de les greus experiències de victimització infantil I juvenil esdevingudes allà per part d'aquells nens, nenes I adolescents més vulnerables I victimitzats

Abuso sexual infantil como práctica desestructurante / Child sexual abuse as a disruptive practice / Abús sexual infantil com a pràctica desestructurant

El abuso sexual en niños y niñas, como modelo de destrucción de lo propio por imposición y dominio de una instancia psíquica sobre otra, puede ser visto en las relaciones familiares y en las sociales como daño en el vínculo. Como efecto se explora la pérdida de sentido, memoria y la repetición compulsiva del acto. El escenario forense colombiano intenta atender a las víctimas, pero se ha quedado en el estudio de la veracidad del testimonio infantil, dejando en espera la juiciosa exploración del daño mental, así como la reparación y la comprensión de daño relacional

Child sexual abuse, as a model of destruction of one's own by the imposition and domination of one psychic instance over another, can be seen in family and social relationships as damaging the bond. As an effect, the loss of meaning, memory and the compulsive repetition of the act are explored. The Colombian forensic scenario attempts to attend the victims, but it stopped at the study of the veracity of child testimony, postponing the judicious exploration of mental harm, as well as the reparation and understanding of relational harm

L'abús sexual en nens I nenes, com a model de destrucció d'allò propi per imposició I domini d'una instància psíquica sobre una altra, pot ser vist en les relacions familiars I en les socials com a dany en el vincle. Com a efecte, s'explora la pèrdua de sentit, de memòria I la repetició compulsiva de l'acte. L'escenari forense colombià intenta atendre les víctimes però s'ha quedat a l'estudi de la veracitat del testimoni infantil, I deixa en espera l'assenyada exploració del dany mental, així com la reparació I la comprensió del dany relacional

What Deters Child Sex Offenders? A Comparison Between Completed and Noncompleted Offenses.

This study examined the role of the reaction of the victim, the nature of the physical setting, and the proximity of third parties in deterring offenders from completing an act of child sexual abuse (CSA). A self-report study was conducted with 238 adult males serving a custodial sentence for CSA, of whom 82 identified an occasion in which they had tried to have sexual contact with a child but did not because they were stopped or discouraged. We examined the situational characteristics of the noncompleted offense and compared these with the most recent completed offense by the same offenders. The most common reason for stopping the noncompleted offense, given by more than half of the participants, was the negative reaction of the child, and in particular, the direct request by the child to stop. Actual or potential actions by third parties were the next most cited reasons, with around a quarter of cases stopped because the offender was interrupted. In comparison to the noncomplete offense, in the completed offense the child was more likely to be younger and to be perceived as a willing participant. The most common suggestion for what might have stopped the completed offense, endorsed almost universally, was a negative reaction from the child. Factors that increased the chance of being detected-someone being nearby and the possibility of being observed-were also strongly endorsed. We argue that the findings provide the basis for devising offense-focused prevention strategies for CSA.

Non-Offending Minor-Attracted Persons: Professional Practitioners' Views on the Barriers to Seeking and Receiving Their Help.

Individuals who are attracted to minors but have abstained from sexual offending (non-offending minor-attracted persons) are an under-researched, hard-to-reach population. The current study explored professionals' perspectives of the barriers this population faces in seeking and receiving help and how these barriers can be reduced. Twenty professionals read an original vignette and answered a series of questions via an online survey. Using an inductive thematic analysis, the accessibility of treatment and perceived risk of disclosure emerged as the main barriers to seeking and receiving help. To reduce these barriers a number of potential solutions were suggested, including increasing publicity, educating the public, and offering enhanced training to professionals. This research should bolster future efforts to prevent child sexual abuse and contribute to strategies focused on helping non-offending minor-attracted persons manage their attraction in a pro-social way.

State of the Art Treatment Options for Actual and Potential Sexual Offenders and New Prevention Strategies.

Sexual violence is a significant and devastating issue for men and women throughout the world. Its consequences are not only disastrous for victims of sexual violence but are also extremely costly (estimated cost of $41,000 per rape) for society. Successful treatment of sexual offenders is therefore an important goal for society as well as for victims and offenders themselves. Over the years, multiple treatment approaches for sex offenders have been developed. Treatment programs range from the risk-need-responsivity (RNR) model, which focuses on providing tailored treatment for high-risk and low-risk offenders, to psychodynamic models. This article presents an overview for clinicians of state-of-the-art offender treatment, describing the most common treatment approaches, in particular the RNR model, cognitive-behavioral programs (relapse prevention programs, sexual offender treatment programs), psychodynamic approaches (transference-focused psychotherapy, mentalization-based therapy), the Good Lives Model, as well as pharmacological options. In addition, it provides an evaluation of the various treatment programs. However, given the fact that most acts of sexual violence will never be reported to the police, the question arises if treating convicted perpetrators is enough. Do we need rather-in terms of preventive work-a program for potential sexual offenders and men with delinquent sexual fantasies? Given the prevalence of sexual violence and its impact on victims, society, and the medical community, it would be remiss not to try to reach potential/unconvicted perpetrators. This article offers novel ideas and a project the goal of which is to prevent sexual offenses against women by introducing the "I CAN CHANGE" program from Hannover Medical School.

Preventing child sexual abuse from the offenders' side: prevention Dunkelfeld Project / Prevenir el abuso sexual infantil desde el lado del agresor: proyecto Dunkelfeld de prevención

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Bioethical Issues and Secondary Prevention for Nonoffending Individuals with Pedophilia.

Child sexual abuse is a global problem with significant emotional, psychological, and financial implications to victims, perpetrators, and society. Most child sexual abuse prevention programs target young children or those who have already engaged in abusive behavior, in order to prevent further offending. There are numerous secondary prevention programs targeting individuals at-risk of various health conditions in an effort to reduce the likelihood they will go on to experience a particular illness or disease. Considerable research exists regarding the risk factors for engaging in child sexual abuse and more specifically the factors contributing to reoffense. We argue that engaging in secondary prevention programs for people with pedophilia, in order to prevent child sexual abuse, is an ethically responsible and necessary practice. Secondary prevention programs with this focus are reviewed, along with the implications of mandatory reporting in doing this work.

Risk Assessment of Online Child Sexual Exploitation Offenders.

Over the past two decades in the United States, a dramatic increase in access to the Internet has facilitated an increase in the production, viewing, and distribution of child pornography. In this context, forensic mental health professionals may be called on to estimate the risk of future violence, especially of contact sexual offenses, among individuals charged with online sexual offenses. We summarize demographic and clinical characteristics that differentiate online from contact and "mixed" offenders (those who commit both online and contact offenses), offending histories of these three groups, and the current state of knowledge regarding risk of progression from online-only to contact offending. Multiple studies suggest that online, contact, and mixed offenders demonstrate distinct profiles, and wide variations exist in the offense histories of online-offending groups. Longitudinal studies of individuals charged with online offenses are few in number and are mostly limited to detection of formal charges. Nevertheless, available studies suggest that most individuals who are charged with online offenses and who do not have histories of contact offenses are unlikely to engage in future contact offenses. Within the limitations of the current literature, we suggest guidance for the evaluation and treatment of online offenders.

Safeguarding Culture in the Catholic Church of England and Wales in the Twenty-First Century: An Examination of Progress.

In the wake of reported scandals of child sexual abuse by Roman catholic priests in mainstream media in the 1980s/1990s and conviction of Catholic priests on similar charges in England and Wales, Lord Nolan was invited by the Archbishop of Westminster in 2000 to undertake a review of child safeguarding policies of the Catholic Church of England and Wales since 1994, known as the Nolan Report. The Nolan Report led to the establishment of the first Catholic Office for protection of children (COPCA) which remained operative from 2001-2007 before being later modified in light of the Cumberlege Review (2007) as the National Child Safeguarding Commission (NCSC) and the Catholic Safeguarding Advisory service (CSAS) since 2008 which continue to operate till today. This article conducts a hermeneutical analysis of the Nolan Report, the Cumberlege Report, the annual reports of COPCA and the National Catholic Safeguarding Commission from 2007 till 2017. Wider academic literature on the subject is included in order to critically examine the performance of these child safeguarding structures developed to prevent and control clerical sexual abuse and to evaluate the utility of the child protection measures in place within the Catholic Church of England and Wales, since 2001.

Reduction of Risk Factors for Pedophilic Sexual Offending.

INTRODUCTION: Exploratory analysis of characteristics and reduction of risk factors for child sexual abuse (CSA) in a sample treated in the Prevention Projects Dunkelfeld Hannover and Regensburg. AIM: To evaluate a treatment program aimed at reducing dynamic risk factors (DRF) for CSA. METHODS: Using a psychometric test battery based on self-report questionnaires, intergroup analysis between treatment group (TG, n = 35), treatment refusers (TR, n = 51), and drop-out group (DO, n = 14) was conducted with pretreatment data. Intragroup analysis compared data of TG from pre- and posttreatment. The test battery included sociodemographic and sociosexual data, as well as questionnaires measuring DRF. MAIN OUTCOME MEASURE: This study investigated effects of treatment on pedophilic men who are at risk for offending and observed reductions in important risk factors for CSA. RESULTS: TG, TR (consisting of persons who were offered but refused therapy), and DO did not differ regarding sociodemographic and sociosexual variables before therapy. There were no significant differences in education, relationship status, living solitarily, and being a father/stepfather. TR and DO lived farther away from treatment site than TG. In the TG, a reduction in offense-supportive attitudes, coping self-efficacy deficits, and child identification were revealed at second assessment. In TG no participants started the consumption of child abuse content during the course of the study. CLINICAL IMPLICATIONS: Future treatment concepts should focus on the reduction of empirically relevant risk factors for child sexual offending. STRENGTH & LIMITATIONS: The present article is the first that compares TG to TR and DO before assessment regarding DRF and sociosexual variables. Moreover, it is only the second study that investigated treatment effects on a population of pedophilic men who are at risk for offending. These preliminary findings are limited by moderate group size and a missing control group. CONCLUSION: A reduction in some but not all assessed risk factors for sexual offending against minors could be seen within the time frame of therapy. Findings are in line with results from a previous evaluation study. Engel J, Körner M, Schuhman P. Reduction of risk factors for pedophilic sexual offending. J Sex Med 2018;15:1629-1637.

The Perceived Role of General Self-Regulation and Prosocial Support on the Decision Not to Act Among Men Sexually Attracted to Children.

Recent research highlights potential differences between groups of men sexually attracted to children regarding child molestation behavior, attitudes toward sex with children, and the decision not to act on their attractions. The present study furthered this line of research by investigating the roles of general self-regulation and prosocial support on the decision not to act among 69 men sexually attracted to children. Mixed-methods analysis of survey results provided mixed evidence regarding their relevance to refraining from engaging in child molestation behavior. Quantitative results suggested that self-control, but not prosocial support, showed a major influence on participants' decision not to act. Qualitative results offered a more nuanced understanding of the roles of both of these factors in participants' decisions. Overall, findings support an approach for investigating men sexually attracted to children that focuses on differences between men who do and do not act on their attractions, as well as on the active decision to refrain from engaging in child molestation behavior. Implications for research and clinical practice are highlighted.

Misuse of Child Sexual Abuse Images: Treatment Course of a Self-Identified Pedophilic Pastor.

The recurrent use of child sexual abuse images (CSAI) for sexual arousal is considered a valid indicator for the existence of a pedophilic preference, which in turn represents a significant risk factor for committing contact offenses against children. Treatment programs for (potentially) sexually delinquent men endeavor to reduce the risk to offend by addressing relevant risk factors and emphasizing functional and socially acceptable alternative behaviors. Users of CSAI are a particular target group for prevention services and it has been suggested that the primary treatment focus should be on sexual self-regulation deficits.

The Role of Forensic Factors and Potential Harm to the Child in the Decision Not to Act Among Men Sexually Attracted to Children.

To date, sexual abuse prevention efforts have largely focused on tertiary prevention strategies designed to prevent recidivism among forensic samples of men with a history of sex offending behavior. The present study used mixed methodology to investigate the role of several forensic and related factors on the decision not to commit a sex offense among two groups of community men who self-reported a sexual attraction to children: those who reported a history of acting on their attractions (Acted, n = 29) and those who reported never acting on their attractions (Not Acted, n = 71). Participants from both groups described in their own words the factors that contributed to their decision not to act on their attractions. They also responded to quantitative and qualitative questions regarding the influence and role of the following factors on their decision not to act: (a) the possibility of jail or punishment, (b) mental health treatment, and (c) not wanting to hurt the child. Results were compared across groups, and across prompted and unprompted responses. Analyses highlighted harm to the child as a particularly salient factor in the decision not to act among men in the community at risk for sexually offending. The present study suggests that investigating potential protective factors may be an important direction for future research among samples of community men at risk for both first-time and repeat offenses against children.

Pedophilia-Themed Obsessive-Compulsive Disorder: Assessment, Differential Diagnosis, and Treatment with Exposure and Response Prevention.

Fears of sexually harming children are fairly common among clients suffering from obsessive-compulsive disorder (OCD), yet these symptoms are largely unrecognized and frequently misdiagnosed by mental health professionals. Specifically, clients with pedophilia-themed OCD (P-OCD) experience excessive worries and distressing intrusive thoughts about being sexually attracted to, and sexually violating, children. Expressing these concerns may provoke misjudgments from uninformed mental health professionals that a client is presenting instead with pedophilic disorder. This misdiagnosis and subsequent improper interventions can then contribute to increased fear, anxiety, and in many cases, depression, in affected clients. Therefore, it is imperative that mental health professionals first possess a good understanding of this common manifestation of OCD. As such, in this article, we described obsessions and compulsions typical of P-OCD, in order to inform the reader of the distinctive differences between P-OCD and pedophilic disorder. Information about how to assess for P-OCD symptoms is then provided, followed by suggestions on how to tailor aspects of exposure and response prevention to treat this specific form of OCD.