Magnetic Resonance Techniques in Study of Sexual Stimuli Processing in Paedophilia

Abstract

The sexual aggression of children is a major public health and criminological issue and a paedophilic crime causes considerable public concern. Paraphilias are deviant sexual behaviors that have common clinical features: sexual fantasies leading to sexual urges and, ultimately, to the deviant sexual behavior. In these group of disorders is include the paedophilia (American Psychiatric Association [APA], 2000). Paedophilia is defined as a psychiatric disorder characterized by intense sexually arousing urges and behaviours focused on the sexual activity with a prepubescent child (APA, 2000; Fagan et al., 2002). The ICD-10 defines paedophilia as a sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age (World Health Organization [WHO], 2010). The Diagnostic and Statistical Manual of Mental Disorders, define a paedophile as an individual who fantasizes about, is sexually aroused by, or experiences sexual urges toward prepubescent children (generally <13 years) for a period of at least 6 months. Paedophiles are either severely distressed by these sexual urges, experience interpersonal difficulties because of them, or act on them (diagnostic criteria, according to the DSM-IV-TR, are shown in Table 1), usually come to medical or legal attention by committing an act against a child because most do not find their sexual fantasies distressing or ego-dystonic enough to voluntarily seek treatment. The clinical diagnosis of paedophilia is based on a specific act, it usually is not solely the result of intoxication or caused by another state or condition (APA, 2000). Paedophiles are subdivided into several classifications. One of the first classifications divided to the paedophiles in two groups, group “exclusively” attracted to children (exclusive paedophile) or attracted to adults as well as children (nonexclusive paedophile group) (APA, 2000). Other categorization of paedophiles is based in if they are attracted to only male children (homosexual paedophilia), female children (heterosexual paedophilia), or children from both sexes (bisexual paedophilia). The course of paedophilia is usually long term and has yet no cure. The onset of paedophilia usually occurs during adolescence. Occasional paedophiles begin their activities during middle age but this late onset is uncommon. The frequency of behavior associated with paedophilia varies with psychosocial stress . As the paedophile's stress levels increase, the frequency of his or her acting out generally rises also. Various treatments are available. The medical treatments (medications anti-androgens, luteinizing hormone-releasing hormone agonists, female hormones, antidepressant ) and psychological treatments (aversive