486 CHAPTER 11
Pedophilia: Sexually Abusing Children
Child sexual abuse is a crime, but the DSM-IV-TR diagnosis for those who fanta-
size about, have urges, or actually engage in sexual activity with a child (typically
one who has not yet gone through puberty) is pedophilia (see Table 11.3). For this
diagnosis, the person with pedophilia must be at least 16 years old, and at least 5
years older than the child. Thus, someone is diagnosed with pedophilia if he has
had sexual activity with a child (and so would also be considered a child molester)
or if he has sexual fantasies about or urges to do so and these impulses signifi cantly
impair his relationships or cause distress. Someone with pedophilia may or may
not sexually molest children; a child molester may or may not be diagnosed with
pedophilia, depending on the duration of the related fantasies, urges, or behaviors
(Camilleri & Quinsey, 2008).
The sexual behaviors range from fondling to oral-genital contact to penetra-
tion. Approximately 25% of victims (who are more likely to be girls than boys;
McAnulty et al., 2001) are under 6 years of age, 25% are between 6 and 10 years
old, and 50% are between 11 and 13 (Erickson, Walbeck, & Seely, 1988). People
with pedophilia often say that they believe that adult sexual contact with children
has positive effects for the child. Compared to rapists, people with pedophilia who
have molested children view themselves as less responsible for the abuse and view
the child as more responsible (Stermac & Segal, 1989)—claiming that the child “se-
duced” them. In fact, some child molesters with pedophilia report that they didn’t
think they were harming the children they molested, but were “sharing pleasure”
(Spitzer et al., 2002). Studies suggest that men with pedophilia who are sex offend-
ers are likely to have at least one other paraphilia (Heil & Simons, 2008; Raymond
et al., 1999).
Pedophilia often begins in adolescence, and it tends to be a chronic condition.
The relapse rate for pedophiles drawn to boys is twice that of those drawn to girls
(American Psychiatric Association, 2000). Although pedophilia typically involves
sexual behavior with a minor, the disorder may be limited to fantasies, viewing por-
nography, or voyeurism directed toward minors.
Note that not all sexual abuse of children occurs because of a consistent sexual
arousal pattern: Children may be sexually abused because the abuser has another
sort of psychological disorder, such as a substance abuse problem (often alcohol,
which as we saw in Chapter 9 can disinhibit behavior), or the sexual abuse is an act
of aggression (Dorr, 1998; Fagan et al., 2002; Marshall, 1997). (The effects of child
sexual abuse and other forms of child maltreatment are discussed in Chapter 2.)Sexual Sadism and Sexual Masochism: Pain and Humiliation
Sexual sadism and sexual masochism are two complementary sides of a mode of
sexual interaction in which pain, suffering, or humiliation creates or enhances sexual
excitement. People who do not experience signifi cant distress or interpersonal prob-
lems because of their sadistic or masochistic sexual fantasies, urges, and behavior
and whose sexual partners are consenting adults would not be diagnosed with either
of these disorders. Let’s examine the DSM-IV-TR criteria for these two disorders.Sexual Sadism: Infl icting the Pain
A person who feels sexually aroused by fantasies, urges, and behaviors that infl ict
physical or psychological suffering on another person is said to have sexual sadism
(see Table 11.3). Note that sexual sadism involves real acts that cause someone else
to suffer (versus simulated acts, where no real suffering occurs). There are two sets
of circumstances in which someone would be diagnosed with sexual sadism: (1) The
recurrent sadistic fantasies or urges cause the individual signifi cant distress, such as
occurs when a man is horrifi ed to discover that he is consistently aroused when fan-
tasizing about hurting his partner; or (2) the individual has repeatedly subjected a
nonconsenting partner to sexually sadistic acts (as occurs with sadistic rape)—such
behavior is also a criminal act.Pedophilia
A paraphilia characterized by recurrent
sexually arousing fantasies, sexual urges, or
behaviors involving a child who has not yet
gone through puberty (typically aged 13 or
younger).
Sexual sadism
A paraphilia characterized by recurrent
sexually arousing fantasies, urges,
and behaviors that infl ict physical or
psychological suffering on another person.