Pedophilia and the American Psychiatric Association: Mental Illness vs. Aberration

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Home / Pedophilia and the American Psychiatric Association: Mental Illness vs. Aberration
Definitions of illness can vary. Image by Penywise.

Definitions of illness can vary. Image by Penywise.

How does the American Psychiatric Association (APA) view pedophilia? A recent controversy leaves many people wondering about this question. Charisma Magazine, a publication geared toward evangelical Christians, was dismayed to discover that the APA had described pedophilia as a “sexual orientation” rather than a “sexual interest.” The description seems to validate pedophilia, which is a sexual attraction to children, as a viable life choice.

Christian and conservative citizens quickly responded to the report, petitioning Congress and Attorney General Eric Holder to appeal to the APA to change their definition. Immediately after, the concerned groups noticed that the APA had written a news release to correct their error. The APA said that the discussion section of the newest version of the DSM-5 (a manual of psychiatric disorders that is widely used by mental health professionals) contained an error.

The APA said that the discussion about diagnostic criterion for pedophilic disorder contained an error; it should have read, “sexual interest,” instead of “sexual orientation.”

In the news release, the APA affirmed that they strongly support effort to criminally prosecute those who sexually abuse and exploit children and adolescents. They also support ongoing efforts to develop treatment for individuals who have been diagnosed with pedophilic disorder, with the goal of preventing future abusive acts.

Correcting the DSM

What’s behind this issue? The DSM, or Diagnostic and Statistical Manual of Mental Disorders, was first developed in 1952. It has been periodically revised since then, but for nearly two decades, it remained untouched, despite the wealth of new information that researchers had discovered in that time. In 2013, the updated version, called the DSM-5, was finally revealed.

The DSM-5’s chair and vice-chair, David Kupfer and Darrel Regier, published a disclaimer on the tome’s website. They noted that they worked on revising the criteria for the diagnosis and classification of mental disorders for more than a decade, but the work is still not complete. Kupfer and Regier called on the public to play an active role in the next phase of refining the material, including correcting any errors. This disclaimer seems to indicate that the “sexual orientation” vs. “sexual interest” statement was truly a mistake.

A Political Issue?

Conservative groups doubt that the designation of pedophilia as a sexual orientation was far from an honest mistake. Instead, they believe that the APA bowed to the demands of radical groups that maintain that feeling attracted to children is different than acting on one’s attraction to children. Some compare the APA’s attitude toward pedophilia to its attitude toward homosexuality; in much earlier editions of the DSM, homosexuality was considered a disorder, but its definition has been changed over the years.

The issue is more subtle, but still politicized. The APA classifies pedophilia as a type of paraphilia, or an atypical sexual interest. In its notes about changes in the definitions of paraphilia, the APA clearly states that most people with atypical sexual interests do not have a mental disorder. In order to be diagnosed with a paraphilic disorder, the DSM-5 requires that people with these interests must feel personal distress about their interest, and the interest must involve another person’s psychological distress, injury or death. In other words, if they do not cause harm to others, their sexual interests are not deemed mental illnesses.

The APA’s notes explain that they did not change the definition of pedophilia in its new edition of the DSM; instead it only changed the name of the disorder from “pedophilia” to “pedophilic disorder.” Although the writers of the newest version of the DSM had discussed proposals to amend the diagnostic criteria, they decided to leave them virtually the same as in the earlier edition. As it stood before, in order to be diagnosed with Pedophilic Disorder, people must not only have thoughts of attraction to children, they must act on the attraction as well.

Atypical Attraction: Thinking vs. Acting

Not all thoughts require treatment, according to the APA. IMage by ardelfin.

Not all thoughts require treatment, according to the APA. Image by ardelfin.

Many conservative thinkers dislike the distinction between “thinking” and “acting.” As Liberty News, a conservative website, complains, this definition of pedophilia offers academic legitimacy to the unnatural thoughts of would-be predators. They follow the thinking of some academics, such as William O’Donohue, who believe that any sexual attraction to children is pathological, because it has the potential to cause significant harm to others. It’s also difficult for a mental health practitioner to accurately determine whether or not a patient who presents with pedophilic thoughts has actually acted on them.

Pedophilia and the Changed Brain

Although the political right and many psychologists believe that pedophilia is a distortion of otherwise-normal, adult-oriented sexual attractions, those who study the brain disagree. Specifically, James Cantor, Ph.D., a researcher from the University of Toronto, has found marked brain differences in those who have pedophilic tendencies.

Dr. Cantor maintains that physiologically, pedophiles are different from birth. He believes that progress in our understanding of brain functions and structure will help us to correctly diagnose and treat pedophilia.

The APA’s approach of viewing pedophilic thoughts as non-dysfunctional is in line with this research-oriented point of view.

Resources

American Psychiatric Association DSM-5 Development. DSM-5 Implementation and Support. (2013). Accessed November 17, 2013.

American Psychiatric Publishing. Paraphilic Disorders Fact Sheet. (2013). Accessed November 17, 2013.

Calandra, J. Outrageous – American Psychiatric Association Officially Classifies Pedophilia as a Sexual Orientation! (2013). Liberty News. Accessed on November 17, 2013.

O’Donohue, W., et. al. Problems with the DSM-IV Diagnosis of Pedophilia. (2000). Sexual Abuse: A Journal of Research and Treatment. Accessed November 17, 2013.

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