Pedophilic disorder is a diagnosis found in Paraphilic Disorders in the DSM-5 (American Psychiatric Association, 2013). Pedophilia requires the presence of a paraphilia that causes significant distress or impairment to the individual or harm to another (Patricelli, 1995-2016). Paraphilia involves intense sexual interest centered around children, non-humans, or harming oneself or another individual during sexual activity (Patricelli, 1995-2016). The sexual interest may focus on the individuals erotic or sexual activities or it may focus on the target of the sexual interest (Patricelli, 1995-2016).
In order for an individual to be diagnosed with pedophilic disorder, there must be a period of six months in which “recurrent, intense sexually arousing fantasies,” urges, or sexually oriented behaviors with a prepubescent child(ren), with prepubescent declared as under the age of thirteen, has occurred (American Psychiatric Association, 2013). The individual must have at some point acted on the sexually natured urges or fantasies or exclaimed a marked distress / interpersonal difficulty due to the urges or fantasies (American Psychiatric Association, 2013). Additionally, the individual must be five years older than the child(ren), be of at least sixteen years old, and void of an ongoing sexual relationship with a twelve or thirteen-year-old (American Psychiatric Association, 2013).
Pedophilic Disorder should be classified as exclusive type (attracted solely to children) or nonexclusive type (attracted to children and adults) in addition to a specifier including sexually attracted to male, sexually attracted to female, sexually attracted to both, or limited to incest, if a specifier can be established (Patricelli, 1995-2016). According to the DSM-5, the diagnostic criteria can apply to those who disclose a paraphilia or to those who deny it despite substantial evidence (2013). If an individual denies current Paraphilia, but has a proven history or evidence of meeting criteria A over a six-month period may still be diagnosed with Pedophilic Disorder (American Psychiatric Association, 2013). Also noted is that if an individual claims their sexual attraction to children causes psychosocial difficulties, a diagnosis of Pedophilic Disorder may be given as well (American Psychiatric Association, 2013). However, an individual who has never acted on their impulses, legal history is clear of acting on the impulses, is void of guilt, shame, and/or anxiety, and is not limited in functioning, he or she retains Pedophilic Sexual Orientation, not the disorder (American Psychiatric Association, 2013).
The extended commitment of individuals with pedophilia appears to be pretty controversial. An article on the NCBI website claims there are supporters for and against extended commitment. Critics argue that providers tend to use a “catch-all” diagnosis as justification to deprive the individual of liberty and unethical commitment (extended incarceration in this case) should not be utilized for the purpose of public safety (Testa & West, 2010). On the other hand, those in support of extended commitment claim ‘abberant’ sexual disorders remain largely untreatable which causes the individual to pose a risk to innocent citizens (Testa, 2010). The article says supporters claim that no matter how great the treatment, the potential of recidivism is still present to some degree (Testa, 2010). However, a study indicates that with treatment, recidivism decreased by thirty percent over a seven-year period (Testa, 2010). I think that extending a sentence past the maximum is unethical despite the crime. Although with this thinking, there is bound to be backlash, there are other options to in-house commitment, that ensures treatment and seems to still protect society at large. Testa and West explain outpatient civil commitment as a way to allow the individual back into society, but mandates continued treatment (2010). Outpatient Civil Commitment allows the state to continue to monitor the individual while in our community and the mandated treatment ensures the individual does not become harmful to others or themselves (Testa & West, 2010). Additionally, with this type of commitment does allow easier hospitalization commitment at the earliest stage of deterioration or if the individual fails to comply with mandated orders. I believe each individual, despite the crime or circumstance has the right to liberty and ethical treatment and it is important to approach topics like this with an open mind and positivity. I think if we extend punishment, we may create a resentment in the individual that holds potential for the individual to become worse or even develop new symptoms or disorders, and therefore, we as a society, must act ethically in the favor all individuals.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Patricelli, MA, K. (1995-2016). Behvioral connections. Retrieved from http://www.behavioralconnections.org/poc/view_doc.php?type=doc&id=571
Testa, M., & West, S. G. (2010). Civil Commitment in the United States.Psychiatry (Edgmont), 7(10), 30–40. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392176/