Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-23T08:42:33.809Z Has data issue: false hasContentIssue false

Executive Functioning in Pedophilia and Child Sexual Offending

Published online by Cambridge University Press:  17 May 2017

Claudia Massau*
Affiliation:
Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital Bochum, Germany Department of Forensic Psychiatry, LVR-Clinics Essen, University Hospital Essen, University of Duisburg-Essen, Germany
Gilian Tenbergen
Affiliation:
Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany Department of Psychology, SUNY College at Oswego, New York
Christian Kärgel
Affiliation:
Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital Bochum, Germany Department of Forensic Psychiatry, LVR-Clinics Essen, University Hospital Essen, University of Duisburg-Essen, Germany
Simone Weiß
Affiliation:
Department of Forensic Psychiatry, LVR-Clinics Essen, University Hospital Essen, University of Duisburg-Essen, Germany
Hannah Gerwinn
Affiliation:
Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Kiel University, Medical School, Kiel, Germany
Alexander Pohl
Affiliation:
Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
Till Amelung
Affiliation:
Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Germany
Sebastian Mohnke
Affiliation:
Charité, Department of Psychiatry and Psychotherapy, Division for Mind and Brain Research, Campus Mitte, Universitätsmedizin Berlin, Germany
Jonas Kneer
Affiliation:
Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
Matthias Wittfoth
Affiliation:
Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
Inka Ristow
Affiliation:
Clinical Affective Neuroimaging Laboratory, Department for Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
Kolja Schiltz
Affiliation:
Department of Forensic Psychiatry, Psychiatric Hospital of the LMU, München, Germany
Klaus M. Beier
Affiliation:
Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Germany
Jorge Ponseti
Affiliation:
Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Kiel University, Medical School, Kiel, Germany
Martin Walter
Affiliation:
Clinical Affective Neuroimaging Laboratory, Department for Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany Department of Psychiatry, Otto v. Guericke University, Magdeburg, Germany
Tillmann H.C. Kruger
Affiliation:
Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
Henrik Walter
Affiliation:
Charité, Department of Psychiatry and Psychotherapy, Division for Mind and Brain Research, Campus Mitte, Universitätsmedizin Berlin, Germany
Boris Schiffer
Affiliation:
Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital Bochum, Germany Department of Forensic Psychiatry, LVR-Clinics Essen, University Hospital Essen, University of Duisburg-Essen, Germany
*
Correspondence and reprint requests to: Claudia Massau, Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany. E-mail: [email protected]

Abstract

Objectives: Pedophilia (P) is a psychiatric disease associated with sexual attraction toward children and often accompanied by child sexual offending (CSO). Consequently, it is important to address the understanding of executive dysfunctions that may increase the probability of CSO. Moreover, this research field has been lacking to disentangle executive deficits associated with pedophilia (as a deviant sexual preference) from those associated with CSO (as a deviant sexual behavior). Methods: The German multi-sided research network NeMUP offers the opportunity to overcome these limitations. By applying the Cambridge Automated Neuropsychological Test Battery in four carefully matched groups of men: (1) pedophiles with (N=45) and (2) without (N=45) a history of sexual offending against children; (3) child molesters without pedophilia (N=19), and (4) non-offending controls (N=49), we were able to analyze executive functioning in pedophilia and CSO independently. Results: Both CSO groups as compared to both non-CSO groups exhibited worsened response inhibition ability. However, only non-pedophilic offenders showed additionally disabled strategy use ability. Regarding set-shifting abilities, the P+CSO group showed the best performance. We also found that performances were affected by age: only in pedophiles, response inhibition worsened with age, while age-related deficits in set-shifting abilities were restricted to non-pedophilic participants. The latter also differentiated between both sexual preference groups. Conclusions: Our results are the first to demonstrate that executive dysfunctions are related to offense status rather than pedophilic preference. Furthermore, there was evidence for differentiating age and performance correlations between pedophiles and non-pedophiles, which warrants further investigation. (JINS, 2017, 23, 460–470)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Authors Massau and Tenbergen contributed equally to this work.

References

REFERENCES

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association.Google Scholar
American Psychiatric Association (Ed.). (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
Babchishin, K.M., Seto, M.C., Sariaslan, A., Lichtenstein, P., Fazel, S., & Langstrom, N. (2016). Parental and perinatal risk factors for sexual offending in men: A nationwide case-control study. Psychological Medicine, 111. doi: 10.1017/S003329171600249X Google Scholar
Beier, K.M. (1998). Differential typology and prognosis for dissexual behavior - a follow-up study of previously expert-appraised child molesters. International Journal of Legal Medicine, 111(3), 133141. doi: 10.1007/s004140050133 CrossRefGoogle ScholarPubMed
Beier, K.M., Ahlers, C.J., Goecker, D., Neutze, J., Mundt, I.A., Hupp, E., & Schaefer, G.A. (2009). Can pedophiles be reached for primary prevention of child sexual abuse? First results of the Berlin Prevention Project Dunkelfeld (PPD). Journal of Forensic Psychiatry & Psychology, 20(6), 851867. doi: 10.1080/14789940903174188 Google Scholar
Blanchard, R., Christensen, B.K., Strong, S.M., Cantor, J.M., Kuban, M.E., Klassen, P., & Blak, T. (2002). Retrospective self-reports of childhood accidents causing unconsciousness in phallometrically diagnosed pedophiles. Archives of Sexual Behavior, 31(6), 511526. doi: 10.1023/A:1020659331965 CrossRefGoogle ScholarPubMed
Blanchard, R., Kolla, N.J., Cantor, J.M., Klasses, P.E., Dickey, R., Kuban, M.E., & Blak, T. (2007). IQ, handedness, and pedophilia in adult male patients stratified by referral source. Sexual Abuse, 19, 285309. doi: 10.1007/s11194-007-9049-0 Google Scholar
Blanchard, R., Kuban, M.E., Klassen, P., Dickey, R., Christensen, B.K., Cantor, J.M., && Blak, T. (2003). Self-reported head injuries before and after age 13 in pedophilic and nonpedophilic men referred for clinical assessment. Archives of Sexual Behavior, 32(6), 573581. doi: 10.1023/A:1026093612434 CrossRefGoogle ScholarPubMed
Cambridge Cognition Ltd (Producer). (2011). CANTABeclipse 4 Test Administration Guide.Google Scholar
Cantor, J.M., Blanchard, R., Christensen, B.K., Dickey, R., Klassen, P.E., Beckstead, A.L., & Kuban, M.E. (2004). Intelligence, memory, and handedness in pedophilia. Neuropsychology, 18(1), 314. doi: 10.1037/0894-4105.18.1.3 Google Scholar
Cantor, J.M., Kabani, N., Christensen, B.K., Zipursky, R.B., Barbaree, H.E., Dickey, R., & Blanchard, R. (2008). Cerebral white matter deficiencies in pedophilic men. Journal of Psychiatric Research, 42(3), 167183. doi: 10.1016/j.jpsychires.2007.10.013 CrossRefGoogle ScholarPubMed
Clark, L., Robbins, T.W., Ersche, K.D., & Sahakian, B.J. (2006). Reflection impulsivity in current and former substance users. Biological Psychiatry, 60(5), 515522. doi: 10.1016/j.biopsych.2005.11.007 Google Scholar
Clark, L., Roiser, J.P., Robbins, T.W., & Sahakian, B.J. (2009). Disrupted ‘reflection’ impulsivity in cannabis users but not current or former ecstasy users. Journal of Psychopharmacology, 23(1), 1422. doi: 10.1177/0269881108089587 Google Scholar
Dickey, R., Nussbaum, D., Chevolleau, K., & Davidson, H. (2002). Age as a differential characteristic of rapists, pedophiles, and sexual sadists. Journal of Sex & Marital Therapy, 28(3), 211218. doi: 10.1080/009262302760328253 Google Scholar
Downes, J.J., Roberts, A.C., Sahakian, B.J., Evenden, J.L., Morris, R.G., & Robbins, T.W. (1989). Impaired extra-dimensional shift performance in medicated and unmedicated Parkinson’s disease: Evidence for a specific attentional dysfunction. Neuropsychologia, 27(11–12), 13291343. doi: 10.1016/0028-3932(89)90128-0 Google Scholar
Eastvold, A., Suchy, Y., & Strassberg, D.S. (2011). Executive function profiles of pedophilic and nonpedophilic child molesters. Journal of the International Neuropsychological Society, 17, 295307. doi: 10.1017/S1355617710001669 Google Scholar
Gerwinn, H., Weiß, S., Kärgel, C., Tenbergen, G., Wittfoth, M., Jung, S., & Kruger, T.H.C. (2016). Paedophilia and child sexual offending: Clinical characteristics and identification of offence associated factors in the NeMUP-study. [submitted].Google Scholar
Gillis, K.R. (2005). Executive functioning in male adolescent sex offenders. Pacific University, Portland, OR.Google Scholar
Habermeyer, B., Esposito, F., Handel, N., Lemoine, P., Kuhl, H.C., Klarhofer, M., & Graf, M. (2013). Response inhibition in pedophilia: An FMRI pilot study. Neuropsychobiology, 68(4), 228237. doi: 10.1159/000355295 CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, & Psychiatry, 23, 5662.Google Scholar
IBM Corp. (Released 2013). IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.Google Scholar
Jespersen, A.F., Lalumière, M.L., & Seto, M.C. (2009). Sexual abuse history among adult sex offenders and non-sex offenders: A meta-analysis. Child Abuse and Neglect, 33, 179192. doi: 10.1016/j.chiabu.2008.07.004 Google Scholar
Joyal, C.C., Beaulieu-Plante, J., & de Chanterac, A. (2014). The neuropsychology of sex offenders: A meta-analysis. Sexual Abuse, 26(2), 149177. doi: 10.1177/1079063213482842 CrossRefGoogle ScholarPubMed
Joyal, C.C., Black, D.N., & Dassylva, B. (2007). The neuropsychology and neurology of sexual deviance: A review and pilot study. Sexual Abuse, 19(2), 155173. doi: 10.1007/s11194-007-9045-4 Google Scholar
Kärgel, C., Massau, C., Weiß, S., Walter, M., Borchardt, V., Kruger, T.H.C., & Schiffer, B. (2017). Evidence for superior neurobiological and behavioral inhibitory control abilities in non-offending as compared to offending pedophiles. Human Brain Mapping, 38, 10921104. doi: 10.1002/hbm.23443 CrossRefGoogle ScholarPubMed
Kärgel, C., Massau, C., Weiß, S., Walter, M., Kruger, T.H.C., & Schiffer, B. (2015). Diminished functional connectivity on the road to child sexual abuse in pedophilia. Journal of Sexual Medicine, 12(3), 783795. doi: 10.1111/jsm.12819 CrossRefGoogle ScholarPubMed
Kirk, K.M., Bailey, J.M., Dunne, M.P., & Martin, N.G. (2000). Measurement models for sexual orientation in a community twin sample. Behavior Genetics, 30(4), 345356. doi: 10.1023/A:1026557719181 Google Scholar
Kongs, S.K., Thompson, L.L., Iverson, G.L., & Heaton, R.K. (2000). The Wisconsin Card Sorting Test - 64. Odessa, FL: Psychological Assessment Resources.Google Scholar
Kruger, T.H.C., & Schiffer, B. (2011). Neurocognitive and personality factors in homo- and heterosexual pedophiles and controls. Journal of Sexual Medicine, 8(6), 16501659. doi: 10.1111/j.1743-6109.2009.01564.x Google Scholar
Langstrom, N., Babchishin, K.M., Fazel, S., Lichtenstein, P., & Frisell, T. (2015). Sexual offending runs in families: A 37-year nationwide study. International Journal of Epidemiology, 44(2), 713720. doi: 10.1093/ije/dyv029 CrossRefGoogle ScholarPubMed
Logan, G.D., Cowan, W.B., & Davis, K.A. (1984). On the ability to inhibit simple and choice reaction time responses: A model and a method. Journal of Experimental Psychology, 10(2), 276291. doi: 10.1037/0096-1523.10.2.276 Google Scholar
Mohnke, S., Muller, S., Amelung, T., Kruger, T.H.C., Ponseti, J., Schiffer, B., & Walter, H. (2014). Brain alterations in pedophilia: A critical review. Progress in Neurobiology, 122, 123. doi: 10.1016/j.pneurobio.2014.07.005 CrossRefGoogle ScholarPubMed
Morais, H.B., Joyal, C.C., Alexander, A.A., Fix, R.L., & Burkhart, B.R. (2016). The neuropsychology of adolescent sexual offending: Testing an executive dysfunction hypothesis. Sexual Abuse, 28, 741745. doi: 10.1177/1079063215569545 CrossRefGoogle ScholarPubMed
Ornstein, T.J., Iddon, J.L., Baldacchino, A.M., Sahakian, B.J., London, M., Everitt, B.J., & Robbins, T.W. (2000). Profiles of cognitive dysfunction in chronic amphetamine and heroin abusers. Neuropsychopharmacology, 23(2), 113126. doi: 10.1016/S0893-133X(00)00097-X Google Scholar
Owen, A.M., Downes, J.J., Sahakian, B.J., Polkey, C.E., & Robbins, T.W. (1990). Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia, 28(10), 10211034. doi: 10.1016/0028-3932(90)90137-D Google Scholar
Owen, A.M., Evans, A.C., & Petrides, M. (1996). Evidence for a two-stage model of spatial working memory processing within the lateral frontal cortex: A positron emission tomography study. Cerebral Cortex, 6(1), 3138. doi: 10.1093/cercor/6.1.31 CrossRefGoogle ScholarPubMed
Owen, A.M., Sahakian, B.J., Hodges, J.R., Summers, B.A., Polkey, C.E., & Robbins, T.W. (1995). Dopamine-dependent frontrostriatal planning deficits in early Parkinson’s disease. Neuropsychology, 9(1), 126140. doi: 10.1037/0894-4105.9.1.126 CrossRefGoogle Scholar
Ponseti, J., Granert, O., Jansen, O., Wolff, S., Beier, K., Neutze, J., & Bosinski, H. (2012). Assessment of pedophilia using hemodynamic brain response to sexual stimuli. Archives of General Psychiatry, 69(2), 187194. doi: 10.1001/archgenpsychiatry.2011.130 CrossRefGoogle ScholarPubMed
Ridderinkhof, K.R., Span, M.M., & van der Molen, M.W. (2002). Perseverative behavior and adaptive control in older adults: Performance monitoring, rule induction, and set shifting. Brain and Cognition, 49(3), 382401. doi: 10.1006/brcg.2001.1506 Google Scholar
Schiffer, B., Kruger, T.H.C., Paul, T., de Greiff, A., Forsting, M., Leygraf, N., & Gizewski, E. (2008). Brain response to visual sexual stimuli in homosexual pedophiles. Journal of Psychiatry & Neuroscience, 33(1), 2333.Google Scholar
Schiffer, B., Mueller, B.W., Scherbaum, N., Hodgins, S., Forsting, M., Wiltfang, J., & Leygraf, N. (2011). Disentangling structural brain alterations associated with violent behavior from those associated with substance use disorders. Archives of General Psychiatry, 68(10), 10391049. doi: 10.1001/archgenpsychiatry.2011.61 Google Scholar
Schiffer, B., Paul, T., Gizewski, E., Forsting, M., Leygraf, N., Schedlowski, M., & Kruger, T.H.C. (2008). Functional brain correlates of heterosexual paedophilia. Neuroimage, 41(1), 8091. doi: 10.1016/j.neuroimage.2008.02.008 CrossRefGoogle ScholarPubMed
Schiffer, B., Peschel, T., Paul, T., Gizewski, E., Forsting, M., Leygraf, N., & Kruger, T.H.C. (2007). Structural brain abnormalities in the frontostriatal system and cerebellum in pedophilia. Journal of Psychiatric Research, 41(9), 753762. doi: 10.1016/j.jpsychires.2006.06.003 Google Scholar
Schiffer, B., & Vonlaufen, C. (2011). Executive dysfunctions in pedophilic and nonpedophilic child molesters. Journal of Sexual Medicine, 8(7), 19751984. doi: 10.1111/j.1743-6109.2010.02140.x CrossRefGoogle ScholarPubMed
Schiltz, K., Witzel, J., Northoff, G., Zierhut, K., Gubka, U., Fellmann, H., & Bogerts, B. (2007). Brain pathology in pedophilic offenders: Evidence of volume reduction in the right amygdala and related diencephalic structures. Archives of General Psychiatry, 64, 737746. doi: 10.1001/archpsyc.64.6.737 Google Scholar
Seto, M.C. (2008). Pedophilia and sexual offending against children: Theory, assessment, and intervention. Washington, DC: American Psychiatric Association.Google Scholar
Suchy, Y., Eastvold, A.D., Strassberg, D.S., & Franchow, E.I. (2014). Understanding processing speed weaknesses among pedophilic child molesters: Response style vs. neuropathology. Journal of Abnormal Psychology, 123(1), 273285. doi: 10.1037/a0035812 Google Scholar
Suchy, Y., Whittaker, J.W., Strassberg, D.S., & Eastvold, A. (2009). Neurocognitive differences between pedophilic and nonpedophilic child molesters. Journal of the International Neuropsychological Society, 15(2), 248257. doi: 10.1017/S1355617709090353 Google Scholar
U.S. Department of Health & Human Services, Administration for Children & Families, Administration on Children, Youth and Families, Children’s Bureau. (2016). Child maltreatment 2014. Washington, DC: U.S. Department of Health & Human Services.Google Scholar
von Aster, M., Neubauer, A., & Horn, R. (2006). Wechsler Intelligenztest für Erwachsene (WIE). Deutschsprachige Bearbeitung und Adaptation des WAIS-III von David Wechsler. Frankfurt, Germany: Pearson Assessment.Google Scholar
Walter, M., Witzel, J., Wiebking, C., Gubka, U., Rotte, M., Schiltz, K., & Northoff, G. (2007). Pedophilia is linked to reduced activation in hypothalamus and lateral prefrontal cortex during visual erotic stimulation. Biological Psychiatry, 62(6), 698701. doi: 10.1016/j.biopsych.2006.10.018 Google Scholar
Wittchen, H.-U., Zaudig, M., & Fydrich, T. (1997). Strukturiertes Klinisches Interview für DSM-IV: Achse I und II. Göttingen, Germany: Hogrefe.Google Scholar