Are Child Molesters Mentally Ill?

Are all sex offenders who victimize children pedophiles? A raging debate abounds in the psychiatric world. Pedophilia is a mental health diagnosis. Some members of the American Psychiatric Association want to exclude the diagnosis of pedophilia from the books. Others believe doing so would imply that sexual urges towards and acts against children would no longer considered as "abnormal." Normalizing sexual contact with children could have profound legal consequences; if it is normal, then how can it be illegal?

Do all offenders have a mental illness? Not necessarily. For a clinical diagnosis of pedophilia, a person will have had recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children, for a period of at least 6 months. Moreover, the person has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty. The person is at least age 16 years and at least 5 years older than the child or children. The criterion suggests that for a diagnosis of pedophilia, the perpetrator must suffer internal conflict or social consequences. Nepiophilia, also called infantophilia, is the attraction to toddlers and infants (ages 0-3).

Experts have suggested that only 2-10% of sex offenders against children truly meet the above criteria for pedophilia. Pedophiles often start offending at an early age, have a large number of victims who frequently are not familial related, and they are more driven to re-offend. Their value and belief system supports their predatory lifestyle. They are obsessed with children and they act in addictive ways. Subtypes of true pedophiles include (1) regressed offenders who are passively aroused by children and (2) fixated offenders who identify with children and seek sexual relationships with them.

The other most common psychiatric diagnoses for sexual predators of children involve personality disorders; the antisocial personality (the key feature here is a disregard and violation of others), the narcissistic personality (key feature is grandiosity with a need for admiration and lack of empathy), the borderline personality (key feature is emotional instability and impulsivity) and the histrionic personality (key feature is emotionality and attention seeking).

However, the majority of offenders have motivations that are not related to mental illness. These are the situational and opportunistic sexual abusers of children. Situational abusers tend to offend at times of stress, start offending at a later age, have fewer victims (their victims are usually family members) and in general prefer adult partners. They offend during marital difficulties or when an adult partner is not available. Most cases of incest actually involve the situational abuser. The most common perpetrator is a father or stepfather. Brothers, uncles and caregivers are also frequent opportunistic abusers.

There is no common child molester profile. The sexual abuser could be anyone; he crosses over all socioeconomic, ethnic, age, and professional lines. Most typically, the perpetrator is a white male over 30 years old (the average age is 37). Approximately three percent of the perpetrators are female. If he is single, he has few friends. If he is married, the relationship usually lacks sexual relations. Most convicted offenders were in fact married at the time of their crime. He has vague time gaps in his employment history. The pedophile usually seeks out jobs or volunteer work where he will have daily contact with children. Pedophiles tend to have a rigid set of double standards and are frequently very religious. Studies indicate that up to 95% of the perpetrators report they were themselves victims of childhood sexual abuse. However, researchers believe the statistics are much lower, as the perpetrators fabricate stories of personal victimization in an effort to gain sympathy from the justice system.

True pedophiles are simply fascinated with children. They often refer to children in idealistic terms, describing them as innocent, pure, heavenly, angelic, and divine. They prefer children's activities to adults', and frequently hold on to their own previous childhood hobbies. Pedophiles frequently attempt to develop friendships with single parents in order to get close to their children, especially if the parent works. Offenders often project their own attributes or qualities onto the children they abuse, creating a false belief in their own minds that the child in facts wants them to do the sexual acts. Once the child develops secondary adult characteristics, the abuse is likely to stop towards that child, but then is usually redirected to another victim. The pedophile may also stop as the child ages, fearing that he or she may now divulge their relationship to others. If the pedophile does experience guilt, it is not enough to prevent him from re-abusing. Many of them believe that what they are doing is actually "right" and "healthy" for the child.

Pedophiles stalk their victims, and it is common from them to have identified multiple prey. Targets are usually chosen with great forethought. The easiest victim is the shy/withdrawn or handicapped child, especially one from a troubled or underprivileged home. They frequently target children of a specific age. Although pedophiles usually prefer children who are close to puberty, and inexperienced but curious about sex, others prefer younger children. If the pedophile had been sexually abused as a youth, he may target children of the age he was when his abuse began. The gender of the sex is not necessarily important. He has sexual fantasies and urges towards children, and will target the easiest victim, regardless of heterosexual or homosexual preference. Offenders may prefer girls, but simply have more access to boys. Pedophiles will create an environment and ambiance to appeal to the age and sex of their intended victim: decorating special rooms, buying enticing foods, toys, games, exotic pets, etc. The offender may shower the child with gifts or trips to amusement parks, the zoo, movies, and concerts. Pedophiles are masters at manipulating the innocent; they build a friendship, then they work on making the child feel understood and appreciated in an attempt to raise the victim's self-esteem. The child begins to feel valued, is complimented on his/her maturity, and encouraged to act in adult ways that frequently include sexual activity and alcohol/drug usage.

General Tips for Law Enforcement Officers

• Know your beat's registered sex offenders: Who are they, who have they previously targeted?
• Talk to your sexual crimes detective to get a clearer picture of these individuals. Find out the conditions of their parole/probation, where they should and should not be.
• Learn their MO: How had they previously gained the trust of their victim and the victim's family? Was his victim a family member? If not, where did he previously meet his victim(s)?
• Look for red flags: After asking for ID are the first words out of his mouth "I made a mistake years ago, I'm over that, I'm better now." Where is he, what is his proximity to children? Where is he currently working or volunteering? What is his current access to children? If you are in this home, notice the décor. Does it suggest the suspect wants to entice children? Almost all pedophiles have a collection of pornography, which they protect at all costs. Many also collect "souvenirs" from their victims. They rarely discard either their porn or collections for any reason. What kinds of videos do they own? What types of pictures are on their walls, computer, and cell phone? Are there binoculars by the window that faces a park or school? It is common to find a long list of possible victims with detailed notes.
• Remember, just because he is not a registered sex offender does not mean he should not be. 90% of all sexual assaults are not reported to law enforcement. Do a field interview and get photographs on subjects who have demographic features of a child molester, or if you get one of those deep gut reactions.
• Look for signs of abuse in children/teenagers who are called to your attention for behavioral problems, drug/alcohol abuse, suicide attempts, or self-cutting. After establishing a rapport, ask them if they have ever been sexually molested/assaulted.

If the Suspect is Arrested

• Evidence collection is essential: from the scene, the victim's/suspect's personal belongings, their home, their car, as well as the sexual assault physical exam.
• Interview the victim's siblings and any other children the suspect has been in contact with to identify additional victims.
• Child Protective Services will set up counseling/therapy for the victim and family, but make a referral to your crisis intervention team if you have one. Provide the family with crisis phone numbers:
• RAINN National Rape Crisis Hotline: 800-656-4673.
• National Domestic Violence/Abuse Hotline: 800-799-SAFE (800-787-3224 TDD).
• Do not let your own feelings of disgust and anger cloud your judgment.
• One detective or officer, not a mental health clinician, should interview the victim. Explain to the victim in age-appropriate terms what is going on, to reduce fear and build trust. Reassure the victim that you are there to help him/her and that he/she is safe. Realize that some victims may protect the perpetrator, related to fears of abandonment or retaliation, feelings of guilt, or the child may have developed a sense of attachment to the abuser (the Stockholm Syndrome). Utilize anatomical dolls if possible. Remember that these victims often change stories to please the interviewer.
• If the crime has a prolonged emotional effect on you, talk to someone.

Treatment

There is no cure for pedophilia, as there is no cure for heterosexuality or homosexuality. Successful treatment and rehabilitation of individuals with pedophilia is guarded at best. Pedophilia is generally treated with cognitive-behavioral therapy, alone or in combination with medications. Antidepressants and antiandrogens (Depo-Provera injections, commonly referred to as chemical castration) have been demonstrated to reduce recidivism among child molesters.