AFTERWORD

This book is an attempt to present a consilient overview of current scientific knowledge about pedophilia and sexual offending against children. I have drawn from research in many disciplines to discuss the historical and cross-cultural manifestations of adult sexual contacts with children (chap. 1 ), the etiology of pedophilia and the origins of sexual offending against children (chaps. 4 and 5 ), assessment of pedophilic sexual interests and of risk to offend in the future (chaps. 2 and 7 ), and intervention (chap. 8 ). My goal in adopting this integrative and multidisciplinary approach was to summarize the progress and identify future directions for research on assessment, etiology, and intervention. In particular, there are many interesting and important questions to be explored regarding the puzzles of pedophilia and incest (chaps. 3 and 6 ). I also believe that quicker and more consistent progress will be made in the understanding, assessment, and treatment of pedophilia and sexual offending against children if researchers can draw from areas other than the sex offender field rather than relying on research conducted only within that field.

Researchers have made significant advances in the assessment of pedophilia and the assessment of risk posed by sex offenders against children, and some encouraging progress has been made on important etiological questions about pedophilia and sexual offending against children. With regard to pedophilia, a convincing scientific theory of this sexual preference for prepubescent children must account for the fact that the large majority of pedophiles are men; that the majority prefer boys; that pedophiles are more likely to have been sexually abused as children themselves; and that they differ from nonpedophilic men in terms of their intelligence, history of early childhood head injuries, non-right-handedness, and white matter volume. The existing evidence suggests that pedophilia is a neurodevelopmental disorder that selectively affects males, altering their sexual preferences with regard to age.

It is possible that researchers will eventually discover that pedophilia is etiologically heterogeneous, so different explanations will be required for different kinds of pedophiles and possibly for male and female pedophiles. As mentioned in chapter 5 , there is accumulating evidence that homosexuality is etiologically heterogeneous such that the fraternal birth order effect accounts for up to 30% of cases of male homosexuality (Blanchard & Bogaert, 2004), and genetic factors may explain other cases (Hamer, Hu, Magnusson, Hu, & Pattattuci, 1993). Neuroscientific and genetic research are particularly exciting avenues for future work on etiological research on pedophilia.

Pedophilia is logically and empirically related to the likelihood that someone will commit a sexual offense involving a child. However, the relationship is not perfect: Some pedophiles have not acted on their sexual interests in this way, and many individuals who commit sexual offenses are not pedophiles. Antisociality (general antisocial tendencies) can distinguish those who do act from those who do not. Because of this commonality with other groups of offenders, the understanding of sexual offending against children can benefit greatly from the knowledge that has been gained in the developmental study of antisocial and criminal behavior.

Much work remains to be done. More studies of nonclinical and nonforensic samples of pedophiles are needed to disentangle pedophilia from clinical distress or criminal status. Anonymity and confidentiality are important considerations because of the social consequences that might face individuals who admit to having pedophilia (e.g., a school teacher who identifies himself as a pedophile, though he has no known history of sexual contacts with children and no allegations of such contacts have been made) and the legal consequences that might face individuals who admit to previously undetected sexual contact with a child. To estimate the general prevalence of pedophilia, large epidemiological surveys with the appropriate questions about target, persistence, and intensity are required. As demonstrated in this book, much of what is known about pedophilia is drawn from research on sex offenders against children. New knowledge about pedophilia may be gleaned by studying other groups, including users of child prostitutes and child pornography offenders. Finally, understanding the development of pedophilia will require longitudinal studies, especially those using genetically informative designs. Important variables for further study include maternal immunity, fetal neurodevelopment, head injury, intelligence, childhood sexual abuse, and conventional sexual experiences.

More research is needed to develop and evaluate interventions that could be effective in reducing sexual offending against children. Interventions may be more likely to be successful to the extent that they are consistent with the theoretical understanding of pedophilia and sexual offending against children. Thus, treatments that effectively address criminogenic needs such as antisocial attitudes and beliefs (e.g., offense-supportive views regarding sex with children), associations with antisocial peers, and substance use could reduce sexual offending, because such treatments have demonstrated effectiveness in reducing reoffending in general. If neurodevelopmental perturbations are a causal pathway to pedophilia, as suggested by the work completed by the Centre for Addiction and Mental Health research group, then treatments that can target the affected brain structures or functions or that target the factors that result in these neurodevelopmental perturbations could reduce the incidence of pedophilia.

I conclude with a comment about the people I have been discussing in this book. Sex offenders against children are among the most reviled people in contemporary society (see Jenkins, 1998). Because pedophilia and sexual offending against children are inextricably linked in public perceptions, pedophiles are feared, hated, ostracized, and sometimes attacked. Yet pedophiles and sex offenders against children live among us as family members, friends, neighbors, or coworkers. Society understandably condemns sexual offenses against children and the potential harm they might cause, and persons who commit sexual offenses against children should be held accountable for their crimes. However, we can still have compassion for pedophiles who resist acting on their sexual interests in prepubescent children and for sex offenders against children who are sincerely motivated to refrain from offending again. Ostracizing pedophiles or sex offenders against children may mean ostracizing family members, friends, neighbors, and coworkers. Hatred and ostracism will not make the problem of sexual offending against children go away. An unintended and potentially counterproductive consequence of such reactions is that few pedophiles voluntarily identify themselves and seek professional help to refrain from committing sexual offenses against children, even with proactive efforts such as Stop It Now! and the Berlin Prevention Project. Thus, it is mostly those who have acted on their sexual interest in children who come to the attention of clinicians, to the detriment of children who might not otherwise have been sexually victimized. If society is truly concerned about preventing child sexual abuse, then pedophiles and sex offenders against children deserve careful and balanced consideration, academically, clinically, politically, and publicly. I hope this book can make a scientific contribution to these important discussions.