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January 27, 1989, Vol 261, No. 4 >
ARTICLE | January 27, 1989

Child Molestation and Pedophilia: Title and subTitle BreakAn Overview for the Physician FREE

A. Kenneth Fuller, MD
[+] Author Affiliations

Reprint requests to 1811 Wimbledon Dr, Thomasville, GA 31792 (Dr Fuller).


JAMA. 1989;261(4):602-606. doi:10.1001/jama.1989.03420040140034
Text Size: A A A
Published online
Article
References

Child sexual abuse is a serious, pervasive problem with clinical, social, moral, and legal implications. Between 100 000 and 500 000 children in the United States are thought to be sexually molested annually. Physicians in all specialties may detect sexual exploitation of youngsters and are mandated to report such cases. Failure to diagnose child molestation and pedophilia and to treat their cause can have serious, long-lasting consequences for innocent victims and continued distress for the perpetrator and for the professional who missed the diagnosis. A single child molester may commit hundreds of sexual acts on hundreds of children. The etiology of paraphilic syndromes is multifactorial. There are substantial differences among sexual abusers of children in their personalities and psychopathologies. Although available interventions are symptomatically palliative rather than curative, many pedophiles can benefit from appropriate treatment. Primary prevention may be the key to reducing the frequency of child sexual abuse.

(JAMA 1989;261:602-606)

REFERENCES

1 +
Barnard GW, Fuller AK, Robbins L:  Child molesters , in Howells JG (ed): Modern Perspectives in Psychosocial Pathology . New York, Brunner/Mazel Inc, 1988;, pp 23-42.
2 +
Barnard GW, Fuller AK, Robbins L, et al: The Child Molester: An Integrated Approach to Evaluation and Treatment . New York, Brunner/Mazel Inc, 1989;.
3 +
Moore DS:  A literature review on sexual abuse research . J Nurse Midwifery 1984;;29:395-398.
4 +
Finkelhor D: Child Sexual Abuse: New Theory and Research . New York, Free Press, 1984;.
5 +
Finkel KC:  Sexual abuse of children: An update . Can Med Assoc J 1987;;136:245-252.
6 +
Lanyon RI:  Theory and treatment in child molestation . J Consult Clin Psychol 1986;;54:176-182.
7 +
Brown N:  Historical perspective on child abuse , in Downer A (ed): Prevention of Child Sexual Abuse: A Trainer's Manual . Seattle Institute for Child Advocacy Committee for Children, 1985;, pp 22-28.
8 +
Ellis H: Psychology of Sex . London, Pan Books Ltd, 1933;.
9 +
Finkelhor D:  The sexual abuse of children: Current research reviewed . Psychiatr Annals 1987;; 17:233-241.
10 +
Hartwich A: Aberrations of Sexual Life After the 'Psychopathia Sexualis' of Dr. RV Krafft-Ebing , Burbury AV (trans). London, Staples Press, 1959;.
11 +
Karpman B: The Sexual Offender and His Offences: Aetiology, Pathology, Psychodynamics and Treatment . New York, Julian Press, 1954;.
12 +
Krafft-Ebing RV: Psychopathia Sexualis... Eine Medicinisch-Gerichtüche Studie . Stuttgart, Ferdinand Enke, 1901;.
13 +
Rada RT:  Sexual psychopathology: Historical survey and basic concepts , in Rada RT (ed): Clinical Aspects of the Rapist . New York, Grune & Stratton, 1978;, pp 1-19.
14 +
Araji S, Finkelhor D:  Explanations of pedophilia: Review of empirical research . Bull Am Acad Psychiatry Law 1985;;13:17-37.
15 +
Berlin FS:  Sex offenders: A biomedical perspective and a status report on biomedical treatment , in Greer JG, Stuart IR (eds): The Sexual Aggressor: Current Perspectives on Treatment . New York, Van Nostrand Reinhold Co, 1983;, pp 83-123.
16 +
Kelly RJ:  Limited confidentiality and the pedophile . Hosp Community Psychiatry 1987;;38:1046-1048.
17 +
Smith TA: You Don't Have to Molest That Child . Chicago, National Committee for the Prevention of Child Abuse, 1987;.
18 +
Bradford JMW:  Organic treatments for the male sexual offender . Behav Sci Law 1985;;3:355-375.
19 +
Gillespie WH:  The general theory of sexual perversion . Int J Psychoanal 1956;;37:396-403.
20 +
Socarides CW:  Meaning and content of pedophilic perversions . J Am Psychoanal Assoc 1959;;7:84-94.
21 +
Council on Scientific Affairs:  AMA diagnostic and treatment guidelines concerning child abuse and neglect . JAMA 1985;;254:796-800.
22 +
Diagnostic and Statistical Manual of Mental Disorders , ed 3, revised. Washington, DC, American Psychiatric Association, 1987;.
23 +
Baker AW, Duncan SP:  Child sexual abuse: A study of prevalence in Great Britain . Child Abuse Negl 1985;;9:457-467.
24 +
Mrazek PJ, Lynch MA, Bentovim A:  Sexual abuse of children in the United Kingdom . Child Abuse Negl 1983;;7:147-153.
25 +
Russell DEH:  The incidence and prevalence of intrafamilial and extrafamilial sexual abuse of female children . Child Abuse Negl 1983;;7:133-146.
26 +
Russell DEH: The Secret Trauma: Incest in the Lives of Girls and Women . New York, Basic Books Inc Publishers, 1986;.
27 +
Wyatt GE:  The sexual abuse of Afro-American and White-American women in childhood . Child Abuse Negl 1985;;9:507-519.
28 +
Wyatt GE, Peters SD:  Issues in the definition of child sexual abuse in prevalence research . Child Abuse Negl 1986;;10:231-240.
29 +
Herman J, Russell D, Trocki K:  Long-term effects of incestuous abuse in childhood . Am J Psychiatry 1986;;143:1293-1296.
30 +
Abel GG, Becker JV, Cunningham-Rathner J:  Complications, consent and cognitions in sex between children and adults . Int J Law Psychiatry 1984;;7:89-103.
31 +
Abel GG, Becker JV, Mittelman M, et al:  Self-reported sex crimes of nonincarcerated paraphiliacs . J Interpersonal Violence 1987;;2:3-25.
32 +
Groth AN, Hobson WF, Gary TS:  The child molester: Clinical observations , in Conte J, Shore DA (eds): Social Work and Child Sexual Abuse . New York, Haworth Press Inc, 1982;, pp 129-144.
33 +
Freund K:  Diagnosing homo or heterosexuality and erotic age-preference by means of a psychophysiological test . Behav Res Ther 1967;;5:209-228.
34 +
Abel GG, Barlow DH, Blanchard EB, et al:  Measurement of sexual arousal in male homosexuals: Effects of instructions and stimulus modality . Arch Sex Behav 1975;;4:623-629.
35 +
Avery-Clark CA, Laws DR:  Differential erection response patterns of sexual arousal of sexual abusers to stimuli describing activities with children . Behav Ther 1984;;15:71-83.
36 +
Earls CM, Quinsey VL:  What is to be done? Future research on the assessment and behavioral treatment of sex offenders . Behav Sci Law 1985;;3:377-390.
37 +
Freund K, Chan S, Coulthard R:  Phallometric diagnosis with 'nonadmittors.' Behav Res Ther 1979;;17:451-457.
38 +
Fuller AK, Barnard GW, Robbins L, et al:  Sexual maturity as a criterion for classification of phallametric stimulus slides . Arch Sex Behav 1988;;17:271-276.
39 +
Grossman LS:  Research directions in the evaluation and treatment of sex offenders: An analysis . Behav Sci Law 1985;;3:421-440.
40 +
Laws DR, Holmen ML:  Sexual response faking by pedophiles . Criminal Justice Behav 1978;;5:343-357.
41 +
Laws DR, Osborn CA:  How to build and operate a behavioral laboratory to evaluate and treat sexual deviance , in Greer JG, Stuart IR (eds): The Sexual Aggressor: Current Perspectives on Treatment . New York, Van Nostrand Reinhold Co, 1983;, pp 293-335.
42 +
Laws DR, Rubin HB:  Instructional controls of an autonomic sexual response . J Appl Behav Anal 1969;;2:93-99.
43 +
Quinsey VL, Chaplin TC, Carrigan WF:  Sexual preferences among incestuous and nonincestuous child molesters . Behav Ther 1979;;10:562-565.
44 +
Quinsey VL, Steinman CM, Bergersen SG, et al:  Penile circumference, skin conductance, and ranking responses of child molesters and 'normals' to sexual and nonsexual visual stimuli . Behav Ther 1975;;6:213-219.
45 +
Rosen RC, Keefe FJ:  The measurement of human penile tumescence . Psychophysiology 1978;; 15:366-376.
46 +
Miller BL, Cummings JL, McIntyre H, et al:  Hypersexuality or altered sexual preference following brain injury . J Neurol Neurosurg Psychiatry 1986;;49:867-873.
47 +
Lilly R, Cummings JL, Benson DF, et al:  The human Kluver-Bucy syndrome . Neurology 1983;; 33:1141-1145.
48 +
Gaffney GR, Berlin FS:  Is there hypothalamic-pituitary-gonadal dysfunction in pedophilia? Br J Psychiatry 1984;;145:657-660.
49 +
Gaffney GR, Shelly FL, Berlin FS:  Is there a familial transmission of pedophilia? J Nerv Ment Dis 1984;;172:546-548.
50 +
Gurnani PD, Dwyer M:  Serum testosterone levels in sex offenders . J Offender Counsel Serv Rehabil 1986;;11:39-45.
51 +
Rada RT, Laws DR, Kellner R:  Plasma testosterone levels in the rapist . Psychosom Med 1976;;38:257-268.
52 +
Schiavi RC, Theilgaard A, Owen DR, et al:  Sex chromosome anomalies, hormones and aggressivity . Arch Gen Psychiatry 1984;;41:93-99.
53 +
Groth AN:  Patterns of sexual assault against children and adolescents , in Burgess AW, Groth AN, Holmstrom LL, et al (eds): Sexual Assault of Children and Adolescents . Lexington, Mass, Lexington Books, 1978;, pp 3-24.
54 +
Groth AN, Birnbaum HJ:  Adult sexual orientation and attraction to underage persons . Arch Sex Behav 1979;;7:175-181.
55 +
McGuire RJ, Carlisle JM, Young BG:  Sexual deviations as conditioned behavior: A hypothesis . Behav Res Ther 1965;;2:185-190.
56 +
Goldstein MJ, Kant HS: Pornography and Sexual Deviance . Berkeley, University of California Press, 1973;.
57 +
Plummer K:  Pedophilia: Constructing a sociological baseline , in Cook M, Howells K (eds): Adult Sexual Interest in Children . Orlando, Fla, Academic Press Inc, 1981;, pp 221-250.
58 +
Rothblum ED, Solomon LJ, Albee GW:  A sociopolitical perspective of DSM-III , in Millon T, Klerman GL (eds): Contemporary Directions in Psychopathology: Toward the DSM-III . New York, Guilford Press, 1986;, pp 167-189.
59 +
Tingle D, Barnard GW, Robbins L, et al:  Childhood and adolescent characteristics of pedophiles and rapists . Int J Law Psychiatry 1986;;9:108-122.
60 +
Conte JR:  Clinical dimensions of adult sexual abuse of children . Behav Sci Law 1985;;3:341-354.
61 +
Vermont Department of Health:  Adolescent sex offenders—Vermont, 1984 . JAMA 1985;; 255:181-182.
62 +
Hall GCN, Maiuro RD, Vitaliano PP, et al:  The utility of the MMPI with men who have sexually assaulted children . J Consult Clin Psychol 1986;; 54:493-496.
63 +
Fuller AK, Barnard GW, Robbins L:  Screening for child-molesting behavior . Am J Psychiatry 1988;;145:274.
64 +
Fuller AK, Bartucci RJ:  HIV transmission and childhood sexual abuse . JAMA 1988;;259:2235-2236.
65 +
Bloom JD, Bradford J McD, Kofoed L:  An overview of psychiatric treatment approaches to three offender groups . Hosp Community Psychiatry 1988;;39:151-158.
66 +
Sgroi SM, Blick LC, Porter FS:  A conceptual framework for child sexual abuse , in Sgroi SM (ed): Handbook of Clinical Intervention in Child Sexual Abuse . Lexington, Mass, Lexington Books, 1982;, pp 1-38.
67 +
Reid WH:  Treating sex offenders . Harvard Med School Mental Health Letter 1987;;3:4.
68 +
Bancroft J, Tennent TG, Loucas K, et al:  The control of deviant sexual behavior by drugs: I. Behavioral changes following oestrogens and anti-androgens . Br J Psychiatry 1974;;125:310-315.
69 +
Bancroft J:  Hormones and sexual behavior . Psychol Med 1977;;7:553-556.
70 +
Freund K:  Therapeutic sex drive reduction . Acta Psychiatr Scand Suppl 1980;;287:5-38.
71 +
Gagne P:  Treatment of sex offenders with medroxyprogesterone acetate . Am J Psychiatry 1981;;138:644-646.
72 +
Hucker SJ:  Management of anomalous sexual behavior with drugs . Mod Med Can 1985;;40:150-153.
73 +
Laschet U:  Antiandrogen in the treatment of sex offenders: Mode of action and therapeutic outcome , in Zubin J, Money J (eds): Contemporary Sexual Behavior: Critical Issues in the 1970s . Baltimore, The Johns Hopkins University Press, 1973;, pp 311-319.
74 +
Laschet U, Laschet L:  Three years' clinical results with cyproterone-acetate in the inhibiting regulation of male sexuality . Acta Endocrinol Suppl 1969;;138:103.
75 +
Wincze JP, Bansal S, Malamud M:  Effects of medroxy progesterone acetate on subjective arousal, arousal to erotic stimulation, and nocturnal penile tumescence in male sex offenders . Arch Sex Behav 1986;;15:293-305.
76 +
Wettstein RM:  Legal aspects of neuropsychiatry , in Hales RE, Yudofsky SC: The American Psychiatric Press Textbook of Neuropsychiatry . Washington, DC, American Psychiatric Press, 1987;, pp 451-463.
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Langevin R, Lang RA:  Psychological treatment of pedophiles . Behav Sci Law 1985;;3:403-419.
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Cassity JH:  Psychological considerations of pedophilia . Psychoanal Rev 1927;;14:189-209.
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Conn JH:  Brief psychotherapy of the sex offender . J Clin Psychopathol 1949;;10:347-372.
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Crown S:  Psychotherapy of sexual deviation . Br J Psychiatry 1983;;143:242-247.
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Langevin R:  Sexual strands , in: Understanding and Treating Sexual Anomalies in Men . Hillsdale, NJ, Lawrence Erlbaum Associates Inc Publishers, 1983;.
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Hartman V:  Notes on group psychotherapy with pedophiles . Can Psychiatr Assoc J 1965;;10: 283-289.
83 +
Travin S, Bluestone H, Coleman E, et al:  Pedophilia: An update on theory and practice . Psychiatr Q 1985;;57:89-103.
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Giarretto H:  A comprehensive child sexual abuse treatment program . Child Abuse Negl 1982;;6:263-278.
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Giarretto H: Integrated Treatment of Child Sexual Abuse: A Treatment and Training Manual . Palo Alto, Calif, Science and Behavior Books, 1982;.
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Knopp FH: Retraining Adult Sex Offenders: Methods and Models . Syracuse, NY, Safer Society Press, 1984;.
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Abel GG, Becker JV, Cunningham-Rathner J, et al: The Treatment of Child Molesters . Atlanta, Emory University, 1984;.
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Kelly RJ:  Behavioral reorientation of pedophiliacs: Can it be done? Clin Psychol Rev 1982;;2:387-408.
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Council on Scientific Affairs:  Aversion therapy . JAMA 1987;;258:2562-2566.
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Abel GG:  MD: Sex offenders need treatment, not punishment . Am Med News 1986;;Oct 10:21-23.
91 +
Quinsey VL:  The assessment and treatment of child molesters: A review . Can Psychol Rev 1977;;18:204-222.
92 +
Quinsey VL, Marshall WL:  Procedures for reducing inappropriate sexual arousal: An evaluation review , in Greer JG, Stuart IR (eds): The Sexual Aggressor: Current Perspectives on Treatment . New York, Van Nostrand Reinhold Co, 1983;, pp 267-289.
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Cohn A, Finkelhor D, Holmes C: Preventing Adults From Becoming Child Sexual Molesters , working paper 25. Chicago, National Committee for the Prevention of Child Abuse, 1985;.
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Cohn AH:  Preventing adults from becoming sexual molesters . Child Abuse Negl 1986;;10:559-562.
95 +
Berlin FS:  Laws on mandatory reporting of suspected child sexual abuse . Am J Psychiatry 1988;;145:1039.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Barnard GW, Fuller AK, Robbins L:  Child molesters , in Howells JG (ed): Modern Perspectives in Psychosocial Pathology . New York, Brunner/Mazel Inc, 1988;, pp 23-42.
2 +
Barnard GW, Fuller AK, Robbins L, et al: The Child Molester: An Integrated Approach to Evaluation and Treatment . New York, Brunner/Mazel Inc, 1989;.
3 +
Moore DS:  A literature review on sexual abuse research . J Nurse Midwifery 1984;;29:395-398.
4 +
Finkelhor D: Child Sexual Abuse: New Theory and Research . New York, Free Press, 1984;.
5 +
Finkel KC:  Sexual abuse of children: An update . Can Med Assoc J 1987;;136:245-252.
6 +
Lanyon RI:  Theory and treatment in child molestation . J Consult Clin Psychol 1986;;54:176-182.
7 +
Brown N:  Historical perspective on child abuse , in Downer A (ed): Prevention of Child Sexual Abuse: A Trainer's Manual . Seattle Institute for Child Advocacy Committee for Children, 1985;, pp 22-28.
8 +
Ellis H: Psychology of Sex . London, Pan Books Ltd, 1933;.
9 +
Finkelhor D:  The sexual abuse of children: Current research reviewed . Psychiatr Annals 1987;; 17:233-241.
10 +
Hartwich A: Aberrations of Sexual Life After the 'Psychopathia Sexualis' of Dr. RV Krafft-Ebing , Burbury AV (trans). London, Staples Press, 1959;.
11 +
Karpman B: The Sexual Offender and His Offences: Aetiology, Pathology, Psychodynamics and Treatment . New York, Julian Press, 1954;.
12 +
Krafft-Ebing RV: Psychopathia Sexualis... Eine Medicinisch-Gerichtüche Studie . Stuttgart, Ferdinand Enke, 1901;.
13 +
Rada RT:  Sexual psychopathology: Historical survey and basic concepts , in Rada RT (ed): Clinical Aspects of the Rapist . New York, Grune & Stratton, 1978;, pp 1-19.
14 +
Araji S, Finkelhor D:  Explanations of pedophilia: Review of empirical research . Bull Am Acad Psychiatry Law 1985;;13:17-37.
15 +
Berlin FS:  Sex offenders: A biomedical perspective and a status report on biomedical treatment , in Greer JG, Stuart IR (eds): The Sexual Aggressor: Current Perspectives on Treatment . New York, Van Nostrand Reinhold Co, 1983;, pp 83-123.
16 +
Kelly RJ:  Limited confidentiality and the pedophile . Hosp Community Psychiatry 1987;;38:1046-1048.
17 +
Smith TA: You Don't Have to Molest That Child . Chicago, National Committee for the Prevention of Child Abuse, 1987;.
18 +
Bradford JMW:  Organic treatments for the male sexual offender . Behav Sci Law 1985;;3:355-375.
19 +
Gillespie WH:  The general theory of sexual perversion . Int J Psychoanal 1956;;37:396-403.
20 +
Socarides CW:  Meaning and content of pedophilic perversions . J Am Psychoanal Assoc 1959;;7:84-94.
21 +
Council on Scientific Affairs:  AMA diagnostic and treatment guidelines concerning child abuse and neglect . JAMA 1985;;254:796-800.
22 +
Diagnostic and Statistical Manual of Mental Disorders , ed 3, revised. Washington, DC, American Psychiatric Association, 1987;.
23 +
Baker AW, Duncan SP:  Child sexual abuse: A study of prevalence in Great Britain . Child Abuse Negl 1985;;9:457-467.
24 +
Mrazek PJ, Lynch MA, Bentovim A:  Sexual abuse of children in the United Kingdom . Child Abuse Negl 1983;;7:147-153.
25 +
Russell DEH:  The incidence and prevalence of intrafamilial and extrafamilial sexual abuse of female children . Child Abuse Negl 1983;;7:133-146.
26 +
Russell DEH: The Secret Trauma: Incest in the Lives of Girls and Women . New York, Basic Books Inc Publishers, 1986;.
27 +
Wyatt GE:  The sexual abuse of Afro-American and White-American women in childhood . Child Abuse Negl 1985;;9:507-519.
28 +
Wyatt GE, Peters SD:  Issues in the definition of child sexual abuse in prevalence research . Child Abuse Negl 1986;;10:231-240.
29 +
Herman J, Russell D, Trocki K:  Long-term effects of incestuous abuse in childhood . Am J Psychiatry 1986;;143:1293-1296.
30 +
Abel GG, Becker JV, Cunningham-Rathner J:  Complications, consent and cognitions in sex between children and adults . Int J Law Psychiatry 1984;;7:89-103.
31 +
Abel GG, Becker JV, Mittelman M, et al:  Self-reported sex crimes of nonincarcerated paraphiliacs . J Interpersonal Violence 1987;;2:3-25.
32 +
Groth AN, Hobson WF, Gary TS:  The child molester: Clinical observations , in Conte J, Shore DA (eds): Social Work and Child Sexual Abuse . New York, Haworth Press Inc, 1982;, pp 129-144.
33 +
Freund K:  Diagnosing homo or heterosexuality and erotic age-preference by means of a psychophysiological test . Behav Res Ther 1967;;5:209-228.
34 +
Abel GG, Barlow DH, Blanchard EB, et al:  Measurement of sexual arousal in male homosexuals: Effects of instructions and stimulus modality . Arch Sex Behav 1975;;4:623-629.
35 +
Avery-Clark CA, Laws DR:  Differential erection response patterns of sexual arousal of sexual abusers to stimuli describing activities with children . Behav Ther 1984;;15:71-83.
36 +
Earls CM, Quinsey VL:  What is to be done? Future research on the assessment and behavioral treatment of sex offenders . Behav Sci Law 1985;;3:377-390.
37 +
Freund K, Chan S, Coulthard R:  Phallometric diagnosis with 'nonadmittors.' Behav Res Ther 1979;;17:451-457.
38 +
Fuller AK, Barnard GW, Robbins L, et al:  Sexual maturity as a criterion for classification of phallametric stimulus slides . Arch Sex Behav 1988;;17:271-276.
39 +
Grossman LS:  Research directions in the evaluation and treatment of sex offenders: An analysis . Behav Sci Law 1985;;3:421-440.
40 +
Laws DR, Holmen ML:  Sexual response faking by pedophiles . Criminal Justice Behav 1978;;5:343-357.
41 +
Laws DR, Osborn CA:  How to build and operate a behavioral laboratory to evaluate and treat sexual deviance , in Greer JG, Stuart IR (eds): The Sexual Aggressor: Current Perspectives on Treatment . New York, Van Nostrand Reinhold Co, 1983;, pp 293-335.
42 +
Laws DR, Rubin HB:  Instructional controls of an autonomic sexual response . J Appl Behav Anal 1969;;2:93-99.
43 +
Quinsey VL, Chaplin TC, Carrigan WF:  Sexual preferences among incestuous and nonincestuous child molesters . Behav Ther 1979;;10:562-565.
44 +
Quinsey VL, Steinman CM, Bergersen SG, et al:  Penile circumference, skin conductance, and ranking responses of child molesters and 'normals' to sexual and nonsexual visual stimuli . Behav Ther 1975;;6:213-219.
45 +
Rosen RC, Keefe FJ:  The measurement of human penile tumescence . Psychophysiology 1978;; 15:366-376.
46 +
Miller BL, Cummings JL, McIntyre H, et al:  Hypersexuality or altered sexual preference following brain injury . J Neurol Neurosurg Psychiatry 1986;;49:867-873.
47 +
Lilly R, Cummings JL, Benson DF, et al:  The human Kluver-Bucy syndrome . Neurology 1983;; 33:1141-1145.
48 +
Gaffney GR, Berlin FS:  Is there hypothalamic-pituitary-gonadal dysfunction in pedophilia? Br J Psychiatry 1984;;145:657-660.
49 +
Gaffney GR, Shelly FL, Berlin FS:  Is there a familial transmission of pedophilia? J Nerv Ment Dis 1984;;172:546-548.
50 +
Gurnani PD, Dwyer M:  Serum testosterone levels in sex offenders . J Offender Counsel Serv Rehabil 1986;;11:39-45.
51 +
Rada RT, Laws DR, Kellner R:  Plasma testosterone levels in the rapist . Psychosom Med 1976;;38:257-268.
52 +
Schiavi RC, Theilgaard A, Owen DR, et al:  Sex chromosome anomalies, hormones and aggressivity . Arch Gen Psychiatry 1984;;41:93-99.
53 +
Groth AN:  Patterns of sexual assault against children and adolescents , in Burgess AW, Groth AN, Holmstrom LL, et al (eds): Sexual Assault of Children and Adolescents . Lexington, Mass, Lexington Books, 1978;, pp 3-24.
54 +
Groth AN, Birnbaum HJ:  Adult sexual orientation and attraction to underage persons . Arch Sex Behav 1979;;7:175-181.
55 +
McGuire RJ, Carlisle JM, Young BG:  Sexual deviations as conditioned behavior: A hypothesis . Behav Res Ther 1965;;2:185-190.
56 +
Goldstein MJ, Kant HS: Pornography and Sexual Deviance . Berkeley, University of California Press, 1973;.
57 +
Plummer K:  Pedophilia: Constructing a sociological baseline , in Cook M, Howells K (eds): Adult Sexual Interest in Children . Orlando, Fla, Academic Press Inc, 1981;, pp 221-250.
58 +
Rothblum ED, Solomon LJ, Albee GW:  A sociopolitical perspective of DSM-III , in Millon T, Klerman GL (eds): Contemporary Directions in Psychopathology: Toward the DSM-III . New York, Guilford Press, 1986;, pp 167-189.
59 +
Tingle D, Barnard GW, Robbins L, et al:  Childhood and adolescent characteristics of pedophiles and rapists . Int J Law Psychiatry 1986;;9:108-122.
60 +
Conte JR:  Clinical dimensions of adult sexual abuse of children . Behav Sci Law 1985;;3:341-354.
61 +
Vermont Department of Health:  Adolescent sex offenders—Vermont, 1984 . JAMA 1985;; 255:181-182.
62 +
Hall GCN, Maiuro RD, Vitaliano PP, et al:  The utility of the MMPI with men who have sexually assaulted children . J Consult Clin Psychol 1986;; 54:493-496.
63 +
Fuller AK, Barnard GW, Robbins L:  Screening for child-molesting behavior . Am J Psychiatry 1988;;145:274.
64 +
Fuller AK, Bartucci RJ:  HIV transmission and childhood sexual abuse . JAMA 1988;;259:2235-2236.
65 +
Bloom JD, Bradford J McD, Kofoed L:  An overview of psychiatric treatment approaches to three offender groups . Hosp Community Psychiatry 1988;;39:151-158.
66 +
Sgroi SM, Blick LC, Porter FS:  A conceptual framework for child sexual abuse , in Sgroi SM (ed): Handbook of Clinical Intervention in Child Sexual Abuse . Lexington, Mass, Lexington Books, 1982;, pp 1-38.
67 +
Reid WH:  Treating sex offenders . Harvard Med School Mental Health Letter 1987;;3:4.
68 +
Bancroft J, Tennent TG, Loucas K, et al:  The control of deviant sexual behavior by drugs: I. Behavioral changes following oestrogens and anti-androgens . Br J Psychiatry 1974;;125:310-315.
69 +
Bancroft J:  Hormones and sexual behavior . Psychol Med 1977;;7:553-556.
70 +
Freund K:  Therapeutic sex drive reduction . Acta Psychiatr Scand Suppl 1980;;287:5-38.
71 +
Gagne P:  Treatment of sex offenders with medroxyprogesterone acetate . Am J Psychiatry 1981;;138:644-646.
72 +
Hucker SJ:  Management of anomalous sexual behavior with drugs . Mod Med Can 1985;;40:150-153.
73 +
Laschet U:  Antiandrogen in the treatment of sex offenders: Mode of action and therapeutic outcome , in Zubin J, Money J (eds): Contemporary Sexual Behavior: Critical Issues in the 1970s . Baltimore, The Johns Hopkins University Press, 1973;, pp 311-319.
74 +
Laschet U, Laschet L:  Three years' clinical results with cyproterone-acetate in the inhibiting regulation of male sexuality . Acta Endocrinol Suppl 1969;;138:103.
75 +
Wincze JP, Bansal S, Malamud M:  Effects of medroxy progesterone acetate on subjective arousal, arousal to erotic stimulation, and nocturnal penile tumescence in male sex offenders . Arch Sex Behav 1986;;15:293-305.
76 +
Wettstein RM:  Legal aspects of neuropsychiatry , in Hales RE, Yudofsky SC: The American Psychiatric Press Textbook of Neuropsychiatry . Washington, DC, American Psychiatric Press, 1987;, pp 451-463.
77 +
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