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Pedophilia, Minor-Attracted Persons, and the DSM

Pedophilia, Minor-Attracted Persons, and the DSM

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Published by CayoBuay
Brief Descriptions of Presentations at:

Pedophilia, Minor-Attracted Persons, and the DSM: Issues and Controversies
B4U-ACT Symposium Baltimore, MD, August 17, 2011

Fred S. Berlin, M.D., Ph.D. Understanding Pedophilia and Other Paraphilias from a Psychiatric Perspective John Z. Sadler, M.D. Decriminalizing Mental Disorder Concepts — Pedophilia as an Example Lisa J. Cohen, Ph.D. and Igor I. Galynker, M.D., Ph.D. Identifying the Psychobiological Correlates of Pedophilic Desire and Behavior: How C
Brief Descriptions of Presentations at:

Pedophilia, Minor-Attracted Persons, and the DSM: Issues and Controversies
B4U-ACT Symposium Baltimore, MD, August 17, 2011

Fred S. Berlin, M.D., Ph.D. Understanding Pedophilia and Other Paraphilias from a Psychiatric Perspective John Z. Sadler, M.D. Decriminalizing Mental Disorder Concepts — Pedophilia as an Example Lisa J. Cohen, Ph.D. and Igor I. Galynker, M.D., Ph.D. Identifying the Psychobiological Correlates of Pedophilic Desire and Behavior: How C

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Published by: CayoBuay on Jan 31, 2013
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 Brief Descriptions of Presentations at:
Pedophilia, Minor-Attracted Persons, and the DSM: Issues and Controversies
B4U-ACT SymposiumBaltimore, MD, August 17, 2011Fred S. Berlin, M.D., Ph.D.
Understanding Pedophilia and Other Paraphilias from a Psychiatric Perspective
John Z. Sadler, M.D.
 Decriminalizing Mental Disorder Concepts — Pedophilia as an Example
Lisa J. Cohen, Ph.D. and Igor I. Galynker, M.D., Ph.D.
 Identifying the Psychobiological Correlates of Pedophilic Desire and Behavior: How Can We Generalize Our Knowledge Beyond Forensic Samples?
Renee Sorrentino, M.D.
The Forensic Implications of the DSM-V’s Pedohebephilia
Nancy Nyquist Potter, Ph.D.
“Is Anybody Out There?”: Testimony of Minor-Attracted Persons and Hearing versus Listening to their Voices
Richard Kramer, Ph.D.
The DSM and Stigma
Andrew Hinderliter, M.A.
Can the Medicalization of Sexual Deviance ever be Therapeutic?
Jacob Breslow, B.A.
Sexual Alignment: Critiquing Sexual Orientation, The Pedophile, and the DSM
 
Brief descriptions of presentation at:
Pedophilia, Minor-Attracted Persons, and the DSM: Issues and Controversies
B4U-ACT Symposium, Baltimore, MD, August 17, 2011
Understanding Pedophilia and Other Paraphiliasfrom a Psychiatric Perspective
Fred S. Berlin, M.D., Ph.D.Professor of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MDThe word “Pedophilia” is a diagnostic term employed by the psychiatric community to designate a specific type of mental disorder. However, today that term has taken on a different meaning in society’s collective consciousness;serving as a demonizing pejorative that ostracizes those manifesting the condition. This conceptual review isintended to bring enhanced clarity to the matter of how one should understand Pedophilia from a psychiatricperspective, its cultural context, and its treatment. The presentation will also give an overview of other paraphiliasas well.The review addresses (1) the nature of Pedophilia, differentiating it from disorders of character, (2) etiologicalcontributory factors, (3) whether those with it are deserving of treatment, (4) why treatment is even needed, (5)psychosocial and medical interventions, (6) treatment outcome, and (7) recent legislative initiatives related to thecondition. From a mental health perspective, it is important to appreciate that Pedophilia is meant to designate adiagnosable, and potentially treatable, psychiatric condition, rather than a “criminal mind-set;” a mind-set reflectiveof a disregard for society’s values.
 
Brief descriptions of presentation at:
Pedophilia, Minor-Attracted Persons, and the DSM: Issues and Controversies
B4U-ACT Symposium, Baltimore, MD, August 17, 2011
Decriminalizing Mental Disorder Concepts — Pedophilia as an Example
John Z. Sadler, M.D.Professor of Medical Ethics and Psychiatry, UT Southwestern Medical Center, Dallas, TX“Vice” is the term I have used in prior work as a technical term to refer to morally wrongful and/or criminalconduct. In prior work, I have argued that particular categories in DSM-IV-TR and draft DSM-5 categories andcriteria are “vice-laden”, which means that wrongful/criminal conduct is intrinsic to the meaning of some diagnosticcriteria. In my view, vice-laden diagnostic categories are problematic for several reasons: they castpsychiatry/mental health care into police-like social roles, wrongful conduct as diagnostic criterion institutionalizesand perpetuates stigma for all mental disorders, and vice-laden disorders confound public policy about the respectiveroles of mental health, religious and educational institutions, and criminal justice institutions in the regulation of individual conduct. Of the subgroup of DSM categories that are vice-laden, the paraphilias, especially those thatinvolve transgression behavior with others, are deeply vice-laden as currently described in DSM categories. I presenta nosological procedure that, if implemented, would minimize vice-laden diagnostic criteria and the consequentvice/mental disorder confounds in research, practice, and policy. The procedure is based upon key distinctions inmoral philosophy, which separate two kinds of values: moral values, whose meanings involve concepts of good/eviland right/wrong. The other kind of value relevant here, nonmoral values, include a range of meanings relevant toillness and disorder concepts: incapacity, pain, suffering, impairment, to name a few examples. Most cases of disorder criteria are easily identified as involving moral or non-moral values. Disease and injury in physicalmedicine (myocardial infarctions, pneumonia, fractured femurs) universally involve nonmoral values in theirdefining concepts. Most mental disorder concepts in the DSM are based upon nonmoral values as well. However,some categories, including trangressive paraphilias, involve moral values in their diagnostic criteria. My basicprescription for the DSMs is that all DSM disorders should be PRIMARILY based upon nonmoral negative values:pain, suffering, disability, impairments, and incapacities of various kinds, consistent with the rest of medicine.Categories such as Pedophilia are problematic because the diagnostic criteria describe little in the way of nonmoralnegative values; once trangressive molestation of minors (in fantasy or action) is removed from Pedophiliadiagnostic criteria, there is almost nothing left of the disorder phenomenology in the current diagnostic criteria. Suchimpoverishment of the Pedophilia phenomenology raises at least two questions:(1) Should Pedophilia be considered a mental disorder at all, if it is based primarily upon fantasied or actual criminalconduct? (2) If Pedophilia and related categories are to be preserved as legitimate, nonmorally value-laden disorders,then they require a preponderance of nonmorally-value-laden diagnostic descriptors in their diagnostic criteria. I willillustrate these concepts with concrete examples from DSMIV-TR and current DSM-5 proposals, and describe inmore detail how vice-laden disorders may be “rehabilitated” within a scientific psychiatric nosology.ReferencesSadler, J.Z. 2008. Vice and the diagnostic classification of mental disorders: A philosophical case conference.
Philosophy, Psychiatry & Psychology
15(1):1-17Sadler, J.Z. 2005.
Values and Psychiatric Diagnosis
. Oxford, UK: Oxford University Press.

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