Clinical Psychology Review 31 (2011) 872882

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Clinical Psychology Review

Towards a neurobiological model of offending

Ian J. Mitchell , Anthony R. Beech
University of Birmingham, United Kingdom

a r t i c l e

i n f o

a b s t r a c t
In this paper we consider how disturbances in the neurobiological/neurochemical processes at a young age lead to problematic attachment styles in later life, and which can potentiate probability of offending behavior. In particular, we will contrast attachment and offending patterns of the more generalist type of offender (i.e., those who have a varied criminal career, committing both violent and non-violent offenses, in extremis the psychopathic type of offender), with the more specialist sexual offender (prototypically, the xated pedophile), in the light of a preliminary neurobiological model. Here, we will argue that these two extremes of offenders show, or are predicted to show, differential patterns of neurochemical/neurobiological functioning. 2011 Elsevier Ltd. All rights reserved.

Article history: Received 23 July 2009 Received in revised form 5 April 2011 Accepted 5 April 2011 Available online 14 April 2011 Keywords: Offending Attachment Social brain Oxytocin Vasopressin Amygdala

Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Principles of attachment . . . . . . . . . . . . . . . . . . . . . . . . . 2.1. Identication of childhood interaction/attachment styles . . . . . . . 2.2. Attachment and relationships in adulthood . . . . . . . . . . . . . 3. Problematic attachment histories in childhood and links to offending . . . . 3.1. Evidence for problematic attachment histories in generalist offenders . 3.2. Problematic attachment histories in specialist offenders . . . . . . . 4. Neurobiology/neurochemical overview . . . . . . . . . . . . . . . . . . 4.1. Neurobiological overview of the attachment systems/social brain . . 4.1.1. The orbitofrontal cortex . . . . . . . . . . . . . . . . . . 4.1.2. The amygdala . . . . . . . . . . . . . . . . . . . . . . . 4.1.3. The anterior cingulate cortex (ACC) . . . . . . . . . . . . 4.2. The neurochemistry of attachment and the social brain . . . . . . . 4.2.1. OT and social functioning . . . . . . . . . . . . . . . . . 4.2.2. AVP and social functioning . . . . . . . . . . . . . . . . 5. A neurobiological/neurochemical model of offending . . . . . . . . . . . . 5.1. Neurobiology of generalist offending . . . . . . . . . . . . . . . . 5.2. Neurobiology of pedophilia . . . . . . . . . . . . . . . . . . . . . 6. Conclusions and future directions . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 872 873 873 873 874 875 876 876 876 876 876 877 877 877 878 878 878 879 879 880

Corresponding author at: School of Psychology, University of Birmingham, Edbaston, Birmingham B15 2TT, United Kingdom. Tel.: + 44 121 414 7917, + 44 121 414 7215. E-mail addresses: i.j.mitchell@bham.ac.uk (I.J. Mitchell), a.r.beech@bham.ac.uk (A.R. Beech). 0272-7358/$ see front matter 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.cpr.2011.04.001

1. Introduction One of the key evolutionary changes that emerged in the evolution of mammals is the development of the neurobiological attachment systems underlying the care of infants by parents/carers (Gilbert &

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Proctor, 2006). Attachment can be broadly dened as the process by which an infant has an inborn biological need to maintain close contact with its primary carers (Bowlby, 1969, 1973, 1980; Crittenden, 1985). Intimate contact creates experiences of safeness, and impacts upon the self-soothing systems within the brain. Infants are not born with the capacity to self-soothe. Therefore, it is the caregiver's response to distress signals (e.g., holding, caressing smiling, and feeding) that enables modulation and reduction of cortisol levels (which are a measure of adrenocortical activation) (De Zulueta, 2006). Cortisol levels are raised in the infant when briey separated (i.e., the infant is stressed), while endogenous opiates are involved in the development of the ability to self-soothe. Attachment-related behaviors are mainly underpinned by oxytocin (OT) and vasopressin (AVP). These neuropeptides modulate activity in the areas of the brain that play a crucial role in the control of emotions and motivation (i.e., the [anterior] cingulate gyrus, amygdala and the orbitofrontal cortex). For example, distinct populations of neurons in the amygdala are activated by OT and AVP (Huber, Veinante, & Stoop, 2005). OT expression would enable animals to overcome their natural avoidance of proximity and to inhibit defensive behavior (Heinrichs, von Dawans, & Domes, 2009); while AVP modulates male-typical behaviors, including aggression, pair-bond formation, and courtship (Henrichs et al., 2009). The central release of these neuropeptides, acting upon cortico-limbic systems, is associated with attachment related behaviors (i.e., social bonding/recognition), stress regulation, social communication, and emotional reactivity (particularly the perception of internal states and the emotional states of others) (Kirsch et al., 2005; Wismer Fries, Ziegler, Kurain, Jacoris, & Pollack, 2005). Fonagy (2001) suggests that attachment patterns are shaped by a combination of genetic factors and social experiences. Some candidate genes have been identied that predispose a person to a certain style of attachment (Gillath, McCall, Shaver, Baek, & Chun, 2008). The predisposed style is shaped by early social experiences. Therefore, an individual's attachment style can be seen as a set of enduring characteristics for making sense of one's life experiences and interactions (Young, Klosko, & Weisharr, 2003), in that the relationship between infant and primary caregiver provides a model for future interpersonal and intimate relationships (Collins & Read, 1994). This model is maintained irrespective of whether the relationship between the individual and their primary caregiver/s in childhood was positive or negative, and hence a model for individual's future social interactions is formed, whether this is primarily about approach or avoidance behaviors/interactions. Ward, Hudson, and Marshall (1996) argue that this model governs how an individual's expectations are developed about inter-personal relationships in that individuals may see themselves as being worthy and deserving of another's attention; or conversely as being worthless and undeserving. Secure attachments give rise to internal working models of others as safe, helpful and supportive (Baldwin, 2005), while an insecure attachment style causes the individual to become highly inuenced by social rank, and focused on the power of others to control, or reject them (Gilbert, 2005). There have been indications in the general attachment literature of a relationship between problematic attachment and antisocial behavior. Craissati (2009) notes that violent criminals' lives are associated with extremely disturbed attachment representations, a history of abuse, and a marked lack of empathy, while over 60 years ago, Bowlby (1944) postulated that violent anti-social acts are really distorted attempts at interpersonal emotional exchanges. Although the neurobiology/neurochemistry of the social brain is a topic of active research, relatively little has been written about dysfunctions in these areas and relationships to offending. Therefore, we think it is important to explore this area in more detail. This paper acts as a background to this topic, and is organized in the following way: (1) the concept of attachment in childhood and

adulthood is described; (2) we will outline what is known about the relationship between attachment/sociality and offending, contrasting the offending patterns of the more generalist type of offender (i.e., those who have a varied criminal career, committing both violent and non-violent offenses), and the more specialist offender (i.e., the xated pedophile); (3) the neurobiology/neurochemistry of the social brain/attachment system will be briey described; (4) a preliminary model of offending will be outlined which describes extremes of offending in which different patterns of neurobiological/neurochemical function are known or are predicted to occur. 2. Principles of attachment Main (1995) notes the following principles about attachment: (1) the earliest attachments are usually formed by the age of seven months; (2) nearly all infants become attached; (3) attachments are only formed to a few people in the child's life at this stage; (4) these selective attachments appear to be derived from social interactions with primary attachment gures; (5) they lead to specic organizational changes in an infant's behavior and brain function. Positive attachments are thought to lead to positive emotional states, such as joy, when attachments are renewed, and security when the attachment bond is maintained; on the other hand negative emotional states can occur when attachments are threatened or lost. 2.1. Identication of childhood interaction/attachment styles Ainsworth, Blehar, Waters, and Wall (1978) have used the Strange Situation Task, in which children's reactions to separation and reunion from their caregivers are observed in the laboratory, to identify the child's attachment style to its primary caregiver. These styles we would note are essentially the way the child interacts with signicant others and those around them. This, and later work by Main and Hesse (1990), indicates that four main childhood interaction styles can be identied. These are: (1) securewhere there are appropriate behaviors expressed by the child upon separation and reunion with the caregiverupset at separation, pleased to see the caregiver upon reunion; (2) avoidant indifference to separation, on the part of the child, and avoidance upon caregiver return; (3) resistant or ambivalentdistress by the child at separation, yet ambivalence at reunion; (4) disorganized/disoriented where both avoidant and ambivalent styles are in operation at differing times. Infant attachment style is a strong predictor of general interactions in later-life and adult romantic relationship style. There is a neurobiological basis for this observation as both childhood attachment and romantic love are: a biosocial process by which affectionate bonds are formed between adult lovers, just as affectionate bonds are formed earlier in life between human infants and their parents (Hazan & Shaver, 1987, p. 511). Thus, disruption of the attachment processes during early life can have enduring effects upon the later formation of interpersonal and sexual relationships as adults. We will now examine how the childhood attachment styles map onto identied adult styles, and how these models developed in childhood inuence adult romantic relationships. 2.2. Attachment and relationships in adulthood Four1 adult attachment styles, one secure, three insecure, have been identied. As for the diagnostic classication of insecure attachment, DSM-IV-TR (American Psychiatric Association, 2000) describes the syndrome of Reactive Attachment Disorder of Infancy and Early Childhood where two types of attachment disturbance are
1 We should also note that some studies use a fth term unclassiable where no identiable attachment style can be identied (e.g., Bifulco, Moran, Ball, & Bernazzani, 2002).

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reported: (1) the Inhibited type, where there is the persistent failure to initiate and respond to most social interactions in an appropriate way; (2) the Disinhibited type, where there is an indiscriminate sociability, or lack of selectivity in the choice of attachment gures. We will now examine the more general notion of three insecure adult attachment styles, as follows: (1) Secure (autonomous) attachment is a style characterized by objective evaluations of attachment-related experiences, whether these are good or bad. This pattern is associated with sensitive and responsive parenting in childhood. Individuals with a secure attachment style have been found to have high levels of self-esteem, and view others as warm and accepting, and report high levels of intimacy in close adult relationships (Ward et al., 1996). Secure attachment can be understood as providing a neurobiological buffer against stress, as well as promoting attunement with others, and providing a capacity for self-reection and empathic perception (Fonagy, 1999). Hazan and Shaver (1987) note that a secure style of attachment in childhood maps onto adult romantic styles, reported by Lee (1973), as eros (passionate love) and agape (seless love). (2) Dismissive attachment (related to avoidant in childhood) is a style, which is characterized by an emphasis on achievement and self-reliance at the expense of intimacy. This pattern is associated with a rejecting or interfering parenting style in that the parent has behaved in a remote, cold and controlling way (Belsky, 1999). Siegel (2007) suggests that if parents are emotionally unavailable the child would tend to pull away from them and so develop a way of operating that minimizes reliance on others. This would continue into later life. This leads to deactivation of attachment mechanisms, which may ultimately result in an adult who is emotionally autonomous, and only ready to express self-preservative behaviors (Henry & Wang, 1998). By denition, such a person would be expected to show some later antisocial and externalizing problems (Green & Goldwyn, 2002), to be often self-absorbed, and unwilling to approach others for help and emotional support (Sawle & KearColwell, 2001). There are strong indications that avoidant attachment is related to Conduct Disorder (CD) (Rosenstein & Horowitz, 1996). CD in childhood is a repetitive and persistent pattern of behavior in which the basic rights of others, or societal conventions, are outed, and is typically seen as precursor of later antisocial behaviors. Many individuals with CD show little empathy and concern for others, and may frequently misperceive the intentions of others as being more hostile and threatening than is actually the case (DSM-IV-TR; APA, 2000). Frodi, Dernevik, Sepa, Philison, and Bragesj (2001), in a study of 26 criminal offenders (mainly psychopaths2), found that most of the sample reported a dismissing attachment style. Similarly, Taylor (1997) found that dismissive attachment was correlated with psychopathy in a sample of women. The relationship found in these studies does not necessarily suggest that psychopathy evolves from a dismissive style of attachment (Beech & Mitchell, 2009). However, the seeming unfamiliarity with the concept of attachment in these samples clearly suggests a link, which we will explore later. Feeney, Noller, and Patty (1993) note that individuals with a dismissing attachment style have a strong interest in casual sex, and are therefore likely to engage in one night stands (Brennan & Shaver, 1995), frequenting prostitutes, and/or in extremis engage in coercive sex. Ward et al. (1996) found some evidence that rapists were more likely to report a dismissing style. Furthermore, Stirpe, Abracen, Stermac, and Wilson
2 Here psychopathy is dened as containing both a narcissistic personality style and strong evidence of antisocial personality (Hare, 1999, 2003).

(2006) found that rapists, and incestuous sex offenders, were likely to have a dismissing attachment style. (3) Preoccupied attachment (related to resistant or ambivalent in childhood) is a style which is characterized as the individual being enmeshed in past (typically childhood) unsatisfactory attachment experiences, and has an inability to report a coherent view of interpersonal interactions with others (Holmes, 1993). This style has been found to be associated with an individual experiencing an inconsistent parenting style in childhood, where the parent/s behave in ways that interfere with the child's autonomy or exploration (Cassidy & Berlin, 1994, p. 981). This leads the individual to become uncertain of the quality of relationships, and live in fear of rejection in later life (Henry & Wang, 1998). Hence, the person has a sense of confusion, especially when it comes to relational issues (Siegal, 2007). This style is associated with an increased risk of social withdrawal in middle childhood, a heightened sense of rejection and feelings of general incompetence and inadequacy (Finzi, Ram, Har-Even, Shnitt, & Weizman, 2001), leading to anxiety disorders often beginning in late adolescence (Green & Goldwyn, 2002). At a romantic level the individual may feel threatened by others and hence will constantly seek reassurance, comfort and love. This style can therefore cause problems in the way that individuals relate to others, and cause feelings of inadequacy and loneliness (Ward & Beech, 2006). (4) Disorganized/unresolved attachment (related to disorganized/ disoriented in childhood) is the style most often associated with chronic childhood abuse (Carlson, Cicchetti, Barnett, & Braunwald, 1989; Van Ijzendoorn, Schuengel, & Bakermans-Kranenberg, 1999), and/or where the primary caregivers have experienced an unresolved loss or trauma of their own (Ainsworth & Eichberg, 1991; Main & Hesse, 1990). Hence, this style of attachment is associated with separate psychobiological response patterns (Craissati, 2009), hyperarousal (the ght/ight response of the sympathetic autonomic nervous system), and dissociation (freezing activated by the sympathetic part of the autonomic nervous system). This is because with a parenting style that is frightening or frightened, the individual (as a child) is caught in a conict where what should be their source of security is a source of fear. In such traumatic states of helplessness, endogenous opiates are released to numb psychological pain (Lyons-Ruth & Jacobvitz, 2003). Craissati (2009) notes that with no appropriate caregiver input to restore equilibrium these chronic stress states can cause severe damage to [right] cortico-limbic circuits. This results in long-term problems in the regulation of emotion. Furthermore, low levels of cortisol as a consequence of such chronic stress are associated with emotional withdrawal in general. Therefore, individuals with this style may not be actively hostile in their interactions with others, but may behave in a passiveaggressive manner. In intimate relationships, fear of rejection and avoidance of closeness may lead to sex being sought out in an impersonal manner (Ward et al., 1996), or individuals may be involved in domestic violence, as either a victim or perpetrator (West & George, 1999). Baker and Beech (2004), and Lyn and Burton (2004), found violent/sexual criminals were distinguished from non-criminals by this attachment style. We would also note that unresolved [disorganized] status is the most over represented state of mind among persons with psychiatric disorders (Dozier, Stovall, & Albus, 1999, p. 515). We will now examine in more detail the putative relationship between problematic attachment histories and subsequent offending. 3. Problematic attachment histories in childhood and links to offending Secure attachment would appear to act as a buffer to adverse life events, while insecure attachment acts as a vulnerability/risk factor.

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Several authors have noted the role of problematic attachment (in terms of coercive parentchild interactions and the absence of a positive and affectionate bond between parent and child), neglect, inconsistent parenting and severity of punishments, and the development of disruptive, aggressive and violent behaviors. (Frodi et al., 2001; Greenberg, Speltz, & DeKlyen, 1993; Heide, 1999; Sampson & Laub, 1990). As for how insecure attachment in part leads to antisocial behaviors in adulthood, Bowlby (1944) was one of the rst to suggest that absence, or early separations from primary attachment gures (i.e., mother/father gures), predisposes individuals to develop emotional coldness or the affectionless characteristic of psychopathy, and a variety of other kinds of psychopathology. Dozier et al. (1999) note that prolonged separations from parents, combined with frightening threats from parents/caregivers, are likely to lead to a dysfunctional level of rage/anger towards the parents/primary caregivers, which often involves intense hate. Initially the anger may be directed towards the parents, but this would obviously be a dangerous strategy (given the parents' previous behaviors). Craissati (2009) has observed that, for such individuals, early absence of a strong attachment to the parent may have been masked by the adult's physical capacity to control the child. Consequently delinquency only starts to express itself in adolescence when individuals become more inuenced by anti-social peers, when the child is more able to stand up to the parent, and when there is a lack of strong internalized controls through morality, empathy, caring and commitment (Fonagy, Target, Steele, & Steele, 1997), which would normally prevent the individual from drifting into criminality. Hence, it is plausible that poor attachment processes could foster the development of generally antisocial, and in extremis, psychopathic traits. Blair, Mitchell, and Blair (2005), for example, note an adverse upbringing and poor attachment disrupts the processes that lead to the development of morality in adolescence/early adulthood. Weineld, Sroufe, Egeland, and Carlson (2008) note that children with avoidant, or disorganized, attachment styles are likely to show angry, aggressive behaviors with parents and peers, perhaps in response to rejection and insensitivity from the caregivers. LyonsRuth, Alpern, and Repacholi (1993) report that insecure (particularly disorganized attachment), together with maternal psychosocial problems, are highly predictive of hostileaggressive behaviors in young children. Finzi et al. (2001) report that physically abused children were characterized by an avoidant attachment style and were aggressive and suspicious of others. Therefore, it is not surprising that an insecure attachment style, and a problematic upbringing, predicts later criminality (Allen, Hauser, & BormanSpurell, 1996). Allen et al. measured states of mind among adolescents who were either psychiatric inpatients, or high school students, nding that dismissing attachment style (specically derogation of attachment a form of dismissing attachment in which the person belittles, or negatively criticizes, attachment gures or attachmentrelated experiences) predicted criminality 10-years later, even when psychiatric hospitalization was taken into account. Therefore, differing personality traits and dysfunctional responding may emerge, in part, from different attachment styles, set the scene for less than ideal interpersonal relationships and, in some cases may lead to offending, whether it is generalist or specialist (Soothill, Francis, Sanderson, & Ackerley, 2000). Generalists have a varied criminal career and who typically have committed a wide range of offenses, both violent and non-violent. In contrast, specialist offenders typically only commit one type of offense (typically sexual offenses against children) and may be generally viewed as pro-social in other ways. The weight of evidence indicates that most offenders are generalists (Simon, 1997). Figures would suggest (www.mentalhealth.com) that 80%85% of incarcerated [generalist] offenders can be diagnosed as having Anti-Social Personality Disorder (DSM-IV-TR: APA, 2000), while 20% can be regarded as psychopaths. Here, it should be noted that psychopaths account for

roughly half of all the most serious crimes committed, including half of all serial killings and repeat rapes (www.mentalhealth.com). By contrast, pedophilic child molesters are the most likely to t the prole of the specialist offender, and may account for 4%5% of all incarcerated offenders, (although some white-collar criminals could also be viewed as specialist offenders). We will now examine these two groups and their social interactions in terms of the attachment formulations described above.

3.1. Evidence for problematic attachment histories in generalist offenders With respect to developmental precursors of early onset violent criminality, Raine, Brennan, and Mednick (1997) found that both birth complications and maternal abandonment during the rst year of life were signicant predictors. Similarly, Saltaris (2002) found that a history of abuse and extremely disturbed attachment representations leading to a marked lack of empathy towards others were also associated with subsequent violent general criminality. There is some evidence that a history of attachment related problems have been identied in both Anti-Social Personality Disorder (ASPD), and psychopathy, which can be regarded as extreme examples of generalist offending. ASPD is described in DSM-IV-TR (APA, 2000) as a pervasive pattern of disregard for and the violation of the rights of others (p. 706), and can include ignoring social norms, deceitfulness, impulsivity, irritability/aggressiveness, recklessly ignoring the safety of others, and a failure to show remorse for wrongdoing. Psychopathy is viewed as a developmental disorder with psychopathic traits often being observed before the age of eight (Blair, 2005; Blair, Peschardt, Budhani, Mitchell, & Pine, 2006). Evidence for the association between problematic attachment histories and ASPD comes from, among others, Zanarini, Gunderson, Marino, Schwartz, and Franenber (1989), who found that 89% of individuals in their sample meeting DSM-III-R (APA, 1987) criteria for ASPD, reported experiencing prolonged separations from a parent/ caregiver at some point during their childhood, specically through divorce or separation. McCord (1979) found that ASPD was a likely outcome when the individual's mother was unaffectionate and did not provide adequate supervision, and when the father was deviant: Zanarini et al. (1989) also reported that many of those diagnosed with ASPD had experienced physical abuse and/or harsh physical punishment in childhood. Ullrich and Marneros (2007), in a study looking at the factor analysis of the personality disorder dimensions of the International Personality Disorder Examination (Mombour, et al., 1996), found that individuals scoring highly on the antisocial factor of the IPDE (i.e., high loadings of dissocial, paranoid, histrionic, and impulsive traits) were much more likely to: have grown up with only one primary carer; had frequent change of carers; had violent carers; and/or there was prolonged and severe substance misuse by their primary carers. As for adverse developmental histories in psychopathy, Lang, Klinteberg, and Alm (2002) reported a relationship between victimization as a child and later violence, as evidenced by the frequency of psychopaths having alcoholic or antisocial fathers. Such individuals often report evidence of severe childhood abuse, extensive neglect, early foster placements and institutionalization. While, in a Swedish longitudinal study, Lang et al. (2002) demonstrated that childhood neglect or abuse was associated with elevated levels of violence in adulthood. However, we would also note that any association between adverse upbringing and psychopathy is complicated by the idea that there is a heritable component to some aspects of the disorder. Twin studies, for example, have provided evidence for a genetic predisposition to callousness (would be expected to interfere with secure attachment formation), but not other aspects of the psychopath's personality such as grandiosity and manipulativeness (Blair et al., 2006; Larsson, Andershed, & Lichtenstein, 2006). We will

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now examine problematic attachment histories in individuals who are specialist offenders. 3.2. Problematic attachment histories in specialist offenders The type of offender probably most often regarded as specialist are pedophilic individuals. A set of diagnostic criteria exist for pedophilia in DSM classications (e.g., DSM-IV-TR, APA, 2000) which are based on the following criteria: (a) the offender has experienced, for at least six months, recurrent and intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a pre-pubescent child or children (aged 13 years or younger); (b) is likely to have a number of victims outside (although sometimes inside and outside) of the family. For a number of these pure pedophiles there may be little evidence of other types of offending, with a number of them being regarded as pillars of the community (Sullivan & Beech, 2002). Marshall (1989) was one of the rst to suggest that insecure attachment in childhood would lead to difculties in establishing intimate adult relationships and the pursuit of intimacy through inappropriate sexual behavior. Evidence for this observation has been provided by Miner et al. (2010) who report that feelings of interpersonal inadequacy, combined with over-sexualization and positive attitudes toward others distinguished [adolescent] sex offenders with child victims from non-sex delinquents, and from sex offenders with peer/adult victims (p58). This is often in conjunction with an affectionless control style of parenting (Craissati, McClurg, & Browne, 2002). Ward et al. (1996) found evidence that adult pedophilic child sexual abusers were more likely to report having a preoccupied attachment style compared to rapists, violent offenders, and non-violent offenders. Similarly, Stirpe et al. (2006) reported that a preoccupied attachment style is particularly prevalent in extrafamilial child molesters. Child molesters who reported an insecure attachment style are also more likely to report being sexually abused than those with a secure attachment style (Smallbone & McCabe, 2003). This may be due to being less well looked-after than securely attached children. Evidence for this observation is provided by Craissati and colleagues among others (Craissati et al., 2002; Craissati & Beech, 2004, 2006), examining a complete cohort of sex offenders in a particular area of south London. They found that nearly half of their sample of child molesters reported being sexually abused, indicating a route to disturbed sexual functioning. Such sexually abused child molesters were signicantly more likely to engage in a range of psychosexually disturbed behavior in adulthood. These abused offenders were also more likely to report emotional abuse in childhood than non-abused child molesters (73% vs. 33%), and report a number of behavioral disturbances (73% vs. 33%). Therefore, it is probably unsurprising that a signicant proportion of pedophiles suffer from anxiety disorders and, in particular, social phobia compared to other groups of offenders (e.g., Hoyer, Kunst, & Schmidt, 2001; McElroy et al., 1999; Raymond, Coleman, Ohlerking, Christenson, & Miner, 1999). Social anxiety and social phobia are thought to reect fear precipitated by social evaluation, and result in social avoidance (Rapee & Spence, 2004). Evidence for this is reported by Eastwood et al. (2005) who demonstrated that patients with social phobia are adept at picking out negative, but not positive, facial expressions from neutral face distracters. However, socially anxious people may paradoxically also show high levels of interpersonal dependency (Darcy, Davila, & Beck, 2005). This may go some way to explaining why such offenders feel that their emotional/sexual needs can be better met by children rather than peer relationships. Social phobics nd interactions with adults extremely anxiety provoking, especially when they run the risk of negative evaluation. Therefore, social anxiety may lead some pedophiles to be drawn to children as these are viewed as less threatening than adults.

Certainly it has been observed that pedophilic individuals are typically socially inadequate, lacking in interpersonal skills and condence, and ill at ease in adult interactions (e.g., Baxter, Marshall, Barbaree, Davidson, & Malcolm, 1984). These observations have also been veried more recently with the socio-emotional characteristics of some pedophilic child molesters being described in the following terms: inadequacy; low self-esteem (Beech, 1998; Thornton, 2002; Webster et al., 2007); distorted intimacy balance (i.e., preferring to meet their emotional needs to be met through relationships with children rather than with adults; Thornton, 2002; Webster et al., 2007); and having high levels of emotional congruence/overidentication with children (Beech, Fisher, & Beckett, 1999; Hanson, Harris, Scott, & Helmus, 2007). However, this is not to say that all pedophiles are necessarily socially phobic, but, taken together, these observations would suggest a link. We will now outline the neurobiology/neurochemistry of the social brain/attachment systems, before we go on to outline how problems in these areas may, to some extent, underpin the types of offending problems outlined above. 4. Neurobiology/neurochemical overview 4.1. Neurobiological overview of the attachment systems/social brain The most important area of the forebrain that is associated with the types of attachment problems outlined above is the limbic system. This area is a loosely dened collection of brain structures, which play crucial roles in the control of emotions and motivation. The principal limbic structures involved are the amygdala and anterior cingulate cortex along with the orbitofrontal cortex to which they are tightly interconnected. We will now briey describe these areas and their broad functions. 4.1.1. The orbitofrontal cortex The orbitofrontal cortex (OFC) can be considered as the apex of the neural networks of the social brain and is critical to the adaptation of behavior in response to predicted changes in reinforcement (Rushworth, Behrens, Rudebeck, & Walton, 2007). It can be regarded as an extension of the limbic system as much as it is part of the cerebral cortex (Fuster, 1997), in that it bridges the cognitive analysis of complex social events taking place within the cerebral cortex, and emotional reactions mediated by the amygdala and the autonomic nervous system (Hariri, Bookheimer, & Mazziotta, 2000; Mah, Arnold, & Grafman, 2004). The OFC therefore acts as a convergence zone with its connections to the hypothalamus allowing it to integrate internal and external information. Fuster (1985) and Shore (2004) note that its inhibitory role in autonomic functioning (via the amygdala and other subcortical regions) means that it is critically involved in emotional regulation. It has been suggested that another role of the OFC is to generate an expectation of the reaction of others which is used to direct behavior (Blair & Cipolotti, 2000). The OFC is also involved in the calculation of the magnitude of reward, or punishment value, such as winning or losing money while gambling, the representation of preferences, or using others in soothing interactions (Damasio, 1994; O'Doherty, Kringelbach, Rolls, Hornak, & Andrews, 2001; Rushworth et al., 2007). 4.1.2. The amygdala The amygdala's functions are largely related to emotional responses and emotional memories. These include: vigilance, the control of behavioral, autonomic and endocrine responses associated with fear, the control of reproductive behaviors, reward, and aversive conditioning (Cozolino, 2008). The amygdala can be split into two major subdivisions: the basolateral complex, and the centromedial complex. The basolateral complex can be roughly thought of as being the principal input region of the amygdala with incoming projections coming from the prefrontal cortex, limbic cortex and hippocampus. This complex exerts potent effects upon sexual behaviors, enabling

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conditional associations to be made between neutral stimuli and sexual reinforcers. The basal nuclei also play a role in reinforcement more generally (Everett, Cador, & Robbins, 1989). The centromedial complex is the major source of amygdaloid outputs3 to the hypothalamus, and to the preoptic area (which includes the sexually dimorphic nucleus). There are also projections to the periaqueductal grey (PAG) region of the midbrain where many species-specic behaviors are encoded (Dean, Redgrave, & Westby, 1989; Van der Horst & Holstege, 1998). The centromedial complex is involved in responding to fearful stimuli. Outputs are directed to the PAG which can trigger avoidance or defense responses. The sensory inputs to the central nuclei, which drive these fear responses, arise principally from cortical and thalamic projections to the lateral nuclei of the amygdala. These sensory inputs have a high degree of plasticity, enabling the encoding of conditioned emotionally signicant stimuli, and hence this area plays an important role in aversive conditioning (LeDoux, 2000). The medial nuclei are essential for social olfactory recognition (Ferguson, Aldag, Insel, & Young, 2001; Kavaliers et al., 2003; Kendrick et al., 1997). Other olfactory inputs to these nuclei can trigger sexual behaviors. In lower mammals these nuclei are strongly implicated in processing information derived from pheromonal activity. It is generally assumed that pheromones do not play a critical role in reproductive behaviors in humans, however, the centromedial complex may still guide sexual responses in humans. In addition to the olfactory system the amygdala is strongly connected to the visual system. Studies of patients with damage to the cortical visual systems and scanning studies of neurologically intact participants have demonstrated that information about facial features can also be accessed by the amygdala, independent of the cerebral cortex (Johnson, 2005; Morris, Ohman, & Dolan, 1998, 1999; Pegna, Khateb, Lazeyras, & Seghier, 2005). This relatively primitive neural circuitry would potentially enable responses to sexually attractive features to be initiated independently of cortical activity. 4.1.3. The anterior cingulate cortex (ACC) In evolutionary terms, the ACC rst appeared in animals demonstrating maternal behavior (MacLean, 1985), in that it evolved around the time sounds became an important aspect of social communication, and particular scent glands became modied to become mammary glands (Duvall, 1986). Therefore, the ACC provides the basic circuitry for communication, cooperation and empathy (Rilling et al., 2002), and is also involved in the monitoring and allocation of attention to the most pertinent information in the environment at a particular moment in time. The ACC can be subdivided into an affective part and a cognitive part (Devinsky, Morrell, & Vogt, 1995). The affective part of the ACC has extensive connections with the amygdala, PAG, and autonomic motor nuclei in the brainstem. These systems regulate endocrine and autonomic functions and play important roles in conditioned emotional learning, emotional vocalizations and maternalinfant interactions. For example, lesions to this affective area of the ACC in infant monkeys disrupt crying which is normally induced by separation from the mother (Devinsky et al., 1995). Bush, Luu, and Posner (2000) note that the affective portion of the ACC also integrates emotional and attentional processing, which means that in caretaking relationships attention is shifted from the environment to signicant others (Cozolino, 2008). The ACC also becomes activated when individuals, particularly those who have a close emotional bond with, experience pain, or social stress (Panksepp, 2003; Singer et al., 2004). 4.2. The neurochemistry of attachment and the social brain The process of attachment at a neurobiological level, as noted earlier, is heavily dependent on the release of neuropetides: oxytocin
3 Though it does receive inputs from outside the amygdala, most noticeably from the hypothalamus.

and vasopressin, and their subsequent actions on the amygdala, the OFC, and the ACC. OT and AVP differ from each other at only two amino acid positions. These neuropeptides are synthesized and released from the dendrites and terminals of parvocellular neurons in the paraventricular nucleus of the hypothalamus (Wotjak, Landgraf, & Engelmann, 2008). This mechanism ensures that OT and AVP can directly affect diverse regions of the cortico-limbic system which is the focus for the acquisition of specic forms of knowledge that can regulate social and emotional behaviors (particularly the perception of internal states and the emotional states of others). OT has behavioral and neural effects associated with pair bonding, reduced anxiety, relaxation, growth and restoration; while AVP appears to be associated with pair bonding and increased vigilance, anxiety, arousal, and activation. These actions are modulated by the actions of the neurotransmitters serotonin (5-hydroxytryptamine, 5HT), and dopamine (Insel & Winslow, 1998). Recent molecular genetic studies have suggested that different attachment styles may reect variations in the genes for dopamine and 5HT receptors (Gillath et al., 2008). Thus, a polymorphism of the DRD2 dopamine receptor gene is associated with preoccupied attachment, while a polymorphism of the 5HT2A receptor gene is associated with dismissive attachment (Gillath et al., 2008). The effects of the central release of OT and AVP have also been studied by examining the pair bonding of small mammals. Several different species of voles exist which vary greatly in this aspect of behavior. For example, the prairie vole forms monogamous partner bonds, whereas the montane vole is polygamous. These different mating strategies are reected in differential central distributions of OT and AVP receptors. For the female prairie vole, OT seems to be essential for the formation of monogamous partner bonds, whereas this function is underpinned by AVP in the male (Winslow & Insel, 1993). Chronic OT treatment doubles the time spent in social contact by rodents, whereas AVP stimulates social communication in birds, frogs and hamsters, and increases afliative and paternal behaviors, and aggression in rodents (Young, 1999). We will now examine the research into the actions of OT and AVP in attachment/social relationships in relation to human activities.

4.2.1. OT and social functioning There is strong evidence that there is an association between levels of OT and attachment. The actions of OT are particularly important as regards attachment formation, in that at birth and during breastfeeding, the peripheral release of OT (acting systemically as a hormone) is often accompanied by the central synaptic release of OT (Sjogren, Widstrom, Edman, & Uvnas-Moberg, 2000). Gordon et al. (2008) reports a positive relationship between OT levels and self-reported bonding to the individual's parents. Levine, Zagoory-Sharon, Feldman, and Weller (2007) found that women who showed an increase in levels of OT from early to late pregnancy reported high levels of maternalfetal bonding. Conversely, Heim et al. (2008) found attenuated levels of OT in cerebrospinal uid in women who reported emotional abuse during early childhood. Meinlschmidt and Heim (2007) found that potential of OT to suppress cortisol levels was less in men who had experienced early parental separation compared to control subjects. Other studies have found that high plasma levels of OT are associated with trustworthy behavior (Zak, Kurzban, & Matzner, 2004, 2005). Kosfeld, Heinrichs, Zak, Fischbacher, and Fehr (2005) report that increasing levels of OT through a nasal spray increases trust in humans. Domes, Heinrichs, Glascher, et al. (2007), in an fMRI study found that such intranasal administration reduced amygdala responses to fearful, angry, and happy faces. Similarly, Kirsch et al. (2005) found, in another fMRI study that intranasal administration of OT reduced amygdala activity to brainstem regions implicated in autonomic and behavioral manifestations of fear. Heinrichs et al. (2009) suggest that this attenuating effect of amygdala function by OT

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reduces uncertainty about the predictive value of a social stimulus and thereby facilitate[s] social response behavior. (p. 550). OT would appear to be involved in social cognition in humans (Bartz & Hollander, 2006; Heinrichs & Domes, 2008). OT appears to specically inuence theory of mind (Domes, Heinrichs, Michel, Berger, & Herpertz, 2007), that is the ability to attribute mental states (i.e., beliefs, intents, desires) in others. Evidence would suggest that this is done by increasing facial processing by increasing the focus on the region of the face around the eyes (Guastella, Mitchell, & Dadds, 2008). The intranasal administration of OT has recently been found to increase social interactions of high functioning individuals with autism or Asperger's syndrome (Hollander et al., 2003, 2007). Other research suggests that the inhalation of OT can also increase levels of envy and gloating (Shamay-Tsoory et al., 2009). Therefore, OT may be an overall trigger for social sentiments. Thus when associations with others are positive OT boosts pro-social behaviors; when associations are negative it would appear to produce negative emotions (Shamay-Tsoory et al., 2009). Most importantly, for the argument being presented here, large surges in OT, peripherally and centrally, have been observed in sexual climax and afterplay in humans (Blaicher et al., 1999; Caldwell, 2002), and hence has been conceptualized as the love chemical (New Scientist, 29th April 2006, P35). 4.2.2. AVP and social functioning Compared to the level of research carried out with humans examining OT and its effects, relatively little has examined the effects of AVP on social behaviors. In terms of animal analogs of human behavior, AVP is also thought to play a role in pair-bonding behaviors (Goodson & Bass, 2001), in that it is released during sexual activity and therefore initiates and sustains patterns of activity between the sexual partners. Although the exact role that AVP release plays in long-term pair bonding is currently unclear, it is assumed that it is involved in the consolidation of social memory, a critical component of attachment behavior (Ferguson et al., 2001). AVP has also been implicated in male-typical social behaviors, including aggression in humans. For example, Coccaro, Kavoussi, Hauger, Cooper, and Ferris (1998) found a positive correlation between cerebrospinal uid levels of AVP and aggression in personality-disordered patients, which suggests an enhancing effect of central AVP in individuals with impulsive aggressive behaviors. The effect of intranasal AVP has also been examined in response to emotionally expressive facial stimuli (Thompson, Gupta, Miller, & Orr, 2004). Whereas, as noted above, intranasal OT reduced amygdala responding to fearful, angry, and happy faces (Domes, Heinrichs, Glascher, et al., 2007), such administration of AVP increased the level of electromyogram (measurement of facial muscle) responses to emotional neutral faces to the level found in placebo subjects' responses to angry facial expressions. Heinrichs et al. (2009) suggest that AVP may facilitate aggressive responding to emotionally ambiguous social stimuli. There are also clear sex differences in the effects of intranasal administration (Thompson, George, Walton, Orr, & Benson, 2006), in a similar task. In men AVP stimulated agonistic facial motor expressions in response to facial stimuli of unfamiliar men, while also decreasing the rating of friendliness of these faces. In female subjects AVP stimulated afliative expressions to unfamiliar faces, and increased perceptions of friendliness of these faces. There is also some evidence to show that elevated AVP levels are associated with a propensity to experience anxiety and stress (Debiec, 2005). Pitkow et al. (2001), for example, using an adreno-associated viral vector to deliver the V1aR gene, found that monogamous male (prairie) voles exhibited increased levels of both anxiety, and afliative behavior, compared with control males. They also formed strong partner preferences after an overnight cohabitation with a female without mating. This effect was due to the increased density of V1aR binding in the ventral pallidal region. Thompson et al. (2006)

found that AVP affected autonomic responses to threatening faces by increasing anxiety in human subjects. We will now describe a neurobiological/neurochemical model of offending which can putatively start to help us account for the offenders who exemplify very different kinds of offending. In this model we will consider both the generalist type of offender (i.e., the generally antisocial offender) and the specialist (i.e., pedophilic) offender in terms of neurobiological/neurochemical functioning. 5. A neurobiological/neurochemical model of offending Early deprivation and other suboptimal rearing conditions are associated with severe problems in social and emotional functioning, which potentially endure throughout life. These early experiences are reected in long-term changes in the underlying neurobiology of the amygdala, OFC and the ACC, and the neurochemistry of attachment/ social brain systems (Teicher, 2007). These changes could be reected in neuronal number, by changes in either neurogenesis or neuronal apoptosis, or differences in dendritic and synaptic organization. The ensuing atypical morphological organization could result in social withdrawal, pathological shyness, explosive and inappropriate emotionality, and an inability to form normal emotional attachments (Joseph, 2003). We will now examine neurobiological explanations of generalist offfenders' problems and specialist pedophilic offenders. 5.1. Neurobiology of generalist offending A number of lines of evidence associate impaired functioning in areas of the social cortico-limbic brain (i.e., the amygdala, the OFC, and the ACC) with increases in violence and instrumental aggression, and, in extremis, ASPD/psychopathic behaviors. Blair et al. (2006), for example, argue that the psychological/behavioral characteristics identied in psychopaths (and by extension ASPD) reect abnormal functioning in the neural circuitry involving the amygdala and the OFC (Mitchell, Colledge, Leonard, & Blair, 2002). Specically, the OFC generates expectations of the reaction of others, which individuals use to modulate their behaviors (Blair & Cipolotti, 2000; Dolan, 2002). In regard to the ACC, damage to this area can include, among other things, decreased empathy, abnormal emotional stability and inappropriate social behavior (Brothers, 1996). This aspect of behavior is of course under-expressed in those with ASPD. There is functional evidence of these ideas. For example Kruesi, Casanova, Mannheim, and Johnson-Bilder (2004), report that diminished right temporal lobe volume (which includes the amygdala) is associated with Conduct Disorder. Kruesi et al. (2004) also report reduced temporal lobe, but not prefrontal volumes, in incarcerated psychopaths. Furthermore, Birbaumer et al. (2005) using fMRI, found that psychopaths show no signicant activity in the limbic-prefrontal circuit (amygdala, OFC, insula, and the ACC), during a task which involved in verbal and autonomic conditioning. As these areas of the brain are known to play critical roles in the processing of emotionally signicant stimuli, especially those associated with fear, individuals with ASPD/psychopathy would be predicted to show emotional decits, particularly in relation to fear. There are several lines of evidence to support this prediction. Psychopaths show poor performance on aversive conditioning tasks (Blair et al., 2006). Specically in this group there is: (1) evidence of reduced amygdala activation during emotional memory and aversive conditioning tasks; (2) decits in the recognition of fearful facial expression; (3) poor recognition of fearful facial expressions which is accompanied by reduced autonomic responses to distressed and fearful faces (Blair, 2005; Blair et al., 2006) and (4) reduced amygdala activation in situations of high affect (van Goozen & Fairchild, 2006). This lack of recognition of fear, due to a measurable lack of amygdala function, would suggest that this would make it easier to offend, as a key component of committing interpersonal violence

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towards others is the requirement to not recognize or understand the mental state of the victim. These preconditions, therefore, make generalist offending that much easier. As noted in Section 4.1.2, the amygdala also plays important roles in directing and organizing sexual behaviors. Consequently hypoamygdala function would be predicted to affect their sexual behavior including sexual promiscuity, another dening characteristic of psychopathy (Hare, 2003). Support for this idea comes from studies of KluverBucy syndrome in which bilateral damage to the temporal lobe, including the amygdala, is associated with hypersexuality and indiscriminate sexual responses. Thus, such individuals will attempt to mate with conspecics of the same sex, other species, and even inanimate objects (Jha & Patel, 2004). The presumed decrease in amygdala dysfunction will not only remove a natural barrier to incest but cause those with ASPD/ psychopathy to fail to discriminate between sexual targets on the basis of health status. As argued earlier in the paper OT and AVP are key mediators of complex emotional and social behaviors, including attachment, social recognition and aggression. Given that there is a large number of OT and AVP binding sites in many areas of the amygdala (Cozolino, 2006), these neuropeptides can be seen as playing a role in the conditioning of fear behavior. For example Kirsch et al. (2005), in an fMRI study, demonstrated that OT clearly modulates the action of the amygdala in the presence of fear inducing stimuli in normal subjects. There is currently no direct research evidence concerning the functioning of the OT and AVP systems in generalist offenders. However, given what we know about the adverse backgrounds of these individuals and their poor attachment styles it would be strongly predicted that OT/ AVP functioning would be severely compromised in these individuals, with the prediction being that they have low levels of OT and AVP, compared to control subjects. 5.2. Neurobiology of pedophilia We have suggested above that some aspects of the problems that those who commit sexual offenses against children have problems in socio-affective functioning, and, in extremis, some of these problems are akin to social phobia. Therefore what is known about social phobia may help us to understand the problems found in xated pedophiles at a neurobiological level. Patients with social phobia are adept at picking out faces expressing negative emotional expressions, but not positive facial expressions, from neutral face distracters (Eastwood et al., 2005). In keeping with this observation, social phobia is associated with exaggerated levels of amygdala responding. It has been found that increased amygdala activation in social phobics correlates with the severity of social anxiety symptoms, but not with general state or trait anxiety levels (Phan, Fitzgerald, Nathan, & Tancer, 2006). Other evidence suggests that social phobics show abnormal increases in amygdala activation from looking at novel compared to familiar faces (Cottraux, 2005) and when looking at angry and contemptuous faces (Stein, Goldin, Sareen, Zorrilla, & Brown, 2002). A similar exaggerated increase in amygdala activity is seen in response to social threat (Phan et al., 2006), in response to strong aversive reactions to looking at the eyes of faces expressing negative emotions (Horley, Williams, Gonsalvez, & Gordon, 2003, 2004) and on viewing a neutral facial expression when it is paired with a negative odor in aversive conditioning experiments (Schneider et al., 1999). The excellent recognition of facial emotions seen in social phobics is in marked contrast to the decits seen in psychopaths, where the latter show problems in recognizing fearful facial expressions. Veit et al. (2002), for example, provide the clear evidence that social phobics and psychopaths are the diametric opposites of each other with regard to amygdala-prefrontal function in a scanning experiment involving aversive conditioning to neutral faces. Individuals with social phobia evidenced abnormally increased amygdala activation when looking at angry and contemptuous faces, while psycho-

paths showed a lack of anticipatory fear, and a brief amygdala response. Hyperamygdaloid functioning can also been seen in Obsessive Compulsive Disorder (OCD) when patients are challenged with salient stimuli. For example, van den Heuvel et al. (2004) investigated effects of contamination images in OCD patients in a PET study. OCD patients and normal controls were shown photos of contamination fear images. The OCD patients showed enhanced amygdala activity in response to the photographs of feces, and other potential sources of contamination. This common hyperamygdala functioning in both social phobia and in OCD patients suggests that these two conditions may be linked by a common neurobiological mechanism. We have recently explored the possibility that social phobia symptoms are related to fear of contamination. Our results show that social phobia symptoms correlate strongly with both fear of contamination and disgust sensitivity (Mitchell, Keylock, Campbell, Beech, & Kogan, in press). As for the relationship between amygdala overactivation in pedophilia, Mitchell et al. (in press), found that such individuals show an abnormal fear of contamination from the bodily uids of others. These fears, however, are reduced if the bodily uids originate from children rather than adults. These abnormal contamination fears are most likely mediated by the amygdala as increased activity in this area of the brain is associated with exposure to images relating to threat or contamination (van den Heuvel et al., 2004). These factors acting in concert, we would argue, cause the xated pedophile to be driven to form intimate attachments, but to be afraid of approaching adult women because of a combination of fear of negative evaluation/rejection and a fear of contamination from them. Children therefore would represent less of an apparent health threat as well as being less of a social threat. Experimental studies support this proposition. For example, Keating and Doyle (2002) working with manipulated digitized images of adult faces showed that faces with small, mature looking eyes and mouths signaled dominance and appeared emotionally cold. In contrast faces with immature looking eyes and mouths signaled submissiveness. Similarly, ndings have been reported by Pettijohn and colleagues. They conclude that neotenous (childlike) features (i.e., large eyes, soft round cheeks and soft skin) are associated with personalities that are non-dominant (Pettijohn & Tesser, 2005). As regards levels of OT, Hoge, Pollack, Kaufman, Zak, and Simon (2008) have found that dissatisfaction with social relationships in those with generalized social anxiety disorder was associated with higher OT levels, suggesting a link between neuropeptide level and the type of problems reported by some pedophiles. OT has also been implicated in anxiety disorders in humans, with Leckman et al. (1994) nding high levels of OT in patients with ObsessiveCompulsive Disorder. Similarly, Hoge et al. (2008) found that dissatisfaction with social relationships was associated with higher OT levels. Therefore, if the socially phobic pedophile can be characterized by high levels of OT and hyper-amygdaloid functioning they would be expected to nd social or sexual interactions with attractive, high status adults challenging. Equally intimate contact with less attractive adults would be difcult as social phobia is associated with high levels of fear of contamination and such fears are elevated when the contact is with older and less attractive individuals. Consequently they will be drawn to children who will be viewed as a low contamination risk whilst their low status will result in a lower fear of negative evaluation. Of course a lot of these ideas still need to be formally tested. 6. Conclusions and future directions In this article we have attempted to outline what is known, and what we would predict, about the attachment patterns of the two extreme ends of offending (generalist and specialist offenders), and

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have suggested a model of offending, that at a neurobiological/ neurochemical level, are due to abnormal experiences. Specically, we have argued in the model that it is either known, or would be predicted, that: The generalist offender who shows emotional decits which are characterized by an inability to recognize fear in others and difculties with aversive conditioning. Their sexual behavior is characterized by promiscuity, and a relative indifference to the age and attractiveness of potential partners. Their style of attachment, if one is identied at all, is dismissive. Evidence would suggest that this style of functioning is, in part, driven by hypo-amygdala functioning, and we would predict, by low levels of OT and AVP function. In contrast, the pedophilic offender is a specialist offender, typically with a preoccupied style of attachment, who shows social behaviors that are similar, in some respects, to social phobia. There is also tentative evidence that pedophiles evidence an abnormal fear of contamination. This fear of contamination will prevent them from being intimate with appropriate adults. We have argued that due to this they will be drawn to children who will be viewed as a lower contamination risk. The low social status of children will simultaneously result in the pedophile not being concerned about the prospect of negative evaluation from interacting with them. This pattern of functioning we would suggest is in part driven by hyperamygdala function and abnormal neuropeptide levels. A number of these predictions are currently untested, but we would suggest that these can be carried out in a fairly straightforward manner. Having a clearer understanding of the putative neurobiological decits in a signicant number of offenders can potentially lead to innovative and exciting approaches to the management and treatment of such individuals.

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