0022-3018/02/19011–757 Vol. 190, No.

11
THE JOURNAL OF NERVOUS AND MENTAL DISEASE Printed in U.S.A.
Copyright © 2002 by Lippincott Williams & Wilkins

Childhood Sexual History of 20 Male Pedophiles vs. 24 Male Healthy

Control Subjects
LISA J. COHEN, PH.D.,1 PAMELA G. MCGEOCH, M.A.,2 SNIEZYNA WATRAS GANS, PH.D.,3
KONSTANTIN NIKIFOROV, M.D.,1 KEN CULLEN, M.S.W.,4 and IGOR I. GALYNKER, M.D., PH.D.1

Despite the widespread incidence of childhood sexual abuse, there is insufficient

investigation into the childhood sexual history of perpetrators. In addition, there is
little published on the specific similarities between childhood and adult sexual
histories. The present study investigates the incidence of childhood sexual abuse in
a carefully characterized sample of male pedophiles compared with a demograph-
ically similar control group. Concordance between and cognitive distortions about
characteristics of childhood abuse and pedophilic behavior are also studied. Twenty
men with pedophilia, heterosexual type were compared with 24 demographically
similar, healthy male control subjects on a questionnaire specifically designed to
assess childhood sexual history in pedophiles. Sixty percent of pedophiles com-
pared with 4% of control subjects reported adult sexual advances as a child.
Seventy-five percent of pedophiles and 22% of control subjects reported a first
sexual encounter before age 14 years. About 60% concordance was found between
acts experienced as a child and perpetrated as an adult. Finally, numerous incon-
sistencies throughout the questionnaire add preliminary support for the role of
cognitive distortions with regard to childhood and adult sexual history. The present
findings replicate the elevated rate of childhood sexual abuse found among pedo-
philes and are consistent with the notion of a causative relationship between early
childhood abuse and later pedophilic behavior.
—J Nerv Ment Dis 190:757–766, 2002

Despite the widespread incidence of child sexual
abuse, there is insufficient empirical investigation
into the childhood sexual abuse history of perpetra-
tors. Systematic investigation into the precursors of
pedophilic behavior can help elucidate etiological
factors in pedophilia and as such addresses an im-
portant clinical and public health issue. One etiolog-
ical theory of pedophilia holds that pedophiles are
“abused abusers” who are sexually attracted to chil-
dren because they themselves were subject to child-
hood sexual abuse (Araji and Finkelhor, 1985). Such
behavior has been posited to reflect an attempt at
mastery of the trauma through repetition of the trau-
matic act (Araji and Finkelhor, 1985). In this way,
they attempt to combat (or deny) their own feelings
of powerlessness and humiliation by assuming the
role of the powerful victimizer (Garland and
1
Beth Israel Medical Center, 6 Karpas, 1st Ave. and 16th St.,
New York, New York 10003. Send reprint requests to Dr. Cohen.
2
New School for Social Research, New York, New York.
3
Montefiore Medical Center, Bronx, New York.
4
CAP Behavior Associates, Brooklyn, New York.
Supported in part by Singer grant # I-480-400 to Dr. Galynker.
The authors thank Olga Poznansky, M.S.W., Sarah Acker, B.A.,
Elena Itskovich, M.D., and Marina Moskovitch, M.D., for their
contributions.
DOI: 10.1097/01.NMD.0000038171.34345.D8
757
Dougher, 1988). However, the evidence for such a
theory has been mixed.
Numerous reports do suggest an elevated rate of
child sexual abuse in the history of pedophile of-
fenders (Araji and Finkelhor, 1985; Bagley et al.,
1994; Freund et al., 1990; Haywood et al., 1996).
Moreover, the rate of childhood sexual trauma
among pedophiles may be higher than that among
other groups of sexual offenders (Freund and
Kuban, 1994; Worling, 1995a). However, estimates of
the incidence of childhood sexual abuse among pe-
dophiles vary widely, ranging from 28.6% (Freund et
al., 1990) to 93% (Knopp and Lackey, 1987). This is
compared with rates such as 13.4% in a group of
healthy control subjects (Freund and Kuban, 1994)
and 15.6% in a community sample of young men
(Bagley et al., 1994). It also appears that the rates of
childhood sexual abuse histories may differ accord-
ing to several factors, including the age and sex of
victim and of perpetrator.
In a study comparing pedophile offenders, nonpe-
dophilic sexual offenders, and healthy control sub-
jects, Freund and Kuban (1994) found that 43.9% of
83 pedophiles compared with 13.4% of 134 control
subjects reported childhood sexual abuse histories.
758 COHEN
This rate was also substantially higher than that
found in gynephilic sex offenders (sexual offenders
against women) where 17.6% of 34 reported such
histories. In an earlier study of 131 pedophilic of-
fenders, the incidence of reported child sexual
abuse was much higher among heterosexual (28.6%
of 77) and homosexual (25.9% of 54) pedophiles than
in nonpedophilic child molesters, i.e., those with an
erotic preference for adults (19.6% of 51); gynephilic
offenders (10.7% of 36); and homosexual (11.8% of
51) and heterosexual (10.7% of 75) control subjects
(Freund et al., 1990). Further, in a study of 151 male
perpetrators, 57% of the child molesters compared
with 23% of the rapists reported having been victims
of child sexual abuse (Seghorn et al., 1987). On the
other hand, while Dhawan and Marshall (1996)
found that the rate of child sexual abuse was higher
among incarcerated pedophiles (50%, 8 of 16) than
nonsexual offenders (20%, 4 of 20), it was not higher
than that reported among rapists, (62%, 18 of 29).
Moreover, Worling (1995a) found that the rate of
child sexual abuse in a sample of adolescent male
sexual offenders was approximately equal between
those who had sexually assaulted children (24%, 7 of
29) and those who had assaulted postpubescent fe-
males (26%, 7 of 27).
The rates of sexual victimization during childhood
in female pedophiles are also high, possibly higher
than those of male pedophiles. Based on clinician
reports, the incidence of childhood sexual abuse in
a sample of female perpetrators ranged from 93% to
100% across three age groups (Knopf and Lackey,
1987). Similarly, Johnson (1989) found that of 13
girls who had sexually assaulted other children,
100% had been sexually abused themselves. How-
ever, Faller (1987) found that 47.5% (19) of 40 female
perpetrators reported abuse in their own childhood.
Among adolescent offenders, the incidence of
childhood sexual abuse has also been reported to be
much higher than that in the general population.
Forty percent of 57 adolescents who had sexually
assaulted children reported having been sexually
abused compared with 29% of 38 adolescents who
had sexually assaulted peers or adults (O’Brien,
1991; Worling, 1995b). In a study utilizing retrospec-
tive chart reviews, 42% of 90 male adolescent sexual
offenders reported sexual abuse histories (Worling,
1995b). These accounts were corroborated by exter-
nal agencies in all but seven cases. Significant dif-
ferences in the rate of sexual abuse were found
when grouping offenders by choice of victim.
Among those who had assaulted boys, the rate was
74%. However, among those who assaulted only fe-
males of any age, the rate was only 25%.
et al.
Finally, in a randomly selected sample of commu-
nity males (N ⫽ 750), only .2% of men who reported
no sexual abuse in childhood had perpetrated sexual
contact with children aged 13 years and younger.
This is compared with 7.7% of men who had re-
ported multiple events of sexual contact in their
own childhood (Bagley et al., 1994).
In summary, there is clear consensus of an ele-
vated rate of childhood sexual abuse in pedophiles.
On its own, however, evidence of an increased inci-
dence of childhood sexual abuse in male pedophiles
is insufficient to establish a causative relationship
between childhood abuse and adult pedophilia. Ev-
idence of concordance between age of abuse and
age of victims or between acts experienced and acts
perpetrated would provide additional evidence of
the etiological role of child sexual abuse in pedo-
philia. Thus, also of interest is the degree of concor-
dance between the age of the victims chosen by the
perpetrator and the age at which the perpetrator’s
own sexual abuse began. Similarly, the actual acts
pedophiles perpetrate on victims may bear a striking
relationship to the acts of victimization that they
themselves endured as children. Only one case re-
port, to our knowledge, examined concordance of
age and type of sexual act. Haapasalo et al. (1999)
reported a case in which the sexual acts perpetrated
and the ages of the victims were almost identical to
those in the perpetrator’s own childhood experi-
ences.
In addition, there is wide variation in the rates
reported. The variation, in part, may relate to the age
and sex of victim and perpetrator, highlighting the
importance of such data in studies of childhood
sexual abuse. However, the accuracy of such figures
has also been questioned, with some investigators
suggesting the rates are overreported, as pedophiles
may falsify the incidence or extent of abuse in an
attempt to mitigate the legal consequences of their
behavior (Hanson and Slater, 1988; Hindman, 1988;
Langevin et al., 1989). Others suggest the rates are
substantially underreported, and even that perpetra-
tors may fear appearing guilty of their legal charges
if they admit to sexual victimization (Hanson and
Slater, 1988). On the other hand, pedophiles may
underreport their own history of sexual abuse for
purely psychological reasons. Due to the traumatic
nature of the sex abuse history, there may be an
inability or failure to cognitively process the memo-
ries. As such, the memories of childhood abuse are
denied or distorted. In other words, the cognitive
distortions operate at least partially outside of con-
scious control.
Cognitive distortions and the denial of the implica-
tions for pedophilic behavior have been widely dis-
 CHILDHOOD SEXUAL HISTORY OF 20 PEDOPHILES
cussed (Fischer et al., 1999; Haywood and Grossman,
1994). Pedophiles routinely deny and minimize the
deviant nature of their behavior and its destructive
impact on the children involved. Thus, one possibility
could be that, among pedophiles, the denial and cog-
nitive distortions of pedophilic behavior may be etio-
logically related to the denial and cognitive distortions
of their own history of sexual abuse.
In the following study, 20 male pedophiles, het-
erosexual, nonexclusive type were compared with
24 demographically similar healthy control subjects
on a detailed measure of sexual history. Specifically,
the present study assessed a) the incidence of child-
hood sexual abuse in pedophiles versus control sub-
jects; and b) the nature of and concordance between
characteristics of childhood abuse and adult pedo-
philic behavior. A secondary analysis assessed the
presence of cognitive distortions regarding child-
hood sexual history and pedophilic behavior
through examination of response discrepancies
throughout the questionnaire.
Methods
Subjects
Twenty male subjects with a DSM-IV diagnosis of
pedophilia, heterosexual type, were recruited from
CAP Behavior Associates, a facility specializing in
outpatient treatment of court-referred sexual of-
fenders. CAP provides a comprehensive treatment
program that includes group psychotherapy incor-
porating cognitive-behavioral techniques, psychiat-
ric coverage, and coordination with the judicial sys-
tem. At least 1 year of treatment is required.
Subjects were recruited within the first few weeks
of treatment.
All pedophilic subjects were diagnosed with pe-
dophilia, heterosexual, nonexclusive, nonincest type
according to DSM-IV criteria by psychiatric evalua-
tion at CAP Behavior Associates. Incest refers to
sexual activity with first-degree relatives. To reduce
potential confounds of a heterogeneous subject pop-
ulation, we used strict inclusion and exclusion cri-
teria. All pedophilia subjects had been convicted of
a sexual offense against a prepubescent child (aged
13 years or younger), which they committed when
aged at least 18 years or when 5 years older than
their victim, and were currently either on parole or
on probation. In addition, all subjects admitted to
committing the act for which they were charged and
had committed more than one act against more than
one victim, with the exception of one subject who
denied having had direct sexual engagement with a
759
child and was on probation for Internet trafficking
of child pornography.
Twenty-four demographically similar healthy
male control subjects were recruited through adver-
tising in a local newspaper. Exclusion criteria for
both groups included significant axis I psychiatric
disorder (psychotic disorder, major affective disor-
der, serious anxiety disorder), substance abuse or
dependence within the past 6 months, major medical
or neurological disease, and mental retardation. For
pedophiles, this was defined as any major mood
disorder (major depressive disorder, bipolar disor-
der), psychotic disorder, or significantly debilitating
disorder requiring hospitalization. For control sub-
jects, it was defined as any Structured Clinical In-
terview for DSM (SCID-I) diagnosis. Further exclu-
sion criteria for control subjects included any
history of pedophilia or of sexual contact with a
child aged 14 years or younger after the age 16 years,
or with a child aged 16 years or younger after the age
18 years. All subjects expressed sexual attraction to
women.
Procedure
This study was part of a larger, comprehensive
investigation of neuropsychiatric function in pedo-
philes, which included PET and plethysmographic
methods. The 44 subjects who entered the current
study were paid $50.00 after they completed a bat-
tery of psychometric tests.
Recruitment
To recruit pedophiles, a research assistant visited
CAP Behavior Associates and spoke to the clients
immediately prior to their group therapy appoint-
ment. The research assistant first described the
project in general to the assembled group of CAP
Behavior Associates clients. Pedophilic patients
who expressed interest in the project were inter-
viewed individually. Interested subjects were sched-
uled for an appointment at Beth Israel Medical Cen-
ter for further evaluation and further explanation of
study protocol. Control subjects were screened by
phone for initial eligibility. Of the 119 volunteers
who were initially screened by telephone, 50 were
interviewed, 29 signed informed consent, and 24
completed the psychometric studies. Fourteen were
excluded for admitting sexual attraction to girls
aged 13 years or younger. After primary inclusive
criteria were met, subjects were interviewed in per-
son by research staff at Beth Israel Medical Center.
Control subjects completed a SCID-I interview (First
et al., 1996) and a clinical interview by a psycholo-
760 COHEN
gist. All interested subjects who met inclusion and
exclusion criteria were entered into the study after
signing an informed consent form. The BIMC Com-
mittee on Scientific Activities (COSA) approved this
study.
Materials
Sexual History Questionnaire. A detailed 72-item
self-report questionnaire assessing childhood sexual
experiences, sexual interest, and pedophilic behav-
ior was developed for this study. Sexual age prefer-
ences were assessed in a grid-format checklist, with
three columns of the grid labeled “sexually attracted
to,” “have had sexual encounters with,” and “have
had legal trouble for sexual activity with.” The 10
rows included five categories of age groups for first
girls and then boys, ranging from infancy through
adulthood (18 years or more). Control subjects com-
pleted a shortened form, which collapsed the young-
est age categories into one category of 12 years and
younger. To increase the reliability of subjects’ re-
ported sexual abuse history, childhood sexual his-
tory was assessed with multiple questions. At the
beginning of the questionnaire, subjects are asked to
list the age of their first sexual experience, with
whom it occurred, and the age of their first partner.
Later in the questionnaire, they are asked a series of
questions such as: “When you were a child did any
adult ever make sexual advances at you?” and “How
old were you when it started?” They are also asked
the number of people who made advances toward
them, their gender, ages, and whether they were
family members.
Last, possible concordance between acts experi-
enced in childhood and pedophilic acts is assessed
by asking subjects to check from a list of eight
sexual practices any acts performed on them as a
child by an adult: fondling, kissing, tongue kissing,
masturbating adult, adult touching child’s genitals,
fellatio on adult, sexual intercourse, and anal inter-
course. They were then asked to check any of their
adult pedophilic behaviors from a separate list with
the same eight categories of sexual acts.
Cognitive distortions were evaluated indirectly
through assessment of inconsistencies in the ques-
tionnaire. Age of first reported sexual contact was
compared with age at which an adult made a sexual
advance. Patterns of admitted attraction to, sexual
activity with, and legal trouble involving children of
different age groups were also examined for incon-
sistencies. Finally, 9 of the 20 pedophiles were given
an amended version of the questionnaire, with two
questions about the effect of their own childhood
et al.
sexual experiences on them and of their pedophilic
behavior on the child recipient. The 6-point scales
ranged from 1 ⫽ very bad effect, 2 ⫽ bad effect, 3 ⫽
slightly bad effect, 4 ⫽ none, 5 ⫽ positive effect, to
6 ⫽ very positive effect.
Statistical Analysis
Chi-square analyses were used with frequency
variables to compare scores across the subject
groups, and t-test statistics were calculated for con-
tinuous variables. When homogeneity of variance
was not supported by Levene test for equal variance,
t-tests for unequal variance were reported. Because
years of education significantly differed across
groups (see below), it was entered as a covariate in
all of the analyses of childhood sexual history. In
addition, because of the large number of compari-
sons in the self-reported sexual preferences data,
Bonferroni corrections were applied. Analysis was
performed using SPSS for Windows, version 10.0.
Results
Subjects
Pedophiles and control subjects did not signifi-
cantly differ on age, marital status, ethnicity, or
religion. Pedophiles had fewer years of education
compared with control subjects (12.00 ⫾ 3.2 vs.
14.75 ⫾ 2.1, t ⫽ ⫺3.43, df ⫽ 42, p ⫽ .001) and a lower
level of employment [65% vs. 92%, chi-square ⫽ 4.8,
df ⫽ (1), p ⫽ .035]. Twenty percent of pedophiles
were European American, 25% African American,
45% Hispanic, and 5% Asian. Thirty-five percent were
single, 20% married, 20% separated, and 25% di-
vorced. Twenty-nine percent of control subjects
were European American, 21% were African Ameri-
can, 46% Hispanic, and 4% Asian. Fifty percent were
single, 29% married, 8% separated, and 13% divorced.
Pedophilic Age Preferences
All pedophiles and control subjects admitted at-
traction to adult women, aged 18 years or more
(Table 1). While 3% of control subjects also admitted
attraction to teenage girls aged 13 to 17 years, none
reported being attracted to girls aged younger than
13 years, and no control subjects reported any sex-
ual activity with girls aged 12 years and younger. In
contrast, 50% of pedophiles report attraction to girls
aged 13 to 17 years, 30% to girls aged 10 to 12 years,
and 5% to girls aged 6 to 9 years. Of note, only 30%
admitted being attracted to girls aged 12 years and
younger, yet 40% admitted to sexual encounters with
them, and 60% of pedophiles admitted to legal trou-
 CHILDHOOD SEXUAL HISTORY OF 20 PEDOPHILES 761
TABLE 1
Self-Reported Sexual Age Preferences
Age Group Sexual History Pedophiles Controls Statistic ␹2 (df) Significance
Women, 18⫹ Attracted to 20 (100%) 24 (100%) ns
Encounters 17 (85%) 24 (100%) 3.86 (1,44) .049
Legal trouble 0 (0%) 0 (0%) ns
Girls 13–17 Attracted to 10 (50%) 3 (13%) 7.37 (1,44) .007
Encounters 8 (40%) 3 (13%) 4.40 (1,44) .036
Legal trouble 7 (35%) 0 (0%) 9.99 (1,44) .002
Girls 10–12 Attracted to 6 (30%) 0 (0%) 8.34 (1,44) .004
Encounters 8 (40%) 0 (0%) 11.73 (1,44) .001*
Legal trouble 10 (50%) 0 (0%) 15.53 (1,44) ⬍.001*
Girls 6–9 Attracted to 1 (5%) 0 (0%) ns
Encounters 3 (15%) 0 (0%) 3.86 (1,44) .049
Legal trouble 5 (25%) 0 (0%) 6.77 (1,44) .009
Girls 3–5 Attracted to 0 (0%) 0 (0%) ns
Encounters 1 (5%) 0 (0%) ns
Legal trouble 1 (5%) 0 (0%) ns
Men 18⫹ Attracted to 0 (0%) 1 (5%) ns
Encounters 0 (0%) 0 (0%) ns
Legal trouble 0 (0%) 0 (0%) ns
Boys 13–18 Attracted to 0 (0%) 0 (0%) ns
Encounters 0 (0%) 0 (0%) ns
Legal trouble 0 (0%) 0 (0%)
Boys 10–12 Attracted to 1 (5%) 0 (0%) ns
Encounters 1 (5%) 0 (0%) ns
Legal trouble 1 (5%) 0 (0%)
Boys 6–9 Attracted to 1 (5%) 0 (0%) ns
Encounters 1 (5%) 0 (0%) ns
Legal trouble 1 (5%) 0 (0%) ns
*Reaches significance at Bonferroni corrected level of p ⱕ .001

ble for their sexual activity with those girls. One
pedophile subject (5%) admitted to sexual attrac-
tion, sexual activity, and legal trouble with boys
aged 10 to 12 years, and one other (5%) admitted to
the same with boys aged 6 to 9 years. This is in direct
contrast to the initial psychiatric evaluations at CAP,
in which all pedophiles were diagnosed as hetero-
sexual. Statistically, groups only differed in admis-
sion of sexual encounters with women, and with
girls aged 13 to 17 years, 10 to 12 years, and 6 to 9
years; sexual attraction to girls aged 13 to 17 years
and 10 to 12 years; and legal trouble with girls aged
13 to 17 years, 10 to 12 years, and 6 to 9 years.
However, after Bonferroni corrections, only sexual
encounters and legal trouble with girls aged 10 to 12
years maintained significance (Table 1).
Childhood Sexual History
Pedophiles relative to control subjects reported a
much higher incidence of child sexual abuse (Table
2). Twelve (60%) of the pedophiles compared with
only one (4%) control subject reported adult sexual
advances in childhood [chi-square ⫽ 16.34 (1), p ⱕ
.001]. Age of reported abuse for pedophiles averaged
7.83 ⫾ 3.74 years (range: 3 to 16 years). Eight (40%)
pedophiles reported sexual abuse by one or more
men, six (30%) reported abuse by one or more
women, and three (15%) reported abuse by a family
member. One control subject reported being sexu-
ally abused by an aunt at age 12 years.
As sexual abuse may be underreported, we also
calculated age of earliest sexual encounter, which
was defined as the younger of either first reported
sexual experience or age at which an adult made a
sexual advance. The reported age of earliest sexual
encounter occurred significantly earlier among the
pedophilic group, at an average age of 11.10 ⫾ 5.2
years compared with 16.13 ⫾ 2.42 years in the con-
trol group (t ⫽ ⫺3.97, df ⫽ 25.73, p ⫽ .001). There
was also a notable difference in the proportion of
subjects whose earliest sexual encounter occurred
at age 13 years or younger. Seventy-five percent of
pedophiles compared with only 21.7% of control
subjects reported their first sexual encounter when
younger than age 13 years [chi-square ⫽ 12.2 (1),
p ⫽ .000]. The age difference between self and first
partner averaged 14.40 ⫾ 9.7 years among the pedo-
philic group and only 2.33 ⫾ 7.3 years for control
subjects (t ⫽ 4.60, df ⫽ 34.81, p ⫽ .000). All of these
comparisons retained statistical significance when
covaried by education (Table 2).
762 COHEN et al.
TABLE 2
Self-Reported Sexual History of Male Pedophiles
Pedophiles (20) Controls (23) Statistic Signif*
Age of 1st sexual encounter 11.10 ⫹ 5.2 16.13 ⫹ 2.42 t ⫽ ⫺3.97 (25.73) .001
Age of 1st partner 25.50 ⫹ 7.8 18.46 ⫹ 6.7 t ⫽ 3.18 (37.7) .003
Age difference 14.40 ⫹ 9.7 2.33 ⫹ 7.3 t ⫽ 4.60 (34.81) ⬍.001
1st sex at age 13 and under 15 (75%) 5 (21.7%) ␹2 ⫽ 12.2 (1,43) ⬍.001
Adult advances during childhood 12 (60%) 1 (4%) ␹2 ⫽ 16.34 (1,44) ⬍.001
By more than one adult 5 (25%) 0 (0%) ␹2 ⫽ 6.77 (1,44) .009
Number of men ␹2 ⫽ 11.73 (3,44) .008
0 12 (60%) 24 (100%)
1 6 (30%) 0
2 1 (%) 0
3 1 (%) 0
Number of women ␹2 ⫽ 5.62 (3,44) ns
0 14 (70%) 23 (96%)
1 4 (20%) 1 (4%)
4 1 (5%) 0
20 1 (5%) 0
Perpetrator was family member 3 (15%) 1 (4%) ␹2 ⫽ 1.55 (1,44) ns
*All significant comparisons maintained significance when covaried by education.

Concordance dophiles admitted being attracted to girls aged 10 to

Pedophiles also report a wide range of sexual acts
experienced as children and performed on children
as adults. They reported a mean of 1.2 ⫾ .2 types of
acts experienced as a child with an adult and a mean
of 2.95 ⫾ .2 types of acts performed on a child as an
adult. The concordance between childhood experi-
ence of a given sexual act and pedophilic perfor-
mance of such an act averaged 58%. For seven of the
eight particular sexual acts, 66% of pedophiles on
average (range: 50% to 100%) admitted to repeating
the particular act in their adult pedophilic behavior.
The one exception was anal intercourse, which was
not reported as having been repeated. However, of
note, almost twice the number of subjects reported
pedophilic performance of most sexual acts than
childhood experience of the same acts. To assess
the concordance between age of earliest sexual con-
tact and age of victim, a rough estimate of victim age
was calculated by recoding the youngest age prefer-
ence listed (involving sexual encounters or legal
trouble with) into a 5-point scale, ranging from 1 ⫽
age 3 to 5 years to 5 ⫽ adults only. This was then
correlated with the earliest age of pedophiles’ own
sexual contact. The correlation was significant (r ⫽
.511, p ⫽ .021, N ⫽ 20).
Cognitive Distortions
Response discrepancies throughout the question-
naire were also examined as a preliminary estimate
of propensity toward cognitive distortions. Pedo-
philes demonstrated numerous response discrepan-
cies in reports of adult pedophilic behavior and
childhood sexual experience. While only 30% of pe-
12 years, 40% admitted to having had sexual encoun-
ters with them, and 50% to having had legal trouble
for this behavior. Similarly, while only 5% of pedo-
philes admitted attraction to girls aged 6 to 9 years,
15% admitted to sexual encounters with them, and
25% had undergone legal trouble for those actions.
With regard to older age groups, i.e., women and
girls aged 13 to 17 years, the pattern was reversed,
with attraction being the most frequently endorsed,
sexual encounters the next, and legal trouble the
least. One subject denied any attraction, sexual in-
volvement, or legal trouble with children aged less
than 18 years despite a documented history of pe-
dophilic offenses. In contrast, there is no discrep-
ancy among control subjects regarding their re-
ported age preferences.
Of the 12 pedophiles who reported experiences of
adult sexual advances as a child, 9 (75%) reported a
different age of first sexual contact (mean ⫽ 11.94 ⫾
3.83 years) than age of adult sexual advances (7.83 ⫾
3.74 years). The one control subject who reported a
sexual abuse history reported the same age of first
sexual contact as age of adult advance (12 years).
Moreover, of the 20 pedophiles, 9 answered the
question about the effect of their pedophilic behav-
ior on the involved children. One (11%) responded a
very positive effect, two (22%) reported no effect,
one (11%) answered slightly bad effect, and five
(56%) answered very bad effect. Of the 12 pedo-
philes who reported adult sexual advances in child-
hood, 6 answered the questions about the effect of
their own childhood sexual history. Two (33%) an-
swered no effect, one (17%) answered slightly bad
effect, two (33%) answered bad effect, and one (17%)
 CHILDHOOD SEXUAL HISTORY OF 20 PEDOPHILES
answered very bad effect. Hence, a sizable fraction of
the pedophiles did not consider childhood sexual
abuse to have a strongly negative effect on a child.
Discussion
The present study assessed the childhood sexual
history and pedophilic practices of 20 pedophilic
men compared with 24 healthy male control sub-
jects. Major findings were as follows: A number of
variables converge to support the finding of a dis-
proportionately high rate of childhood sexual abuse
histories in male pedophiles. Sixty percent of pedo-
philes compared with 4% of control subjects report
experiencing adult sexual advances as a child. Pe-
dophiles’ reported average age of first sexual en-
counter was 11.10 years compared with 16.13 years
for control subjects. The proportion of pedophiles
who reported a first sexual encounter at age 13
years or younger was 75% versus 22% for control
subjects. Forty percent report sexual advances in
childhood by at least one man and 30% by at least
one woman; 25% report sexual advances by more
than one adult. A 58% concordance rate was found
between reported acts experienced as a child and
perpetrated as an adult. Finally, numerous inconsisten-
cies throughout the questionnaire support the role of
cognitive distortions with regard to present pedophilic
behavior and also childhood sexual history.
Incidence of Childhood Sexual Abuse
The elevated rate of admitted childhood sexual
abuse in the present study is consistent with numer-
ous reports of elevated rates of childhood sexual
abuse among pedophiles (Dhawan and Marshall,
1996; Freund et al., 1990; Freund and Kuban, 1994;
Seghorn et al., 1987). Other studies of adult male pe-
dophiles report incidences of 27% (Freund et al., 1990),
43.9% (Freund and Kuban, 1994), 50% (Dhawan and
Marshall, 1996), and 57% (Seghorn et al., 1987). Hence,
our rate is somewhat higher than those found in sim-
ilar populations. That our subjects were outpatients
currently in group treatment may have increased their
readiness to disclose their sexual abuse history. This is
in contrast to the incarcerated status of several of the
previous studies’ populations (Dhawan and Marshall,
1996; Seghorn et al., 1987; Worling, 1995a). However,
our incidence is lower than those found in samples of
girls who abuse other children (100%; Johnson, 1989;
Knopf and Lackey, 1987) and adult female pedophiles
(93%; Knopf and Lackey, 1987). This may reflect gen-
der differences either in self-disclosure patterns or in
sexual abuse histories of male and female pedophiles.
763
The methods of assessing sexual abuse histories
may also affect results. Our assessment method in-
volves a retrospective, self-report questionnaire that
uses several questions to assess the variables. Other
studies differ in assessment measures. Very few use
questionnaires specifically designed to assess child-
hood history of sexual abuse (Bagley et al., 1994;
Dhawan and Marshall, 1996), although Dhawan and
Marshall (1996) used a semistructured interview in
addition to a questionnaire. Many studies used data
culled from more general assessment instruments,
for example, with a few questions about sexual
abuse history embedded in a sexual preference
questionnaire (Freund and Kuban, 1994; Freund et
al., 1990), semistructured interviews (Faller, 1987;
Worling, 1995a, 1995b), or in intake evaluations
(Johnson, 1989). Several studies utilized retrospec-
tive data from clinical charts (Seghorn et al., 1987)
or treatment providers (Knopf and Lackey, 1987).
On the other hand, corroborative legal or clinical
data were used in a study of adolescent offenders
(Worling, 1995b).
However, in all retrospective studies of childhood
sexual abuse, assessment methods pose significant
challenges to the reliability and validity of the re-
sults. Subjects’ willingness to disclose such sensitive
material, their ability to recognize and label child-
hood experiences, and the accuracy of their memory
for distant events cannot be assumed. In the absence
of objective or at least corroborative data, struc-
tured assessment instruments can best approximate
an accurate assessment. Nonetheless, that the high
incidence of sexual abuse is so widely replicated
supports the robustness of the present findings.
Characteristics of Childhood Sexual Abuse
Our study differed from many other studies, how-
ever, in that we also asked questions about the age
and gender of the adult sexual abusers. It is of note
that the proportion of subjects who report child-
hood sexual encounters with women (30%) does not
significantly differ from those who report such en-
counters with men (40%). This intriguing finding
either suggests that sexual abuse by female perpe-
trators is much more frequent than generally known
or that victims of female sexual perpetrators are
disproportionately represented in samples of male
pedophiles.
Regarding the concordance between childhood
sexual history and adult pedophilic behavior, there
is very little literature. Johnson (1989) noted concor-
dance of relationship status in child perpetrators. Of
the 11 children who were abused by a family mem-
ber, 91% subsequently abused a relative. Regarding
764 COHEN
concordance of age of victim, there are no reported
data in the literature. However, as discussed earlier,
there is a fair amount of evidence that pedophiles
have a higher rate of childhood sexual abuse than do
gynephilic offenders. As to concordance of type of
sexual act, to our knowledge, there are no data.
Several studies assess in detail either the specific
acts experienced in childhood sexual abuse (Bagley
et al., 1994) or those perpetrated on child victims
(Johnson, 1989), but no study to date has attempted
to correlate such data. That our current study found
a 58% concordance rate between type of pedophilic
act sustained in childhood and perpetrated in adult-
hood adds support to the notion of concordance
between childhood experience of sexual abuse and
adult pedophilic behavior. However, clearly other
factors influence choice of pedophilic acts. These
may include situational factors, e.g., expedience or
risk of discovery and sexual preferences developed
in adulthood. Although we did not systematically
assess concordance between age of youngest victim
and earliest age of victimization, our post hoc cor-
relation supports such a relationship. This finding
can be seen as consistent with the notion of a caus-
ative relationship between early childhood abuse
and later pedophilic behavior.
Cognitive Distortions
Despite multiple studies on pedophiles’ cognitive
distortions about pedophilic behavior (Blumenthal
et al., 1999; Keenan and Ward, 2000; McGrath et al.,
1998), there is very little information on their distor-
tions of their own childhood sexual abuse and none,
to our knowledge, on both. Although we did not
study cognitive distortions with previously vali-
dated, structured instruments, our study found mul-
tiple inconsistencies within the data, suggestive of
such cognitive distortions. Pedophiles appeared to
slant their reports of sexual age preferences in the
direction of social desirability. This implies that they
understand the social stigma associated with pedo-
philic behavior. Nonetheless, only five of nine stated
that their behavior had a very negative effect on
their victims, suggesting a minimization of the im-
pact of their behavior. This is consistent with the
multiple reports of pedophiles minimizing and ratio-
nalizing pedophilic behavior (Blumenthal et al.,
1999; Keenan and Ward, 2000; McGrath et al., 1998).
Of interest, however, our study also provided pre-
liminary data of similar minimization with regard to
their own history of childhood sexual abuse. Many
disregarded their early childhood sexual abuse his-
et al.
tory when reporting their age of first sexual experi-
ence, and only one of six reported such a history to
have had a strongly negative effect. Given the wealth
of data supporting the pervasive and pernicious ef-
fect of early sexual abuse, such findings are more
likely to reflect pedophiles’ own response biases
than the genuinely benign effect of their childhood
sexual experiences. That our subjects appear to
more readily admit the negative impact of their pe-
dophilic behavior on their victim than of their own
childhood experiences on themselves is intriguing
but may reflect the focus of their outpatient treat-
ment. We would expect that increased treatment
time would decrease cognitive distortions. Future
studies could control for the effect of length of time
in treatment.
However, it is also possible that such response in-
consistencies reflect intentional attempts to deceive,
associated with widely documented antisocial traits
(Black et al., 1997; Raymond et al., 1999). Certainly,
pedophiles may be motivated to bias their responses to
protect their own self-interest within the criminal jus-
tice system. Many other authors, however, have dis-
cussed the central role of such cognitive distortions in
the development and perpetuation of pedophilic be-
havior, above and beyond the obvious self-serving
functions. The current findings add preliminary sup-
port to the notion that pedophiles may distort their
understanding of their own childhood sexual abuse,
perhaps in an attempt to regulate the associated dis-
tress of such traumatic memories. This distortion pre-
vents the effective processing of the trauma and leaves
the person vulnerable to the development of maladap-
tive coping mechanisms, such as compulsive repetition
of the trauma via assumption of the active role. Such
an interpretation is certainly consistent with many
models of trauma and the maladaptive sequelae of
trauma (Bagley et al., 1994; Courtois, 1988; Worling,
1995a, 1995b). Of course, any such model must be seen
as highly speculative, given the preliminary nature of
the data about not only the incidence of childhood
sexual abuse in pedophiles but also the role of cogni-
tive distortions in the processing of such histories.
Finally, even if robust evidence supporting the current
model is demonstrated, it is unlikely to wholly explain
the etiology of pedophilia. In all but two studies, a
significant fraction of child sexual molesters denied
any childhood history of sexual abuse. Moreover, the
vast majority of sexual abuse victims do not become
abusers (Bagley et al., 1994).
The present study investigated the incidence of
childhood sexual abuse in a sample of male, hetero-
sexual, nonexclusive pedophiles compared with a
demographically similar control group. By applying
fairly rigorous inclusion and exclusion criteria and a
 CHILDHOOD SEXUAL HISTORY OF 20 PEDOPHILES
structured instrument specifically designed to study
the topic of this article, the present findings manage
to avoid many of the potential confounds found in
other studies. Furthermore, our findings add sup-
port to the extant literature and contribute new
information on the characteristics of childhood sex-
ual abuse in male pedophiles and its concordance
with characteristics of adult pedophilic behavior.
Nonetheless, the current study also presents several
important limitations. The study sample was small,
and the pedophilic subjects were restricted to an
outpatient clinic specializing in sex offenders and,
thus, perhaps were representative neither of incar-
cerated pedophiles nor those living in the commu-
nity. Two subjects admitted to bisexual pedophilic
activity despite being previously classified as hetero-
sexual by psychiatric evaluation.
The question of diagnostic certainty is intrinsic to
this population. Due to their propensity toward un-
reliable self-reports, it is difficult to ascertain
whether pedophilic behavior reflects a consistent
sexual orientation or an opportunistic encounter,
i.e., whether our subjects are true pedophiles or
nonpedophilic child molesters. In our sample, all
pedophile subjects admitted to more than one pedo-
philic encounter and more than one victim. More-
over, it is most likely that pedophilic behavior in
convicted child molesters is significantly underre-
ported rather than overestimated. In a report by
Abel et al. (1987), using a federal guarantee of con-
fidentiality, convicted child molesters admitted to an
average 240 pedophilic acts, far greater than the
rates reported in most studies. It is also possible that
our stringent criteria for control subjects may exag-
gerate the distinctions between pedophiles and con-
trol subjects. Further research with community sam-
ples could be conducted to address this potential
confound. Nevertheless, it is important to note that
only 14 of the 119 potential control subjects were
rejected for admitting sexual attraction to girls aged
less than 14 years. Furthermore, the questionnaire
was developed for the present study and thus has no
previously demonstrated psychometric properties.
The accuracy of pedophile subjects’ responses is
often questionable, as discussed above, thus compli-
cating the interpretation of the findings. Finally, the
assessment of response discrepancies was per-
formed only as a secondary analysis and thus not
supported by structured measures of cognitive dis-
tortions.
Further research is needed with rigorous assess-
ment methods, such as structured interviews and
questionnaires specifically designed to assess child-
hood histories of sexual abuse, including the types
of acts, perpetrators, and ages of victimization. Cor-
765
roborative data, if possible, are also important given
the validity problems of retrospective reports. Sys-
tematic assessments of the degree and nature of
cognitive distortions are also needed. Pedophilic di-
agnoses could be corroborated with plethysmo-
graphic or other objective measures of sexual
arousal patterns. Given the pervasive and devastat-
ing effects of childhood sexual abuse, such investi-
gations are unquestionably indicated, if not overdue.
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