Measuring Pedophilic Sexual Interest

Introduction: Pedophilic sexual interest is an important risk factor in sexual offender recidivism and remains a key component in the clinical assessment of child sexual offenders and people diagnosed with pedophilia. Despite concerns about the absence of universally accepted standardized clinical assessment methods, there are a number of established techniques aimed at assessing people with sexual interest in children. Aim: To provide a foundation from which to understand existing methods available for the assessment of people with pedophilic sexual interests, including strengths and limitations of each approach. Methods: A group of clinical experts provide a clinically oriented, narrative review on assessment methods for pedophilic sexual interest, including the rationale behind each method and its implementation. Evidence on validity supporting the techniques, limitations, and ethical issues is also discussed. Results: The assessment methods were grouped according to the following categories: self-report, genital psychophysiological assessment, indirect measurement, and behavioral measurement of pedophilic interest. Although most techniques performed well in discriminating child sexual offenders with pedophilic interest from distinct comparison groups, there are several limitations, including the current lack of standardization and the ethical challenges posed by this sensitive area. Clinical implications: An understanding of the different measures available for the assessment of problematic sexual interests plays a vital role in forensic clinical determinations of risk of recidivism and in the identification of treatment targets for men who have committed sexual offenses. Several independent but complimentary methods exist to assess sexual interest. Ongoing work on the international standardization of assessment based on methodologically sound research aimed at determining best practices will address some of the shortcomings of these assessments while improving their reliability. Strengths & limitations: This article provides a general review on a number of methods aimed at assessing pedophilic interest. However, these methods mirror clinical practice largely used within North America and parts of continental Europe. As a result of cultural differences, opposing paradigms on assessment and treatment of pedophilia, and diverse legal regulation between jurisdictions and countries, these practices may not be applicable on an international scale where other special procedures may be required. Conclusion: A number of techniques have been used within clinical and research settings that vary from self-report to objective measures. Most methods have demonstrated efficacy. Continued work to combine evidence and experience from diverse populations and multiple countries will improve the quality of the methods available. Carvalho J, Bradford J, Murphy L, et al. Measuring Pedophilic Sexual Interest. J Sex Med 2020;17:378–392.