From what we know today, paedophilia affects around 1% of the male population. Nevertheless, paedophilia is the paraphilia that gets virtually all media coverage, although human sexual interest can become fixated on a wide variety of targets. After a century of broad clinical discussion about paraphilia in the western world, only paedophilia is to be excluded from the 'fun-and games, plug and play laundry list of healthy kink interests'. Hence, it is not surprising that most research on the prevalence of paedophilia involves samples of individuals in forensic settings. As a result, almost nothing is known about ways of living with that sexual interest without causing harm.
The DSM-5 diagnostic criteria for paedophilia and paedophilic disorder have been criticized by numerous experts for a variety of reasons. There has been a controversial discussion about the fact that no diagnostic category for individuals with a preference for pubertal adolescents – so-called hebephilia – was created. Criticism has also been expressed that according to DSM-5, paedophilia is the only paraphilic disorder without an 'in remission' and an 'in controlled environment' specifier. The latter is noteworthy because recent research has challenged the assumption that paedophilic interest is unchangeable, and scientific evidence on the immutability of paedophilic disorder is lacking.
Some results of neuropsychological research and neuroimaging provide evidence of brain abnormalities in individuals with paedophilia. Nevertheless, functional neuroimaging has been able to support neither the association of paedophilic behaviour with frontal lobe disorder, nor the hypothesis that paedophilic individuals show deficits in cognitive or perceptual categorization of sexual stimuli.
Curr Opin Psychiatry. 2015;28(6):440-444. © 2015 Lippincott Williams & Wilkins