Problems with the DSM-IV Diagnosis of Pedophilia
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
This paper examines the taxonomic adequacy of the Diagnostic and Statistical Manual, 4th ed., DSM-IV (American Psychiatric Association, 1994) diagnostic category of pedophilia. This diagnosis, as well as the other sexual disorders, have been ignored in DSM field trials. There is no empirical information about the reliability or validity of this diagnosis. Moreover, because the vagueness of the diagnostic criteria, clinicians would need to make inferences that would likely lead to reliability problems in diagnosis. Further, the DSM diagnostic criteria include constructs that are not intersubjectively verifiable and for which there are no valid measures. This can also lead to lack of diagnostic reliability and accuracy. Most problematical however, there are aspects of the diagnostic criteria, most notably the presence of an “ego dystonic sexual attraction to children,” that are incorrect exclusion criteria. Suggestions for improvement are provided.
- American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed.). Washington, DC: Author.
- American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.). Washington, DC: Author.
- American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.
- American Psychiatric Association. (1996). DSM-IV Sourcebook (Vol. 2). Washington, DC: Author.
- American Psychiatric Association. (1997). DSM-IV Sourcebook (Vol. 3). Washington, DC: Author.
- Abel, G. G., Becker, J. V., Mittelman, M., Cunningham-Rather, J., Rouleau, J. L., & Murphy, W. D. (1987). Self-reported sex crimes on non-incarcerated paraphiliacs.Journal of Interpersonal Violence, 2, 3–25.
- DeYoung, M. (1988). The indignant page: Techniques of neutralization in the publications of pedophile organizations.Child Abuse and Neglect, 12, 583–591.
- Dohrenwend, B. P., & Dohrenwend, B. S. (1965). The problem of validity in field studies of psychological disorder.Journal of Abnormal Psychology, 70, 52–69.
- Hempel, C. G. (1965). Fundamentals of taxonomy.Aspects of scientific explanation and other essays in the philosophy of science.New York: The Free Press.
- Marshall (1997). Pedophilia: Psychopathology and theory.In D. Laws and W. O'Donohue (Eds.), Sexual deviance (pp. 152–174). New York: Guilford.
- Nelson-Gray, R. O. (1991). DSM-IV: Empirical guidelines from psychometrics.Journal of Abnormal Psychology, 100, 308–315.
- O'Donohue, W. T., & Geer, J. H. (1993). Research issues in the sexual dysfunctions.In W. O'Donohue & J. Geer (Eds.), Handbook of sexual dysfunctions (pp. 1–14). Boston, MA: Allyn & Bacon.
- O'Donohue, W., & Letourneau, E. (1992). The psychometric properties of the penile tumescence assessment of child molesters.Journal of Psychopathology and Behavioral Assessment, 14, 123–174.
- O'Donohue, W., & Letourneau, E. (1993). A brief group treatment for the modification of denial in child sexual abusers: Outcome and follow up.Child Abuse and Neglect, 17, 299–304.
- Spitzer, R. L., Williams, J., Gibbon, M., & First, M. (1989). Structured clinical interview for the DSM-III-R.New York: New York State Psychiatric Institute.
- Wakefield, J. C. (1992a). Disorder as harmful dysfunction: A conceptual critique of DSM-III-R's definition of mental disorder.Psychological Review, 99, 232–247.
- Wakefield, J. C. (1992b). The concept of mental disorder: On the boundary between biological facts and social values.American Psychologist, 47, 373–388.
- Problems with the DSM-IV Diagnosis of Pedophilia
Sexual Abuse: A Journal of Research and Treatment
Volume 12, Issue 2 , pp 95-105
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers-Plenum Publishers
- Additional Links
- sexual interest
- behavioral disorder