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Pedophilia-Themed Obsessive–Compulsive Disorder: Assessment, Differential Diagnosis, and Treatment with Exposure and Response Prevention

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Abstract

Fears of sexually harming children are fairly common among clients suffering from obsessive–compulsive disorder (OCD), yet these symptoms are largely unrecognized and frequently misdiagnosed by mental health professionals. Specifically, clients with pedophilia-themed OCD (P-OCD) experience excessive worries and distressing intrusive thoughts about being sexually attracted to, and sexually violating, children. Expressing these concerns may provoke misjudgments from uninformed mental health professionals that a client is presenting instead with pedophilic disorder. This misdiagnosis and subsequent improper interventions can then contribute to increased fear, anxiety, and in many cases, depression, in affected clients. Therefore, it is imperative that mental health professionals first possess a good understanding of this common manifestation of OCD. As such, in this article, we described obsessions and compulsions typical of P-OCD, in order to inform the reader of the distinctive differences between P-OCD and pedophilic disorder. Information about how to assess for P-OCD symptoms is then provided, followed by suggestions on how to tailor aspects of exposure and response prevention to treat this specific form of OCD.

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Acknowledgements

The authors would like to thank Jessica Combs, Psy.D., and Judy Mier-Chairez, B. S., for their assistance with earlier drafts of this article, and Chandler Smith for help with data entry.

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Authors and Affiliations

  1. Department of Psychology, Spalding University, Louisville, KY, 40203, USA

    Simone Leavell Bruce

  2. Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA

    Terence H. W. Ching & Monnica T. Williams

  3. Louisville OCD Clinic, Louisville, KY, USA

    Simone Leavell Bruce & Monnica T. Williams

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  1. Simone Leavell Bruce
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  2. Terence H. W. Ching
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Correspondence to Simone Leavell Bruce.

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Bruce, S.L., Ching, T.H.W. & Williams, M.T. Pedophilia-Themed Obsessive–Compulsive Disorder: Assessment, Differential Diagnosis, and Treatment with Exposure and Response Prevention. Arch Sex Behav 47, 389–402 (2018). https://doi.org/10.1007/s10508-017-1031-4

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