Archives of Sexual Behavior

, Volume 47, Issue 2, pp 389–402 | Cite as

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

  • Simone Leavell Bruce
  • Terence H. W. Ching
  • Monnica T. Williams
Original Paper


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.


Obsessive–compulsive disorder Pedophilia Exposure and response prevention DSM-5 



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.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of PsychologySpalding UniversityLouisvilleUSA
  2. 2.Department of Psychological SciencesUniversity of ConnecticutStorrsUSA
  3. 3.Louisville OCD ClinicLouisvilleUSA

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