Archives of Sexual Behavior

, Volume 31, Issue 6, pp 511–526 | Cite as

Retrospective Self-Reports of Childhood Accidents Causing Unconsciousness in Phallometrically Diagnosed Pedophiles

  • Ray Blanchard
  • Bruce K. Christensen
  • Scott M. Strong
  • James M. Cantor
  • Michael E. Kuban
  • Philip Klassen
  • Robert Dickey
  • Thomas Blak


The present study investigated whether head injuries in childhood might increase the risk of pedophilia in males. The subjects were 1206 patients referred to a clinical sexology service for assessment of their erotic preferences. These were classified, on the basis of phallometric test results, as pedophilic (n = 413) or nonpedophilic (n = 793). Information regarding early head injuries, other signs of possible neurodevelopmental problems, and parental histories of psychiatric treatment were collected with self-administered questionnaires. The results showed that childhood accidents that resulted in unconsciousness were associated with pedophilia and with lower levels of intelligence and education. These associations were statistically significant for accidents that occurred before the age of 6, but not for accidents that occurred between the ages of 6 and 12. These results are compatible with the hypothesis that neurodevelopmental perturbations in early childhood may increase the risk of pedophilia. They are also, however, compatible with the alternative explanation that prior neurodevelopmental problems lead to accident-proneness and head injury, on the one hand, and to pedophilia, on the other, and that head injury has no causal influence on pedophilia. A secondary finding was that the pedophiles were more likely to report that their mothers had undergone psychiatric treatment. This finding suggests that pedophilia may be influenced by genetic factors, which are manifested in women as an increased risk of psychiatric problems, and in their sons, as an increased risk of erotic interest in children.

childhood accidents head injury neuropsychology pedophilia phallometry sex offenders 


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  1. Almli, C. R., & Finger, S. (1984). Early brain damage: Vol. 1. Research orientations and clinical observations. New York: Academic Press.Google Scholar
  2. Anderson, S. A., Classey, J. D., Conde, F., Lund, J. S., & Lewis, D. A. (1995). Synchronous development of pyramidal neuron dendritic spines and parvalbumin-immunoreactive chandelier neuron axon terminal in layer III of monkey prefrontal cortex. Neuroscience, 67, 7–22.Google Scholar
  3. Aram, D. M., & Eisele, J. A. (1992). Plasticity and recovery of higher cognitive functions following early brain injury. In I. Rapin & S. J. Segalowitz (Eds.), Handbook of neuropsychology (Vol. 6, pp. 73–92). Amsterdam: Elsevier.Google Scholar
  4. Barbaree, H. E., & Seto, M. C. (1997). Pedophilia: Assessment and treatment. In D. R. Laws & W. O'Donohue (Eds.), Sexual deviance: Theory, assessment, and treatment (pp. 175–193). New York: Guilford Press.Google Scholar
  5. Barkley, R. A. (1996). Attention-deficit/hyperactivity disorder. In E. Mash & R. A. Barkley (Eds.), Child psychopathology (pp. 63–112). New York: Guilford Press.Google Scholar
  6. Bates, E., Reilly, J., Wulfreck, B., Dronkers, N., Opie, M., Fenson, J., et al. (2001). Differential effects of unilateral lesions on language production in children and adults. Brain and Language; 79, 223–265.Google Scholar
  7. Biro, V., & Stukovsky, R. (1995). Handedness as manifested in school children from a region polluted by neurotoxins. Studia Psychologica, 37, 81–87.Google Scholar
  8. Blanchard, R. (1989). The concept of autogynephilia and the typology of male gender dysphoria. Journal of Nervous and Mental Disease; 177, 616–623.Google Scholar
  9. Blanchard, R. (1998). Cross-Gender Fetishism Scale. In C. M. Davis, W. L. Yarber, R. Bauserman, G. Schreer, & S. L. Davis (Eds.), Handbook of sexuality-related measures (pp. 581–582). Thousand Oaks, CA: Sage.Google Scholar
  10. Blanchard, R. (2001). Fraternal birth order and the maternal immune hypothesis of male homosexuality. Hormones and Behavior; 40, 105–114.Google Scholar
  11. Blanchard, R., & Ellis, L. (2001). Birth weight, sexual orientation and the sex of preceding siblings. Journal of Biosocial Science; 33, 451–467.Google Scholar
  12. Blanchard, R., Klassen, P., Dickey, R., Kuban, M. E., & Blak, T. (2001). Sensitivity and specificity of the phallometric test for pedophilia in nonadmitting sex offenders. Psychological Assessment; 13, 118–126.Google Scholar
  13. Blanchard, R., Watson, M. S., Choy, A., Dickey, R., Klassen, P., Kuban, M., et al. (1999). Pedophiles: Mental retardation, maternal age, and sexual orientation. Archives of Sexual Behavior; 28, 111–127.Google Scholar
  14. Blanchard, R., Zucker, K. J., Cavacas, A., Allin, S., Bradley, S. J., & Schachter, D. C. (2002). Fraternal birth order and birth weight in probably prehomosexual feminine boys. Hormones and Behavior; 41, 321–327.Google Scholar
  15. Bogaert, A. F. (2001). Handedness, criminality, and sexual offending. Neuropsychologia; 39, 465–469.Google Scholar
  16. Brown, G., Chadwick, O., Shaffer, D., Rutter, M., & Traub, M. (1981). A prospective study of children and head injuries: III. Psychiatric sequelae. Psychological Medicine; 11, 63–78.Google Scholar
  17. Cantor, J. M., Blanchard, R., Paterson, A. D., & Bogaert, A. F. (2002). How many gay men owe their sexual orientation to fraternal birth order? Archives of Sexual Behavior; 31, 63–71.Google Scholar
  18. Cantor, J. M., Christensen, B. K., Klassen, P. E., Dickey, R., & Blanchard, R. (2001, July). Neuropsychological functioning in pedophiles. In R. Blanchard (Chair), Diagnosis, prognosis, and etiology of pedophilia. Symposium conducted at the meeting of the International Academy of Sex Research, Bromont, Quebec.Google Scholar
  19. Caviness, V. S. (1989). Normal development of cerebral neocortex. In P. Evrard & A. Minkowski (Eds.), Developmental neurobiology (pp. 1–10). New York: Raven Press.Google Scholar
  20. Chapman, B. S., & McKinnon, L. (2000). Discussion of developmental plasticity: Factors affecting cognitive outcome after pediatric brain injury. Journal of Communication Disorders; 33, 333–344.Google Scholar
  21. Coren, S. (1994). Twinning is associated with an increased risk of left-handedness and inverted writing hand posture. Early Human Development; 40, 23–27.Google Scholar
  22. Coren, S., & Halpern, D. (1991). Left-handedness: A marker for decreased survival fitness. Psychological Bulletin, 109, 90–106.Google Scholar
  23. Dennis, M., & Barnes, M. A. (1994). Neuropsychologic function in same-sex twins discordant for perinatal brain damage. Journal of Developmental and Behavioral Pediatrics, 15, 124–130.Google Scholar
  24. DiScala, C., Lescohier, I., Barthel, M., & Li, G. (1998). Injuries to children with attention deficit hyperactivity disorder. Pediatrics; 102, 1415–1421.Google Scholar
  25. Earls, C. M., Quinsey, V. L., & Castonguay, L. G. (1987). A comparison of three methods of scoring penile circumference changes. Archives of Sexual Behavior; 16, 493–500.Google Scholar
  26. Ellis, A. (1951). A study of 300 sex offenders. International Journal of Sexology; 4, 127–134.Google Scholar
  27. Finger, S., & Almli, C. R. (1984). Early brain damage: Vol. 2. Neurobiology and behavior. New York: Academic Press.Google Scholar
  28. Fisch, G. S., Simensen, R., Tarleton, J., Chalifoux, M., Holden, J. J., Carpenter, N., et al. (1996). Longitudinal study of cognitive abilities and adaptive behavior levels in fragile X males: A prospective multicenter analysis. American Journal of Medical Genetics, 64, 356–361.Google Scholar
  29. Freund, K. (1967). Diagnosing homo-or heterosexuality and erotic agepreference by means of a psychophysiological test. Behaviour Research and Therapy; 5, 209–228.Google Scholar
  30. Freund, K. (1981). Assessment of pedophilia. In M. Cook & K. Howells (Eds.), Adult sexual interest in children (pp. 139–179). London: Academic Press.Google Scholar
  31. Freund, K., & Blanchard, R. (1983). Is the distant relationship of fathers and homosexual sons related to the sons' erotic preference for male partners, or to the sons' atypical gender identity, or to both? Journal of Homosexuality; 9, 7–25.Google Scholar
  32. Freund, K., & Blanchard, R. (1989). Phallometric diagnosis of pedophilia. Journal of Consulting and Clinical Psychology; 57, 100–105.Google Scholar
  33. Freund, K., & Blanchard, R. (1998). Gender identity and erotic preference in males. In C. M. Davis, W. L. Yarber, R. Bauserman, G. Schreer, & S. L. Davis (Eds.), Handbook of sexuality-related measures (pp. 454–462). Thousand Oaks, CA: Sage.Google Scholar
  34. Freund, K., Scher, H., & Hucker, S. (1983). The courtship disorders. Archives of Sexual Behavior; 12, 369–379.Google Scholar
  35. Freund, K., & Watson, R. J. (1991). Assessment of the sensitivity and specificity of a phallometric test: An update of phallometric diagnosis of pedophilia. Psychological Assessment; 3, 254–260.Google Scholar
  36. Frosh, J., & Bromberg, W. (1939). The sex offender—A psychiatric study. American Journal of Orthopsychiatry; 9, 761–776.Google Scholar
  37. Frydman, M. (1996). The smoking addiction of pregnant women and the consequences on their offspring's intellectual development. Journal of Environmental Pathology, Toxicology, and Oncology, 15, 169–172.Google Scholar
  38. Gerring, J. P., Brady, K., Chen, A., Vasa, R., Grados, M., Bandeen-Roche, K. J., et al. (1998). Premorbid prevalence of ADHD and development of secondary ADHD after closed head injury. Journal of the American Academy of Child and Adolescent Psychiatry; 37, 647–654.Google Scholar
  39. Gottfried, A. W. (1973). Intellectual consequences of perinatal anoxia. Psychological Bulletin, 80, 231–242.Google Scholar
  40. Hambridge, J. A. (1994). Pedophiles' ratings of adult and child photographs using a semantic differential. Journal ofForensic Sciences; 39, 456–461.Google Scholar
  41. Harris, G. T., Rice, M. E., Quinsey, V. L., Chaplin, T. C., & Earls, C. (1992). Maximizing the discriminant validity of phallometric assessment data. Psychological Assessment; 4, 502–511.Google Scholar
  42. Hayes, A., & Batshaw, M. L. (1993). Down syndrome. Pediatric Clinics of North America, 40, 523–535.Google Scholar
  43. Henn, F. A., Herjanic, M., & Vanderpearl, R. H. (1976). Forensic psychiatry: Profiles of two types of sex offenders. American Journal of Psychiatry; 133, 694–696.Google Scholar
  44. Henry, P. C., Hauber, R. P., & Rice, M. (1992). Factors associated with closed head injury in a pediatric population. Journal of Neuroscience Nursing; 24, 311–316.Google Scholar
  45. Hepper, P. G., Shahidullah, S., & White, R. (1991). Handedness in the human fetus. Neuropsychologia; 29, 1107–1111.Google Scholar
  46. Hucker, S., Langevin, R., Wortzman, G., Dickey, R., Bain, J., Handy, L., et al. (1988). Cerebral damage and dysfunction in sexually aggressive men. Annals of Sex Research; 1, 33–47.Google Scholar
  47. Jernigan, T. L., & Sowell, E. R. (1997). Magnetic resonance imaging studies of developing brain. In M. S. Keshavan & R. M. Murray (Eds.), Neurodevelopment and adult psychopathology (pp. 63–70). New York: Cambridge University Press.Google Scholar
  48. Kennard, M. (1938). Reorganization of motor function in the cerebral cortex of monkeys deprived of motor and premotor areas in infancy. Journal of Neurophysiology; 1, 477–496.Google Scholar
  49. Kieler, H., Cnattingius, S., Haglund, B., Palmgren, J., & Axelsson, O. (2001). Sinistrality-a side-effect of prenatal sonography: A comparative study of young men. Epidemiology; 12, 618–623.Google Scholar
  50. Kolb, B., Gibb, R., & Gorny, G. (2000). Cortical plasticity and the development of behavior after early frontal cortical injury. Developmental Neuropsychology, 18, 423–444.Google Scholar
  51. Koskiniemi, M., Kyykkä, T., Nybo, T., & Jarho, L. (1995). Long-term outcome after severe brain injury in preschoolers is worse than expected. Archives ofPediatric and Adolescent Medicine; 149, 249–254.Google Scholar
  52. Kozma, C. (1998). Oncognitive variability in velocardiofacial syndrome: profound mental retardation and autism. American Journal of Medical Genetics, 81, 269–270.Google Scholar
  53. Kraus, J., & McArthur, D. (1996). Epidemiologic aspects of brain injury. Neurological Clinics; 14, 435–450.Google Scholar
  54. Kuban, M., Barbaree, H. E., & Blanchard, R. (1999). A comparison of volume and circumference phallometry: Response magnitude and method agreement. Archives of Sexual Behavior; 28, 345–359.Google Scholar
  55. Langevin, R. (1985). Introduction. In R. Langevin (Ed.), Erotic preference, gender identity, and aggression in men: New research studies (pp. 1–13). Hillsdale, NJ: Erlbaum.Google Scholar
  56. Langevin, R., Hucker, S. J., Handy, L., Purins, J. E., Russon, A. E., & Hook, H. J. (1985). Erotic preference and aggression in pedophilia: A comparison of heterosexual, homosexual, and bisexual types. In R. Langevin (Ed.), Erotic preference, gender identity, and aggression in men: New research studies (pp. 137–159). Hillsdale, NJ: Erlbaum.Google Scholar
  57. Langevin, R., Wortzman, G., Dickey, R., Wright, P., & Handy, L. (1988). Neuropsychological impairment in incest offenders. Annals of Sex Research; 1, 401–415.Google Scholar
  58. Langevin, R., Wortzman, G., Wright, P., & Handy, L. (1989). Studies of brain damage and dysfunction in sex offenders. Annals of Sex Research; 2, 163–179.Google Scholar
  59. Levin, H. S., Fletcher, J. M., Kusnerik, L., Kufera, J. A., Lilly, M. A., Duffy, F. F., et al. (1996). Semantic memory following pediatric head injury: Relationship to age, severity of injury, and MRI. Cortex; 32, 461–478.Google Scholar
  60. Lewis, D. A. (1997). Development of the primate prefrontal cortex. In M. S. Keshavan & R. M. Murray (Eds.), Neurodevelopment and adult psychopathology (pp. 12–30). New York: Cambridge University Press.Google Scholar
  61. Lund, J. S. (1997). Development of the cerebral cortex: an overview. In M. S. Keshavan & R. M. Murray (Eds.), Neurodevelopment and adult psychopathology (pp. 3–11). New York: Cambridge University Press.Google Scholar
  62. Lund, J. S., & Lewis, D. A. (1993). Local circuit neurons of developing and mature macaque prefrontal cortex: Golgi and immunocytochemical characteristics. Journal of Comparative Neurology, 328, 282–312.Google Scholar
  63. Mahoney, W. J., D'Souza, B. J., Haller, A., Rogers, M. C., Epstein, M. H., & Freeman, J. M. (1983). Long-term outcome of children with severe head trauma and prolonged coma. Pediatrics; 71, 756–762.Google Scholar
  64. Marlow, M., Roberts, B. L., & Cooke, R. W. I. (1989). Laterality and prematurity. Archives of Disease in Childhood, 64, 1713–1716.Google Scholar
  65. Needleman, H. L, Schell, A., Bellinger, D., Leviton, A., & Allred, E. N. (1990). The long-term effects of exposure to low doses of lead in childhood. An 11-year follow-up report. New England Journal of Medicine, 322, 83–88.Google Scholar
  66. Neyens, L. G., Aldenkamp, A. P., & Meinardi, H. M. (1999). Prospective follow-up of intellectual development in children with a recent onset of epilepsy. Epilepsy Research, 34, 85–90.Google Scholar
  67. Olson, H. C., Feldman, J. J., Streissguth, A. P., Sampson, P. D., & Bookstein, F. L. (1998). Neuropsychological deficits in adolescents with fetal alcohol syndrome: Clinical findings. Alcoholism: Clinical and Experimental Research, 22, 1998-dy2012.Google Scholar
  68. Overgaard, J., Christensen, S., Hvid-Hansen, O., Haase, J., Land, A., Hein, O., et al. (1973). Prognosis after head injury based on early clinical examination. Lancet; 2, 631–635.Google Scholar
  69. Pfefferbaum, A., Mathalon, D. H., Sullivan, E. V., Rawles, J. M., Zipursky, R. B., & Lim, K. O. (1994). A quantitative magnetic resonance imaging study of changes in brain morphology from infancy to late adulthood. Archives of Neurology, 51, 874–887.Google Scholar
  70. Plant, T. M. (1988). Neuroendocrine basis of puberty in the rhesus monkey (Macaca mulatta). In L. Martin & W. F. Ganong (Eds.), Frontiers in neuroendocrinology (Vol. 10, pp. 215–238). New York: Raven Press.Google Scholar
  71. Quinsey, V. L., Arnold, L. S., & Pruesse, M. G. (1980). MMPI profiles of men referred for a pretrial psychiatric assessment as a function of offense type. Journal of Clinical Psychology; 36, 410–416.Google Scholar
  72. Radcliffe, J., Bunin, G. R., Sutton, L. N., Goldwein, J. W., & Phillips, P. C. (1994). Cognitive deficits in long-term survivors of childhood medulloblastoma and other noncortical tumors: Age-dependent effects of whole brain radiation. International Journal of Developmental Neuroscience, 12, 327–334.Google Scholar
  73. Saigal, S., Rosenbaum, P., Szatmari, P., & Hoult, L. (1992). Non-right handedness among ELBW and term children at eight years in relation to cognitive function and school performance. Developmental Medicine and Child Neurology; 34, 425–433.Google Scholar
  74. Scott, M. L., Cole, J. K., McKay, S. E., Golden, C. J., & Liggett, K. R. (1984). Neuropsychological performance of sexual assaulters and pedophiles. Journal of Forensic Sciences; 29, 1114–1118.Google Scholar
  75. Taylor, H. G., Yeates, K. O., Wade, S. L., Drotar, D., Klein, S. K., & Stancin, T. (1999). Influences of first-year recovery from traumatic brain injury in children. Neuropsychology, 13, 76–89.Google Scholar
  76. Wesseling, J., VanDriel, D., Heymans, H. S., Rosendaal, F. R., Geven-Boere, L. M., Smrkovsky, M., et al. (2001). Coumarins during pregnancy: long-term effects on growth and development of school-age children. Thrombosis and Haemostasis; 85, 609–613.Google Scholar
  77. Williams, C. S., Buss, K. A., & Eskenazi, B. (1992). Infant resuscitation is associated with an increased risk of left-handedness. American Journal of Epidemiology; 136, 277–286.Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Ray Blanchard
    • 1
    • 2
  • Bruce K. Christensen
    • 3
    • 2
  • Scott M. Strong
    • 1
    • 3
  • James M. Cantor
    • 1
  • Michael E. Kuban
    • 1
  • Philip Klassen
    • 1
    • 2
  • Robert Dickey
    • 1
    • 2
  • Thomas Blak
    • 1
  1. 1.Law and Mental Health ProgramCentre for Addiction and Mental HealthTorontoCanada
  2. 2.Department of Psychiatry, Faculty of MedicineUniversity of TorontoTorontoCanada
  3. 3.Schizophrenia and Continuing Care ProgramCentre for Addiction and Mental HealthTorontoCanada

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