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Aspects of Behavior in Pedophillic Sex Offenders Treated with Leuprolide Acetate

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Hormones and Social Behaviour

Part of the book series: Research and Perspectives in Endocrine Interactions ((RPEI))

Abstract

Testosterone-lowering agents, serotonin re-uptake inhibitors, surgical castration, and stereotaxic neurosurgery have been used to reduce libido, deviant sexual arousal and fantasy, and the frequency of deviant sexual behavior in pedophiles. Though classified as a psychosexual disorder, there are strong obsessionand compulsioncomponents that make incorporation of cognitive behavioral skills difficult. Medications that lower sex drive are thought to enhance voluntary control. Leuprolide acetate (LA) has been used for this type of therapy. It is one of several synthesized agonist analogs of luteinizing hormone-releasing hormone (LHRH, aka GnRH), the hypothalamic factor that stimulates gonadotropin release from the pituitary and produces a paradoxical effect on the pituitary,with initial stimulationof the release of luteinizinghormone (LH) and folliclestimulating hormone (FSH) followed by inhibition after repeated administration. LA causes a reduction in testosterone release (a decrease in testicular steroidogenesis) that is probably secondary to a primary reduction in LH levels. With LA, testosterone levels are lower than those attained with other medications. Pedophiles were studied in a placebo-controlled, blinded, multidisciplinary study that detailed the objective effects of this drug onmeasurable aspects of the arousal response. One year of therapy on LA was followed by one year on a saline placebo. Testosterone levels were correlated with outcomes from polygraph testing, plethysmography (PPG) with audio and visual stimuli, viewing time for visual stimuli, and self report of urges and masturbatory frequency toward children. Testosterone levels on LA decreased to less than 50 ng/dl with sustained suppression of testosterone, FSH, and LH for the duration of treatment. On placebo, testosterone levels rose to approach baseline. The study subjects reported decreased sex drive, decreased pedophilic sexual urges, and decreased masturbation frequency when on LA.Modified visual reaction time and PPG indicated no consistent change in pedophilic interest preferences with LA. PPG verified self-reported claims of significant reductions in the magnitude of sexual arousal. LA reduced pedophilic fantasies, urges, and masturbation on self report with polygraph agreement.

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References

  • Anderson RA, Bancroft J, Wu FC (1992) The effects of exogenous testosterone on sexuality and mood of normal men. J Clin Endocrinol Metab 75:1503–1507

    Article  PubMed  CAS  Google Scholar 

  • Bambino TH, Schreiber JR, Hsueh AJ (1980) Gonadotropin-releasing hormone and its agonist inhibit testicular luteinizing hormone receptor and steroidogenesis in immature and adult hypophysectomized rats. Endocrinology 107:908–917

    PubMed  CAS  Google Scholar 

  • Bancroft J (1989) Human sexuality and its problems. Edinburgh, Churchill Livingstone

    Google Scholar 

  • Barbaree HE, Mewhort DJ (1994) The effects of the z-score transformation on measures of relative erectile response strength: a re-appraisal. Behav Res Ther 32:547–558

    Article  PubMed  CAS  Google Scholar 

  • Belchetz PE, Plant TM, Nakai Y, Keogh EJ, Knobil E (1978) Hypophysial responses to continuous and intermittent delivery of hypothalamic gonadotropin-releasing hormone. Science 202:631–633

    Article  PubMed  CAS  Google Scholar 

  • Berger P, Berner W, Bolterauer J, Gutierrez K, Berger K (1999) Sadistic personality disorder in sex offenders: relationship to antisocial personality disorder and sexual sadism. J Personal Disord 13:175–186

    PubMed  CAS  Google Scholar 

  • Bergquist C, Nillius SJ, Wide L (1979) Intranasal gonadotropin-releasing hormone agonist as a contraceptive agent. Lancet 2:215–217

    Article  PubMed  CAS  Google Scholar 

  • Berlin FS (1983). Sex offenders: A biomedical perspective and a status report on biomedical treatment. In: Greer JC, Stuart IR (eds) The sexual aggressor: current perspectives on treatment. New York, Van Nostrand Reinhold Company, pp 82–123

    Google Scholar 

  • Berner W, Karlick-Bolten E (1986) Verlaufsformen der Sexualkriminalität [Development of sex offenders]. Stuttgart, Germany, Ferdinand Enke-Verlag

    Google Scholar 

  • Blanchard R, Barbaree HE (2005) The strength of sexual arousal as a function of the age of the sex offender: comparisons among pedophiles, hebephiles, and teleiophiles. Sex Abuse 17:441–456

    PubMed  Google Scholar 

  • Blanchard R, Watson MS, Choy A, Dickey R, Klassen P, Kuban M, Ferren DJ (1999) Pedophiles: mental retardation, maternal age, and sexual orientation. Arch Sex Behav 28:111–127

    Article  PubMed  CAS  Google Scholar 

  • Blocher D, Henkel K, Retz W, Retz-Junginger P, Thome J, Rösler M (2001) Symptoms from the spectrum of Attention-Deficit/Hyperactivity Disorder (ADHD) in sexual delinquents [German]. Fortschr Neurol Psychiatr 69:453–459

    Article  PubMed  CAS  Google Scholar 

  • Briken P, Kafka MP (2007) Pharmacological treatments for paraphilic patients and sexual offenders. Curr Opin Psychiat 20:609–613

    Google Scholar 

  • Briken P, Nika E, Berner W (2001) Treatment of paraphilia with luteinizing hormone-releasing hormone agonists. J Sex Marital Ther 27:45–55

    Article  PubMed  CAS  Google Scholar 

  • Byrne PM (2000) The reliability and validity of a less explicit audio and “clothed” visual penile plethysmograph set with child molesters and nonoffenders. Unpublished doctoral dissertation, University of Utah, Salt Lake City, Utah.

    Google Scholar 

  • Caldwell JD (2002) A sexual arousability model involving steroid effects at the plasma membrane. Neurosci Biobehav Rev 26:13–30

    Article  PubMed  CAS  Google Scholar 

  • Davidson JM, Camargo CA, Smith ER (1979) Effects of androgen on sexual behavior in hypogonadal men. J Clin Endocrinol Metab 48:955–958

    PubMed  CAS  Google Scholar 

  • Dei M, Verni A, Bigozzi L, Bruni V (1997) Sex steroids and libido. Eur J Contracept Reprod Health Care 2:253–258

    PubMed  CAS  Google Scholar 

  • Evans RM, Doelle GC, Alexander AN, Uderman HD, Rabin D (1984) Gonadotropin and steroid secretory patterns during chronic treatment with a luteinizing hormone-releasing hormone agonist analog in men. J Clin Endocrinol Metab 58:862–867

    PubMed  CAS  Google Scholar 

  • Everaerd W (1993) Male erectile disorder. In: O’Donohue WT, Geer JH (eds) Handbook of sexual dysfunctions: assessment and treatment. Boston: Allyn and Bacon, pp 201–224

    Google Scholar 

  • Freund K, Blanchard R (1989) Phallometric diagnosis of pedophilia. J Consult Clin Psychol 57:100–105

    Article  PubMed  CAS  Google Scholar 

  • Hall RC, Hall RC (2007) A profile of pedophilia: definition, characteristics of offenders, recidivism, treatment outcomes, and forensic issues. Mayo Clin Proc 82:457–471

    PubMed  Google Scholar 

  • Hanson RK, Bussière MT (1998) Predicting relapse: a meta-analysis of sexual offender recidivism studies. J Consult Clin Psychol 66:348–362

    Article  PubMed  CAS  Google Scholar 

  • Hanson RK, Morton-Bourgon KE (2005) The characteristics of persistent sexual offenders: a meta-analysis of recidivism studies. J Consult Clin Psychol 73:1154–1163

    Article  PubMed  Google Scholar 

  • Harris GT, Rice ME, Quinsey VL, Chaplin TC, Earls C (1992) Maximizing the discriminant validity of phallometric assessment data. Psychol Assess 4:502–511

    Article  Google Scholar 

  • Heil P, Ahlmeyer S, Simons D, English K (1999) The impact of polygraphy on admissions of crossover offending behavior in adult sexual offenders. Paper presented at the meeting of The 18th Annual ATSA Research and Treatment Conference, Lake Buena Vista, Florida

    Google Scholar 

  • Hill A, Briken P, Kraus C, Strohm K, Berner W (2003) Differential pharmacological treatment of paraphilias and sex offenders. Int J Offender Ther Comp Criminol 47:407–421

    Article  PubMed  Google Scholar 

  • Ichikawa T, Akimoto S, Shimazaki J (1988) Effect of leuprolide on growth of rat prostatic tumor (R 3327) and weight of male accessory sex organs. Endocrinol Jpn 35:181–187

    PubMed  CAS  Google Scholar 

  • Kraus C, Berner W, Nigbur A (1999) Bezüge der Psychopathy Checklist-Revised (PCL-R) zu den DSM-II-R und ICD-10-Klassifikationen bei Sexualstraftätern [Relations between the Psychopathy Checklist-Revised (PCL-R) and the DSM-III-R and JCD-10 classifications in sexual offenders]. Mschr Krim 82:36–46

    Google Scholar 

  • Krueger RB, Kaplan MS (2001) Depot-leuprolide acetate for treatment of paraphilias: a report of twelve cases. Arch Sex Behav 30:409–422

    Article  PubMed  CAS  Google Scholar 

  • Kuban M, Barbaree HE, Blanchard R (1999). A comparison of volume and circumference phallometry: response magnitude and method agreement. Arch Sex Behav 28:345–359

    Article  PubMed  CAS  Google Scholar 

  • Langevin R (2002) Yes, Virginia, there are real pedophiles: a need to revise and supervise, not eliminate, DSM. Peer Commentaries on Green (2002) and Schmidt (2002). DSM IV, p 488

    Google Scholar 

  • Marshall WL, Fernandez YM (2000) Phallometric testing with sexual offenders: limits to its value. Clin Psychol Rev 20:807–822

    Article  PubMed  CAS  Google Scholar 

  • McConaghy N (1999) Unresolved issues in scientific sexology. Arch Sex Behav 28:285–318

    Article  PubMed  CAS  Google Scholar 

  • McElroy SL, Soutullo CA, Taylor P Jr, Nelson EB, Beckman DA, Brusman LA, Ombaba JM, Strakowski SM, Keck PE Jr (1999) Psychiatric features of 36 men convicted of sexual offenses. J Clin Psychiatry 60:414–420; quiz 421–422

    Google Scholar 

  • Money J (1961) Components of eroticism in man. I. The hormones in relation to sexual morphology and sexual desire. J Nerv Ment Dis 132:239–248

    Article  PubMed  CAS  Google Scholar 

  • Murphy WD, Barbaree HE (1994) Assessments of sex offenders by measures of erectile response: psychometric properties and decision making. Brandon, VT: Safer Society Press.

    Google Scholar 

  • Rice ME, Harris GT (2003) The size and sign of treatment effects in sex offender therapy. Ann NY Acad Sci 989:428–440; discussion 441–445

    Google Scholar 

  • Rösler A, Witztum E (1998) Treatment of men with paraphilia with a long-acting analogue of gonadotropin-releasing hormone. New Engl J Med 338:416–422

    Article  PubMed  Google Scholar 

  • Saleh FM, Berlin FS (2003) Sex hormones, neurotransmitters, and psychopharmacological treatments in men with paraphilic disorders. J Child Sex Abus 12:233–253

    Article  PubMed  Google Scholar 

  • Saleh FM, Guidry LL (2003) Psychosocial and biological treatment considerations for the paraphilic and nonparaphilic sex offender. J Am Acad Psychiatry Law 31:486–493

    PubMed  Google Scholar 

  • Schober JM, Kuhn PJ, Kovacs PG, Earle JH, Byrne PM, Fries RA (2005) Leuprolide acetate suppresses pedophilic urges and arousability. Arch Sex Behav 34:691–705

    Article  PubMed  Google Scholar 

  • Schouten PG, Simon WT (1992) Validity of phallometric measures with sex offenders: comments on the Quinsey, Laws, and Hall debate. J Consult Clin Psychol 60:812–814

    Article  PubMed  CAS  Google Scholar 

  • Smith AD, Taylor PJ (1999) Serious sex offending against women by men with schizophrenia. Relationship of illness and psychotic symptoms to offending. Br J Psychiat 174:233–237

    CAS  Google Scholar 

  • Vaih-Koch SR, Ponseti J, Bosinski HAG (2001) ADHD und Störung des Sozialverhaltens im Kindesalter als Prädiktoren aggressiver Sexualdelinquenz? [ADHD and conduct disorder during childhood and predictors of sexual delinquency?]. Sexuologie 8:1–18

    Google Scholar 

  • van Lunsen RH, Laan E (1997) Sex, hormones and the brain. Eur J Contracept Reprod Health Care 2:247–251

    Article  PubMed  Google Scholar 

  • Vance MA, Smith JA Jr (1984) Endocrine and clinical effects of leuprolide in prostatic cancer. Clin Pharmacol Ther 36:350–354

    PubMed  CAS  Google Scholar 

  • Vilchez-Martinez JA, Coy DH, Arimura A, Coy EJ, Hirotsu Y, Schally AV (1974) Synthesis and biological properties of (Leu-6)-LH-RH and (D-Leu-6,desGly-NH210)-LH-RH ethylamide. Biochem Biophys Res Commun 59:1226–1232

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Hamot Medical Center, Erie, PA, Department of Neurobiology and Behavior, The Rockefeller University, New York, NY, USA

    Justine Schober

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  1. Justine Schober
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Editors and Affiliations

  1. Lab. Neurobiology & Behavior, Rockefeller University, 1230 York Ave, 10021, New York, NY, USA

    Donald W. Pfaff

  2. Institut Necker, 156, rue de Vaugirard, 75015, Paris, France

    Claude Kordon

  3. Endocrinology and Reproductive Diseases, University Hospital Bicêtre, 78, rue du Général Leclerc, 94275, Le Kremlin-Bicêtre, France

    Philippe Chanson

  4. Pour la Recherche Thérapeutique, Fondation IPSEN, 24, rue Erlanger, 75781, Paris, France

    Yves Christen

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Schober, J. (2008). Aspects of Behavior in Pedophillic Sex Offenders Treated with Leuprolide Acetate. In: Pfaff, D., Kordon, C., Chanson, P., Christen, Y. (eds) Hormones and Social Behaviour. Research and Perspectives in Endocrine Interactions. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-79288-8_11

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  • DOI: https://doi.org/10.1007/978-3-540-79288-8_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-79286-4

  • Online ISBN: 978-3-540-79288-8

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