Assessment of pedophilia using hemodynamic brain response to sexual stimuli

Arch Gen Psychiatry. 2012 Feb;69(2):187-94. doi: 10.1001/archgenpsychiatry.2011.130. Epub 2011 Oct 3.


Context: Accurately assessing sexual preference is important in the treatment of child sex offenders. Phallometry is the standard method to identify sexual preference; however, this measure has been criticized for its intrusiveness and limited reliability.

Objective: To evaluate whether spatial response pattern to sexual stimuli as revealed by a change in the blood oxygen level-dependent signal facilitates the identification of pedophiles.

Design: During functional magnetic resonance imaging, pedophilic and nonpedophilic participants were briefly exposed to same- and opposite-sex images of nude children and adults. We calculated differences in blood oxygen level-dependent signals to child and adult sexual stimuli for each participant. The corresponding contrast images were entered into a group analysis to calculate whole-brain difference maps between groups. We calculated an expression value that corresponded to the group result for each participant. These expression values were submitted to 2 different classification algorithms: Fisher linear discriminant analysis and κ -nearest neighbor analysis. This classification procedure was cross-validated using the leave-one-out method.

Setting: Section of Sexual Medicine, Medical School, Christian Albrechts University of Kiel, Kiel, Germany.

Participants: We recruited 24 participants with pedophilia who were sexually attracted to either prepubescent girls (n = 11) or prepubescent boys (n = 13) and 32 healthy male controls who were sexually attracted to either adult women (n = 18) or adult men (n = 14).

Main outcome measures: Sensitivity and specificity scores of the 2 classification algorithms.

Results: The highest classification accuracy was achieved by Fisher linear discriminant analysis, which showed a mean accuracy of 95% (100% specificity, 88% sensitivity).

Conclusions: Functional brain response patterns to sexual stimuli contain sufficient information to identify pedophiles with high accuracy. The automatic classification of these patterns is a promising objective tool to clinically diagnose pedophilia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brain / blood supply
  • Brain / physiopathology*
  • Case-Control Studies
  • Child
  • Female
  • Heterosexuality / physiology
  • Heterosexuality / psychology
  • Homosexuality, Male / psychology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pedophilia / diagnosis*
  • Pedophilia / physiopathology
  • Pedophilia / psychology
  • Sexual Behavior / physiology
  • Young Adult