Health care professionals’ view on pedophilic disorder: a qualitative study

Abstract

In the last few years there has been a shift in the view on pedophilia and its treatment in international diagnostic manuals and expert consensus documents. This study seeks to investigate the approach of health care professionals’ on some of the topics that are mostly debated: whether pedophilia without distress or acting out should be considered a mental disorder, whether there can be a changeability of pedophilic sexual interest over life and what the main aim of treatment should be. Qualitative content analysis was used to analyze the responses in semi-structured interviews of eight Swedish health care professionals with significant clinical experience from this patient category. These results suggest that there is a lack of consensus regarding all three topics, and that the opinions of the experienced health care professionals did not fully comply with the international experts agreements. This might lead to differences in clinical practice depending on who meets the patient, it can make the patients unsure about how they will be treated if they seek help, and it demonstrates a gap between published international research and clinical practice.

Keywords:

• Pedophilia
• expert opinion
• diagnostic and statistical manual of mental disorders
• goals of care
• sexual orientation

Acknowledgements

We would like to express our sincere thanks to all professionals who agreed to be interviewed and to share their experiences gained in many years.

Disclosure statement

The authors declare that there is no conflict of interest.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Notes on contributors

Gökçe Bayram

Gökçe Bayram is a sixth-year undergraduate medical student at Ankara Yildirim Beyazit University, where she continues her education. She has interests in sexual medicine and psychiatric approaches. She is the corresponding author of this article.

Allison McMahan

Allison McMahan is a Therapist at Psychiatry South Stockholm with a masters degree in Clinical Behavioral Psychology from Eastern Michigan University. She works in the project Prevent It, a randomized clinical therapy trial conducted to establish an evidenced based Cognitive Behavioral therapy for persons who view child sexual abuse material.

Niklas Juth

Niklas Juth is an associate professor in medical ethics at Karolinska Institutet. His main research interests are in ethics and bioethics, genethics, and the intersection between political philosophy and medical ethics, e.g. autonomy and justice in health care. Currently involved in the Stockholm Centre for Health Care Ethics (CHE) project “Prioritizing in Health Care: The Reasonableness and Applicability of the Principles of Cost-Efficiency, Need, and Responsibility” as researcher. He is currently teaching on e.g. The ethics of medical research and the philosophy of medical science, Autonomy and justice in medicine, and The ethics of pre- and neonatal medicine at Karolinska institute.

Christoffer Rahm

Christoffer works as chief psychiatrist at Psychiatry South Stockholm, Sweden. He's now the Principal Investigator of Priotab and Prevent-IT, two academically initiated clinical trials at Karolinska University Hospital, Stockholm, on pharmaceutical and psychotherapeutical methods to reduce the risk of men with pedophilia committing child sexual abuse. Christoffer is lecturer in psychiatry and the author of Neurovetenskaplig Psykiatri (Natur och Kultur, 2018), a textbook in Swedish on neuroscientific psychiatry.