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Cantor, J. M. (2011, November). Brain research and pedophilia:
What it means for assessment, treatment, and policy.
Plenary address presented to the 30th Annual Meeting of the
Association for the Treatment of Sexual Abusers, Toronto,
Canada. Lecture slides retrieved from
http://individual.utoronto.ca/james_cantor/cantorplenary.ppt
Updates via twitter @JamesCantorPhD
Brain Research and Pedophilia:Brain Research and Pedophilia:
What it means for assessment, What it means for assessment, treatment, and policytreatment, and policy
James M. Cantor,James M. Cantor, PhD PhD
Head of Research, CAMH Sexual Behaviours ClinicHead of Research, CAMH Sexual Behaviours ClinicAssociate Professor of Psychiatry, University of TorontoAssociate Professor of Psychiatry, University of Toronto
Editor-in-Chief, Editor-in-Chief, Sexual Abuse: A Journal of Research and TreatmentSexual Abuse: A Journal of Research and Treatment
The Big QuestionsThe Big Questions
Is it in the brain? Is it in the brain? Can we treat it?Can we treat it?
Is it in the genes?Is it in the genes?
Were they born with it? Were they born with it?
Does it run in families?Does it run in families?
Can it change? Can it change? Are they responsible for it?Are they responsible for it?
Can we prevent it?Can we prevent it?
1886 Founding of modern sexology
1900–2000 Large scale studies of forensic samples
1980–1999 Neuropsych testing, early imaging (CT) studies
1999 First neuroimaging study of sexual arousal
2000– Large-scale studies of homogeneous samples
2007–2008 High-resolution studies of pedophilia published
2007 First fMRI studies of pedophilia published
Sexual Offending and the Brain: HistorySexual Offending and the Brain: History
Richard von Krafft-Ebing (1840Richard von Krafft-Ebing (1840–1902–1902))
Richard von Krafft-Ebing (1840Richard von Krafft-Ebing (1840–1902–1902))
Psychopathia Sexualis (1886)
Richard von Krafft-Ebing (1840Richard von Krafft-Ebing (1840–1902–1902))
Sexual anomalies are a“diseased condition of the
central nervous system” (p. 61).
Psychopathia Sexualis (1886)
1886 Founding of modern sexology
1900–2000 Large scale studies of forensic samples
1980–1999 Neuropsych testing, early imaging (CT) studies
1999 First neuroimaging study of sexual arousal
2007–2008 High-resolution studies of pedophilia published
2007 First fMRI studies of pedophilia published
Sexual Offending and the Brain: HistorySexual Offending and the Brain: History
Meta-Analysis of all reports, 1931–2004
• 75 reports with IQ data• 236 non-overlapping samples• 25,146 cases (7,045 sexual offenders and 18,101 controls)
IQ FindingsIQ Findings
—Cantor, Blanchard, Robichaud, & Christensen (2005). Psychological Bulletin, 131, 555–568.
85
90
95
100
105
110
SexualOffenders
AgainstChildren
SexualOffenders
Against Adults
NonsexualOffenders
Nonoffenders SexualOffenders,
Victims' AgesMixed orUnknown
Adj
uste
d M
ean
IQ S
core
(s.
e.)
IQ of Adult Samples by Victims’ Age Group IQ of Adult Samples by Victims’ Age Group
—Cantor, Blanchard, Robichaud, & Christensen (2005). Psychological Bulletin, 131, 555–568.
85
90
95
100
105
110
SexualOffenders
AgainstChildren
SexualOffenders
Against Adults
NonsexualOffenders
Nonoffenders SexualOffenders,
Victims' AgesMixed orUnknown
Adj
uste
d M
ean
IQ S
core
(s.
e.)
IQ of Adult Samples by Victims’ Age Group IQ of Adult Samples by Victims’ Age Group
—Cantor, Blanchard, Robichaud, & Christensen (2005). Psychological Bulletin, 131, 555–568.
F (4, 158) = 7.74p < .0001
k=56 k=8 k=53 k=12 k=36
IQ by Definition of “Child” VictimIQ by Definition of “Child” Victim
85
90
95
100
105
110
115
12 13 14 15 16 17 18 19
Cutoff Defining "child"
Sam
ples
' Mea
n IQ
r (29) = .50p = .005
—Cantor, Blanchard, Robichaud, & Christensen (2005). Psychological Bulletin, 131, 555–568.
1886 Founding of modern sexology
1900–2000 Large scale studies of forensic samples
1980–1999 Neuropsych testing, early imaging (CT) studies
1999 First neuroimaging study of sexual arousal
2007–2008 High-resolution studies of pedophilia published
2007 First fMRI studies of pedophilia published
Sexual Offending and the Brain: HistorySexual Offending and the Brain: History
Frontal Lobe vs. Temporal Lobe TheoriesFrontal Lobe vs. Temporal Lobe Theories
Frontal Lobe vs. Temporal Lobe TheoriesFrontal Lobe vs. Temporal Lobe Theories
Frontal Lobe vs. Temporal Lobe TheoriesFrontal Lobe vs. Temporal Lobe Theories
Inhibition/self-control
The 4 F’s
Halstead-Reitan Battery
Yeudall (1977) RapistsYeudall et al. (1979) HeterogeneousLangevin et al. (1985) SadistsLangevin et al. (1988) Sexual killers, aggressivesLangevin et al. (1989) Exhibitionists
Luria-Nebraska Battery
Graber et al. (1982) HeterogeneousScott et al. (1984) Offenders vs. children, adultsHucker et al. (1986) PedophilesHucker et al. (1988) Sadists, sexual aggressivesLangevin et al. (1988) Sexual killers, aggressivesGalski et al. (1990) Heterogeneous
Neuropsychological BatteriesNeuropsychological Batteries
Halstead-Reitan Battery
Yeudall (1977) RapistsYeudall et al. (1979) HeterogeneousLangevin et al. (1985) SadistsLangevin et al. (1988) Sexual killers, aggressivesLangevin et al. (1989) Exhibitionists
Luria-Nebraska Battery
Graber et al. (1982) HeterogeneousScott et al. (1984) Offenders vs. children, adultsHucker et al. (1986) PedophilesHucker et al. (1988) Sadists, sexual aggressivesLangevin et al. (1988) Sexual killers, aggressivesGalski et al. (1990) Heterogeneous
Neuropsychological BatteriesNeuropsychological Batteries
Indications of general impairment.No reliable localization.
Trail-MakingBowden (1987)Cohen et al. (2002)Dolan et al. (2002)Knox-Jones (1994)Langevin et al. (1989)Stone & Thompson (2001)Tarter et al. (1983)Yeudall et al. (1987)
StroopCohen et al. (2002)Dolan et al. (2002)Stone & Thompson (2001)Gillespie & Mckenzie (2000)
Wisconsin Card SortCohen et al. (2002)Dolan et al. (2002)Kruger & Schiffer (2011)Miller (1997)Rubenstein (1992)Stone & Thompson (2001)Westergren (2002)Yeudall et al. (1987)
Bender Gestalt TestLewis et al. (1979)Yeudall et al. (1986)
Controlled Oral Word Assoc.Cohen et al. (2002)Dolan et al. (2002)Gillespie & Mckenzie (2000)Knox-Jones (1994)Rubenstein (1992)Stone & Thompson (2001)Yeudall et al. (1987)
Wechsler Memory ScaleDolan et al. (2002)Knox-Jones (1994)Langevin et al. (1989)Rubenstein (1992)Tarter et al. (1983)
Williams Verbal Learning TestAbracen et al. (1991)Baker (1985)O’Carroll (1989)Yeudall et al. (1986)
Finger-TappingKnox-Jones (1994)Langevin et al. (1989)Tarter et al. (1983)Yeudall et al. (1986)
Individual Neuropsychological TestsIndividual Neuropsychological Tests
Trail-MakingBowden (1987)Cohen et al. (2002)Dolan et al. (2002)Knox-Jones (1994)Langevin et al. (1989)Stone & Thompson (2001)Tarter et al. (1983)Yeudall et al. (1987)
Individual Neuropsychological TestsIndividual Neuropsychological Tests
StroopCohen et al. (2002)Dolan et al. (2002)Stone & Thompson (2001)Gillespie & Mckenzie (2000)
Bender Gestalt TestLewis et al. (1979)Yeudall et al. (1986)
Controlled Oral Word Assoc.Cohen et al. (2002)Dolan et al. (2002)Gillespie & Mckenzie (2000)Knox-Jones (1994)Rubenstein (1992)Stone & Thompson (2001)Yeudall et al. (1987)
Wechsler Memory ScaleDolan et al. (2002)Knox-Jones (1994)Langevin et al. (1989)Rubenstein (1992)Tarter et al. (1983)
Williams Verbal Learning TestAbracen et al. (1991)Baker (1985)O’Carroll (1989)Yeudall et al. (1986)
Finger-TappingKnox-Jones (1994)Langevin et al. (1989)Tarter et al. (1983)Yeudall et al. (1986)
Wisconsin Card SortCohen et al. (2002)Dolan et al. (2002)Kruger & Schiffer (2011)Miller (1997)Rubenstein (1992)Stone & Thompson (2001)Westergren (2002)Yeudall et al. (1987)
Trail-MakingBowden (1987)Cohen et al. (2002)Dolan et al. (2002)Knox-Jones (1994)Langevin et al. (1989)Stone & Thompson (2001)Tarter et al. (1983)Yeudall et al. (1987)
Individual Neuropsychological TestsIndividual Neuropsychological Tests
StroopCohen et al. (2002)Dolan et al. (2002)Stone & Thompson (2001)Gillespie & Mckenzie (2000)
Bender Gestalt TestLewis et al. (1979)Yeudall et al. (1986)
Controlled Oral Word Assoc.Cohen et al. (2002)Dolan et al. (2002)Gillespie & Mckenzie (2000)Knox-Jones (1994)Rubenstein (1992)Stone & Thompson (2001)Yeudall et al. (1987)
Wechsler Memory ScaleDolan et al. (2002)Knox-Jones (1994)Langevin et al. (1989)Rubenstein (1992)Tarter et al. (1983)
Williams Verbal Learning TestAbracen et al. (1991)Baker (1985)O’Carroll (1989)Yeudall et al. (1986)
Finger-TappingKnox-Jones (1994)Langevin et al. (1989)Tarter et al. (1983)Yeudall et al. (1986)
Wisconsin Card SortCohen et al. (2002)Dolan et al. (2002)Kruger & Schiffer (2011)Miller (1997)Rubenstein (1992)Stone & Thompson (2001)Westergren (2002)Yeudall et al. (1987)
Indications of general impairment.(Methodological confound?)
No reliable localization.
CT studies
Graber et al. (1982) Offenders vs. women, children
Langevin et al. (1985) Sadists, nonsadistic offenders
Hucker et al. (1986) PedophilesHendricks et al. (1988) Offenders vs. childrenHucker et al. (1988) Sadists, nonsadistic vs.
womenLangevin et al. (1988) Incest offendersLangevin et al. (1989) PedophilesWright et al. (1990) Offenders vs. women,
pedophiles, incest offenders,
nonsex offenders
Early Brain ImagingEarly Brain Imaging
Early Brain ImagingEarly Brain Imaging
CT studies
Early Brain ImagingEarly Brain Imaging
CT studies
Indications of diffuse neuropathy.No reliable localization.
Contemporary Neuropsychology and BiometricsContemporary Neuropsychology and Biometrics
85
90
95
100
105
110
Pedophiles(n=47)
Hebephiles (n=158)
Teleiophiles(n=93)
Me
an
(S
E)
Fu
ll-S
cale
IQ
Covariates: F (2, 293) = 6.77 age, age@ESL p = .001
Intelligence Quotient (IQ)Intelligence Quotient (IQ)
—Cantor, Blanchard, Christensen, Dickey, et al. (2004). Neuropsychology, 18, 3–14.
Verbal Memory by Phallometric GroupVerbal Memory by Phallometric Group
20
21
22
23
24
25
Pedophiles(n=47)
Hebephiles (n=161)
Teleiophiles(n=94)
Me
an
(S
E)
HV
LT
-R T
ota
l R
ec
all Covariates: F (2, 297) = 5.08
age, age @ ESL p = .007
—Cantor, Blanchard, Christensen, Dickey, et al. (2004). Neuropsychology, 18, 3–14.
Visuospatial Memory by Phallometric GroupVisuospatial Memory by Phallometric Group
15
16
17
18
19
20
21
22
23
24
25
Pedophiles(n=43)
Hebephiles (n=138)
Teleiophiles(n=79)
Me
an
(S
E)
BV
MT
-R T
ota
l R
ec
all Covariates: F (2, 255) = 6.51
age, age @ ESL p = .002
—Cantor, Blanchard, Christensen, Dickey, et al. (2004). Neuropsychology, 18, 3–14.
Proportions Failing or in Special Ed. by GroupProportions Failing or in Special Ed. by Group
—Cantor, Kuban, Blak, Klassen, Dickey, & Blanchard. (2006). Archives of Sexual Behavior, 35, 743–751.
0%
10%
20%
30%
40%
50%
60%
70%
80%
TeleiophilicNonoffenders
TeleiophilicSexual
Offenders
Hebephilic Men Pedophilic Men
n=71 n=139 n=377 n=114
Wald = 16.72p = .001
Co-variates:IQ, parental edu.age, age @ ESL
0
5
10
15
20
25
30
35
% w
ith a
ny in
jurie
s
3+ Injuries
2 Injuries
1 Injury
Accidents Causing UnconsciousnessAccidents Causing Unconsciousness
Age < 13 Age ≥ 13p = .01 p = .66
—Blanchard, Kuban, Klassen, Dickey, Christensen, Cantor, & Blak. (2003). Archives of Sexual Behavior, 32, 573–581.
0
5
10
15
20
25
30
35
% w
ith a
ny in
jurie
s
3+ Injuries
2 Injuries
1 Injury
Accidents Causing UnconsciousnessAccidents Causing Unconsciousness
Age < 13 Age ≥ 13p = .01 p = .66
—Blanchard, Kuban, Klassen, Dickey, Christensen, Cantor, & Blak. (2003). Archives of Sexual Behavior, 32, 573–581.
175
176
177
178
179
180
Pedophiles Hebephiles TeleiophilicSexual
Offenders
Teleiophilic Non-offenders
Me
an
(s.
e.)
He
igh
t, in
cm
Covariate: F (4, 1220) = 4.11 age p = .003
—Cantor, Kuban, Blak, Klassen, Dickey, & Blanchard. (2007). Sexual Abuse, 19, 395–407.
n =n = n = n =237662 178 148
Physical HeightPhysical Height
Handedness in Pedophilia and HebephiliaHandedness in Pedophilia and Hebephilia
0
10
20
30
40
% n
on
-rig
ht-
ha
nd
ed
—Cantor, Klassen, Dickey, Christensen, Kuban, Blak, et al. (2005). Archives of Sexual Behavior, 34, 447–459.
age: Wald = 14.25, p = .0008sex: Wald = 0.64, p = .43
n= n= n= n= n= n= 325 242 41 38 40 41
Covariates:IQ, parental ed.,age, age @ ESL
Pedophilic men demonstrate:Pedophilic men demonstrate:
• Lower IQsLower IQs
• Lower scores on memory testsLower scores on memory tests
• More frequent grade failureMore frequent grade failure
• Less physical heightLess physical height
• Less right-handednessLess right-handedness
Consistent indications of general impairment in:Consistent indications of general impairment in:large large samples of samples of homogeneous homogeneous offenders (pedophiles) withoffenders (pedophiles) withphallometricphallometric data. data.
SummarySummary
Are Brain Differences Observable Are Brain Differences Observable Directly?Directly?
Study Theory Prediction Subjects VBM Analysis
Schiltzet al.
(2007)
Schifferet al.
(2007)
Cantoret al.
(2008)
Structural MRI Studies of PedophiliaStructural MRI Studies of Pedophilia
Structural MRI Studies of PedophiliaStructural MRI Studies of Pedophilia
Study Theory Prediction Subjects VBM Analysis
Schiltzet al. limbic “temporal”(2007)
Schiffer OCD/et al. impulsivity frontal(2007)
Cantoret al.
(2008)
Schiltz et al. (2007)Schiltz et al. (2007)
Study Theory Prediction Subjects VBM Analysis
Schiltz 15 pedophileset al. limbic “temporal” 15 community(2007) controls
Schiffer OCD/et al. impulsivity frontal(2007)
Cantoret al.
(2008)
Schiltz et al. (2007)Schiltz et al. (2007)
Study Theory Prediction Subjects VBM Analysis
Schiltz 15 pedophiles small volumeet al. limbic “temporal” 15 community corrected(2007) controls
Schiffer OCD/et al. impulsivity frontal(2007)
Cantoret al.
(2008)
Schiltz et al. (2007)Schiltz et al. (2007)
Study Theory Prediction Subjects VBM Analysis
Schiltz 15 pedophiles small volumeet al. limbic “temporal” 15 community corrected(2007) controls
Schiffer OCD/et al. impulsivity frontal(2007)
Cantoret al.
(2008)
Schiffer et al. (2007)Schiffer et al. (2007)
Study Theory Prediction Subjects VBM Analysis
Schiltz 15 pedophiles small volumeet al. limbic “temporal” 15 community corrected
(2007) controls
Schiffer OCD/ 18 pedophiles small volumeet al. impulsivity frontal 24 community corrected
(2007) controls
Cantoret al.
(2008)
Schiffer et al. (2007)Schiffer et al. (2007)
Study Theory Prediction Subjects VBM Analysis
Schiltz 15 pedophiles small volumeet al. limbic “temporal” 15 community corrected
(2007) controls
Schiffer OCD/ 18 pedophiles small volumeet al. impulsivity frontal 24 community corrected
(2007) controls
Cantoret al.
(2008)
Junk Data or Blind Monks?Junk Data or Blind Monks?
Structural MRI Studies of PedophiliaStructural MRI Studies of Pedophilia
Study Theory Prediction Subjects VBM Analysis
Schiltz 15 pedophiles small volumeet al. limbic “temporal” 15 community corrected
(2007) controls
Schiffer OCD/ 18 pedophiles small volumeet al. impulsivity frontal 24 community corrected
(2007) controls
Cantoret al.
(2008)
Cantor et al. (2008)Cantor et al. (2008)
Study Theory Prediction Subjects VBM Analysis
Schiltz 15 pedophiles small volumeet al. limbic “temporal” 15 community corrected
(2007) controls
Schiffer OCD/ 18 pedophiles small volumeet al. impulsivity frontal 24 community corrected
(2007) controls
Cantor 65 pedophiles whole brainet al. atheoretical none 62 nonsexual volume
(2008) offenders corrected
ProceduresProcedures
Sexological Measures MRI Measures
Phallometry Automated parcellation
Self-report, Voxel-based morphometry offense history (VBM)
ProceduresProcedures
Sexological Measures MRI Measures
Phallometry Automated parcellation
Self-report, Voxel-based morphometry offense history (VBM)
What’s a “voxel”?What’s a “voxel”?
SubjectsSubjects
PatientsPatientsnn = 65 sexology patients = 65 sexology patients Recruited from the Kurt Freund Laboratory (CAMH, Toronto)Recruited from the Kurt Freund Laboratory (CAMH, Toronto)
ControlsControlsnn = 62 nonsexual offenders = 62 nonsexual offendersRecruited from federal and provincial parole/probation officesRecruited from federal and provincial parole/probation offices
Exclusion criteriaExclusion criteria<18 years age<18 years age>300 lbs weight>300 lbs weightEver suffered traumatic brain injuryEver suffered traumatic brain injuryEver diagnosed with schizophreniaEver diagnosed with schizophreniaEver employed grinding metalEver employed grinding metalAny other metal object in body, counterindicating MRIAny other metal object in body, counterindicating MRI
From: Cantor, Kabani, Christensen, Zipursky, Barbaree, et al. (2008). Journal of Psychiatric Research, 42, 167–183.
SubjectsSubjects
CharacteristicCharacteristic PatientsPatients ControlsControls ComparisonComparison pp
AgeAge 36.436.4 ( (13.5)13.5) 36.936.9 ( (9.4)9.4) t t (125)(125) = = ––0.230.23 .82.82
Full-Scale IQFull-Scale IQ 96.296.2 ( (15.3)15.3) 96.396.3 (11.5) (11.5) t t (125)(125) = = ––0.030.03 .98.98
EducationEducation 12.212.2 ( (3.0)3.0) 12.112.1 (2.8) (2.8) t t (125)(125) = 0.20 = 0.20 .84.84
CAGE alcohol CAGE alcohol screenscreen
1.11.1 ( (1.4)1.4) 2.12.1 ( (1.6)1.6) t t (125)(125) = = ––3.83.8 .0003.0003
% non-right-% non-right-handedhanded
23.1%23.1% 14.5%14.5% 22 (1)(1) = 1.52 = 1.52 .22.22
From: Cantor, Kabani, Christensen, Zipursky, Barbaree, et al. (2008). Journal of Psychiatric Research, 42, 167–183.
VBM of Pedophilic vs. Nonsexual Offender MenVBM of Pedophilic vs. Nonsexual Offender Men
VBM of Pedophilic vs. Nonsexual Offender MenVBM of Pedophilic vs. Nonsexual Offender Men
From: Cantor, Kabani, Christensen, Zipursky, Barbaree, et al. (2008). Journal of Psychiatric Research, 42, 167–183.
VBM of Pedophilic vs. Nonsexual Offender MenVBM of Pedophilic vs. Nonsexual Offender Men
From: Cantor, Kabani, Christensen, Zipursky, Barbaree, et al. (2008). Journal of Psychiatric Research, 42, 167–183.
Superior Occipitofrontal FasciculusSuperior Occipitofrontal Fasciculus
From: Cantor, Kabani, Christensen, Zipursky, Barbaree, et al. (2008). Journal of Psychiatric Research, 42, 167–183.
(right) Arcuate Fasciculus(right) Arcuate Fasciculus
From: Cantor, Kabani, Christensen, Zipursky, Barbaree, et al. (2008). Journal of Psychiatric Research, 42, 167–183.
From Jellison et al. (2004). Amer J of Neurorad, 25, 356–369.
But, what does this But, what does this mean?mean?
Middle Frontal Gyrus (Ferretti et al., 2005; Garavan et al., 2000; Gizewski et al., 2006; Karama et al., 2002; Montosori et al., 2003; Rauch et al., 2000)
Insula and Opercula (Garavan et al., 2000; Gizewski et al., 2006; Karama et al., 2002; Park et al., 2001; Stoléru et al., 1999)
Sup./Inf. Parietal Lobules (Beauregard et al., 2001; Bocher et al., 2001; Ferretti et al., 2005; Mouras et al., 2003; Stoléru et al., 2003)
Occipital Cortex (Beauregard et al., 2001; Bocher et al., 2001; Ferreti et al., 2005; Garavan et al., 2000; Mouras et al., 2003; Park et al., 2001)
But, what does this But, what does this mean?mean?
1.1. Humans have multiple social instincts.Humans have multiple social instincts.
2. In typical men, multiple grey matter regions are networked 2. In typical men, multiple grey matter regions are networked together to identify socially significant stimuli and evoke the together to identify socially significant stimuli and evoke the species-typical response:species-typical response:
●● Nurturance, parentingNurturance, parenting●● Obedience, imitationObedience, imitation●● Sexual arousal, courtshipSexual arousal, courtship●● Competition, combatCompetition, combat●● EscapeEscape……etc.etc.
3. In pedophiles, the white matter tissue is underdeveloped and 3. In pedophiles, the white matter tissue is underdeveloped and connects the wrong stimulus to the wrong response. connects the wrong stimulus to the wrong response.
??
But, what does this But, what does this mean?mean?
Study Theory Prediction Subjects VBM Analysis
Schiltzet al.
(2007)
Schifferet al.
(2007)
Cantoret al.
(2008)
Towards Understanding the ContradictionsTowards Understanding the Contradictions
Why didn’t Schiltz and Schiffer find white matter?
Why didn’t Cantor find grey matter?
Study Theory Prediction Subjects VBM Analysis
Schiltzet al.
(2007)
Schifferet al.
(2007)
Cantoret al.
(2008)
Towards Understanding the ContradictionsTowards Understanding the Contradictions
Why didn’t Schiltz and Schiffer find white matter?
Why didn’t Cantor find grey matter?
Towards Understanding the ContradictionsTowards Understanding the Contradictions
Study Theory Prediction Subjects VBM Analysis
Schiltz 15 pedophiles small volumeet al. limbic “temporal” 15 community corrected
(2007) controls
Schiffer OCD/ 18 pedophiles small volumeet al. impulsivity frontal 24 community corrected
(2007) controls
Cantor 65 pedophiles whole brainet al. atheoretical unbiased 62 nonsexual volume
(2008) offenders corrected
Towards Understanding the ContradictionsTowards Understanding the Contradictions
Study Theory Prediction Subjects VBM Analysis
Schiltz 15 pedophiles small volumeet al. limbic “temporal” 15 community corrected
(2007) controls
Schiffer OCD/ 18 pedophiles small volumeet al. impulsivity frontal 24 community corrected
(2007) controls
Cantor 65 pedophiles whole brainet al. atheoretical unbiased 62 nonsexual volume
(2008) offenders corrected
Study Theory Prediction Subjects VBM Analysis
Schiltzet al.
(2007)
Schifferet al.
(2007)
Cantoret al.
(2008)
Towards Understanding the ContradictionsTowards Understanding the Contradictions
Why didn’t Schiltz and Schiffer find white matter?
Why didn’t Cantor find grey matter?
Towards Understanding the ContradictionsTowards Understanding the Contradictions
Study Theory Prediction Subjects VBM Analysis
Schiltz 15 pedophiles small volumeet al. limbic “temporal” 15 community corrected
(2007) controls
Schiffer OCD/ 18 pedophiles small volumeet al. impulsivity frontal 24 community corrected
(2007) controls
Cantor 65 pedophiles whole brainet al. atheoretical unbiased 62 nonsexual volume
(2008) offenders corrected
Towards Understanding the ContradictionsTowards Understanding the Contradictions
Striatum Hypothalamus AmygdalaOrbitofrontal cortex
Prefrontal cortex
Anti-Sociality
Pedophilia
Hippocampus
AdverseChildhood
Events
Cerebellar vermis
Corpus callo-sum
Fronto-occipital fasciculusArcuate fasciculus
Yes, in groups.
But…there is still disagreement over which anatomy.
No (or not yet), in individuals.
But…there is also functional brain scanning (fMRI).
So, can an MRI detect pedophilia?So, can an MRI detect pedophilia?
functional functional MRI (MRI (ffMRI)MRI)Higher bloodflow = higher activity
Stuart Clare, FMRIB
Subject performs two+ tasks, including a control task.
Posner & Raichle, Images of Mind
Subject performs two+ tasks, including a control task.Use “subtractive” statistics to compare activity between tasks.
functional functional MRI (MRI (ffMRI)MRI)
Subject perform two+ tasks, including a control task.Use “subtractive” statistics to compare activity between tasks.
Study Anatomy Subjects Results
Walter et al.(2007)
Schiffer et al.(2008a)
Schiffer et al.(2008b)
Poeppl et al.(2011)
Sartorius et al.(2008)
Ponseti et al. (in press)
functional functional MRI (MRI (ffMRI)MRI)
Subject perform two+ tasks, including a control task.Use “subtractive” statistics to compare activity between tasks.
Study Anatomy Subjects Results
Walter et al. whole pedophiles, pedophiles respond(2007) brain healthy controls analogously to controls
Schiffer et al. whole homosexual pedophiles, pedophiles respond(2008a) brain healthy gay men analogously to controls
Schiffer et al. whole heterosexual pedophiles, no pedophilic responses(2008b) brain heterosexual controls
Poeppl et al. whole pedophiles, pedophiles respond(2011) brain nonsexual offenders analogously, but > controls
Sartorius et al.(2008)
Ponseti et al.(in press)
functional functional MRI (MRI (ffMRI)MRI)
Subject perform two+ tasks, including a control task.Use “subtractive” statistics to compare activity between tasks.
Study Anatomy Subjects Results
Walter et al. whole pedophiles, pedophiles respond(2007) brain healthy controls analogously to controls
Schiffer et al. whole homosexual pedophiles, pedophiles respond(2008a) brain healthy gay men analogously to controls
Schiffer et al. whole heterosexual pedophiles, no pedophilic responses(2008b) brain heterosexual controls
Poeppl et al. whole pedophiles, pedophiles respond(2011) brain nonsexual offenders analogously, but > controls
Sartorius et al. amygdala homosexual pedophiles, amygdala responded(2008) center heterosexual controls analogously
Ponseti et al.(in press)
functional functional MRI (MRI (ffMRI)MRI)
Subject perform two+ tasks, including a control task.Use “subtractive” statistics to compare activity between tasks.
Study Anatomy Subjects Results
Walter et al. whole pedophiles, pedophiles respond(2007) brain healthy controls analogously to controls
Schiffer et al. whole homosexual pedophiles, pedophiles respond(2008a) brain healthy gay men analogously to controls
Schiffer et al. whole heterosexual pedophiles, no pedophilic responses(2008b) brain heterosexual controls
Poeppl et al. whole pedophiles, pedophiles respond(2011) brain nonsexual offenders analogously, but > controls
Sartorius et al. amygdala homosexual pedophiles, amygdala responded(2008) center heterosexual controls analogously
Ponseti et al. empirical diverse pedophiles, 88% sensitivity and(in press) subset of diverse controls 100% specificity
brain
functional functional MRI (MRI (ffMRI)MRI)
Research Clinical Screening Evidence
Phallometry of deniers (61% / 96%)
PSA for prostate c. (72% / 93%)
Digital exam of prostate (53% / 84%)
fMRI of admitters (95% / 95%)
Glucose tolerance (58% / 77%)
fMRI of amygdala (67% / 67%)
HIV antibody (99+% / 99+%)
“Rapid” H1N1 test (51% / 99%)
So, can So, can fMRIfMRI detect arousal to child stimuli? detect arousal to child stimuli?
Research Clinical Screening Evidence
Phallometry of deniers (61% / 96%)
PSA for prostate c. (72% / 93%)
Digital exam of prostate (53% / 84%)
fMRI of admitters (95% / 95%)
Glucose tolerance (58% / 77%)
fMRI of amygdala (67% / 67%)
HIV antibody (99+% / 99+%)
“Rapid” H1N1 test (51% / 99%)
So, can So, can fMRIfMRI detect arousal to child stimuli? detect arousal to child stimuli?
Getting close.
●● Overall features suggest early (Overall features suggest early (pre-natalpre-natal) origins) origins
●● Pedophilic Pedophilic brain structure slightly different brain structure slightly different from typicalfrom typical
●● Brain differences Brain differences not consistent with what changes not consistent with what changes withwith therapy, surgery, or current stem cell researchtherapy, surgery, or current stem cell research
●● Pedophilic brain Pedophilic brain “lights up” in same pattern “lights up” in same pattern as non-pedophilesas non-pedophiles
● ● Pedophiles respond to stimuli of children rather than adultsPedophiles respond to stimuli of children rather than adults
SummarySummary
The Big QuestionsThe Big Questions
Is it in the brain? Is it in the brain? Can we treat it?Can we treat it?
Is it in the genes?Is it in the genes?
Were they born with it? Were they born with it?
Does it run in families?Does it run in families?
Can it change? Can it change? Are they responsible for it?Are they responsible for it?
Can we prevent it?Can we prevent it?
The Public’s FearsThe Public’s Fears
MyMy Fears Fears
My HopesMy Hopes
What if…?
fMRI provides the next increment in accuracy of diagnosing pedophilia and is employed only within the bounds of contemporary professional ethics:
● Informed Consent● Confidentiality
My HopesMy Hopes
What if…?
fMRI provides the next increment in accuracy of diagnosing pedophilia and is employed only within the bounds of contemporary professional ethics:
● Informed Consent● Confidentiality
With continued research, we pinpoint the prenatal process that goes awry.
Perhaps: A general prenatal health factor already known to interfere with normal growth of both body and brain...
My HopesMy Hopes
What if…?
fMRI provides the next increment in accuracy of diagnosing pedophilia and is employed only within the bounds of contemporary professional ethics:
● Informed Consent● Confidentiality
With continued research, we pinpoint the prenatal process that goes awry.
Perhaps: A general prenatal health factor already known to interfere with normal growth of both body and brain...
Instead of preventing a second offense,
we can prevent the first offense.
Magnus Hirschfeld (1868Magnus Hirschfeld (1868–1935–1935))
““Justice through science”Justice through science”Wissenschaftlich-humanitäres KomiteeWissenschaftlich-humanitäres Komitee
(Scientific-Humanitarian Committee)(Scientific-Humanitarian Committee)
AcknowledgementsAcknowledgements
CAMH Law & Mental HealthCAMH Law & Mental HealthHoward BarbareeHoward BarbareeRobert DickeyRobert DickeyPhilip KlassenPhilip Klassen
CAMH Schizophrenia ProgramCAMH Schizophrenia ProgramBruce ChristensenBruce ChristensenRobert ZipurskyRobert Zipursky
TGH Dept. of Neuroimaging TGH Dept. of Neuroimaging David MikulisDavid MikulisHien TranHien Tran
Ontario Ministry of CorrectionsOntario Ministry of CorrectionsRobert BrownRobert Brown
CAMH Image Processing LabCAMH Image Processing LabNoor KabaniNoor KabaniKate Hanratty Kate Hanratty Blake RichardsBlake Richards
Kurt Freund LaboratoryKurt Freund LaboratoryRay BlanchardRay BlanchardThomas BlakThomas BlakMichael KubanMichael KubanSophie LafailleSophie LafailleNanci LipsteinNanci Lipstein
Correctional Service CanadaCorrectional Service CanadaElias ConstantatosElias ConstantatosRobert SmallRobert Small