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A promising line of research on forensic assessment of paraphilic sexual interest focuses on behavioral measures of visual attention using sexual stimuli as distractors. The present study combined event-related potentials (ERPs) with behavioral measures to investigate whether detection of a hidden sexual preference can be improved with ERPs. Normal variants of sexual orientation were used for a proof-of-concept investigation. Accordingly, 40 heterosexual and 40 gay men participated in the study. Within each group, half of the participants were instructed to hide their sexual orientation. The results showed that a match between sexual orientation and stimulus delays responses and influences ERP before motor responses. Late ERP components showed higher potential in differentiating hidden sexual preferences than motor responses, thereby showing how ERPs can be used in combination with reaction time measures to potentially facilitate the detection of hidden sexual preferences.

Objectives: Individuals with pedophilic disorder (PD) experience personal and interpersonal difficulties and are at risk of sexually offending against children. As such, innovative and empirically validated treatments are needed. Recent studies have indicated that men who have sexually offended against children (SOC) with PD display an automatic attention bias for childrelated stimuli as well as reduced activity in the dorsolateral prefrontal cortex (dlPFC), a brain area involved in cognitive control, including control over sexual arousal. In this preregistered pilot study, we are the first to investigate whether acutely increasing prefrontal activity could reduce the putative pedophilic attention bias. Materials and Methods:We delivered a single 20-min session of active anodal versus sham transcranial direct current stimulation (tDCS) over the left dlPFC to 16 SOC with PD and 16 matched healthy controls, while they performed a task requiring controlled attention to computer-generated images of clothed and nude children and adults. We collected responses unobtrusively by recording eye movements.Results: Our results did not support the presence of the expected automatic attention bias across outcome measures. Nonetheless, we found a response facilitation with child targets in patients and, unexpectedly, in controls, likely due to unwanted salience effects. Active versus sham tDCS reduced this bias across groups, as indicated by a significant group*condition interaction (p = 0.04). However, no attentional bias and no tDCS effects on attentional responses to child and adult images emerged following tDCS.Conclusions: These results suggest enhanced cognitive control in response to salient stimuli during active tDCS. Thus, to assist future studies on neuromodulation in PD, we provide suggestions for design improvement.

Individuals with Pedophilic Disorder (PD) experience personal and interpersonal difficulties and are at risk of sexually offending against children. As such, innovative and empirically validated treatments are needed. Recent studies have indicated that sex offenders with child victims (SOC) with PD display an automatic attention bias for child-related stimuli as well as reduced activity in the dorsolateral prefrontal cortex (dlPFC), a brain area involved in cognitive control, including control over sexual arousal. In the present pre-registered pilot study, we were the first to investigate whether acutely increasing prefrontal activity could reduce the putative pedophilic attention bias. To do so, we delivered a single 20-minute session of active anodal vs. sham transcranial direct current stimulation (tDCS) over the left dlPFC to 16 SOC with PD and 16 matched healthy controls, while they performed a task requiring controlled attention to computer-generated images of clothed and nude children and adults. We collected responses unobtrusively by recording eye movements. No significant tDCS effect on visual attention to sexually salient stimuli emerged during or immediately after stimulation. From a qualitative perspective, observations were in line with a bias for sexually preferred vs. non-preferred stimuli in patients but not in controls. Importantly, active vs. sham tDCS reduced this bias across outcome measures in patients but not in controls. Based on these preliminary findings, it is worth further investigating the possibility of using brain stimulation as a therapeutic intervention for PD. Methodological improvements were also identified and discussed to assist future research.

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