Immediate processing of erotic stimuli in paedophilia and controls: a case control study

Abstract

BackgroundMost neuroimaging studies investigating sexual arousal in paedophilia used erotic pictures together with a blocked fMRI design and long stimulus presentation time. While this approach allows the detection of sexual arousal, it does not enable the assessment of the immediate processing of erotically salient stimuli. Our study aimed to identify neuronal networks related to the immediate processing of erotic stimuli in heterosexual male paedophiles and healthy age-matched controls.MethodsWe presented erotic pictures of prepubescent children and adults in an event related fMRI-design to eight paedophilic subjects and age-matched controls.ResultsErotic pictures of females elicited more activation in the right temporal lobe, the right parietal lobe and both occipital lobes and erotic pictures of children activated the right dorsomedial prefrontal cortex in both groups. An interaction of sex, age and group was present in the right anteriolateral oribitofrontal cortex.ConclusionsOur event related study design confirmed that erotic pictures activate some of the brain regions already known to be involved in the processing of erotic pictures when these are presented in blocks. In addition, it revealed that erotic pictures of prepubescent children activate brain regions critical for choosing response strategies in both groups, and that erotically salient stimuli selectively activate a brain region in paedophilic subjects that had previously been attributed to reward and punishment, and that had been shown to be implicated in the suppression of erotic response and deception.

Response Inhibition in Pedophilia: An fMRI Pilot Study

“…Rather it underlines the need to interpret some of the neuropsychological findings in pedophilia against the background of a more complex interplay between cognitive processes during the test situation and the test itself. Further evidence for this interplay can be found in a recent fMRI study showing, for example, an immediate activation of brain regions involved in evaluating emotional salience and reward as well as in the regulation of emotional responses in pedophilic subjects when confronted with erotic pictures of children [36]. …”

Connectivity and functional profiling of abnormal brain structures in pedophilia

“…However, at least parts of this network responding to visual sexual stimuli in healthy men seem to be active also in pedophiles when viewing pedosexual stimuli [Mohnke et al, 2014]. Yet, abnormal brain activation patterns in pedophiles during visual sexual stimulation have been documented by fMRI studies and are regarded as the neural correlates underlying sexual attraction to children [Habermeyer et al, 2013a;Poeppl et al, 2011;Sartorius et al, 2008;Schiffer et al, 2008a,b;Stol eru et al, 2013;Walter et al, 2007]. In addition, this neurobiological endophenotype may potentially be informative to be further developed into a biomarker allowing for observerindependent diagnosis of pedophilia [Ponseti et al, 2012].…”

Evidence for superior neurobiological and behavioral inhibitory control abilities in non-offending as compared to offending pedophiles

“…The only replicated finding is limited to an amygdala volume reduction in offending pedophiles [Poeppl et al, ; Schiffer et al, ; Schiltz et al, ], although other authors using more stringent type‐1 error correction did not corroborate this result [Cantor et al, ; Cantor et al, ; Gerwinn et al, ], suggesting insufficient effect sizes of the aberrant amygdala volume. In addition, there are studies reporting evidence for frontocortical neural dysfunction in pedophiles with a history of CSO (P + CSO) as indicated by regionally decreased brain volume [Mendez and Shapira, ; Schiffer et al, ], impaired neuro‐cognitive functions [Kruger and Schiffer, ; Schiffer and Vonlaufen, ], as well as altered activity in prefrontal areas comprising the orbitofrontal cortex (OFC) [Habermeyer et al, ], dorsolateral prefrontal cortex (DLPFC) [Schiffer et al, ], and the anterior cingulate cortex (ACC) [Schiffer et al, ] during the processing of sexual stimuli. As normal brain function is highly dependent on appropriate communication within and across neural structures, recent studies investigated the pedophilia related differences in white matter axonal projections to other brain areas, which form the structural basis of connectivity in the brain.…”

“…For an exhaustive discussion of this topic, please see Mohnke et al [2014]. While some studies controlled for the influence of offence status by comparing groups of offending pedophiles with non-sexual offenders [Cantor et al, 2008[Cantor et al, , 2015Poeppl et al, 2011], other studies compared (mixed groups of non-offending and) offending pedophiles with non-pedophilic non-offenders [Habermeyer et al, 2013a[Habermeyer et al, , 2013bSchiffer et al, 2007]. Since none of the previous studies differed between offending and non-offending groups of pedophiles, it remains largely unclear to what extent their results are related to a deviant sexual preference, i.e., pedophilia or aberrant behavior, i.e., CSO.…”