Leuprolide Acetate Suppresses Pedophilic Urges and Arousability

Abstract

Cognitive-behavioral psychotherapy was compared with cognitive-behavioral psychotherapy augmented by leuprolide acetate (LA) for suppression of pedophilic behavior. Five male pedophiles (M age, 50 years; range, 36-58) were administered LA by Depo injection for 12 months, followed by saline placebo for 12 months. Testosterone levels, sexual interest preference by visual reaction time (Abel Assessment), penile tumescence (Monarch Penile Plethysmography, PPG), as well as strong sexual urges toward children and masturbatory frequency involving thoughts of children (polygraph), were measured every 3 months. On LA, testosterone decreased to castrate levels. Penile tumescence was significantly suppressed compared with baseline, but sufficient response remained to detect pedophilic interest. Pedophilic interest was also detected by visual reaction times. When asked about having pedophilic urges and masturbating to thoughts of children, all subjects self-reported a decrease. Polygraph responses indicated subjects were not deceptive. On placebo, testosterone and physiologic arousal eventually rose to baseline. As noted by polygraph, at baseline and on placebo, subjects were deceptive regarding increased pedophilic urges and masturbatory frequency. Interest preference, as measured by Abel Assessment and Monarch PPG, was generally unchanged throughout the study. Cognitive-behavioral psychotherapy augmented with LA significantly reduced pedophilic fantasies, urges, and masturbation; however, pedophilic interest did not change during 1 year of therapy. Deceptive responses by polygraph suggested that self-report was unreliable. Follow-up utilizing objective measures is essential for monitoring efficacy of treatment in pedophilia. Our study supports the premise that suppression of pedophilic behavior is possible. LA may augment cognitive-behavioral psychotherapy and help break the sequence leading to a re-offense.

“I’m not homosexual or heterosexual, I’m paedosexual”: exploring sexual preference for children using interpretive phenomenology

“…Whilst pharmacological therapies may reduce the intensity of inappropriate arousal and self-regulation training increase arousal control, the direction of sexual preference may remain intact (e.g. Schober Kuhn, Kovacs, et al 2005). In response to the lack of research, the aim of this study was to investigate this problem through the lived experience of convicted perpetrators of child sexual abuse with a sexual preference for children.…”

Die antiandrogene Behandlung von Sexualstraftätern vor dem Hintergrund der aktuellen Wirksamkeitsforschung und der kriminologischen Realität

“…im Zuge der behandlung wurde den Probanden 12 Monate lang ein zentralwirksames Antiandrogen (Lhrh-Agonist) verabreicht, gefolgt von einer einjährigen Placebogabe [34]. Unter der Medikation kam es zu einer deutlichen Abnahme pädosexueller Fantasien und des entsprechenden Masturbationsverhaltens.…”

Therapieangebote für Männer mit sexuellen Präferenzstörungen und Sexualdelinquenz

“…es lassen sich sieben offene studien beschreiben, die GnrhAgonisten (triptorelin, Leuprorelin) bei sexual straftätern untersuchten. (eine davon war eine doppelblind durchgeführte [21,22].) Die veröffentlichten offenen studien umfassen die behandlung von 86 Männern; überwiegend erfüllten diese die Kriterien für eine Pädophilie [5,6,9,10,15,19,21,22,[24][25][26].…”