Pedophilia

===Comorbidity and personality traits===
Studies of pedophilia in child sex offenders often report that it co-occurs with other [[psychopathology|psychopathologies]], such as low [[self-esteem]],<ref>{{cite journal | first=William L. |last = Marshall | title = The relationship between self-esteem and deviant sexual arousal in nonfamilial child molesters | url = https://archive.org/details/sim_behavior-modification_1997-01_21_1/page/86 | journal = [[Behavior Modification (journal)|Behavior Modification]] | publisher=[[SAGE Publishing]] | location=Thousand Oaks, California | volume = 21 | issue = 1 | pages = 86–96 | year = 1997 | pmid = 8995044 | doi = 10.1177/01454455970211005 | s2cid = 22205062 }}</ref> depression, anxiety, and personality problems. It is not clear whether these are features of the disorder itself, artifacts of [[sampling bias]], or consequences of being identified as a sex offender.<ref name="setocomorbidity"/> One review of the literature concluded that research on personality correlates and [[psychopathology]] in pedophiles is rarely methodologically correct, in part owing to confusion between pedophiles and child sex offenders, as well as the difficulty of obtaining a representative, community sample of pedophiles.<ref>Okami, P. & Goldberg, A. (1992). "Personality Correlates of Pedophilia: Are They Reliable Indicators?", ''Journal of Sex Research'', Vol. 29, No. 3, pp. 297–328. "For example, because an unknown percentage of true pedophiles may never act on their impulses or may never be arrested, forensic samples of sex offenders against minors clearly do not represent the population of "pedophiles", and many such persons apparently do not even belong to the population of "pedophiles"."</ref> Seto (2004) points out that pedophiles who are available from a clinical setting are likely there because of distress over their sexual preference or pressure from others. This increases the likelihood that they will show psychological problems. Similarly, pedophiles recruited from a correctional setting have been convicted of a crime, making it more likely that they will show anti-social characteristics.<ref name="seto2004"/>

Impaired self-concept and interpersonal functioning were reported in a sample of child sex offenders who met the diagnostic criteria for pedophilia by Cohen et al. (2002), which the authors suggested could contribute to motivation for pedophilic acts. The pedophilic offenders in the study had elevated [[psychopathy]] and cognitive distortions compared to healthy community controls. This was interpreted as underlying their failure to inhibit their criminal behavior.<ref>{{cite journal | vauthors = Cohen LJ, McGeoch PG, Watras-Gans S, Acker S, Poznansky O, Cullen K, Itskovich Y, Galynker I | title = Personality impairment in male pedophiles | journal = [[Journal of Clinical Psychiatry]] | publisher=Physicians Postgraduate Press | location = Memphis, Tennessee |volume = 63 | issue = 10 | pages = 912–9 | date = October 2002 | pmid = 12416601 | doi = 10.4088/JCP.v63n1009 }}</ref> Studies in 2009 and 2012 found that non-pedophilic child sex offenders exhibited psychopathy, but pedophiles did not.<ref>{{cite journal | first1 = Donald S. | last1 = Strassberg | first2 = Angela | last2 = Eastvold | first3 = J. Wilson | last3 = Kenney | first4 = Yana | last4 = Suchy | title = Psychopathy among pedophilic and nonpedophilic child molesters | journal = [[Child Abuse & Neglect]] | publisher=[[Elsevier]] | location=Amsterdam, Netherlands | volume = 36 | issue = 4 | pages = 379–382 | date = April 2012 | doi=10.1016/j.chiabu.2011.09.018 | pmid = 22571910 }}</ref><ref>{{cite journal | first1 = Yana | last1 = Suchy | first2 = Wilson J. | last2 = Whittaker | first3 = Donald S. | last3 = Strassberg | first4 = Angela | last4 = Eastvold | title = Facial and prosodic affect recognition among pedophilic and nonpedophilic criminal child molesters | journal = [[Sexual Abuse (journal)|Sexual Abuse: A Journal of Research and Treatment]] | publisher=[[SAGE Publishing]] | location=Thousand Oaks, California | volume = 21 | issue = 1 | pages = 93–110 | date = March 2009 | doi=10.1177/1079063208326930 | pmid = 19218480 | s2cid = 25360637 }}</ref> 
 
Wilson and Cox (1983) studied the characteristics of a group of pedophile club members. The most marked differences between pedophiles and [[control variable|controls]] were on the introversion scale, with pedophiles showing elevated shyness, sensitivity and depression. The pedophiles scored higher on [[neuroticism]] and [[psychoticism]], but not enough to be considered pathological as a group. The authors caution that "there is a difficulty in untangling cause and effect. We cannot tell whether paedophiles gravitate towards children because, being highly introverted, they find the company of children less threatening than that of adults, or whether the social withdrawal implied by their introversion is a result of the isolation engendered by their preference i.e., awareness of the social [dis]approbation and hostility that it evokes" (p.&nbsp;324).<ref>{{cite journal | author1 = Wilson G. D. | author2 = Cox D. N. | year = 1983 | title = Personality of paedophile club members | journal = [[Personality and Individual Differences]] | publisher=[[Elsevier]] | location=Amsterdam, Netherlands | volume = 4 | issue = 3 | pages = 323–329 | doi = 10.1016/0191-8869(83)90154-X }}</ref> In a non-clinical survey, 46% of pedophiles reported that they had seriously considered suicide for reasons related to their sexual interest, 32% planned to carry it out, and 13% had already attempted it.<ref name="jahnkeblind"/>

A review of qualitative research studies published between 1982 and 2001 concluded that child sexual abusers use [[cognitive distortion]]s to meet personal needs, justifying abuse by making excuses, redefining their actions as love and mutuality, and exploiting the power imbalance inherent in all adult–child relationships.<ref>{{cite journal | first=Louanne | last = Lawson | title = Isolation, gratification, justification: offenders' explanations of child molesting | journal = [[Issues in Mental Health Nursing]] | publisher=[[Taylor & Francis]] | location=Abingdon, England | volume = 24 | issue = 6–7 | pages = 695–705 | year = 2003 | pmid = 12907384 | doi=10.1080/01612840305328 | s2cid = 13188168 }}</ref> Other cognitive distortions include the idea of "children as sexual beings", uncontrollability of sexual behavior, and "sexual entitlement-bias".<ref>{{cite journal | first1 = Stephen | last1 = Mihailides | first2 = Grant J. | last2 = Devilly | first3 = Tony | last3 = Ward | title = Implicit cognitive distortions and sexual offending | journal = [[Sexual Abuse (journal)|Sexual Abuse: A Journal of Research and Treatment]] | publisher = [[SAGE Publishing]] | location=Thousand Oaks, California | volume = 16 | issue = 4 | pages = 333–350 | date = October 2004 | pmid = 15560415 | doi = 10.1177/107906320401600406 | s2cid = 220359426 }}</ref>