The abused-abuser theory offers another model of pedophilic motivation. This suggests that a pedophile’s own history of childhood sexual abuse predisposes him or her to pedophilic tendencies. Indeed this is the one proposed etiological factor that has received robust support in the literature. Estimates of the incidence of childhood sexual abuse in pedophiles’ histories range from 40% up to 100%.15,16 Female offenders might have an even higher incidence of childhood sexual abuse.17 Moreover, pedophilic offenders have a higher incidence of childhood sexual abuse than do sexual offenders against older age-groups and nonsexual offenders.15,18 Finally, in a randomly selected sample of men living in the community, men who had reported multiple events of sexual contact in their own childhood were almost 40 times more likely to report having sexual contact with children 13 years and younger than men who reported no sexual abuse in childhood (0.2% vs 7.7%).2
Thus, childhood sexual abuse appears to play an important role in the development of pedophilic tendencies. The underlying mechanism for this is not clear. Psychological processes, such as identification with the aggressor and normalization of adult-child sexual activity have been proposed.19 We have suggested that abuse sustained during early childhood may result in neurodevelopmental abnormalities that predispose to pedophilic sexual desire.12
Nonetheless, most studies suggest that a sizable proportion of pedophiles were not abused as children.12 While this might reflect underreporting because of denial and/or inadequately processed emotions about past traumas, the data suggest that childhood sexual abuse is neither necessary nor sufficient for the development of sexual attraction to children.1,2 However, it is also possible that childhood abuse histories are more characteristic of “true” pedophiles than “opportunistic” ones.
A number of studies have investigated the neurobiological or neuropsychological correlates of pedophilia. Some studies have shown lowered IQ in pedophiles compared with healthy controls.20 Cortical abnormalities in frontotemporal regions have also been documented using MRI, positron emission tomography, CT, and electroencephalography, as have subcortical abnormalities in the amygdala and related limbic structures.12,21-23
We can speculate that frontal dysfunction may underlie disinhibition while temporolimbic abnormalities may relate to abnormal motivation via aberrant sexual arousal patterns. However, not all studies have documented such impairment and the neurobiological and neuropsychological literature has been contradictory.23 In our study of 20 pedophiles and 24 demographically matched healthy controls, we found no difference on tests of executive function despite highly significant differences on personality measures.12