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Sexual and Other Axis I Diagnoses of 60 Males Arrested for Crimes Against Children Involving the Internet

  • Richard B. Krueger, Meg S. Kaplan and Michael B. First

Objective: This study was conducted to describe Axis I sexual diagnoses of 60 males arrested for possession of child pornography obtained via the Internet and/or attempting to meet children via the Internet.

Methods: Data was obtained from a chart review of evaluations conducted on 60 males referred for a psychosexual evaluation following an arrest for possession of child pornography and/or attempting to meet children. All crimes involved use of the Internet. Information obtained from the chart review was entered into SAS. All diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Simple descriptive statistics were computed and cross tabulations were tested for significance using χ2 or Fisher's Exact test.

Results: Of the total sample, 40% had at least one paraphilia. Thirty-one percent had a diagnosis of pedophilia and 18% of a paraphilia not otherwise specified (NOS). Thirty-three percent had a sexual disorder NOS, characterized by hypersexuality. Seventy percent of the total sample had an Axis I disorder that antedated and was judged to be contributory to the behavior leading to their arrest.

Conclusions: This sample of men arrested for committing crimes against children and adolescents via the Internet has a high incidence of lifetime sexual and other psychopathology.

Corresponding author
Richard B. Krueger, MD, New York State Psychiatric Institute, Unit #45, 1051 Riverside Drive, New York, NY 10032; Tel: 212-740-7330, Fax: 212-740-7341; e-mail:
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1.Bryan-Low, C. Internet transforms child porn into lucrative criminal trade. The Wall Street Journal. January 17, 2006:16.
2.Stewart, WG II.Statistics Child Pornography update. Washington, DC: U.S. Department of Justice, Executive Office for United States Attorneys, Freedom of Information/Privacy Act Unit; 2009.
3.Mitchell, KJ, Finkelhor, D, Wolak, J. Risk factors for and impact of online sexual solicitation of youth. JAMA. 2001;285:30113014.
4.Motivans, M, Kyckelhahn, T. Federal prosecution of child sex exploitation offender, 2006. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics; December 2007.
5.Harris, A, Phenix, A, Hanson, RK, Thornton, D. Static-99 Coding Rules. Ottawa, Canada; 2003.
6.Fazel, S, Sjöstedt, G, Långström, N, Grann, M. Severe mental illness and risk of sexual offending in men: A case-control study based on Swedish national registers. J Clin Psychiatry. 2007;68:588596.
7.Langstrom, N, Sjostedt, G, Grann, M. Psychiatric disorders and recidivism in sexual offenders. Sex Abuse. 2004;16:139150.
8.Quayle, E, Taylor, M. Child pornography and the internet: Perpetuating a cycle of abuse. Deviant Behav. 2002;23:331361.
9.Frei, A, Erenay, N, Dittmann, V, Graf, M. Paedophilia on the internet—a study of 33 convicted offenders in the Canton of Lucerne. Swiss Med Wkly. 2005;135:488494.
10.Alexy, EM, Burgess, AW, Baker, T. Internet offenders. Traders, travelers, and combination trader-travelers. J Interpers Violence. 2005;20:804812.
11.Webb, L, Craissati, J, Keen, S. Characteristics of internet child pornography offenders: A comparison with child molesters. Sex Abuse. 2007;19:449465.
12.Elliott, IA, Beech, AR, Mandeville-Norden, R, Hayes, E. Psychological profiles of internet sexual offenders. Comparisons with contact sexual offenders. Sex Abuse. 2009;21:7692.
13.Wolak, J, Finkelhor, D, Mitchell, KJ, Ybarra, ML. Online “predators” and their victims. Myths, realities, and implications for prrevention and treatment. Am Psychol. 2008;63:111128.
14.Galbreath, NW, Berlin, FS, Sawyer, D. Paraphilias and the internet. In: Cooper, A, ed. Sex and the Internet. A Guidebook for Clinicians. New York, NY: Brunner-Routledge; 2002:187205.
15.Seto, MC, Cantor, JM, Blanchard, R. Child pornography offenses are a valid diagnostic indicator of pedophilia. J Abnorm Psychol. 2006;115:610615.
16.Blanchard, R, Kolla, NJ, Cantor, JM, et al.IQ, handedness, and pedophilia in adult male patients stratified by referral source. Sex Abuse. 2007;19:285309.
17.Stein, DJ, Black, DW, Shapira, NA, Spitzer, RL. Hypersexual disorder and preoccupation with internet pornography. Am J Psychiatry. 2001;158:15901594.
18.Blanchard, R, Klassen, P, Dickey, R, Kuban, ME, Blak, T. Sensitivity and specificity of the phallometric test for pedophilia in nonadmitting sex offenders. Psychol Assess. 2001;13:118126.
19.Delmonico, DL, Griffin, EJ. Sex offenders online–What clinicians need to know. In: Schwartz, BK, ed. The Sex Offender. Issues in Assessment, Treatment, and Supervision of Adult and Juvenile Populations. Volume V. Kingston, NJ: Civic Research Institute; 2005:4.14.25.
20.Stein, DJ, Black, DW. Can too much sex be a bad thing? CNS Spectr. 2000;5:18.
21.Stein, DJ, Black, DW, Pienaar, W. Sexual disorders not otherwise specified: Compulsive, addictive, or impulsive? CNS Spectr. 2000;5:6064.
22.Krueger, RB, Kaplan, MS. The paraphilic and hypersexual disorders: An overview. J Psychiatr Pract. 2001;7:391403.
23.Kafka, MP. Successful antidepressant treatment of nonparaphilic sexual addictions and paraphilias in men. J Clin Psychiatry. 1991;52:6065.
24.Kafka, MP. Paraphilia-related disorders. The evaluation and treatment of nonparaphilic hypersexuality. In: Leiblum, SR, ed. Principles and Practice of Sex Therapy. Fourth ed. New York, NY: The Guilford Press; 2007:442476.
25.Black, DW. Compulsive sexual behavior. A review. Journal of Practical Psychiatry and Behavioral Health. 1998;4:219229.
26.Black, DW. The epidemiology and phenomenology of compulsive sexual behavior. CNS Spectr. 2000;5:2672.
27.Kuzma, JM, Black, DW. Epidemiology, prevalence, and natural history of compulsive sexual behavior. Psychiatr Clin North Am. 2008;31:603611.
28.Stein, DJ. Classifying hypersexual disorders: Compulsive, impulsive, and addictive models. Psychiatr Clin North Am. 2008;31:587591.
29.Daneback, K, Cooper, A, Mansson, S-A. An internet study of cybersex participants. Arch Sex Behav. 2005;34:321328.
30.Raymond, NC, Coleman, E, Miner, MH. Psychiatric comorbidity and compulsive/impulsive traits in compulsive sexual behavior. Compr Psychiatry. 2003;44:370380.
31.Black, DW, Kehrberg, LLD, Flumerfelt, DL, Schlosser, SS. Characteristics of 36 subjects reporting compulsive sexual behavior. Am J Psychiatry. 1997;154:243249.
32.Dunsieth, NW Jr., Nelson, EB, Brusman-Lovins, LA, et al.Psychiatric and legal features of 113 men convicted of sexual offenses. J Clin Psychiatry. 2004;65:293300.
33.McElroy, SL, Soutullo, CA, Taylor, JP, et al.Psychiatric features of 36 men convicted of sexual offenses. J Clin Psychiatry. 1999;60:414420.
34.Raymond, NC, Coleman, E, Ohlerking, F, Christenson, GA, Miner, M. Psychiatric comorbidity in pedophilic sex offenders. Am J Psychiatry. 1999;156:786788.
35.Kafka, MP, Hennen, J. A DSM-IV Axis I comorbidity study of males (n = 120) with paraphilias and paraphilia-related disorders. Sex Abuse. 2002;14:349366.
36.Kafka, MP, Prentky, RA. Preliminary observations of DSM-III-R AXIS I comorbidity in men with paraphilias and paraphilia-related disorders. J Clin Psychiatry. 1994;55:481487.
37.Kafka, MP, Prentky, RA. Attention-deficit/hyperactivity disorder in males with paraphilias and paraphilia-related disorders: A comorbidity study. J Clin Psychiatry. 1998;59:388396.
38.Krueger, RB, Kaplan, MS. Evaluation and treatment of sexual disorders: Frottage. In: Vandecreek, L, Jackson, TL, eds. Innovations in Clinical Practice: A Source Book. Vol 18. Sarasota, FI: Professional Resource Press; 2000:185197.
39.Diagnostic and Statistical Manual of Mental Disorders. 4th ed, text rev. Washington, DC: American Psychiatric Association; 2000.
40.Wolak, J, Finkelhor, D, Mitchell, K. Internet-initiated sex crimes against minors: Implications for prevention based on findings, from a national study. J Adolesc Health. 2004;35:424.e11e20.
41.Money, J. Paraphilias: Phenomenology and classification. Am J Psychother. 1984;38:164179.
42.Cimbolic, P, Carter, P. Looking at ephebophilia through the lens of cleric sexual abuse. Sexual Addiction & Compulsivity. 2006;13:347359.
43.Nuñez, J. Outpatient treatment of the sexually compulsive ephebophile. Sexual Addiction & Compulsivity. 2003;10:2351.
44.Blanchard, R, Lykins, AD, Wherrett, D, et al.Pedophilia, hebephilia, and the DSM-V. Arch Sex Behav. 2009;38:335350.
45.First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. User's guide for the structured clinical interview of the DSM-IV Axis I disorders. Washington, DC: American Psychiatric Press; 1997.
46.Davis, CM, Yarber, WL, Bauserman, R, Schreer, G, Davis, SL. Handbook of Sexuality-Related Measures. Thousand Oaks, California: Sage Publications; 1998.
47.Prentky, R, Edmunds, SB. Assessing Sexual Abuse: A Resource Guide for Practitioners. Brandon, VT: The Safer Society Press; 1997.
48.Black, OW, Belsare, G, Schlosser, S. Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior. J Clin Psychiatry. 1999;60:838844.
49.Shapira, NA, Goldsmith, TD, Keck, PE Jr., Khosla, UM, McElroy, SL. Psychiatric features of individuals with problematic internet use. J Affect Disord. 2000;57:267272.
50.Shapira, NA, Lessig, MC, Goldsmith, TD, et al.Problematic internet use: Proposed classification and diagnostic criteria. Depress Anxiety. 2003;17:207216.
51.Ko, C-H, Yen, J-Y, Chen, C-S, Chen, C-C, Yen, C-F. Psychiatric comorbidity of internet addiction in college students: An interview study. CNS Spectr. 2008;13:147153.
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