The Neuropsychology and Neurology of Sexual Deviance: A Review and Pilot Study

Institut Philippe-Pinel de Montréal, 10905 Henri-Bourassa Bld, Montreal, QC, H1C 1H1, Canada.
Sexual Abuse A Journal of Research and Treatment (Impact Factor: 2.28). 07/2007; 19(2):155-73. DOI: 10.1007/s11194-007-9045-4
Source: PubMed


Current neurological hypotheses of paraphilia posit that sexual deviance is associated with frontal and/or temporal lobe damage. This broad conception is based on few investigations, however, and the first goal of this study was to review the existing data derived from neuropsychiatry, neuroimaging and neuropsychology. It is concluded that although fronto-temporal dysfunctions are sporadically reported among sexual offenders, the evidence is scarce and it might not be specific to this type of offending. The second objective of this investigation was to gather preliminary neuropsychological data with more homogeneous subgroups of sexual offenders. A profile of lower-order executive dysfunctions (e.g. sustained attention and inhibition) and verbal deficits with intact or good capacities for higher-order executive functioning (e.g. reasoning and cognitive flexibility) and visuo-spatial processing was preferentially found among sexual offenders, suggesting basal fronto-temporal anomalies. Importantly, pedophiles were more consistently and severely impaired than rapists of adults. However, this basal fronto-temporal profile is not characteristic of sexual deviance, as it is also found in association with delinquency and criminality in general. Future neuropsychological and brain imaging studies should consider subgroups of sexual offenders and recruit non-sexual violent persons and non-violent individuals in order to disentangle the complex relations between brain anomalies and sexual deviance.


Available from: Christian C Joyal, Jan 18, 2014
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    • "For example, recent fMRI studies have suggested functional differences in selective neural pathways in victims of CSA, including greater engagement of emotion and salience processing regions, and less engagement of executive function and cognitive control regions (Rauch, Shin, & Phelps, 2006; Rauch et al., 2000; Shin et al., 2001; Shin et al., 2005). In addition, morphological abnormalities have been identified in adult pedophiles when compared with the general population and non-sexualoffenders , such as more diffuse white and gray matter hypodensities; reductions in the volume of limbic structures, particularly the right amygdala; and neurodevelopmental abnormalities in the temporal and frontal regions of the brain that are responsible for sexual arousal and behavior inhibition (Cantor & Blanchard, 2012; Cantor et al., 2008; L. J. Cohen et al., 2002; Joyal, Black, & Dassylva, 2007; Kargel et al., 2015; Poeppl et al., 2015; Roszyk & Lukaszewska, 2011; Schiffer et al., 2007; Wright, Nobrega, Langevin, & Wortzman, 1990). "
    [Show abstract] [Hide abstract] ABSTRACT: To effectively address the needs of youth who perpetrate sexual violence and reduce rates of recidivism, a better understanding of the mechanisms of juvenile sexual offending is needed. Current literature identifies various factors that are believed to put youth at risk for sexual offending, two of which are empathy deficits and childhood sexual abuse (CSA). The extent to which empathy deficits contribute to juvenile sexual offending, however, is often debated, though studies have not yet explored a neurobehavioral model of this mechanism. This pilot study used functional magnetic resonance imaging (fMRI) to explore the neural correlates of empathy in juveniles who sexually offend (JSOs), and the possible role of CSA. A total of 38 males (ages 12-20) were enrolled, including 11 healthy control subjects and 27 JSOs, of which, 11 had a history of CSA. Participants underwent clinical assessment and completed an empathy task during fMRI. Using both whole-brain and region-of-interest analysis, results of the fMRI data showed no statistical differences in engagement of brain regions associated with empathy between controls and all JSOs. There were also no significant differences between JSOs with and without a history of CSA. These null findings pose implications for guiding future research studies with larger samples and more statistical power, and may support the need to further explore empathy-related explanatory models and interventions for JSOs. Neuroimaging may demonstrate to be a useful tool to identify individualized risk factors and aid in tailoring interventions for this population.
    Full-text · Article · Feb 2016 · Sexual Abuse A Journal of Research and Treatment
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    • "claim that acquired paedophilia can be predicted solely on the basis of a specific pathognomonic or an exclusive neurobiological cause (Joyal, Black, and Dassylva 2007). The hypersexual disorder needs to be understood within a multidimensional framework with several factors interacting with each other (psychological, environmental , social, cognitive capacities, testosterone levels, dopaminergic rewarding system, etc.). "
    Full-text · Article · Jul 2015 · Journal of Bioethical Inquiry
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    • "In contrast, the insula seed was consistently associated with 'action execution' in the BrainMap database. Hence, the morphological alteration of this region seems to contribute to the wellknown executive deficits, most notably in sustained and response inhibition, in pedophiles [Joyal et al., 2007;. This causal connection is strengthened by the FC of the insula seed with key structures for cognitive and motor control such as inferior frontal gyrus, supplementary motor area, midcingulate cortex, thalamus, basal ganglia, and cerebellum (cf. "
    [Show abstract] [Hide abstract] ABSTRACT: Despite its 0.5-1% lifetime prevalence in men and its general societal relevance, neuroimaging investigations in pedophilia are scarce. Preliminary findings indicate abnormal brain structure and function. However, no study has yet linked structural alterations in pedophiles to both connectional and functional properties of the aberrant hotspots. The relationship between morphological alterations and brain function in pedophilia as well as their contribution to its psychopathology thus remain unclear. First, we assessed bimodal connectivity of structurally altered candidate regions using meta-analytic connectivity modeling (MACM) and resting-state correlations employing openly accessible data. We compared the ensuing connectivity maps to the activation likelihood estimation (ALE) maps of a recent quantitative meta-analysis of brain activity during processing of sexual stimuli. Second, we functionally characterized the structurally altered regions employing meta-data of a large-scale neuroimaging database. Candidate regions were functionally connected to key areas for processing of sexual stimuli. Moreover, we found that the functional role of structurally altered brain regions in pedophilia relates to nonsexual emotional as well as neurocognitive and executive functions, previously reported to be impaired in pedophiles. Our results suggest that structural brain alterations affect neural networks for sexual processing by way of disrupted functional connectivity, which may entail abnormal sexual arousal patterns. The findings moreover indicate that structural alterations account for common affective and neurocognitive impairments in pedophilia. The present multimodal integration of brain structure and function analyses links sexual and nonsexual psychopathology in pedophilia. Hum Brain Mapp, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
    Full-text · Article · Jun 2015 · Human Brain Mapping
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