Formal help-seeking among community-based Czech individuals with sexual interest in minors is associated with the perceived urgency of self-identified concerns
Status PubMed-not-MEDLINE Jazyk angličtina Země Švýcarsko Médium electronic-ecollection
Typ dokumentu časopisecké články
PubMed
41020124
PubMed Central
PMC12460231
DOI
10.3389/fpsyg.2025.1546102
Knihovny.cz E-zdroje
- Klíčová slova
- barriers, children, mental health, paraphilia, pedophilia, prevention, sexual abuse, therapy,
- Publikační typ
- časopisecké články MeSH
BACKGROUND: In the community, there are non-forensic individuals who experience sexual interest in minors and have specific mental health needs and concerns. If left unaddressed, these issues may contribute to problematic sexual behaviors. Although supportive treatment programs are emerging in Czechia, self-motivated help-seeking remains generally low in this at-risk population. OBJECTIVE: To inform strategies for encouraging preventive service use, this study aimed to examine how past help-seeking experiences relate to factors that may influence the likelihood of seeking professional help, as identified in the literature. METHODS: An online survey was conducted with a purposive sample of 97 community-based, predominantly male, non-forensic adults whose responses to hypothetical scenarios suggested a sexual interest in minors. The study investigated the relationship between self-reported past formal help-seeking behavior (any vs. none) and two key variables: perceived urgency of self-identified concerns and dismissive attitudes toward professional assistance. Analyses controlled for other forms of support sought. RESULTS: Formal support sources were rarely approached. A significant association was found between low perceived urgency of self-identified concerns and the absence of formal help-seeking behavior (β = 0.33, F(1) = 6.34, p = 0.014). CONCLUSION: To promote professional service uptake among this difficult-to-reach population, it is essential to enhance mental health literacy across the broader community and to educate individuals about the role of psychological well-being in preventing problematic behaviors.
Center for Sexual Health and Interventions National Institute of Mental Health Klecany Czechia
Department of Psychology and Life Sciences Faculty of Humanities Prague Czechia
Zobrazit více v PubMed
Adebahr R., Soderstrom E. Z., Arver S., Jokinen J., Oberg K. G. (2021). Reaching men and women at risk of committing sexual offences - findings from the national Swedish telephone helpline PrevenTell. J. Sex. Med. 18, 1571–1581. doi: 10.1016/j.jsxm.2021.06.008, PMID: PubMed DOI
Agapoff J., Johnson T. W., Wassersug R. J., Wibowo E. (2024). Group comparisons of the sexual interests and behaviors of assigned males and their association with genital ablation fantasies. Arch. Sex. Behav. doi: 10.1007/s10508-024-02976-5, PMID: PubMed DOI
Alempijevic D., Beriashvili R., Beynon J., Birmanns B., Brasholt M., Cohen J., et al. (2020). Statement on conversion therapy. J. Forensic Leg. Med. 72:101930. doi: 10.1016/j.jflm.2020.101930, PMID: PubMed DOI
Andersen R. M. (1995). Revisiting the behavioral model and access to medical care: does it matter? J. Health Soc. Behav. 36, 1–10. doi: 10.2307/2137284, PMID: PubMed DOI
Andersen R. M., Davidson P. L. (2007). “Improving access to care in America: individual and contextual indicators” in Changing the U.S. health care system: Key issues in health services policy and management. 3rd ed. (eds.) Andersen R. M., Rice T. H., Kominski G. F. (Hoboken, NJ, US: Jossey-Bass/Wiley; ), 3–31.
Andrade L. H., Alonso J., Mneimneh Z., Wells J. E., Al-Hamzawi A., Borges G., et al. (2014). Barriers to mental health treatment: results from the WHO world mental health surveys. Psychol. Med. 44, 1303–1317. doi: 10.1017/s0033291713001943, PMID: PubMed DOI PMC
Andrade G., Campo Redondo M. (2022). Is conversion therapy ethical? A renewed discussion in the context of legal efforts to ban it. Ethics Med. Public Health 20:100732. doi: 10.1016/j.jemep.2021.100732 DOI
APA (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (fifth edition, text revision). Washington, DC: American Psychiatric Association Publishing.
Armitage R., Wager N., Wibberley D., Hudspith L. F., Gall V. (2024). "We're not allowed to have experienced trauma. We're not allowed to go through the grieving process" - exploring the indirect harms associated with child sexual abuse material (CSAM) offending and its impacts on non-offending family members. Vict. Offender. 19, 915–941. doi: 10.1080/15564886.2023.2172504 DOI
Babchishin K. M., Seto M. C., Långström N. (2025). Psychiatric and neurological morbidity predicts sexual offending: a nationwide, population-based, case-control study. J. Crim. Justice 96:102355. doi: 10.1016/j.jcrimjus.2025.102355 DOI
Baier D. (2024). Paraphilic interests in the Swiss population: results of a representative survey in the canton of Zurich. J. Psychosexual Health 6, 137–147. doi: 10.1177/26318318241255783 DOI
Barker E. D., Friedreich S., Rahman Q. A. (2025). A survey of the united kink-dom: investigating five paraphilic interest groups and their demographic and psychological correlates. J. Sex Res. 1, 1–19. doi: 10.1080/00224499.2025.2486472, PMID: PubMed DOI
Barros S., Oliveira C., Araújo E., Moreira D., Almeida F., Santos A. (2022). Community intervention programs for sex offenders: a systematic review. Front. Psych. 13:949899. doi: 10.3389/fpsyt.2022.949899, PMID: PubMed DOI PMC
Barroso R., Pham T., Greco A. M., Thibaut F. (2019). “Challenges in the treatment of sex offenders” in Long-term forensic psychiatric care: Clinical, ethical and legal challenges. eds. Völlm B., Braun P. (Cham: Springer International Publishing; ), 169–180.
Bártová K., Androvičová R., Krejčová L., Weiss P., Klapilová K. (2021). The prevalence of paraphilic interests in the Czech population: preference, arousal, the use of pornography, fantasy, and behavior. J. Sex Res. 58, 86–96. doi: 10.1080/00224499.2019.1707468, PMID: PubMed DOI
Bayram G., Parks A., Juth N., Rahm C. (2021). Health care professionals' view on pedophilic disorder: a qualitative study. Sex. Relat. Ther. 2021:560. doi: 10.1080/14681994.2021.1900560 DOI
Beggs Christofferson S. M. (2019). Is preventive treatment for individuals with sexual interest in children viable in a discretionary reporting context? J. Interpers. Violence 34, 4254–4280. doi: 10.1177/0886260519869236, PMID: PubMed DOI
Beier K. M., Nentzl J., von Heyden M., Fishere M., Amelung T. (2024). Preventing child sexual abuse and the use of child sexual abuse materials: following up on the German prevention project Dunkelfeld. J. Prev. Dent. 45, 881–900. doi: 10.1007/s10935-024-00792-0, PMID: PubMed DOI PMC
Beier K. M., Neutze J., Mundt I. A., Ahlers C. J., Goecker D., Konrad A., et al. (2009). Encouraging self-identified pedophiles and hebephiles to seek professional help: first results of the prevention project Dunkelfeld (PPD). Child Abuse Negl. 33, 545–549. doi: 10.1016/j.chiabu.2009.04.002, PMID: PubMed DOI
Bekkers L. M. J., Leukfeldt E. R., Holt T. J. (2024). Online communities for child-attracted persons as informal mental health care: exploring self-reported wellbeing outcomes. Sex. Abus. 36, 158–184. doi: 10.1177/10790632231154882, PMID: PubMed DOI
Bellis A., Pinède D., Moulier V., Martin-Bertsch I., Januel D. (2024). French national helpline "stop" for minor-attracted persons: first findings. Encéphale. 51, 349–354. doi: 10.1016/j.encep.2024.06.002 PubMed DOI
Blanchard R., Lykins A. D., Wherrett D., Kuban M. E., Cantor J. M., Blak T., et al. (2009). Pedophilia, hebephilia, and the DSM-V. Arch. Sex. Behav. 38, 335–350. doi: 10.1007/s10508-008-9399-9, PMID: PubMed DOI
Brown A., Barker E. D., Rahman Q. (2023). Psychological and developmental correlates of paraphilic and normophilic sexual interests. Sex. Abus. 35, 428–464. doi: 10.1177/10790632221120013, PMID: PubMed DOI
Cant R. L., Harries M., Chamarette C. (2022). Using a public health approach to prevent child sexual abuse by targeting those at risk of harming children. Int. J. Child Maltreat. 5, 573–592. doi: 10.1007/s42448-022-00128-7 DOI
Cantor J. M. (2018). Can pedophiles change? Curr. Sex. Health Rep. 10, 203–206. doi: 10.1007/s11930-018-0165-2 DOI
Carrola P. A. (2023). Experiences addressing denial in sex offender counseling. J. Forensic Psychol. Res. Pract. 23, 1–20. doi: 10.1080/24732850.2021.2013363 DOI
Chan H. C. (2023). Youth sexual offending in Hong Kong: examining the role of self-control, risky sexual behaviors, and paraphilic interests. Front. Psych. 14:1143271. doi: 10.3389/fpsyt.2023.1143271, PMID: PubMed DOI PMC
Chan H. C., Myers W. C. (2023). Risky sexual behavior, paraphilic interest, and sexual offending: the study of a community sample of young adults in Hong Kong. Int. J. Environ. Res. Public Health 20:4279. doi: 10.3390/ijerph20054279, PMID: PubMed DOI PMC
Chatterjee P. (2023). Necrophilia: a complex intersection of crime and psychological disorder. J. Indian Acad. Forensic Med. 45, 193–198. doi: 10.48165/jiafm.2023.45.2.23 DOI
Christophersen L., Brotto G. (2024). The effectiveness of educational interventions for mental health professionals in reducing stigmatization toward people with pedophilia: a meta-analysis. Trauma Violence Abuse 25, 3796–3813. doi: 10.1177/15248380241262286, PMID: PubMed DOI PMC
Chronos A., Jahnke S., Blagden N. (2024). The treatment needs and experiences of pedohebephiles: a systematic review. Arch. Sex. Behav. 53, 3329–3346. doi: 10.1007/s10508-024-02943-0, PMID: PubMed DOI PMC
Clayton J., Hocken K., Blagden N. (2022). A compassionate intervention for individuals with problematic sexual interests: group and individual outcomes in the UK. Abuse 3, 4–23. doi: 10.37576/abuse.2022.035 DOI
Clement S., Schauman O., Graham T., Maggioni F., Evans-Lacko S., Bezborodovs N., et al. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol. Med. 45, 11–27. doi: 10.1017/S0033291714000129, PMID: PubMed DOI
Cohen L. J., Ndukwe N., Yaseen Z., Galynker I. (2018). Comparison of self-identified minor-attracted persons who have and have not successfully refrained from sexual activity with children. J. Sex Marital Ther. 44, 217–230. doi: 10.1080/0092623X.2017.1377129, PMID: PubMed DOI
Cohen L. J., Wilman-Depena S., Barzilay S., Hawes M., Yaseen Z., Galynker I. (2020). Correlates of chronic suicidal ideation among community-based minor-attracted persons. Sex. Abus. 32, 273–300. doi: 10.1177/1079063219825868, PMID: PubMed DOI
Combridge K., Lastella M. (2023). Stigmatisation of people with deviant sexual interest: a comparative study. Sexes 4, 7–25. doi: 10.3390/sexes4010002, PMID: DOI
Cornally N., McCarthy G. (2011). Help-seeking behaviour: a concept analysis. Int. J. Nurs. Pract. 17, 280–288. doi: 10.1111/j.1440-172X.2011.01936.x, PMID: PubMed DOI
CZSO (2013). Statistical yearbook of the Czech Republic 2013. Prague: Czech Statistical Office.
Davison G. C., Walden K.-R. (2024). History and iatrogenic effects of conversion therapy. Annu. Rev. Clin. Psychol. 20, 333–354. doi: 10.1146/annurev-clinpsy-080822-052144, PMID: PubMed DOI
de Roos M. S., Longpré N., van Dongen J. D. M. (2025). When kinks come to life: an exploration of paraphilic behaviors and underlying predictors. J. Sex Res. 62, 317–329. doi: 10.1080/00224499.2024.2319242, PMID: PubMed DOI
de Tribolet-Hardy F., Veitz S., Dittli L., Habermeyer E. (2025). Perspective: clinical care of pedophilic individuals in Zurich, Switzerland. Int. J. Impot. Res. 37, 199–203. doi: 10.1038/s41443-024-00968-6, PMID: PubMed DOI PMC
de Vries Robbé M., Mann R. E., Maruna S., Thornton D. (2015). An exploration of protective factors supporting desistance from sexual offending. Sex. Abus. 27, 16–33. doi: 10.1177/1079063214547582, PMID: PubMed DOI
Di Gioia R., Beslay L. (2023). Help seeker and perpetrator prevention initiatives - child sexual abuse and exploitation. Luxembourg: Publications Office of the European Union.
Drane C. F., Jalleh G., Lin C., Donovan R. J. (2023). Impact of the act-belong-commit campaign on mental health help-seeking behaviour. Health Promot. J. Austr. 34, 232–236. doi: 10.1002/hpja.605, PMID: PubMed DOI PMC
Engel J., Nagy L., Dickhut C., Veit M., Kneer J., Kruger T. H. C. (2025). Paraphilias and sexual offending in compulsive sexual behavior in the sex@brain-study. Sex. Health. Compuls. 32, 25–44. doi: 10.1080/26929953.2024.2392204 DOI
Erkan V., Schröder J., Briken P., Tozdan S. (2024). Factors associated with contact sexual offending among a non-forensic sample of women with sexual interest in children – results from an anonymous online survey. Sex. Abus. 36, 418–440. doi: 10.1177/10790632231159076, PMID: PubMed DOI
European Commission (2020). EU strategy for a more effective fight against child sexual abuse. Directorate-general for migration and home affairs. Brussels: European Commission.
Fafejta M. (2021). Coming out of people with pedophilic orientation. Int. J. Sex. Health 33, 312–325. doi: 10.1080/19317611.2021.1913687, PMID: PubMed DOI PMC
Farmer C., Salter M., Woodlock D. (2024). A review of academic use of the term “minor attracted persons”. Trauma Violence Abuse 25, 4078–4089. doi: 10.1177/15248380241270028, PMID: PubMed DOI PMC
Ferguson C. J. (2009). An effect size primer: a guide for clinicians and researchers. Prof. Psychol. Res. Pr. 40, 532–538. doi: 10.1037/a0015808 DOI
Fernandez J. A., Fernandez J. A., Jaladin, R A. M. (2023). Beware of the menacing monsters around us: protecting Malaysian children from sexual abuse. Br. J. Guid. Counc. 51, 705–714. doi: 10.1080/03069885.2021.1938970 DOI
Fox M. H., Seto M. C., Refaie N., Lavrinsek S., Hall V., Curry S., et al. (2022). The relation between the paraphilias and anxiety in men: a case–control study. Arch. Sex. Behav. 51, 4063–4084. doi: 10.1007/s10508-022-02346-z, PMID: PubMed DOI
Gibbels C., Kneer J., Hartmann U., Krueger T. H. C. (2019). State of the art treatment options for actual and potential sexual offenders and new prevention strategies. J. Psychiatr. Pract. 25, 242–257. doi: 10.1097/pra.0000000000000395 PubMed DOI
Glina F., Carvalho J., Barroso R., Cardoso D. (2022). Lay people's myths regarding pedophilia and child sexual abuse: a systematic review. Sex. Med. Rev. 10, 596–619. doi: 10.1016/j.sxmr.2022.06.010 PubMed DOI
Goerlich S. (2024). Cradle and all: outcome differences between kink-affirming and kink uninformed therapies for a complex client with paraphilia. Sex. Relation. Ther. 39, 997–1020. doi: 10.1080/14681994.2023.2215739 DOI
Grady M. D., Levenson J. S., Mesias G., Kavanagh S., Charles J. (2019). "I can’t talk about that": stigma and fear as barriers to preventive services for minor-attracted persons. Stigma Health 4, 400–410. doi: 10.1037/sah0000154 DOI
Grundmann D., Krupp J., Scherner G., Amelung T., Beier K. M. (2016). Stability of self-reported arousal to sexual fantasies involving children in a clinical sample of pedophiles and hebephiles. Arch. Sex. Behav. 45, 1153–1162. doi: 10.1007/s10508-016-0729-z, PMID: PubMed DOI
Gündoğdu H., Aslan K., Ayhan H. C., Aktaş C. M. (2024). Variables predicting psychological help seeking attitudes: self-stigma, mental health literacy, and depression/anxiety. Eur. Psychiatry 67:S678. doi: 10.1192/j.eurpsy.2024.1409 DOI
Hales S. T., Rawers C., Gannon T. A. (2024). Empirically assessing the effectiveness of the pathways Programme: an online self-help intervention for male sexual aggression at UK universities. Arch. Sex. Behav. 53, 1377–1394. doi: 10.1007/s10508-024-02808-6, PMID: PubMed DOI PMC
Hallberg J., Kaldo V., Arver S., Dhejne C., Jokinen J., Görts Öberg K. (2019). A randomized controlled study of group-administered cognitive behavioral therapy for hypersexual disorder in men. J. Sex. Med. 16, 733–745. doi: 10.1016/j.jsxm.2019.03.005, PMID: PubMed DOI
Harper C. A., Lievesley R., Blagden N. J., Hocken K. (2022). Humanizing pedophilia as stigma reduction: a large-scale intervention study. Arch. Sex. Behav. 51, 945–960. doi: 10.1007/s10508-021-02057-x, PMID: PubMed DOI PMC
Heindl P., Schobel S., Fischer K., Nenov-Matt T., Chrobok A., Wertz M., et al. (2024). Risk assessment and treatment - evaluation of a group therapy for people with pedophilia. Eur. Psychiatry 67:S377. doi: 10.1192/j.eurpsy.2024.775 DOI
Houtepen J. A., Sijtsema J. J., Bogaerts S. (2016). Being sexually attracted to minors: sexual development, coping with forbidden feelings, and relieving sexual arousal in self-identified pedophiles. J. Sex Marital Ther. 42, 48–69. doi: 10.1080/0092623x.2015.1061077, PMID: PubMed DOI
Howard K. A., Griffiths K. M., McKetin R., Ma J. (2018). Can a brief biologically-based psychoeducational intervention reduce stigma and increase help-seeking intentions for depression in young people? A randomised controlled trial. J. Child Adolesc. Ment. Health 30, 27–39. doi: 10.2989/17280583.2018.1467323, PMID: PubMed DOI
Hunn C., Prichard J., Cockburn H. (2022). Internet users' beliefs about a novice-user of child sexual abuse material (CSAM): what can they tell us about introducing offender-focused prevention initiatives? Vict. Offender 17, 1–21. doi: 10.1080/15564886.2020.1865224 DOI
Insoll T., Soloveva V., Díaz Bethencourt E., Ovaska A. K., Nurmi J., Paju A., et al. (2024). Factors associated with help-seeking among online child sexual abuse material offenders: results of an anonymous survey on the dark web. J. Online Trust Saf. 2:205. doi: 10.54501/jots.v2i4.205 DOI
Ischebeck J., Kuhle L. F., Rosenbach C., Stelzmann D. (2024). Journalism and pedophilia: background on the media coverage of a stigmatized minority. Stigma Health 9, 20–29. doi: 10.1037/sah0000301 DOI
Jackson T., Ahuja K., Tenbergen G. (2022). Challenges and solutions to implementing a community-based wellness program for non-offending minor attracted persons. J. Child Sex. Abuse 31, 316–332. doi: 10.1080/10538712.2022.2056103, PMID: PubMed DOI
Jahnke S. (2018). Emotions and cognitions associated with the stigma of non-offending pedophilia: a vignette experiment. Arch. Sex. Behav. 47, 363–373. doi: 10.1007/s10508-017-1073-7, PMID: PubMed DOI
Jahnke S., Hoyer J. (2017). The stigma of pedophilia: retest-reliability and validity of the social distance and the punitive attitudes scale.
Jahnke S., Imhoff R., Hoyer J. (2015a). Stigmatization of people with pedophilia: two comparative surveys. Arch. Sex. Behav. 44, 21–34. doi: 10.1007/s10508-014-0312-4, PMID: PubMed DOI
Jahnke S., McPhail I. V., Antfolk J. (2024). Stigma processes, psychological distress, and attitudes toward seeking treatment among pedohebephilic people. PLoS One 19:e0312382. doi: 10.1371/journal.pone.0312382, PMID: PubMed DOI PMC
Jahnke S., Philipp K., Hoyer J. (2015b). Stigmatizing attitudes towards people with pedophilia and their malleability among psychotherapists in training. Child Abuse Negl. 40, 93–102. doi: 10.1016/j.chiabu.2014.07.008, PMID: PubMed DOI
Jahnke S., Schmidt A. F., Geradt M., Hoyer J. (2015c). Stigma-related stress and its correlates among men with pedophilic sexual interests. Arch. Sex. Behav. 44, 2173–2187. doi: 10.1007/s10508-015-0503-7, PMID: PubMed DOI
Janz N. K., Becker M. H. (1984). The health belief model: a decade later. Health Educ. Q. 11, 1–47. doi: 10.1177/109019818401100101, PMID: PubMed DOI
Jara G. A., Jeglic E. (2021). Changing public attitudes toward minor attracted persons: an evaluation of an anti-stigma intervention. J. Sex. Aggress. 27, 299–312. doi: 10.1080/13552600.2020.1863486 DOI
Jimenez-Arista L. E., Reid D. B. (2023). Realization, self-view, and disclosure of pedophilia: a content analysis of online posts. Sex. Abus. 35, 214–240. doi: 10.1177/10790632221099256, PMID: PubMed DOI
Jones S. J., Ó Ciardha C., Elliott I. A. (2021). Identifying the coping strategies of nonoffending pedophilic and hebephilic individuals from their online forum posts. Sex. Abus. 33, 793–815. doi: 10.1177/1079063220965953, PMID: PubMed DOI PMC
Jones C., Salter M., Woodlock D. (2023). Someone who has been in my shoes: the effectiveness of a peer support model for providing support to partners, family and friends of child sexual abuse material offenders. Vict. Offender 18, 715–731. doi: 10.1080/15564886.2022.2051108 DOI
Jorm A. F. (2012). Mental health literacy: empowering the community to take action for better mental health. Am. Psychol. 67, 231–243. doi: 10.1037/a0025957, PMID: PubMed DOI
Joyal C. C., Carpentier J. (2022). Concordance and discordance between paraphilic interests and behaviors: a follow-up study. J. Sex Res. 59, 385–390. doi: 10.1080/00224499.2021.1986801, PMID: PubMed DOI
Kavanagh E., Kinsella E., Ryan P. (2023). The lived experiences of female relatives of child sexual abuse material (CSAM) offenders in Ireland and the United Kingdom. J. Child Sex. Abuse 32, 940–962. doi: 10.1080/10538712.2023.2274888, PMID: PubMed DOI
Kavanagh E., Kinsella E. L., Ryan P. (2024). "your world, everything just implodes, it really is a life-changing experience": how do relatives of child sexual abuse material (CSAM) offenders navigate life following discovery of the offence? J. Sex. Aggress. 1-17, 1–17. doi: 10.1080/13552600.2024.2332933, PMID: DOI
Kinsey A. C., Pomeroy W. B., Martin C. E. (1948). Sexual behavior in the human male. Bloomington: Indiana University Press.
Kinsey A. C., Pomeroy W. B., Martin C. E., Gebhard P. H. (1953). Sexual behavior in the human female. Bloomington: Indiana University Press.
Klapilová K., Demidova L. Y., Elliott H., Flinton C. A., Weiss P., Fedoroff J. P. (2019). Psychological treatment of problematic sexual interests: cross-country comparison. Int. Rev. Psychiatry 31, 169–180. doi: 10.1080/09540261.2019.1591353, PMID: PubMed DOI
Konrad A., Heid L. M., Scheuermann H., Beier K. M., Amelung T. (2025). Acceptance of sexual attraction and its link to psychological distress and sexual offending among pedohebephilic clients: results from a preliminary analysis. Front. Psychol. 15:1463191. doi: 10.3389/fpsyg.2024.1463191, PMID: PubMed DOI PMC
Kothari R., Key R., Lawrenson J., Squire T., Farnham F., Underwood A. (2021). Understanding risk of suicide among perpetrators who view child sexual abuse material (CSAM). J. Forensic Leg. Med. 81:102188. doi: 10.1016/j.jflm.2021.102188, PMID: PubMed DOI
Krejčová L., Plášilová L., Potyszová K., Čiženkova A., Šinkner F., Klapilová K. (2021). Parafilik: program primární prevence pro jedince s parafilní preferencí a jejich blízké. Sexuológia 20, 13–17.
Kulik A., Lubenets I., Kulakova N., Zelenyak P., Lisnychenko L. (2021). Pedophilia as a cause of child sexual abuse: a medical and legal problem. Georgian Med. News 312, 172–180. PubMed
Lampalzer U., Tozdan S., von Franqué F., Briken P. (2021). Hypersexuality and impulsivity in self-referred men with sexual interest in minors: are they related? Do they change during treatment? An exploratory pilot study. Sex. Med. 9:100429. doi: 10.1016/j.esxm.2021.100429, PMID: PubMed DOI PMC
Langvik E., Størdal T. R., Steel C. M., Christiansen L. F., Iversen A. (2024). Public perception of individuals who commit child sexual abuse material offences: exploring the impact of demographic variables and cross-national differences. Child Abuse Negl. 25:106922. doi: 10.1016/j.chiabu.2024.106922, PMID: PubMed DOI
Lasher M. P., Stinson J. D. (2017). Adults with pedophilic interests in the United States: current practices and suggestions for future policy and research. Arch. Sex. Behav. 46, 659–670. doi: 10.1007/s10508-016-0822-3, PMID: PubMed DOI
Lassche M. M., Lasogga L., de Roos M. S., Leeflang A., Ajazi V., Axioti M., et al. (2024). Dark tetrad personality traits, paraphilic interests, and the role of impulsivity: an EEG-study using a go/no-go paradigm. Sci. Rep. 14:10884. doi: 10.1038/s41598-024-61214-z, PMID: PubMed DOI PMC
Lätth J., Joleby M., McMahan A., Luke T. J., Rahm C. (2025). Child sexual abuse material users on the Darknet: psychiatric morbidities related to offence behavior. Sex. Abus. 2024:10790632251347562. doi: 10.1177/10790632251347562, PMID: PubMed DOI
Lätth J., Landgren V., McMahan A., Sparre C., Eriksson J., Malki K., et al. (2022). Effects of internet-delivered cognitive behavioral therapy on use of child sexual abuse material: a randomized placebo-controlled trial on the Darknet. Internet Interv. 30:100590. doi: 10.1016/j.invent.2022.100590, PMID: PubMed DOI PMC
Lawrence A. L., Willis G. M. (2021). Understanding and challenging stigma associated with sexual interest in children: a systematic review. Int. J. Sex. Health 33, 144–162. doi: 10.1080/19317611.2020.1865498, PMID: PubMed DOI PMC
Lawrence A. L., Willis G. M. (2022). Understanding and influencing public attitudes surrounding people with a sexual interest in children. Stigma Health 7, 260–269. doi: 10.1037/sah0000391 DOI
Lawrence A. L., Willis G. M. (2023). Cognitive and affective impacts of antistigma interventions surrounding people with a sexual interest in children. J. Sex Marital Ther. 49, 945–959. doi: 10.1080/0092623X.2023.2224323, PMID: PubMed DOI
Lawrence A. L., Willis G. M. (2024). Facilitators and barriers to understanding and accepting people with a sexual interest in children: a thematic analysis. Arch. Sex. Behav. 53, 1361–1375. doi: 10.1007/s10508-023-02757-6, PMID: PubMed DOI
Lehmann R. J. B., Jahnke S., Bartels R., Butzek J., Molitor A., Schmidt A. F. (2024). Public stigmatizing reactions toward nonoffending pedophilic individuals seeking to relieve sexual arousal. J. Sex Res. 61, 1119–1129. doi: 10.1080/00224499.2023.2198512, PMID: PubMed DOI
Lehmann R. J. B., Obermeier F., Schmidt A. F., Enge S. (2025). The propensity for deviant sexual behavior in the general population: an empirical examination of the motivation-facilitation model. Sex. Abus. 37, 426–447. doi: 10.1177/10790632241283752, PMID: PubMed DOI
Lehmann R. J. B., Schmidt A. F., Jahnke S. (2021). Stigmatization of paraphilias and psychological conditions linked to sexual offending. J. Sex Res. 58, 438–447. doi: 10.1080/00224499.2020.1754748, PMID: PubMed DOI
Levenson J. S. (2011). "But I didn't do it!": ethical treatment of sex offenders in denial. Sex. Abus. 23, 346–364. doi: 10.1177/1079063210382048, PMID: PubMed DOI
Levenson J. S., Grady M. D. (2019a). "I could never work with those people…": secondary prevention of child sexual abuse via a brief training for therapists about pedophilia. J. Interpers. Violence 34, 4281–4302. doi: 10.1177/0886260519869238 DOI
Levenson J. S., Grady M. D. (2019b). Preventing sexual abuse: perspectives of minor-attracted persons about seeking help. Sex. Abus. 31, 991–1013. doi: 10.1177/1079063218797713, PMID: PubMed DOI
Levenson J. S., Grady M. D., Morin J. W. (2020). Beyond the “ick factor”: counseling non-offending persons with pedophilia. Clin. Soc. Work. J. 48, 380–388. doi: 10.1007/s10615-019-00712-4 DOI
Levenson J. S., Willis G. M., Vicencio C. P. (2017). Obstacles to help-seeking for sexual offenders: implications for prevention of sexual abuse. J. Child Sex. Abuse 26, 99–120. doi: 10.1080/10538712.2016.1276116, PMID: PubMed DOI
Lex A., Gehlenborg N., Strobelt H., Vuillemot R., Pfister H. (2014). UpSet: visualization of intersecting sets. IEEE Trans. Vis. Comput. Graph. 20, 1983–1992. doi: 10.1109/TVCG.2014.2346248, PMID: PubMed DOI PMC
Lien Y. J., Chen L., Cai J., Wang Y. H., Liu Y. Y. (2024). The power of knowledge: how mental health literacy can overcome barriers to seeking help. Am. J. Orthopsychiatry 94, 127–147. doi: 10.1037/ort0000708, PMID: PubMed DOI
Lievesley R., Harper C. A. (2022). Applying desistance principles to improve wellbeing and prevent child sexual abuse among minor-attracted persons. J. Sex. Aggress. 28, 1–14. doi: 10.1080/13552600.2021.1883754 DOI
Lievesley R., Harper C. A., Swaby H., Woodward E. (2023). Identifying and working with appropriate treatment targets with people who are sexually attracted to children. J. Sex Marital Ther. 49, 497–516. doi: 10.1080/0092623X.2022.2149437, PMID: PubMed DOI
Lievesley R., Harper C. A., Woodward E. (2025a). Toward a holistic approach to treatment and support for people with attractions to children. Curr. Sex. Health Rep. 17:7. doi: 10.1007/s11930-025-00403-x DOI
Lievesley R., Swaby H., Stevenson J., Harper C. A. (2025b). Not offending is easy. The double life, the secrets, the loneliness are the hardest parts I needed help with: understanding the treatment needs of people with attractions to children. J. Sex Marital Ther. 51, 22–41. doi: 10.1080/0092623X.2024.2402320 PubMed DOI
Mann R. E., Webster S. D., Wakeling H. C., Keylock H. (2013). Why do sexual offenders refuse treatment? J. Sex. Aggress. 19, 191–206. doi: 10.1080/13552600.2012.703701 DOI
Marečková A., Androvičová R., Bártová K., Krejčová L., Klapilová K. (2022). Men with paraphilic interests and their desire to interact with a sex robot. J. Future Robot Life 3, 39–48. doi: 10.3233/FRL-210010 DOI
Martijn F. M., Babchishin K. M., Pullman L. E., Seto M. C. (2020). Sexual attraction and falling in love in persons with pedohebephilia. Arch. Sex. Behav. 49, 1305–1318. doi: 10.1007/s10508-019-01579-9, PMID: PubMed DOI
Mathews B. (2015). “Mandatory reporting laws: their origin, nature, and development over time” in Mandatory reporting laws and the identification of severe child abuse and neglect. eds. Mathews B., Bross D. C. (Dordrecht: Springer Netherlands; ), 3–25.
McCann T. V., Lubman D. I. (2018). Help-seeking barriers and facilitators for affected family members of a relative with alcohol and other drug misuse: a qualitative study. J. Subst. Abus. Treat. 93, 7–14. doi: 10.1016/j.jsat.2018.07.005, PMID: PubMed DOI
McKillop N., Price S. (2023). The potential for anti-stigma interventions to change public attitudes toward minor-attracted persons: a replication and extension of Jara and Jeglic's study. J. Child Sex. Abuse 32, 694–714. doi: 10.1080/10538712.2023.2204864 PubMed DOI
McPhail I. V. (2024). The subjective experience of individuals with pedohebephilic interest. Curr. Sex. Health Rep. 16, 35–46. doi: 10.1007/s11930-023-00381-y DOI
McPhail I. V., Hermann C. A., Fernane S., Fernandez Y. M., Nunes K. L., Cantor J. M. (2019). Validity in phallometric testing for sexual interests in children: a meta-analytic review. Assessment 26, 535–551. doi: 10.1177/1073191117706139, PMID: PubMed DOI
Mojtabai R., Olfson M., Sampson N. A., Jin R., Druss B., Wang P. S., et al. (2011). Barriers to mental health treatment: results from the National Comorbidity Survey Replication. Psychol. Med. 41, 1751–1761. doi: 10.1017/s0033291710002291, PMID: PubMed DOI PMC
Mokros A., Banse R. (2019). The "Dunkelfeld" project for self-identified pedophiles: a reappraisal of its effectiveness. J. Sex. Med. 16, 609–613. doi: 10.1016/j.jsxm.2019.02.009, PMID: PubMed DOI
Murphy R. (2024). A pilot study: exploring suicidal ideation among non-offending adults with sexual attraction to minors, through their online forum posts. J. Soc. Work. 24, 777–794. doi: 10.1177/14680173241240973 DOI
Navrátil M., Klapilová K., Kucera M., Krejcová L., Martinec Nováková L., Jozefík D. (2025). Effectiveness and cost-effectiveness of the Parafilik program in Czechia. J. Sex. Med. 22:173. doi: 10.1093/jsxmed/qdaf077.173 DOI
Nematy A., Flynn S., McCarthy-Jones S. (2024). Perspectives, treatment goals, and approaches of prevention-specialist mental health professionals in working with clients attracted to children. Sex. Abus. 2024:10790632241268465. doi: 10.1177/10790632241268465, PMID: PubMed DOI PMC
Nielsen M. H., Aaskov L., Larsen J. E. (2022). When virtuous paedophiles meet online: a sociological study of a paedophile community. Sexualities 25, 598–614. doi: 10.1177/1363460720979306 DOI
Noorishad P.-G., Levaque E., Byers E. S., Shaughnessy K. (2019). More than one flavour: university students' specific sexual fantasies, interests, and experiences. Can. J. Hum. Sex. 28, 143–158. doi: 10.3138/cjhs.2019-0024 DOI
Nurmi J., Paju A., Brumley B. B., Insoll T., Ovaska A. K., Soloveva V., et al. (2024). Investigating child sexual abuse material availability, searches, and users on the anonymous Tor network for a public health intervention strategy. Sci. Rep. 14:7849. doi: 10.1038/s41598-024-58346-7, PMID: PubMed DOI PMC
Özparlak A., Karakaya D., Özer Z. (2023). The association of mental health literacy with mental well-being and help-seeking in young people: a systematic review and meta-analysis. J. Pediatr. Nurs. 73, e243–e250. doi: 10.1016/j.pedn.2023.09.017 PubMed DOI
Paquette S., Brouillette-Alarie S., Seto M. C. (2022). Pornography use, offense-supportive cognitions, atypical sexual interests, and sexual offending against children. J. Sex Res. 59, 792–804. doi: 10.1080/00224499.2021.2023450, PMID: PubMed DOI
Parks A., Sparre C., Soderquist E., Arver S., Andersson G., Kaldo V., et al. (2020). Illegal online sexual behavior during the COVID-19 pandemic: a call for action based on experiences from the ongoing prevent it research study. Arch. Sex. Behav. 49, 1433–1435. doi: 10.1007/s10508-020-01750-7 PubMed DOI PMC
Páv M., Krejčová L., Klapilová K. (2024). “People with paraphilia as targets of sexual offence prevention strategies in Czechia: recent developments and future directions” in Innovative treatment approaches in forensic and correctional settings. ed. Siglag M. (New York, NY: Routledge; ), 226–238.
Piwowar M., Görts Öberg K., Hallberg J., Jokinen J. (2022). Internet-administered cognitive behavioral therapy for hypersexual disorder, with or without paraphilia(s) or paraphilic disorder(s) in men: a pilot study. J. Sex. Med. 19:S67. doi: 10.1016/j.jsxm.2022.08.008 PubMed DOI
Požarskis A., Požarska R. (2023). Socially dangerous sexual paraphilias: description of the problem. Proc. Latv. Acad. Sci. B Nat. Exact Appl. Sci. 77, 217–225. doi: 10.2478/prolas-2023-0031 DOI
Price S., McKillop N., Scanlan J., Rayment-McHugh S., Christensen L., Prichard J. (2024). A review of digital interventions as secondary prevention measures to combat online child sexual abuse perpetration. J. Child Sex. Abuse 33, 869–890. doi: 10.1080/10538712.2024.2415549, PMID: PubMed DOI
Reichert J., Wielinga F. E., Olver M. E. (2025). Under pressure: identifying pathways to sexual coercion in a community sample. J. Sex. Aggress. 1-18, 1–18. doi: 10.1080/13552600.2025.2487917 DOI
Robinson J. H., Callister L. C., Berry J. A., Dearing K. A. (2008). Patient-centered care and adherence: definitions and applications to improve outcomes. J. Am. Acad. Nurse Pract. 20, 600–607. doi: 10.1111/j.1745-7599.2008.00360.x, PMID: PubMed DOI
Rosenberg M. S. (2010). A generalized formula for converting chi-square tests to effect sizes for meta-analysis. PLoS One 5:e10059. doi: 10.1371/journal.pone.0010059, PMID: PubMed DOI PMC
Salter M., Woodlock D., Jones C. (2024). "You feel like you did something so wrong": women's experiences of a loved one's child sexual abuse material offending. Violence Against Women 30, 890–910. doi: 10.1177/10778012231208974, PMID: PubMed DOI PMC
Santtila P., Antfolk J., Räfså A., Hartwig M., Sariola H., Sandnabba N. K., et al. (2015). Men's sexual interest in children: one-year incidence and correlates in a population-based sample of Finnish male twins. J. Child Sex. Abuse 24, 115–134. doi: 10.1080/10538712.2015.997410, PMID: PubMed DOI
Savoie V., Quayle E., Flynn E. (2021). Prevalence and correlates of individuals with sexual interest in children: a systematic review. Child Abuse Negl. 115:105005. doi: 10.1016/j.chiabu.2021.105005, PMID: PubMed DOI
Schaefer A., Wittenberg A., Galynker I., Cohen L. J. (2023). Qualitative analysis of minor attracted persons' subjective experience: implications for treatment. J. Sex Marital Ther. 49, 391–411. doi: 10.1080/0092623X.2022.2126808, PMID: PubMed DOI
Schmidt A. F., Niehaus S. (2022). Outpatient therapists' perspectives on working with persons who are sexually interested in minors. Arch. Sex. Behav. 51, 4157–4178. doi: 10.1007/s10508-022-02377-6, PMID: PubMed DOI PMC
Schnyder N., Panczak R., Groth N., Schultze-Lutter F. (2017). Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis. Br. J. Psychiatry 210, 261–268. doi: 10.1192/bjp.bp.116.189464, PMID: PubMed DOI
Seto M. C. (2019). The motivation-facilitation model of sexual offending. Sex. Abus. 31, 3–24. doi: 10.1177/1079063217720919, PMID: PubMed DOI
Seto M. C., Curry S., Dawson S. J., Bradford J. M. W., Chivers M. L. (2021). Concordance of paraphilic interests and behaviors. J. Sex Res. 58, 424–437. doi: 10.1080/00224499.2020.1830018, PMID: PubMed DOI
Shahwan S., Lau J. H., Goh C. M. J., Ong W. J., Tan G. T. H., Kwok K. W., et al. (2020). The potential impact of an anti-stigma intervention on mental health help-seeking attitudes among university students. BMC Psychiatry 20:562. doi: 10.1186/s12888-020-02960-y, PMID: PubMed DOI PMC
Shields R. T., Murray S. M., Ruzicka A. E., Buckman C., Kahn G., Benelmouffok A., et al. (2020). Help wanted: lessons on prevention from young adults with a sexual interest in prepubescent children. Child Abuse Negl. 105:104416. doi: 10.1016/j.chiabu.2020.104416, PMID: PubMed DOI
Spada A. H., Winters G. M., Jeglic E. L., Johnson B. N., Allan C. (2025). An exploration of racial and ethnic differences in paraphilic interests and behaviours among a nonoffending sample. J. Sex. Aggress. 31, 245–259. doi: 10.1080/13552600.2024.2332943 DOI
Stelzmann D., Jahnke S., Kuhle L. F. (2020). Media coverage of pedophilia: benefits and risks from healthcare practitioners' point of view. Int. J. Environ. Res. Public Health 17:5739. doi: 10.3390/ijerph17165739, PMID: PubMed DOI PMC
Stelzmann D., Jahnke S., Kuhle L. F. (2022). Media coverage of pedophilia and its impact on help-seeking persons with pedophilia in Germany - a focus group study. Int. J. Environ. Res. Public Health 19:9356. doi: 10.3390/ijerph19159356, PMID: PubMed DOI PMC
Stephens S., McPhail I. V., Heasman A., Moss S. (2021). Mandatory reporting and clinician decision-making when a client discloses sexual interest in children. Can. J. Behav. Sci. 53, 263–273. doi: 10.1037/cbs0000247 DOI
Stevens E., Wood J. (2019). I despise myself for thinking about them. A thematic analysis of the mental health implications and employed coping mechanisms of self-reported non-offending minor attracted persons. J. Child Sex. Abuse 28, 968–989. doi: 10.1080/10538712.2019.1657539 PubMed DOI
Swaby H., Lievesley R. (2023). "falling through the cracks": a retrospective exploration of the barriers to help-seeking among men convicted of sexual crimes. Sex. Abus. 35, 812–841. doi: 10.1177/10790632221146501, PMID: PubMed DOI
Tenbergen G., Martinez-Dettamanti M., Christiansen C. (2021). Can nonoffending pedophiles be reached for the primary prevention of child sexual abuse by addressing nonoffending individuals who are attracted to minors in the United States? New strategies with the global prevention project. J. Psychiatr. Pract. 27, 265–272. doi: 10.1097/pra.0000000000000561, PMID: PubMed DOI
Van der Molen L., Ronis S. T., Benoit A. A. (2023). Paraphilic interests versus behaviors: factors that distinguish individuals who act on paraphilic interests from individuals who refrain. Sex. Abus. 35, 403–427. doi: 10.1177/10790632221108949, PMID: PubMed DOI PMC
van Horn J., Eisenberg M., Nicholls C. M., Mulder J., Webster S., Paskell C., et al. (2015). Stop it now! A pilot study into the limits and benefits of a free helpline preventing child sexual abuse. J. Child Sex. Abuse 24, 853–872. doi: 10.1080/10538712.2015.1088914, PMID: PubMed DOI
von Franqué F., Bergner-Koether R., Schmidt S., Pellowski J. S., Peters J. H., Hajak G., et al. (2023). Individuals under voluntary treatment with sexual interest in minors: what risk do they pose? Front. Psych. 14:1277225. doi: 10.3389/fpsyt.2023.1277225, PMID: PubMed DOI PMC
Wagner T., Jahnke S., Beier K. M., Hoyer J., Scherner G. (2016). Pädophile Neigungen offenbaren: Stigma-Management bei Patienten aus dem Berliner Präventionsprojekt Dunkelfeld. Z. Sex. Forsch. 29, 106–130. doi: 10.1055/s-0042-108000 DOI
Waldmann T., Staiger T., Oexle N., Rüsch N. (2020). Mental health literacy and help-seeking among unemployed people with mental health problems. J. Ment. Health 29, 270–276. doi: 10.1080/09638237.2019.1581342, PMID: PubMed DOI
Walker A., Butters R. P., Nichols E. (2022). "I would report it even if they have not committed anything": social service students' attitudes toward minor-attracted people. Sex. Abus. 34, 52–77. doi: 10.1177/1079063221993480, PMID: PubMed DOI
Warkentin H. F., Mazinan R. G., Fuss J., Kratzer L., Biedermann S. V. (2025). BDSM and masochistic sexual fantasies in women with borderline personality disorder: simply on the spectrum of "normality" or source of suffering? Borderline Personal. Disord. Emot. Dysregul. 12:7. doi: 10.1186/s40479-025-00283-6, PMID: PubMed DOI PMC
Wibowo E., Wong S. T. S., Wassersug R. J., Johnson T. W. (2022). Paraphilic sexual attraction to males without genitals is associated with traumatic childhood experience, body image, and thoughts/behaviors related to genital ablation. Arch. Sex. Behav. doi: 10.1007/s10508-022-02427-z [Published online ahead of print]., PMID: PubMed DOI
Wild T. S. N., Müller I., Fromberger P., Jordan K., Klein L., Müller J. L. (2020). Prevention of sexual child abuse: preliminary results from an outpatient therapy program. Front. Psych. 11:88. doi: 10.3389/fpsyt.2020.00088, PMID: PubMed DOI PMC
Woodward E., Lievesley R., Harper C. A., McDermott D. T. (2024). Sexual fulfilment, wellbeing and risk considerations for people with sexual attractions to children. Child Abuse Negl. 107037:107037. doi: 10.1016/j.chiabu.2024.107037, PMID: PubMed DOI
World Health Organization (2015). International statistical classification of diseases and related health problems, 10th revision. Fifth Edn. Geneva: World Health Organization.
Xu Z., Huang F., Kösters M., Staiger T., Becker T., Thornicroft G., et al. (2018). Effectiveness of interventions to promote help-seeking for mental health problems: systematic review and meta-analysis. Psychol. Med. 48, 2658–2667. doi: 10.1017/S0033291718001265, PMID: PubMed DOI
Yakeley J., Rost F., Wood H., Abid S. (2025). Paraphilias, problematic sexual behaviours and personality disorder—to what extent are they linked? Personal. Ment. Health 19:e1650. doi: 10.1002/pmh.1650, PMID: PubMed DOI
Zakaria R. (2018). Demons of disaster. Why the foreign-aid world attracts sexual abusers. Baffler 41, 126–134.
Zakreski E., Androvičová R., Bártová K., Chronos A., Krejčová L., Martinec Nováková L., et al. (2024). Childhood adversity and offense-supportive cognitions among Czech adults with a sexual interest in violence or children. Arch. Sex. Behav. 53, 2159–2172. doi: 10.1007/s10508-024-02837-1, PMID: PubMed DOI
Zidenberg A. M., Saad I., Schwier M. (2025). Understanding attitudes and psychological characteristics of zoophilic fantasy endorsers. Anthrozoös 38, 473–487. doi: 10.1080/08927936.2025.2476295 DOI