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Distinction between Pedophilia and Pedophilic disorder

Hey @Crossroads !

I disagree with the notion of undue weight (Wikipedia:UNDUE )

There is confusing of terms in the article (MOS:CONFUSE) Such a vagueness and confusion of the content of terms leads readers to misunderstanding both Pedophilia and Pedophilic disorder.

So the distinction is critical for the quality of the article.

For example: “The diagnosis can therefore be made based on the presence of fantasies or sexual urges even if they have never been acted upon.”

It is an incorrect statement. The diagnosis can not be made based on the presence of paraphilia solely. There MUST be the second criterion (actions OR distress)

“Pedophilia is termed pedophilic disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)”

It is an incorrect statement because it openly confuses the terms and overshadows a critical distinction.

Pedophilic disorder is not simly a new term for pedophilia. These are two significantly distinct concepts, which can be easily verified.

"And I just double-checked the ICD-11, and yes, it defines pedophilia as *inherently* a disorder unlike what was being claimed here."

Please explain why you made such a conclusion. Neither DSM 5 nor ICD 11 do not define paraphilias as a disorder on its own. Paraphilia is a necessary but not sufficient condition for the paraphilic disorder under both classifications

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Medical article requieres precision in terms. As the diagnosis depends on the distinction of these concepts, it is a critical distinction, not undue weighted. APA directly highlights the distinction, so we should do the same:

"Change to Diagnostic Names

In DSM-5, paraphilias are not ipso facto mental disorders. There is a distinction between paraphilias and paraphilic disorders. A paraphilic disorder is a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others. A paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder, and a paraphilia by itself does not automatically justify or require clinical intervention.

The distinction between paraphilias and paraphilic disorders was implemented without making any changes to the basic structure of the diagnostic criteria as they had existed since DSM-III-R. In the diagnostic criteria set for each of the listed paraphilic disorders, Criterion A specifies the qualitative nature of the paraphilia (e.g., an erotic focus on children or on exposing the genitals to strangers), and Criterion B specifies the negative consequences of the paraphilia (distress, impairment, or harm—or risk of harm—to others).

The change for DSM-5 is that individuals who meet both Criterion A and Criterion B would now be diagnosed as having a paraphilic disorder. A diagnosis would not be given to individuals whose symptoms meet Criterion A but not Criterion B—that is, to those individuals who have a paraphilia but not a paraphilic disorder." [1] Azureham (talk) 13:54, 14 August 2022 (UTC)

First off, please note point 1 under the FAQ at the top of this page: Fundamentally, Wikipedia articles need to reflect the consensus expressed in the best-available reliable sources. Those sources characterize pedophilia as a mental or psychiatric disorder, so this article must as well. Those sources state that a mental disorder is a mental or behavioral pattern or anomaly that causes distress, disability or a strong impulse to harm oneself or others. Because pedophilia creates a strong impulse to have sexual relations with prepubertal children (an act which is innately harmful), and people with the disorder that avoid doing so often suffer great distress, it is considered to be a mental disorder. This is what differentiates it from other types of sexual attractions or orientations that do not innately lead to harm or distress.

Regarding the "can therefore be made" sentence, the DSM and ICD-11 requirements are quoted a few paragraphs earlier. The point is that action is not required for a diagnosis.

You are overgeneralizing aspects of other paraphilias that do not apply here. Here is what the ICD-11 says: Pedophilic disorder is characterised by a sustained, focused, and intense pattern of sexual arousal—as manifested by persistent sexual thoughts, fantasies, urges, or behaviours—involving pre-pubertal children. That is how it is defined. Actions or distress are needed for diagnosis, but that doesn't mean if those are not present that it is not a disorder.

You are overlooking important parts of your own quote: A paraphilic disorder is a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others....Criterion B specifies the negative consequences of the paraphilia (distress, impairment, or harm—or risk of harm—to others). As satisfying pedophilia involves child sexual abuse, a harmful act, it is by that very fact a disorder. That makes it very different from something like a foot fetish where a person can fulfill it with a consenting partner, and hence if there is a lack of distress, it is non-disordered. Crossroads ^-talk- 05:33, 16 August 2022 (UTC)

@Crossroads Thanks for the comments!

I have looked the FAQ. I think the first item in the FAQ needs to be changed. Here the arguments

1.“Those sources characterize pedophilia as a mental or psychiatric disorder”

https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Words_to_watch#Unsupported_attributions

The  sources are not specified. In order to state this way, it is necessary that it is directly and clearly stated  in current classifications without the need for readers to make such  inferences. The ICD11, the DSM 5, and the explanation by APA  contradicts this statement.

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2. “Because pedophilia creates a strong impulse to have sexual relations with prepubertal children (an act which is innately harmful), and people with the disorder that avoid doing so often suffer great distress, it is considered to be a mental disorder.”

Yes, if people with pedophilia do not offend, they may still experience distress often. But it would be more accurate to say that we do not know how often, we can only state that some of them experience distress and some do not. More importantly, not every dissatisfaction or distress is clinically relevant. The presence of such clinically significant distress as a diagnostic criterion can be established only by a clinician in individual case, and cannot be attributed by us to people with pedophilia in advance.

Such an attribution and the generalization of any case of pedophilia as a pedophilic disorder is an arbitrary conclusion (original research). This significantly distorts the meaning and obscures a critical difference between the definitions of pedophilia and pedophilic disorder.

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And here are the answers to your explanations

3. “The point is that action is not required for a diagnosis. “

This statement is true on its own, but there is an ignorance of the rest of the definition, which includes the marked distress. The definition given only in part becomes quite another definition. This leads to a blurring of meaning to the incorrect conclusion that pedophilic preference itself is a disorder. That is not consistent with modern classifications.

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4.“You are overgeneralizing aspects of other paraphilias that do not apply here."

It seems to me that you are using an outdated understanding of paraphilias in general. Sexual deviation that do not include offending others or are not harmful in performance are no longer considered a paraphilia. So what we are talking about here exactly are pedophilia, sadism, voyeurism and others mentioned in the ICD11 and the DSM5.

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5. "Here is what the ICD-11 says: Pedophilic disorder is characterised by a sustained, focused, and intense pattern of sexual arousal—as manifested by persistent sexual thoughts, fantasies, urges, or behaviours—involving pre-pubertal children. That is how it is defined.”

Characteristics should not be confused with disorder definitions. “Pedophilic disorder is characterized by” - means that pedophilic arousal pattern is a mandatory qualitative characteristic for attribution to the categorical unit of pedophilic disorder, but not a definition of the pedophilic disorder.

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6. “Actions or distress are needed for diagnosis, but that doesn't mean if those are not present that it is not a disorder.”

That’s exactly what it says. “The individual must have acted on these thoughts, fantasies or urges or be markedly distressed by them.” This is an essential diagnostic requirement. If this requirement is not met in the presence of pedophilia, then the diagnosis of pedophilic disorder is not applicable. Pedophilia is a paraphilia and a deviation, but it is not a disorder. I assume you are confusing the disorder (nosological unit) and deviation.

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7. “You are overlooking important parts of your own quote: A paraphilic disorder is a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others....Criterion B specifies the negative consequences of the paraphilia (distress, impairment, or harm—or risk of harm—to others). As satisfying pedophilia involves child sexual abuse, a harmful act, it is by that very fact a disorder.”

Again, the arbitrary conclusion is drawn that criterion A necessarily implies criterion B. Satisfaction can occur through fantasies and masturbation. And again, this is not even the main thing, but the more important thing is that dissatisfaction or distress is not necessarily clinically significant distress. Otherwise, all normal people would fall under the definition of disorder every time they get upset that they cannot get a sexual partner.

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8. “That makes it very different from something like a foot fetish where a person can fulfill it with a consenting partner, and hence if there is a lack of distress, it is non-disordered”

Foot fetish is not a paraphilia as it does not include nonconsenting others. Bear in mind that the very definition of paraphilias has changed from past classifications. Previously, there was only the term “paraphilia”, which was a nosological unit. To date, simultaneously, we have both an updated definition of the "paraphilia" (which no longer a nosological category) and a separate new term, "paraphilic disorder". We are talking about new “paraphilias” only, which are specifiers for paraphilic disorders in modern classifications. In the APA quote I cited, you can see that we are talking about pedophilia as well.

I apologize in advance for any misunderstanding! Azureham (talk) 06:44, 17 August 2022 (UTC)

The Manual of Style does not apply to talk pages.

Sexual deviation that do not include offending others or are not harmful in performance are no longer considered a paraphilia. Nope, incorrect: Paraphilic disorder involving solitary behaviour or consenting individuals is characterised by a persistent and intense pattern of atypical sexual arousal— manifested by sexual thoughts, fantasies, urges, or behaviours— that involves consenting adults or solitary behaviours. One of the following two elements must be present: 1) the person is markedly distressed by the nature of the arousal pattern and the distress is not simply a consequence of rejection or feared rejection of the arousal pattern by others... [2]

Satisfaction can occur through fantasies and masturbation. No, that's not what it means. By that logic, nothing falls under harm—or risk of harm—to others, and there would be no reason to mention it. Pedophilia absolutely carries a strong risk of harm. Crossroads ^-talk- 18:43, 18 August 2022 (UTC)

The full quote looks like this:

One of the following two elements must be present: The individual is markedly distressed by the nature of the arousal pattern and the distress is not simply a consequence of rejection or feared rejection of the arousal pattern by others; or The nature of the paraphilic behavior involves significant risk of injury or death either to the individual (e.g., asphyxophilia or achieving sexual arousal by restriction of breathing) or to the individual's partner (e.g., consensual sadism that results in injuries requiring medical attention) .

This category includes asphyxophilia and sadism by consent and is not specified by pedophilic arousal. Asphyxophilia and consensual sadism is a paraphilia due to its harm if it goes into action (In contrast to the foot fetish). And this paraphilia is not a disorder by it self too.

By that logic, nothing falls under harm—or risk of harm—to othersNo, harm can only be caused by behavior, that is why there is a behavioral criterion. Risk of harm - is a qualification for consensual actions such as consensual sadism. Pedophilia is not considered to be consentual in action and not an action by itself.

Pedophilia absolutely carries a strong risk of harm. I agree, there is a risk due to pedophilia can result in actions. We don't know exactly what the risk is because we don't know the full nonforensic statistics. And the risk of action do not define a disorder. Disorder is determined only by the actions that have taken place or by the distress to the individual. If actions occur, then this would be a pedophilic disorder. We should not conflate a disorder and prerequisite for a disorder. Azureham (talk) 19:34, 20 August 2022 (UTC)

@Crossroads, I wanted to know if you agree with any of the arguments I made? Do you see any opportunities for improving the article in connection with the arguments I gave? Maybe you will suggest some wording more suitable than what I suggested in my edit. Azureham (talk) 10:16, 23 August 2022 (UTC)

I, for one and as a professional, do not find Azureham's arguments compelling. It's all very "lawyery" in it's approach, rather than scientific or clinical, which much quibbling over exact words despite not being a native English speaker. It reads far too much like advocacy. I'm reluctant to say more lest I have my words picked apart line by line.Legitimus (talk) 13:48, 23 August 2022 (UTC)

I carefully responded to every argument against my edit that I received from commenters that seemed like arbitrary synthesis, POV, and quote mining. I have carefully explained why the data in the sources should not be interpreted otherwise than as written in the sources, and why definitions should be provided clearly. (Please re-read the quote from the APA explanation at the start of the thread.)

Don't be personal and judgmental, comment on content please. And you are welcome to point out my mistakes in English. Azureham (talk) 19:05, 24 August 2022 (UTC)

No, your arguments are unconvincing, ignore the actual text of the sources regarding risk of harm, and have already been addressed. Multiple editors have commented and do not agree with any changes. I see no reason to debate this further. Crossroads ^-talk- 18:45, 24 August 2022 (UTC)

Well, it looks like we've run out of arguments. What should I do next to resolve the dispute? Azureham (talk) 19:11, 24 August 2022 (UTC)

Notice, I have answered you regarding the risk of harm.  You picked these words from another nosological unit and arbitrarily interpret them in support of particular and outdated point of view, while ignoring the clear explanation of the APA i provided. Azureham (talk) 08:52, 26 August 2022 (UTC)

I second this objection to the text of the article. I stumbled on this problem while consulting the DSM-5-TR in a discussion with online pedophilia advocates, who insisted attraction to fictional characters with the characteristics of children does not constitute pedophilia. The DSM was of no help in this regard, but it did include a piece of information in blatant contradiction with the Wikipedia article. Under the header "Differential diagnosis", the DSM-5-TR says,

"Pedophilia Individuals with pedophilia experience recurrent, intense, sexually arousing fantasies or sexual urges involving sexual activity with a prepubescent child or children. Unless the individual has acted on these sexual urges with a prepubescent child or unless the sexual urges or fantasies cause marked distress or interpersonal difficulty, a diagnosis of pedophilic disorder is not warranted."

This is an explicit distinction between pedophilia and pedophilic disorder. So when the article states "Pedophilia is termed pedophilic disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5),", this is at best outdated and misleading, but arguably a straight misrepresentation of the text. Update: I've taken the liberty of changing the text of the introduction to reflect this distinction. Farco (talk) 06:57, 10 September 2022 (UTC)

To say "associated with" like you did might be warranted since the DSM-5 has the phrasing it does, but most authorities call pedophilia a disorder, and so I agree with due emphasis on it as a disorder in the article. To build the article as a split between pedophilia and pedophilic disorder any more than your edit does would be to give undue emphasis to one manual's diagnostic phrasing. Javan009 (talk) 16:50, 10 September 2022 (UTC)

The "pedophilia/pedophilic disorder" distinction seems to have been largely unintentional and it seems the significance of it is being exaggerated, usually by those with an agenda. The good intentions of changing the sexual-based mental disorder names was to make it a clear differentiation between terms like Sadism or Voyeurism that are used in common parlance in a non-disorder sense, and the actual disorders involving those impulses. The DSM-IV used diagnostic criteria that made the disorders separate from their common meanings, but they found they needed to change the names too, to avoid stigmatizing non-disordered behavior. However, when they got to pedophilia, they accidentally wrote themselves into a corner, because pedophilia is always a disordered impulse, compared to the others. This is why the criteria and text pull what is basically a overwhelming exception: It's virtually impossible for a person to be experiencing the required sexual attraction/fantasies and not also meet the other criteria for the disorder; the only possible circumstance would be someone with an anxiety disorder to fears they have the attraction, but doesn't actually have it. It's worth noting that several people contributing to the DSM-5 felt that the criteria for pedophilic disorder should be some variation of "any evidence of genuine sexual attraction to prepubescent minors."Legitimus (talk) 21:44, 10 September 2022 (UTC)

I agree that the significance is being exaggerated. People want to cite the DSM as saying pedophilia can exist without being a paraphilia. The DSM doesn't say this. However, it also doesn't say pedophilia and pedophilic disorder are identical. Farco (talk) 12:27, 13 September 2022 (UTC)

"It's virtually impossible for a person to be experiencing the required sexual attraction/fantasies and not also meet the other criteria for the disorder" - sorry, this is an unsupported statement unless someone provide reliable source which directly states that this is mainstream medical view. The modern classifications suggest the opposite

"someone with an anxiety disorder to fears they have the attraction, but doesn't actually have it" no, this applies to OCD category

@Legitimus @Crossroads i am wondering if you suppose any possible consensual edit regarding the pedophlia/ pedophilic disorder distinction? Azureham (talk) 13:25, 16 September 2022 (UTC)

I agree. It would be inappropriate to discuss the distinction in any length, but it is likewise inappropriate to cite the DSM as identifying pedophilia and pedophilic disorder, which the page currently does. The latest edition of the DSM explicitly does not do this. Farco (talk) 12:04, 13 September 2022 (UTC)

@Azureham: There is a complication that you need to be aware of. Wikipedia has long been used by those who advocate in favor of sex with children from full-on enthusiasm to suggestions that it's ok so long as it is not acted on with real children. The proposed "In addition, in order for Pedophilic Disorder to be diagnosed, the individual must have acted on these thoughts, fantasies or urges or be markedly distressed by them" is too close to the line pushed by advocates. In general Wikipedia does not provide how-to advice (WP:NOTHOWTO) and there is no need to explain how to perform a diagnosis. This is an encyclopedic article for general readers and not a guide for US practioneers. Johnuniq (talk) 23:54, 18 August 2022 (UTC)

"is too close to the line pushed by advocates"

As far as I know, the mentioned shift in definitions was made by the APA and WHO, among other things, in order to reduce the mental illness stigma in those people with paraphilias who do not offend. So it is understandable, that this is perceived as close to advocacy. But bear in mind that such stigma worsens the mental state of people, make them more distant from social control, and more impulsive and therefore such a stigma has nothing to do with the crime prevention.

"there is no need to explain how to perform a diagnosis"

This is a medical article where clear definitions of diagnoses should be given, so that there is no confusion in the definitions of disorders. Such a confusion is unacceptable here. Imagine if you were writing about HIV treatment recommendations but confused them with recommendations for AIDS treatment. Azureham (talk) 20:30, 20 August 2022 (UTC)

"Minor Attracted Person" listed at Redirects for discussion

An editor has identified a potential problem with the redirect Minor Attracted Person and has thus listed it for discussion. This discussion will occur at Wikipedia:Redirects for discussion/Log/2022 September 9#Minor Attracted Person until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Jay 💬 12:11, 18 September 2022 (UTC)

The article need update

DSM-5-TR was published. There are some change in the diagnostic Features:

The article wrote that, "Acting on sexual urges is not limited to overt sex acts for purposes of this diagnosis, and can sometimes include indecent exposure, voyeuristic or frotteuristic behaviors, or masturbating to child pornography."

But according to DSM-5-TR, "Although the use of sexually explicit content depicting prepubescent children is typical of individuals with pedophilic sexual interests and thus might contribute important information relevant to the evaluation of Criterion A, such behavior in the absence of the individual’s sexual interactions with children (i.e., acting on these sexual urges in person) is insufficient to conclude that Criterion B is met."'

So the editor may consider to delete the "masturbating to child pornography" statement or just list out how the criteria are different between DSM-5-TR and ICD-11.

DSM-5-TR also stated that, "if they report an absence of feelings of guilt, shame, or anxiety about these impulses and are not functionally limited by their paraphilic impulses (according to self-report, objective assessment, or both), and their self-reported and legally recorded histories indicate that they have never acted on their impulses, then these individuals have a pedophilic sexual interest but not pedophilic disorder."

This may challenge the definition, since the DSM-5-TR just like DSM-5, keep a division of "pedophilic sexual interests" and "pedophilic disorder" --So47009 (talk) 08:53, 23 December 2022 (UTC)

Quote from DSM-5-TR,for some to ref:"Individuals with pedophilia experience recurrent, intense, sexually arousing fantasies or sexual urges involving sexual activity with a prepubescent child or children. Unless the individual has acted on these sexual urges with a prepubescent child or unless the sexual urges or fantasies cause marked distress or interpersonal difficulty, a diagnosis of pedophilic disorder is not warraned."--So47009 (talk) 00:11, 25 December 2022 (UTC)

I initially didn't understand what you were referring to and so had to re-read the chapter. It does appear that yes, the Text Revision does make this distinction between "pedophilia" and "pedophilic disorder" even though previous versions did not. The APA's decision to do this is not without controversy, as many clinicians don't feel this distinction is necessary. To be frank, a patient being credibly sexual attracted to children is a very bad sign for their mental health prognosis, regardless of whether the patient has acted on it in person or feels distressed by it. But that's merely opinion and at this time, original research. Right now, my main issue is that the lead doesn't seem to explain why this distinction is being made in it's current wording.Legitimus (talk) 03:05, 25 December 2022 (UTC)

Yes, but I don't judge any reliable source as it is the up to date info. and I can't find any source explain why APA do this. So it may expain if the source exist in the future. So47009 (talk) 03:22, 25 December 2022 (UTC)

A paper of potential interest regarding this issue, but for which I will have to request the full text at a later time: Seto MC (May 2022). "Clinical and Conceptual Problems With Pedophilic Disorder in the DSM-5-TR". Arch Sex Behav. 51 (4): 1833–1837. doi:10.1007/s10508-022-02336-1. PMID 35471678.Legitimus (talk) 03:13, 25 December 2022 (UTC)