Reliability and validity of the DSM-IV-TR and proposed DSM-5 criteria for pedophilia

What is it about?

Wetested the inter-rater reliability and criterion-related validity of the DSM-IV-TR pedophilia diagnosis and proposed DSM-5 pedohebephilia diagnosis in a sample of 79 men who had committed child pornography offenses, contact sexual offenses against children, orwhowere referred because of concerns aboutwhether they had a sexual interest in children. Participants were evaluated by two independent psychiatrists with an interview and questionnaire regarding demographic characteristics, sexual history, and self-reported sexual interests; they also completed phallometric and visual reaction time testing. Kappawas .59 for ever meeting DSM-IV-TR criteria for pedophilia and .52 for ever meeting the proposed DSM-5 criteria for pedohebephilia. Ever meeting DSM-IVTR diagnosis was significantly related to self-reported index of sexual interest in children (highest AUC = .81, 95% CI = .70–.91, p b .001) and to indices of sexual interest in children from phallometric testing (AUC = .70; 95% CI = .52–.89; p b .05) or a computerized assessment based on visual reaction time and self-report (AUC = .75; 95% CI = .62–.88; p b .005). Ever meeting the proposed DSM-5 “diagnosis” was similarly related to self-report (AUC = .84, 95% CI = .74–.94, p b .001) and to the two objective indices, with AUCs of .69 (95% CI=.53–.85; p b .05) and .77 (95% CI=.64–.89; p b .001), respectively. Because the pDSM-5 criteria did not produce significantly better reliability or validity results and users aremore familiarwith the current DSM-5 criteria, webelieve these results suggest the revision ofDSM-5 and development of ICD-11 could benefit fromdrawing on the current DSM-5 criteria,which are essentially the same as DSM-IV-TR except for a distinction between having a paraphilia (the interest) and a paraphilic disorder (the paraphilia plus clinically significant distress or impairment).

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