Development and Preliminary Validation of the Pedophilic Fantasies, Desires, and Activities Questionnaire

• Date: 01 August 2020
• Published date: 01 August 2020
• DOI: 10.1177/0306624X19883758
• Subject Matter: Articles

https://doi.org/10.1177/0306624X19883758

International Journal of

Offender Therapy and

Comparative Criminology

2020, Vol. 64(10-11) 1134 –1155

© The Author(s) 2019

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DOI: 10.1177/0306624X19883758

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Original Manuscript

Development and Preliminary

Validation of the Pedophilic

Fantasies, Desires, and

Activities Questionnaire

Serge Stoléru1, Virginie Moulier2,3,

and Véronique Fonteille4

Abstract

Although sexual interest in children is a risk factor for recidivism of sexual offenses

against children, there is a dearth of measures for assessing its current level in

patients with pedophilic disorder. The objective was to develop the Pedophilic

Fantasies, Desires, and Activities Questionnaire (PFDAQ) to assess the current

level of sexual interest in patients with pedophilic disorder. In total, 57 patients with

pedophilic disorder and 53 controls were recruited. In addition to the PFDAQ,

participants were presented with other measures of sexual interest. PFDAQ

scores were significantly higher in patients than in controls and were correlated

with other measures of sexual interest. Three PFDAQ scores were correlated

with a phallometric index of preference for children. These results suggest that

the PFDAQ may be valid and potentially useful for assessing the current level of

pedophilic attraction.

Keywords

pedophilic disorder, instrument development, sexual fantasies, sexual desires, sexual

activities

1Inserm U1178, Hôpital Paul Brousse, Villejuif, France

2EPS Ville Evrard, Neuilly-sur-Marne, France

3Centre Hospitalier du Rouvray, Sotteville-lès-Rouen, France

4Hospices Civils de Lyon, Bron, France

Corresponding Author:

Serge Stoléru, CESP, Fac. de médecine–Univ. Paris-Sud, Fac. de médecine–UVSQ, INSERM U1178,

Université Paris-Saclay, Hôpital Paul Brousse, Porte 45, 16 avenue Paul Vaillant-Couturier, Villejuif Cedex

94807, France.

Email: serge.stoleru@inserm.fr

883758IJOXXX10.1177/0306624X19883758International Journal of Offender Therapy and Comparative CriminologyStoléru et al.

research-article2019

Stoléru et al. 1135

Introduction

Accurate assessment of sexual interest in children is essential to inform appropriate

offender supervision, risk assessment, and treatment of child sex offenders (Babchishin,

Nunes, & Kessous, 2014). In a meta-analysis by Hanson and Bussière (1998), sexual

interest in children as measured by phallometric assessment was the single strongest

predictor of sexual offense recidivism. In a subsequent meta-analysis, deviant sexual

interests assessed through self-report were found to be a strong predictor of sexual

offense recidivism (Hanson & Morton-Bourgon, 2005). However, there is no validated

standardized questionnaire specifically designed to assess the current levels of sexual

fantasy, desire, and behavior directed toward children. Instead, available question-

naires, such as the Clarke Sex History Questionnaire for Males–Revised (Langevin &

Paitich, 2002) and the Multiphasic Sex Inventory (Kalichman, Henderson, Shealy, &

Dwyer, 1992), investigate these variables over the lifetime but do not focus on their

current levels at the time of clinical assessment.

According to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.,

text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000), the diagnostic

criteria for pedophilia are as follows: (a) over a period of at least 6 months, recurrent,

intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activ-

ity with a prepubescent child or children, (b) the person has acted on these urges, or the

sexual urges or fantasies cause marked distress or interpersonal difficulty, (c) the per-

son is at least age 16 years and at least 5 years older than the child or children in first

criterion. The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-

5; APA, 2013) uses “pedophilic disorder” instead of “pedophilia” to make clear that

experiencing sexual attraction to prepubescent children is not per se a mental disorder

(APA, 2013).

It should be noted that several studies have sought to determine whether the latent

structure of pedophilic disorder is taxonic (patients with pedophilic disorders repre-

sent a discrete class of individuals) or dimensional (sexual interest in children is best

conceptualized as a continuum). No definitive conclusion has been reached, with stud-

ies supporting a dimensional structure (Mackaronis, Strassberg, & Marcus, 2011;

Stephens, Leroux, Skilling, Cantor, & Seto, 2017) or a taxonic one (McPhail, Olver,

Brouillette-Alarie, & Looman, 2018; Schmidt, Mokros, & Banse, 2013). In the present

study, we assumed that within the population of men with pedophilia, sexual interest

for children varied across patients or even within patients.

The development of an instrument to assess in each individual patient the current

level of pedophilic attraction is needed for a variety of reasons. First, the clinical pre-

sentation of patients with pedophilic disorder is highly variable, ranging from men

who remain abstinent, to men who use child pornography but do not offend children,

to those who commit repeated sexual offenses on children (Tenbergen et al., 2015). At

the other end of this clinical spectrum, among nonclinical samples, 6% to 7% of men

indicate some likelihood of having sex with a child if they are guaranteed they would

not be caught or punished (Wurtele, Simons, & Moreno, 2014). An assessment of cur-

rent pedophilic attraction is needed to determine whether its level varies across these