Mental Health Matters
Forensic Edition
March 2010
 Published by: Lepage Associates 
In This Issue:
Pedophilia and Pornography
Groups and Seminars
A New Resource for Blended and Step-Families
Services for Medicaid and NC Health Choice Clients
Distinguishing Pedophilia and 'Situational' Child Molesters;
and How  Pornography Impacts These Offenders 
Oprah recently did a series of interviews with convicted child molesters. These interviews demonstrated that most child molesters are known to their victims (versus strangers) and that the molestation occurs based on a relationship built on trust and coercion (versus physical force).

Whether you are a family law attorney trying to make a case regarding whether someone should have access to their child, or a criminal law attorney trying to understand the likelihood that your client will reoffend, it is important to recognize the difference between a 'situational' offender and a pedophile.

The Diagnostic and Statistical Manual of Mental Disorders defines pedophilia:
*Intense, recurrent sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally 13 or younger).
*The person has either acted on the fantasies OR the sexual urges and fantasies cause marked distress OR interpersonal difficulty (which can include just getting caught).
*The person is at least 16 years and at least 5 years older than the child or children.
*This does not include an individual in late adolescence involved in an ongoing sexual relationship with a 12-or 13-year-old.
*The individual can be sexually attracted to males, females, or both. The offense can be limited to incest. The person can be exclusively attracted to children or also attracted to adults.
Most importantly, you can molest someone and NOT be a pedophile. These situations occur due to (although are not limited to) mental illness, depression, substance use, marital distress, negative peer groups, stress, and unemployment. Despite the fact that the individual has committed the offense, they do not meet the criteria of having a history of deviant sexual fantasies or sexual attraction to children. In fact, these offenders usually molest children because they have a high need for comfort, a desire to control others, or cognitive distortions due to substance use.   
So, how does someone even develop the idea about offending against a child if they aren't a pedophile?

One of the interesting topics broached by Oprah's interviews was the use of 'barely legal' pornography. This is pornography where women, who are supposed to be 18-years-old, or older, are depicted as children. There have been some who advocate for the use of such material in order to 'keep children safe.' It is believed that using this material to masturbate keeps people from actually molesting children. However, there is evidence that the use of this type of pornography is basically the same as child pornography, which contributes to cognitive distortions about sex and children.Therefore, if someone is not a pedophile, the combination of situational stressors and 'barely legal' pornography can trigger someone to molest a child.

Using 'barely legal' pornography encourages sexual urges towards children when used for the purpose of masturbation. The use of related chat rooms validates the sexual desires by communicating with others who share their fantasies. The use of 'barely legal' pornography also develops erroneous beliefs that children respond to sexual advances. This way of thinking leads the individual to misperceive children as sexual and seeking this type of attention from adults.
Howitt and Sheldon (2007) found that Internet viewers actually showed signs of greater cognitive distortions relating to the sexuality of minors than did "hands on" offenders. The differing characteristic between the two groups was that offenders more readily use these distortions to validate their behavior.
It has been suggested that while child sexual abuse is not necessarily caused by viewing child pornography, masturbation serves to reinforce sexual drives towards children and can lead to attempts at fulfilling their fantasies through either organized encounters with minors or forced attempts (Sullivan and Breech, 2004). 
One study found that out of 429 men who possessed child pornography, 11% had previously been charged with a sexual offense (Wolak, Finkelhor, and Mitchell, 2005). In addition, 55% of 241 legal cases were deemed "dual offenders" (40% had committed a contact sexual offense against a child and 15% had attempted to commit a contact sexual offense).

So, what does this all mean? It's important to recognize that using pornography is not inherently dangerous. However, the use of 'barely legal' pornography is more of a slippery slope towards offending than many originally thought. And, there are many people who view 'barely legal' pornography who are not pedophiles but who may be just as likely to offend against a child.

Howitt, D. and Sheldon, K. (2007). The role of cognitive distortions in pedophilic offending: Internet and contact offenders compared. Psychology, Crime & Law, 13(5), 469-486.
Sullivan, J. and Beech, A.R. (2004). Assessing Internet sex offenders. In M. C. Calder (Ed.), Child sexual abuse and the Internet: tackling the new frontier (pp. 69−83). Lyme Regis, U.K.: Russell House.

Wolak, J.,Finkelhor, D., and Mitchell, K.J. (2005). Child pornography possessors arrested in internet-related crimes: findings from the National Online Victimization Study. Retrieved, 10 October, 2006 from

Groups and Seminars for
  Addictions/Compulsions Group
Attention Blended and Step-Families!
Looking for more information on how to navigate the ins and outs of a successful blended family? On March 26th, Dr. Parks will be part of an online conference addressing the common issues that people face when joining their families together. 
The conference, part of the United Marriage and Family Associates, includes Dr. Parks and 9 other professionals, including other psychologists, therapists, and attorneys, who specialize in working with children and families. Topics such as estate planning through divorce, how to help your children succeed in two households, strategies for successful family mediation, and determining when your child needs to see a therapist will be covered over the course of the conference. Best of all, this 8-10 hour conference is affordable, and when purchased, can be downloaded and watched or listened to at your convenience and will be yours to keep as a podcast. As an added incentive, everyone who registers will be entered to win consultations, books, and
other resources offered by each presenter. For more information, click on the link below. 
We will let you know when one of the Lepage Associates' psychologists is presenting in a conference with United Marriage and Family Associates.  In the meantime, check out information about future conferences at 
This is an excellent online resource for couples, families, and professionals looking for comprehensive and affordable information on a wide variety of issues facing families today. Stay tuned!    
Having trouble finding a psychiatrist for your clients?
A good psychiatrist without wait lists can be hard to find.

CHILD AND ADULT PSYCHIATRIST TAKING MEDICAID AND NC HEALTH CHOICE! No waiting lists! All ages served! Call Dr. Jason Machalicky at Diverse Family Services at 572-8833. (For all other major insurances and private pay for teens and adults, call Dr. Jennie Byrne at Lepage Associates at 572-0000.)
CHILD AND ADULT PSYCHOLOGIST for outpatient therapy or in-home services. Call Dr. Colleen Hamilton at Diverse Family Services. Again, no waiting lists and all ages served at 572-8833.
Lepage Associates
Lepage Associates
Psychological and Psychiatric Services