Клинико-онтогенетическая дифференциация педофильного расстройства
Рекомендуемое оформление библиографической ссылки:
Васильев Н.Г., Ткаченко А.А. Клинико-онтогенетическая дифференциация педофильного расстройства // Российский психиатрический журнал. 2022. №6. С. 14-25.
В одномоментном ретроспективном исследовании с целью выделения параметров, значимых для диагностики педофильного расстройства, обследованы 133 мужчины, совершившие сексуальные действия с детьми. У 90 (67,7%) испытуемых установлено сексуальное влечение в отношении педофильного объекта согласно критериям МКБ-10. Выявлены признаки, достоверно различающие группы испытуемых с педофилией и без расстройств сексуального предпочтения. Обосновываются представления о деперсонификации как ключевом феномене педофилии, по отношению к которому иные клинические признаки являются производными. Дизонтогенетическая природа и сопоставимость с этапами нарушения формирования модели психического задают её дименсиональный характер, определяющий типологическую разнородность педофильного расстройства.
Ключевые слова педофилия; педофильное расстройство; восприятие; модель психического; деперсонификация; дименсиональный подход
1. Shport SV, Kamenskov MY, Vvedenskii GE, et al. Pedofiliya: sotsial'no-pravovye i meditsinskie aspekty [Pedophilia: social, legal and medical aspects]. Obshchestvennoe zdorov'e [Public Health]. 2022;2(4):45–57. (In Russ.) DOI: https://doi.org/10.21045/2782-1676-2022-2-4-45-57 2. Reed GM, Drescher J, Krueger RB, et al. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations. World Psychiatry. 2016;15(3):205–21. DOI: https://doi.org/10.1002/wps.20354 3. Kneer J, Engel J, Veit M, et al. 201 Neural mechanisms underlying pedophilia and sexual offending against children – first results of a multicenter study. J Sex Med. 2018;15(7):S201–2. DOI: https://doi.org/10.1016/j.jsxm.2018.04.169 4. Storch M, Kanthack M, Amelung T, et al. Hypothalamic volume in pedophilia with or without child sexual offense. Eur Arch Psychiatry Clin Neurosci. 2022. Advance online publication. DOI: https://doi.org/10.1007/s00406-022-01501-w 5. Gerwinn H, Weiß S, Tenbergen G, et al. Clinical characteristics associated with paedophilia and child sex offending – Differentiating sexual preference from offence status. Eur Psychiatry. 2018;51:74–85. DOI: https://doi.org/10.1016/j.eurpsy.2018.02.002 6. Schiffer B, Vonlaufen C. Executive dysfunctions in pedophilic and nonpedophilic child molesters. J Sex Med. 2011;8(7):1975–84. DOI: https://doi.org/10.1111/j.1743-6109.2010.02140.x 7. Massau C, Tenbergen G, Kärgel C, et al. Executive Functioning in Pedophilia and Child Sexual Offending. J Int Neuropsychol Soc. 2017;23(6):460–70. DOI: https://doi.org/10.1017/S1355617717000315 8. World Health Organization. ICD-10: international statistical classification of diseases and related health problems: tenth revision, 2nd ed. 2004. World Health Organization. URL: https://apps.who.int/iris/handle/10665/42980 (accessed on: 02.10.2022). 9. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. 947 p. 10. Groth AN, Hobson WF, Gary TS. The child molester: Clinical observations. J Soc Work Hum Sex. 1982;1(1–2):129–44. DOI: https://doi.org/10.1300/J291v01n01_08 11. Holmes ST, Holmes RM. Sex Crimes: Patterns and Behavior. SAGE Publication, Inc. 2008. Vol. 3. 327 p. 12. World Health Organization. International Classification of Diseases, Eleventh Revision (ICD-11). World Health Organization (WHO), 2019/2021. URL: https://icd.who.int/browse11 (accessed on: 02.10.2022). 13. Scarpazza C, Finos L, Genon S, et al. Idiopathic and acquired pedophilia as two distinct disorders: an insight from neuroimaging. Brain Imaging Behav. 2021;15(5):2681–92. DOI: https://doi.org/10.1007/s11682-020-00442-z 14. Camperio Ciani AS, Scarpazza C, Covelli V, Battaglia U. Profiling acquired pedophilic behavior: Retrospective analysis of 66 Italian forensic cases of pedophilia. Int J Law Psychiatry. 2019;67:101508. DOI: https://doi.org/10.1016/j.ijlp.2019.101508 15. Knight RA, Carter DL, Prentky RA. A System for the Classification of Child Molesters. J Interpers Violence. 1989;4(1):3–23. DOI: https://doi.org/10.1177/088626089004001001 16. Martijn FM, Babchishin KM, Pullman LE, et al. Attraction to Physical and Psychological Features of Children in Child-Attracted Persons. J Sex Res. 2022;59(3):391–402. DOI: https://doi.org/10.1080/00224499.2021.1948957 17. Keeley JW, Briken P, Evans SC, et al. Can Clinicians Use Dimensional Information to Make a Categorical Diagnosis of Paraphilic Disorders? An ICD-11 Field Study. J Sex Med. 2021;18(9):1592–606. DOI: https://doi.org/10.1016/j.jsxm.2021.06.016 18. Stephens S, Leroux E, Skilling T, et al. Taxometric analyses of pedophilia utilizing self-report, behavioral, and sexual arousal indicators. J Abnorm Psychol. 2017;126(8):1114–9. DOI: https://doi.org/10.1037/abn0000291 19. Tkachenko AA. Seksual'nye izvrashcheniya-parafilii. Moscow: Triada; 1999. 461 p. (In Russ.) 20. Vasilev NG, Tkachenko AA. [Features of perception of the abnormal object as the basis of the typology of pedophilic disorder]. Sotsial'naya i klinicheskaya psikhiatriya [Social and clinical psychiatry]. 2022;32(2):33–41. (In Russ.) 21. Tkachenko AA. Igrovoi mir transgressivnoi seksual'nosti: osnovaniya k psikhopatologicheskoi fenomenologii parafilii. [The Game world of Transgressive Sexuality: Foundations for the Psychopathological Phenomenology of Paraphilias]. Logos. 1998;1:204–29. (In Russ.) 22. McAnulty RD, Burnett MM. Sex and Sexuality, Vol. 1. Sexuality today: trends and controversies. 2006. 377 p. 23. Stelzmann D, Jahnke S, Kuhle LF. Media Coverage of Pedophilia: Benefits and Risks from Healthcare Practitioners’ Point of View. Int J Environ Res Public Health. 2020;17(16):5739. DOI: https://doi.org/10.3390/ijerph17165739 24. Stermac LE, Segal ZV. Adult sexual contact with children: An examination of cognitive factors. Behav Ther. 1989;20(4):573–84. DOI: https://doi.org/10.1016/S0005-7894(89)80135-2 25. Ward T, Hudson SM, Marshall WL, Siegert R. Attachment style and intimacy deficits in sexual offenders: A theoretical framework. Sex Abus A J Res Treat. 1995;7(4):317–35. DOI: https://doi.org/10.1007/BF02256835 26. McPhail IV, Hermann CA, Fernane S, et al. Validity in Phallometric Testing for Sexual Interests in Children: A Meta-Analytic Review. Assessment. 2019;26(3):535–51. DOI: https://doi.org/10.1177/1073191117706139 27. Sergienko EA, Ulanova AYu, Lebedeva EI. Model' psikhicheskogo: Struktura i dinamika. Moscow; 2020. 503 p. (In Russ.) 28. Wellman HM, Liu D. Scaling of Theory-of-Mind Tasks. Child Dev. 2004;75(2):523–41. DOI: https://doi.org/10.1111/j.1467-8624.2004.00691.x
DOI: http://dx.doi.org/10.47877/1560-957Х-2022-10602
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