The diagnostic criteria for pedophilic disorder are intended to apply both to individuals who
freely disclose this paraphilia and to individuals who deny any sexual attraction to prepubertal
children (generally age 13 years or younger), despite substantial objective evidence to the
contrary. Examples of disclosing this paraphilia include candidly acknowledging an intense
sexual interest in children and indicating that sexual interest in children is greater than or equal
to sexual interest in physically mature individuals. If individuals also complain that their sexual
attractions or preferences for children are causing psychosocial difficulties, they may be diagnosed
with pedophilic disorder. However, 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.
Examples of individuals who deny attraction to children include individuals who are
known to have sexually approached multiple children on separate occasions but who deny
any urges or fantasies about sexual behavior involving children, and who may further claim
that the known episodes of physical contact were all unintentional and nonsexual. Other individuals
may acknowledge past episodes of sexual behavior involving children but deny any
significant or sustained sexual interest in children. Since these individuals may deny experiences
impulses or fantasies involving children, they may also deny feeling subjectively distressed.
Such individuals may still be diagnosed with pedophilic disorder despite the absence
of self-reported distress, provided that there is evidence of recurrent behaviors persisting for
6 months (Criterion A) and evidence that the individual has acted on sexual urges or experienced
interpersonal difficulties as a consequence of the disorder (Criterion B).
Presence of multiple victims, as discussed above, is sufficient but not necessary for diagnosis;
that is, the individual can still meet Criterion A by merely acknowledging intense
or preferential sexual interest in children.
The Criterion A clause, indicating that the signs or symptoms of pedophilia have persisted
for 6 months or longer, is intended to ensure that the sexual attraction to children is
not merely transient. However, the diagnosis may be made if there is clinical evidence of
sustained persistence of the sexual attraction to children even if the 6-month duration cannot
be precisely determined.