Leuprolide Acetate Suppresses Pedophilic Urges and Arousability |
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Authors: | Email author" target="_blank">Justine?M?SchoberEmail author Phyllis?J?Kuhn Paul?G?Kovacs James?H?Earle Peter?M?Byrne Ruth?A?Fries |
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Institution: | (1) Hamot Medical Center, Erie, Pennsylvania;(2) Lake Erie Research Institute, Erie, Pennsylvania;(3) Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania;(4) JHE Consultant Group Inc., Colorado Springs, Colorado;(5) Behavioral Technology Inc., Salt Lake City, Utah;(6) 333 State Street, Suite 201, Erie, Pennsylvania, 16507 |
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Abstract: | Cognitive–behavioral psychotherapy was compared with cognitive–behavioral psychotherapy augmented by leuprolide acetate (LA)
for suppression of pedophilic behavior. Five male pedophiles (M age, 50 years; range, 36–58) were administered LA by Depo injection for 12 months, followed by saline placebo for 12 months.
Testosterone levels, sexual interest preference by visual reaction time (Abel Assessment), penile tumescence (Monarch Penile
Plethysmography, PPG), as well as strong sexual urges toward children and masturbatory frequency involving thoughts of children
(polygraph), were measured every 3 months. On LA, testosterone decreased to castrate levels. Penile tumescence was significantly
suppressed compared with baseline, but sufficient response remained to detect pedophilic interest. Pedophilic interest was
also detected by visual reaction times. When asked about having pedophilic urges and masturbating to thoughts of children,
all subjects self-reported a decrease. Polygraph responses indicated subjects were not deceptive. On placebo, testosterone
and physiologic arousal eventually rose to baseline. As noted by polygraph, at baseline and on placebo, subjects were deceptive
regarding increased pedophilic urges and masturbatory frequency. Interest preference, as measured by Abel Assessment and Monarch
PPG, was generally unchanged throughout the study. Cognitive–behavioral psychotherapy augmented with LA significantly reduced
pedophilic fantasies, urges, and masturbation; however, pedophilic interest did not change during 1 year of therapy. Deceptive
responses by polygraph suggested that self-report was unreliable. Follow-up utilizing objective measures is essential for
monitoring efficacy of treatment in pedophilia. Our study supports the premise that suppression of pedophilic behavior is
possible. LA may augment cognitive–behavioral psychotherapy and help break the sequence leading to a re-offense. |
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Keywords: | leuprolide acetate pedophilia sex therapy paraphilia |
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