Pedophilic disorder

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Pedophilic disorder is characterized by recurrent, intense sexually arousing fantasies, urges, or behaviors involving prepubescent or young adolescents (usually ≤ 13 years); it is diagnosed only when people are ≥ 16 years and ≥ 5 years older than the child who is the target of the fantasies or behaviors.
(See also Overview of Paraphilic Disorders and Sexual abuse.)
Pedophilia is a form of paraphilia that causes harm to others and is thus considered a paraphilic disorder.
Sexual offenses against children constitute a significant proportion of reported criminal sexual acts. For older adolescents (ie, 17 to 18 years old), ongoing sexual interest or involvement with a 12- or 13-year-old may not meet the clinical criteria for a disorder. However, legal criteria may be different from psychiatric criteria. For example, sexual activity between a 19-year-old and a 16-year-old may be a crime and not a pedophilic disorder, depending on the jurisdiction. Diagnostic age guidelines apply to Western cultures and not to the many cultures that accept sexual activity, marriage, and childbearing at much younger ages and accept much greater age differences between sex partners than Western cultures do.
Most pedophiles are male. Attraction may be to young boys, girls, or both. But pedophiles prefer opposite-sex to same-sex children 2:1. In most cases, the adult is known to the child and may be a family member, stepparent, or a person with authority (eg, a teacher, a coach). Looking or touching seems more prevalent than genital contact. Pedophiles may be attracted only to children (exclusive form) or also adults (nonexclusive form); some are attracted only to children who are related to them (incest).
Predatory pedophiles, many of whom have antisocial personality disorder, may use force and threaten to physically harm the child or the child’s pets if the abuse is disclosed.
The course of pedophilia is chronic, and perpetrators often have or develop substance abuse or dependence and depression. Pervasive family dysfunction, a personal history of sexual abuse, and marital conflict are common. Other comorbid disorders include attention-deficit/hyperactivity disorder, anxiety disorders, and posttraumatic stress disorder.