Αλέξανδρος Γ. Σφακιανάκης: 06/08/19

Saturday, June 8, 2019

Pedophilic Behavior from Brain Disease

Author links open overlay panelMarioMendezMD, PhD*†Jill S.ShapiraRN, PhD‡
*
VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
†
UCLA—Neurology & Psychiatry, UCLA Medical Plaza, Los Angeles, CA, USA
‡
UCLA—Neurology, Los Angeles, CA, USA
Available online 16 December 2015.

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https://doi.org/10.1111/j.1743-6109.2010.02172.xGet rights and content
ABSTRACT
Introduction
Child molestation or other pedophilic behavior may result as a consequence of a brain disorder.

Aim
To characterize the mechanisms of pedophilic behavior associated with neurological diseases.

Methods
We report eight patients with pedophilic behavior as a manifestation of their brain disorder and review the literature.

Main Outcome Measures
The sexual, neuropsychiatric, and neurological aspects of a series of patients.

Results
All eight developed sexual behavior toward prepubescent children in mid‐ to late‐life coincident with the development of a neurological disorder. Five had limited insight, anxiety, or concern for their behavior and tended to have frontal lobe executive deficits. Most of this group had frontally predominant disorders. Two others retained insight and concern in the context of marked hypersexuality. This second group had treated Parkinson's disease and resembled reports of pedophilic behavior from subcortical lesions. The further presence of right temporal lobe‐amygdala involvement may have predisposed to specific sexual preoccupation in some patients.

Conclusions
Brain disorders may release a predisposition to sexual attraction for children through disinhibition with frontal disease, sexual preoccupation with right temporal disease, or hypersexuality with subcortical disease in non‐motor basal ganglia, hypothalamus, or septal nuclei. Differentiating these mechanisms of pedophilic behavior from brain disease could facilitate targeted interventions. Mendez M and Shapira JS. Pedophilic behavior from brain disease.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Hypersexual behavior in frontotemporal dementia

: a comparison with early-onset Alzheimer's disease.
Mendez MF1, Shapira JS.
Author information
1
Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, 300 Medical Plaza, Suite B-200, Box 956975, Los Angeles, CA 90095-6975, USA. mmendez@ucla.edu
Abstract
The basis of hypersexual behavior among patients with dementia is not entirely clear. Hypersexual behavior may be a particular feature of behavioral variant frontotemporal dementia (bvFTD), which affects ventromedial frontal and adjacent anterior temporal regions specialized in interpersonal behavior. Recent efforts to define hypersexual disorder indicate an increasing awareness of heightened sexual activity as a source of personal distress and functional impairment, and clarification of hypersexuality in bvFTD could contribute to understanding the neurobiology of this behavior. This study reviewed 47 patients with bvFTD compared to 58 patients with Alzheimer's disease (AD) for the presence of heightened sexual activity to the point of distress to caregivers and others. Hypersexual behavior occurred in 6 (13 %) bvFTD patients compared to none of the AD patients. Caregivers judged all six bvFTD patients with hypersexual behavior as having a dramatic increase in sexual frequency from premorbid levels. All had general disinhibition, poor impulse control, and actively sought sexual stimulation. They had widened sexual interests and experienced sexual arousal from previously unexciting stimuli. One patient, with early and predominant right anterior temporal involvement, was easily aroused by slight stimuli, such as touching her palms. Although previously considered to be predominantly disinhibited sexual behavior as part of generalized disinhibition, these patients with dementia illustrate varying degrees of increased sexual desire. We conclude that bvFTD is uniquely associated with hypersexuality; it is more than just cognitive impairment with frontal disinhibition but also involves alterations in sexual drive, possibly from right anterior temporal- limbic involvement in this disease.

PMID: 23297146 PMCID: PMC3596488 DOI: 10.1007/s10508-012-0042-4

Figure 1. From: Hypersexual Behavior in Frontotemporal Dementia: A Comparison with Early-Onset Alzheimer's Disease.

Magnetic resonance imaging (MRI) of the brain for Patient No. 6. The upper left is an axial flair image showing anterior temporal areas of atrophy and gliosis, with the right side involved to a much greater degree than the left. The upper right is an axial T2 imaging of the same findings. The lower right is an axial flair image at a slightly higher level. The lower left is a saggital FLAIR image showing atrophy extending to the medial frontal region consistent with bvFTD.

Mario F. Mendez, et al. Arch Sex Behav. ;42(3):501-509.

Citation Full text

Figure 2. From: Hypersexual Behavior in Frontotemporal Dementia: A Comparison with Early-Onset Alzheimer's Disease.

Single photon emission tomography (SPECT) imaging of the brain for Patient No. 6. The images are, left to right, axial, coronal, saggital, and 3-dimensional (3-D) reconstructions of the SPECT images. They show disproprtionate hypoperfusion of the right frontotemporal region with relative sparing of the left. There is clear involvement of the right anterior temporal area extending to adjacent frontal areas. The 3-D reconstructions illustrate a lateral view of the right hemisphere in the upper right and a corresponding lateral view of the left hemisphere in the lower right.

Mario F. Mendez, et al. Arch Sex Behav. ;42(3):501-509.

Citation Full text

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Criminal behavior in frontotemporal dementia and Alzheimer disease

Liljegren M1, Naasan G2, Temlett J3, Perry DC2, Rankin KP2, Merrilees J2, Grinberg LT2, Seeley WW2, Englund E1, Miller BL2.
Author information
1
Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden.
2
Memory and Aging Center, Department of Neurology, University of California, San Francisco.
3
Department of Medicine, University of Notre Dame, Fremantle, Australia.
Abstract
IMPORTANCE:
Neurodegenerative diseases can cause dysfunction of neural structures involved in judgment, executive function, emotional processing, sexual behavior, violence, and self-awareness. Such dysfunctions can lead to antisocial and criminal behavior that appears for the first time in the adult or middle-aged individual or even later in life.

OBJECTIVE:
To investigate the frequency and type of criminal behavior among patients with a diagnosed dementing disorder.

DESIGN, SETTING, AND PARTICIPANTS:
We conducted a retrospective medical record review of 2397 patients who were seen at the University of California, San Francisco, Memory and Aging Center between 1999 and 2012, including 545 patients with Alzheimer disease (AD), 171 patients with behavioral variant of frontotemporal dementia (bvFTD), 89 patients with semantic variant of primary progressive aphasia, and 30 patients with Huntington disease. Patient notes containing specific keywords denoting criminal behavior were reviewed. Data were stratified by criminal behavior type and diagnostic groups.

MAIN OUTCOMES AND MEASURES:
Frequencies of criminal behavior and χ² statistics were calculated.

RESULTS:
Of the 2397 patients studied, 204 (8.5%) had a history of criminal behavior that emerged during their illness. Of the major diagnostic groups, 42 of 545 patients (7.7%) with AD, 64 of 171 patients (37.4%) with bvFTD, 24 of 89 patients (27.0%) with semantic variant of primary progressive aphasia, and 6 of 30 patients (20%) with Huntington disease exhibited criminal behavior. A total of 14% of patients with bvFTD were statistically significantly more likely to present with criminal behavior compared with 2% of patients with AD (P < .001) and 6.4% were statistically significantly more likely to exhibit violence compared with 2% of patients with AD (P = .003). Common manifestations of criminal behavior in the bvFTD group included theft, traffic violations, sexual advances, trespassing, and public urination in contrast with those in the AD group, who commonly committed traffic violations, often related to cognitive impairment.

CONCLUSIONS AND RELEVANCE:
Criminal behavior is more common in patients with bvFTD and semantic variant of primary progressive aphasia than in those with AD and is more likely to be an early manifestation of the disorder. Judicial evaluations of criminality in the demented individual might require different criteria than the classic "insanity defense" used in the American legal system; these individuals should be treated differently by the law. The appearance of new-onset criminal behavior in an adult should elicit a search for frontal and anterior temporal brain disease and for dementing disorders.

Comment in
Dementia. Criminality can be an early sign of frontotemporal dementia. [Nat Rev Neurol. 2015]
PMID: 25559744 PMCID: PMC4432918 DOI: 10.1001/jamaneurol.2014.3781

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Sexual Behavior

Sexual Science versus Progressive Advocacy: The Need for Resistance

Tracking Mouse Trajectories Related to Decisions About Sexual Interest

Abstract

The current research explored continuous behavioral processes by recording participants' hand movements toward a response option using Mousetracker software. Across three studies, we tested the idea that sexual interest-related decisions can be indexed using automatic movements. Using a UK sample of self-identified same- and opposite-gender attracted men (N = 43), Study 1 showed that the process of approaching the response button was faster, more direct, and less curved when participants responded from their own (vs. a non-preferred) perspective. Study 2 supported these findings using a German sample of self-identified same- and opposite-gender attracted men (N = 66). Using a teleiophilic sample of 100 self-identified opposite-gender attracted men (n = 51) and women (n = 49), Study 3 examined age-specific sexual interests (i.e., responding to stimuli from a pedophilic and a teleiophilic perspective). As expected, in the teleiophilic block, participants' responses were faster, more direct, and less curved than in the pedophilic block. Collectively, the results suggest that mousetracking shows promise as a measure of sexual interest (across the dimension of both gender and age), providing grounds for future research.

Identifying Basic Classes of Sexual Orientation with Latent Profile Analysis: Developing the Multivariate Sexual Orientation Classification System

Abstract

Despite considerable progress, research on sexual minorities has been hindered by a lack of clarity and consistency in defining sexual minority groups. Further, despite recent recommendations to assess the three main dimensions of sexual orientation—identity, behavior, and attraction—it remains unclear how best to integrate such multivariate information to define discrete sexual orientation groups, particularly when identity and behavior fail to match. The current study used a data-driven approach to identify a parsimonious set of sexual orientation classes. Latent profile analysis (LPA) was run within a large (N = 3182) and sexually diverse sample, using dimensions of sexual identity, behavior, and attraction as predictors. LPAs supported four fundamental sexual orientation classes not only in the overall sample, but also when conducted separately in men (n = 980) and women (n = 2175): heterosexual, homosexual, bisexual, and heteroflexible (a class representing individuals who self-identify as heterosexual or mostly heterosexual but report moderate same-sex sexual behavior and attraction). Heterosexuals reported the highest levels of psychological functioning and lowest risk behaviors. Homosexuals showed similarly high levels of psychological functioning to heterosexuals, but higher levels of risk behaviors. Bisexuals and heteroflexibles showed similarly low levels of psychological functioning and high risk taking. To facilitate applications of this classification approach, the study developed the Multivariate Sexual Orientation Classification System, reproducing the four LPA groups with 97% accuracy (kappa = .95) using just two items. Implications of this classification approach are discussed.

Exploratory Factor Analysis of Two Sexual Health Scales for Transgender People: Trans-Specific Condom/Barrier Negotiation Self-Efficacy (T-Barrier) and Trans-Specific Sexual Body Image Worries (T-Worries)

Abstract

Few sexual health measures have been validated for transgender (trans) populations. Condom/barrier self-efficacy and sexual body image worries are interrelated constructs that may contribute to enhanced and poor sexual health, respectively. We report on the development and initial validation of trans-specific scales designed to measure these constructs. Trans people in Ontario, Canada, who had ever had sex completed these scales as a part of a larger Trans PULSE survey (n = 323). Using exploratory factor analysis, a one-factor solution fit the 8-item Condom/Barrier Negotiation Self-Efficacy Scale (T-Barrier). Two factors were identified for the 7-item Sexual Body Image Worries Scale (T-Worries): "general body image worries" and "trans-related image worries," while two items were recommended for deletion. The scales demonstrated convergent validity with measures such as self-esteem, sexual anxiety, sexual satisfaction, sexual fear, and experiences of transphobia. Further evaluation to confirm these structures within an independent trans sample would be valuable. We recommend the use of these scales for studies of sexual health within trans populations, to enhance our ability to better understand and promote sexual health within trans communities.

Correction to: Sexual Identity and Behavior Among U.S. High School Students, 2005–2015

The following correction should be noted to the caption of Fig. 1 in this article.

Richard Green, M.D., J.D. (1936–2019)

Using Photovoice to Understand Suicidality Among Gay, Bisexual, and Two-Spirit Men

Abstract

This study explored the drivers of suicidality from the perspectives of gay, bisexual, and two-spirit men (GB2SM) with a history of suicidality. Twenty-one GB2SM participated in this photovoice study taking photographs to depict and discuss their previous suicidality. Data were collected from in-depth individual interviews in which participants discussed their photographs and in turn offered verbal/narrative accounts of suicidality. Drawing on intersectionality, analyses of the photographs and interview data revealed three interconnected themes. First, adverse childhood events and negative adolescent experiences were described as the root causes of mental health struggles and suicidality. Second, violence and homophobia had disrupted these men's education and employment opportunities and some participants detailed how their lack of capital and challenges for maintaining employment shaped their suicidality. Third, a sociality of stigma and sense of isolation compounded experiences of suicidality. The three themes overlapped and were shaped by multiple intersectional axes including sexuality, class, ethnicity, and mental health status. The findings have implications for services and health professionals working with GB2SM who need to thoughtfully consider life-course trajectories and multiple social axes when assessing and treating GB2SM experiencing suicidality. More so, because these factors relate to social inequities, structural and policy changes warrant targeted attention.

Power and Privilege in the Field of Sexuality Research and Beyond

Uncertainty and Posttraumatic Stress: Differences Between Mothers and Fathers of Infants with Disorders of Sex Development

Abstract

Parents of children with disorders of sex development (DSD) report significant psychological distress, including posttraumatic stress symptoms (PTSS), with mothers consistently reporting higher rates of psychological distress than fathers. However, psychological factors contributing to PTSS in both parents are not well understood. The present study sought to fill this gap in knowledge by examining PTSS and illness uncertainty, a known predictor of psychological distress, in parents of children recently diagnosed with DSD. Participants were 52 mothers (M_age = 32.55 years, SD = 5.08) and 41 fathers (M_age = 35.53 years, SD = 6.78) of 53 infants (M_age = 9.09 months, SD = 6.19) with DSD and associated atypical genital development. Participants were recruited as part of a larger, multisite study assessing parents' psychosocial response to their child's diagnosis of DSD. Parents completed measures of illness uncertainty and PTSS. Mothers reported significantly greater levels of PTSS, but not illness uncertainty, than fathers, and were more likely than fathers to report clinical levels of PTSS (21.2% compared to 7.3%). Hierarchical regression revealed that parent sex, undiagnosed or unclassified DSD status, and illness uncertainty were each associated with PTSS. The overall model accounted for 23.5% of the variance associated with PTSS. Interventions targeting illness uncertainty may be beneficial for parents of children with newly diagnosed DSD.

Visual Attention to Sexual Stimuli in Mostly Heterosexuals

Abstract

Individuals who report mostly heterosexual orientations (i.e., mostly sexually attracted to the opposite sex, but occasionally attracted to the same sex) outnumber all other non-heterosexual individuals combined. The present study examined whether mostly heterosexual men and women view same- and other-sex sexual stimuli differently than exclusively heterosexual men and women. A novel eye-tracking paradigm was used with 162 mostly and exclusively heterosexual men and women. Compared to exclusively heterosexual men, mostly heterosexual men demonstrated greater attention to sexually explicit features (i.e., genital regions and genital contact regions) of solo male and male–male erotic stimuli, while demonstrating equivalent attention to sexually explicit features of solo female and female–female erotic stimuli. Mediation analyses suggested that differences between mostly and exclusively heterosexual profiles in men could be explained by mostly heterosexual men's increased sexual attraction to solo male erotica, and their increased sexual attraction and reduced disgust to the male–male erotica. No comparable differences in attention were observed between mostly and exclusively heterosexual women—although mostly heterosexual women did demonstrate greater fixation on visual erotica overall—a pattern of response that was found to be mediated by reduced disgust.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

A bibliometric analysis of the 103 top-cited articles in endodontics Bülent Yılmaz ORCID Icon, Muzaffer...

A bibliometric analysis of the 103 top-cited articles in endodonticsBülent Yılmaz ORCID Icon, Muzaffer Emir Dinçol ORCID Icon & Turgut Yağmur Yalçın ORCID IconReceived 25 Feb 2019, Accepted 15 May 2019, Published online: 07 Jun 2019Download citation https://doi.org/10.1080/00016357.2019.1621378 Select Language▼Translator disclaimerAbstractObjective: The purpose of this study was to identify the 100 top-cited articles in endodontics and analyse their bibliometric characteristics.Material and...

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