Skip to main content Accessibility help

Executive Functioning in Pedophilia and Child Sexual Offending

  • Claudia Massau (a1) (a2), Gilian Tenbergen (a3) (a4), Christian Kärgel (a1) (a2), Simone Weiß (a2), Hannah Gerwinn (a5), Alexander Pohl (a3), Till Amelung (a6), Sebastian Mohnke (a7), Jonas Kneer (a3), Matthias Wittfoth (a3), Inka Ristow (a8), Kolja Schiltz (a9), Klaus M. Beier (a6), Jorge Ponseti (a5), Martin Walter (a8) (a10), Tillmann H.C. Kruger (a3), Henrik Walter (a7) and Boris Schiffer (a1) (a2)...


Objectives: Pedophilia (P) is a psychiatric disease associated with sexual attraction toward children and often accompanied by child sexual offending (CSO). Consequently, it is important to address the understanding of executive dysfunctions that may increase the probability of CSO. Moreover, this research field has been lacking to disentangle executive deficits associated with pedophilia (as a deviant sexual preference) from those associated with CSO (as a deviant sexual behavior). Methods: The German multi-sided research network NeMUP offers the opportunity to overcome these limitations. By applying the Cambridge Automated Neuropsychological Test Battery in four carefully matched groups of men: (1) pedophiles with (N=45) and (2) without (N=45) a history of sexual offending against children; (3) child molesters without pedophilia (N=19), and (4) non-offending controls (N=49), we were able to analyze executive functioning in pedophilia and CSO independently. Results: Both CSO groups as compared to both non-CSO groups exhibited worsened response inhibition ability. However, only non-pedophilic offenders showed additionally disabled strategy use ability. Regarding set-shifting abilities, the P+CSO group showed the best performance. We also found that performances were affected by age: only in pedophiles, response inhibition worsened with age, while age-related deficits in set-shifting abilities were restricted to non-pedophilic participants. The latter also differentiated between both sexual preference groups. Conclusions: Our results are the first to demonstrate that executive dysfunctions are related to offense status rather than pedophilic preference. Furthermore, there was evidence for differentiating age and performance correlations between pedophiles and non-pedophiles, which warrants further investigation. (JINS, 2017, 23, 460–470)


Corresponding author

Correspondence and reprint requests to: Claudia Massau, Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany. E-mail:


Hide All

Authors Massau and Tenbergen contributed equally to this work.



Hide All
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association.
American Psychiatric Association (Ed.). (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th ed.). Washington, DC: American Psychiatric Association.
Babchishin, K.M., Seto, M.C., Sariaslan, A., Lichtenstein, P., Fazel, S., & Langstrom, N. (2016). Parental and perinatal risk factors for sexual offending in men: A nationwide case-control study. Psychological Medicine, 111. doi: 10.1017/S003329171600249X
Beier, K.M. (1998). Differential typology and prognosis for dissexual behavior - a follow-up study of previously expert-appraised child molesters. International Journal of Legal Medicine, 111(3), 133141. doi: 10.1007/s004140050133
Beier, K.M., Ahlers, C.J., Goecker, D., Neutze, J., Mundt, I.A., Hupp, E., & Schaefer, G.A. (2009). Can pedophiles be reached for primary prevention of child sexual abuse? First results of the Berlin Prevention Project Dunkelfeld (PPD). Journal of Forensic Psychiatry & Psychology, 20(6), 851867. doi: 10.1080/14789940903174188
Blanchard, R., Christensen, B.K., Strong, S.M., Cantor, J.M., Kuban, M.E., Klassen, P., & Blak, T. (2002). Retrospective self-reports of childhood accidents causing unconsciousness in phallometrically diagnosed pedophiles. Archives of Sexual Behavior, 31(6), 511526. doi: 10.1023/A:1020659331965
Blanchard, R., Kolla, N.J., Cantor, J.M., Klasses, P.E., Dickey, R., Kuban, M.E., & Blak, T. (2007). IQ, handedness, and pedophilia in adult male patients stratified by referral source. Sexual Abuse, 19, 285309. doi: 10.1007/s11194-007-9049-0
Blanchard, R., Kuban, M.E., Klassen, P., Dickey, R., Christensen, B.K., Cantor, J.M., && Blak, T. (2003). Self-reported head injuries before and after age 13 in pedophilic and nonpedophilic men referred for clinical assessment. Archives of Sexual Behavior, 32(6), 573581. doi: 10.1023/A:1026093612434
Cambridge Cognition Ltd (Producer). (2011). CANTABeclipse 4 Test Administration Guide.
Cantor, J.M., Blanchard, R., Christensen, B.K., Dickey, R., Klassen, P.E., Beckstead, A.L., & Kuban, M.E. (2004). Intelligence, memory, and handedness in pedophilia. Neuropsychology, 18(1), 314. doi: 10.1037/0894-4105.18.1.3
Cantor, J.M., Kabani, N., Christensen, B.K., Zipursky, R.B., Barbaree, H.E., Dickey, R., & Blanchard, R. (2008). Cerebral white matter deficiencies in pedophilic men. Journal of Psychiatric Research, 42(3), 167183. doi: 10.1016/j.jpsychires.2007.10.013
Clark, L., Robbins, T.W., Ersche, K.D., & Sahakian, B.J. (2006). Reflection impulsivity in current and former substance users. Biological Psychiatry, 60(5), 515522. doi: 10.1016/j.biopsych.2005.11.007
Clark, L., Roiser, J.P., Robbins, T.W., & Sahakian, B.J. (2009). Disrupted ‘reflection’ impulsivity in cannabis users but not current or former ecstasy users. Journal of Psychopharmacology, 23(1), 1422. doi: 10.1177/0269881108089587
Dickey, R., Nussbaum, D., Chevolleau, K., & Davidson, H. (2002). Age as a differential characteristic of rapists, pedophiles, and sexual sadists. Journal of Sex & Marital Therapy, 28(3), 211218. doi: 10.1080/009262302760328253
Downes, J.J., Roberts, A.C., Sahakian, B.J., Evenden, J.L., Morris, R.G., & Robbins, T.W. (1989). Impaired extra-dimensional shift performance in medicated and unmedicated Parkinson’s disease: Evidence for a specific attentional dysfunction. Neuropsychologia, 27(11–12), 13291343. doi: 10.1016/0028-3932(89)90128-0
Eastvold, A., Suchy, Y., & Strassberg, D.S. (2011). Executive function profiles of pedophilic and nonpedophilic child molesters. Journal of the International Neuropsychological Society, 17, 295307. doi: 10.1017/S1355617710001669
Gerwinn, H., Weiß, S., Kärgel, C., Tenbergen, G., Wittfoth, M., Jung, S., & Kruger, T.H.C. (2016). Paedophilia and child sexual offending: Clinical characteristics and identification of offence associated factors in the NeMUP-study. [submitted].
Gillis, K.R. (2005). Executive functioning in male adolescent sex offenders. Pacific University, Portland, OR.
Habermeyer, B., Esposito, F., Handel, N., Lemoine, P., Kuhl, H.C., Klarhofer, M., & Graf, M. (2013). Response inhibition in pedophilia: An FMRI pilot study. Neuropsychobiology, 68(4), 228237. doi: 10.1159/000355295
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, & Psychiatry, 23, 5662.
IBM Corp. (Released 2013). IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.
Jespersen, A.F., Lalumière, M.L., & Seto, M.C. (2009). Sexual abuse history among adult sex offenders and non-sex offenders: A meta-analysis. Child Abuse and Neglect, 33, 179192. doi: 10.1016/j.chiabu.2008.07.004
Joyal, C.C., Beaulieu-Plante, J., & de Chanterac, A. (2014). The neuropsychology of sex offenders: A meta-analysis. Sexual Abuse, 26(2), 149177. doi: 10.1177/1079063213482842
Joyal, C.C., Black, D.N., & Dassylva, B. (2007). The neuropsychology and neurology of sexual deviance: A review and pilot study. Sexual Abuse, 19(2), 155173. doi: 10.1007/s11194-007-9045-4
Kärgel, C., Massau, C., Weiß, S., Walter, M., Borchardt, V., Kruger, T.H.C., & Schiffer, B. (2017). Evidence for superior neurobiological and behavioral inhibitory control abilities in non-offending as compared to offending pedophiles. Human Brain Mapping, 38, 10921104. doi: 10.1002/hbm.23443
Kärgel, C., Massau, C., Weiß, S., Walter, M., Kruger, T.H.C., & Schiffer, B. (2015). Diminished functional connectivity on the road to child sexual abuse in pedophilia. Journal of Sexual Medicine, 12(3), 783795. doi: 10.1111/jsm.12819
Kirk, K.M., Bailey, J.M., Dunne, M.P., & Martin, N.G. (2000). Measurement models for sexual orientation in a community twin sample. Behavior Genetics, 30(4), 345356. doi: 10.1023/A:1026557719181
Kongs, S.K., Thompson, L.L., Iverson, G.L., & Heaton, R.K. (2000). The Wisconsin Card Sorting Test - 64. Odessa, FL: Psychological Assessment Resources.
Kruger, T.H.C., & Schiffer, B. (2011). Neurocognitive and personality factors in homo- and heterosexual pedophiles and controls. Journal of Sexual Medicine, 8(6), 16501659. doi: 10.1111/j.1743-6109.2009.01564.x
Langstrom, N., Babchishin, K.M., Fazel, S., Lichtenstein, P., & Frisell, T. (2015). Sexual offending runs in families: A 37-year nationwide study. International Journal of Epidemiology, 44(2), 713720. doi: 10.1093/ije/dyv029
Logan, G.D., Cowan, W.B., & Davis, K.A. (1984). On the ability to inhibit simple and choice reaction time responses: A model and a method. Journal of Experimental Psychology, 10(2), 276291. doi: 10.1037/0096-1523.10.2.276
Mohnke, S., Muller, S., Amelung, T., Kruger, T.H.C., Ponseti, J., Schiffer, B., & Walter, H. (2014). Brain alterations in pedophilia: A critical review. Progress in Neurobiology, 122, 123. doi: 10.1016/j.pneurobio.2014.07.005
Morais, H.B., Joyal, C.C., Alexander, A.A., Fix, R.L., & Burkhart, B.R. (2016). The neuropsychology of adolescent sexual offending: Testing an executive dysfunction hypothesis. Sexual Abuse, 28, 741745. doi: 10.1177/1079063215569545
Ornstein, T.J., Iddon, J.L., Baldacchino, A.M., Sahakian, B.J., London, M., Everitt, B.J., & Robbins, T.W. (2000). Profiles of cognitive dysfunction in chronic amphetamine and heroin abusers. Neuropsychopharmacology, 23(2), 113126. doi: 10.1016/S0893-133X(00)00097-X
Owen, A.M., Downes, J.J., Sahakian, B.J., Polkey, C.E., & Robbins, T.W. (1990). Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia, 28(10), 10211034. doi: 10.1016/0028-3932(90)90137-D
Owen, A.M., Evans, A.C., & Petrides, M. (1996). Evidence for a two-stage model of spatial working memory processing within the lateral frontal cortex: A positron emission tomography study. Cerebral Cortex, 6(1), 3138. doi: 10.1093/cercor/6.1.31
Owen, A.M., Sahakian, B.J., Hodges, J.R., Summers, B.A., Polkey, C.E., & Robbins, T.W. (1995). Dopamine-dependent frontrostriatal planning deficits in early Parkinson’s disease. Neuropsychology, 9(1), 126140. doi: 10.1037/0894-4105.9.1.126
Ponseti, J., Granert, O., Jansen, O., Wolff, S., Beier, K., Neutze, J., & Bosinski, H. (2012). Assessment of pedophilia using hemodynamic brain response to sexual stimuli. Archives of General Psychiatry, 69(2), 187194. doi: 10.1001/archgenpsychiatry.2011.130
Ridderinkhof, K.R., Span, M.M., & van der Molen, M.W. (2002). Perseverative behavior and adaptive control in older adults: Performance monitoring, rule induction, and set shifting. Brain and Cognition, 49(3), 382401. doi: 10.1006/brcg.2001.1506
Schiffer, B., Kruger, T.H.C., Paul, T., de Greiff, A., Forsting, M., Leygraf, N., & Gizewski, E. (2008). Brain response to visual sexual stimuli in homosexual pedophiles. Journal of Psychiatry & Neuroscience, 33(1), 2333.
Schiffer, B., Mueller, B.W., Scherbaum, N., Hodgins, S., Forsting, M., Wiltfang, J., & Leygraf, N. (2011). Disentangling structural brain alterations associated with violent behavior from those associated with substance use disorders. Archives of General Psychiatry, 68(10), 10391049. doi: 10.1001/archgenpsychiatry.2011.61
Schiffer, B., Paul, T., Gizewski, E., Forsting, M., Leygraf, N., Schedlowski, M., & Kruger, T.H.C. (2008). Functional brain correlates of heterosexual paedophilia. Neuroimage, 41(1), 8091. doi: 10.1016/j.neuroimage.2008.02.008
Schiffer, B., Peschel, T., Paul, T., Gizewski, E., Forsting, M., Leygraf, N., & Kruger, T.H.C. (2007). Structural brain abnormalities in the frontostriatal system and cerebellum in pedophilia. Journal of Psychiatric Research, 41(9), 753762. doi: 10.1016/j.jpsychires.2006.06.003
Schiffer, B., & Vonlaufen, C. (2011). Executive dysfunctions in pedophilic and nonpedophilic child molesters. Journal of Sexual Medicine, 8(7), 19751984. doi: 10.1111/j.1743-6109.2010.02140.x
Schiltz, K., Witzel, J., Northoff, G., Zierhut, K., Gubka, U., Fellmann, H., & Bogerts, B. (2007). Brain pathology in pedophilic offenders: Evidence of volume reduction in the right amygdala and related diencephalic structures. Archives of General Psychiatry, 64, 737746. doi: 10.1001/archpsyc.64.6.737
Seto, M.C. (2008). Pedophilia and sexual offending against children: Theory, assessment, and intervention. Washington, DC: American Psychiatric Association.
Suchy, Y., Eastvold, A.D., Strassberg, D.S., & Franchow, E.I. (2014). Understanding processing speed weaknesses among pedophilic child molesters: Response style vs. neuropathology. Journal of Abnormal Psychology, 123(1), 273285. doi: 10.1037/a0035812
Suchy, Y., Whittaker, J.W., Strassberg, D.S., & Eastvold, A. (2009). Neurocognitive differences between pedophilic and nonpedophilic child molesters. Journal of the International Neuropsychological Society, 15(2), 248257. doi: 10.1017/S1355617709090353
U.S. Department of Health & Human Services, Administration for Children & Families, Administration on Children, Youth and Families, Children’s Bureau. (2016). Child maltreatment 2014. Washington, DC: U.S. Department of Health & Human Services.
von Aster, M., Neubauer, A., & Horn, R. (2006). Wechsler Intelligenztest für Erwachsene (WIE). Deutschsprachige Bearbeitung und Adaptation des WAIS-III von David Wechsler. Frankfurt, Germany: Pearson Assessment.
Walter, M., Witzel, J., Wiebking, C., Gubka, U., Rotte, M., Schiltz, K., & Northoff, G. (2007). Pedophilia is linked to reduced activation in hypothalamus and lateral prefrontal cortex during visual erotic stimulation. Biological Psychiatry, 62(6), 698701. doi: 10.1016/j.biopsych.2006.10.018
Wittchen, H.-U., Zaudig, M., & Fydrich, T. (1997). Strukturiertes Klinisches Interview für DSM-IV: Achse I und II. Göttingen, Germany: Hogrefe.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed