Penile tumescence assessment used for a diagnosis of paraphilia: A pedophilia case report

We report on the use of penile tumescence assessment to diagnose a paraphiliac client who was in denial about his problem. An 18-year-old male was accused of sexually assaulting a 4-year-old girl using physical restraint and vaginal penetration with a finger. During a psychiatric evaluation requested by the court, a comprehensive psychosexual assessment revealed that the subject was in denial about clarification of the paraphiliac experience. Penile tumescence under distinct visual stimulus was evaluated with electrobioimpedence volumetric assessment using child and adult female pictures in separate time frames. Both types of stimuli evoked arousal responses. However, child female stimuli demonstrated stronger responses than did adult female ones. Deviant sexual interest in children as well as a diagnosis of pedophilia was implied. Paraphiliac clients tend to be in denial toward psychosexual assessment which limits the interpretation of its results. Penile tumescence assessment may be more reliable than psychosexual assessment alone for detecting and diagnosing paraphilia. Further study is warranted in order to aid in more accurate diagnoses of paraphilia.