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Changed processing of visual sexual stimuli under GnRH-therapy--a single case study in pedophilia using eye tracking and fMRI.

ABSTRACT: BACKGROUND: Antiandrogen therapy (ADT) has been used for 30 years to treat pedophilic patients. The aim of the treatment is a reduction in sexual drive and, in consequence, a reduced risk of recidivism. Yet the therapeutic success of antiandrogens is uncertain especially regarding recidivism. Meta-analyses and reviews report only moderate and often mutually inconsistent effects. CASE PRESENTATION: Based on the case of a 47 year old exclusively pedophilic forensic inpatient, we examined the effectiveness of a new eye tracking method and a new functional magnetic resonance imaging (fMRI)-design in regard to the evaluation of ADT in pedophiles. We analyzed the potential of these methods in exploring the impact of ADT on automatic and controlled attentional processes in pedophiles. Eye tracking and fMRI measures were conducted before the initial ADT as well as four months after the onset of ADT. The patient simultaneously viewed an image of a child and an image of an adult while eye movements were measured. During the fMRI-measure the same stimuli were presented subliminally. Eye movements demonstrated that controlled attentional processes change under ADT, whereas automatic processes remained mostly unchanged. We assume that these results reflect either the increased ability of the patient to control his eye movements while viewing prepubertal stimuli or his better ability to manipulate his answer in a socially desirable manner. Unchanged automatic attentional processes could reflect the stable pedophilic preference of the patient. Using fMRI, the subliminal presentation of sexually relevant stimuli led to changed activation patterns under the influence of ADT in occipital and parietal brain regions, the hippocampus, and also in the orbitofrontal cortex. We suggest that even at an unconscious level ADT can lead to changed processing of sexually relevant stimuli, reflecting changes of cognitive and perceptive automatic processes. CONCLUSION: We are convinced that our experimental designs using eye tracking and fMRI could prospectively add additional and valuable information in the evaluation of ADT in paraphilic patients and sex offenders. But with respect to the limited significance of this single case study, these first results are preliminary and further studies have to be conducted with healthy subjects and patients.

SUBMITTER: Jordan K

PROVIDER: S-EPMC4036749 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Changed processing of visual sexual stimuli under GnRH-therapy--a single case study in pedophilia using eye tracking and fMRI.

Jordan Kirsten K Fromberger Peter P Laubinger Helge H Dechent Peter P Müller Jürgen L JL

BMC psychiatry 20140517

<h4>Background</h4>Antiandrogen therapy (ADT) has been used for 30 years to treat pedophilic patients. The aim of the treatment is a reduction in sexual drive and, in consequence, a reduced risk of recidivism. Yet the therapeutic success of antiandrogens is uncertain especially regarding recidivism. Meta-analyses and reviews report only moderate and often mutually inconsistent effects.<h4>Case presentation</h4>Based on the case of a 47 year old exclusively pedophilic forensic inpatient, we exami ...[more]

PMID: 24885644

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Project description:Audio-visual integration relies on temporal synchrony between visual and auditory inputs. However, differences in traveling and transmitting speeds between visual and auditory stimuli exist; therefore, audio-visual synchrony perception exhibits flexible functions. The processing speed of visual stimuli affects the perception of audio-visual synchrony. The present study examined the effects of visual fields, in which visual stimuli are presented, for the processing of audio-visual temporal synchrony. The point of subjective simultaneity, the temporal binding window, and the rapid recalibration effect were measured using temporal order judgment, simultaneity judgment, and stream/bounce perception, because different mechanisms of temporal processing have been suggested among these three paradigms. The results indicate that auditory stimuli should be presented earlier for visual stimuli in the central visual field than in the peripheral visual field condition in order to perceive subjective simultaneity in the temporal order judgment task conducted in this study. Meanwhile, the subjective simultaneity bandwidth was broader in the central visual field than in the peripheral visual field during the simultaneity judgment task. In the stream/bounce perception task, neither the point of subjective simultaneity nor the temporal binding window differed between the two types of visual fields. Moreover, rapid recalibration occurred in both visual fields during the simultaneity judgment tasks. However, during the temporal order judgment task and stream/bounce perception, rapid recalibration occurred only in the central visual field. These results suggest that differences in visual processing speed based on the visual field modulate the temporal processing of audio-visual stimuli. Furthermore, these three tasks, temporal order judgment, simultaneity judgment, and stream/bounce perception, each have distinct functional characteristics for audio-visual synchrony perception. Future studies are necessary to confirm the effects of compensation regarding differences in the temporal resolution of the visual field in later cortical visual pathways on visual field differences in audio-visual temporal synchrony.

Dataset Information

Changed processing of visual sexual stimuli under GnRH-therapy--a single case study in pedophilia using eye tracking and fMRI.

Publications

Changed processing of visual sexual stimuli under GnRH-therapy--a single case study in pedophilia using eye tracking and fMRI.

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