Pedophilia is a sexual preference that is often associated with child sex
offending (CSO). Sexual urges towards prepubescent children and specifically
acting upon those urges are universally regarded as immoral. However, up until
now, it is completely unknown whether moral processing of sexual offenses is
altered in pedophiles. A total of 31 pedophilic men and 19 healthy controls
were assessed by using functional magnetic resonance imaging (fMRI) in
combination with a moral judgment paradigm consisting of 36 scenarios
describing different types of offenses. Scenarios depicting sexual offenses
against children compared to those depicting adults were associated with
higher pattern of activation in the left temporo-parietal-junction (TPJ) and
left posterior insular cortex, the posterior cingulate gyrus as well as the
precuneus in controls relative to pedophiles, and vice versa. Moreover, brain
activation in these areas were positively associated with ratings of moral
reprehensibility and negatively associated with decision durations, but only
in controls. Brain activation, found in key areas related to the broad network
of moral judgment, theory of mind and (socio-)moral disgust - point to
different moral processing of sexual offenses in pedophilia in general. The
lack of associations between brain activation and behavioral responses in
pedophiles further suggest a biased response pattern or dissected implicit
valuation processes
