Original article Clinical characteristics associated with paedophilia and child sex offending – Differentiating sexual preference from offence status Hannah Gerwinn a,b, 1 , Simone Weiß c,d, 1 , Gilian Tenbergen e,f , Till Amelung g , Carina Födisch h , Alexander Pohl a,b , Claudia Massau c,d , Jonas Kneer e , Sebastian Mohnke i , Christian Kärgel c,d , Matthias Wittfoth e , Stefanie Jung e , Krassimira Drumkova j , Kolja Schiltz h,k , Martin Walter h,l , Klaus M. Beier g , Henrik Walter i , Jorge Ponseti b , Boris Schiffer c,d,2 , Tillmann H.C. Kruger e,2, * a Department of Neurology, Medical School, Kiel University, Arnold-Heller-Str. 3, 24105 Kiel, Germany b Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Niemannsweg 147, 24105 Kiel, Germany c Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Forensic Psychiatry, LWL-University Hospital, Alexandrinenstr. 1-3, 44791 Bochum, Germany d Institute of Forensic Psychiatry, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany e Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany f Department of Psychology, State University of New York at Oswego, 7060 State Route 104, 13126 Oswego, NY, USA g Institute of Sexology and Sexual Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany h Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany i Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany j State Hospital for Forensic Psychiatry Uchtspringe, Schnöggersburger Weg 1, 39576 Stendal, Germany k Department of Forensic Psychiatry, Psychiatric Hospital, LMU Munich, Nußbaumstr. 7, 80336 München, Germany l Department of General Psychiatry and Psychotherapy, University Hospital Tübingen, Osianderstr. 24, 72076 Tübingen, Germany A R T I C L E I N F O Article history: Received 29 August 2017 Received in revised form 12 February 2018 Accepted 13 February 2018 Available online xxx Keywords: Pedophilia Child sex offending Childhood trauma Childhood sexual abuse SCID Intelligence A B S T R A C T Contrary to public perception, child sex offending (CSO) and paedophilia are not the same. Only half of all cases of CSO are motivated by paedophilic preference, and a paedophilic preference does not necessarily lead to CSO. However, studies that investigated clinical factors accompanying and contributing to paedophilia so far mainly relied on paedophiles with a history of CSO. The aim of this study was to distinguish between factors associated with sexual preference (paedophile versus non-paedophile) and offender status (with versus without CSO). Accordingly, a 2 (sexual preference)  2 (offender status) factorial design was used for a comprehensive clinical assessment of paedophiles with and without a history of CSO (n = 83, n = 79 respectively), child sex offenders without paedophilia (n = 32) and healthy controls (n = 148). Results indicated that psychiatric comorbidities, sexual dysfunctions and adverse childhood experiences were more common among paedophiles and child sex offenders than controls. Offenders and non-offenders differed in age, intelligence, educational level and experience of childhood sexual abuse, whereas paedophiles and non-paedophiles mainly differed in sexual characteristics (e.g., additional paraphilias, onset and current level of sexual activity). Regression analyses were more powerful in segregating offender status than sexual preference (mean classification accuracy: 76% versus 68%). In differentiating between * Corresponding author at: Medizinische Hochschule Hannover, Zentrum für Seelische Gesundheit, Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Arbeitsbereich Klinische Psychologie und Sexualmedizin, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. E-mail address: krueger.tillmann@mh-hannover.de (T.H.C. Kruger). 1 These authors contributed equally to this work. 2 Shared last authorship. http://dx.doi.org/10.1016/j.eurpsy.2018.02.002 0924-9338/© 2018 Elsevier Masson SAS. All rights reserved. European Psychiatry 51 (2018) 74–85 Contents lists available at ScienceDirect European Psychiatry journal homepage: htt p://www.europsy-journa l.com