Arch Sex Behav (2007) 36:423–436 DOI 10.1007/s10508-006-9091-x ORIGINAL PAPER The Utility of the Diagnosis of Pedophilia: A Comparison of Various Classification Procedures Drew A. Kingston · Philip Firestone · Heather M. Moulden · John M. Bradford Received: 4 November 2005 / Revised: 11 April 2006 / Accepted: 24 June 2006 / Published online: 21 December 2006 C  Springer Science+Business Media, Inc. 2006 Abstract This study examined the utility of the diagnosis of pedophilia in a sample of extra-familial child molesters assessed at a university teaching hospital between 1982 and 1992. Pedophilia was defined in one of four ways: (1) DSM diagnosis made by a psychiatrist; (2) deviant phallometric profile; (3) DSM diagnosis and a deviant phallometric pro- file; and, (4) high scores based on the Screening Scale for Pedophilic Interest (Seto & Lalumi` ere, 2001). Demographic data, psychological tests, and offence history were obtained and group differences were analyzed along with the ability of certain variables to contribute uniquely to the classification of pedophilia. Results indicated that few significant differ- ences existed on psychological measures between pedophilic and nonpedophilic extra-familial child molesters regardless of the classification system employed. Finally, results indi- cated that the procedures used to define pedophilia were not significantly related to one another. Results are discussed in terms of the utility of the diagnosis of pedophilia. Keywords Sex offender . DSM . Pedophilia . Child molesters . Phallometric assessment D. A. Kingston · P. Firestone () · H. M. Moulden School of Psychology, University of Ottawa, 120 University Private, Ottawa, Ontario K1N 6N5, Canada e-mail: fireston@uottawa.ca J. M. Bradford Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada Introduction Issues of classification have significant implications for the assessment and treatment of sexual offenders. Previous re- search has suggested that sexual offenders are a heteroge- neous group, such that those who offend against adults vs. children differ on important dimensions, such as criminal his- tory and risk to re-offend (Hanson & Bussi` ere, 1998). With regard to child molesters, it is evident that there are addi- tional differences with respect to victim selection (i.e., intra- familial or incest vs. extra-familial) (Hanson & Bussi` ere, 1998; Quinsey, Lalumi` ere, Rice, & Harris, 1995) and vic- tim gender (Barbaree & Seto, 1997; Walsh, 1994). However, most research on child molesters has neglected to differenti- ate this group based on the presence or absence of a diagnosis of pedophilia (Barbaree & Seto, 1997; Seto, 2004), despite the fact that such a diagnosis implies a deviant sexual in- terest, and differential consequences for the prediction of recidivism. The Diagnostic and Statistical Manual of Mental Dis- orders (DSM-IV-TR; American Psychiatric Association [APA], 2000) specifies three criteria that must be met to apply a diagnosis of pedophilia. Criterion A requires that the individual has experienced recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sex- ual activity with a prepubescent child or children (generally aged 13 years or younger) over a period of at least 6 months. Criterion B states that the person must have acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty. Lastly, Criterion C re- quires that the individual being assessed is at least 16 years old and at least 5 years older than the child or children in Criterion A. The DSM-IV-TR further qualifies the diagnosis with specifiers indicating an attraction to males, females, or Springer