SCREENING TESTS

FOR PEDOPHILIA

GENE G. ABEL
Behavioral Medicine Institute of Atlanta and Morehouse School of Medicine
SUZANN S. LAWRY
Behavioral Medicine Institute of Atlanta and Georgia State University
ELISABETH KARLSTROM
CANDICE A. OSBORN
Behavioral Medicine Institute of Atlanta
CHARLES F. GILLESPIE
Georgia State University

Child molesters frequently position themselves in organizations so as to easily access children.

Interviews for applicants of such positions, psychological tests, home visits to applicants residences,
criminal record checks for prior convictions, and letters of reference have all been used in an attempt
to identify applicants with proclivities toward pedophilia, but none of these methodologies have been
validated. The standard methods for reporting the effectiveness of screening tests are reviewed with
special emphasis on the sensitivity, specificity, and efficiency of such testing, within the context of the
prevalence of various diseases being screened for. Volumetric and circumferential phallometry have
relatively high efficiencies, but their intrusiveness, cost, and the length of the assessment process
preclude their use as a screening methodology for pedophiles within organizations. The efficiency of a
new, less intrusive, screening methodology, the Abel Screen, compares favorably with phallometry in
identifying those at risk for involvement with prepubescent and pubescent boys. The risk of
applicants accessing boys in institutional settings could be significantly reduced by using the Abel
Screen in such settings.

C
and
hild molestation is a public health problem (Abel & Osborn,
1992). Finkelhor et al. (1986) summarized studies from North
America that investigated the prevalence of child molestation

AUTHORS NOTE: Address correspondence to Gene G. Abel, Behavioral Medicine

Institute of Atlanta, 3280 Howell Mill Road, N. W, Suite T-30, West Wing, Atlanta, GA
30327-4101.
CRIMINAL JUSTICE AND BEHAVIOR, Vol. 21 No. 1, March 1994 115-131
1994 American Association for Correctional Psychology
115

from the SAGE Social Science Collections. All Rights

Reserved.
116 CRIMINAL JUSTICE AND BEHAVIOR

found that across numerous studies 6% to 62% of adult females and 3%

to 31% of adult males had been molested as children. A public health
problem of such proportions necessitates a variety of approaches to
reduce the devastation resulting from molestation. Efforts are needed to
(a) increase victim reportingthis allows more victims to be treated and
also acts as a deterrent to perpetrators, because molesters would be less
likely to molest children knowing that reporting is likely to occur; (b)
develop better treatments to reduce the consequences of molestation on
its victims; (c) improve the effectiveness of treatment programs for
molesters and the monitoring of molesters after treatment to stop
subsequent molestations; (d) identify the antecedents to sexually
abusive behavior so as to attack its etiology and thereby prevent
children from being victimized; and (e) improve the working
relationship between those counseling victims, those treating molesters,
and those working in the criminal justice system who are giving a legal
response to child molestation. In recent years, the media has brought to
the publics attention yet another critical aspect of child molestation
child molestation perpetrated by individuals in pivotal positions within
institutions that serve children. Covenant House (Priest in, 1992), the
Roman Catholic Church (Berry, 1992; Butterfield, 1992), the Foxfire
Corporation (Harmon & McCarthy, 1992), the Cleaner Air Foundation
(Hechler, 1988), the Episcopal Church (Sexual Abuse, 1992), the Boy
Scouts of America (Boyle, 1991), and the Big Brothers and Big Sisters
of America (Wolff, 1986) are but a few of the organizations recently
identified as having volunteers or employees who have molested
children under their supervision. Screening methods to prevent potential
child molesters from holding such critical positions have been used for a
number of years. Identifying individuals at high risk to molest children
will reduce the opportunity for pedophiles to have easy access to large
numbers of children within these organizations.
Pedophilia is a disease well described in the medical literature.
Pedophiles have sustained, recurrent, repetitive sexual interests and/or
sexual behaviors with children (American Psychiatric Association,
1987). The perpetrators who join organizations for children are almost
exclusively males, and their victims are usually young boys or, more
frequently, adolescent boys. The present article reviews several clinical
cases demonstrating typical patterns of how child molesters victimize
children within their organizations, describes some of the screening
 Abel et al. / SCREENING FOR PEDOPHILIA 117

systems currently in use by organizations and their limitations, and

delineates the features that are critical in the development of effective
screening systems. Finally, a brief overview of a screen for pedophilia
developed by the first author will be presented.

CASE STUDIES OF CHILD

MOLESTERS WITHIN INSTITUTIONS

Bob was in his late 30s when he was referred for evaluation and
treatment following his arrest for four charges involving, sexual contact
with adolescent boys. He first became involved with males at age 13,
when he was sexually involved with boyfriends of his older sister, and
by age 15 he first realized that he had sustained sexual interests in
males. In his late teens, he began smoking marijuana, a behavior that
continued up to the time of his evaluation. During his early 20s, his
attraction to adolescent boys led to his fondling them.
He entered the seminary in his early 20s, and within a few years he
was assigned to a parish as its only priest. As a priest, he made a point
of spending an inordinate amount of time with adolescent boys because
he believed he had a special empathy for them. Ultimately, he began
fondling boys in the parish, then had oral and anal sex with them, and
by the time he was caught he had victimized seven adolescent boys.
Bobs sexual attraction to boys was obvious to him from his
midteens and continued throughout his entering the seminary and his
eventual ordination. He failed to reveal his proclivities toward adoles-
cent boys throughout his religious training as well as during his
subsequent clerical work. His placement as the only priest in his small
church put him in a position of great authority and allowed him to
counsel the very group to whom he was most sexually attracted
adolescent boys. His increasing solitary interactions with the boys, and
the intimacy of the counseling situation, made it more and more difficult
for him to control his sexual interest in boys.
Marvin was in his early 40s when referred following his arrest for
the rape of a preteenage, female elementary school student. He came
from a large family and had been involved in extensive sexual behavior
with his siblings since age 4. While he was a teenager he recognized
that he was sexually attracted to young girls and began fondling young
118 CRIMINAL JUSTICE AND BEHAVIOR

neighborhood girls, his nieces, and, eventually, the daughters of a

woman he dated in his early 20s.
He married in his late 20s, but in the last 10 years of his marriage he
had essentially discontinued his sexual relationship with his wife and
had become sexually involved with his own daughters. These incestuous
relationships continued for 8 years. His vocation was that of an
elementary school teacher, and, because of his exceptional teaching
skills, he was given an award as an outstanding teacher during the year
prior to his arrest. Eight months prior to his evaluation he became
infatuated with a female, preadolescent student. He wrote her love
letters, kissed and fondled her, and arranged for his daughters to go on
outings with her so that he might eventually join them to be with her.
Eventually he began having intercourse with her.
His attachment to the young girl did, however, come to the attention
of school authorities. He was confronted about the time he was spending
with her, resigned, and was eventually charged with statutory rape. By
the time of his initial evaluation, 70% of his sexual fantasies involved
young girls, and he had been involved in more than 300 molestations of
girls under 14 years of age, both within and outside of his family.
Marvins case demonstrates the perpetrators awareness of his
pedophilic interest from an early age and his extensive involvement
with young girls long before his sexual involvement with the student
had come to the attention of the school authorities. Within the school
setting, accessing girls was relatively easy because appointments
between teachers and students are expected and normal.
Jerry was in his early 30s when he was evaluated for possible
pedophilia following his arrest for having sex with a boy under 14 years
of age. Prior to age 12 he had been molested by an older boy at his
church. That same year he started having sex with a male relative of a
similar age. At age 12, he joined the Boy Scouts of America, at which
time a senior patrol leader gradually began molesting him. This
molestation eventually progressed to mutual fellatio. By age 13, Jerrys
fantasies were exclusively of 12- to 13-year-old boys.
At age 15, he left the Boy Scouts of America and at age 17 became
further involved with boys in their early teens. By age 21, he began
collecting pictures of young boys to use during masturbation, and by
age 22, he realized that he had a specific attraction to young boys.
 Abel et al. / SCREENING FOR PEDOPHILIA 119

In his mid-20s he rejoined the Boy Scouts of America, as a leader,

and began molesting adolescent boy scouts. His usual grooming
behavior began with emotional attachment, then progressing to back
rubs, then fellating them, and eventually talking them into fellating him.
Jerry prided himself on his skill at involving himself with boy scouts
without being caught. On a number of occasions, some of his boy scout
victims were actually in attendance at talks he gave to the boy scouts
about child molestation and how to identify child molesters. He believed
that he wasnt reported by his victims because he was their leader and
they would interpret what he was doing to them as somehow different
than molestation.
On occasions when he was confronted by parents because of the
excessive attention he showed scout members or when it was alleged
that he had touched boys inappropriately, he would respond by giving
the outward appearance of being highly affronted, which was effective
at stopping parents from further inquiry. He would agree that their son
spent an excessive amount of time with him but would camouflage his
behavior by saying that he was simply meeting the emotional needs of
their troubled and overly needy boy.
By the time he was evaluated, he had been involved with more than
40 boys on more than 190 separate occasions. Jerry reported that 90%
of his victims were scouts whom he had met either initially when he was
a scout himself or later when he was a boy scout leader.
Jerrys history again reflects a long-standing pedophilic interest in
boys. He had passed the Boy Scouts of Americas screening system to
identify possible child molesters because he had never been arrested, his
previous acts of child molestation had not come to the attention of
others, and the boy scouts under his care did not report him due to his
role and his careful grooming of them.

SCREENING METHODOLOGIES CURRENTLY USED

BY INSTITUTIONS TO IDENTIFY CHILD MOLESTERS

A number of organizations have developed screening systems to

identify child molesters attempting to enter or who are already members
of their organizations. Access to records that would throw light on the
efficacy of such screening interventions is usually protected by the risk
120 CRIMINAL JUSTICE AND BEHAVIOR

management branch of the specific organizations. Consequently, it is

difficult to assess the screening systems 9 utility. The following is a
review of these various screening methods, with critiques of their
limitations.

Interviews with applicants. All organizations rely on interviews to

identify those at high risk to be involved with children. Armed with
descriptions of what pedophiles are allegedly like (e.g., unmarried, poor
social skills, high interests in activities enjoyed by children, prior
history of being sexually abused, prior history of arrest, drug misuse),
the interviewer attempts to match the applicants profile with those of
pedophiles (Boyle, 1991; Wolff, 1986).
Interviews to identify potential child molesters are very problematic.
First, the characteristics frequently described as specific to pedophiles
are not specific to them at all but describe a number of nonpedophiles
equally well. Second, the interviewing process is highly specific and,
even when conducted by experts, frequently fails to yield valid
information because the child molester denies or conceals his interests.
An attempted remedy is to include interviews with the applicants
family or friends. However, in addition to the ongoing problems of
gathering accurate information, it is unlikely that applicants would
identify family members or friends who would have information
regarding their past pdophilie behaviors. Indeed, when the family and
friends of pedophiles are interviewed, one is impressed by their lack of
information regarding the sex offenders behaviors. This results in part
from the offenders purposefully withholding or denying previous
sexual misconduct as well as from the familys own denial systems.

Paper-and-pencil questionnaires. Although one questionnaire has

been suggested to identify potential sex offenders (McCormack &
Selvaggio, 1989), it has not been documented to reliably separate
potential child molesters from those who do not molest children.
Without such validation, the exclusion of potential applicants based on
such questionnaires would be problematic and could lead to a litigious
response from the excluded applicant.
Home visits. Wolff (1986) has described the use of home visits,
where staff from the institution go into the applicants home and
neighborhood to see if there is evidence of specific proclivities toward
children, such as the applicants possessing childrens games, photo
 Abel et al. / SCREENING FOR PEDOPHILIA 121

albums depicting children, art work, and books. Such home visits are
problematic because, once again, there is no evidence that these
procedures are effective in identifying child molesters. Furthermore,
child molesters frequently keep collections of pornography and other
child-specific paraphernalia separate from their homes specifically to
prevent detection.

Police reports regarding prior convictions for child molestation.

Certainly, prior conviction would be a clear indication of the applicants
being at risk for child molestation. However, as a screening system, it is
insufficient. First, investigations without convictions do not become part
of an individuals criminal record. Consequently, checking official
records would miss individuals who have been accused repeatedly of
child molestation but have not been convicted. Second, child molesters
frequently move to different states after being convicted. In such
situations, the institution is then unable to gain access to records
retained in other states (Boyle, 1991; D. L. Wolff, personal communi-
cation, February 13, 1991). Furthermore, when such record systems
have been computerized, an individual is able to obviate such a system
simply by changing the spelling of his or her name. Finally, a number of
organizations have hired individuals prior to obtaining the applicants
arrest record. Because acquiring such information can be time-
consuming and institutions may be under pressure to hire applicants, the
tendency for hiring without completing a records check presents
problems.

Letters of reference. Many times applicants are asked to submit

letters of reference regarding their suitability for a position within the
institution. However, as with the family interviews, it is exceedingly
unlikely that an applicant would request a letter of reference from a
colleague who is aware of his deviant sexual interest. Furthermore, as
Wolff points out (D. L. Wolff, personal communication, February 13,
1991), sometimes applicants have been accepted for employment even
when the content of their letters of recommendations were unfavorable.
It appears that in some cases, such letters of reference are treated as
acceptable as long as they are in the file, irrespective of their content.
122 CRIMINAL JUSTICE AND BEHAVIOR

ALTERNATIVES TO SCREENING

In addition to the above screening procedures, a number of organi-

zations have implemented programs that might lead to early detection or
prevention of child molestation within their institutions. Although these
are not specific screening methodologies, their goal is to reduce the
occurrence of sexual abuse within the organization. These include the
following programs.

Education and training of children in the institution. Children within

the institutions care are educated regarding child molestation, how to
identify inappropriate touching, and how to report such touching to
individuals in authority. These programs sometimes also extend to the
childrens family members so that they can assist in identifying and
reporting incidences of child molestation.

Education and training of volunteers and institutional staff. Volun-

teers and institutional staff are also trained in the alleged characteristics
of child molesters and the symptomatology of molested children. In
some cases (D. L. Wolff, personal communication, February 13, 1991),
such training includes making it explicitly clear to the staff that children
under the care of the institution have been trained how to identify and
report child molestation, in the hope of deterring some potential
perpetrators through fear of being reported by the children.

Elimination of individual staff-child interactions. In the past, adults

have been able to access children when there was only one staff member
present with the children. This has allowed perpetrators to groom and
eventually involve themselves sexually with children. A number of
institutions now require that at least two institutional staff members be
present at meetings involving children so as to reduce the likelihood of
grooming behaviors and subsequent molestations.
The above procedures may, in fact, be steps in the right direction.
However, without empirical validation, it is impossible to determine
whether these methods actually decrease the incidence of molestation
within organizations or whether they are merely procedures that appear
to make sense but have little or no impact on the safety of children.
 Abel et al. / SCREENING FOR PEDOPHILIA 123

INTERPRETING SCREENING TESTS

Standard methods exist for reporting the usefulness of screening

tests with patient populations (Galen & Gambino, 1975). The terms true
positive (TP) and true negative (TN) reflect the number of diseased and
nondiseased patients correctly classified by a screening test. A false
positive (FP) would be a disease-free patient who was incorrectly
classified as diseased, and a false negative (FN) would be a patient who
had a disease that was missed by the screening test and who was
classified as nondiseased.
Other terms relevant to screening for disease include sensitivity,
specificity, and efficiency of a screening test as well as the prevalence of
a disease. Sensitivity refers to the ability of a test to identify diseased
individuals, whereas specificity refers to the tests ability to correctly
identify individuals without a disease. Most individuals would assume
that a screening test for pedophilic interest with a high sensitivity would
be ideal. A high sensitivity is desired when the disease is serious and
should not be missed, when the disease is treatable, and when FN results
could lead to serious psychological, social, or financial consequences. In
the case of pedophilia, the disease is serious and should not be missed, it
is treatable, and FN results could lead to serious emotional, social,
and/or financial consequences to a victim molested by someone who
had passed a screening.
On the other hand, high specificity is desired when the disease is
serious but not treatable, when the knowledge that the disease is absent
has psychological and public health value, and when false positive
results can lead to serious psychological, financial, and/or social
consequences. In the case of pedophilia, it is important to know that an
individual does not have the disease, and it could have serious
consequences if an individual without the disease were incorrectly
labeled as a pedophile (FP). High test efficiency is necessary when
screening for pedophilia. High efficiency of a screening test is important
when the disease is serious but treatable, and both FP and FN
124 CRIMINAL JUSTICE AND BEHAVIOR

results would be damaging to society or the individual. In the case of

screening for pedophilia, it is not only important to identify individuals
at high risk to have the condition (TPs) but also to have a low rate of
FPs so as to not falsely accuse individuals who are not pedophiles. The
formula for calculating efficiency is as follows:
TP + TN
Efficiency = TP + FN + TN + FP x 100.

Another issue of relevance is the prevalence of a disease. Prevalence

refers to the percentage of the population who are diseased. The
interrelationship between prevalence of a disease and other measures of
a screening test is frequently overlooked. A common error in reporting
the accuracy of various tests for pedophilia is to report the true positive
and true negative rates of the test based on two experimental groups
diagnosed as either pedophiles or nonpedophiles, while ignoring the
expected prevalence of pedophilia in the general population. The
prevalence or estimated prevalence of pedophilia in the general
population makes a marked difference in the impact of testing for
pedophiles.
Table 1 shows the sensitivity, specificity, and efficiency of various
tests used for a variety of diseases, assuming 5% prevalence of the
diseases. The role that prevalence of a disease plays in the accuracy of
screening tests can be seen in the following example. First, assume that
pedophilia has a prevalence of 50% in the population being screened
and that the sensitivity and specificity of a screen for pedophilia are
both 90%. Because 50% of the population to be screened would be true
pedophiles, and the sensitivity of the test is 90%, then 45 (50 x .90) of
the 50 pedophiles found in a sample of 100 individuals from the
population would be diagnosed as probable pedophiles. Because the
remaining 50% of the sample are nonpedophiles and the specificity of
the screen for pedophilia is also 90%, then 45 (50 x .90) of these
nonpedophiles would be diagnosed as nonpedophiles. This might
initially appear to be a good screening test for pedophilia.
However, in screening of the general population, the assumed
prevalence of pdophilie interest would be nowhere near 50% and
would probably be closer to 5%. Assuming the same sensitivity and
specificity of the screening test for pedophilia and assuming the 5%
 Abel et al. / SCREENING FOR PEDOPHILIA 125

TABLE 1: Sensitivity, Specificity, and Efficiency of Tests Assuming 5% Preva-

lence of the Disease (in percentages)
Disease Sensitivity Specificity Efficiency

Urine test for diabetes mellitus 44.3 96.5 93.9

Blood test for diabetes mellitus 64.3 96.9 95.3
EKG for left ventricular enlargement 58.0 97.0 95.1
EKG for heart disease 46.9 89.3 87.2
Personality disorders (PDQ-R) 100.0 43.0 45.9
Alcoholism (MAST) 100.0 69.8 71.3
Pedophilia (volumetric phallometry) 86.7 95.0 94.6
Pedophilia (circumferential
plethysmography) 47.5 97.4
Abel Screen for risk of behavior 100.0
With prepubescent boys 76.0 98.0 96.9
With pubescent boys 90.0 98.0 97.6
With prepubescent girls 91.0 77.0 77.7
With pubescent girls 86.0 77.0 77.5

of the population might be attracted to children, then of the five

pedophiles present in the population, 4.5 (5 x .90) of such individuals
would be correctly identified as having pedophilic interest. The prob-
lem, however, develops when one examines the remaining 95% of the
population who have no pedophilic interest. Because the specificity
remains at 90, 85.5 of the 95 (95 x .90) nonpedophiles per 100
individuals screened would be correctly identified as nonpedophiles, but
the remaining 9.5 (95 - 85.5) people would be erroneously categorized
as pedophiles, or FPs.
These 9.5 FPs and the 4.5 TPs would need further testing. Indeed, if
an individual failed the test, only 32% [4.5/(4.5 + 9.5)] of failures would
actually be pedophiles, assuming a 5% prevalence rate of pedophilia
(this 32% is called the predictive value of a positive test). This is in
contrast to 90% of individuals actually being pedophiles, assuming a
prevalence rate of 50% for pedophilia with the same 90% sensitivity and
specificity rates. If the subsequent testing of all those with positive
screens were to include psychiatric interviews, psychological tests, and
psychophysiological testing such as plethysmography, the cost of further
assessing these FPs would be significant and would increase the total
cost of the screening process considerably.
Also problematic are the emotional, social, and potential financial
consequences of identifying these 9.5 individuals as being possible
126 CRIMINAL JUSTICE AND BEHAVIOR

pedophiles when, in actuality, they are FPs. These individuals would

most likely feel quite uncomfortable about returning for subsequent
testing, because preliminary screening raised the possibility of their
being at high risk to be sexually attracted to children.
Assuming different prevalence rates of pedophilic interest dramat-
ically changes the predictive value of a positive screening test from
90%, at an assumed prevalence of 50%, to 32%, at an assumed
prevalence rate of 5%. This example demonstrates the importance for
screening systems to have both high sensitivity and high specificity
when the prevalence of the condition is anticipated to be relatively low.
For this reason a high test efficiency appears to be the best criteria for a
good screening test for pedophilia.
To enable comparison, the various measures of the accuracy of the
tests in Table 1 have been calculated assuming a prevalence of 5% for
the disease being investigated. Tests that one would expect to be highly
accurate, such as the blood test for diabetes mellitus (Galen & Gambino,
1975), and an EKG for a left ventricular enlargement (Galen &
Gambino, 1975) show low sensitivities, high specificities, and modest
predictive values of a positive test (Galen & Gambino, 1975). EKG
testing for heart disease has a surprisingly low sensitivity and only a
modestly high specificity, with a resultant predictive value of a positive
test of only 18.8% (Galen & Gambino, 1975). Tests to identify
personality disorders such as the Personality Diagnostic Questionnaire-
Revised (PDQ-R), although very effective at identifying individuals
with personality disorders (a sensitivity of 100%), have such a low
specificity that the predictive value of a positive test is only 8.5%
(Hyler, Skodol, Oldham, Kellman, & Doidge, 1992). If such a test were
used to screen personality disorders in the general population, it would
be surprisingly ineffective, because so many FPs would be obtained that
the investigation of those FPs would be exceedingly time-consuming
and costly. The Michigan Alcoholism Screening Test (MAST) is the
most commonly used test to screen for alcoholism (Martin, Liepman, &
Young, 1990). Although its sensitivity is 100%, thereby identifying all
individuals with alcoholism, its specificity is only 69.8%, thereby
yielding a very high percentage of false positives. The predictive value
of a positive test using this screen is exceedingly low, with its overall
efficiency being a very modest 71.3%.
 Abel et al. / SCREENING FOR PEDOPHILIA 127

In spite of the numerous methods organizations use to screen out

pedophiles, none of these organizations have reported accuracy mea-
sures for their screening procedures. Although certainly not a screen for
pedophilia, volumetric phallometry has been used extensively to
diagnose pdophilie interest. The use of volumetric phallometry as a
screen is precluded because of its costs, its physical intrusiveness, and
the time involved in completing the assessment (Freund & Blanchard,
1989). However, its sensitivity and specificity are high, and the resultant
efficiency of volumetric phallometry is relatively high, 94.6%. Although
21% of subjects evaluated are not able to be categorized (which
increases the cost of screening considerably), the accuracy measures are
surprisingly high, given the fact that the groups compared have been
nonpedophilic sex offenders versus strongly suspected pedophiles who
denied their pedophilia (Freund & Blanchard, 1989).
Circumferential plethysmography also has been reported to be
effective at separating pedophiles from nonpedophiles (Barbaree &
Marshall, 1989). Although its sensitivity is relatively low (see Table 1),
its specificity is 100%, and its resultant efficiency is 97.4%. As with
volumetric phallometry, circumferential plethysmography is intrusive
because it involves direct measurement of penile size, and it also is
limited because during assessment many individuals (called
nonresponders) fail to have erection responses sufficient to analyze,
thereby markedly increasing the cost of screening.

THE ABEL SCREEN

Over the last 5 years, the first author has been developing a portable,
noninvasive, brief screen for pedophilia that uses both psychophysio-
logical and self-report data. The Abel Screen works by matching the
arousal patterns and cognitions of men who have admitted to a
pedophilia diagnosis against the arousal patterns and cognitions of men
in the general population who deny such diagnoses. The individual first
completes a questionnaire and then sits at a laptop computer and
completes two further tests. For the first test he views computer- driven
slides of children, adolescents, and adults, and rates his sexual arousal to
each. In the initial set of slides the figures are partially clothed and in
the subsequent set of slides they are nude. For the second test, a
128 CRIMINAL JUSTICE AND BEHAVIOR

psychophysiological hand monitor records a noninvas- ive physiological

response to each slide, which is recorded without the patients
awareness.
To empirically evaluate the efficacy of the screen, a sample of 101
normal subjects was recruited through local media publications and
given $10.00 for their participation. The responses of these normal
subjects were then compared to the responses given by known offend-
ers. The sample of offenders consisted of 30 pedophiles who had
molested pubescent males, 25 who had molested prepubescent males, 57
who had molested pubescent girls, and 73 who had molested
prepubescent girls. Four separate discriminate function analyses were
conducted for each pdophilie group. A discriminate function analysis
attempts to correctly categorize subjects into previously determined
groups with as few errors as possible, using the variance of the
measures.
In discerning pedophiles who had molested prepubescent males from
normals, the Abel Screen correctly classified 98% of the normals (TNs)
and 76% of the pedophiles (TPs). In discriminating pedophiles who had
molested pubescent males from normal subjects, the screen correctly
identified 98% of the normals and 90% of the pedophiles. The screen
was less effective in discerning pedophiles who had molested
preadolescent girls from normals, correctly classifying 77% of the
normals and 91% of the pedophiles. In discriminating pedophiles who
had targeted pubescent girls from normal subjects, the screen accurately
classified 77% of the normals and 86% of the pedophiles.
Given that persons seeking work with children within organizations
would probably attempt to conceal any pdophilie interest during a
screening procedure, it is important to evaluate whether a screen can be
faked. One way to test this would be to have self-admitted pedophiles
take the screen and instruct them to respond in such a way as to appear
to have normal sexual interests. These responses could then be
compared to normal subjects responses. Another way to examine this
issue would be to take a group of subjects for whom a reasonable
clinical judgment can be made regarding the presence of pdophilie
interest from their demographic data but who deny their pdophilie
interest. The efficacy of a screen could then be computed with this
subgroup of deniers. Data that could be used in making such clinical
judgments would include the presence of multiple victims, repeated
 Abel et al. / SCREENING FOR PEDOPHILIA 129

charges without convictions, or the accuseds explanation of the alleged

occurrence being so preposterous as to be beyond belief.
Both methods for discerning the Abel Screens efficacy with deniers
are currently being investigated. The first method needs further data
before conclusive evidence can be presented. However, preliminary
reports show no differences on measures of pedophiles instructed to
reveal versus instructions to conceal their deviant sexual interests. The
second method has been completed for 13 deniers. Their data were then
compared to a sample of 101 normal subjects, and a discriminate
function analysis was conducted. The Abel Screen correctly classified
88.12% of the normals and 100% of the deniers. Although the small
sample makes conclusions regarding this method premature, the data are
certainly promising.

CROSS-VALIDATION OF THE ABEL SCREEN

A discriminate function analysis generates an equation that is used to

predict correct groupings using all the variability of the measures.
Consequently, it is predictable that when a new sample of subjects is
classified using the equation developed from the first discriminate
function, there will be a decrease in the accuracy of the classification
matrix. For this reason, the use of discriminate function analysis
requires cross-validation to examine the extent of this predictable
decrease. To maintain adequate sample size for the cross-validation
procedures on the Abel Screen, pedophiles who target prepubescent and
pubescent victims were combined while maintaining the sex of target
distinction.
A split-half discriminate function was performed for each sex and for
each step of the screen (viewing slides of partially clothed and nude
figures). For pedophiles who had molested females, there was a 8.9%
decrease in accurate prediction of TNs and only a 2.0% decrease in
correct classification of TPs for the analysis that used measures for
slides of partially clothed figures. For pedophiles who had molested
males, there was a 9.4% decrease in TNs and a 6.0% decrease in TPs on
the measures for slides of partially clothed figures.
The analyses that used the slide presentations of nude figures were
even more stable between split halves. There was a 6.8% decrease in
130 CRIMINAL JUSTICE AND BEHAVIOR

TNs and only a 1.1% decrease in TPs for pedophiles of females. For
pedophiles who had molested only males, there was 2.6% decrease in
TNs and an actual increase in detection of TPs by 8.1%. The decrease in
accuracy of classification when the sample was split into random halves
and reclassified using the discriminate function equations derived from
the first half is well within acceptable ranges.
This screen, like all screens, is a first pass at sorting out people who
have a high probability of having pedophilia. Its ability to sort out
individuals who molest prepubescent or pubescent boys is quite high,
but further refinements are needed for its use in screening those who
molest girls.
If an individual fails the screen for pedophilia against prepubescent
or pubescent boys, subsequent, more invasive testing (circumferential
plethysmography) would then be suggested. This subsequent testing
should reduce the Abel Screens 2% FP rate. Although the Abel Screen
identifies most pedophiles, its sensitivity is below the 90th percentile, so
a few individuals at high risk for molesting children will be missed.

PROACTIVE STEPS

Thirty years ago an effective physiological test for pedophilia did not
exist. Since then, we have made significant advances. Volumetric
phallometry and circumferential plethysmography have proven to be
effective diagnostic tests, and now the Abel Screen technology for mass
screening is available.
Limited technology has hampered us in the past so that we were
forced to address the problem of child sexual abuse only after the child
had suffered. Now, we have the possibility of change; we can be
proactive. A major proactive step is to exclude pedophiles from being in
positions of power over children. Although organizations who supervise
children have used a variety of screening procedures, only the two
phallometric measures and the Abel Screen have shown themselves to
have a high efficiency. Although the two phallometric tests are excellent
diagnostic tools, they are far too intrusive, costly, and time-consuming
to be used to screen the general population.
If the majority of the numerous victim studies showing that pedo-
philia damages children in epidemic numbers are true, then pedophilia is
 Abel et al. / SCREENING FOR PEDOPHILIA 131

a major public health problem. We need to protect children from

pedophilia in the same way we protect them from all other diseases. We
need to screen for pedophilia.

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