Mainstream theorizing of paedophilia from the mid-1920s through to mid-1960, and even into the 1980s, was importantly psychodynamically oriented. The early history of the concept of paedophilia in early psychodynamic thought is problematic, however. Extant historical references are not without problems of their own, and have suffered from a lack of insight in the wider history of sexuality at this point of ‘erotic age preferences’. Review of primary sources highlights several contemporaneous interfaces of early psychodynamic theory: with the established forensic psychology of perpetrators of child sexual abuse; Krafft-Ebing's specific aetiological concept of age fetishism; early study and typologies of homosexual age preferences; emergent and divergent ideas about psychosexual infantilism; and strikingly late empirical attention to the psychiatry of the perpetrator of intergenerational incest.
Background. Studies of alleged victims of child sexual abuse vary greatly in the reported frequency of physical findings based on differences in definition of abuse and of "findings." This study was designed to determine the frequency of abnormal findings in a population of children with legal confirmation of sexual abuse, using a standardized classification system for colposcopic photographic findings.
Methods. Case files and colposcopic photographs of 236 children with perpetrator conviction for sexual abuse, were reviewed. The photos were reviewed blindly by a team member other than the examiner, and specific anatomical findings were noted and classified as normal to abnormal on a scale of 1 to 5. Historical and behavioral information, as well as legal outcome was recorded, and all data entered into a dBase III program. Correlations were sought between abnormal findings and other variables.
Results. The mean age of the patients was 9.0 years (range 8 months to 17 years, 11 months), with 63% reporting penile-genital contact. Genital examination findings in girls were normal in 28%, nonspecific in 49%, suspicious in 9%, and abnormal in 14% of cases. Abnormal anal findings were found in only 1% of patients. Using discriminant analysis, the two factors which significantly correlated with the presence of abnormal genital findings in girls were the time since the last incident, and a history of blood being reported at the time of the molest.
Conclusions. Abnormal genital findings are not common in sexually abused girls, based on a standardized classification system. More emphasis should be placed on documenting the child's description of the molestation, and educating prosecutors that, for children alleging abuse: "It's normal to be normal."