Some individuals, such as Dr. Fred S. Berlin, assert sexual attraction to children to be a sexual orientation in itself. This is at odds with the current popular acceptance of the term sexual orientation as meaning attraction to the opposite sex, the same sex, or both.
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The APA's Diagnostic and Statistical Manual of Mental Disorders 4th edition, Text Revision gives the following as its "Diagnostic criteria for 302.2 Pedophilia":
--Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).
--The person has acted on these urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.
--The person is at least age 16 years and at least 5 years older than the child or children in Criterion A.
--Note: Do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12 or 13-year-old.
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Some studies have concluded that at least a quarter of all adult men may have some feelings of sexual arousal in connection with children. A study by Hall et al. of Kent State University, for example, found that 32.5% of their sample — consisting of eighty adult males — exhibited sexual arousal to pedophilic stimuli that equaled or exceeded their arousal to the adult stimuli. Further studies indicate that even men erotically fixated on adult females are generally prone to react sexually when exposed to nude female children.
In 1989 Briere and Runtz conducted a study on 193 male undergraduate students concerning pedophilia. Of the sample, 21% acknowledged sexual attraction to some small children; 9% reported sexual fantasies involving children; 5% admitted masturbating to these fantasies; and 7% conceded some probability of actually having sex with a child if they could avoid detection and punishment.
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A perpetrator of child sexual abuse is commonly assumed to be a pedophile, and referred to as such; however, there may be other motivations for the crime, much as adult rape can sometimes have non-sexual reasons. Thus, child sexual abuse alone may or may not be an indicator that its perpetrator is a pedophile; most perpetrators of it are in fact not primarily interested in children -- as has been recognized by law enforcement.
Those who have committed sexual crimes against children, but do not meet the normal diagnosis criteria for pedophilia, are referred to as situational or regressed offenders, whereas offenders primarily attracted toward children are called structured pedophiles or fixated pedophiles, as their orientation is fixed by the structure of their personality. It is estimated that only 2 to 10 percent of child sexual abuse perpetrators meet the regular criteria for pedophilia.
Most cases of father-daughter incest are believed to involve fathers who are situational offenders, rather than pedophiles.