Contemporary Treatments of Paraphilias P

Contemporary Treatments of Paraphilias
J e r u s a l e m - I s r a e l
Paraphilias
is the biomedical term for sexual deviations of which there have been
described several hundred varieties. The most frequent ones are pedophilia (love for
children), voyeurism (“Peeping Tom”) and exhibitionism. All these are banned by the
law and punishable. During the course of many years physicians and law men have
devised many forms of treatments and punishments for individuals with pedophilia,
but besides surgical castration and long term incarceration no effective solution had
been found. Castration is irreversible and nowadays considered an unethical
punishment, whereas incarceration usually comes to an end after a certain moment
in time, so that sexual predators are again free searching for potential victims.
During
the last decade and a half new and effective therapies have changed this
panorama radically. The use of long term GnRH agonists or other anti-androgens,
new psychopharmacological drugs with correct psychiatric management, proper
education of potential victims, together with novel laws that are being enacted almost
certainly will protect children and the population at large from sexual predators.
For this meeting and workshop we have invited faculty members and world leading
experts in the area of paraphilias to speak on the contemporary treatments of
paraphilias - “State of the Art” - in a series of lectures and discussion panels.
We invite you to participate at the scientific session’s program of this challenging
and innovative paraphilias meeting, and welcome you to come to eternal Jerusalem.
Chairman
Co-Chairman
Prof. Ariel Rosler
Endocrinology & Metabolism
Hadassah University Medical Center
Jerusalem, Israel
E-mail: rosler@cc.huji.ac.il
Prof. Eliezer Witztum
Psychiatry, Faculty of Health Sciences
Ben-Gurion Univeristy of the Negev
Beer-Sheba, Israel
Email: elyiit@actcom.co.il
Executive Coordinator
Executive Coordinator
Esther Ben-Arzi, Director
Abarbanel Non-profit Organization
15 Kakal Sreet, Bat Yam
Telephone: +972 3 5552784
E-mail: ester5556@gmail.com
Tal Vered, Manager
Abarbanel Hospital Paraphilias Clinic
15 Kakal Sreet, Bat Yam
Telephone: +972 3 5552784
E-mail: talvrd@gmail.com
1
Contemporary Treatments of Paraphilias
J e r u s a l e m - I s r a e l
Lectures and Biographies
16/6/10 - Wednesday (Invited lecturers)
17.30 - Reception at the Knesset
19.30 - Welcome dinner at CANELA kosher restaurant
17/6/10
- Thursday
7.00 - 8.25 Breakfast
Scientific Program
Session I Chairman - Prof. Ariel Rosler
8.25 - 8.30
Prof. Ariel Rosler - Welcome and Acknowledgements
8.30 - 9.00
Prof. Lisa J. Cohen - Psychological Correlates of Pedophilia:
Implications for Treatment
9.00 - 9.30
Prof. Richard Krueger - Paraphilic Diagnoses of DSM-V
9.30 - 10.00
Prof. Lucinda A. Rasmussen - The “Victim” within the Victimizer:
The Role of Traumatic Experiences As Risk Factors for Young People Who
Sexually Offend
10.00 - 10.30
Prof. Martin Kafka - The role of Axis I co-morbidity in paraphilic
sexual offenders: implications for pharmacological treatment approaches
10.30 - 11.30
Coffee break
Session II Chairman - Prof. Richard Krueger
2
Contemporary Treatments of Paraphilias
J e r u s a l e m - I s r a e l
11.30 – 12.00
Prof. Florence Thibaut - Guidelines for Therapy of Paraphilias
12.00 - 12.30
Prof. Ariel Rosler and Prof. Eliezer Witztum - Effects of Triptorelin
Long Term Therapy : 17 years Experience with Males with Paraphilias
12.30 - 13.00
Prof Eliezer Witztum, Netzer Daie and Prof. Ariel Rosler
Psychodiagnostic Analysis in 68 Males with Paraphilias
13.00 – 14.30
Lunch
Session III Chairman - Prof. Florence Thibaut
14.30 - 15.00
Prof. Lisa J. Cohen - Considering a Sexual Addiction Model for
Pedophilia
15.00 – 15.30 Dr. Meg Kaplan - Cognitive-Behavioral Treatment of Paraphilias
and Hypersexual Disorders
15.30 -16.00
Coffee break
Session IV Chairman - Prof. Martin Kafka
16.00- 16.30
Dr. Yitzhak Ben-Zion - The ethnic diversity of sexual offenders in
southern Israel: Anti-androgen therapy experience at Soroka University Medical
Center
16.30 – 17.00 Dr. Peer Briken and Prof. Wolfgang Berner - The double-blind,
controlled clinical trial planned in Germany to investigate the treatment of
triptorelin in combination with psychotherapy in adult male patients with severe
sexual deviations
3
Contemporary Treatments of Paraphilias
J e r u s a l e m - I s r a e l
18/6/10 - Friday
7.00 - 8.30 Breakfast
Session V - Chairman - Prof. Ariel Rosler and Dr. Moshe Birger
8.30 - 9.00
Dr. Eija Lundström - Triptorelin in paraphilia - history and current
status. (Background of the European registrations and the current US situation)
9.00 - 9.30
Dr. Maurice Wagner - Triptorelin and paraphilia: What do
stakeholders think? The experience of Debiopharm Group.
9.30 -10.00
Dr. Moshe Birger - Anti-Androgenic Therapy Among Incarcerated
Sex Offenders - The Israeli Experience
10.00 - 10.30
Prof. Martin Kafka - Sexual appetite and sexual offending: The
clinical relevance of hypersexuality
10.30 - 11.00
Coffee break
Session VI - Chairmen - Prof. Eliezer Witztum and PM Eli Aflalo
11.00 - 11.30 The war against pedophilia: A law proposal for voluntary option of
anti-androgen therapy for male sex offenders released from jail.
Session VIII - Panel
11.30 - 13.00 - General Discussion.
13.00 - 14.30
Lunch
END OF SCIENTIFIC PROGRAM
4
Contemporary Treatments of Paraphilias
J e r u s a l e m - I s r a e l
19/6/10 - Saturday
7.00 - 8.30 - Breakfast
9.00 - 16.00 - Guided Tour at the Old City of Jerusalem *
(13.00 - 14.00 - Lunch break - stop at a Old City Oriental Restaurant) *
21.00 – 23.30 - Farewell Dinner at Terasa Restaurant
20/6/10 - Sunday
12.00 - Departure
* Participant’s fees are applicable.
BIOGRAPHIES AND E-MAILS
Yitzhak Ben-Zion, MD, Born 1964, M+4, Medicine studies in Beer-Sheba. Specialization in sex
medicine in Israel and Netherlands. Residency in urology and later in psychiatry. Lecturer at BenGurion University. Lecturer in sexology courses at our faculty. Board member of the Israeli society of
sex medicine, and recently elected to the board of Israeli sexology society. We lead the biggest
Internet based sex counseling forum in Israel (www.clalit.co.il/sex). E-MAIL: benzion@clalit.org.il
5
Contemporary Treatments of Paraphilias
J e r u s a l e m - I s r a e l
Wolfgang Berner, MD, Is a psychiatrist and Director of the Department of Sex Research and
Forensic Psychiatry University Medical Center Hamburg, Germany. He is Clinical Professor of
Psychiatry and Psychotherapy. He received his M.D. degree from the University of Vienna in 1970. He
organized treatment for sex-offenders in different settings inside and outside the prison system and
published follow up studies on different groups of sex-offenders. First publications on treatment of
sex-offenders with cyproterone-acetat in 1983 and first publications on treatment of sex offenders
with leuproreline-acetat in Germany together with Briken and Hill in 2001. Special scientific interests
in paraphilias and personality disorders as risk-factors for offending.
E-MAIL: berner@uke.uni-hamburg.de
Moshe Birger, MD, is a Board Certified psychiatrist with 29 years of clinical and academic
experience. For the last 13 years, he is the Director of the Forensic Psychiatry Division of the Israeli
Prisons Services. He specialized in the domain of sex offenders in issues such as risk assessment,
pharmacological treatment and sex offenses among mental patients. A lecturer in various
academic institutions in the area of paraphilias. Dr. Birger is an advisor to governmental agencies
regarding legislations and treatment of sex offenders. E-MAIL: zomrib@yahoo.com
Peer Briken, MD, Is a forensic psychiatrist, psychotherapist, sexologist and Co-Director of the
Department of Sex Research an Forensic Psychiatry, University Medical Center, Hamburg-Eppendorf;
Germany. He is an Assistant Professor of Psychiatry and Psychotherapy. He received his M.D. degree
from Hamburg Medical School in 1999. His research interests and publications have focused on the
etiology, classification and treatment of paraphilias, on sexual homicide perpetrators, and
pharmacotherapy of sex offenders. E-MAIL: briken@uke.uni-hamburg.de
Dr. Lisa Cohen, PhD, is a Associate Professor of Clinical Psychiatry and Director of Research for
Psychology and Psychiatry at Beth Israel Medical Center/ Albert Einstein College of Medicine in New
York City. Dr. Cohen received her PhD in clinical psychology at the City University of New York and
completed her clinical internship at St. Luke’s Hospital, also in New York. Prior to coming to Beth
Israel, Dr. Cohen held an appointment as an assistant professor of psychiatry at Mount Sinai Medical
School and previously worked as a research scientist at New York State Psychiatric Institute/Columbia
College of Physicians and Surgeons. Dr. Cohen has published widely on a broad range of topics,
including obsessive compulsive disorder, opiate addiction, and pedophilia. Her book “The Handy
Psychology Answer Book” will be published in 2011 by Visible Ink Press. Dr. Cohen’s current research
interests involve the interplay
between trauma and personality
development.
MAIL: LCohen@chpnet.org
6
Contemporary Treatments of Paraphilias
J e r u s a l e m - I s r a e l
Netzer Daie, MA, Senior Psychologist, expert in Psychotherapy, Psychodiagnostics, and
Hypnotherapy. Received his M.A. In psychology from Hebrew University, Jerusalem in 1980. Formerly
deputy-chief of the IDF central mental health clinic, and later chief psychologist of the department of
psychiatry in Hadassah Ein Kerem Hospital, Jerusalem. Currently in private practice as expert
psychologist, also presides as head of an internship examinations committee in the Israeli Health
Department and a member of an examination committee for the Israeli Society of Hypnosis.
E-MAIL : daien@013.net
Martin Kafka, MD, is a Clinical Associate Professor of Psychiatry at Harvard Medical School who
has clinically worked with men with sexual impulsivity disorders for over 20 years. Dr. Kafka's primary
research interests have included the study of Axis I psychiatric co-morbidities in men with paraphilias
and non-paraphilic hypersexual disorders. He has also published clinical-research papers
demonstrating that the pharmacological amelioration of Axis I co-morbid conditions in male
paraphilic sexual offenders, such as mood disorders and attention deficit hyperactivity disorder, can
reduce the frequency and intensity of paraphilic behavior. Dr. Kafka is currently a member of the
Sexual and Gender Identity Disorders Working Group for DSM-5. E-MAIL: mpkafka@rcn.com
Meg S. Kaplan, PhD, a clinical psychologist, is currently the Director of the Sexual Behavior Clinic at
the New York State Psychiatric Institute, and an Associate Professor of Clinical Psychology in
Psychiatry at Columbia University, College of Physicians and Surgeons. She received her Ph.D. in
Human Sexuality from New York University in 1984 and has conducted clinical research in
psychosexual disorders since then. Dr. Kaplan is the current Chairperson of the Special Classification
Review Board at Avenel Correctional Facility in New Jersey. She reviews for numerous publications
and has over 60 publications in the sexual disorders field. E-MAIL: msk2@columbia.edu
Richard B. Krueger, MD, Is a psychiatrist and Medical Director of the Sexual Behavior Clinic at
New York State Psychiatric Institute. He is an Associate Clinical Professor of Psychiatry in the
Department of Psychiatry, Columbia University, College of Physicians and Surgeons. He received his
M.D. degree from Harvard Medical School in 1977. He consults on sex offenders for the New York
State Office of Mental Health and his research interests and publications have focused on the
psychopharmacological treatment of compulsive and aggressive sexual
behavior.
E-MAIL: rbk1@columbia.edu
Eija Lundström, MD, Medical Director, Medical affairs, Debiopharm SA. Received her degree in
medicine from the University of Helsinki, Finland. She then acted several years as General Practitioner
at communal and private clinics in Finland. Dr. Lundstrom also worked as Senior House Officer at the
7
Contemporary Treatments of Paraphilias
J e r u s a l e m - I s r a e l
Queen Elisabeth II Hospital in UK, in the Department of Gynecology and Obstetrics before she moved
into pharmaceutical industry. First she worked for 4 years at Hoffman-La Roche in Basel, Switzerland
in the clinical development of recombinant human erythropoietin in the indication of renal anemia.
Since 2003 she has been Medical Director at Debiopharm in Lausanne, Switzerland, where she has
been in charge of the clinical development of the GnRH agonist triptorelin in its different indications.
E-MAIL: elundstrom@debiopharm.com
Lucinda A. Rasmussen, PhD, LCSW is a Associate Professor in the School of Social Work at San
Diego State University and is currently on Sabbatical at the School of Social Work at the University of
Haifa. Her research focuses on effects of trauma and risk assessment of young people who sexually
abuse others. She has developed the Trauma Outcome Process Assessment (TOPA) model for
assessing effects of trauma and has assisted in the cross-validation research of MEGA, a risk
assessment tool developed by her colleague, L.C. Miccio-Fonseca, Ph.D.
E-MAIL: lucindaramussen@cox.net
Ariel Rosler, MD, is a full professor at Hadassah Hebrew University Medical Center, Jerusalem.
Board Certified in Pediatrics, Endocrinology and Pediatric Endocrinology. Former head of the Division
of Endocrinology at Mount. Scopus Hadassah Hospital. He founded the Steroid Laboratory at
Hadassah Hospital and developed sophisticated steroid techniques that allowed the diagnosis of rare
inborn errors in steroid biosynthesis. Using these methods he discovered 3 previously unknown
disorders: Isolated Hypoaldosteronism in Jews of Iran due to CMO-II deficiency (for which he was
awarded the Ziegler Prize from the Israel Institute of Technology, Haifa Faculty of Medicine), 11betahydroxylase deficiency in Jews from Morocco, and Male Pseudohermaphroditism due to (testicular)
Type3-betaHSD Deficiency in Arabs from Gaza. In 1991-2 he trained with Prof. Fernand Labrie at the
Centre de Recherches en Endocrinologie Moléculaire, Le Centre Hospitalier de l'Université Laval,
Québec, Canada. On his return to Israel Dr. Rosler was laboratory qualified to elucidate and publish
the genetic mutations responsible for these defects. As from 1993, together with Prof. Eliezer
Witztum, developed a method for successfully treating males with paraphilia with a long acting GnRH
agonist (triptorelin). This mode of therapy has been implemented legally in Israel (from 2005), and
later on in various European countries. Dr. Rosler is author or co-author of 90 peer reviewed articles,
several chapters in books, and recipient of various prizes. E-MAIL: rosler@cc.huji.ac.il
Florence Thibaut, PhD, Psychiatrist and Endocrinologist, PhD in Neurosciences, is Professor of
Psychiatry at University Hospital Ch Nicolle, Rouen, France. Member of the Molecular Genetics
Research Unit (INSERM Unit 614) at the University of Medicine of Rouen. She is also investigator in
many clinical and pharmaceutical studies. She has consulted for many US and European
8
Contemporary Treatments of Paraphilias
J e r u s a l e m - I s r a e l
pharmaceutical companies. She is currently President of the French Association for Biological
Psychiatry. She is currently the President of the World Federation of Societies of Biological Psychiatry.
She is a member of the French Drug Agency. She is author or co-author of more than 150 papers, 1
book (genetics) and 35 books chapters. She was an invited speaker in many national and international
meetings. She was coordinator of the WFSBP Task Force about pharmacological treatment of
paraphilias. E-MAIL: Florence.Thibaut@chu-rouen.fr
Maurice Wagner, PhD, obtained a PhD in law (intellectual property) from the Lausanne University
in 1978. He started his career in the healthcare industry in 1975 at Hoffmann-La Roche: he held
various functions in Basel (Intellectual property, law and pharma marketing), in the UK (pharma
marketing, anaesthetic drugs) and in Belgium (public affairs at the European level). In 1996, he
became head of the international and European fragrance and flavor industry trade associations in
Brussels and Geneva, before taking on the responsibility of the European medical technology trade
association in Brussels, in 2002. He joined Debiopharm Group in 2008 as Director Corporate Affairs
and Communication. E-MAIL: mwagner@debiopharm.com
Eliezer Witztum, MD, is a full Professor in the Division of Psychiatry, Faculty of Health Sciences,
Ben-Gurion University of the Negev and Director of Psychotherapy Supervision, Mental Health Center,
Beer Sheva. He also serves as Senior Psychiatrist, Jerusalem Mental Health Center, where he
established a Culture and Religion Consultation Unit providing a culture-sensitive psychiatry service
for religious patients. He is well known for his work in the field of medical psychology, forensic and
cultural psychiatry, dissociation and the history of PTSD and the Arab–Israeli wars, and research and
treatment of paraphilias, especially pedophilia together with Prof. Ariel Rosler. His book Sanity and
Sanctity: Mental health work among the Ultra-Orthodox community in Jerusalem was published by
Yale University Press) in 2001 and an edited volume Traumatic and non traumatic loss and
bereavement: Clinical theory and practice was published in the 2000 His recent publications are King
Herod: A Persecuted Persecutor: A Case Study in Psychohistory and Psychobiography (with Aryeh
Kasher) published in 2007, and Genius and Madness: The Complex Relationships Between Creativity
and Psychopathology (with Professor Vladimir Lerner) in 2009 (Hebrew). E-MAIL: elyiit@actcom.co.il
9