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: [email protected] Prof. Eliezer Witztum Psychiatry, Faculty of Health Sciences Ben-Gurion Univeristy of the Negev Beer-Sheba, Israel Email: [email protected] Executive Coordinator Executive Coordinator Esther Ben-Arzi, Director Abarbanel Non-profit Organization 15 Kakal Sreet, Bat Yam Telephone: +972 3 5552784 E-mail: [email protected] Tal Vered, Manager Abarbanel Hospital Paraphilias Clinic 15 Kakal Sreet, Bat Yam Telephone: +972 3 5552784 E-mail: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] 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 : [email protected] 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: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] 9
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