Pedophilia appears to be less common in incest offenders, especially fathers and step-fathers. According to a U.S. study on 2429 adult male sex offenders who were categorized as "pedophiles", only 7% identified themselves as exclusive; indicating that many or most child sexual abusers may fall into the non-exclusive category.Some pedophiles do not molest children. Little is known about this population because most studies of pedophilia use criminal or clinical samples, which may not be representative of pedophiles in general. Researcher Michael Seto suggests that pedophiles who commit child sexual abuse do so because of other anti-social traits in addition to their sexual attraction. He states that pedophiles who are "reflective, sensitive to the feelings of others, averse to risk, abstain from alcohol or drug use, and endorse attitudes and beliefs supportive of norms and the laws" may be unlikely to abuse children. A 2015 study indicates that pedophiles who molested children are neurologically distinct from non-offending pedophiles. The pedophilic molesters had neurological deficits suggestive of disruptions in inhibitory regions of the brain, while non-offending pedophiles had no such deficits.According to Abel, Mittleman, and Becker (1985) and Ward et al. (1995), there are generally large distinctions between the characteristics of pedophilic and non-pedophilic molesters.
These observations, however, do not exclude pedophilia from being classified as a mental disorder since pedophilic acts cause harm, and mental health professionals can sometimes help pedophiles to refrain from harming children.In response to misinterpretations that the American Psychiatric Association considers pedophilia a sexual orientation because of wording in its printed DSM-5 manual, which distinguishes between paraphilia and what it calls "paraphilic disorder", subsequently forming a division of "pedophilia" and "pedophilic disorder", the association commented: "[S]exual orientation is not a term used in the diagnostic criteria for pedophilic disorder and its use in the DSM-5 text discussion is an error and should read sexual interest." They added, "In fact, APA considers pedophilic disorder a paraphilia, not a sexual orientation. This error will be corrected in the electronic version of DSM-5 and the next printing of the manual." They said they strongly support efforts to criminally prosecute those who sexually abuse and exploit children and adolescents, and "also support continued efforts to develop treatments for those with pedophilic disorder with the goal of preventing future acts of abuse." Comorbidity and personality traits
Studies of pedophilia in child sex offenders often report that it co-occurs with other psychopathologies, such as low self-esteem, depression, anxiety, and personality problems. It is not clear whether these are features of the disorder itself, artifacts of sampling bias, or consequences of being identified as a sex offender.