Pedophilia, the brain, and cause-and-effect

One of the questions I commonly receive about MRI research on pedophilia is: How do we know what causes what?  Comparing the brain scans of pedophiles with non-pedophiles gives us a correlation, and correlation does not necessarily mean causation.

It is true that correlation does not equal causation, but that does not mean we are powerless about it either.  To understand how to attack this kind of problem, we need to recall a few important (but pretty rarely discussed) principles of science:

Is there an asexual in the House?

A recent episode of House featured a married couple who identified as asexuals, people who lack a sexual orientation towards women or towards men (or towards anyone/anything else).  As the character explained to Dr. Wilson: They were not celibate—they were not choosing to supress their sexual attractions. Rather, they did not experience sexual attractions.  Asexuality was their sexual identity.  House doesn't buy asexality as an identity and bet he could find a medical reason that would explain their lack of sexual desire.  The asexual community (yep; there is one) greatly anticipated the episode: It would be the first time their identity would be described to such a large audience, addressing the big question: Is asexuality a sexual orientation?

How realistic was the sex addiction in Shame?

I went to the theatre already pretty cynical about big-screen depictions of hypersexuality (my preferred term for the phenomenon). On the one hand, I've seen very many people in my clinic seeking help in controlling some aspect of their sex life. On the other hand, I have read very many commentaries about what hypersexuality means, usually based on hypotheticals or tid-bits from celebrity cases. None of those discussions, however, ever seem to describe the actual people I see.

So, popcorn in hand, I was expecting a re-telling of a daytime, self-help cliché: abuse in childhood, causing addiction in adulthood, hitting rock bottom, resolved by confronting past abuse.  (Probably followed by falling in love for the first time, after finally completing some period of sexual abstinence.)  Instead, I saw situations very close to what I do see in therapy.

Dear Dr. Cantor,

Is there a professional term for one who derives sexual pleasure from watching himself masturbate in the mirror?  I assume I’m not the only one who sees cases like this (albeit only 2 over the last 5 years—both with totally different personality disorders and sex crimes). Does anyone have a reference for literature on the phenomenon?

Thanks, David