This diagnosis, as well as the other sexual disorders, have been ignored in DSM field trials. There is no empirical information about the reliability or validity of this diagnosis. Because of the vagueness of the diagnostic criteria, clinicians would need to make inferences that would likely lead to reliability problems in diagnosis. Further, the DSM diagnostic criteria include constructs that are not intersubjectively verifiable and for which there are no valid measures. This can also lead to lack of diagnostic reliability and accuracy. Most problematic, however, are aspects of the diagnostic criteria, most notably the presence of an “ego dystonic sexual attraction to children,” that are incorrect exclusion criteria. The paper argues for modified and more refined diagnostic criteria to assess for pedophilia. It suggests changes to several criteria in the DSM-IV, more specific definitions of the words “recurrent” and “behavior,” a justification for the minimal temporal period of 6 months and addition of assessment tools aside from the self-report. References