Very good news! I have managed to obtain a copy of the Danish letter to the Ministry of Justice. Thanks to Dr Ellids Kristensen for providing this! Here is the full text, automatically translated from a PDF copy (any errors are my responsibility):
Psychiatric Center Copenhagen
2100 Copenhagen East
Ministry of Justice
1216 Copenhagen K
Re: Request for opinion on fictitious child pornography
In a letter of June 23, 2010, the Ministry of Justice has sent to the Sexological Clinic and the Visitation and Treatment Network, a request for an opinion that could shed light on whether the possession, etc. of fictional child pornography that are not realistic depictions that appear in the same way or almost the same way as photographs, etc., can lead people to commit act of child sexual abuse.
In response to the above, the requested authorities have contacted the doctors and experts abroad. Furthermore, an extensive literature search has been carried out. In addition, several employees from the Sexological Clinic and Visitation and Treatment Network from 1-4. September 2010 participated in congress under the auspices of IATSO (International Association for the Treatment of Sexual Offenders). The title of congress held in Oslo, was: “ New perspectives in sex offender treatment: Restorative justice, legal questions and humanistic traditions as challenges to therapy ”. Relevant research presented at this congress is referenced in this answer.
We have had to find that, to the best of our knowledge, there are no scientific studies related to the question asked, and therefore no documentation for the consumption of fictional images of child sexual abuse, so-called "child-porn,” alone can lead people to commit child sexual abuse. The area may be subject to investigations in the future, as delegates at the abovementioned Congress conduct investigations into the consumption / abuse of (non-fictional) visual and film material of sexual child abuse. This is an area of growing interest in scientific research.
In the following, a number of the most recent studies in this area will be briefly referenced and structured:
Kingston et al (2008)1 examined persons convicted of sexual crime where had a real physical sexual contact between offender and victim ( hands-on ) and found that consuming images of child sexual abuse for this group was a risk factor, the sex criminals who had used the illegal pornographic material were more likely to fall back into similar crime than those who had not.
Seto and Eke (2005)2, based on a study of 201 abusers of images of child sexual abuse, stated that the likelihood that abusers of images of child sexual abuse will later commit hands-on abuse is unknown. In their study, they find that people with previous convictions were significantly more likely to commit offenses and offenses again. Abusers of images of child sexual abuse who, prior to the current verdict, had committed sexual abuse, were the individuals most likely to re-offend - either generally or sexually.
In a Swiss study, Endrass et al (2009)3 attempted to assess whether consumers of images of child sexual abuse on the Internet present a greater risk of committing hands-on abuse on children. It involved 231 men convicted of possession of illegal images of child sexual abuse. The study found that 11 (5%) of the men had a previous conviction for sexual and / or violent abuse, 2 (1%) had a sentence for on sexual abuse involving child sexual abuse, 8 (3%) had a sentence for one sexual violation where there had been no physical sexual contact between the violator and victim (hands-off), and one was convicted of a non-sexual violent assault. Evaluation of relapse for the group showed that 7 (3%) of those surveyed relapsed with a violent and / or sexual offense, 9 (4%) relapsed with a hands-off violation and 2 (1%) with a hands-on sexual assault.
On the basis of this material, Endrass et al concluded that the consumption of images of sexual child abuse alone was not a risk factor for committing hands-on sexual abuse – at least not for those individuals who had never before been convicted of hands-on sexuality assault. The majority of those surveyed had no previous convictions for hands-on offenses. The researchers estimate that the prognosis for not committing hands-on sexual violations and abuses as well as recidivism of child pornography for this group were good.
At the Oslo Congress, Endrass et al presented4 follow-ups to the above study. The group of 231 men convicted of possession of sexual images was re-examined for child abuse, and found that after six years, no one had been convicted of hands-on abuse. The majority of these had no criminal history, either sexually or otherwise.
The empirical literature in the field of non-fictional images of child sexual abuse has not provided clear evidence that consumption of this material may pose a significant risk of engaging in hands-on sexual abuse. Some studies (e.g. Endrass 2009, Benz 20105) put forward the assumption that abusers of images of child sexual abuse form a special group. They state that although some of these also commit hands-on abuse, most do not. As stated in several studies, there may be a real risk of former hands-on convicts committing similar crimes again if they fail to use non-fictional images of child sexual abuse. The consumption of images of child sexual abuse alone do not appear to be a predictor of hands-on sexual abuse of children.
As mentioned, research in this area has only begun to increase in recent years. Further and more comprehensive studies must and will be conducted for prevention purposes. Previous studies seem to show that a high-risk group exists for those who the use of non-fictional images of child sexual abuse may contribute to the abuse. The referenced studies seem to doubt the abuse of child pornographic imagery alone can lead to sexual assault.
Documentation that “possession, etc., of fictitious child pornography which is not realistic depicted-things that appear the same or approximately the same as photographs etc., can lead people to commit child sexual abuse” does not appear to exist at the current time.
Professor, Dr. Med.
Consultant, Clinical Lecturer
Coordinator of the Visitation and Treatment Network
1Kingston DA, Fedoroff P, Firestone P, Curry S, Bradford JM. Pornography use and sexual aggression: the impact of frequency and type of pornography use on recidivism among sexual offenders. Aggressive Behavior 2008; 34: 341-351.
2Seto MC, Eke AW. The criminal histories and later offending of child pornography offenders. Sexual abuse: a journal of research and treatment 2005; 17: 201-210.
3Endrass J, Urbaniok F, Hammermeister LC, Benz C, Elbert T, Laubacher A, Rossegger A. The consumption of Internet child pornography and violent and sex offending. BMC Psychiatry 2009, 9:43.
4Endrass J, Rossegger. Is the consumption of child pornography a risk factor for child sexual abuse? Forensic Psychiatry and Psychotherapy 2010; 17 (suppl 1): 33.
5Benz C. Treatment of consumers of illegal pornography: More than relapse prevention. Forensic Psychiatry and Psychotherapy 2010; 17 (suppl 1): 13.