academic conferences for the American Academy of Psychiatry and Law and International Association for the Treatment of Sexual Offenders, symbolic votes were taken regarding whether the DSM-5 should include pedohebephilia, and in both cases an overwhelming majority voted against this. In a letter to the editor, clinical psychologist Joseph Plaud criticized the study for lacking control groups for post-pubescent and normal patterns of male sexual arousal, overlap between groups Blanchard believed were separate, and lack of specificity in the data. Blanchard replied that the initial publication used sex offenders who had committed crimes against post-pubescent adults as a control group, and that the results supported victim age preferences being a continuous rather than categorical variable. In separate letters to the editor, forensic psychologist Gregory DeClue and mathematician Philip Tromovitch agreed the term would be valuable for research purposes and to subdivide the current diagnosis of pedophilia into victim age preferences, but expressed concern over the term's potential to dramatically expand the number of people diagnosed with a paraphilia without an adequate research base to support it, and that the article did not include a definition of "mental disorder" and thus lacked the ability to distinguish the pathological from the non-pathological. Blanchard stated in a reply that his paper was written under the assumptions that the DSM-5's definition of mental disorder and pathologizing of sexual activity with underaged individuals would be similar to the one found in the DSM-IV. Child sexual abuse researcher William O'Donohue believes, based on the incentive for offenders to lie, that there is a risk of false negatives. O'Donohue praised Blanchard et al.'s proposal to distinguish hebephilia from pedophilia, but questioned the inclusion of offender distress, the use of child pornography as a determining factor and requiring a minimum of three victims, believing the latter choice would result in delayed treatment for hebephiles who have not acted on their urges while ignoring the often hidden nature of child sexual abuse. O'Donohue also had concerns over how information for making decisions about the proposed diagnosis would be acquired, whether the diagnosis could be made with reliability and sufficient agreement between clinicians and issues related to treatment. Attraction as normal or abnormal Debate about hebephilia has also concerned whether the attraction is normal or abnormal. Karen Franklin has criticized use of the term hebephilia for pathologizing and criminalizing an adaptation, arguing that the concept stigmatizes a "widespread and, indeed,