It’s a simple rule of thumb. The efficacy of a diagnostic test is determined largely by the base rate of the phenomena under study. If pedophilia is rare, for example, it’s going to be hard to detect.
Presume that pedophiles comprise 5% of the male population. If one then asserts that pedophilia is baseless, that statement is 95% accurate. Only 5% of the population is misdiagnosed. Psychological tests for pedophilia, despite comforting illusions to the contrary, never approach that level of precision.
Pedophiles are also extremely secretive; they’re devious too, eliminating confidence in self-reports. The bigger concern however is the appalling costs of diagnostic errors. In custody battles, for instance, men who are not pedophiles (false positives) can lose their kids, whereas men who are pedophiles (false negatives) can gain them. Imprudent evaluators and expert witnesses, who then arm themselves with makeshift psychological tests for pedophilia and unabashedly insert themselves into protracted litigation, make mockery of diagnostic decision-making. That such tests, and the testimony surrounding them, have gained admissibility as scientific evidence in the courtroom is regrettable in the extreme.