<![CDATA[Introduction: Sexually harmful behavior in adolescents presents developmental, diagnostic, forensic, and safeguarding challenges. A history of childhood sexual victimization may be clinically relevant, but it does not establish the cause of later harmful behavior. Methods: This case report describes a brief psychiatric evaluation conducted to support therapeutic follow-up for a 15-year-old male residing in a juvenile correctional facility. Information was obtained through autoanamnesis and a mental status examination. A structured assessment of the risk of repeated sexual violence was not conducted because a separate legal assessment was still pending Results: The patient reported a sexual offense against a 3-year-old child when he was 12, persistent intrusive urges associated with the prior behavior, anger and retaliatory thoughts preceding the offense, and repeated childhood sexual victimization by an older cousin. He denied sexual attraction to the child and attributed the offense to anger and retaliation. During the interview, he was calm and cooperative, with intact orientation, memory, and reality testing; insight was partial, and he described impaired judgment. The available information did not independently corroborate the reported history. Discuss: The available information is insufficient to establish conduct disorder or a paraphilic disorder. The reported urges require further assessment before they can be classified as obsessions, sexual fantasies, aggressive impulses, or another experience. The reported trauma history warrants sensitive clinical consideration but cannot be assumed to explain the offense. The absence of a structured risk assessment limits conclusions about recurrence risk. Conclusion: This case highlights developmentally informed diagnostic reasoning, cautious interpretation of trauma history, and the distinction between brief therapeutic follow-up and a comprehensive forensic or legal assessment. Ethical safeguards and protection of the identities of both the adolescent and the child victim are essential.]]>
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