Cross-Cultural Validity of Sexual Recidivism Risk Assessments Using Static-99R, STABLE-2007, and the VRS-SO.

PURPOSE OF REVIEW: The overrepresentation of certain racial/ethnic groups in criminal legal systems raises concerns about the cross-cultural application of risk assessment tools. We provide a framework for conceptualizing and measuring racial bias/fairness and review research for three tools assessing risk of sexual recidivism: Static-99R, STABLE-2007, and VRS-SO. RECENT FINDINGS: Most cross-cultural research examines Static-99R and generally supports its use with Black, White, Hispanic, and Asian men. Preliminary research also supports STABLE-2007 with Asian men. Findings are most concerning for Indigenous men, where Static-99R and STABLE-2007 significantly predict sexual recidivism, but with significantly and meaningfully lower accuracy compared to White men. For the VRS-SO and the combined Static-99R/STABLE-2007 risk levels, predictive accuracy was not significantly lower for Indigenous men, for which we discuss several possible explanations. We offer considerations for risk scale selection with Indigenous men and highlight recent guidance produced for cross-cultural risk assessment.

Therapeutic and risk relevance of psychopathy and general criminal attitude change in an institutional sexual offense treatment program.

We examined the interrelationships between psychopathy, changes in general criminal attitudes, and community recidivism in a sample of 212 men who attended an institutional sexual offense treatment program (SOTP) and were followed for an average of 12.73 years post-release. The men completed a self-report measure of general criminal attitudes, the Criminal Sentiments Scale, as part of routine SOTP service delivery, Psychopathy Checklist-Revised (PCL-R) ratings were completed via file review, and recidivism data were obtained from official criminal records. Criminal attitude endorsement and criminal attitude change had clinically meaningful, but differential, associations with the antisocial and interpersonal features of psychopathy. Further, positive changes in criminal attitudes-particularly tolerance of law violations (i.e., rationalizations for criminal behavior)-were significantly predictive of reductions in community violent and general recidivism after controlling for PCL-R score. Results demonstrate that general criminal attitude change has risk relevance in the treatment of high psychopathy persons with sexual offense histories.

The Risk, Need, and Responsivity Relevance of Working Alliance in a Sexual Offense Treatment Program: Its Intersection With Psychopathy, Diversity, and Treatment Change.

The current study examined the self-reported working alliance of men attending a high intensity sexual offense treatment program and its associations with psychopathy, sexual violence risk, treatment change, and recidivism, in a Canadian sample of 317 incarcerated men followed up an average of approximately 10 years post release. Working Alliance Inventory (WAI; Horvath & Greenberg, 1989) self-reported total, Task, Bond, and Goal scores were positively correlated with treatment related changes in risk, and inversely associated with Psychopathy Checklist-Revised (PCL-R; Hare, 1991; Wang & Hare, 2003) scores. The Affective facet of the PCL-R, representing the callous-unemotional features of the syndrome, uniquely predicted lower Bond and Goal scores controlling for the other facets. Cox regression survival analyses demonstrated that sexual violence risk predicted increased sexual recidivism while change predicted decreased sexual recidivism controlling for PCL-R total score; however, WAI scores (particularly the Goal component) were also unexpectedly associated with increased sexual recidivism. For violent recidivism, psychopathy, risk, and change incremented the prediction of general violence, while the WAI was not significantly associated with this outcome. A set of parallel analyses, stratified by Indigenous ethnocultural heritage, demonstrated some continuity, but also potential areas of difference, in substantive findings. Risk, need, responsivity implications of the working alliance for the treatment of high psychopathy correctional clientele, and how this may intersect with Indigenous heritage, are discussed.

One is the loneliest number: Involuntary celibacy (incel), mental health, and loneliness.

Incels-a ragtag collection of young males who have rallied around their shared experience of romantic rejection-have slowly emerged as an online group of interest to researchers, no doubt as a result of several high-profile attacks. Much of this work has centered around incels' dating experiences, sexual attitudes, and online forums. However, it is possible that their moniker, short for involuntary celibate, has resulted in an overemphasis on their sexual exclusion and frustration. Recent work has identified social isolation as a key aspect of inceldom, which may help explain why incels have responded negatively to romantic rejection. The present study thus sought to examine the role of social support and loneliness in experiences of rejection in a sample of incel (n = 67) and non-incel (n = 103) men. Results indicated that incels experience more feelings of loneliness and less social supports than non-incel men. Both of these variables were associated with multiple mental and relational health issues that incels also scored more highly on. Further, incels reported using more solitary and problematic coping mechanisms. These results suggest that incels may be missing a key buffer in sheltering them from the adverse effects of romantic rejection. It also extends previous findings highlighting the importance of attachment styles in differentiating incels from non-incels, which may perpetuate feelings of isolation. Implications for how this may relate to incel discourse and clinical interventions are discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-023-04275-z.

Psychometric Properties of Common Measures of Hypersexuality in an Online Canadian Sample.

BACKGROUND: Hypersexuality has been posited as the central defining feature of Compulsive Sexual Behavior Disorder, and although the acceptance and inclusion of this construct in psychiatric nosologies provides some legitimacy, concerns surrounding terminology, assessment, and diagnosis remain. AIM: The present study was an independent psychometric examination of 2 of the most commonly used measures of Compulsive Sexual Behavior Disorder; specifically, the gender invariance of the latent structure, reliability (test retest, internal consistency), and external correlates (concurrent validity) of these measures. METHODS: The Sexual Compulsivity Scale and the Hypersexual Behavior Inventory were completed by 2 nonclinical online community samples of cisgender women (ns = 525 and 359), cisgender men (ns = 419 and 364), and transgender or non-binary individuals (ns = 38 and 11). OUTCOMES: Criterion based measures of sexual history and total sexual outlet (number of orgasms per week) were gathered to validate Sexual Compulsivity Scale and Hypersexual Behavior Inventory total and factor scores. RESULTS: Results supported the factorial validity of both assessment measures: correlated 3 factor solutions were established through exploratory factor analysis of 1 sample, and confirmatory factor analysis in the second sample. Multiple group confirmatory factor analysis, conducted on the 2 combined samples, also supported the gender invariance of the 3-factor solutions. Additional basic psychometric indices of test-retest and internal consistency reliability and criterion-related (concurrent) validity conducted across the 2 online samples were supported. CLINICAL IMPLICATIONS: Common measures of hypersexuality have potential for use in its assessment, treatment, and management. STRENGTHS & LIMITATIONS: Study strengths include: the inclusion of 2 fairly large and diverse online samples, thorough checks for insufficient effort/validity of responding, validity and reliability methodology (ie, measurement at multiple time points, obtaining behavioral indicators of sexual health), and a comprehensive set of psychometric analyses to inform conclusions regarding the external validity, reliability, and latent structure of hypersexuality measures across gender groups. Study limitations include: potential concerns related to validity and accuracy of responding owing to a reliance on self-report, the potential for selection bias, and limiting the examination of the latent structure of hypersexuality to cisgender men and women such that the results may not generalize to gender diverse populations. CONCLUSION: Hypersexuality is a multidimensional construct, with a common latent structure among cisgender men and women, consistency in measurement over time, and meaningful concurrent associations with behavioral criteria that have relevance for sexual health. Olver ME, Kingston DA, Laverty EK, et al. Psychometric Properties of Common Measures of Hypersexuality in an Online Canadian Sample. J Sex Med 2022;19:331-346.

Involuntary Celibacy: A Review of Incel Ideology and Experiences with Dating, Rejection, and Associated Mental Health and Emotional Sequelae.

PURPOSE OF REVIEW: Incels (involuntary celibates) have recently garnered media attention for seemingly random attacks of violence. Much attention has centered around the misogynistic and violent discourse that has taken place in online incel forums as well as manifestos written by incels who have perpetrated deadly attacks. Such work overlooks the experiences and issues faced by incels themselves, the majority of which have not engaged in any violent behavior. RECENT FINDINGS: A small number of studies have recruited incels. Results from these studies highlight the nuanced nature of the incel identity. It is also apparent that incels suffer from high levels of romantic rejection and a greater degree of depressive and anxious symptoms, insecure attachment, fear of being single, and loneliness. Incels report significant issues pertaining to their mental, social, and relational well-being and may seek support from forums that often feature misogynistic and violent content.

Measurement and Correlates of Zoophilic Interest in an Online Community Sample.

Sexual interest in animals (zoophilia) is a scant investigated topic owing partially to difficulties in assessing the behavior outside of a clinical setting. While there have been previous attempts to categorize individuals with a sexual interest in animals into classification systems, this requires extensive clinical interviews and psychometric testing. Previous classifications also lack clarity on the adjacent concept of furryism (i.e., interest in anthropomorphized animals) and how it may be related to zoophilia. As there are currently no validated psychometric measures of zoophilia, individuals with a sexual interest in animals are a challenging population to research and may be underdetected in clinical settings. The central aim of the present study was to examine the measurement and correlates of sexual attraction to nonhuman animals through the development and refinement of psychometric and visual stimulus measures of animal sexual interest. Participants included 1,228 respondents (72% zoophilic and 35% furries; 67% men and 22.9% women) recruited from the online community. The results indicated that a Sexual Interest in Animals-Self-Report (SIA-SR) scale had four distinct subscales with excellent discrimination for self-reported zoophilia. Moreover, endorsement of sexual interest in horses and dogs from visual stimuli was most common among the individuals in the sample, while dog and horse sexual and romantic attractiveness ratings also had the largest and most consistent associations with SIA-SR scores and self-reported zoophilia. The results contribute to a greater understanding of the sexual interest patterns for persons with zoophilia and have implications for theory, future research, and clinical practice.

Use of the Psychopathy Checklist-Revised in Legal Contexts: Validity, Reliability, Admissibility, and Evidentiary Issues.

The construct of psychopathy has received considerable attention from clinicians, researchers, and legal practitioners because of its demonstrated association with a range of outcomes of interest to the criminal justice system. The Psychopathy Checklist-Revised (PCL-R) is generally regarded as the premier assessment tool for measuring psychopathy in correctional and legal contexts, and the PCL-R is being used with increased frequency to address a variety of legal questions. This article provides a comprehensive examination and review of the PCL-R's use in legal contexts. We begin by reviewing various uses (appropriate and inappropriate) of the PCL-R in legal contexts, using the risk-need-responsivity (RNR) model as the conceptual framework. After reviewing available data regarding the use of the PCL-R in legal contexts, we review and synthesize psychometric research with psycholegal relevance, with a focus on the PCL-R's construct validity, predictive validity, and interrater reliability. We then discuss the scientific acceptability and clinical utility of the PCL-R's structural, predictive, and measurement properties for credibility in court, followed by sample cross-examination questions. We conclude with a review of admissibility issues relating to the use of the PCL-R in various legal proceedings.

Understanding the Latent Structure of Dynamic Risk: Seeking Empirical Constraints on Theory Development Using the VRS-SO and the Theory of Dynamic Risk.

The present study is part of a larger project aiming to more closely integrate theory with empirical research into dynamic risk. It seeks to generate empirical findings with the dynamic risk factors contained in the Violence Risk Scale-Sexual Offense version (VRS-SO) that might constrain and guide the further development of Thornton's theoretical model of dynamic risk. Two key issues for theory development are (a) whether the structure of pretreatment dynamic risk factors is the same as the structure of the change in the dynamic risk factors that occurs during treatment, and (b) whether theoretical analysis should focus on individual dynamic items or on the broader factors that run through them. Factor analyses and item-level prediction analyses were conducted on VRS-SO pretreatment, posttreatment, and change ratings obtained from a large combined sample of men (Ns = 1,289-1,431) convicted and treated for sexual offenses. Results indicated that the latent structure of pretreatment dynamic risk was best described by a three-factor model while the latent structure of change items was two dimensional. Prediction analyses examined the degree to which items were predictive beyond prediction obtained from the broader factor that they loaded on. Results showed that for some items, their prediction appeared to be largely carried by the three broad factors. In contrast, other items seem to operate as funnels through which the broader factors' predictiveness flowed. Implications for theory development implied by these results are identified.

A Preliminary Analysis of Sexual Recidivism and Predictive Validity of the Static-99R in Men Discharged From State Hospitals Pursuant to California's Sexually Violent Predator Act.

We examined the recidivism rates and the predictive validity of the Static-99R in 335 men who were detained or civilly committed and released from California State Hospitals pursuant to the Sexually Violent Predator (SVP) Act, and followed up for approximately 21 years from date of hospital admission. In all, 8.7% were arrested or convicted for a new sexual offense during the total follow-up (N = 335) and 7.8% over a fixed 5-year follow-up (n = 205). The Static-99R demonstrated small in magnitude discrimination for sexual, violent, and general recidivism (area under the curve [AUC]/C = .56 to .63). Calibration analyses, conducted through expected/observed (E/O) index, demonstrated that the Static-99R overpredicted sexual recidivism, irrespective of whether the Routine or High Risk/Need norms were used. Observed recidivism rates were lower than predicted by Static-99R scores and may be the result of the sample's older age at release, lengthy hospitalization, or other factors.

Sexual Violence Risk Assessment With Indigenous Men: Context, Controversies, and Current Findings.

PURPOSE OF REVIEW: We review the issues, controversies, and main findings from the sexual violence risk assessment literature with Indigenous men. An argument is presented for the incorporation of structured and validated risk assessment measures as part of a comprehensive assessment to inform risk management and the prevention of sexual violence. RECENT FINDINGS: Extant research demonstrates that Canadian Indigenous men convicted for sexual offenses tend to score higher on sexual violence risk measures and to have higher rates of sexual and violent recidivism. Established static and dynamic tools, however, have moderate predictive accuracy for sexual and violent recidivism and changes in risk from treatment or other change agents are associated with decreases in recidivism. Static-99R and the Violence Risk Scale-Sexual Offense version demonstrate acceptable properties of calibration for indigenous men with respect to sexual recidivism, although Indigenous men continue to show higher rates of violent recidivism associated with risk scores. The extant literature provides support for the discrimination and calibration properties of established static and dynamic sexual violence risk tools with Indigenous men; use of a dynamic tool is critical to inform risk management interventions and evaluate change. Risk measures are one component of a comprehensive and integrated assessment process that incorporates responsivity considerations, conducted in a culturally competent, ethical, and humane manner.

Does Treatment for Sexual Offending Work?

PURPOSE OF REVIEW: We review and synthesize the literature on the effectiveness of offense-focused treatment for sexual offending. Specifically, we consider whether the extant literature suggests treatment is effective in reducing sexual reoffending and features of effective interventions. We also consider how the design of program evaluations may influence treatment outcomes. RECENT FINDINGS: Recent research suggests that offense-focused psychological treatment for sexual offending shows some level of effectiveness in reducing both sexual and general reoffending. Further, there appear to be key program, individual, and study design features associated with treatment effectiveness. Although recent findings paint an optimistic outlook for offense-focused psychological treatment for sexual offending, further high-quality differential studies are needed to fully understand the range of content, delivery, and individual factors associated with successful treatment outcomes so as to establish what works best for whom.

Convergent and Predictive Associations of Three Measures of Pedophilic Interest.

Pedophilic interest is a central risk factor for sexual offending against children. Multiple measures exist to assess pedophilic interest, and the present study aims to provide validity evidence for three of these measures in a sample of men convicted of sexual offenses. The association between a phallometric test for pedophilic interest, the Screening Scale for Pedophilic Interest (SSPI), and the sexual deviance factor of the Violence Risk Scale-Sexual Offense (VRS-SO) version was examined in a sample of 261 men who participated in sexual violence reduction services. The association between these measures and sexual recidivism, both as sole predictors and while controlling for static risk, was also assessed. The second aim of the study was to examine the validity of different methods for modeling the distribution of pedophilic interests, using phallometric test scores, based on the findings in recent taxometric research. The measures generally showed a positive and moderate relationship with each other and predicted sexual recidivism. However, the SSPI did not significantly predict sexual recidivism, and when controlling for static risk, only the VRS-SO Sexual Deviance factor significantly predicted this outcome. Modeling phallometric test scores continuously and trichotomously produced significant associations with sexual recidivism; however, only a trichotomous model with two levels remained predictive after controlling for static risk. The results are broadly supportive of measures of pedophilic interest and underscore the importance of appropriately modeling the latent structure of pedophilic interest.

Evaluating Change in Men Who Have Sexually Offended: Linkages to Risk Assessment and Management.

PURPOSE OF REVIEW: We provide a review and synthesis of the sexual offense treatment change literature with implications for dynamic sexual violence risk assessment and management. An argument is presented for the need for a dynamic approach in research and practice, and that for change to be prognostic, such changes need to be risk relevant and to come from credible change agents. RECENT FINDINGS: Extant research demonstrates that changes on psychologically meaningful dimensions of risk and need (e.g., sexual deviance; attitudes and cognitions; anger, aggression, and hostility) tend to be associated with reductions in sexual and other forms of recidivism; however, changes in domains less germane to risk and need tend not to be (e.g., empathy, mental health and well-being). Formalized dynamic sexual offense risk measures can be administered at multiple time points to reliably measure changes in sexual violence risk. Change information can then be used systematically to adjust risk appraisals. The extant literature supports the dynamic nature of sexual violence risk. Working toward the routine assessment of change with psychometrically sound measures, and integrating this information into risk management interventions, can not only improve lives and reduce sexual violence but is an ethical and human responsibility.

Validity and Reliability of the Violence Risk Scale-Youth Sexual Offense Version.

The present study examined the validity and reliability of a youth sexual offense risk assessment and treatment planning tool, the Violence Risk Scale-Youth Sexual Offense Version (VRS-YSO), on a sample of 102 court-adjudicated youth referred to assessment and/or treatment outpatient services followed up an average of 11.7 years in the community. VRS-YSO scores demonstrated "good" to "excellent" interrater reliability (intraclass correlation coefficients [ICCs] = .64-.83). Exploratory factor analysis (EFA) of the static and dynamic items identified three latent dimensions consistent with the extant risk literature labeled Sexual Deviance, Antisocial Tendencies, and Family Concerns. VRS-YSO scores showed strong patterns of convergence with scores from the Estimate of Risk for Adolescent Sexual Offense Recidivism (ERASOR), Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II), and the Juvenile Sexual Offense Recidivism Risk Assessment Tool-II (J-SORRAT-II). VRS-YSO scores, in turn, demonstrated moderate to high predictive accuracy for sexual, violent (sexual and nonsexual), and general recidivism (significant areas under curve [AUCs] = .67-.88). Examination of pre-posttreatment change data on the subset of youth who attended treatment services found VRS-YSO change scores to be significantly associated with reductions in general recidivism, but not other recidivism outcomes. Future research and clinical applications of the VRS-YSO in youth sexual offense assessment and treatment planning are discussed.

Predictors of Historical Clinical Risk Management-20 Version 3 (HCR-20:V3) summary risk ratings.

How individual risk factors on structured professional judgement (SPJ) assessment tools translate into SPJ final risk formulations is unclear due to a lack of structured criteria. Understanding pathways to risk formulations is vital, as they serve as intervention targets for risk management. This study examined how Historical Clinical Risk Management-20 Version 3 (HCR-20:V3) raters weighed varied information sources to complete summary risk ratings (SRRs). Four independent raters retrospectively coded an archived sample of 32 inpatients at a Canadian forensic psychiatric hospital. HCR-20:V3 SPJ SRRs were regressed on the 20 individual items and sample covariates to identify unique predictors of risk formulations across each rater. Raters consistently used HCR-20:V3 items and composite subscales for SRRs. Despite strong inter-rater agreement on the SRRs, there were variations across raters regarding which items informed each SRR. Rater-unique biases were also shown to influence SRRs. Implications for forensic practice and risk management are discussed.

Taxometric Analysis of the Latent Structure of Pedophilic Interest.

The present study examined the latent structure of pedophilic interest. Using data from phallometric tests for pedophilic interest across four samples of offenders (ns = 805, 632, 531, 261), taxometric analyses were conducted to identify whether pedophilic interest is best characterized as taxonic or dimensional. Across the samples, the majority of analyses supported taxonic latent structure in pedophilic interest. Visual inspection of taxometric curves indicated trichotomous latent structure (i.e., three-ordered classes) may characterize pedophilic interest in these samples. In a second step of taxometric analysis, the results supported trichotomous latent structure, indicating the presence of a complement taxon and two pedophilic taxa. In comparison with the complement taxon, the men in the first pedophilic taxon were non-exclusively pedophilic and had similar rates of sexual recidivism and sexual compulsivity. The men in the second pedophilic taxon were exclusively pedophilic, had more child victims and total victims, sexually re-offended at a higher rate, and were more sexually compulsive. The finding of trichotomous latent structure in pedophilic interest is both consistent and inconsistent with previous taxometric studies and has implications for research, assessment, and treatment of pedophilic interest.

Understanding the Latent Structure of Hypersexuality: A Taxometric Investigation.

We examined the latent structure and taxonicity of hypersexuality in large university and community samples of male and female respondents. Participants completed the Hypersexual Behavior Inventory (HBI) and Sexual Compulsivity Scale (SCS), each as part of larger anonymous online surveys of sexual behavior. Exploratory factor analyses (EFA) were performed in part to prepare the data for taxometric analysis and also to identify the putative dimensions underpinning each measure. Three latent dimensions were identified from each of the Sexual Compulsivity Scale (dyscontrol, consequences, and preoccupation) and Hypersexual Behavior Inventory (coping, dyscontrol, and consequences). Taxometric analyses of the generated factors using mean above minus below a cut (MAMBAC), maximum covariance (MAXCOV), and latent mode factor analysis (L-Mode) broadly supported a dimensional latent structure for hypersexuality, particularly in female participants. Implications pertaining to the assessment of hypersexuality are discussed.

Predictive Accuracy of Violence Risk Scale-Sexual Offender Version Risk and Change Scores in Treated Canadian Aboriginal and Non-Aboriginal Sexual Offenders.

The present study examined the predictive properties of Violence Risk Scale-Sexual Offender version (VRS-SO) risk and change scores among Aboriginal and non-Aboriginal sexual offenders in a combined sample of 1,063 Canadian federally incarcerated men. All men participated in sexual offender treatment programming through the Correctional Service of Canada (CSC) at sites across its five regions. The Static-99R was also examined for comparison purposes. In total, 393 of the men were identified as Aboriginal (i.e., First Nations, Métis, Circumpolar) while 670 were non-Aboriginal and primarily White. Aboriginal men scored significantly higher on the Static-99R and VRS-SO and had higher rates of sexual and violent recidivism; however, there were no significant differences between Aboriginal and non-Aboriginal groups on treatment change with both groups demonstrating close to a half-standard deviation of change pre and post treatment. VRS-SO risk and change scores significantly predicted sexual and violent recidivism over fixed 5- and 10-year follow-ups for both racial/ancestral groups. Cox regression survival analyses also demonstrated positive treatment changes to be significantly associated with reductions in sexual and violent recidivism among Aboriginal and non-Aboriginal men after controlling baseline risk. A series of follow-up Cox regression analyses demonstrated that risk and change score information accounted for much of the observed differences between Aboriginal and non-Aboriginal men in rates of sexual recidivism; however, marked group differences persisted in rates of general violent recidivism even after controlling for these covariates. The results support the predictive properties of VRS-SO risk and change scores with treated Canadian Aboriginal sexual offenders.

A randomised controlled trial of a cognitive skills programme for offenders with mental illness.

BACKGROUND: Interventions for offenders with mental illness have tended to be confined to treatment of illness, with the expectation that symptom reduction will be accompanied by reduced criminal recidivism, but recent evidence suggests that other treatment targets may be more effective against recidivism. AIM: The aim of this study was to examine the effect of a cognitive skills programme (Reasoning and Rehabilitation 2: Short Version for Adults [R&R2]) among offenders with mental illness. Our first hypothesis was that participation in this programme would result in significantly greater improvement in antisocial attitudes than among similar prisoners who did not participate; both groups received "treatment as usual" (TAU). Our second hypothesis was that those receiving R&R2 would show less post-treatment violent or general recidivism than those receiving TAU alone. METHOD: Incarcerated offenders with serious mental illness (N = 101) were randomly assigned to R&R2 or TAU alone. Criminal attitudes and mental state were examined before and after treatment. Violent and non-violent recidivism was measured, on average, 18 months after release. RESULTS: In both intervention and TAU alone trial arms, there were significant pre- to post-treatment changes in criminal attitudes and symptoms or signs of mental disorder. There was no difference between groups in these respects. These pre/post changes were not associated with reductions in recidivism over time, whether or not controlling for baseline risk. CONCLUSIONS: Although there was no demonstrable advantage of R&R2 over TAU alone, non-significant trends towards lower violent recidivism in the R&R2 group and general recidivism in the TAU group suggest that it may be worth repeating the trial in a larger sample with more differentiated control groups.