Pornography use and sexual aggression: the impact of frequency and type of pornography use on recidivism among sexual offenders.

In this study, we examined the unique contribution of pornography consumption to the longitudinal prediction of criminal recidivism in a sample of 341 child molesters. We specifically tested the hypothesis, based on predictions informed by the confluence model of sexual aggression that pornography will be a risk factor for recidivism only for those individuals classified as relatively high risk for re-offending. Pornography use (frequency and type) was assessed through self-report and recidivism was measured using data from a national database from the Royal Canadian Mounted Police. Indices of recidivism, which were assessed up to 15 years after release, included an overall criminal recidivism index, as well as subcategories focusing on violent (including sexual) recidivism and sexual recidivism alone. Results for both frequency and type of pornography use were generally consistent with our predictions. Most importantly, after controlling for general and specific risk factors for sexual aggression, pornography added significantly to the prediction of recidivism. Statistical interactions indicated that frequency of pornography use was primarily a risk factor for higher-risk offenders, when compared with lower-risk offenders, and that content of pornography (i.e., pornography containing deviant content) was a risk factor for all groups. The importance of conceptualizing particular risk factors (e.g., pornography), within the context of other individual characteristics is discussed.

Defense styles of pedophilic offenders.

This pilot study investigated the defense styles of pedophile sexual offenders. Interviews with 20 pedophiles and 20 controls were scored using the Defense Mechanisms Rating Scales. Results showed that pedophiles had a significantly lower overall defensive functioning score than the controls. Pedophiles used significantly fewer obsessional-level defenses but more major image-distorting and action-level defenses. Results also suggested differences in the prevalence of individual defenses where pedophiles used more dissociation, displacement, denial, autistic fantasy, splitting of object, projective identification, acting out, and passive aggressive behavior but less intellectualization and rationalization.

The impact of sex offender residence restrictions: 1,000 feet from danger or one step from absurd?

Several states have enacted public policies that prohibit sex offenders who have abused children from living within close proximity to a school, park, day care center, or school bus stop. The purpose of this exploratory study was to describe the impact of residence restrictions on sex offender reintegration and to better understand sex offenders' perceptions of these laws. A survey of 135 sex offenders in Florida was conducted. Most of the molesters who responded to the survey indicated that housing restrictions increased isolation, created financial and emotional stress, and led to decreased stability. Respondents also indicated that they did not perceive residence restrictions as helpful in risk management and, in fact, reported that such restrictions may inadvertently increase triggers for reoffense. Implications for policy and practice are discussed.

A plan analysis of pedophile sexual abusers' motivations for treatment: a qualitative pilot study.

Many authors have suggested adapting treatment programs to the specific needs of sexual abusers. However, little research has been conducted to understand what these patients seek in therapy or what elements play a key role in keeping them in treatment. In this pilot study, fifteen (N=15) pedophile sexual abusers from La Macaza clinic for sexual abusers were interviewed. Plan analysis was used to investigate the most prevalent components involved in staying in or leaving therapy. Results suggest that many components involved in the plans leading to doing and to avoiding treatment were similar. Differences were found in regards to the outcome of confrontations with the therapists, a tendency to isolate and overcomply, guilt related to the abuse, a need for a stable environment, and a need to be accepted. These results are discussed along with possible ways to improve the patients' involvement in treatment.

Media distortion of the public's perception of recidivism and psychiatric rehabilitation.

OBJECTIVE: The public's perception about the success or failure of psychiatric rehabilitation is frequently dependent upon information received through the news media. The primary objective of this report is to present an example of how the news media can distort public perceptions of treatment outcome. METHOD: Verbatim quotations were presented from a television news series that alleged criminal recidivism by nine patients purportedly treated for various paraphilias at a large, community-based sexual disorders clinic. Brief case vignettes about each of the nine were then reviewed. This allowed for comparisons between what the media had alleged and what had actually occurred. RESULTS: Two of the nine cases were relatively minor instances of recidivism involving no genital contact, although the media presentation had either failed to report this or had suggested otherwise. A third case of alleged recidivism involved a patient who was evaluated but never actually treated by the clinic in the community. A fourth patient had refused recommended clinic treatment upon prison release, and a fifth patient had been discharged from treatment at the clinic because of noncompliance years before recidivating. Other cases presented contained additional misleading information. None of the nine cases was reported by the media in the context of a balanced approach that included treatment successes. Clinic staff were constrained from responding publicly to correct certain misinformation because of patient-psychiatrist privilege. CONCLUSIONS: Inaccurate media presentations about psychiatric rehabilitation that ignore treatment successes and focus only on alleged failures do a disservice to patients, mental health workers, and society at large.

A logical functional analysis of reinforcement-based disorders: alcoholism and pedophilia.

This article discusses a nomothetic functional strategy, termed logical functional analysis, as an approach to the refinement of the structural diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders (e.g., 4th ed.; DSM-IV; American Psychiatric Association, 1994). As heterogeneous diagnostic categories are more the norm than the exception in the DSM-IV, an argument is made for the identification of homogenous subgroups within diagnostic classes based on functional principles. Outlines of a logical functional analysis for 2 reinforcement-based disorders, alcoholism and pedophilia, are presented. The outlines show how topographically similar behavior patterns can serve different functions that are important to consider when making treatment decisions. The logical functional analysis is a strategy that helps practitioners to identify motivational conditions, antecedents, consequences, and concomitant behavioral repertoires associated with a given disorder. It also provides guidance for the selection of intervention strategies.

Sexual recidivism among child molesters released from a maximum security psychiatric institution.

The recidivism of 136 extrafamilial child molesters who had received phallometric assessment in a maximum security psychiatric institution from 1972 to 1983 was determined over an average 6.3-year follow-up. Fifty had participated in behavioral treatment to alter inappropriate sexual age preferences. Thirty-one percent of the subjects were convicted of a new sex offense, 43% committed a violent or sexual offense, and 58% were arrested for some offense or returned to the institution. Subjects convicted of a new sex offense had previously committed more sex offenses, had been admitted to correctional institutions more frequently, were more likely to have been diagnosed as personality disordered, were more likely to have never married, and had shown more inappropriate sexual preferences in initial phallometric assessment than those who had not. Behavioral treatment did not affect recidivism.

The abstinence violation effect in child molesters.

The reformulation of the abstinence violation effect (AVE) is briefly described together with the empirical support for the construct. Twenty-six incarcerated male child molesters were assessed, using the Differential Emotions Scale and the Attributional Dimension Scale, at three points (high-risk, lapse, and relapse) while they listened to an audiotaped recording of a description of their most typical offense chain. Eighteen Ss experienced an AVE at the point of relapse and 7 as a result of lapse. There were significant increases in most negative emotions and decreases in interest over the relapse chain. There were significantly higher disgust, contempt, hostility, fear, shame, shyness and anger scores reported by those showing an AVE. Conversely, the AVE group showed significantly lower scores for joy and surprise. There were no significant differences on any of the 4 attributional dimensions across the relapse process but those showing an AVE reported significantly more uncontrollability and higher stability scores. The significance of these results for clinical practice are discussed.

Treatment of sexual offenses by persons with developmental disabilities.

Sexual offenses, particularly paraphilias, although infrequent, are committed by people with mental retardation. Their management poses clinical and ethical dilemmas. Available treatments were reviewed, especially the literature on the most effective agent, medroxyprogesterone acetate (MPA). A case history was presented of a young man with mild mental retardation who was successfully treated with MPA. The role of antiandrogen treatments of paraphilias among the mentally retarded population includes a consideration of informed consent and ethical aspects of treatment.

Child sexual abuse prevention: what offenders tell us.

Ninety-one child sex offenders were interviewed about the methods they used to target children, the age range of their victims, how they selected children and maintained them as victims, and what suggestions they had for preventing child sexual abuse. Offenders were selected from treatment programs, probation, special hospitals, and prisons. They were interviewed using a semi-structured questionnaire. Results indicate that offenders gained access to children through caretaking, such as babysitting; targeted children by using bribes, gifts and games; used force, anger, threats, and bribes to ensure their continuing compliance; and systematically desensitized children through touch, talk about sex, and persuasion. Nearly half the offenders had no bad feelings about sexually abusing children. The implications for prevention programs are discussed.

The economics of child sex-offender rehabilitation programs: beyond Prentky & Burgess.

In a 1990 article in this journal, Prentky and Burgess examined cost-effectiveness of the rehabilitation of child molesters. Their estimates were based on the tangible costs of incarceration and particular recidivism rates. This paper extends those findings by estimating the intangible costs of child sexual abuse and a range of recidivism rates. The result is to focus greater attention on the efficacy of treatment programs and the potential economic damage done to children by child molesters.

Rehabilitation of child molesters: a cost-benefit analysis.

This study examined the cost effectiveness of the rehabilitation of child molesters by designing and testing a cost-benefit model. The model uses program and reoffense data from a treatment center for offenders and costs derived from averaged figures obtained from state agencies. Results of the analysis, as well as related policy issues, are discussed.

Using humor in psychotherapy with a sex offender.

Humor was used during psychotherapy with a 22-year-old child molester. The humor appeared to help establish rapport and led to his admission of desires to rape and torture adult women. Here exchange of humor seemed to be a helpful adjunct to psychotherapy.

Denigration of a victim in group psychotherapy by violent vs seductive sex offenders.

Two psychotherapy groups were set up in a prison treatment program, one for violent sex offenders, the other for sex offenders who were less violent and primarily used seduction to obtain sex. Most of the patients were child molesters. Observations showed that over the course of 10 group psychotherapy sessions, 8 out of 10 violent offenders said denigrating things about their victims vs 2 out of 10 seductive offenders. The significant comparison if supported by cross-validation suggests the value of the distinction of violence vs seduction for sex offenders.

Can men who abuse children change?

Convicted child sexual offenders studied and method of treatment described. The role of alcohol is looked at and the sex offender who abuses alcohol is distinguished from the alcoholic who molests or rapes children. The criteria for success are set out and the rate of success recorded.

An examination of the interrater reliability between practitioners and researchers on the static-99.

Many studies have validated the psychometric properties of the Static-99, the most widely used measure of sexual offender recidivism risk. However much of this research relied on instrument coding completed by well-trained researchers. This study is the first to examine the interrater reliability (IRR) of the Static-99 between practitioners in the field and researchers. Using archival data from a sample of 1,973 formerly incarcerated sex offenders, field raters' scores on the Static-99 were compared with those of researchers. Overall, clinicians and researchers had excellent IRR on Static-99 total scores, with IRR coefficients ranging from "substantial" to "outstanding" for the individual 10 items of the scale. The most common causes of discrepancies were coding manual errors, followed by item subjectivity, inaccurate item scoring, and calculation errors. These results offer important data with regard to the frequency and perceived nature of scoring errors.

Community reintegration of sex offenders of children in new zealand.

Reintegration of offenders following incarceration is most successful if matched to the needs of offenders, victims, and the community. This study explored child sex offenders' expectations for and experiences of reintegration into the community. A longitudinal design was used in which semistructured interviews covered issues identified in the literature as being related to reintegration. Nine offenders were interviewed within 1 week prior to release, 3 months post release, and 6 months post release. Interviews were analysed using thematic analyses producing six key themes. The interviews revealed that most of the participants feared their release from prison into the community and once released struggled to live in society. Overall, reintegration planning was simplistic and aimed primarily to manage risk factors rather than promote reintegration. Those participants who reported most satisfaction with their adjustment following release had more comprehensive reintegration plans, which enabled them to visualise what life would be like after release.

Does consideration of psychopathy and sexual deviance add to the predictive validity of the static-99R?

The Static-99 is the most commonly used actuarial risk assessment tool for the prediction of sexual recidivism. In addition, the use of psychopathy and sexual deviance has been common in assessing sexual offenders, based on research suggesting that these factors have predictive validity. It has also become common practice to modify risk assessments based on the Static-99/99R because of the presence of psychopathy and indicators of deviant sexual interests, although to date there has been no research validating this procedure. The current research was conducted to fill this gap in the literature. Using a sample of 272 sexual offenders, the extent to which psychopathy, sexual deviance, and their interaction added to the predictive validity of the Static-99R was examined. Analyses were conducted using the whole sample as well as subgroups of rapists and child molesters. It was found that although the Static-99R predicted sexual recidivism, adding psychopathy and sexual deviance in a Cox regression analysis did not improve the prediction. This held true for child molesters when examined on their own. For rapists, although psychopathy and sexual deviance did not contribute to the prediction of sexual recidivism, for serious (i.e., violent including sexual) recidivism, the inclusion of psychopathy added to the prediction. Results are discussed in terms of implications for practice.

Androgen deprivation therapy of self-identifying, help-seeking pedophiles in the Dunkelfeld.

Androgen deprivation therapy (ADT) is considered an effective strategy in sexual offender treatment. However, the evidence base concerning its effects on sexual arousal control is limited. Past research has focused almost exclusively on men in forensic contexts. The present retrospective observational study provided data on ADT in a sample of self-identifying, help-seeking pedohebephilic men applying for a one-year group therapy program. Factors possibly influencing the readiness to take up or discontinue ADT were presented. Effects of a combination of ADT and group psychotherapy program on changes in paraphilic sexual behavior and associated psychological factors were examined. The proportion of men having taken up ADT was rather small (n=15). Greater awareness of potentially risky situations to commit child sexual offenses and self-rated uncontrollability of sexual urges were identified as characterizing men resorting to ADT. Additionally, these men were initially more open to include medical treatment. Examination of the effects of ADT and psychotherapy was limited to a sample of six men providing complete data sets. Descriptive data demonstrated a reduction of paraphilic sexual behaviors, an increase of risk-awareness and self-efficacy, and a decrease of offense-supportive cognitions and self-esteem. The present study underlined the importance of careful education and monitoring of self-identifying, help-seeking pedohebephilic patients interested in ADT concerning the effects and side effects of the treatment in a clinical context.