The Intensity and Timing of Sex Offender Treatment.

Current evidence about the impact of specialized sex offender treatment on reoffending remains inconsistent, drawing attention to the need to focus more on those program characteristics that potentially moderate outcome. This review considers current professional perspectives and evidence on two defining aspects of treatment: its intensity and timing. It is concluded that insufficient evidence currently exists to articulate best practice in this area and there is a pressing need to collect empirical evidence about the effectiveness of different intensity treatments offered at different stages of sentence.

Ethical practice in sex offender assessment: consideration of actuarial and polygraph methods.

The current generation of community protection laws represents a shift in priorities that may see the individual rights of sex offenders compromised for the goal of public safety. At the center of many judicial decisions under these laws are the risk assessment reports provided by mental health practitioners. The widespread enactment of laws allowing for additional sanctions for sex offenders, and a burgeoning research literature regarding the methods used to assess risk have served to heighten rather than resolve the ethical concerns associated with professional practice in this area. This article examines ethical issues inherent in the use of two assessment methods commonly used with sex offenders in the correctional context, focusing on actuarial measures and polygraph tests. Properly conducted and adequately reported actuarial findings are considered to provide useful information of sufficient accuracy to inform rather than mislead judicial decision makers, although careful consideration must be given to the limitations of current measures in each individual case. Despite its increasing use, polygraph testing is considered controversial, with little consensus regarding its accuracy or appropriate applications. On the basis of the current state of the professional literature regarding the polygraph, its use with sex offenders raises unresolved ethical concerns.

Recent research (N = 9,305) underscores the importance of using age-stratified actuarial tables in sex offender risk assessments.

A useful understanding of the relationship between age, actuarial scores, and sexual recidivism can be obtained by comparing the entries in equivalent cells from "age-stratified" actuarial tables. This article reports the compilation of the first multisample age-stratified table of sexual recidivism rates, referred to as the "multisample age-stratified table of sexual recidivism rates (MATS-1)," from recent research on Static-99 and another actuarial known as the Automated Sexual Recidivism Scale. The MATS-1 validates the "age invariance effect" that the risk of sexual recidivism declines with advancing age and shows that age-restricted tables underestimate risk for younger offenders and overestimate risk for older offenders. Based on data from more than 9,000 sex offenders, our conclusion is that evaluators should report recidivism estimates from age-stratified tables when they are assessing sexual recidivism risk, particularly when evaluating the aging sex offender.

The use of virtual reality in the military's assessment of service members with traumatic brain injury: recent developments and emerging opportunities.

Traumatic brain injury (TBI) is a common event in the current extended conflicts by American service members, with estimates that as many as 300,000 have sustained combat-related concussions during Operation Iraqi Freedom and Operation Enduring Freedom. The limited ecological validity of traditional neuropsychological assessment measures presents a challenge to effective postconcussion evaluation of service members in relation to fitness-for-duty decisions or rehabilitation needs. Virtual reality (VR) technology offers a promising opportunity to advance the field of functional assessment for TBI. This article reviews the current professional literature on VR applications for TBI assessment, with special emphasis on those that are particularly relevant to U.S. service members. VR affords several advantages for clinical use. These include assessment of complex sets of cognitive and behavioral functions rather than the isolated components assessed by traditional measures; more precise control over the standardized presentation of task stimuli and the recording of response data; and enhanced ecological validity that can lead to more useful assessment data in the applied contexts faced by the U.S. military.

Risk assessment of sexual offenders for extended supervision orders in New Zealand: basic principles and current practice.

A growing number of jurisdictions in North America, the United Kingdom, and Australasia have enacted legislation allowing for special sentencing, civil commitment, and community supervision options for high risk sexual offenders. In New Zealand, one example of this concern for public protection is the Parole (Extended Supervision) Amendment Act 2004, which provides for additional supervision of sexual offenders with child victims for up to 10 years after their release from prison. Recent experience with expert evidence and judicial decision making in such cases suggests that those involved in the process might benefit from a more thorough understanding of the current state of sexual offender risk assessment that can be provided by mental health professionals.

Subtypes of psychopathy: proposed differences between narcissistic, borderline, sadistic, and antisocial psychopaths.

Atascadero State Hospital (ASH) is a maximum-security forensic hospital that houses male patients with a wide range of psychiatric diagnoses. Psychopaths at this institution appear to be a heterogeneous group of individuals who, while sharing core personality characteristics, manifest substantial variability in their behavior. Identifying subtypes within this clinical classification can have implications for patient treatment and management, as well as for the safety of the staff who work with them and for the communities to which they will eventually return. Several means of identifying subtypes have been proposed in the literature, and potential subgroups have been identified. Clinical observations at ASH have suggested 4 possible subtypes of psychopathy: narcissistic, borderline, sadistic, and antisocial. Issues related to the conceptualization of psychopathy are addressed, recognizing that additional data are needed to understand the observed variations in cases of psychopathy.

An evaluation of the Bumby RAPE and MOLEST scales as measures of cognitive distortions with civilly committed sexual offenders.

Cognitive distortions are commonly viewed as an important factor in the assessment and treatment of sexual offenders. However, consensus about the operational definition of cognitive distortions and the best instrument to measure such distortions is lacking. This paper evaluates the Bumby MOLEST and RAPE scales as measures of cognitive distortions with patients civilly committed under California's Sexually Violent Predator law. Rapists and child molesters in the current sample endorsed markedly fewer cognitive distortions than the sexual offenders in Bumby's original study (K. M. Bumby, 1996). It is suggested that current self-report measures such as the MOLEST and RAPE scales are too susceptible to a socially desirable response set to provide useful data with sexual offenders who are involuntarily committed for treatment.

An evaluation of the Empat as a measure of victim empathy with civilly committed sexual offenders.

Enhancement of victim empathy is a common component in the treatment of sexual offenders. However, consensus about the definition of empathy and the best instrument to measure empathy in sexual offenders is lacking. This paper evaluates the Empat as a measure of empathy with patients civilly committed under California's Sexually Violent Predator law. Rapists and child molesters in the current sample scored significantly higher in victim empathy than any of the original sex offender groups, with rapists scoring higher than the control group cited by M. McGrath, S. Cann, and R. Konopasky (1998). Clinicians have found the Empat to be too face valid and easily manipulated by patients within this population. The construct of empathy as applied to sex offenders is reviewed and the properties of a more adequate measure of this construct are suggested.