Reexamining predictors of trial outcomes in New York State's sex offender civil management process.

OBJECTIVE: In 2007, New York enacted the Sex Offender Management and Treatment Act, empowering the state to civilly manage individuals who have committed sexual offenses (respondents) and are deemed to have a mental abnormality (MA) that predisposes them to sexually recidivate after serving their criminal sentences. We sought to replicate and extend a previous study (Lu et al., 2015) to identify factors predicting legal decisions. HYPOTHESES: We predicted, on the basis of previous research, that clinical information (e.g., diagnosis) as well as empirically supported risk factors (e.g., sexual deviance) would predict trial outcomes. METHOD: We analyzed multiple pieces of demographic, criminogenic, and clinical data on three nested subsamples of respondents on the basis of the legal process: MA consent (n = 713), MA trial (n = 316), and disposition hearing (n = 643). The binary outcomes of interest were as follows: For the MA consent subsample, it was whether the respondent waived their MA trial; for the MA trial subsample, it was whether the respondent was found at trial to have an MA; and for the disposition hearing, it was whether the respondent was ordered to inpatient or outpatient civil management. RESULTS: The strongest predictor of waiving the trial was geographic location; respondents outside New York City and Long Island were more likely to waive their trials (ORs = 2.38-3.37). The strongest predictors of MA trial and disposition hearing outcomes were Diagnostic and Statistical Manual of Mental Disorders diagnoses; pedophilia (ORs = 4.05-7.22) and sexual sadism (ORs = 2.68-7.03) diagnoses increased the likelihood of an MA finding and confinement order. CONCLUSIONS: Judges and juries give significant weight to clinical information, particularly pedophilia diagnoses, when making civil management legal decisions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Coprophilia and Coprophagia: A Literature Review.

BACKGROUND: Coprophilia and coprophagia are distinct paraphilias that fall under the category of other specified paraphilic disorders in the current edition of the Diagnostic and Statistical Manual of Mental Disorders. Coprophilia refers to sexual excitement from viewing, smelling, or handling feces, as well as fantasizing about another person engaging in these activities. Coprophagia, or eating one's own or another person's excrement, has also been observed in some patients with coprophilia. AIMS: The purposes of this review are to examine the current literature on the etiology, symptoms, interviewing techniques, pharmacotherapy, and psychotherapy used for each disorder and to elicit best practice guidelines in the treatment of patients with coprophila and coprophagia. METHODS: Electronic and hand searches were initiated using CINAHL, EBSCOhost, SAGEpub, and MEDLINE databases between 1990 and 2022 using the terms "coprophilia," "coprophagia," "paraphilia NOS," and "other specified paraphilic disorder" restricted to English. RESULTS: Individual case reports and limited studies were found in this literature. Reported treatment protocols included individual and tandem use of pharmacotherapy and psychotherapy, with mixed outcomes. Future studies are needed to explore the factors that mitigate the paraphilias, therapeutic management, and treatment outcomes, to produce evidence-based practice treatment guidelines. CONCLUSIONS: Understanding the psychological and biological factors that may contribute to these disorders' manifestations may portend a greater understanding and insight into the genesis of the paraphilias. Having specific evidence-based treatment protocols will afford the psychiatric nurse practitioner to render patient-centered, safe, and culturally competent care and effect better patient outcomes among this understudied population.

The Viewing Reaction Time as a Diagnostic Tool of Pedohebephilia in the Dunkelfeld.

Diagnosing pedohebephilia is fraught with obstacles given the tabooed nature of this sexual preference. The viewing reaction time effect (VRT) provides a non-intrusive indirect measure of sexual interest in minors. In forensic populations, the ability of the difference between the latencies while viewing child and adult sexual stimuli (VRT index) to discern child sexual offenders from a range of control groups has been ascertained meta-analytically. Given that the effect has been studied almost exclusively in forensic samples, its dependence or independence on prior overt (deviant) sexual behavior remains unclear. The present study sought to examine the relationship of prior sexual and non-sexual behaviors with the VRT in a sample of 282 self-referring, help-seeking men with and without pedohebephilia with and without a history of prior child sexual offenses (CSO) or a use of child sexual abuse materials (CSAM) recruited outside a forensic context. We found that (1) the clinical diagnosis of pedohebephilia but not prior CSO or CSAM showed a significant association with the VRT index; (2) the discriminatory ability of the VRT index did not differ significantly between samples with and without a history of prior overt sexual behavior with children; (3) the VRT index correlated positively with a behavioral marker of pedohebephilia in a subsample of individuals with prior judicially detected or undetected overt sexual behavior with children; and (4) in the same subsample, the VRT index correlated positively with markers of sexual interests in minors or hypersexuality but not of antisociality. Equivalence testing failed to refute a potential effect of prior sexual behavior on the VRT index. Our study showed that the VRT may provide an unintrusive diagnostic tool for pedohebephilia. The effect of prior overt sexual behavior with children needs further examination.

Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools.

Background and aims: Despite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide standardized, state-of-the-art screening tools for research and clinical practice. Method: Using data from the International Sex Survey (N = 82,243; Mage = 32.39 years, SD = 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD. Results: A total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were present in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability. Discussion and conclusions: This study contributes to a better understanding of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive prevention and intervention strategies for CSBD that are currently missing from the literature.

Paraphilia without symptoms of primary psychiatric disorder: a case report.

BACKGROUND: Paraphilias are recurrent and arousing fantasies, thoughts, and behaviors that cause distress to sufferers and surrounding people. This case report details the challenge of managing multiple paraphilias with compulsive sexual behavior. CASE PRESENTATION: A 48-year-old Malay man presented with compulsive sexual behavior, encompassing voyeuristic, frotteurism, and exhibitionistic behavior, increasing progressively over the years, with accompanying overvalued ideas of erotomania. Despite the high level of dysfunction occupationally and socially, there were no apparent psychotic, manic, or depressive symptoms. An organic workup was unremarkable, and he was diagnosed with multiple paraphilias. Treatment with selective serotonin reuptake inhibitors was commenced, and psychologically he was managed with techniques specific to compulsive sexual behavior. CONCLUSION: Though rare in the literature, both paraphilic disorders and compulsive sexual behaviors are very distressing to sufferers and their families alike, and thorough biopsychological investigations are essential to ensure reversible causes are not overlooked.

Efforts to Reify Other Specified Paraphilic Disorder (Nonconsent) and Their Implications.

The concept of a paraphilic interest in rape was first described in the 1970s but became popular in the early 1990s with the advent of sexually violent predator laws. Today, the concept is described as other specified paraphilic disorder (nonconsent) (OSPD (nonconsent)) and is the second most common diagnosis of individuals committed to state facilities as sexually violent predators. This usage continues despite research indicating that OSPD (nonconsent) lacks scientific validity and has consistently poor interrater reliability. Furthermore, the concept of paraphilic rape has been repeatedly rejected from inclusion in the DSM over a span of decades. Despite obvious flaws in the construct, some experts continue to promote OSPD (nonconsent) and to present unresearched, unvalidated, and idiosyncratic criteria by which to assess individuals. This article reviews the history and development of the concept of a paraphilic interest in rape, describes its scientific flaws, reviews its proponents' efforts to reify it as a clinical entity, and considers the ethics, legal, and evaluative implications of experts' efforts to do so.

The Development, Content Validation, and Pilot Testing of the Paraphilic Interests and Disorders Scale.

The prevalence rates of paraphilic interests and disorders in the general population have been understudied, in large part due to the lack of a standardized assessment measure. As a result, the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 provides little information regarding the prevalence of paraphilic disorders. The present study involved the development of a self-report measure, Paraphilic Interests and Disorders Scale (PIDS), that can be used to assess for the eight paraphilic interests/disorders in the DSM-5 for use with general population samples. Study 1 established the content validity of the PIDS using feedback from 22 experts in the field, and recommendations from these experts were utilized to modify the measure. In Study 2, the PIDS was piloted on 100 individuals in the general population, which supported the feasibility of implementation and its limited-efficacy. While the PIDS requires further psychometric support, the current research suggests the PIDS is a promising tool to gather self-report, population-based data on DSM-5 paraphilic interests and disorders.

Paraphilic Interests Versus Behaviors: Factors that Distinguish Individuals Who Act on Paraphilic Interests From Individuals Who Refrain.

Little is known about distinct factors linked with acting on paraphilic interests or refraining from engaging in paraphilic behaviors. Participants from Canada and the United States (N = 744), aged 19-42 years (M = 29.2; SD = 3.18), were recruited through Amazon's Mechanical Turk. Participants completed questionnaires about their paraphilic interests and behaviors, as well as potential key factors linked to behavioral engagement (i.e., perceptions of consent, sexual excitation/inhibition, impulsivity, moral disengagement, empathy). Results indicated that higher moral disengagement and impulsivity, lower sexual control (i.e., high sexual excitation, low sexual inhibition), and maladaptive understandings of consent were best able to differentiate individuals who reported highly stigmatized (e.g., hebephilia, pedophilia, coprophilia) or Bondage and Dicipline, Dominance and Submission, Sadism and Masochism(BDSM)/Fetish paraphilic interests and engagement in the paraphilic behaviours associated with these interests relative to individuals who did not report such paraphilic interests or behaviors. Moreover, higher moral disengagement, impulsivity, and maladaptive perceptions of consent were best able to differentiate non-consensual paraphilic interests and behaviours (e.g., voyeurism, exhibitionism) compared to individuals who did not report these paraphilic interests or behaviours. These results provide future directions for the exploration of mechanisms that may contribute to engagement in paraphilic behaviors and may be targets for intervention aimed at preventing engagement in potentially harmful paraphilias.

Deconstructing "Sexual Deviance": Identifying and Empirically Examining Assumptions about "Deviant" Sexual Fantasy in the DSM.

We identify and examine three assumptions underpinning "sexual deviance" in the Diagnostic and Statistical Manual (DSM) of Mental Disorders: (1) the "sexual deviant" - often, "the male sex offender" - prefers "deviant," and has limited (if any) "non-deviant," sexual fantasies; (2) this differentiates them from the non-sexual-/non-offending "norm"; (3) preferred fantasies are "deviant" or "non-deviant." Adult volunteers (N = 279; equal numbers of sexual offending [SO], non-sexual offending [NSO] and non-offending [NO] men) provided anonymous descriptions of their favorite sexual thought and responses to a revised Wilson Sex Fantasy Questionnaire during a wider computerized survey of 6,289 men from prison and the community. Latent class analysis identified five types of favorite sexual thought; vaginal/oral sex with 1+ woman was commonest for SO men and the WSFQ findings supported this - challenging the first assumption. Both SO and NO men were over-represented for thought types considered "deviant" by the DSM - tempering the second assumption - although SO men were over-represented for thoughts involving children specifically. All thought types were multidimensional; none included solely elements considered "deviant" by the DSM - contesting the third assumption. Notions of the "sexual deviant" as "different"/"other" may underpin these assumptions, potentially negatively impacting research, therapy and understanding sexual crime.

Cross-Sectional and Longitudinal Associations Between Posttraumatic Stress Symptoms and Hypersexual Behaviors Among Individuals Who have Gambled in Their Lifetimes.

BACKGROUND: Exposure to traumatic experiences represent one factor that may contribute to the development of hypersexual behaviors. AIM: We investigated the associations between posttraumatic stress symptoms and hypersexual behaviors by analyzing survey data from 2 samples. METHOD: The first sample consisted of n = 585 college students, and the second consisted of n = 786 adults recruited via Amazon's Mechanical Turk (MTurk), n = 337 of whom completed a 6-month follow-up survey. We conducted 3 hierarchical regression analyses adjusting for age, gender, sexual orientation, impulsivity, drug use, alcohol use, and gambling. OUTCOMES: The primary outcomes for this investigation were associations between posttraumatic stress symptoms, measured using the PTSD Checklist for DSM-IV and DSM-5 (PCL-C and PCL-5), and hypersexual behaviors, measured using the Hypersexual Behavior Inventory (HBI). RESULTS: A significant regression, R2 = 0.230, R2adjusted = 0.211, F (14,570) = 12.17, P < .001, revealed posttraumatic stress symptoms were associated with hypersexual behaviors in the university student sample (ß = 0.154). A significant regression using the MTurk sample, R2 = 0.403, R2adjusted = 0.392, F (14,771) = 37.13, P < .001, confirmed this finding (ß = 0.259). In addition, a significant regression, R2 = 0.562, R2adjusted = 0.541, F (15,321) = 27.42, P < .001, indicated that posttraumatic stress symptoms were longitudinally associated with increased hypersexual behaviors (ß = .190) after adjusting for all variables, including baseline hypersexuality. CLINICAL TRANSLATION: Results suggest that individuals experiencing posttraumatic stress symptoms are at increased risk for current and future hypersexual behaviors. STRENGTHS & LIMITATIONS: This investigation involved secondary analyses of adults who had gambled at least once in their lives and findings may not generalize to those who have never gambled. Furthermore, longitudinal findings may be impacted by selection bias (42% completion rate) and may not generalize to follow up periods longer than 6-months. CONCLUSION: This study provides support for the hypothesis that posttraumatic stress symptoms are associated with increased hypersexual behavior, and further research is indicated to explore the etiology and directionality of this relationship. Rosansky JA, Borgogna NC, Kraus SW, et al. Cross-Sectional and Longitudinal Associations Between Posttraumatic Stress Symptoms and Hypersexual Behaviors Among Individuals Who have Gambled in Their Lifetimes. J Sex Med 2022;19:1813-1823.

Mental and sexual health perspectives of the International Classification of Diseases (ICD-11) Compulsive Sexual Behavior Disorder •.

After introduction of compulsive sexual behavior disorder (CSBD) in the ICD-11, many questions regarding etiology, classification and diagnostic criteria remain unanswered, providing rationale for further research. In this commentary, we critically review the ongoing discussion reflected in some relevant articles, and try to point out the risks of oversimplification of the broad clinical phenomenon, as well as attract attention to the neglected aspects, such as psychosexual development, intimacy disorder and the role of sexological expertise in the assessment and treatment of individuals presenting with out-of-control sexual behaviors. We also advocate for multimodal, transtheoretical approach and suggest that CSBD may be reconsidered as a condition related to sexual health.

Hypersexuality as a tip of the iceberg of a primary psychopathology: a joined position statement of the Italian Society of Andrology and Sexual Medicine (SIAMS) and of the Italian Society of Psychopathology (SOPSI).

In the last years, hypersexual behavior has been broadly scientifically studied. The interest in this topic, belonging to psycho-sexology and sexual medicine, has been due to its still unclear aetiology, nature, and its manifestation in relationship with several organic and psychopathological conditions. So, the specialist (the psychologist, psychiatrist, endocrinologist, neurologist) may encounter some difficulties in diagnosing and managing this symptom. The first main objective of this position statement, which has been developed in collaboration between the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Psychopathology (SOPSI) is to give to the reader evidence about the necessity to consider hypersexuality as a symptom related to another underlying condition. Following this consideration, the second main objective is to give specific statements, for the biopsychosocial assessment and the diagnosis of hypersexual behavior, developed on the basis of the most recent literature evidence. To develop a psycho-pharmacological treatment tailored on patients' needs, our suggestion is to assess the presence of specific comorbid psychopathological and organic conditions, and the impact of pharmacological treatments on the presence of an excess of sexual behavior. Finally, a suggestion of a standardized psychometric evaluation of hypersexuality will be given.

Pharmacological Treatment for Pedophilic Disorder and Compulsive Sexual Behavior Disorder: A Review.

Guidelines for the pharmacological treatment of paraphilic disorders have historically been based on data from forensic settings and on risk levels for sexual crime. However, emerging treatment options are being evaluated for individuals experiencing distress because of their sexual urges and preferences, targeting both paraphilic disorders such as pedophilic disorder (PeD) and the new diagnosis of compulsive sexual behavior disorder (CSBD) included in the International Classification of Diseases, 11th Revision (ICD-11). As in other mental disorders, this may enable individualized pharmacological treatment plans, taking into account components of sexuality (e.g. high libido, compulsivity, anxiety-driven/sex as coping), medical and psychiatric comorbidity, adverse effects and patient preferences. In order to expand on previous reviews, we conducted a literature search focusing on randomized controlled trials of pharmacological treatment for persons likely to have PeD or CSBD. Our search was not restricted to studies involving forensic or criminal samples. Twelve studies conducted between 1974 and 2021 were identified regardless of setting (outpatient or inpatient), with only one study conducted during the last decade. Of a total of 213 participants included in these studies, 122 (57%) were likely to have PeD, 34 (16%) were likely to have a CSBD, and the remainder had unspecified paraphilias (40, 21%) or sexual offense (17, 8%) as the treatment indication. The diagnostic procedure for PeD and/or CSBD, as well as comorbid psychiatric symptoms, has been described in seven studies. The studies provide some empirical evidence that testosterone-lowering drugs reduce sexual activity for patients with PeD or CSBD, but the body of evidence is meager. There is a need for studies using larger samples, specific criteria for inclusion, longer follow-up periods, and standardized outcome measures with adherence to international reporting guidelines.

Are Female Paraphilias Hiding in Plain Sight? Risqué Male-Male Erotica for Women in Sinophone and Anglophone Regions.

Female-oriented male-male erotica is a genre of popular culture often know as Boys' Love (BL), yaoi, and danmei. It is one of the largest by-and-for women sexual subcultures and a global phenomenon. With the largest data sets in the field, we ask: Which risqué sexual content do Sinophone (Chinese-speaking) and Anglophone (English-speaking) participants particularly enjoy in BL and does this differ between cultures?, and Are there sub-demographics in Sinophone and in Anglophone culture who enjoy particular forms of risqué sexual content in BL and do these forms relate also to enjoyment of particular storylines and concern with legal issues? The material studied meets the DSM-5 definition of the paraphilic, and little is known about paraphilias in women or in the general population. Using Categorical Principal Component Analysis we explored one 15-response question from our Sinophone (N = 1922) and Anglophone (N = 1715) BL fandom surveys: Which risqué sexual content do you particularly enjoy in BL? We also tested for associations with seven demographic and other BL content-related questions. Notably, the component structure was nearly replicated between the two independent samples, in order of strength: BDSM Specialist, Mechanoid/Animal Sex Specialist, Underage Sex Specialist, and Minority Paraphilia Specialist. In both samples, it was the avid BL fans and/or those who liked explicitly sexual stories, a largely overlapping demographic, who most engage the risqué content, while, for the Sinophone, this included also more non-heterosexual and/or other-gendered people. We conclude that women's paraphilias have been largely overlooked because they might be expressed more commonly through fantasy than action, that their mass expression has awaited both the means and the market force, and that current conceptualization of, and assumptions about, paraphilias is overly modeled on that of men.

[Aggressiveness, assertiveness, and sexual deviance: An empirical-quantitative examination of Stoller's perversion theory]. / Aggressivität, Assertivität und sexuelle Devianz: Eine empirisch-quantitative Prüfung der Stoller'schen Perversionstheorie.

Aggressiveness, assertiveness, and sexual deviance: An empirical-quantitative examination of Stoller's perversion theory Objectives: The main aim of the present study was to empirically examinate the psychodynamic-founded perversion theory of Robert D. Stoller (1979), particularly his assumption of a transformation of aggressive impulses into sexual deviant fantasies due to traumatic experiences. Methods: In the present study different aspects of the theory were examined by using a sample (N = 954) of individuals convicted of sexually motivated offenses who had been clinically and forensically assessed between 2002 and 2018 at the Federal Evaluation Centre for Violent and Sexual Offenders (FECVSO) in the Austrian Prison System. As a part of the psychological testing procedure, German-speaking questionnaires for the assessment of aggressiveness and assertiveness were applied. Results: The results indicated that participants with a diagnosis of paraphilia showed significantly less spontaneously expressed aggression and less social competence compared to individuals without such a diagnosis. Conclusions: The findings of the present study are in line with the core assumptions of Stoller's perversion theory by demonstrating an inverse relationship between the diagnosis of paraphilia and self-reported aggression.

[The Influence of Occupational Group and Experience with Regard to the Criteria-Based Assessment of Culpability for Paraphilic Disorders - A Randomized Control Trial]. / Der Einfluss von Profession und Erfahrung hinsichtlich der kriteriengeleiteten Beurteilung der Schuldfähigkeit bei paraphilen Störungen ­ eine randomisierte kontrollierte Studie.

OBJECTIVE: This study examines whether occupation and level of experience have an impact on criteria-based assessment of criminal responsibility in paraphilic disorders. METHODS: Two different sets of criteria were tested for predictive validity by three different professional groups (psychologists, psychiatrists and lawyers), each with different levels of prior experience. For this purpose, 349 raters evaluated the criteria of one of two criteria catalogs on the basis of one of two exemplary case vignettes. Group assignment was randomized. RESULTS: The variables degree of experience and professional affiliation did not show a connection with the prediction performance regarding the estimation of the severity of the disorder and the diminished capacity, respectively, with respect to either of the two sets of criteria. CONCLUSION: Using a criteria based approach, the methodology used in the present study (presentation of short case vignettes) did not reveal any significant influence of professional group and experience on the assessment in questions of criminal responsibility related to paraphilic disorders. The use of criteria catalogs may be able to contribute substantially to predictive performance relatively independent of relevant prior experience in the area of the assessment of criminal responsibility, but should not be considered the sole source of assessment.

The Paraphilias and Medical Licensure in the United States.

BACKGROUND: As part of their mission to protect the public from exploitation, state medical boards query physicians about a wide range of topics prior to licensure, including in some cases whether the applicant has been diagnosed with or been treated for paraphilias or paraphilic disorders. AIM: We investigated the prevalence of questions inquiring about the applicants' history of paraphilias and paraphilic disorders on applications for medical licensure. METHODS: The allopathic medical licensure application forms for each of the 50 United States and the District of Columbia were reviewed. Medical boards with questions pertaining to paraphilias or paraphilic disorders were asked how many affirmative responses had been obtained in the prior 5 years and how they would treat an affirmative response. OUTCOMES: Eight medical boards inquired about paraphilias or paraphilic disorders, however there was no evidence of an affirmative response to these questions in the prior 5 years. RESULTS: Of the 51 applications reviewed, 8 (16%) inquired whether the applicant had, was diagnosed with, or had been treated for a paraphilia or paraphilic disorder. The wording of the questions was variable and often failed to distinguish between paraphilias and paraphilic disorders. All but one medical board responded to requests for further information. The medical board staff members stated that an affirmative response would result in case-by-case review, including request for further information and possibly an in-person appearance before the board. None of the medical boards were willing or able to provide a formal count of affirmative responses in the last 5 years. CLINICAL IMPLICATIONS: Medical boards may be contributing to the stigma experienced by both physicians and patients with diverse sexual interests. The benefit of retaining these questions is not clear. STRENGTHS AND LIMITATIONS: This study is the first to investigate the use of paraphilias and paraphilic disorders as screening questions for medical licensure. Data regarding the number of affirmative responses were limited by the medical boards' inability or unwillingness to respond to share the information. CONCLUSIONS: Eliminating or modifying physician licensing application questions pertaining to paraphilias and paraphilic disorders may decrease the stigma encountered by persons with diverse sexual interests. Removal also may diminish the barriers to accessing health care services for both physicians and patients with diverse sexualities. If the questions are retained, they should conform to the current DSM-5 nosology, which distinguishes between the mere presence of a paraphilia and a diagnosis of a paraphilic disorder. Cranstoun LM, Moser C. The Paraphilias and Medical Licensure in the United States. J Sex Med 2021;18:1130-1133.

Validity and reliability of the short version of the Problematic Pornography Consumption Scale (PPCS-6-A) in adolescents.

OBJECTIVE: Despite the high prevalence of adolescents' pornography use and increasing societal concerns about it, the examination of problematic pornography use (PPU) among this population is still scarce, potentially due to the lack of well-validated, reliable measures. The aims of the present study were to validate a short, theory-based measure of PPU in a diverse sample of adolescents and identify a potentially at-risk problematic pornography user group. METHOD: We used a sample of 802 adolescents (35% girls; 14% sexual minority; Mage = 15.4 years, SD = 0.6) who reported lifetime pornography use, collected as part of an ongoing longitudinal study on adolescents' sexual health. To examine the psychometric properties of the short, six-item version of the Problematic Pornography Consumption Scale for adolescents (PPCS-6-A), we conducted confirmatory factor analysis, gender and sexual orientation measurement invariance testing, and assessed theoretically relevant correlates (e.g., masturbation frequency). We conducted latent profile analysis to identify adolescents at risk of PPU. RESULTS: The PPCS-6-A demonstrated strong psychometric properties in terms of factor structure, measurement invariance (i.e., boys vs. girls, and heterosexual vs. sexual minority adolescents), and reliability, and correlated reasonably with the assessed variables. Ten percent of participants were identified as being at-risk of PPU. CONCLUSIONS: The PPCS-6-A can be considered a short, reliable, and valid scale to assess PPU in adolescents, and may distinguish between low-risk and at-risk problematic users. Its use in future studies could lead to a better understanding of the prevalence and characteristics of adolescents' PPU. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Forensic Evaluation of Sexsomnia.

Sexsomnia is a non-rapid eye movement parasomnic behavior characterized by sexual activity during sleep. Recognized in the most recent editions of the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Sleep Disorders, sexsomnia is likely to arise with increasing frequency in court as a potential explanation for sexual offending. The forensic psychiatrist has a unique role in the evaluation and management of sexsomnia. The psychosexual evaluation may elucidate the presence or absence of paraphilias and paraphilic disorders and identify any overlap between the alleged sexsomnic behavior and paraphilic interest. In addition, forensic psychiatrists may assess for malingered sexsomnia, provide an opinion regarding criminal responsibility, or evaluate the risk for committing future sexual offenses. Forensic psychiatrists should therefore understand basic information regarding the disorder, as well as how to conduct a psychosexual evaluation effectively in cases of alleged sexsomnia. This article describes the various considerations involved in the forensic evaluation of sexsomnia.

[Interrater reliability of the criteria-based assessment of criminal responsibility in paraphilic disorders]. / Interrater-Reliabilität der kriteriengeleiteten Beurteilung der Schuldfähigkeit bei paraphilen Störungen.

BACKGROUND: For the assessment of criminal responsibility in the context of sexual delinquency, the evaluation of the severity of a paraphilic disorder and the ability to be controlled are of particular importance. Established assessment criteria are insufficiently operationalized. AIM AND METHODS: The existing criteria were tested by experts of various professional groups with respect to the reliability. For this purpose, 14 experts assessed the criteria of 2 different sets of criteria based on 2 case vignettes (see electronic supplementary material). RESULTS AND CONCLUSION: The interrater reliability (IRR) with reference to the criteria of Briken and Müller was higher than the previously established criteria of Boetticher et al. The evaluation of the subjective importance of the criteria of both assessment scales showed that all criteria were rated as at least of average importance. It could thus be useful to initially include both sets of criteria for a greater transparency in the assessment process and to investigate this procedure in further studies.