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.

Attachment Theory and Sexual Offending: Making the Connection.

PURPOSE OF REVIEW: The purpose of this review is to discuss how attachment theory can be applied to explain sexual violence. Specifically, it discusses how the development of certain risk factors contributes to these behaviors and how attachment-based models can be used to address this issue through prevention and therapeutic interventions. RECENT FINDINGS: Recent research demonstrates that individuals who commit sexual offenses have higher rates of insecure attachment styles and that these styles are associated with a number of criminogenic risk factors associated with sexual offending. Such risk factors include cognitive processing difficulties, affect dysregulation, and challenges in interpersonal relationships, among others. Fortunately, treatment interventions have been shown to foster more secure attachment styles and reduce these risk factors. Attachment theory is a viable theory to both understand and intervene with those who have committed sexual violence to reduce the risk factors associated with sexual violence.

Neuropsychological Functioning in Sexual Offenders With and Without Pedophilic Disorder.

This study sought to examine neuropsychological functioning in men with pedophilic disorder (PD), in order to assess whether findings from prior neuropsychological studies are replicated in a diverse sample including men with non-contact sexual offenses. It was hypothesized that when non-contact offenders are included in the study, a slowed processing speed will emerge as the only finding unique to men with PD. A comprehensive neuropsychological battery was administered to 58 men convicted of a sexual offense, 20 of whom were classified as having PD. The sample included men with contact sexual offenses (n = 33), non-contact sexual offenses (n = 5), and child sexual abuse material (CSAM) offenses (n = 20). Test performance was compared by PD status. Participants with PD performed significantly better on verbal memory and visual discrimination than those without PD. Men with PD made more errors on a set-shifting task but no significant differences were seen in domains of attention, intellectual functioning, visual learning and memory, visuospatial ability, or language ability. Effect sizes were generally small, although some medium effects were seen (visual discrimination and verbal learning and memory). Scores in both groups (with and without PD) were generally in the average range across tasks. Within the subgroup of CSAM offenders, minimal differences emerged between those with and without PD, although those with PD were slower on visuomotor set-shifting but made fewer errors (d = - 0.89). CSAM offenders with PD were in the high average range on many tasks of intellectual functioning; however, a potential trend was identified such that CSAM offenders without PD had lower scores on a task of verbal learning and memory, with medium effect sizes observed. As few differences in neuropsychological functioning emerged when comparing offenders with and without PD, differences demonstrated in prior research may be better attributed to contact offending status rather than sexual interest.

Childhood Adversity and Offense-Supportive Cognitions Among Czech Adults with a Sexual Interest in Violence or Children.

Individuals with paraphilic interests in sexual violence or children may be more likely to sexually offend if they possess offense-supportive cognitions. These cognitions may develop in response to childhood adversity. However, this idea is largely based on research in men convicted of sexual offenses and may not generalize to non-incarcerated adults with paraphilic interests. In a sample of 178 adults screened for paraphilic interests in violence or children (from the general Czech population), we hypothesized that childhood sexual abuse and emotional neglect would be associated with offense-supportive cognitions about rape and child molestation. Participants came from a nationally representative sample of Czech adults and were selected if they self-reported high levels of sexual interest in violence and/or children. Participants completed an online survey with self-report measures of sexual orientation, offense-supportive cognitions (Bumby RAPE and MOLEST scales), and childhood sexual abuse and emotional neglect (Childhood Trauma Questionnaire). Controlling for gender, age, and sexual orientation, we found that both rape-supportive cognitions and child molestation-supportive cognitions were significantly associated with higher levels of childhood sexual abuse, but not emotional neglect. These findings indicate that childhood sexual abuse may lead to offense-supportive cognitions among men and women with paraphilia.

Sexual Exploitation of Children in Travel and Tourism Perpetration: An Expansion of the Ecosystem Model.

The sexual exploitation of children in travel and tourism (SECTT), also referred to as child sex tourism, involves engaging in sexual activity with someone under the age of 18 in the context of travel and/or tourism. Research on the perpetration of SECTT is vastly underdeveloped. The present review considers the operationalization of SECTT, its prevalence, and existing theoretical models. Existing theory on SECTT provides a good overview of environmental factors that contribute to SECTT, but the model is insufficient in fully accounting for individual-level risk factors related to sexual offending against children. The present paper expands an existing theoretical model of SECTT, the ecosystem model, to account for these individual risk factors and considers their interaction with environmental factors. The paper concludes by highlighting different avenues for future research.

Intellectual Ability and Sexual Recidivism Risk Assessment: Comparing Predictive Accuracy in an Incarcerated U.S. Sample.

While studies indicate that individuals with intellectual disabilities (ID) and borderline intellectual functioning (BIF) are overrepresented among those incarcerated for sexual offenses, there is a paucity of research with respect to risk assessment for this population, particularly among incarcerated U.S. samples. This gap is concerning given that individuals perceived as high risk may be denied bail, given harsher sentences, or subject to civil confinement. The present study examined the predictive validity of the Static-99 and Static-99R, which rely on historical predictors, and the MnSOST-R, which includes a dynamic subscale. Archival records were used to compare individuals with (n = 459) and without (n = 459) ID/BIF released from New Jersey state prisons between 1996 and 2007, with an average follow-up period of 5.7 years. All three instruments demonstrated good predictive validity for those without ID/BIF, while only the MnSOST-R produced a significant AUC value for those with ID/BIF. Reincarceration rates for those with ID/BIF within high-risk groups ranged from 0% to 8%, similar to the overall recidivism base rate of 4%. Results highlight the need for additional research to determine which risk factors should be considered for those with ID/BIF.

Relationships Between Early Maladaptive Schemas and Emotional States in Individuals With Sexual Convictions.

This study seeks to add to the existing knowledge and available literature on schema therapy elements in forensic inpatient samples. Early maladaptive schemas and emotional states were assessed in Dutch individuals with sexual convictions and compared to individuals with nonsexual violent convictions. Self-ratings of the Young Schema Questionnaire and the Schema Mode Inventory of 95 patients with either convictions for child sexual abuse (N = 30), sexual violence against adults (N = 34), and nonsexual violent convictions (N = 31) were examined using one-way multivariate ANOVAs. Regardless of victim type, forensic patients convicted for sexual offending, and patients with convictions for nonsexual violent offending, seem to make equal use of specific maladaptive cognitive schemas and schema modes during mandated inpatient care. Other studies have shown that people with sexual offense histories are typically characterized by insecure attachment, overvigilance towards women, or a child-like self-concept. Our study indicates that forensic patient in Dutch mandated care may be qualitatively different from typical patients with sexual offense histories and that Dutch patients with violent or sexual offense histories are more similar than they are dissimilar.

Are Sex Offending Allegations Viewed Differently? Exploring the Effect of Offense Type and Conviction Status on Criminal Stigmatization.

Attitudes towards individuals with sexual convictions play a major role in the formation of legislative action, including sentencing policies and registration and notification procedures. However, there is little research about stigmatization directed at those who are accused of such offenses prior to conviction. In this work we explored this gap by comparing stigmatization (e.g., a desire for social distance, and negative personality attributions) towards people accused of a range of crimes (sexual, violent, and acquisitive), and whether this was further impacted by whether or not allegations led to a conviction. We recruited 403 community-based participants for a between-subjects experimental survey. We found support for the conclusion that people accused of and convicted for sexual offenses are more heavily stigmatized than allegations related to other crime types, and especially so when allegations involved child victims. Stigmatization took the form of greater levels of support for police-initiated notifications about allegations before conviction, increased desires for social distance, and attributions of negative personality traits. We discuss the theoretical and applied implications of these findings in relation to stigma research and issues related to anonymity for those accused of sexual offenses.

Moderators of Sexual Recidivism as Indicator of Treatment Effectiveness in Persons With Sexual Offense Histories: An Updated Meta-analysis.

The present meta-analysis is an update of the meta-analysis by Schmucker and Lösel [Campbell Syst. Rev. 2017; 13: 1-75], which synthesized evidence on sexual recidivism as an indicator of treatment effectiveness in persons with sexual offense histories. The updated meta-analysis includes 37 samples comprising a total of 30,394 individuals with sexual offense histories, which is nearly three times the sample size reported by Schmucker and Lösel (2017: 28 samples, N = 9781). In line with Schmucker and Lösel (2017), the mean treatment effect was small with an odds ratio of 1.54 [95% CI 1.22, 1.95] (p < .001). A moderator analysis suggested three predictors of importance, i.e., risk level, treatment specialization, and author confounding. Greater treatment effectiveness was suggested in high- and medium-compared to low-risk individuals and in specialized compared to non-specialized treatments. Authors affiliated with treatment programs reported larger effectiveness than independent authors. These findings were overall in line with Schmucker and Lösel (2017), though the effects of risk level and treatment specialization were stronger in the current meta-analysis. The findings of the updated meta-analysis reinforce the evidence for the first and second principle of the Risk-Need-Responsivity model. The results may support researchers and decision-makers in interpreting the current evidence on sexual recidivism as an indicator of treatment effectiveness, and, based on that, implement and carry out informative, methodologically sound evaluations of ongoing treatment programs in persons with sexual offense histories.

A Grounded Theory Model of Relationship Decision-Making in Non-Offending Partners of Individuals Accused of Sexual Offending.

Non-offending partners of individuals who have committed sexual offenses often choose to end their relationship given the many negative consequences they face as a result of their partner's offending behavior. Despite a focus on relationships in rehabilitation frameworks and the importance of the relationship for the individual who has offended and their partner, research has thus far failed to examine the process underlying why non-offending partners decide to stay in or leave their relationship following an offense. In this study we developed the first descriptive model of relationship decision-making in non-offending partners. Twenty-three individuals whose current or previous partners were accused of sexual offending were interviewed about affective, behavioral, cognitive, and contextual factors contributing to their decision to stay with or leave their partner. Participants' narrative accounts were analyzed using Grounded Theory. Our resulting model consists of four main periods: (1) background factors, (2) relationship factors, (3) finding out, and (4) relationship decision-making. Clinical implications, limitations, and directions for future research are discussed.

A Descriptive Model of Voyeuristic Behavior.

Over the last 50 years, there has been a plethora of research exploring sexual offending with a recent focus on online offending. However, little research has focused on voyeurism despite convictions and media awareness growing rapidly. Currently, there is sparse theoretical or empirical literature to guide research and practice for individuals engaging in voyeuristic behaviors. As such, 17 incarcerated men with a conviction of voyeurism in the UK were interviewed on the cognitive, affective, behavioral, and contextual factors leading up to and surrounding their offense(s). Grounded theory analyses were used to develop a temporal model from background factors to post-offense factors; the Descriptive Model of Voyeuristic Behavior (DMV). The model highlights vulnerability factors for men engaging in voyeuristic behaviors in this sample. Following this, the same 17 men were plotted through the model and three key pathways were identified: Sexual Gratification, Maladaptive Connection Seeking, and Access to Inappropriate Person(s). The characteristics of each pathway are discussed, and treatment implications considered.

Latent profiles identified from psychological test data for people convicted of sexual offences in the UK.

BACKGROUND: One size does not fit all in assessment and intervention for people with convictions for sexual offences. Crime scene indicators and risk-related variables have been used to identify distinct clusters of people with convictions for sexual offences, but there is a need for more robust typologies that identify clusters based on psychologically meaningful risk factors that can be targeted in treatment. AIMS: To use robust modelling techniques to identify latent profiles of people with convictions for sexual offences based on indicators of dynamic risk. METHOD: Adult male participants, who had been convicted for sexual offences and assessed for eligibility for the prison-based Core Sex Offender Treatment Programme delivered by His Majesty's Prison and Probation Service (UK), were randomly allocated to a test (n = 1577: 70.2%) or validation (n = 668: 29.8%) data-set. Exploratory factor analysis (EFA) was used to select measures of dynamic risk from psychological test data. EFA indicated four factors, from which six measures were selected for inclusion in latent profile analysis. RESULTS: Five latent profiles were identified in the test and validation data-sets. These were labelled low psychological impairment, impulsive, distorted thinker, rape preoccupied and child fantasist. Profiles varied in individual characteristics, offence histories, victim preferences and level of risk. CONCLUSIONS: Our findings should be used to guide assessment and intervention practices that are tailored to distinct psychological profiles consistent with principles of risk, need and responsivity.

Association of intellectual disability with violent and sexual crime and victimization: a population-based cohort study.

BACKGROUND: Intellectual disability (ID) is associated with violent and sexual offending and victimization, but the importance of neuropsychiatric comorbidity and severity of disability remains unclear. METHODS: In a register-based cohort study of people born in Sweden 1980-1991 (n = 1 232 564), we investigated associations of mild and moderate/severe ID with any, violent and sexual crimes, and with assault victimization, stratified by comorbid autism and attention deficit hyperactivity disorder (ADHD). We defined ID by attendance at a special school or registered diagnosis and obtained data on criminal convictions and injuries or deaths due to assaults from nationwide registers until end of 2013. RESULTS: Compared to people without ID, autism or ADHD, men and women with mild or moderate/severe ID and comorbid ADHD had elevated risks of violent crimes [range of hazard ratios (HRs) 4.4-10.4] and assault victimization (HRs 2.0-7.7). Women with mild ID without comorbidities or with comorbid autism also had elevated risks of violent crimes and victimization (HRs 1.8-4.6) compared to women without ID, autism or ADHD. The relative risks of sexual offending and victimization were elevated in men and women with ID without comorbidities (HRs 2.6-12.7). The highest risks for sexual offending in men (HRs 9.4-11.0) and for sexual assault victimization in women (HRs 11.0-17.1) related to ID and comorbid ADHD. CONCLUSIONS: The elevated risk of violent offending and assault victimization in people with ID is largely explained by comorbid ADHD, whereas ID is independently associated with sexual crimes and victimization, even though absolute risks are low.

Practitioner Reflections on Sex Offender Treatment in Remote Communities.

PURPOSE OF REVIEW: We offer reflections on practitioner service provision for sex offenders when working in remote communities. The social ecological model framework is used to capture the influence on practitioner working at an individual, relationship, community, and societal level. RECENT FINDINGS: The social construction and geographic conditions of sexual offending within remote communities present myriad challenges for professionals working in these isolative settings in which they are embedded. Challenges include being the sole expert in a community, unavoidable dual relationships, community anxieties, and restrictive guidelines and assessment measures. Despite the challenges presented to practitioners operating in remote communities, many opportunities are available for building local and international peer relationships, connecting with the community, individualized treatment for clients, and flexibility in the adaptation of best practice to fit the needs of remote communities while maintaining ethical integrity.

Hypothalamic volume in pedophilia with or without child sexual offense.

The hypothalamus regulates sexual behavior and is simultaneously associated with aggression and violence. Consequently, this brain region is relevant in research of pedophilia and child sexual offenses (CSO). The distinction between these two phenomena is of great importance and was the object of consideration of this study. We analyzed exclusively men, including 73 pedophilic offenders who committed CSO, an equal number of people with pedophilia but without such offenses, and 133 non-pedophilic, non-offending subjects who formed the control group. All data were collected in a multicenter in vivo study and analyzed using a semi-automated segmentation algorithm for 3-Tesla magnetic resonance images. Men with pedophilia who committed CSO on average had a 47 mm3 smaller hypothalamus per side than people without committed CSO. This effect was driven by both the group of non-offending people with pedophilia and the control group. By contrast, the exploratory comparison of pedophilic persons without CSO with the control group showed no significant difference. The present study demonstrates a deviant hypothalamic structure as a neurobiological correlate of CSO in pedophiles, but not in people with pedophilia who have not committed CSO. Thus, it strengthens the argument to distinguish between sexual offending and paraphilic sexual preferences.

Relations between peer influence, perceived costs versus benefits, and sexual offending among adolescents aware of sex offender registration risk.

A policy's general deterrent effect requires would-be offenders to be aware of the policy, yet many adolescents do not know they could be registered as sex offenders, and even adolescents who do know may still commit registerable sexual offenses. We tested whether peer influences shape the perceived costs/benefits of certain sexual offenses and, subsequently, registration policy's general deterrent potential in a sample of policy-aware adolescents. The more adolescents believed their peers approve of sexting of nude images, the more likely they were to have sexted. For forcible touching, having more positive peer expectations about sex and perceiving forcible touching as more prevalent among peers related to adolescents' likelihood of engaging in that behavior. Perceiving registration as a possible consequence was unrelated to sexual offending. Findings highlight the nuanced roles peers play in adolescent sexual decision-making and support emerging evidence that juvenile registration policy has limited general deterrent efficacy.

Serious Mental Illness and Sexual Offending in Forensic Psychiatric Patients.

The role of serious mental illness among those who sexually offend is not well understood. We investigated clinical and risk-related areas of difference between male forensic psychiatric patients with (n = 86) and without (n = 245) a sexual offense history, including the age at which indications of mental disorder and criminal offending first emerged, from a registry of Ontario patients adjudicated Not Criminally Responsible on account of Mental Disorder (NCRMD) from 1999-2012. We further explored motivations for offending among a subset of patients deemed NCRMD for a sexual offense specifically (n = 41). While no differences were found in the age onset of illness or offending across those with and without a sexual offending history, the former group was rated as having higher levels of historical/static risk for violence. Forensic patients with a sexual offense history were also more likely to offend against a stranger, and less likely to offend against a family member. Sexual index offenses were psychotically-motivated in the majority of cases, but with a meaningful proportion appearing to reflect criminogenic motivations, especially substance use and paraphilic interests. Results suggest greater similarity than difference among forensic patients with and without a sexual offense history, but also highlight an important divergence from the literature showing that victims of sexual offenses are frequently known to the individual committing them.

Differentiating Between Sexual Offending and Violent Non-sexual Offending in Men With Schizophrenia Spectrum Disorders Using Machine Learning.

Forensic psychiatric populations commonly contain a subset of persons with schizophrenia spectrum disorders (SSD) who have committed sex offenses. A comprehensive delineation of the features that distinguish persons with SSD who have committed sex offenses from persons with SSD who have committed violent non-sex offenses could be relevant to the development of differentiated risk assessment, risk management and treatment approaches. This analysis included the patient records of 296 men with SSD convicted of at least one sex and/or violent offense who were admitted to the Centre for Inpatient Forensic Therapy at the University Hospital of Psychiatry Zurich between 1982 and 2016. Using supervised machine learning, data on 461 variables retrospectively collected from the records were compared with respect to their relative importance in differentiating between men who had committed sex offenses and men who had committed violent non-sex offenses. The final machine learning model was able to differentiate between the two types of offenders with a balanced accuracy of 71.5% (95% CI = [60.7, 82.1]) and an AUC of .80 (95% CI = [.67, .93]). The main distinguishing features included sexual behaviours and interests, psychopathological symptoms and characteristics of the index offense. Results suggest that when assessing and treating persons with SSD who have committed sex offenses, it appears to be relevant to not only address the core symptoms of the disorder, but to also take into account general risk factors for sexual recidivism, such as atypical sexual interests and sexual preoccupation.

Latent Profile Analysis Predicting Recidivism Among Women Who Have Sexually Offended.

The few existing typology studies on women who have sexually offended (WWSO) have largely been limited by small sample sizes, have not included scale scores from risk assessments, or used recidivism within their typology (instead of using typologies to predict recidivism). In our sample of 241 WWSO, we conducted a latent profile analysis and observed four, distinct profiles: "low-risk WWSO," characterized by fewer criminal history incidents and lower risk-assessment scores; "problem-endorsing WWSO," with higher probability of endorsing various life problems such as educational/employment and emotional/personal issues; "antisocial WWSO" with more criminal history incidents, alcohol/drug problems, and higher scores on psychopathy; and "combined WWSO" with characteristics of both the problem-endorsing and antisocial profiles. This last profile showed elevations in general and/or violent recidivism risk, but relatively low recidivism. There were no cases of sexual recidivism in our sample following an average 30-month follow-up period. Membership in the antisocial profile predicted general and/or violent recidivism and suggests that WWSO typologies may be useful in predicting non-sexual recidivism for this population.

A Multi-Perspective Qualitative Study About Working With Autistic Individuals in Prison-Based Interventions to Address Sexual Offending.

Research suggests that sexual offending is one of the more common forms of offending behaviour committed by autistic individuals. Despite this, very little research has investigated approaches to rehabilitation for autistic individuals who have sexually offended. The small body of literature that does exist suggests that interventions to address sexual offending may not be sufficiently adapted for this group. In this paper we present an exploratory qualitative study that (i) explores how prison-based interventions to address sexual offending are experienced by autistic individuals with sexual offense convictions and the staff who work with them, and (ii) identifies and explores the features of prison-based sexual offending interventions that may be challenging or beneficial for autistic individuals, from the perspective of those involved in treatment. Semi-structured interviews were conducted with 12 autistic men serving prison sentences for sexual convictions, and 13 members of prison staff. A multi-perspective phenomenologically-informed thematic (MPT) analysis identified three themes of 'Feeling overwhelmed', 'Out of the comfort zone', and '(Dis)connected to others'. These themes highlight some of the key issues relating to the format and delivery of interventions, as well as the impact of the broader prison context on rehabilitation.