Verläufe bei sexuellen Tötungen

This article summarizes main results of studies on forensic psychiatric court reports on 166 men who had been persecuted between 1963 and 1991 for a sexual offence leading to the death of the victim. Comparing perpetrators with a single victim and those with multiple victims we found similar results as in two previous studies with smaller samples: Multiple sexual homicide perpetrators showed more often sexual sadism and other paraphilias, as well as antisocial, schizoid and sadistic personality disorders. Follow-up data from the federal criminal records could be obtained for 139 offenders. Ninety perpetrators had been released after a mean detention of 12.2 years, whereas the 49 offenders who were still in prison or forensic psychiatric hospitals had been detained for a mean period of 20.6 years. The non-released offenders showed more often paraphilias as well as antisocial and sadistic personality disorders than the released perpetrators. Paraphilias and antisocial personality traits are empirically well proven risk factors for criminal recidivism with sexual reoffences. In addition, the non-released sexual homicide perpetrators had higher scores in all applied risk assessment instruments (PCL-R, HCR-20, SVR-20, Static-99). Among the released offenders only 1.1% (n=1) reoffended with a completed homicide and 2.2% (n=2) with attempted homicide. The recidivism rates with sexual and other violent reoffences in this sample of sexual homicide perpetrators were similar to those in a large meta-analysis on recidivism in sexual offenders by Hanson and Morton-Bourgon (4). Since well established risk factors had apparently been “used-up” for the decisions about release or non-release, in the follow-up data about the released offenders only age at the sexual homicide and age at the time of release were found as risk factors for recidivism with any violent (sexual or non-sexual) reoffence, i.e. the younger the offender at the time of the homicide and the younger at the time of release, the more likely is the risk of violent reoffending.     

Sadistic personality disorder in sex offenders: relationship to antisocial personality disorder and sexual sadism.

To investigate the relationship of sadistic personality disorder (SPD), as defined in the appendix of DSM-III-R, to other personality disorders and to sexual sadism, 70 sex offenders (27 child molesters, 33 rapists, and 10 murderers) were assessed by the International Personality Disorder Examination. In 19 subjects (27.2%) from the total sample, SPD was diagnosed. The highest overlap appeared with borderline personality disorder (31.6%) and antisocial personality disorder (42.1%). However, in four cases SPD was the only personality disorder diagnosed. Factor analysis of the antisocial and sadistic criteria resulted in four major factors--one factor with high loadings on the sadistic criteria and the violent criteria of antisocial personality disorder, two factors with different forms of adult and juvenile aggression, and a fourth factor with high loadings on the antisocial criteria covering exploitative behavior. The results do not support SPD as a discrete disorder. Nevertheless, SPD may be seen as an important subdimension of antisocial personality disorder, distinct from more exploitative forms of antisocial behavior with less violence. Of those patients with SPD, 42.1% also had a DSM-III-R diagnosis of sexual sadism, which may be the most dangerous configuration.     

Psychopathie,antisoziale Persönlichkeitsstörung und Sexualdelinquenz

In today’s field of forensic psychiatry, psychopathy is seen as a subtype of antisocial personality disorder and includes manipulative behavior, egocentric and arrogant characteristics, high-risk behavior as well as a lack of empathy. Empirical data on the prevalence of psychopathy and antisocial personality disorder among offenders greatly vary depending on the study design and the composition of the sampled population. Offenders who committed both violent and sex offenses seem to have antisocial traits with a higher probability than offenders who committed only violent or only sex offenses. In the context of criminal responsibility and risk assessment for sex offenders, antisocial and psychopathic traits have a negative impact on the prediction of recidivism. Many study results, even though not all, additionally indicate that the combination of psychopathic traits and sexual deviance (i.?e. for example a paraphilic disorder such as sexual sadism) in sex offenders may be associated with a particularly high risk to reoffend. Due to the specific interpersonal characteristics (e.?g., dominant, provocative behavior, exaggerated self-esteem), therapeutic treatment of sex offenders with antisocial and psychopathic traits is often difficult. The regular supervision by the therapist is considered to be crucial to avoid harmful relationship dynamics or distorted perception of the therapist.     

Will They Do It Again? Predicting Sex-Offense Recidivism

This article reviews the empirical research on the prediction of reoffending among sexual offenders. The major predictors of sexual-offense recidivism are factors related to sexual deviance (e.g., deviant sexual preferences, previous sex crimes) and, to a lesser extent, criminal lifestyle (e.g., antisocial personality disorder, total number of prior offenses). The factors that predict general recidivism among sex offenders are the same as the factors that predict general recidivism among nonsexual criminals (e.g., juvenile delinquency, prior violent offenses). Given that there are special predictors of sexual recidivism, evaluators should consider separately the risk for sexual and nonsexual recidivism.     

The sexual responses of sexual sadists

On average, rapists show greater relative genital responses to rape stories than do nonrapists in the laboratory. It has been suggested that this robust group difference is explained by the fact that many rapists are sexually sadistic. It is not clear, however, what the critical cues underlying rapists' genital responses are, because rape stories used in previous research include a mix of sadistic cues of violence and victim injury as well as cues of victim resistance and nonconsent. The present study was conducted to identify the critical cues producing self-identified sadists' sexual responses, and thereby to test sexual sadism as an explanation of rapists' arousal pattern. The present study was also conducted to develop a new phallometric test for sexual sadism for research and clinical applications, given evidence of poor diagnostic reliability and validity. Eighteen self-identified male sadists, 22 men with some sadistic interests who did not meet all of our sadist criteria, and 23 nonsadists (all recruited from the community) were compared in their genital and subjective responses to a new set of stories that disentangle violence/injury cues from resistance/nonconsent cues. The three groups differed in both their genital and subjective responses: using indices of relative responding, sadists responded significantly more to cues of violence/injury than nonsadists and men with some sadistic interests. The group difference for cues of nonconsent was not significant. The results suggest that sexual sadism primarily involves arousal to violence/injury in a sexual context rather than resistance/nonconsent. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

The psychometric properties and utility of the Short Sadistic Impulse Scale (SSIS)

Sadistic personality disorder (SPD) has been underresearched and often misunderstood in forensic settings. Furthermore, personality disorders in general are the subject of much controversy in terms of their classification (i.e., whether they should be categorical or dimensional). The Sadistic Attitudes and Behaviors Scale (SABS; Davies & Hand, 2003; O'Meara, Davies, & Barnes-Holmes, 2004) is a recently developed scale for measuring sadistic inclinations. Derived from this is the Short Sadistic Impulse Scale (SSIS), which has proved to be a strong unidimensional measure of sadistic inclination. Through cumulative scaling, it was investigated whether the SSIS could measure sadism on a continuum of interest, thus providing a dimensional view of the construct. Further, the SSIS was administered along with a number of other measures related to sadism in order to assess the validity of the scale. Results showed that the SSIS has strong construct and discriminant validity and may be useful as a screening measure for sadistic impulse.     

Sexueller Sadismus und Sexualkriminalität

The categorization of sadism has turned out to be a versatile phenomenon, which covers a spectrum from harmless symbolic rituals to extremely violent acts where strong impulses or prolonged fantasies and rituals are involved. As the phenomenon is versatile its causes and appearances vary as well, although so-called BDSM (bondage & discipline & dominance & submission & sadism & masochism) practitioners and persons with severe sadism in a forensic context share only few common preferences. Based on own clinical experiences with sadism in forensic patients the authors support the proposed revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) especially the diagnostic disjuncture of sadism and masochism. Sexual sadism appears more frequently in forensic contexts in combination with sadistic, antisocial and borderline personality disorders but rarely with masochism. Masochism is otherwise reported to be more prevalent in patients of general psychiatry, however, combined with depression or dependent personality traits rather than with sadism. Moreover, the authors believe that if use of the diagnostic term sadism is perpetuated the establishment of the proposed new diagnosis “paraphilic coercive disorder” is unnecessary. The diagnostic term is also important for treatment and assessment. Despite the lack of reliable long-term studies with larger samples, it is reasonable to assume that medication, sometimes even anti-androgenic treatment, can be indicated in patients with severe sadism.     

Psychopathology of incarcerated sex offenders

The psychopathology and particularly the personality disorders of sex offenders were compared to general inmates of the Colorado Department of Corrections. Using the MCMI-III (Millon, 1994, 1997), sex offenders in general were found to have more varied types of personalities than general population inmates. Specifically, they were more schizoid, avoidant, depressive, dependent, self-defeating, and schizotypal. General population inmates had the more classically criminal personality characteristics of antisocial, narcissistic, and sadistic. Multivariate analysis showed the Dependent, Narcissistic, Antisocial, and Schizotypal scales to be the most differentiating. Sex offenders were also found to have more affective psychopathology such as anxiety, dysthymia, PTSD, and major depression. A similar trend was found when comparing child molesters to rapists. The child molesters were more neurotic, affective, and socially impaired than the rapists. Multivariate analysis showed the Dependent scale to be the most important in differentiating these two types of sex offenders.     

Comparing serial homicides to single homicides: A study of prevalence,offender, and offence characteristics in Sweden

Multiple and serial homicides constitute around 1.6% of all homicides but have unusually tragic outcomes. The aims of this study were to report the prevalence serial‐homicide offences and the characteristics of serial‐homicide offenders in a non‐North American context. The study included all convicted serial‐homicide offenders in Sweden from 1973 to 2012 (n = 25), as well as a population‐based control sample of single‐homicide offenders collected during 2007 and 2009 (n = 201). Similar to U.S. findings, approximately 1.6% of homicides could be attributed to serial‐homicide offenders. Serial offenders were more often diagnosed with personality disorders and autism‐spectrum disorders compared with single offenders; and serial offences more often involved victims who were female and unacquainted with the offender, as well as planning, sexual motives, and asphyxia as method of violence. One third of serial offences involved actions aimed at disguising the manner of death; such actions were considerably less common in single‐homicide offences. Few offenders displayed the traditional profile of a serial‐homicide offender; however, one third displayed sexual motives, a rate roughly 10 times higher than that in the single‐homicide group. The study concludes that serial‐homicide offenders should be subjected to forensic‐psychiatric examinations and that research involving cross‐contextual differences and similarities in serial‐homicide offenders is needed.     

Behavioural Profiles and Offender Characteristics across 111 Korean Sexual Assaults

Although the potential usefulness of the offence action–offender characteristic (A–C) relationships is widely accepted and operational ‘offender profiling’ units now exist around the world, few such relationships have been empirically established. To explore this, the offending action patterns within 111 sexual assault cases from South Korea were coded in terms of 16 distinctive, objective crime scene criteria and subjected to an agglomerative hierarchical cluster analysis. Background psychiatric and general characteristics, Personality Assessment Inventory (PAI) scale scores, and criminal histories were described for each cluster. The cluster analysis drew attention to six clusters or behavioural profiles within the sexual assaults. Cluster 1 included serial offenders who aggressively raped and robbed adult women, with some pseudo‐intimate sexual behaviour, in their homes. Two thirds of these offenders had histories of sexual assault. Cluster 2 included offenders who again targeted adults in their homes, but without pseudo‐intimate sexual behaviour. Cluster 3 included offenders who targeted adults outdoors at night. These offenders showed high antisocial personality PAI scores and psychiatric histories of sexual sadism. Cluster 4 included unarmed offenders who targeted adults in their homes without robbery. These offenders often had psychiatric histories of depression. Cluster 5 included offenders who targeted adults outdoors with a blitz‐style attack, and Cluster 6 included offenders who targeted minors outdoors, without weapons, using a confidence‐trick style of approach. Paedophilia and histories of psychiatric treatment were prominent amongst these offenders. The results indicate therefore some of the key empirical relationships that future research may develop as the basis for sexual assault ‘profiles’. Copyright © 2014 John Wiley & Sons, Ltd.     

Sexual sadism in sexual offenders: An elusive diagnosis

The present review considers the various conceptual and operational definitions of sexual sadism as this has been diagnosed among sexual offenders. The most persistent problem this review identified concerns the criteria of the fusion of sexual arousal with one or more of the various features of the offenders' actions or of the victims' responses. Not only do the definitions of sadism vary considerably in what it is that is thought to provoke sexual arousal, the operationalization of these definitions also varies. Furthermore, none of the operational definitions appears to satisfactorily or reliably measure sadism. In face of these discouraging observations we recommend abandoning the present diagnostic criteria and shifting to a dimensional approach to defining sadism.     

Zur Häufigkeit der Schuldfähigkeitsbegutachtung von Sexualstraftätern im Erkenntnisverfahren

This study investigated how often and depending on which factors sexual offenders are examined by mental health experts regarding their criminal responsibility. Out of a total of 306 legal charges against sex offenders accused of child sexual abuse (CSA: n?=?145), rape or sexual assault (n?=?89), exhibitionism (n?=?39), sexual abuse of adolescents, mentally defective, physically helpless or warded persons (n?=?18) that were admitted by a criminal court in 2001 in the German federal state of Schleswig-Holstein, 209 (95.6 %) were analyzed regarding the following questions: how often was the accused examined by a mental health professional regarding mental responsibility? Was the chance of being examined systematically related to certain factors (e.g., personality of the accused)? Expert advice regarding the mental responsibility of the accused was obtained by the court in only 34 cases (11.7 %). No systematic relationships of personal variables as well as the modus operandi and the chance of commissioning a mental health expert were found. The main reason for assigning a forensic expert opinion was the vague impression of a psychic disorder. Re-offending increased the rate of a mental health examination only in CSA (34.6 % of re-offenders were examined compared to 9.2 % of first-time offenders), but not in rape or sexual assault. Also age does not predict the commissioning of an expert opinion. Only one fifth of all accused below the age of 21 were investigated by a mental health professional. Results are discussed in terms of legal background, consequences for risk assessment and relapse prevention.     

The role of gender in claiming partial or complete homicide-related amnesia

The current study examined offence and offender characteristics in female and male offenders claiming no, partial or complete homicide-related amnesia. Pre-trial file information consisting of forensic examination reports and crime reports of all female (n = 79) and male (n = 577) offenders subject to forensic psychiatric examination in 1995–2004 and convicted of homicide were retrospectively analysed. The Psychopathy Check List Revised (PCL-R) was used for scoring psychopathy. Claiming homicide-related amnesia was significantly more frequent in female (60.7%) than male (42.1%) offenders. Findings indicate that in males the use of sharp instrument, intoxication, staying at the scene and feeling regret for the killing accompany claims of crime-related amnesia. In females, personality disorder and criminal history were significantly more frequent in offenders claiming crime-related amnesia. Analysis of intelligence, psychopathology or psychopathy indicated no significant relationship with claims of amnesia in either gender groups.     

Offender-Victim Relationships in Criminal Homicide Followed by Offender's Suicide,North Carolina, 1972–1977

ABSTRACT: An analysis of 90 cases of criminal homicide followed by suicide in North Carolina, 1972 to 1977. Homicidal victim-offender relationships were investigated in regard to age, sex, race and whether victim and offender were member of the same family, friends, acquaintances, or strangers. These results were compared with victim-offender relationships in 994 criminal homicide cases in North Carolina in which offenders did not commit suicide. Married white males over 30 years were much more involved in homicide-suicide than they were in homicide alone. In these homicide-suicide cases, the victim was usually the spouse. Except for marital status, characteristics of homicide offenders who killed themselves resembled those of suicide-only individuals much more than those of homicide-only offenders. In the homicide-suicide cases, the killing of someone in close relationship to the offender, often a wife, appeared to be part of the evolving process of suicide. This clearly has implications for intervention into marital strife and also for immediate treatment of homicide offenders who kill spouses and other family members.     

Delinquenzverläufe jugendlicher Sexualmörder

Sexual homicides by juvenile offenders are statistically rare and until now only a few studies explored this phenomenon. Studies on forensic psychiatric court reports and follow-up data from federal criminal records were used to investigate the delinquency of a sample of 19 juvenile sexual homicide perpetrators from their childhood up to the mean age of 45 years of age. More than the half (58%) committed or attempted sexual assaults prior to the sexual homicide. Seven from 13 who were released from custody (54%) committed sexual or violent reoffences. In a long-time analysis as much favourable as unfavourable developments were found. The results suggest that most of the persons who commit sexual homicides as juveniles already committed sexual offences before and have a high risk of sexual and violent reoffending even a long time after the homicide.     

The nature and dynamics of sexual homicide: An integrative review

The author reviews the definitions, epidemiology, evolving research, offender, and offense characteristics of sexual homicide, a form of intentional killing that occurs in less than 1% of homicides in the United States. Although the extant research is limited by very few comparative studies, repetitive use of small, nonrandom samples, retrospective data, no prospective studies, and the absence of any predictive statistical analyses, the yield over the past 100 years is impressive. The author advances a clinical typology of sexual murderers. The first group of compulsive sexual murderers leaves behind organized crime scenes and are usually diagnosed with sexual sadism and antisocial/narcissistic personality disorders. They are chronically emotionally detached, often primary psychopaths, are autonomically hyporeactive, and the majority experience no early trauma. The second group of catathymic sexual murderers leave behind disorganized crime scenes and are usually diagnosed with a mood disorder and various personality disorders that may include schizoid and avoidant traits. They are hungry for attachment, only moderately psychopathic, are autonomically hyperreactive, and have a history of physical and/or sexual trauma.     

The Severe Sexual Sadism Scale: cross-validation and scale properties

The Severe Sexual Sadism Scale (SSSS) is a screening device for the file-based assessment of forensically relevant sexual sadism. The SSSS consists of 11 dichotomous (yes/no) items that code behavioral indicators of severe sexual sadism within sexual offenses. Based on an Austrian sample of 105 sexual offenders, the present study replicated the 1-dimensional scale structure of the SSSS, as evidenced by confirmatory factor analysis. More specifically, the scale was commensurate with the 1-parameter logistic test model (Rasch model). Reliability was estimated to be good. Criterion validity for the clinical diagnosis of sexual sadism was good. With a cutoff value of 7 points, sensitivity and specificity were estimated at 56% and 90%, respectively.     

Empirical clusters of DSM-III personality disorders in violent offenders

Violent male offenders in a maximum security hospital and special units in prisons (N = 164) were interviewed with the Structured Clinical Interview for DSM-III Axis II disorders (SCID-II). Cluster analysis of the personality disorder criteria sets identified six diagnostic patterns: (1) antisocial-narcissistic; (2) paranoid-antisocial; (3) borderline-antisocial-passive-aggressive; (4) borderline; (5) compulsive-borderline; and (6) schizoid. Offenders in the first three groups had more extensive criminal careers, and most were identified as psychopaths by the Psychopathy Checklist-Revised (PCL-R). These Groups also had more frequent lifetime histories of substance abuse. A history of affective and anxiety disorders was more common in Groups 3 and 5, and almost two thirds of Group 2 had a history of psychotic disorder. The results emphasize that dangerous offenders are heterogeneous in personality pathology. They also suggest that personality disorder among violent offenders is more commonly represented by recurring patterns of covarying traits than by single categorical entities proposed in the DSM classification.