The treatment of youthful sexual offenders

Approximately 20% of all rapes and between 30% and 50% of child molestations are perpetrated by adolescent males. These statistics underscore the need for improved understanding of youthful sexual offending so that effective prevention measures may be utilized for those adolescents at risk of offending and effective treatments may be utilized with those adolescents who have already committed sexual offenses. In this article we review the current knowledge of the characteristics of youthful offenders, proposed etiologies of youthful offending, proposed typologies of, assessment protocols, and treatments for youthful offenders. Finally we discuss the need for further research in the area of youthful sex offending.     

Treatment of incest and pedophilic offenders: A pilot study

Twenty-nine incest and 22 heterosexual pedophilic offenders, under sentence, participated in a study of therapeutic outcome. Results showed the two groups were remarkably similar in their pretreatment level of psychosocial functioning. However, pedophiles had a significantly higher recidivism rate than incestuous men. Incest offenders, on the whole, changed most relative to single or married pedophiles. Pedophiles appeared more treatment resistant in dealing with their disturbed family relations, verbal hostility, irritability, and feelings of anger that, in part, underlie their sexual anomaly. At follow-up 36 months later, only 2 incest and 4 pedophilic men had recidivated. The discussion links these findings with earlier research and proposes a multimodal, group-oriented approach to treating sex offenders.     

Combining cognitive-behavioral therapy and pharmacotherapy in the treatment of pedophilic incest offenders

Treatment programs for incest offenders traditionally do not differentiate between pedophilic and nonpedophilic perpetrators. This oversight has failed to meet the specialized needs of pedophilic incest offenders, who differ from other incest as well as nonfamilial sex offenders in important ways. This paper describes a treatment intervention combining cognitive-behavioral therapy and pharmacotherapy for the specialized treatment needs of the pedophilic incest offender. A case report is presented to illustrate the use of combined treatment and to highlight indicators for this strategy.     

Intimacy, loneliness and sexual offenders

As part of a general theory of sexual offending, it is suggested that the failure to achieve intimacy in relations with adults produces emotional loneliness, which leads to an aggressive disposition, and a tendency to pursue sex with diverse partners in the hope of finding intimacy through sexuality or through less threatening partners. The development of intimacy and its benefits are described, as are the consequences that befall those who fail to achieve it. The history of sexual offenders illustrates why they fail to develop the attitudes and skills necessary to attain intimacy, and why this failure leads to sexual abuse. Finally, suggestions are made for the modification of programs for the assessment and treatment of sexual offenders, in order to include problems of intimacy and loneliness.     

Therapeutic change in adolescents sexual offenders

IntroductionA number of studies have shown that the treatment of adolescents who have engaged in sexually abusive behavior (AESABs) reduces their risk of sexual recidivism. However, few studies have examined the internal processes leading to these results.ObjectiveThe purpose of our research was to determine whether the treatment of AESABs (n = 43) influences the following factors related to sexual offending: deficient social skills, social isolation, ineffective coping strategies, and cognitive distortions. The impact of motivation for change and trauma symptoms on therapeutic progress was also examined.MethodPre/post-treatment analyses were completed.ResultsThe results of our pre/post-treatment analyses indicate significant changes in social isolation, coping strategies and cognitive distortions, and a significant reduction of trauma symptoms. Only social skills remained deficient. The data on motivation were not sufficient to establish whether motivation was linked to the progress of the subjects.DiscussionOur study highlights the importance of interventions targeting the acquisition of social skills in AESABs. Trauma is also an important factor to consider in the assessment of therapeutic progress, despite not being directly related to sexually abusive behaviour. The limits of the study highlight the importance of establishing an a priori program evaluation framework.     

Assessment of intellectually disabled sexual offenders: The current position

Treatment relies on appropriate assessment, guided by the ‘What Works’ approach. As such, the assessment of sexual offenders with intellectual disabilities has three primary purposes: addressing the risk, needs, and responsivity principles. The aim of this paper is to examine different assessment methods for this population. Existing risk assessment protocols are discussed, as well as specific dynamic risk assessment tools for sexual offenders with an intellectual disability. The paper also investigates use of existing, adapted and new psychological tests to assess treatment needs. Assessment of responsivity specific to this population is discussed in terms of intellectual and adaptive functioning, as well as comprehension. Suggestions are made for moving towards a comprehensive assessment strategy for this population.     

Predicting recidivism in adolescent sexual offenders

The prediction of risk of sexual recidivism in adult sex offenders has been grounded on research identifying reliable markers or risk factors, the so-called static and dynamic variables. For adolescents such reliable factors in the prediction of risk of sexual recidivism have so far not been unequivocally revealed. The aim of this systematic review was to screen the available research literature for such factors. The results indicated that regarding static or historical risk variables some can be found repeatedly to be linked to sexual recidivism in adolescents such as previous offending and multiple or stranger victims. Considering dynamic variables there is much less documented evidence in the research literature possibly as a result of lack of adequate psychometric tools. Overall, regarding risk of sexual recidivism there continues to be a great need for research.     

Prevalence of childhood and adolescent sexual abuse among sex offenders.

A simple nonstandardized questionnaire was developed and administered to 150 men convicted of various sexual offenses currently on probation or parole, living in the community, admitting their offenses and attending treatment. The hypothesis that men who engaged in sexual activity as adolescents with women would be at a higher risk of committing statutory rape-type sexual offenses was not substantiated.     

The collectors: Serial sexual offenders who preserve evidence of their crimes

In our prior research, we have encountered a distinct category of serial, sexual offenders who invest themselves in developing unique collections of artifacts that link them to their victims. This behavior is counter-intuitive as it represents irrefutable proof of their responsibility for multiple serious crimes. Nonetheless, the process of collecting these artifacts and the experience of maintaining them together, and in proximity to the offender, appear to represent a psychological experience that is central to the motivation for perpetrating the crimes. In this paper, we explore five modalities of recording used singularly or in combination by some of the most prolific and egregious sexual offenders prosecuted in the past 40 years. We use these case studies as a platform for exploring the psychological dynamics underlying this behavior, and to further alert law enforcement and forensic evaluators to the existence and significance of these unique forms of crime evidence.     

Gender differences in attitudes toward psychopathic sexual offenders

Although a considerable amount of research has been conducted examining the validity of psychopathy as a psychological construct, relatively few studies have focused on the effects of using this disorder in "real-world" settings to influence the attitudes of laypersons who are making life-altering decisions about offenders. This study attempted to replicate and extend earlier findings (Guy & Edens, 2003) suggesting that there are gender differences in the impact of expert testimony regarding psychopathy. A sample of 599 undergraduates reviewed case facts regarding a hypothetical Sexually Violent Predator trial in which the type of risk assessment testimony provided (clinical opinion, actuarial scale, psychopathy evaluation) and the age of the victims (adult versus child) were manipulated. Consistent with prior research, despite overall high rates of support for commitment in the adult victim condition, men were less prone than women to support civil commitment when the defendant was described as "a psychopath" (62.5 versus 86.5%). No such gender differences were noted in the clinical opinion or actuarial conditions. When the victims were identified as children, type of testimony had no impact because support for commitment was almost unilateral. Finally, ratings of how psychopathic the defendant was perceived to be (regardless of the testimony provided) were significantly associated with support for commitment across most conditions.     

Female sexual offenders: Five Italian case studies

Women who sexually abuse children are rare and case histories are scarce; even less is known about sexually abusive mothers. Due to the number of cases in which women sexually abuse minors, more in-depth studies on this subject are needed. This article examines the clinical files of five women who are currently serving time in Italian prisons for the sexual abuse of children. Records of the abuse cases and other records were utilized. The cases involved varying degrees of participation in the abuse by the mothers, and ranged from active sexual engagement to allowing others to abuse their children. Female perpetrators are likely to be experiencing problems in many areas of their life, including relationship dysfunction and psychological impairment. In three cases women revealed an antisocial personality disorder (ASPD), while in two cases a borderline personality disorder (BPD) was diagnosed according with DSM-IV criteria. Possible motivations for women who molest their children are explored and discussed. The current review shows that most female sex offenders fall into several suggested typology models. Therefore, the existing typologies used to classify female child sex offenders may be insufficient, and more comprehensive exploration of this offender population is needed.     

Three methods of developing MMPI taxonomies of sexual offenders

In a sample of 261 state hospital sexual offenders, Minnesota Multiphasic Personality Inventory (MMPI) profiles did not differ for offenders with adult victims versus offenders with child victims when offender age was controlled. MMPI 2-point analyses for the whole sample revealed five common codes that were independent of victim maturity. The sample was randomly divided in half and subjected to a cluster-analytic procedure which revealed two MMPI clusters. The first cluster was unelevated, with Scale 4 as its high point. The second cluster had multiple elevations, with Scales 8, 4, 2, and 7 as the highest scales. These clusters were replicated in a cluster analysis of the second half of the sample. However, when the sample was recombined, the two clusters were not externally validated basis on demographic and criminological variables. The results suggest that common psychological variables among sexual offenders may have more discriminative value than victim maturity in developing sexual offender taxonomies.     

Exhibitionists: sexual preferences for exposing

An assessment of the sexual preferences of exhibitionists and matched non-offenders, revealed greater arousal to scenes of exposing among the offenders but the actual degree of deviant preferences was not marked. Closer analyses of the individual response profiles, using various criteria for deviance, indicated that only a small proportion of exhibitionists displayed deviant arousal. We take these results, along with the findings from previous research, to deny the primacy of sexual motivation in exhibiting behavior. We also consider these results to indicate that there is little value in determining the sexual preferences of exhibitionists when planning treatment or estimating their risk to re-offend.     

Identification of adolescent sexual offenders: A rebt model

The adolescent sexual offender is perhaps one of the most misunderstood, misdiagnosed and maltreated clinical populations facing today's mental health practitioner. They are often the adolescents whom no one wishes to have in their family, school, neighborhood and, sometimes, office. Since this clinical population is relatively new and research has yet to establish consistent findings, attempts to categorize these adolescents are often subjective and inaccurate. This article outlines the problems in traditional diagnostic schemes for identifying adolescent sexual offenders, the myths surrounding the predisposing factors for becoming an adolescent sexual offender, the rationale and process based on Rational Emotive Behavior Therapy (Ellis, 1962) for identifying adolescent sexual offenders and how to discriminate this group from adolescents who engage in inappropriate sexual behavior. These two classifications are the two categories for identifying the adolescent sexual offenders for our program at Children's Service Center in Wilkes-Barre, Pennsylvania. The Children's Service Center adolescent sexual offender program currently has a zero recidivism rate for the past four years.     

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.     

MMPI taxonomies of child sexual and nonsexual offenders: a cross-validation and extension.

In a court clinic sample of 107 child sexual and nonsexual offenders, Minnesota Multiphasic Personality Inventory (MMPI) profiles did not differ as a function of arrests for sexual versus nonsexual offending. However, a three-group cluster-analytic solution was generated. Two of these clusters replicated those derived by Hall, Graham, and Shepherd (1991). The first cluster was unelevated, with Scales 4 and 9 as high points. The second cluster had MMPI Scales 4, 8, 2, and 7 as the highest scales. The third cluster was even more elevated than the other two clusters, characterized by extreme elevations on MMPI Scales F, 2, 4, 6, 7, and 8. The somewhat different results of this study versus previous studies (e.g., Hall et al., 1991) may be a function of the different populations sampled. The results provide evidence of within-group heterogeneity among sexual and nonsexual offenders that may be as important as between-group differences.