Pornography use and sexual aggression: the impact of frequency and type of pornography use on recidivism among sexual offenders

How online data informs forensic mental health evaluations of sexual behavior: An overview

The Internet plays a pervasive role in modern life including the expression of human sexuality and sexual offending. A range of online sexual activities may be of interest in forensic mental health evaluations (FMHE), including those which are clearly illegal or those which are legal but functionally problematic. Online sexual offenses will clearly prompt forensic evaluators to consider the role of the Internet in these offending behaviors. The Internet may also be relevant in forensic evaluations of contact sexual offending including informing on history of mixed or cross-over offending, and Internet-facilitated contact offenses. A review of Internet-data may span several online domains, many of which provide the user with substantial anonymity and would likely not be available to the evaluator unless provided through the process of discovery. Early guidelines for the review of Internet-data in FMHEs have been proposed and support the Internet as a useful source of collateral data in the conduct of forensic evaluations of sexual behavior.

Psychometric Evaluation of Initial Domains on the Comprehensive Assessment of Pornography Use Tool

Research on pornography use and sexual coercion has provided inconsistent results. One explanation for this is the lack of a valid, reliable, and comprehensive measure of pornography use. This study seeks to address this need by developing a comprehensive pornography use instrument consisting of four domains identified in research: type of pornography used, sexual scripts, habits, and compulsivity. A sample of 324 college men was used. Results of the study yielded factor structures for these domains and evidence of reliability and validity. Findings present the initial development of a pornography use instrument that could improve research in this area and aid practitioners in treatment and supervision decisions.

Examining the Roles of Prior Victimization, Perpetrator Identity and the Correlates of Female Rape Myth Acceptance Among Indian Females

This research attempts to address a widely under-explained phenomenon of female rape myth acceptance (RMA) among the female population. A total number of 500 literate women from India with a mean age of 28.89 years were selected to examine the different determinants of their RMA. The research explored the important correlates of RMA among women, where the stepwise regression model revealed the significant impact of sexual desires, rejection sensitivity, loneliness, and neuroticism/emotional stability on their RMA. This further implied that women high on these four constructs run a 17.7% chance of endorsing female rape myths. The model eliminated the construct of online pornography usage, owing to its non-significant impact on RMA. Further, it was revealed that the history of prior victimization had a significant effect on the rape myths endorsed by the women. The study also reflected on the identity of the perpetrators of the women with a prior victimization history, where 55.43% reported it was perpetrated by a "known" person in their last experienced assault (and 44.57% "stranger" perpetrator). Whereas most women were victimized by "known" perpetrators, there was no significant difference in the sample's RMA, between the perpetrator identity groups (known and stranger perpetrators). The research concretely adds novel knowledge on identifying and predicting the female rape supportive attitudes among females.

The Role of Sexual Scripts in the Relationship Between Pornography Use and Sexual Coercion

Decades of research have examined the association between pornography use and sexual coercion, with the most significant relationships found between more deviant genres of pornography use and sexual violence. However, researchers have yet to provide a comparable body of research examining the theoretical mechanism of this association. One theory that has shown promise in explaining the association between certain variables of pornography use and sexual coercion is the sexual script theory. In this theory, scripts can best be understood as a mechanism through which society defines and disseminates what is acceptable, desirable, and pleasurable sexual conduct. Studies examining the application of the sexual script theory to the association between pornography use and sexual coercion have found that pornography use has a significant indirect effect on sexual coercion and correlates of sexual coercion through sexual scripts. The current study sought to extend this line of inquiry by examining the relationship between pornography use, sexual scripts, and sexual coercion. A structural equation model examining direct and indirect effects of sexual scripts and pornography use on sexually coercive behaviors was run using a sample of 390 college-aged males. Results of the study indicated there were significant direct and indirect effects in the model. Specifically, pornography use, while not directly related to sexually coercive behaviors, had a significant indirect effect on sexual coercion through sexual scripts. These results further support the use of the sexual scripts theory to help explain the relationship between pornography use and sexual coercion.

The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder

OBJECTIVES

The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD.

METHODS

An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews.

RESULTS

Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD.

CONCLUSIONS

An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.

Current Perspectives on Pornography Use by Individuals Convicted of a Sexual Offense

PURPOSE OF REVIEW

This review examines the literature on the impact of pornography use by individuals convicted of sexual offenses; specifically, it highlights relevant research regarding the effect pornography use has on sexual offense recidivism and explores the implications for treatment and supervision.

RECENT FINDINGS

The current literature suggests that the use of pornography, by itself, does not consistently increase risk for sexual recidivism. Research suggests that pornography use may increase risk for sexual recidivism among adult males who have been assessed as high-risk, while the same cannot be said for low-risk adult males. Pornography may reinforce attitudes supportive of sexual aggression, such as hostility and sexual preoccupation, both variables that have been shown to relate to further acts of sexual offending. Pornography use is more predictive of risk when matched to the type of offense. The extent to which pornography impacts the conceptualization of risk (and therefore treatment and supervision plans) depends on several factors such as the type of pornographic material viewed, the congruence of that material with the individual's offending history, and the expectations regarding the use of pornography within the treatment/supervision context.

Pornography Use, Offense-Supportive Cognitions, Atypical Sexual Interests, and Sexual Offending against Children

The effects of pornography are hotly debated in the scientific literature, especially its potentially negative influence on sexual offending. While studies do not support direct effects of pornography use on sexual offending, pornography is hypothesized to have a catalytic effect among men who are predisposed to sexually offend due to the presence of other risk factors. Using a sample of 241 men varying in sexual offending history, this study examined the associations of different types of pornography consumption, offense-supportive cognitions, and atypical sexual interests on sexual offending against boys or girls. Bivariate analyses support the idea that people seek pornography that matches their sexual interests. Multivariate analyses revealed that the only type of pornography associated with contact sexual offending against boys or girls was child pornography, as it had incremental validity predicting number of victims beyond offense-supportive cognitions and atypical sexual interests. Moderation analyses suggested that, as hypothesized, child pornography consumption amplifies the effect of sexual interests for boys on sexual offending against boy victims. However, that moderation effect was not found for sexual offending against girls. Clinical and research implications are discussed, focusing on the importance of including measures of pornography consumption within forensic assessment and management protocols.

Who Seeks Aggression in Pornography? Findings from Interviews with Viewers

Despite the recent proliferation of research on aggression in pornography, we still know relatively little about the preferences and perceptions of viewers themselves. In particular, very little research has examined how women who watch pornography feel when encountering aggression toward women. To explore this question, we conducted interviews with 122 regular pornography viewers (61 women, 60 men, and 1 gender-diverse). Quantitative and qualitative analyses of the data show that the majority of both men and women reported that they did not enjoy aggressive content. However, in contrast to common conceptions among most scholars and pundits, it was women, not men, who were more likely to report being aroused by aggression, mainly consensual aggression toward women, which was perceived as pleasurable. Women were also more likely to report actively seeking for aggression and wanting to see more aggression in mainstream pornography. These findings challenge long-held radical feminist views regarding the preferences of both women and men and offer new insights on the relationship between gender and sexual fantasies.

Self-Perceived Problematic Use of Online Pornography Is Linked to Clinically Relevant Levels of Psychological Distress and Psychopathological Symptoms

Online pornography is a widespread Internet application. As with other Internet applications, in some cases its use can become problematic. First indications point to a link between problematic use of online pornography and psychological distress and general functional impairment. However, to date, there are no standardized criteria for assessing problematic use of online pornography. In this study, we used the Online Pornography Disorder Questionnaire (OPDQ)-an instrument which adapted the official criteria for Internet Gaming Disorder to online pornography-to measure problematic use and investigated to what extent consumers with a self-perceived problematic use of online pornography differed from casual users with regard to their psychological distress. An online sample of German adult visitors to a popular casual dating site completed the OPDQ, the Brief Symptom Inventory (BSI), and provided information on their online pornography use (n = 1539; 72.6% male; 31.43 ± 11.96 years). T-scores for the BSI were calculated and independent t-tests were conducted to compare casual users with consumers with a self-perceived problematic use of online pornography. Of the users, 5.9% fulfilled the criteria for problematic use. This group consumed online pornography for longer amounts of time and showed higher levels of psychological distress (Hedges' g from 0.75 to 1.21). The T-scores of users with self-perceived problematic online pornography use reached clinically relevant levels on all subscales. Overall, the results of the study indicate that self-perceived problematic use of online pornography seems to be linked to severe psychological distress that may warrant clinical attention.

Prioritizing Indecent Image Offenders: A Systematic Review and Economic Approach to Understand the Benefits of Evidence-Based Policing Strategies

In 2013, there were an estimated 50,000 individuals involved in downloading and sharing indecent images of children (IIOC) in the United Kingdom (UK). This poses challenges for limited police resources. We argue that police officers can make most effective use of limited resources by prioritizing those offenders who pose the greatest risk of contact offending, by nature of demonstrable pedophilia, hebephilia or dual offending status and thus, those at highest risk must be dealt with first. What is currently lacking is a clear idea of the potential scale of the problem in socio-economic terms and why, therefore, it is so important that evidence-based approaches to offender detection and investigation continue to be a top priority for funders and policy makers. A systematic literature review was undertaken to address two related questions. First, what is the scale of the problem in the UK, in terms of the number of pedophilic and hebephilic individuals who pose a risk of contact offending against a child? Second, what is the potential socio-economic burden generated by the national IIOC suspect pool if left unattended to by targeted police action? Applying population estimates of pedophilia and hebephilia to the male population (16–89 years), we estimate there are between 2,365–5,991 males with paedophila and 12,218–30,952 males with hebephilia who are likely contact offenders. Applying average prevalence and incidence based costing methods to a conservative estimate of one victim per offender, the combined socio-economic burden from these persons could amount to £236-£597 million (incident costs) increasing to £2.9-£7.3 billion (lifetime costs; £3.3-£8.3 billion including QALY measures). Applying the same costs to CEOP (2013) estimate of 50,000 IIOC offenders we estimate that between 6,000 and 27,500 dual offenders could have already committed past contact offenses, contributing an economic burden of between £97–£445 million (incident costs) increasing to £1.2–£5.4 billion (lifetime costs; £1.4–£6.2 billion including QALY measures). Future contact offenses could contribute a further burden of £16–£18.6 million (incident costs) increasing to £198–£227 million (lifetime costs; £226–£260 million including QALY measures). Drawing upon these findings, we argue for the benefits of a research-informed prioritization approach to target IIOC offenders.

Crossing the Threshold From Porn Use to Porn Problem: Frequency and Modality of Porn Use as Predictors of Sexually Coercive Behaviors

According to recent statistics, as many as one in five female college students are victims of sexual assault during their college career. To combat what has been called the "Campus Rape Crisis," researchers have attempted to understand what variables are associated with sexually coercive behaviors in college males. Although investigators have found support for the relationship between pornography consumption and sexually coercive behavior, researchers typically operationalize pornography use in terms of frequency of use. Furthermore, frequency of use has been assessed vaguely and inconsistently. The current study offered a more concrete assessment of frequency of use and an additional variable not yet included for pornography use: number of modalities. Beyond examining the relationship between pornography use and sexual coercion likelihood, the current study was the first to use pornography variables in a threshold analysis to test whether there is a cut point that is predictive of sexual coercion likelihood. Analyses were conducted with a sample of 463 college males. Results indicated that both pornography use variables were significantly related to a higher likelihood of sexually coercive behaviors. When both frequency of use and number of modalities were included in the model, modalities were significant and frequency was not. In addition, significant thresholds for both pornography variables that predicted sexual coercion likelihood were identified. These results imply that factors other than frequency of use, such as number of modalities, may be more important for the prediction of sexual coercive behaviors. Furthermore, threshold analyses revealed the most significant increase in risk occurred between one modality and two, indicating that it is not pornography use in general that is related to sexual coercion likelihood, but rather, specific aspects of pornography use.

Do Varying Levels of Exposure to Pornography and Violence Have an Effect on Non-Conscious Emotion in Men?

As we are often inundated with images of violence and pornography in modern times with the aid of mobile devices and unrestricted online access and content, the non-conscious effect of such exposure is an area of concern. To date, many clinicians and researchers in behavioral sciences rely on conscious responses from their clients to determine affective content. In doing so, they overlook the effect the non-conscious has on an individual's emotions. The present study aimed to examine variations in conscious and non-conscious responses to emotion-inducing images following varying amounts of exposure to violent and pornographic images. Eighteen participants who self-reported as being low pornography users were presented with emotion-inducing images after no exposure (Session 1), after one round of exposure to 50 pornographic and 50 violent images (Session 2) and after a further nine rounds of exposure to 50 pornographic and 50 violent images (Session 3). Sessions were temporally separated by at least 2 days while startle reflex modulation (SRM) and scalp-recorded event-related potentials (ERPs) were used to determine non-conscious emotion-related responses to pre-evaluated emotion pictures. Explicit valence and arousal ratings were assessed for each of those emotion pictures to determine conscious emotion effects potentially changing as a function of increasing controlled exposure to pornographic and violent visual material. Conscious explicit ratings and SRM amplitudes revealed no significant difference between the sessions. However, frontal ERP analysis revealed significant changes between processing of "violent" and "unpleasant" images at later ERP time windows, further supporting the growing body of research which shows that relying on self-report data does not result in a full understanding of emotional responses.

Dependencia emocional y adicción al sexo en una comunidad LGBT y heterosexuales

Resumen (analítico): La investigación desarrollada de diseño descriptivo correlacional simple, tuvo como objetivo general relacionar la dependencia emocional y la adicción al sexo en una muestra de 37 heterosexuales y 15 participantes una comunidad LGBT de la ciudad de Trujillo, tuvo como objetivo evidenciar la relación entre la dependencia emocional y la adicción al sexo, por lo cual se utilizó el Cuestionario de dependencia emocional y el Instrumento de medición de adicción al sexo. Los resultados obtenidos evidencian que existe diferencias estadísticamente significativas según identidad sexual en la variable adicción al sexo con puntuaciones más altas en los participantes de la comunidad LGBT, asimismo en la población heterosexual la adicción al sexo y fetichismo reporta una relación directa estadísticamente significativa con la dependencia emocional, además en la comunidad LGBT se reporta una relación directa estadísticamente significativa con la dependencia emocional y la dimensión ansiedad de separación, asimismo entre fantasías sexuales y expresión limite alcanza una relación directa estadísticamente significativa.

Pornography Use by Sex Offenders at the Time of the Index Offense: Characterization and Predictors

The purpose of this study was to characterize and predict sex offenders' pornography consumption at the time of the index offense. Participants were 146 male sex offenders incarcerated in a Portuguese prison establishment. A semi-structured interview and the Wilson Sex Fantasy Questionnaire were administered. While for some individuals pornography did not appear to play a role in their offenses, there were others whose prolonged use led to more sex fantasies and urges to enact the visualized contents. As pornography does not have the same effects on all people, management officials should bear this in mind when tailoring specific treatment programs.

Male-Centric and Female-Centric Pornography Consumption: Relationship With Sex Life and Attitudes in Young Adults

Pornography availability has increased in recent years, and while there is plenty of speculation about its effects, empirical investigation about how porn influences our lives has yielded mixed results. Additionally, few studies have addressed the effects of specific pornography characteristics. Past research has shown that male-centric pornography can be related to negative outcomes, while female-centric pornography is related to more positive outcomes, particularly in women. The present survey study examined the relationship between pornography characteristics (male- and female-centric) and the self-reported attitudes and sexual experiences of men and women. Participants in the full sample were 195 men and 310 women who completed an online questionnaire. Although effect sizes were small, women who reported viewing pornography with more female-centric features also reported more positive effects of pornography on sex life and perceptions of the other gender. While men were more likely than women to report negative effects relating to pornography use on these same measures, there were very few reported negative effects of pornography overall. These findings demonstrate a small association between the use of female-centric pornography and more positive outcomes, particularly for women.

Risk Factors for Sexual Offending in Men Working With Children: A Community-Based Survey

Identifying risk factors for sexual abuse in men who work with children and who have already abused a child could lead to more appropriate screening and prevention strategies and is thus of major scientific and societal relevance. A total of 8649 German men from the community were assessed in an extensive anonymous and confidential online survey. Of those, 37 (0.4 %) could be classified as child sexual abusers working with children, 90 (1.0 %) as child sexual abusers not working with children, and 816 (9.4 %) as men who work with children and who have not abused a child. We assessed the impact of working with children as an individual risk factor for self-reported child sexual abuse and compared personal factors, pedophilic sexual fantasies, deviant sexual behaviors, antisocial behaviors, and hypersexuality among the three groups. Most interestingly, working with children was significantly associated with a self-reported sexual offense against children; however, it explained only three percent of its variance. Child sexual abusers working with children admitted more antisocial and more sexually deviant behaviors than child sexual abusers not working with children and than men working with children who have not abused a child. Our findings support some of the suggestions made by other researchers concerning factors that could be considered in applicants for child- or youth-serving institutions. However, it has to be pointed out that the scientific basis still seems premature.

Nudity as a Disinhibiting Cue in a Date Rape Analogue

Situational factors likely play a role in date rape. The sexual inhibition hypothesis suggests that men are typically sexually inhibited by violence and non-consent, but that inhibition can also be disrupted. We attempted to determine if female nudity reduces inhibition of sexual arousal to non-consensual cues in sexually non-aggressive men. In two studies, heterosexual men (aged 18-25) were presented with six 2-min audiotaped narratives depicting consensual sexual interactions, non-consensual sexual interactions (rape), and non-sexual interactions (neutral) involving a man and a woman. In the first study, 20 participants saw pictures depicting nude or clothed women while listening to the stories. In the second study, 20 other participants saw videos depicting nude or clothed women exercising, also while listening to the stories. Genital responses and subjective sexual arousal were measured. Results suggested that nudity may have a disinhibitory effect on sexual arousal to non-consensual cues, but only when presented in the form of moving images.

The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the treatment of adolescent sexual offenders with paraphilic disorders

The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment of adolescents with paraphilic disorders who are also sexual offenders or at-risk of sexual offending. Psychotherapeutic and psychosocial treatments were also reviewed. Adolescents with paraphilic disorders specifically present a different therapeutic challenge as compared to adults. In part, the challenge relates to adolescents being in various stages of puberty and development, which may limit the use of certain pharmacological agents due to their potential side effects. In addition, most of the published treatment programmes have used cognitive behavioural interventions, family therapies and psychoeducational interventions. Psychological treatment is predicated in adolescents on the notion that sexually deviant behaviour can be controlled by the offender, and that more adaptive behaviours can be learned. The main purposes of these guidelines are to improve the quality of care and to aid physicians in their clinical decisions. These guidelines brought together different expert views and involved an extensive literature research. Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for efficacy, safety, tolerability and feasibility. An algorithm is proposed for the treatment of paraphilic disorders in adolescent sexual offenders or those who are at risk.

Are Sex Drive and Hypersexuality Associated with Pedophilic Interest and Child Sexual Abuse in a Male Community Sample?

Although much is currently known about hypersexuality (in the form of excessive sexual behavior) among sexual offenders, the degree to which hypersexual behavior is linked to paraphilic and especially pedophilic interests in non-forensic populations has not been established.The purpose of the present study was to elucidate the associations between total sexual outlets(TSO) and other sex drive indicators, antisocial behavior, pedophilic interests, and sexual offending behavior in a large population-based community sample of males. The sample included 8,718 German men who participated in an online study. Hypersexual behavior as measured by self-reported TSO, self-reported sex drive, criminal history, and pedophilic interests were assessed. In moderated hierarchical logistic regression analyses self-reported contact sexual offending against children was linked to sexual fantasizing about children and anti sociality.There was no association between aggregated sex drive, and sexual abusive behaviour in the multivariate analyses. In contrast, self-reported child pornography consumption was associated with sex drive, sexual fantasies involving children, and anti sociality. Nevertheless, in convicted sexual offenders anti sociality, sexual preoccupation (like hypersexuality), and pedophilic interest are important predictors of sexual reoffending against prepubescent children.Therefore, in clinical practice an assessment of criminal history and pedophilic interests in hypersexual individuals and vice versa hypersexuality in antisocial or pedophilic men should be considered [corrected].

A Preliminary Model of Motivation for Pornography Consumption Among Men Participating in Zoophilic Virtual Environments

Although zoophilic blogs and websites attract the attention of zoophiles and others who are curious about this sexual activity, the motivations for consuming this type of pornography are not clear. This study aimed to confirm the factorial validity of the Pornography Consumption Inventory in an online sample of men with sexual interest in animals, and to construct an association model between motivations for pornography consumption and the following psychological variables: depression, sexual impulsiveness, and strength of sexual interest in animals. In this cross-sectional study, we located a website that catered to a network of people with a sexual interest in animals. Subsequently, a questionnaire was made available online to members of this network. Results support the 4-factor model of the Pornography Consumption Inventory. Depression and strength of sexual interest in animals were negatively and positively correlated with the sexual curiosity factor, respectively. Sexual impulsiveness was positively associated with the emotional avoidance, excitement seeking, and sexual pleasure factors. Depression and sexual impulsiveness were positively correlated. Psychological factors can differently motivate the consumption of pornography among men who visit zoophilic blogs and websites. With these preliminary data, we can identify some characteristics of this population.

Theorising sexual media and sexual violence in a forensic setting: men's talk about pornography and offending

This article reports findings from a discourse analytic study which critically explored the language of mental health nurses, and detained sexual offenders, in relation to pornography in one high-security hospital. It recognised previous empirical investigation, and pro-feminist theorising, into mediated representations and male sexual violence, but situated the research process in a forensic nursing context. Decision-making about access to, or restriction of, commercial sexual literature, as a component of therapeutic intervention and offender management, reveals tensions between service-user rights and treatment goals. The aim was to access nurse and patient talk in a specific culture. Semi-structured interviews with eighteen nursing staff, and nine patients, were used to co-construct accounts of pornography, sexual offending, and treatment. Analysis and data collection were undertaken concurrently. Interviews were audio-taped and transcribed. Data was coded to identify theoretical/conceptual themes and sub-themes representing discursive repertoires. Attention was given to how textual variation positioned respondents in relation to each other and the institution. Findings suggested collective male talk textured the environment, promoted gendered inequality, marginalised female nurses, and undermined rehabilitation. Shared discourse enabled male staff and patients to relate to each other as men, while maintaining distance through constructions of otherness. Discussion focuses on discriminatory discursive-practices, where men's talk about pornography and sexual violence embodied gendered knowledge/experience and contributed to a toxic culture. Consideration is given to ways of resisting institutional impediments and promoting positive therapeutic relations.

Female partners of men who use pornography: are honesty and mutual use associated with relationship satisfaction?

The authors discuss findings pertaining to male pornography use and female partners' relationship satisfaction and distress. The authors investigated honesty regarding pornography use and mutual consumption between partners, along with honesty and mutual use as predictors of satisfaction. Female participants (N = 340) in committed relationships completed the Pornography Distress Scale and Couples Satisfaction Index online. Participants reporting more honesty showed higher satisfaction and lower levels of distress, and participants disclosing mutual use showed lower levels of distress, although no differences were reported in satisfaction. Honesty regarding pornography use significantly predicted relationship dissatisfaction. Directions for future research and counseling implications are discussed.

How Much Child Sexual Abuse is "Below the Surface," and Can We Help Adults Identify it Early?

Child sexual abuse (CSA) occurs frequently in society to children aged between 2 and 17. It is significantly more common in girls than boys, with the peak age for CSA occurring when girls are aged 13-17. Many children experience multiple episodes of CSA, as well as having high rates of other victimizations (such as physical assaults). One of the problems for current research in CSA is different definitions of what this means, and no recent review has clearly differentiated more severe forms of CSA, and how commonly this is disclosed. In general we suggest there are four types of behavior that should be included as CSA, namely (1) non-contact, (2) genital touching, (3) attempted vaginal and anal penetrative acts, and (4) vaginal and anal penetrative acts. Evidence suggests that CSA involving types (2), (3), and (4) is more likely to have significant long-term outcomes, and thus can be considered has having higher-impact. From the research to date approximately 15% of girls aged 2-17 experience higher-impact CSA (with most studies suggesting that between 12 and 18% of girls experience higher-impact CSA). Approximately 6% of boys experience higher-impact CSA (with most studies suggesting that between 5 and 8% experience higher-impact CSA). The data also suggests that in over 95% of cases the CSA is never disclosed to authorities. Thus, CSA is frequent but often not identified, and occurs "below the surface" in the vast majority of higher-impact cases. Helping adults to understand "below the surface" CSA might help them to recognize it early, but there are very few indicators specific to CSA, making this a challenging goal to achieve. Nonetheless, given that CSA frequently occurs with other types of abuse, a training program that focuses on both CSA and other abuse may offer a method to allow both early recognition and prevention by adults in the general population.

Pornography, sex crime, and paraphilia

The current paper reviews research findings concerning the association of pornography with sexual violence and paraphilic interests. Little clarity concerning the causal impact of pornography on sexual aggression or child-oriented sexual behavior has been achieved in the scientific literature. Laboratory experimentation demonstrates that violent pornography may contribute to antiwoman aggression, but the artificiality and constraints of the experimental setting severely limit generalization of these findings to real-world situations, and observational studies in natural settings consistently find no association or an inverse association of pornography with sexual aggression. In addition, although pedophiles often use child pornography, the causal impact of child pornography on child sexual offending is not conclusive. The current analysis considers the confluence of predisposing factors and pornography use as issues requiring clinical judgment in the reduction of sexual aggression and management of paraphilic interest in children.

High-risk sexual offenders: an examination of sexual fantasy, sexual paraphilia, psychopathy, and offence characteristics

High-risk sexual offenders are a complex and heterogeneous group of offenders about whom researchers, clinicians, and law enforcement agencies still know relatively little. In response to the paucity of information that is specifically applicable to high-risk offenders, the present study investigated the potential influence of sexual fantasy, sexual paraphilia, and psychopathy on the offending behaviour of 139 of the highest risk sexual offenders in one province of Canada. The sample included 41 child molesters, 42 rapists, 18 rapist/molesters, 30 mixed offenders, and 6 "other" sexual offenders. Two offenders could not be categorized by type due to insufficient file information. Data analyses revealed significant differences between offender types for a number of criminal history variables including past sexual and nonsexual convictions, number of victims, weapon use, and age of offending onset. Further, there were significant differences between offender types for sexual fantasy themes, paraphilia diagnoses, and levels of psychopathy. For example, results revealed that offenders' sexual fantasies were significantly more likely to correspond with the specific type of index sexual offence that they had committed. Further, offenders scoring high in psychopathy were significantly more likely to have a sadistic paraphilia than offenders with either low or moderate psychopathy scores. Results from the current study provide a refined and informed understanding of sexual offending behaviour with important implications for future research, assessment, and treatment, as well as law enforcement practices when working with high-risk sexual offenders.

Child pornography and the internet

The dramatic increase in child pornography offenses over the past 10 years is directly related to the availability of such material on the Internet. Child pornography can be found on the Web, in newsgroups, and on peer-to-peer networks (the most common source at present). Offenders are a heterogeneous group, with different motivations and levels of risk. The possibility of crossover to a contact sexual offense exists, depending on the presence of other risk factors. Possession of child pornography without a history of contact offenses does not appear to increase the risk of future contact reoffending.

Patterns of federal Internet offenders: a pilot study

Internet-facilitated sexual offending is receiving increased forensic and clinical attention. Two issues confront this field. First, studies are equivocal as to whether (or not) the possession of Internet pornography can escalate to contact sexual offenses against a child, and second, federal judges have been questioning the length of sentences for users only of child pornography. The findings of this pilot study of 101 federal Internet offenders revealed over half of the men at the time of arrest were employed, educated, were in (or had been in) a relationship, had children, and did not have a prior criminal offense, suggesting a changing profile of a convicted sex offender. Forensic and psychiatric nurses who evaluate users of child pornography contraband need to be knowledgeable of Internet file transfer technology and the various types of contraband viewed specifically for the age of the preferred child, extreme acts to the child (e.g., bondage, S&M), and whether the user prefers images of adults with children or images of children only.

Watching pornographic pictures on the Internet: role of sexual arousal ratings and psychological-psychiatric symptoms for using Internet sex sites excessively

Excessive or addictive Internet use can be linked to different online activities, such as Internet gaming or cybersex. The usage of Internet pornography sites is one important facet of online sexual activity. The aim of the present work was to examine potential predictors of a tendency toward cybersex addiction in terms of subjective complaints in everyday life due to online sexual activities. We focused on the subjective evaluation of Internet pornographic material with respect to sexual arousal and emotional valence, as well as on psychological symptoms as potential predictors. We examined 89 heterosexual, male participants with an experimental task assessing subjective sexual arousal and emotional valence of Internet pornographic pictures. The Internet Addiction Test (IAT) and a modified version of the IAT for online sexual activities (IATsex), as well as several further questionnaires measuring psychological symptoms and facets of personality were also administered to the participants. Results indicate that self-reported problems in daily life linked to online sexual activities were predicted by subjective sexual arousal ratings of the pornographic material, global severity of psychological symptoms, and the number of sex applications used when being on Internet sex sites in daily life, while the time spent on Internet sex sites (minutes per day) did not significantly contribute to explanation of variance in IATsex score. Personality facets were not significantly correlated with the IATsex score. The study demonstrates the important role of subjective arousal and psychological symptoms as potential correlates of development or maintenance of excessive online sexual activity.

Sexual history disclosure polygraph examinations with cybercrime offences: a first Dutch explorative study

This article presents the first study on post-conviction polygraphy in the Netherlands. Importantly, it exclusively focuses on cybercrime offenders. The study is designed to systematically address the different child sexual behaviours exhibited by 25 participants who are in treatment for possessing child abuse images. The results indicate that post-conviction polygraphy can provide additional data to inform the development of theory in this area and contribute to the treatment, supervision, and more effective containment of offending behaviour and the reduction of future victimization.

Hypersexual disorder: a proposed diagnosis for DSM-V

Hypersexual Disorder is proposed as a new psychiatric disorder for consideration in the Sexual Disorders section for DSM-V. Historical precedents describing hypersexual behaviors as well as the antecedent representations and proposals for inclusion of such a condition in the previous DSM manuals are reviewed. Epidemiological as well as clinical evidence is presented suggesting that non-paraphilic "excesses" of sexual behavior (i.e., hypersexual behaviors and disorders) can be accompanied by both clinically significant personal distress and social and medical morbidity. The research literature describing comorbid Axis I and Axis II psychiatric disorders and a purported relationship between Axis I disorders and Hypersexual Disorder is discussed. Based on an extensive review of the literature, Hypersexual Disorder is conceptualized as primarily a nonparaphilic sexual desire disorder with an impulsivity component. Specific polythetic diagnostic criteria, as well as behavioral specifiers, are proposed, intended to integrate empirically based contributions from various putative pathophysiological perspectives, including dysregulation of sexual arousal and desire, sexual impulsivity, sexual addiction, and sexual compulsivity.

Pornography and attitudes supporting violence against women: revisiting the relationship in nonexperimental studies

A meta-analysis was conducted to determine whether nonexperimental studies revealed an association between men's pornography consumption and their attitudes supporting violence against women. The meta-analysis corrected problems with a previously published meta-analysis and added more recent findings. In contrast to the earlier meta-analysis, the current results showed an overall significant positive association between pornography use and attitudes supporting violence against women in nonexperimental studies. In addition, such attitudes were found to correlate significantly higher with the use of sexually violent pornography than with the use of nonviolent pornography, although the latter relationship was also found to be significant. The study resolves what appeared to be a troubling discordance in the literature on pornography and aggressive attitudes by showing that the conclusions from nonexperimental studies in the area are in fact fully consistent with those of their counterpart experimental studies. This finding has important implications for the overall literature on pornography and aggression.

The consumption of Internet child pornography and violent and sex offending

BACKGROUND

There is an ongoing debate on whether consumers of child pornography pose a risk for hands-on sex offenses. Up until now, there have been very few studies which have analyzed the association between the consumption of child pornography and the subsequent perpetration of hands-on sex offenses. The aim of this study was to examine the recidivism rates for hands-on and hands-off sex offenses in a sample of child pornography users using a 6 year follow-up design.

METHODS

The current study population consisted of 231 men, who were subsequently charged with consumption of illegal pornographic material after being detected by a special operation against Internet child pornography, conducted by the Swiss police in 2002. Criminal history, as well as recidivism, was assessed using the criminal records from 2008.

RESULTS

4.8% (n = 11) of the study sample had a prior conviction for a sexual and/or violent offense, 1% (n = 2) for a hands-on sex offense, involving child sexual abuse, 3.3% (n = 8) for a hands-off sex offense and one for a nonsexual violent offense. When applying a broad definition of recidivism, which included ongoing investigations, charges and convictions, 3% (n = 7) of the study sample recidivated with a violent and/or sex offense, 3.9% (n = 9) with a hands-off sex offense and 0.8% (n = 2) with a hands-on sex offense.

CONCLUSION

Consuming child pornography alone is not a risk factor for committing hands-on sex offenses - at least not for those subjects who had never committed a hands-on sex offense. The majority of the investigated consumers had no previous convictions for hands-on sex offenses. For those offenders, the prognosis for hands-on sex offenses, as well as for recidivism with child pornography, is favorable.

The importance of individual differences in pornography use: theoretical perspectives and implications for treating sexual offenders

This article reviews the extant literature regarding pornography's influence on antisocial attitudes, sexual arousal, and sexually aggressive behavior in both noncriminal and criminal samples. The article concludes that when examined in the context of multiple, interacting factors, the findings are highly consistent across experimental and nonexperimental studies and across differing populations in showing that pornography use can be a risk factor for sexually aggressive outcomes, principally for men who are high on other risk factors and who use pornography frequently. Finally, this article presents theoretical implications based on these findings, as well as some clinical implications relevant to the assessment and treatment of sexual offenders.

Pornography use as a risk marker for an aggressive pattern of behavior among sexually reactive children and adolescents

Sexually reactive children and adolescents (SRCAs), sometimes referred to as juvenile sexual offenders, may be more vulnerable and likely to experience damaging effects from pornography use because they are a high-risk group for a variety of aggressive behaviors. The purpose of this study is to describe the characteristics of those who use pornography and those who do not and to examine the associations between pornography use and aggressive behaviors among SRCAs. This secondary analysis used a descriptive, exploratory design to study 160 SRCAs. Chi-square and individual odds ratio analyses were employed to examine the associations between use of pornography and aggressive behaviors. SRCAs who used pornography were more likely to display aggressive behaviors than their nonusing cohort. Recommendations for nurses and mental health professionals encountering these children and adolescents are offered. J Am Psychiatr Nurses Assoc, 2009; 14(6), 442-453.

Long-term predictive validity of the risk matrix 2000: a comparison with the static-99 and the sex offender risk appraisal guide

The purpose of this study is to examine the predictive accuracy of the Risk Matrix 2000 on an independent sample of 351 sexual offenders, followed in the community for an average duration of 11.4 years (range 0-20 years, SD = 4.4 years). For comparison purposes, this study also examines the predictive accuracy of two other risk assessment instruments, specifically modified versions of the Static-99 and the Sex Offender Risk Appraisal Guide (SORAG). Results indicate that the Risk Matrix 2000 demonstrates convergent validity by correlating with the other risk assessment instruments. Moreover, the Risk Matrix 2000 is predictive of recidivism above chance levels, exhibiting medium to large effect sizes, although in general, the other two instruments, particularly the SORAG, are superior. Results also indicate differences in predictive validity when comparing 2-year, 5-year, and variable follow-up periods. Finally, a cumulative meta-analysis compares and integrates current findings with those obtained from the accumulation of previous studies, and new cumulative estimates are provided.