Complications, consent, and cognitions in sex between children and adults

The Relation Between Sexual Fantasies and Offense-Supportive Cognitions in People Convicted of Sexual Offenses: A Preliminary Study

The main objective of this research is to study the relationships of offense-supportive cognitions and sexual fantasies with sex crime. The research involved 48 men: 26 convicted of sexual offenses against minors and 22 convicted of sexual offenses against adults from different prisons in the Community of Madrid, Spain. We used the RAPE Scale and the Sex With Children Scale to evaluate offense-supportive cognitions and an ad hoc adaptation of the Multidimensional Developmental, Sex and Aggression Inventory to evaluate sexual fantasies with minors and sadomasochistic fantasies. The results show that both groups present similar offense-supportive cognitions, while each group had significantly more sexual fantasies related to their specific crime. Participants who had sexual fantasies about minors presented significantly more offense-supportive cognitions justifying child sexual abuse than those who did not present these fantasies, while participants with sadomasochistic fantasies did not present more offense-supportive cognitions about rape. After collecting this information, we ran four mediation models to assess potential relationships between fantasies, offense-supportive cognitions, and specific sexual crime. The mediation models showed that both sexual fantasies with minors and sadomasochistic fantasies had direct relationships with sex crimes. Upon further confirmation with studies with larger sample sizes, our findings support the importance of dealing with sexual fantasies in treatment of people convicted of sexual offenses and imply a need for differentiated treatment, since the content of sexual fantasies was different in each group.

An Analysis of the Effectiveness of a Psychotherapy Program for Individuals Convicted of Sexual Crimes in South Korean Prisons: A Two-Wave Latent Change Score Approach

Prisons in South Korea have implemented psychotherapy programs for people convicted of sexual offenses to reduce sexual crime recidivism post-release. This study evaluated the effectiveness of the treatment by analyzing data from 13,200 men convicted of sexual offenses released from 2015 to 2019. We estimated the latent change score (LCS) for rape myths acceptance (RMA) and child sexual assault supportive attitudes (CSA) utilizing the 2W-LCS model. We examined the relationship between the LCS and sexual crime recidivism. Additionally, we employed multigroup analysis to compare the results based on program completion status. The results showed that regardless of completion, the LCSs for both RMA and CSA were significant and negative, indicating a decrease in both levels of cognitive distortion after treatment. In addition, the absolute values of the LCSs for both RMA and CSA were larger in the fully-treated group than in the partially-treated group. The CSA LCSs exhibited a significant relationship with sexual crime recidivism only in the fully-treated group. Overall, the study supports the treatment's effectiveness and underscores the importance of treatment completion.

Sexual Grooming Behavior and Processes of Women Who Commit Sexual Offenses Against Children

Individuals who sexually offend often engage in manipulative and coercive behavior to begin, conceal, and continue the sexual abuse of children over time, referred to as grooming behavior. The large majority of research regarding grooming behavior derives exclusively from male sex offending samples, which is problematic because male and female sex offenders vary widely in their offending patterns, motivations, and behaviors. For the present study, we examined the nature of sexual grooming and processes exhibited by a sample of 50 women convicted of sexual offenses against a child. We were guided by Craven et al. model of sexual grooming, which focuses on self, environmental, and child grooming. To date, this is the only proposed model of sexual grooming that includes self-grooming as a step in the grooming process. Data included narrative interviews with women who were arrested, convicted, and assessed for risk and community notification purposes between 2014 and 2019. We also examined interviews with victims, witnesses, and other guardians. The findings from the current study indicated that women who sexually offend utilize a variety of self, environmental, and child grooming behaviors. Self-grooming was an intricate, complex, and layered process that continued throughout the duration of the offense. Details provided by the women in our sample suggested that environmental and child grooming occurred simultaneously rather than two distinct steps. A better understanding of grooming behaviors can assist in the detection of grooming behavior, development of appropriate responses to child victims, and inform future legislation and its implementation. Theoretical and policy implications are discussed.

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.

Empathy and Cognitive Distortions in Sex Offenders Participating in Community Based Treatment

This study examined the relationship between empathy as measured by the Empathy Index (EI) and the Cognitive Distortion Scale (CDS) among a sample (N = 151) of individuals who committed sexual offenses who were receiving community-based sex offender treatment in a large southern state. The extent to which the relationships by age was also considered. The findings indicated a weak but significant positive correlation between total empathy and each of the cognitive distortion scales, and a similar positive correlation between the instrumental aggression empathy subscale and the three cognitive distortion scales. Furthermore, these findings suggested that those with lower empathy were more likely to have cognitive distortions than those with higher empathy. Recommendations for future research and implications for treatment are provided.

Offense-Supportive Cognitions Expressed by Men Who Use Internet to Sexually Exploit Children: A Thematic Analysis

Although offense-supportive cognitions are related to the maintenance of contact sexual offending behavior, it is unknown whether this finding also applies to online sexual offending behavior. A few studies have examined the cognitions of men convicted for using child sexual exploitation material, but findings remain limited due to important methodological limitations. Furthermore, fewer studies have investigated the cognitions of men who use the internet to solicit sexual activities with children. The objective of this study was to examine the nature of the cognitions that support online sexual offending against children. The content of police interviews was analyzed using a thematic analysis to identify the cognitive themes present in the offense-related views expressed by 20 men who consumed child sexual exploitation material, 15 who sexually solicited children, and 18 who committed both types of online offenses. Results revealed eight cognitive themes that reflected four underlying themes related to interpersonal relationships, the sexualisation of children, perceptions of the self, and perceptions of the virtual environment. Findings indicate that while the cognitive themes of the three groups are similar, their specific content varies according to the types of offenses. Implications for future research are discussed.

Assessment of Recidivism Risk in Sex Offenders: A Pilot Study in Central Italy

Knowing the risk factors of recidivism in sex offenders is important in order to prepare effective preventative interventions and treatment in custody. In this regard, the following paper shows the results of a pilot study carried out in the prisons of central Italy in which 44 sex offenders participated. These participants were given the following tests: Historical Clinical Risk Management-20-version 3 (HCR20v3), Psychopathy Checklist-Revised (PCL-R) and Personal Inventory Dimensional (PID-5). The results show a high positivity in the factors of the sub-scales H (historical factors) and C (clinical factors) of HCR20v3; the average total score of the PCR-L is 16.47, with five subjects who are in the “high psychopathy” range (X ≥ 30); with regard to PID-5, the most positive domain is negative affectivity (56.10%).

Offence-Supportive Cognitions, Atypical Sexuality, Problematic Self-Regulation, and Perceived Anonymity Among Online and Contact Sexual Offenders Against Children

Cognitions that support sexual offending, atypical sexuality, and problems with self-regulation are important indicators of offending among men who engage in contact sexual offences against children (e.g., Hanson & Morton-Bourgon, 2005). While sexual interest in children-a major indicator of atypical sexuality-has been identified as a risk factor for online sexual offending against children (Seto & Eke, 2015), several other indicators, such as offence-supportive cognitions, sexual preoccupation, sexual coping, and perceived anonymity-a presumed risk factor for online sexual offending-have not yet been investigated among men who use the internet to solicit children or to consume child sexual exploitation material. This study investigated the associations between offence-supportive cognitions, atypical sexuality, self-regulation using sex, and perceived anonymity with sexual offending behaviors against children in a sample of 241 men convicted of various sexual and non-sexual offences. Results from logistic regressions show that offence-supportive cognitions, sexual interests in children, and sexual coping, but not sexual preoccupation and perceived anonymity, are associated with either or both online and contact sexual offending behaviors against children. Our results support the prior finding showing that men with online sexual offences are more paraphilic or sexually preoccupied then men with only contact offences against children. They also suggest that offence-supportive cognitions, atypical sexual interests, and sexual coping may be motivating factors, and therefore relevant risk factors, for online sexual offending against children.

A Billion Distorted Thoughts: An Exploratory Study of Criminogenic Cognitions Among Men Who Sexually Exploit Children Over the Internet

There is evidence that endorsing a higher level of offense-supportive cognitions is associated with contact sexual offending. Such an association assumes the construct of cognitions as unidimensional, thus ignoring the possibility that specific subtypes of cognitions exist and that certain may be criminogenic. To investigate this possibility, this study aimed at examining the associations between criminal behaviors and cognitive themes found in the discourse of men who engage in sexual offenses against children over the Internet. Through the discourse of a sample of 60 men with online child sexual exploitation material and solicitation offenses, a previous study identified eight cognitive themes: Uncontrollability, Nature of harm, Child as sexual being, Child as partner, Dangerous world, Entitlement, Virtual is not real, and Internet is uncontrollable. These themes were not investigated for their criminogenic nature. Thus, in this study, bivariate analyses were used to determine whether these cognitive themes were linked to three indicators of criminal behaviors: the extent of criminal charges, the diversity of offending behaviors, and the nature of contact with victims. Results suggest that, taken as a whole, online sexual offense-supportive cognitions may not be criminogenic. Moreover, only cognitive themes related to antisocial orientation and atypical sexuality were found linked with criminal behaviors, although associations found remain limited. Findings and associated implications are further discussed for research and clinical purposes.

Reprint of: Juvenile sexual offending in Ghana: Prevalence, risks and correlates

BACKGROUND

Sexual violence research in Africa is overwhelmingly focused on victims with little attention given to perpetrators. In the case of juveniles who perpetrate sexual violence the evidence is mainly from studies in Western industrialized societies. The consequence is that interventions for juveniles who commit sexual violence in Ghana and Africa lack evidential basis.

OBJECTIVES

This study investigates prevalence, correlates and risk factors for juvenile sexual offending.

PARTICIPANTS AND SETTING

The study utilised a sample of 264 male juveniles aged 12•18 in schools and young offender institutions in southern Ghana.

METHOD

Prevalence of the juvenile sexual offending was estimated based on self-report. Odds ratio (OR) was used to calculate the risk for the juveniles engaging in sexual violence. The predictive significance of variables within various domains was estimated using logistic regression models.

RESULTS

Results show that about a fifth (16.7 %) of the juveniles have committed a sexual offense. A deviant sexual tendency such as paying for sex constitutes an important risk marker for juvenile sexual offending (OR: 6.41, 95 % CI [3.28•12.54]). Risk factors for juvenile sexual offending are concentrated in the family domain with parental neglect (OR: 4.55, 95 % CI [2.46•9.44]), parental conflict (OR: 4.45, 95 % CI [2.35•8.44]) alcoholic parents (OR: 3.07, 95 % CI [1.66•5.69] parental abuse (OR: 2.90, 95 % CI [1.63•5.19]), and deprived family economic condition (OR: 2.64, 95 % CI [1.47•4.75]) emerging as statistically significant factors.

CONCLUSION

Prevalence estimates of juvenile sexual offending are influenced by types and number of questions with multiple questions eliciting more accurate estimates than a single item measure. Risk factors for juvenile sexual offending vary based on context. Interventions to reduce juvenile sexual violence must be informed by evidence from the social context.

Evaluating Change in Men Who Have Sexually Offended: Linkages to Risk Assessment and Management

PURPOSE OF REVIEW

We provide a review and synthesis of the sexual offense treatment change literature with implications for dynamic sexual violence risk assessment and management. An argument is presented for the need for a dynamic approach in research and practice, and that for change to be prognostic, such changes need to be risk relevant and to come from credible change agents.

RECENT FINDINGS

Extant research demonstrates that changes on psychologically meaningful dimensions of risk and need (e.g., sexual deviance; attitudes and cognitions; anger, aggression, and hostility) tend to be associated with reductions in sexual and other forms of recidivism; however, changes in domains less germane to risk and need tend not to be (e.g., empathy, mental health and well-being). Formalized dynamic sexual offense risk measures can be administered at multiple time points to reliably measure changes in sexual violence risk. Change information can then be used systematically to adjust risk appraisals. The extant literature supports the dynamic nature of sexual violence risk. Working toward the routine assessment of change with psychometrically sound measures, and integrating this information into risk management interventions, can not only improve lives and reduce sexual violence but is an ethical and human responsibility.

Juvenile sexual offending in Ghana: Prevalence, risks and correlates

BACKGROUND

Sexual violence research in Africa is overwhelmingly focused on victims with little attention given to perpetrators. In the case of juveniles who perpetrate sexual violence the evidence is mainly from studies in Western industrialized societies. The consequence is that interventions for juveniles who commit sexual violence in Ghana and Africa lack evidential basis.

OBJECTIVES

This study investigates prevalence, correlates and risk factors for juvenile sexual offending.

PARTICIPANTS AND SETTING

The study utilised a sample of 264 male juveniles aged 12-18 in schools and young offender institutions in southern Ghana.

METHOD

Prevalence of the juvenile sexual offending was estimated based on self-report. Odds ratio (OR) was used to calculate the risk for the juveniles engaging in sexual violence. The predictive significance of variables within various domains was estimated using logistic regression models.

RESULTS

Results show that about a fifth (16.7 %) of the juveniles have committed a sexual offense. A deviant sexual tendency such as paying for sex constitutes an important risk marker for juvenile sexual offending (OR: 6.41, 95 % CI [3.28-12.54]). Risk factors for juvenile sexual offending are concentrated in the family domain with parental neglect (OR: 4.55, 95 % CI [2.46-9.44]), parental conflict (OR: 4.45, 95 % CI [2.35-8.44]) alcoholic parents (OR: 3.07, 95 % CI [1.66-5.69] parental abuse (OR: 2.90, 95 % CI [1.63-5.19]), and deprived family economic condition (OR: 2.64, 95 % CI [1.47-4.75]) emerging as statistically significant factors.

CONCLUSION

Prevalence estimates of juvenile sexual offending are influenced by types and number of questions with multiple questions eliciting more accurate estimates than a single item measure. Risk factors for juvenile sexual offending vary based on context. Interventions to reduce juvenile sexual violence must be informed by evidence from the social context.

Psychological Assessments in Legal Contexts: Are Courts Keeping “Junk Science” Out of the Courtroom?

In this article, we report the results of a two-part investigation of psychological assessments by psychologists in legal contexts. The first part involves a systematic review of the 364 psychological assessment tools psychologists report having used in legal cases across 22 surveys of experienced forensic mental health practitioners, focusing on legal standards and scientific and psychometric theory. The second part is a legal analysis of admissibility challenges with regard to psychological assessments. Results from the first part reveal that, consistent with their roots in psychological science, nearly all of the assessment tools used by psychologists and offered as expert evidence in legal settings have been subjected to empirical testing (90%). However, we were able to clearly identify only about 67% as generally accepted in the field and only about 40% have generally favorable reviews of their psychometric and technical properties in authorities such as the Mental Measurements Yearbook. Furthermore, there is a weak relationship between general acceptance and favorability of tools’ psychometric properties. Results from the second part show that legal challenges to the admission of this evidence are infrequent: Legal challenges to the assessment evidence for any reason occurred in only 5.1% of cases in the sample (a little more than half of these involved challenges to validity). When challenges were raised, they succeeded only about a third of the time. Challenges to the most scientifically suspect tools are almost nonexistent. Attorneys rarely challenge psychological expert assessment evidence, and when they do, judges often fail to exercise the scrutiny required by law.

Attenuation of Deviant Sexual Fantasy across the Lifespan in United States Adult Males

Deviant sexual fantasy is identified as a risk factor for sexual offending, yet no study has examined deviant sexual fantasy across the lifespan in nonoffending adult males. To bridge this gap, this study examined the frequencies of normative and deviant sexual fantasies among 318 nonoffending adult males in the United States. Participants were recruited via Amazon Mechanical Turk™. Participants took two inventories that assessed demographics and types of sexual fantasies. Normality tests, means tests, Kruskal-Wallis 1-way analyses of variance (ANOVAs), binary logistic regressions, and odds ratio post hoc analyses were conducted. Deviant sexual fantasies progressively declined across all three age groups, while normative sexual fantasy did not. Results suggest that deviant sexual fantasy changes across the lifespan. Applicability of the findings to applied settings, such as sexually violent predator evaluations, is discussed. Limitations and future considerations are addressed.

Preventing Child Sexual Abuse: Screening for Hidden Child Molesters Seeking Jobs in Organizations That Care for Children

Approximately 10% of children and adolescents are sexually abused by adults caring for them outside the home. The current study tested the validity and reliability of a child protection screen to identify job applicants who pose a sexual risk to children. The screen uses three separate measures. In combination, they attempt to identify two types of sexually problematic job applicants: hidden abusers and people with cognitive distortions that encourage child sexual boundary violations by themselves or tolerate them by others. The high specificity (97.8% for males and 98.7% for females) favored the high number of job applicants and volunteers who have not crossed sexual boundaries with children. The study included over 19,000 participants, and the screen correctly identified 77% of the men and over 72% of the women who posed a sexual risk. The test-retest correlation was statistically significant at r(121) = .83, and the screening methodology is valid and reliable. By identifying most of the job applicants who are hiding their history of sexually abusing a child or hiding their belief that adult-child sex causes no harm from the organizations they are attempting to join, this new preemployment screen methodology can help child-centered organizations protect children and adolescents in their care.

Examining the questionnaire on attitudes consistent with sexual offending

BACKGROUND

The Questionnaire on Attitudes Consistent with Sexual Offending (QACSO) is an assessment developed by Lindsay, Whitefield, Carson, Broxholme and Steptoe (2004). The QACSO was designed to assess cognitive distortions relating to sexual offending in males with intellectual disabilities (ID). Cognitive distortions form part of the offence chain in sexual offending and as such require effective assessment and treatment.

METHOD

The QACSO manual and studies utilizing the QACSO were examined.

RESULTS

An overview of characteristics of the QACSO is outlined. The strengths and limitations of the measure are discussed, including validity and reliability of the measure and normative samples.

CONCLUSIONS

The QACSO is a valuable tool in assessing cognitive distortions in intellectual disability sexual offenders. Whilst there are some concerns about validity and reliability which it would be beneficial to address, overall the measure has utility in forensic practice and research, and is unique for being developed specifically for intellectual disability offenders.

Cognitive Distortions Among Sexual Offenders Against Women in Japan

Research in Western countries has indicated that the cognitive distortions of sexual offenders play an etiological and maintenance role in offending. The present study examines whether the cognitive distortions hypothesized by previous Western studies can be found in Japanese sexual offenders against women. This study used the questionnaire administered by probation officers in the special cognitive-behavioral treatment programs for sexual offenders, which have been implemented since 2006 in Japan. Participants in the offender group were 80 Japanese male probationers and parolees (more than 19 years old, M age = 34.6, SD = 8.8) convicted of rape (n = 39) or indecent assault (n = 41). All of them attended special treatment programs at probation offices. The non-offender comparison group consisted of 95 Japanese male probation officers and police officers (M age = 35.5, SD = 11.4). A factor analysis of the questionnaire responses extracted three factors: Blaming the Victim, Minimization, and Avoidance of Responsibility. The data analyses showed that sexual offenders scored significantly higher than non-offender participants on the three subscales. No significant differences were found among four sexual offender groups classified as rapists or indecent assaulters and with or without previous convictions for sexual offenses. In conclusion, the results of this study indicate that rapists and indecent assaulters placed on probation or parole in Japan hold cognitive distortions concerning sexual assaults against women than the control group of probation and police officers. The findings of this study also suggest that cognitive distortions exhibited by sexual offenders against women transcend cultural divides.

"It's My Responsibility, But…" A Qualitative Study of Perpetrators' Understanding of Child Sexual Abuse

The present study looked at child sexual abuse (CSA) from the perpetrator's perspective, focusing on precursors to, sustaining mechanisms, and inhibitors of CSA. Individuals serving sentences for sexual abuse of children under the age of 16 were interviewed (N = 8). A qualitative design using interpretative phenomenological analysis was employed. Negative childhood events such as poly-victimization, poor social skills, loneliness, and insecure sexual identity were reported as predisposing elements. Abuse was sustained due to a strong conviction of not being responsible for doing anything wrong. Respondents conveyed few salient inhibitors for the abuse, though not wanting to physically harm the child was often cited as important. Implications for the prevention of CSA in risk groups suggest the need to increase the understanding of children from a child's perspective, changing conceptions leading to disavowal of adult responsibility toward children, strengthening social competency, integration into a social context, and increasing knowledge about the harmful consequences of CSA.

What if the Child Appears to Enjoy It? Moral Attitudes Toward Adult-Child Sex Among Men With and Without Pedohebephilia

This study attempted to measure cognitions about adult-child sex by approaching the issue from a perspective of moral attitudes. We assessed ratings regarding direct and indirect harmfulness, nonconsent, exploitation, and differences in adults' and children's sexualities based on a description of adult-child sex without apparent child discomfort among an online sample of 120 pedohebephilic and 89 nonpedohebephilic German-speaking men. The results showed that only 7.5% among pedohebephilic men had equal or less permissive attitudes than the average control, while 4.5% of nonpedohebephilic men had equal or more permissive attitudes than the average pedohebephilic man. Both groups did not, however, differ in their appraisal that children may suffer indirect harm via stigmatization. The findings also indicate that the moral perception of adult-child sex shows little differentiation among German-speaking laypeople. We discuss the relevance of these findings for clinical practice and propose ideas for subsequent research.

Psychosocial Correlates of Attitudes Toward Male Sexual Violence in a Sample of Financial Crime, Property Crime, General Violent, and Homicide Offenders

Although those currently serving prison sentences for sexual violence can be identified and receive treatment, the number of prisoners with a history of sexual violence against female partners is unknown. Methods to identify prisoners with a proclivity for such violence and accurately assess the risk they pose before and after incarceration are therefore required. Here, we aimed to assess the level of sexually violent attitudes within dating relationships and to examine their associations with experiences of child abuse and neglect (CAN), psychopathic personality traits, prisonization, number of incarcerations, age, years of schooling, relationship status, and parenting among different types of offenders (financial crime, property crime, general violent, and homicide offenders). Data were collected among a large systematically selected sample of adult male inmates ( N = 1,123). We demonstrated that sexual violence-supportive attitudes appear to be a function of child sexual abuse and psychopathic personality traits, and may be developed through early socialization experiences as well as incarceration. Practical implications of current findings are discussed.

A Brief History of Psychological Theory, Research, and Treatment With Adult Male Sex Offenders

PURPOSE OF REVIEW

The goal of this paper is to provide a history of psychological theories, research, and treatment of male sex offenders from the onset of modern approaches that emerged in the 1960s up to the present time. The questions addressed in this paper primarily concern the reasons and justifications for the observed changes.

RECENT FINDINGS

Current conceptualizations of the motivations of sex offenders are quite comprehensive with a central focus on deficits in attachment and coping skills. Research now provides an empirical foundation for the issues to be addressed in treatment and for the manner in which treatment is delivered. Advances in theory and research have brought the field of sex offender treatment to the point where the empirical bases point to a structure that, if followed, seem likely to achieve the goal of reduced recidivism.

Qualitative Analysis of Attitudes Toward Adult-Child Sexual Activity Among Minor-Attracted Persons

This study uses qualitative methodology to explore narrative responses to a question regarding the harmful versus beneficial effects of adult-child sex on children. Data were gathered from a survey of self-identified minor-attracted persons (MAPs). Two hundred and sixty-seven survey participants provided narrative responses. Results indicated a significant amount of variability in perceptions of harm and of mitigating or aggravating factors. Understanding the subjective perspectives of MAPs, the range of their attitudes, and the issues that they identify as pertinent is critically important for clinical efficacy in the treatment of pedophilia.

Neuroticism in child sex offenders and its association with sexual dysfunctions, cognitive distortions, and psychological complaints

Studies in child sex offenders (CSO) often report deviant personality characteristics. In our study, we investigated neuroticism in CSO and tested the hypothesis that CSO with high neuroticism show more serious abuse behavior and are more likely to exhibit sexual dysfunction and cognitive distortions, as compared to CSO with low neuroticism. A sample of 40 CSO (both child sexual abusers and child sexual material users) was split into two subsamples based on their neuroticism scores, obtained by the NEO-Personality Inventory-Revised (NEO-PI-R) questionnaire. Subsequently, we compared their scores in the Multiphasic Sex Inventory (MSI) questionnaire and Symptom Checklist-90-Revised (SCL-90-R). Our results show that CSO exhibited higher levels of neuroticism than controls, but were still in the normal range. In CSO, neuroticism was associated with sexual dysfunction and cognitive distortions, rather than with more severe abuse behavior. Moreover, neuroticism in this group was linked to a broad range of psychological problems and psychopathological symptoms, such as somatization or anxiety. Our findings suggest that neuroticism even below the level of personality disorder is associated with a broader range of psychological problems in CSO, which should be addressed in therapy.

Inhibiting Sexual Arousal to Children: Correlates and Its Influence on the Validity of Penile Plethysmography

The current study examined the extent to which 1136 men were able to inhibit their sexual arousal on a phallometric assessment, when instructed to do so. Although the observed changes between the two conditions (i.e., Normal and Suppression) were small to moderate in magnitude, the change was not more than what would be expected by measurement error for most participants (e.g., 83% of pedophilic sex offenders against children did not successfully inhibit their sexual arousal in the Suppression condition). There were very few variables that were associated with the ability to suppress. Higher Pedophilia Index scores in the Suppression condition predicted a greater likelihood of sexual recidivism among sex offenders (hazard ratio = 1.17, 95% CI [1.04, 1.32]), but the ability to suppress sexual arousal was not found to predict sexual recidivism. The current study highlights the importance of accounting for measurement error and found that, when doing so, most sex offenders against children are unable to successfully inhibit their sexual arousal to children when instructed to do so, and that the ability to suppress sexual arousal is not associated with recidivism.

Cognitional Impairment: Is There a Role for Cognitive Assessment in the Treatment of Individuals Civilly Committed Pursuant to the Sexually Violent Predator Act?

Sexually Violent Predator statutes allow the involuntary treatment of individuals who are found to pose a threat to public safety. Most sex offender treatment programs rely on cognitive interventions to reduce the risk of recidivism. The purpose of this study was to examine (a) whether individuals with paraphilia diagnoses have cognitive deficits compared with the general population; (b) whether individuals diagnosed with pedophilia differed on cognitive performance when compared with individuals diagnosed with paraphilia not otherwise specified (NOS), nonconsent; and (c) whether individuals with paraphilia plus antisocial personality disorder (ASPD) differed in cognitive performance when compared with individuals with a paraphilia diagnosis only. The sample consisted of 170 males (M age = 50.21; SD = 10.22) diagnosed with pedophilia or paraphilia NOS, nonconsent, who were detained or civilly committed to a forensic psychiatric hospital. Assessments included Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Wechsler Abbreviated Scale of Intelligence (WASI), and Wide Range Achievement Test 4 (WRAT4). Individuals diagnosed with pedophilia and paraphilia NOS, nonconsent, obtained lower scores than matched controls based on the RBANS Immediate Memory, Visuospatial/Constructional, Delayed Memory indices and Total Score. In comparison with individuals with paraphilia NOS, nonconsent, those with pedophilia diagnosis had lower scores on the RBANS Delayed Memory. Individuals diagnosed with a paraphilia disorder combined with ASPD demonstrated trends toward lower IQ scores than those with a paraphilia diagnosis only. Treatment programs can improve their chance of success by assessment of cognitive processes, and offer therapy in a style that is consistent with the cognitive abilities of their clients.

Olfactory Aversion and Directed Masturbation in the Modification of Deviant Preferences

A description is provided of the use of olfactory aversion and directed masturbation with a chronic child molester. Evidence of changes assessed by phallometry demonstrated the effectiveness of these procedures in reducing deviant sexual interests and in enhancing the sexual attractiveness of consensual sex with an adult partner. Attitude change procedures were also employed to facilitate the client's ability to act on these changed sexual preferences. Follow-up data revealed the enduring nature of the changed preferences and there was no evidence of further sexual misconduct.

Stigma-Related Stress and Its Correlates Among Men with Pedophilic Sexual Interests

Despite decades of research on the adverse consequences of stereotyping and discrimination for many stigmatized groups, little is known about how people with pedophilia perceive and react to stigma. In this article, we present a framework that outlines how stigma-related stress might negatively affect emotional and social areas of functioning, cognitive distortions, and the motivation to pursue therapy, all of which may contribute to an increased risk of sexual offending. We tested our hypotheses in an online survey among self-identified German-speaking people with pedophilia (N = 104) using a wide range of validated indicators of social and emotional functioning (Brief Symptom Inventory-53, UCLA Loneliness Scale, Emotion Subscale of the Coping Inventory for Stressful Situations, Fear of Negative Evaluation-5, Rosenberg Self-Esteem Scale). Specific risk factors such as self-efficacy, cognitive distortions, and the motivation to seek treatment were also assessed. In line with our hypotheses, fear of discovery generally predicted reduced social and emotional functioning. Contrary to our predictions, perceived social distance and fear of discovery were not linked to self-efficacy, cognitive distortions, or treatment motivation. Results were controlled for the effects of confounding variables (e.g., age, educational level, social desirability, relationship status). We critically evaluate the empirical contribution of this study to research on stigma and child sex offenses, including a discussion of the results in light of the potential indirect effects that public stigma may have on the overall risk for sexual offenses.

Rape-related cognitive distortions: Preliminary findings on the role of early maladaptive schemas

Despite the important focus on the notion of cognitive distortions in the sexual offending area, the relevance of underlying cognitive schemas in sexual offenders has also been suggested. The aim of the present study was to investigate a potential relationship between Early Maladaptive Schemas (EMSs) and cognitive distortions in rapists. A total of 33 men convicted for rape completed the Bumby Rape Scale (BRS), the Young Schema Questionnaire - Short form-3 (YSQ-S3), the Brief Symptom Inventory (BSI), and the Socially Desirable Response Set Measure (SDRS-5). Results showed a significant relationship between the impaired limits schematic domain and the Justifying Rape dimension of the BRS. Specifically, after controlling for psychological distress levels and social desirability tendency, the entitlement/grandiosity schema from the impaired limits domain was a significant predictor of cognitive distortions related to Justifying Rape themes. Overall, despite preliminary, there is some evidence that the Young's Schema-Focused model namely the impaired limits dimension may contribute for the conceptualization of cognitive distortions in rapists and further investigation is recommended.

Interpreting Child Sexual Abuse: Empathy and Offense-Supportive Cognitions among Child Sex Offenders

Researchers have suggested that child sex offenders hold distorted views on social interactions with children. Misinterpreting children's behavior and intentions could lead to sexually abusive behavior toward children. It is further suggested that the interpretation process is influenced by offenders' offense-supportive cognitions and levels of empathy. To examine the relationships between these three concepts, 47 contact offenders completed self-reports on offense-supportive cognitions and empathy. Vignettes were developed to assess the extent to which offenders attributed responsibility, benefit, and complicity to children in hypothetical child molestation incidents. This study showed that cognitions that justify sexual offending against children seem to diminish the threshold for sexual assault by assigning more cooperation and willingness of the victim in a child molestation incident.

Early maladaptive schemas in convicted sexual offenders: preliminary findings

Core cognitive schemas may play a role in the vulnerability for sexual offending. Identifying these schemas could help to conceptualize sexual crimes and rehabilitate convicted sexual offenders. The aim of this preliminary study was to explore the relationship between early maladaptive schemas (EMSs) and sexual offending, as well as how rapists and child sex molesters differ in terms of these schemas. Thirty-two men convicted for rape, 33 convicted for child sexual abuse, and 30 non-offenders were evaluated using the Young Schema Questionnaire (YSQ-S3) and the Brief Symptom Inventory (BSI). Results showed that participants convicted for child sexual abuse presented significantly more schemas from the disconnection/rejection, impaired autonomy/performance, other directness, and over vigilance/inhibition domains than non-offenders, whereas rapists presented more schemas from the impaired autonomy/performance domain than non-offenders. Differences between sex offenders showed that child molesters presented more schemas of pessimism than rapists. Preliminary findings suggested that EMSs may impact sex offender's perceptions about themselves and about the world. Schema-focused therapy (Young, 1990, 1999) may thus be an acceptable approach to sex offender's psychological assessment and intervention.

Community males show multiple-perpetrator rape proclivity: development and preliminary validation of an interest scale

The literature on Multiple Perpetrator Rape (MPR) is scant; however, a significant proportion of sexual offending involves multiple perpetrators. In addition to the need for research with apprehended offenders of MPR, there is also a need to conduct research with members of the general public. Recent advances in the forensic literature have led to the development of self-report proclivity scales. These scales have enabled researchers to conduct evaluative studies sampling from members of the general public who may be perpetrators of sexual offenses and have remained undetected, or at highest risk of engaging in sexual offending. The current study describes the development and preliminary validation of the Multiple-Perpetrator Rape Interest Scale (M-PRIS), a vignette-based measure assessing community males' sexual arousal to MPR, behavioral propensity toward MPR and enjoyment of MPR. The findings show that the M-PRIS is a reliable measure of community males' sexual interest in MPR with high internal reliability and temporal stability. In a sample of university males we found that a large proportion (66%) did not emphatically reject an interest in MPR. We also found that rape-supportive cognitive distortions, antisocial attitudes, and high-risk sexual fantasies were predictors of sexual interest in MPR. We discuss these findings and the implications for further research employing proclivity measures referencing theory development and clinical practice.

Interpreting child sexual abuse: the impact of victim response

There is little empirical knowledge about whether the interpretation process of child sex offenders is offense-supportive in nature and contributes to the offending process. Vignettes were developed to compare child sex offenders' and nonoffenders' interpretations of child molestation incidents after ambiguous and nonambiguous victim responses. Results showed that child sex offenders' (N = 60) interpretations did not differ from nonoffenders' (N = 40) interpretations. Overall, the more ambiguous the child responses, the more child complicity and child benefit was seen. Our results indicate that offense-supportive interpretations are not unique to child sex offenders. The mechanisms that are responsible for whether or not to commit a sexual offense should be unraveled and treated, to prevent deviant processes to be activated.

Unraveling sexual associations in contact and noncontact child sex offenders using the single category - implicit association test

Previous studies found associations between children and sex in child sex offenders (CSOs) using the Implicit Association Test (IAT). We used a modification of this task, the Single Category-Implicit Association Test (SC-IAT) to unravel child-sex associations in CSOs. Using the SC-IAT, we were able to test whether CSOs indeed hold stronger child-sex associations relative to adult-sex associations, compared to adult sex offenders and nonoffenders. Furthermore, we examined whether contact CSOs differed from noncontact CSOs in their child-sex associations. The hypothesis that CSOs would have stronger child-sex associations, relative to their adult-sex associations, than adult sex offenders and nonoffenders was confirmed. No difference between contact CSOs and noncontact CSOs was found. Although the Sex SC-IAT was able to distinguish CSOs from nonoffenders, the sensitivity and specificity of the test was poor (AUC of .65) and needs refinement. The results of this study support the existence of a child-sex association as a distinctive characteristic of CSOs. These findings are discussed in the context of theories on deviant cognitions in CSOs and risk for sexual offending.

The psychological profiles of internet, contact, and mixed internet/contact sex offenders

A sample of 526 contact offenders, 459 internet offenders, and 143 mixed contact/internet offenders was compared on a range of self-report psychological measures assessing offense-supportive beliefs, socioaffective functioning, emotional management, and socially desirable responding. A multivariate general linear model found a mixed offender profile that was similar to internet offenders rather than contact offenders. The contact group demonstrated lower victim empathy, a greater level of pro-offending attitudes, an externalized locus of control, more assertiveness, a diminished ability to relate to fictional characters, and greater impulsivity than the internet and mixed offender groups. The mixed offender group demonstrated a higher level of empathic concern than the other two groups. The mixed offender group could also be distinguished from the internet group by increased personal distress and perspective-taking ability. A discriminant function analysis highlighted the key linear factor distinguishing between the groups to be one relating to offense-supportive attitudes and identification with fictional characters. A second factor was related to higher levels of empathic concern and poor self-management. These findings are discussed in the context of the potential pathways between internet and contact sexual offenses.

Theories of cognitive distortions in sexual offending: what the current research tells us

Cognitive distortions in sex offenders are specific or general beliefs/attitudes that violate commonly accepted norms of rationality that have been shown to be associated with the onset and maintenance of sexual offending. In this article, we describe the major theories that have been formulated to explain the role of distorted cognition in initiating and maintaining sexual offending. We evaluate each theory in light of a set of theory appraisal criteria and the available empirical research. Finally, we conclude by drawing together the results of this theory evaluation process and highlight the major implications for treatment and future research.

Psychological interventions for adults who have sexually offended or are at risk of offending

BACKGROUND

Sexual offending is a legal construct that overlaps, but is not entirely congruent with, clinical constructs of disorders of sexual preference. Sexual offending is both a social and a public health issue. Victim surveys illustrate high incidence and prevalence levels, and it is commonly accepted that there is considerable hidden sexual victimisation. There are significant levels of psychiatric morbidity in survivors of sexual offences.Psychological interventions are generally based on behavioural or psychodynamic theories.Behavioural interventions fall into two main groups: those based on traditional classical conditioning and/or operant learning theory and those based on cognitive behavioural approaches. Approaches may overlap. Interventions associated with traditional classical and operant learning theory are referred to as behaviour modification or behaviour therapy, and focus explicitly on changing behaviour by administering a stimulus and measuring its effect on overt behaviour. Within sex offender treatment, examples include aversion therapy, covert sensitisation or olfactory conditioning. Cognitive behavioural therapies are intended to change internal processes - thoughts, beliefs, emotions, physiological arousal - alongside changing overt behaviour, such as social skills or coping behaviours. They may involve establishing links between offenders' thoughts, feelings and actions about offending behaviour; correction of offenders' misperceptions, irrational beliefs and reasoning biases associated with their offending; teaching offenders to monitor their own thoughts, feelings and behaviours associated with offending; and promoting alternative ways of coping with deviant sexual thoughts and desires.Psychodynamic interventions share a common root in psychoanalytic theory. This posits that sexual offending arises through an imbalance of the three components of mind: the id, the ego and the superego, with sexual offenders having temperamental imbalance of a powerful id (increased sexual impulses and libido) and a weak superego (a low level of moral probation), which are also impacted by early environment.This updates a previous Cochrane review but is based on a new protocol.

OBJECTIVES

To assess the effects of psychological interventions on those who have sexually offended or are at risk of offending.

SEARCH METHODS

In September 2010 we searched: CENTRAL, MEDLINE, Allied and Complementary Medicine (AMED), Applied Social Sciences Index and Abstracts (ASSIA), Biosis Previews, CINAHL, COPAC, Dissertation Abstracts, EMBASE, International Bibliography of the Social Sciences (IBSS), ISI Proceedings, Science Citation Index Expanded (SCI), Social Sciences Citation Index (SSCI), National Criminal Justice Reference Service Abstracts Database, PsycINFO, OpenSIGLE, Social Care Online, Sociological Abstracts, UK Clinical Research Network Portfolio Database and ZETOC. We contacted numerous experts in the field.

SELECTION CRITERIA

Randomised trials comparing psychological intervention with standard care or another psychological therapy given to adults treated in institutional or community settings for sexual behaviours that have resulted in conviction or caution for sexual offences, or who are seeking treatment voluntarily for behaviours classified as illegal.

DATA COLLECTION AND ANALYSIS

At least two authors, working independently, selected studies, extracted data and assessed the studies' risk of bias. We contacted study authors for additional information including details of methods and outcome data.

MAIN RESULTS

We included ten studies involving data from 944 adults, all male.Five trials involved primarily cognitive behavioural interventions (CBT) (n = 664). Of these, four compared CBT with no treatment or wait list control, and one compared CBT with standard care. Only one study collected data on the primary outcome. The largest study (n = 484) involved the most complex intervention versus no treatment. Long-term outcome data are reported for groups in which the mean years 'at risk' in the community are similar (8.3 years for treatment (n = 259) compared to 8.4 in the control group (n = 225)). There was no difference between these groups in terms of the risk of reoffending as measured by reconviction for sexual offences (risk ratio (RR) 1.10; 95% CI 0.78 to 1.56).Four trials (n = 70) compared one behavioural programme with an alternative behavioural programme or with wait list control. No meta-analysis was possible for this comparison. For two studies (both cross-over, n = 29) no disaggregated data were available. The remaining two behavioural studies compared imaginal desensitisation with either covert sensitisation or as part of adjunctive drug therapy (n = 20 and 21, respectively). In these two studies, results for the primary outcome (being 'charged with anomalous behaviour') were encouraging, with only one new charge for the treated groups over one year in the former study, and in the latter study, only one new charge (in the drug-only group) over two years.One study compared psychodynamic intervention with probation. Results for this study (n = 231) indicate a slight trend in favour of the control group (probation) over the intervention (group therapy) in terms of sexual offending as measured by rearrest (RR 1.87; 95% CI 0.78 to 4.47) at 10-year follow-up.Data for adverse events, 'sexually anomalous urges' and for secondary outcomes thought to be 'dynamic' risk factors for reoffending, including anger and cognitive distortions, were limited.

AUTHORS' CONCLUSIONS

The inescapable conclusion of this review is the need for further randomised controlled trials. While we recognise that randomisation is considered by some to be unethical or politically unacceptable (both of which are based on the faulty premise that the experimental treatment is superior to the control - this being the point of the trial to begin with), without such evidence, the area will fail to progress. Not only could this result in the continued use of ineffective (and potentially harmful) interventions, but it also means that society is lured into a false sense of security in the belief that once the individual has been treated, their risk of reoffending is reduced. Current available evidence does not support this belief. Future trials should concentrate on minimising risk of bias, maximising quality of reporting and including follow-up for a minimum of five years 'at risk' in the community.

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.

Sexual material perception in sexually coercive men: disattending deficit and its covariates

The perceptual bias for sexual material has been explored mainly in normal men, and to date little attention has been paid to sexually aggressive men. The current study compared performance of sexually aggressive and nonaggressive men on experimental tasks involving sexual stimuli. Participants viewed the visual images (neutral or sexual), and, depending on the cue they were presented, they either responded to shape and color questions or just skipped to the next trial. In contrast with noncoercive men, men who admitted sexually coercive behavior showed increased response latencies only in the condition in which they were required to withdraw their attention from sexual stimuli to perform the cognitive task. Correlations with attentional performance suggested that sexually coercive men high on impulsivity and aggressiveness might experience cognitive interference when processing sexual material. These results are interpreted using disinhibition and response modulation models.

The implicit theories of rape-prone men: an information-processing investigation

It has been hypothesised that sexual offenders hold offence-supportive implicit theories (ITs) or schemata. This study aims to determine whether rape-prone men hold the same offence-supportive ITs as those that have been identified in rapists. This study adopts both an explicit and an implicit measure of ITs (a lexical decision task). In the lexical decision task, participants are primed with an incomplete sentence before being presented with a target word. The target word completes the sentence in either a rape-supportive or a non-rape-supportive manner. The authors predict that men higher on proclivity to rape-who presumably hold strong mental representations of rape-supportive themes-would be faster to respond to word completions that are rape supportive relative to men lower on rape proclivity. Using multiple regressions to determine the relative contributions of both explicit and implicit measures for predicting rape proclivity, the authors find that only the explicit self-report questionnaire was significantly related to a person's rape proclivity score.

An application of the theory of planned behavior to the proximal and distal etiology of sexual offending

Emerging from social psychology, the theory of planned behavior offers a potentially useful theoretical framework for research into the etiology of sexual offending in adults and adolescents. The theory of planned behavior--a cognitive-affective theory about the role of attitudes, subjective norms, and perceived behavioral control on behaviors--may provide a means by which to link distal etiological factors into proximal ones involved in the offense process, providing greater specificity to the ''abused- abuser'' hypothesis. The theory of planned behavior also provides a theoretical framework with which to specify mechanisms involved in the proximal offense cycle. Important new directions for research resulting from this conceptual advance are presented, along with limitations of the theory in its application to the etiology of sexual offending. This theoretical framework directs practitioners to classify sexual offenders' cognitive distortions by whether they involve behavioral beliefs, normative beliefs, and/or control beliefs and to modify treatment activities accordingly.

Assessing risk for sexual recidivism: some proposals on the nature of psychologically meaningful risk factors

Risk assessment and treatment for sexual offenders should focus on individual characteristics associated with recidivism risk. Although it is possible to conduct risk assessments based purely on empirical correlates, the most useful evaluations also explain the source of the risk. In this review, the authors propose that the basic requirements for a psychologically meaningful risk factor are (a) a plausible rationale that the factor is a cause of sexual offending and (b) strong evidence that it predicts sexual recidivism. Based on the second of these criteria, the authors categorize potential risk factors according to the strength of the evidence for their relationship with offending. The most strongly supported variables should be emphasized in both assessment and treatment of sexual offenders. Further research is required, however, to establish causal connections between these variables and recidivism and to examine the extent to which changes in these factors leads to reductions in recidivism potential.