The role of alcohol in sexual aggression

"I'll Be That One Cockblocking Friend": Understanding Student Experiences of Bystander Intervention in Alcohol-Related Sexual Assault

The prevalence of sexual assault (SA) among college students (13%) is unacceptable, underreported, and alcohol use by the perpetrator or victim is reported in 50% of SA cases. Bystander intervention (BI) programs, which use prosocial behaviors to prevent or stop a harmful situation from occurring, have been implemented across college campuses to reduce SA. There are several known barriers (e.g. self-intoxication) and facilitators (e.g. peer support) to BI for SA; however, less is known about barriers and facilitators to BI for alcohol-related SA. Alcohol-related SA includes situations in which the perpetrator and/or victim are intoxicated, whereas alcohol-facilitated SA includes situations in which individuals intentionally use alcohol as a perpetration strategy. The current study examined student perspectives of BI for SA opportunities, actions taken in response to opportunities, and barriers and facilitators to action. The team conducted content and deductive thematic analysis of data from focus groups and interviews with diverse undergraduate students (N = 79). Opportunities included perpetrator-focused, victim-focused, and sexual risk opportunities. Actions taken included staying vigilant, monitoring friends, communicating with friends, and removing friends. Barriers included self-intoxication, feeling helpless, peer pressure, not feeling personally responsible, and fearing the consequences of helping. Finally, facilitators included knowing friends' concerning signals and drinking motives, feeling like some intervention strategies are easy, understanding sex-related risks, acknowledging consent and personal boundaries, and feeling personally responsible for friends. Understanding these situations' nuances can help to inform more effective and comprehensive BI programs to reduce SA.

The contribution of psychopathic traits and substance use in the prediction of recidivism of sexual offenders

Substance use and dependence may play an essential role in the risk of reoffending by sex offenders. Research examining the influence of substance use and dependence on the criminal behaviour of psychopathic sex offenders is limited. Alcohol and drug use have been identified as factors which promote criminal behaviour and are suspected to contribute, at least partially, to the probability of reoffending. For instance, previous research showed that elevated scores on the Michigan Alcohol Screening Test (MAST) contribute to the predictability of the Hare Psychopathy Checklist - Revised (PCL-R) on recidivism. The current study retrospectively evaluated a database of incarcerated high-risk offenders registered in the Regional Treatment Center, Sex Offender Treatment Program (RTCSOTP); in order to assess the contribution of self-disclosed histories of alcohol and substance use and dependency have, in concert with measures of psychopathic characteristics, on the predictability of recidivism. Results of the retrospective data identified PCL-R and DAST (Drug Abuse Screening Test) scores as significant predictors of sexual and violent recidivism of male inmates undergoing treatment in RTCSOTP within 5 years of their release. MAST scores, however, did not significantly contribute to the predictability of sexual and violent recidivism in this population. We conclude, drug use should be considered as an important factor when addressing recidivism in sexual offenders who demonstrate psychopathic characteristics.

Alexithymia, Prior Trauma, Alcohol Use, and Sexual Aggression Perpetration: A Cross-Cultural Comparison of a Moderated Mediation Model

In this study, we examined the relationships between prior trauma, alexithymia, and sexual aggression perpetration among 610 U.S. college students and 107 college students from the Philippines utilizing a cross-sectional retrospective design. We tested a moderated mediation model with alexithymia as the mediator between prior trauma and sexual aggression perpetration, and alcohol use as a moderator of the alexithymia-sexual aggression link. Moreover, given that cultural norms may influence these relationships, we also examined the structural invariance of the proposed moderated mediation model. Path analyses and multiple group analysis were used to examine the moderated mediation model, and examine model differences between samples. We did not find evidence for alexithymia as a mediator, but there was a significant interaction between alcohol use severity and alexithymia on sexual aggression perpetration across both samples. Alexithymia is a key variable in understanding the alcohol use-sexual aggression perpetration relationship. Clinical implications and recommendations for future research are also discussed.

Intoxicated aggression: Do alcohol and stimulants cause dose-related aggression? A review

RATIONALE

Violence and drug use are significant public health challenges that are strongly linked. It is known that alcohol plays a major role in the causation of unnatural deaths and that stimulants like cocaine and amphetamine are often implicated in aggressive acts or violence. However, a clear causal relationship between these substances and aggression, and more specifically a blood concentration threshold at which intoxicated aggression emerges is lacking. In case of a crime and subsequent law enforcement, knowledge about dose-response relationships could be of pivotal importance when evaluating the role of alcohol and drugs in aggressive offences.

AIMS

The present review aimed to determine whether there is a causal relation between intoxication with these psychoactive substances and aggression, and to define blood concentration thresholds above which these substances elicit aggression.

METHODS

Empirical articles published between 2013 and 2017 and review papers containing the predefined search strings were identified through searches in the PubMed and Embase databases and additional reference list searches. The complete search query yielded 1578 publications. Initially all articles were manually screened by title and abstract. Articles with irrelevant titles, given the selected search terms and review aims were discarded. Remaining articles were carefully studied and those that did not comply with the main objectives of this review were discarded. At the end of this process, 167 titles were found eligible for review.

FINDINGS AND CONCLUSION

While placebo-controlled experimental studies clearly showed a causal link between alcohol and aggression, it is evident that such a link has not yet been established for cocaine and amphetamines. In case of alcohol, it is clear that there are various individual and contextual factors that may contribute to the occurrence of an aggressive act during intoxication. A clear threshold blood alcohol concentration has not been defined yet for alcohol, but a statistically significant increase of aggression has been demonstrated at a dose of 0.75 g/kg and higher. Future studies into intoxicated aggression should include multiple doses of alcohol and stimulants and take into account individual and contextual factors.

The Motivation-Facilitation Model of Sexual Offending

In this article, I describe the motivation-facilitation model of sexual offending, which identifies the traits of paraphilia, high sex drive, and intense mating effort as primary motivations for sexual offenses, as well as trait (e.g., antisocial personality) and state (e.g., intoxication) factors that can facilitate acting on these motivations when opportunities exist. Originally developed to explain contact sexual offending against children, the motivation-facilitation model was subsequently extended as an explanation for child pornography offending and for online solicitations of young adolescents. Here, I argue it has the potential to be expanded to explain other forms of sexual offending, including sexual assaults of adults and noncontact offenses involving exhibitionism or voyeurism. In this review, I critically examine the evidence for and against the model, discuss its limitations, and identify critical gaps for future research.

Associations Between Substance Use in Commission of Sexual Crimes and Offense Characteristics Among Youth: Mitigating Effects of Substance Use Treatment

The small extant research base on substance use and youth sexual offending has very few descriptive details. Furthermore, research has yet to test associations between the use of substances in the commission of sexual crimes and offense-related characteristics and how substance use treatment can mitigate these effects. In a sample of residentially housed youth adjudicated of a sexual crime ( N = 332), prevalence patterns are broken down by type of substance use behavior. Sequential regression models are run to test the associations between substance use prior to a sexual crime and number of victims, sexual deviance, and non-sexual criminality. Substance use treatment is tested as a mitigating factor in these relationships. Results reveal high levels of family substance use, and high rates of alcohol, marijuana, and other substance use. There were associations between substance use prior to sexual criminality and sexual deviance and non-sexual criminality. Substance use treatment reduced the effects of substance use on non-sexual criminality. Research and treatment implications are offered.

Genital Responses to Rape Vignettes Among Young Men: The Influence of Mood and Directed Attention

Although it is clear that men with a history of sexual assaults against women produce higher relative genital responses to rape vignettes in the laboratory than do men without such a history, it remains unclear what aspects of the vignettes are eliciting these responses, and whether the genital responses are affected by situational factors. The antisocial tendencies hypothesis states that many men are inhibited by cues of violence, suffering, and coercion in rape vignettes, but other men, particularly antisocial and sexually aggressive men, are not so inhibited. In this study, we investigated whether the hypothesized inhibition to rape vignettes among nonoffenders could be affected by manipulation of mood and directed attention. A total of 48 young men were exposed to audio-recorded vignettes describing mutually consenting and nonviolent sexual interactions, mutually consenting and violent sexual interactions, nonconsenting and violent sexual interactions, and nonsexual and nonviolent social interactions (within-subjects). Participants were randomly assigned to a mood manipulation designed to induce a happy, neutral, or sad mood (between-subjects). All were asked to pay attention to either sex words or violent words while listening to the vignettes (within-subjects). As is typically observed, genital responses were lower (inhibited) when vignettes included cues of violence or nonconsent. Both happy and sad mood inductions reduced this inhibition, so that men induced into a happy or sad mood showed greater relative responding to cues of violence or nonconsent compared with men in a neutral mood. The attention manipulation had no significant effect. Results suggest that genital responses to rape cues can be situationally influenced, but not necessarily as predicted by the antisocial tendencies hypothesis.

The Contribution of Alcohol to the Likelihood of Completion and Severity of Injury in Rape Incidents

Alcohol use has consistently been linked to violent crime including sexual assault. However, its effect on the likelihood of rape completion and victim injury has not been explored. This article examines the effect of the perpetrator's alcohol consumption on the probability that a rape will be completed and the likelihood and seriousness of physical injuries to victims of rape. Using data from the National Crime Victimization Survey of the Bureau of Justice Statistics for 1992 through 1994, the authors test three hypotheses regarding the effect of perpetrator drinking using multivariate models to control for situational factors and victim's demographic characteristics. The data suggest that drinking by the perpetrator decreases the likelihood that a rape will be completed, increases the likelihood of victim injury, and shows no relationship between perpetrator drinking and the victim's need for medical care.

Qualitative Analysis of Women's Experiences of Sexual Aggression

Women's descriptions of recent sexually aggressive incidents were examined to gain a better understanding of the situations in which sexual aggression occurs, to understand the events from the woman's perspective, and to examine the actual and perceived role of alcohol in such incidents. The sample consisted of women who were sexually active and drank moderately to heavily. Classification of incidents according to the circumstances surrounding their occurrence revealed four major sexual aggression situations: date, current/previous relationship, unsuspecting, and set-up. Three major themes emerged through thematic analysis: alcohol contributing to the perpetrator's aggression, victim's judgment or behavior contributing to the event, and responses to aggression. Quantitative analyses confirmed that a large percentage of incidents involved alcohol or drugs and that perpetrator's alcohol/drug consumption was associated with more severe outcomes. Implications for prevention are discussed.

Sexual Assault Perpetrators' Justifications for Their Actions: Relationships to Rape Supportive Attitudes, Incident Characteristics, and Future Perpetration

Perpetrators use rape supportive attitudes and sexual assault incident characteristics to justify forcing sex on their victims. Perpetrators who can justify their behaviors are at increased risk for future perpetration. This study examined the relationships between rape supportive attitudes, sexual assault incident characteristics, and the post-assault justifications of 183 men sampled from the community who self-reported committing at least one act of sexual aggression. Hierarchical multiple regression analyses indicated that rape supportive attitudes, expectations for having sex, misperceptions of sexual intent, victims' alcohol consumption, attempts to be alone with her, and the number of consensual sexual activities prior to the unwanted sex were significant predictors of perpetrators' post-assault use of justifications. Greater use of justifications was a significant predictor of sexual aggression over a 1-year follow-up interval. These findings demonstrate the need for further research exploring when and why perpetrators use post-assault justifications and whether they are amenable to change.

The Assessment of Rapists

The assessment of sexual aggression presents many difficulties for clinicians. The tendency of offenders to minimise or deny their offending, and their frequent distrust of mental health professionals, require high levels of skill to circumvent. In addition, the multifactorial nature of rape means that assessment needs to cover a broad range of content areas and utilise a number of different methods. In this paper we suggest that a comprehensive assessment should inquire into the developmental history of rapists, social competency, attitudes and beliefs about women and sexual crimes, sexual knowledge, sexual preferences and disorders, empathy, offence variables, psychiatric history, and substance abuse. The clinical interview remains the primary method of information acquisition, and needs to be tailored to match the particular interpersonal style of rapists. The use of psychometric and physiological measures are also valuable sources of clinical data.

Review of survey and experimental research that examines the relationship between alcohol consumption and men's sexual aggression perpetration

This article systematically reviews empirical studies that examine associations between alcohol consumption and men's sexual aggression with the goal of identifying major findings; gaps in current knowledge; and directions for future research, practice, and policy. We identified 25 cross-sectional surveys, 6 prospective studies, and 12 alcohol administration experiments published between 1993 and August 2013 with male college students and young adult (nonincarcerated) samples. Many cross-sectional surveys have demonstrated that distal and proximal measures of men's alcohol consumption are positively associated with sexual assault perpetration, although very few of these studies evaluated how alcohol interacts with other risk and protective factors to exacerbate or inhibit sexual aggression. There are surprisingly few surveys that examine alcohol's effects at the event level and over short-time intervals to identify how changes in alcohol consumption are associated with changes in perpetration status. Alcohol administration studies suggest some important mechanisms that warrant additional investigation.

Drinking in social groups. Does 'groupdrink' provide safety in numbers when deciding about risk?

AIMS

To investigate the impact of alcohol consumption on risk decisions taken both individually and while part of a four- to six-person ad-hoc group.

DESIGN

A 2 (alcohol: consuming versus not consuming alcohol) × 2 (decision: individual, group) mixed-model design; decision was a repeated measure. The dependent variable was risk preference, measured using choice dilemmas.

SETTING

Opportunity sampling in campus bars and a music event at a campus-based university in the United Kingdom.

PARTICIPANTS

A total of 101 individuals were recruited from groups of four to six people who either were or were not consuming alcohol.

MEASUREMENTS

Participants privately opted for a level of risk in response to a choice dilemma and then, as a group, responded to a second choice dilemma. The choice dilemmas asked participants the level of accident risk at which they would recommend someone could drive while intoxicated.

FINDINGS

Five three-level multi-level models were specified in the software program HLM 7. Decisions made in groups were less risky than those made individually (B = -0.73, P < 0.001). Individual alcohol consumers opted for higher risk than non-consumers (B = 1.27, P = 0.025). A significant alcohol × decision interaction (B = -2.79, P = 0.001) showed that individual consumers privately opted for higher risk than non-consumers, whereas risk judgements made in groups of either consumers or non-consumers were lower. Decisions made by groups of consumers were less risky than those made by groups of non-consumers (B = 1.23, P < 0.001).

CONCLUSIONS

Moderate alcohol consumption appears to produce a propensity among individuals towards increased risk-taking in deciding to drive while intoxicated, which can be mitigated by group monitoring processes within small (four- to six-person) groups.

Substance use disorders in forensic psychiatry: differences among different types of offenders

This is the first study that compared different types of offenders in forensic outpatient treatment (i.e., offenders of general violence [GV], intimate partner violence [IPV], sex crimes, and "other offenses" such as drug smuggling and property crimes) regarding the prevalence of substance use disorders at the time of the offense. In total, 35.8% of participants (n = 187) were diagnosed with any substance use disorder. Specifically, 61.5% of GV perpetrators, 30.9% of IPV perpetrators, 9.1% of sex offenders, and 26.7% of "other offenders" were diagnosed with substance abuse or dependence. More GV offenders and less sex offenders fulfilled diagnostic criteria for a substance use disorder. Furthermore, 29.9% of the offenders were intoxicated by substances at the moment they committed the offense (48.5% of GV perpetrators, 25.0% of IPV perpetrators, 17.4% of sex offenders, and 21.0% of other offenders). More GV perpetrators were intoxicated during the offense. As there is a clear association between substance abuse and criminal behavior, substance abuse in offenders should be assessed and, if present, be treated.

Effects of acute nicotine and alcohol on the rating of attractiveness in social smokers and alcohol drinkers

BACKGROUND

Nicotine and alcohol are often consumed together. Previous research suggests that both can independently increase the perceived attractiveness of social stimuli, which may be a mechanism that drives continued use. This study examined whether there was an additive effect of nicotine and alcohol on perceived attractiveness of social and environmental stimuli.

METHODS

Male and female (n=96) social alcohol consumers and light cigarette smokers (no more than 14 cigarettes per week) were randomized to smoke either a nicotinized or denicotinized cigarette and drink either an alcoholic or non-alcoholic (placebo) beverage. The primary outcome was attractiveness ratings of facial and landscape stimuli. Secondary outcomes were self-report mood and craving.

RESULTS

There was a main effect of drink (p=.031) and a trend toward a main effect of cigarette (p=.057) with higher ratings of attractiveness after alcohol compared to placebo and after a nicotinized cigarette compared to a denicotinized cigarette. Nicotine and alcohol appeared to work additively on ratings of attractiveness, with the highest ratings in the nicotine/alcohol group. There were no interactions between drink, cigarette and stimulus type.

CONCLUSIONS

When co-administered, nicotine and alcohol consumption resulted in the highest perceptions of attractiveness across all stimulus types. This additive effect may be a mechanism by which administration of one drug reinforces use of the other, and which leads to an increased likelihood of habitual consumption and relapse.

The relationships of perpetrator and victim substance use to the sexual aggression of rapists and child molesters

OBJECTIVE

This study investigated substance use in rape and child molestation. We hypothesized that perpetrator substance use would be associated with a greater increase in rapists' aggression in sexual crimes compared with that of child molesters. We also predicted that victim substance use would be negatively related to both rapists and child molesters' aggression in sexual crimes.

METHOD

The sample included 245 male rapists and 273 male child molesters who had been evaluated at the Massachusetts Treatment Center (MTC) between 1959 and 1991 for potential civil commitment. Data were obtained from offenders' archival records and were coded by trained research assistants on perpetrator and victim substance use and perpetrator aggression in sexual crimes.

RESULTS

Analyses showed that the magnitude of the positive association between perpetrator alcohol use and aggression in sexual crimes did not differ between rapists and child molesters. In contrast, perpetrator drug use was associated with increased aggression among child molesters only. Victim substance use was related to increased aggression among rapists only.

CONCLUSIONS

The results indicate that victim substance use and perpetrator drug use, but not perpetrator alcohol use, are differentially related to the aggression of rapists and child molesters in sexual crimes. Those findings imply that substance use may play different roles depending on offender type.

The Assessment of Dangerous Behaviour: Research and Clinical Issues

Mental health professionals in forensic settings are increasingly called upon to assess the probability of dangerous behaviour, or level of risk, that certain individuals pose to the community. These assessments may inform decisions concerning the containment and management of violent offenders within forensic settings, sentencing options, and whether or not to grant bail or parole. In this paper we provide an overview of the key issues associated with the assessment of dangerous behaviour. Specifically, we briefly consider the debate on clinical versus actuarial assessments of dangerous behaviour and risk, and provide a synopsis of the current research on dangerous behaviour, focusing on the key areas of mental disorder, psychopathy, and substance use. Finally, we outline guidelines for addressing specific content areas in the clinical risk-assessment process and discuss areas for future research.

Public house patrons' engagement in hypothetical sexual assault: a test of Alcohol Myopia Theory in a field setting

Previous research has found that drinking establishments are often antecedent to sexual aggression outcomes. In this study, male participants were randomly selected from public houses (i.e., "pubs") and asked to imagine themselves in a hypothetical intimate encounter in which the female in the scenario stops consenting to sexual contact. Participants were given the option to continue making sexual advances up to and including sexual intercourse against the woman's will. It was hypothesized based on Alcohol Myopia Theory that participant blood alcohol concentration (BAC) levels would be associated with hypothetical sexual aggression when stereotypical cues of a woman's sexual availability (revealing clothing and alcohol use) were present in the scenario. Men's engagement in hypothetical sexual aggression was associated with BAC levels, but only when the woman was wearing revealing clothing. The sobriety of the female actor was not associated with sexual aggression. Results indicate that Alcohol Myopia Theory generalizes to a field setting.

Alcohol's role in sexual violence perpetration: theoretical explanations, existing evidence and future directions

ISSUES

There is controversy regarding the extent to which alcohol plays a causal role in sexual assault perpetration.

APPROACH

This paper critically reviews the relevant alcohol administration and survey research literature.

KEY FINDINGS

Alcohol administration researchers have randomly assigned male participants to drink conditions prior to exposure to an acquaintance rape scenario. As compared to sober participants, intoxicated participants find the male character's use of force to obtain sex more acceptable and express greater willingness to act in a similar manner. In several studies, these effects are strongest for intoxicated men with hostile attitudes toward women. Survey researchers have asked male participants to describe incidents in which they behaved in a sexually aggressive manner. Men who commit sexual assault when drinking report having traits, attitudes and experiences similar to those of other perpetrators except in the alcohol domain. Perpetrators who commit sexual assault when drinking tend to drink more than other perpetrators in sexual situations and have stronger expectancies regarding alcohol's effects on sexual behaviour.

IMPLICATIONS

Overall, research suggests that alcohol interacts with personality and aspects of the situation, adding to the risk of perpetration among men already predisposed to engaging in sexual aggression.

CONCLUSIONS

Although there are no simple answers to questions about alcohol's role in sexual assault, research suggests that intoxication may be a more important determinant of when some men commit sexual aggression, rather than who becomes sexually aggressive.

The relationship between drug use and sexual aggression in men across time

The relationship between drug use and sexual aggression in a sample of men was examined at five time points from adolescence through the 4th year of college. Hierarchical linear modeling explored the relationship between proximal drug use and severity of sexual aggression after controlling for proximal alcohol use at each time period. Results revealed that proximal drug use was associated with sexual aggression severity: Increased drug use predicted increased severity of sexual aggression across time. A second set of analyses explored the relationship between distal marijuana use and severity of sexual aggression after controlling for distal alcohol use. Results indicated that increased marijuana use predicted increased severity of sexual aggression across time. A third set of analyses explored the relationship between distal use of other illicit drugs and severity of sexual aggression after controlling for distal alcohol use. Results mirrored those of the second set of analyses and are discussed in terms of drug use as a component of deviant lifestyles that may include sexually aggressive behavior, including implications for applied settings.

DOES ALCOHOL CONTRIBUTE TO THE CONFLUENCE MODEL OF SEXUAL ASSAULT PERPETRATION?

The confluence model of sexual assault provides a useful theoretical integration of factors that influence men's likelihood of committing sexual assault (Malamuth, Sockloskie, Koss, & Tanaka, 1991). This study replicates and extends the confluence model by including alcohol at multiple levels. Participants' usual alcohol consumption and alcohol consumption in sexual situations were included as predictor variables. The number of sexually aggressive acts that participants committed after consuming alcohol and the number of sexually aggressive acts participants committed when sober were separately calculated so that the predictors of each could be distinguished. Participants were 356 men who completed a survey that included measures that assessed the key components of the confluence model. Results of path analyses indicated that the expanded model fit the data well, with both general and situational measures of alcohol use predicting frequency of sexual assault when drinking alcohol. These findings highlight the importance of developing universal and targeted prevention programs for young men.

Toxicological investigation of drug-facilitated sexual assaults

Drug-facilitated sexual assaults have drawn a lot of attention during the last years. The role of the non-forensic doctors in the early recognition and management of such cases is crucial. Diagnosis assisted by samplings must be ascertained without delay, in victims initially brought to the emergency room for a sleepy state, a suspected abuse of drug or a pseudo-alcoholic clinical state. Further, where amnesia is present, it may be prudent to assume that sexual activity has occurred and offer pregnancy and sexually transmitted disease prophylaxis. Forensic doctors should entertain the possibility of poisoning in any presentation involving amnesia. Forensic toxicological laboratories should develop sensitive and specific methods to assure a low threshold of detection of the drugs. The awareness of a delinquent or criminal use of alcohol and/or drugs could permit a better medical recognition, so that proper and timely forensic examination is achieved, and adequate evidence is collected for the establishment of an effective investigation and prosecution.

Explicating alcohol's role in acquaintance sexual assault: complementary perspectives and convergent findings

This article summarizes the proceedings of a symposium presented at the 2004 meeting of the Research Society on Alcoholism (RSA) in Vancouver, British Columbia, Canada. There were four presentations and a discussant. The symposium was co-chaired by Tina Zawacki and Jeanette Norris. The first presentation was made by Jeanette Norris, who found that alcohol consumption and preexisting alcohol expectancies affected women's hypothetical responses to a vignette depicting acquaintance sexual aggression. The second presentation was made by Joel Martell, who reported that alcohol-induced impairment of executive cognitive functioning mediated the effect of intoxication on men's perceptions of a sexual assault vignette. In the third presentation, Antonia Abbey found that the experiences of women whose sexual assault involved intoxication or force were more negative than were the experiences of women whose sexual assault involved verbal coercion. The fourth presentation was made by Tina Zawacki, who reported that men who perpetrated sexual assault only in adolescence differed from men who continued perpetration into adulthood in terms of their drinking patterns and attitudes toward women. William H. George discussed these findings in terms of their implications for theory development and prevention programming.

Alcohol and drug abuse among sexual and nonsexual offenders: relationship to intimacy deficits and coping strategy

Three groups of subjects (N = 95) consisting or rapists, child molesters, and a comparison group of violent offenders were examined with reference to history of alcohol abuse, history of drug abuse, intimacy deficits, and emotionally based coping strategies. No differences were found between the two groups of sex offenders on any of the measures examined. Sex offenders were found to be significantly older than the comparison group. When age was entered as a covariate sex offenders were found to have significantly more difficulties with alcohol use as measured by the Michigan Alcohol Screening Test (MAST) and were significantly more likely to use emotionally based coping strategies as measured by the Coping Inventory for Stressful Situations (CISS). No differences were found between any of the groups with reference to drug abuse as measured by the Drug Abuse Screening Test (DAST). Results are discussed in terms of Marshall's theory of intimacy deficits in sexual offenders.

College women's experiences of sexual coercion: a review of cultural, perpetrator, victim, and situational variables

The literature on college women's experiences with sexual coercion is reviewed, with an emphasis on work published since 1990. Sexual coercion is defined as any situation in which one person uses verbal or physical means (including the administration of drugs or alcohol, with or without the other person's consent) to obtain sexual activity against consent. We argue that coercive sexual behavior among college students can best be understood within the context of other sexual behaviors and values on college campuses. Significant definitional and methodological problems are identified and discussed. Important victim, perpetrator, and situational variables are identified and discussed. These include attitudes toward women, beliefs about sexual behavior (including rape-supporting beliefs and values), communication problems, coercion-supporting peer groups (including fraternities and athletics), concepts of masculinity and femininity, sexual promiscuity, and alcohol.

Gene-environment interplay in alcoholism and other substance abuse disorders: expressions of heritability and factors influencing vulnerability

Factors that confer predisposition and vulnerability for alcoholism and other substance abuse disorders may be described usefully within the gene-environment interplay framework. Thus, it is postulated that heritability provides a major contribution not only to alcohol but also to other substances of abuse. Studies of evoked potential amplitude reduction have provided a highly suitable and testable method for the assessment of both environmentally-determined and heritable characteristics pertaining to substance use and dependence. The different personal attributes that may co-exist with parental influence or exist in a shared, monozygotic relationship contribute to the final expression of addiction. In this connection, it appears that personality disorders are highly prevalent co-morbid conditions among addicted individuals, and, this co-morbidity is likely to be accounted for by multiple complex etiological relationships, not least in adolescent individuals. Co-morbidity associated with deficient executive functioning may be observed too in alcohol-related aggressiveness and crimes of violence. The successful intervention into alcohol dependence and craving brought about by baclofen in both human and animal studies elucidates glutamatergic mechanisms in alcoholism whereas the role of the dopamine transporter, in conjunction with both the noradrenergic and serotonergic transporters, are implicated in cocaine dependence and craving. The role of the cannabinoids in ontogeny through an influence upon the expression of key genes for the development of neurotransmitter systems must be considered. Finally, the particular form of behaviour/characteristic outcome due to childhood circumstance may lie with biological, gene-based determinants, for example individual characteristics of monoamine oxidase (MAO) activity levels, thereby rendering simple predictive measures both redundant and misguiding.

Drugs of abuse and the elicitation of human aggressive behavior

The drug-violence relationship exists for several reasons, some direct (drugs pharmacologically inducing violence) and some indirect (violence occurring in order to attain drugs). Moreover, the nature of that relationship is often complex, with intoxication, neurotoxic, and withdrawal effects often being confused and/or confounded. This paper reviews the existing literature regarding the extent to which various drugs of abuse may be directly associated with heightened interpersonal violence. Alcohol is clearly the drug with the most evidence to support a direct intoxication-violence relationship. The literatures concerning benzodiazepines, opiates, psychostimulants, and phencyclidine (PCP) are idiosyncratic but suggest that personality factors may be as (or more) important than pharmacological ones. Cannabis reduces likelihood of violence during intoxication, but mounting evidence associates withdrawal with aggressivity. The literature on the relationship between steroids and aggression is largely confounded, and between 3,4-methylenedioxymethamphetamine (MDMA) and aggression insufficient to draw any reasonable conclusions. Conclusions and policy implications are briefly discussed.

Morphological changes in genesial system of men: medico-legal aspects

With the purpose of perfection of examination the character of structural changes in testicles and prostate is investigated; the comparative qualitative and quantitative analysis of cellular reactions of persons with chronic somatopathies (rheumatic disease, idiopathic hypertensia) and chronic household intoxications (alcoholic illness, narcomania) is carried out. The work is carried out on 50 corpses of male persons, 18-35 years old, who died of chronic drunkenness (13 observations), narcomania (20), idiopathic hypertensia (9), and rheumatic disease (8). The suppression of testicles was characterized by disturbances of spermatogenesis at a level of the cell population, characteristic for a zero and first degree of spermatogenesis activity especially expressed in chronic narcotic intoxication. The damage to a prostate was stacked in a picture of a chronic relapsing prostatitis and chronic indurative prostatitis with the outcome of cirrhosis of prostata, being most typical for chronic alcohol intoxication. Morpho-functional investigation of a prostate and testicles affected by chronic somatopathies and chronic household intoxications, both qualitative and quantitative, testify to reduction of function of activity of these organs (hormonal imbalances, mail sterility, sex frustration). Thus, the persons suspected of violent actions of a sexual nature should be examined in order to reveal both erectile dysfunctions and disruption of spermatogenesis.

Emotional closeness with perpetrators and amnesia for child sexual abuse

Over the past decade, a contentious debate regarding delayed memories of childhood sexual abuse (CSA) has existed. In order to address this debate, 240 female participants completed questions about CSA, the Dissociative Experience Scale (Bernstein & Putnam, 1986), Perceived Emotional Closeness with Perpetrator Scale (Schultz, Passmore, & Yoder, 2000), and the Gudjonsson Suggestibility Scale 2 (GSS 2) (Gudjonsson, 1987). Eighty-two (36%) reported CSA and 37% of these indicated memory disturbances for the CSA. Participants reporting memory disturbances also reported significantly higher numbers of perpetrators, chemical abuse in their families, and closer relationships with the perpetrator(s) than participants reporting no memory disturbances. Implications for clinicians working with clients reporting CSA are discussed.

Victimization and Substance Abuse among Women: Contributing Factors, Interventions, and Implications

Although the literature indicates that there is an association of victimization with substance abuse, there has been limited research focused on understanding and synthesizing the factors that have been identified as contributing to victimization and substance abuse and on interventions designed to address these contributing factors. The purposes of this article are to (a) review the literature on factors related to victimization and substance abuse, (b) review interventions and outcomes, and (c) discuss clinical implications for interventions and research. Results suggest that there is a high rate of co-occurrence of victimization and substance abuse among women, that the factors contributing to victimization and substance abuse are complex, and that there is a lack of treatment models addressing victimization and substance abuse.

The impact of men's alcohol consumption on perpetration of sexual aggression

Epidemiological and experimental literature examining the link between men's alcohol consumption and perpetration of sexual aggression is reviewed. The following are included in the review: (1) associational studies that examine the correlation between typical alcohol consumption and history of sexual aggression perpetration; (2) event-level studies that examine the impact of alcohol consumption at the time of sexual assault; and (3) experimental studies that consider the impact of administered alcohol on men's responses to a sexual aggression analog. Associational studies suggest a modest correlation between typical alcohol consumption and history of sexual aggression perpetration, but spurious effects may account for much of the relationship. Event-level studies offer mixed evidence in support of a relationship between alcohol consumption at the time of the sexually aggressive incident and severity of outcome. Experimental analog studies provide evidence of a proximal, pharmacological effect of alcohol on the likelihood of sexual aggression perpetration and more modest evidence supporting an alcohol expectancy effect. An integrative heuristic model of alcohol's distal and proximal effects on sexual aggression perpetration is proposed. Priorities for future research include greater specificity in measurement of sexual aggression, examination of alcohol's indirect effects on aggression through context, and consideration of mechanisms other than alcohol myopia in understanding alcohol's proximal effects.

Alcohol and adult sexual assault in a national sample of women

PURPOSE

Alcohol use is commonly present in sexual assault incidents, but the nature of its role in these offenses remains unclear. Researchers have argued that the propensity to abuse alcohol generally and the use of alcohol prior to assault by offenders and victims may be associated with increased severity of sexual abuse and physical injury to sexual assault victims. In particular, there is speculation that offender drinking may facilitate offenders' use of greater physical aggression against victims in their attacks, resulting in more serious injuries to victims.

METHODS

The role of alcohol in sexual assault incidents (n = 163) identified from a national sample of women was studied.

RESULTS

In the present sample, offender pre-assault drinking and offender aggression used in the offense were each strong predictors of victim physical injury. Victim heavy episodic drinking did not predict victim injury controlling for other assault characteristics, victim and offender drinking prior to assault, and victim demographic characteristics. Drinking by offenders and victims was more common in assaults where victims were less well acquainted with their assailants prior to attack. Higher levels of offender aggression and victim injury were also associated with stranger attacks.

IMPLICATIONS

Implications of the results for the study of alcohol and sexual assault are discussed.

Alcohol and drug abuse in sexual and nonsexual violent offenders

According to a literature review by Marshall (1996), presently available data have not clarified the proportion of sexual offenders who would meet diagnostic criteria for addictive problems. Our own literature review failed to find published studies comparing sexual offenders to nonsexual violent offenders on standardized measures of substance abuse. Our study is a preliminary investigation of the differences between sexual offenders (rapists: n = 72; child molesters: n = 34) and nonsexual violent offenders (n = 24) on measures of alcohol and drug abuse. The findings indicate that sexual offenders were more likely to abuse alcohol than were nonsexual violent offenders. Nonsexual offenders were significantly more likely to have had a history of other forms of substance abuse. The results are considered in terms of theories of alcohol's contribution to aggressive behavior and sexual aggression. Implications for assessment and treatment of sexual offenders are discussed.

Culture-specific models of men's sexual aggression: intra- and interpersonal determinants

The role of intra- and interpersonal variables was examined in samples of Asian American (N = 91) and European American (N = 377) men. A path model for Asian American men suggested 2 interpersonal paths and 1 intrapersonal path to sexual aggression. For Asian Americans, concern about social standing is a risk factor among those who hold misogynous beliefs and who use alcohol before sex. Concern about the negative reputational impact of sexual aggression is a protective factor among Asian Americans who do not hold these negative attitudes. A European American model suggested only an intrapersonal path to sexual aggression consisting of misogynous beliefs, with interpersonal variables not being predictive of sexual aggression. These results suggest both individualist and collectivist determinants of Asian American sexual aggression, whereas only individualist determinants were found for European American sexual aggression.

A theory of mind perspective on cognitive, affective, and intimacy deficits in child sexual offenders

Previous work in the area of sexual offending has suggested that factors such as intimacy deficits, problems empathizing with victims, and cognitive distortions have all been associated with the genesis and maintenance of sexual abuse. While researchers have constructed theories to account for the role of these variables in sexual offending, a framework that unites their study is lacking. Recently Ward, Keenan, and Hudson have proposed that sexual offenders may suffer from a deficit in their ability to understand and attribute mental states to others. Their review of the literature on the etiology of sexual offending suggested that intimacy deficits, empathy deficits, and cognitive distortions all point to a lack of awareness of other peoples' beliefs, desires, perspectives, and needs, what is commonly referred to in the developmental literature as a theory of mind. In this paper, we expand on this argument, illustrating some of the developmental pathways by which deficits in one's theory of mind can explain the pattern of deficits exhibited by many sexual offenders.

The effect of alcohol on the responses of sexually coercive and noncoercive men to an experimental rape analogue

This study examined the impact of the psychological and pharmacological effects of alcohol on the ability of sexually coercive and noncoercive men to discriminate when a female wants a partner to stop sexual advances. In a 2 (alcohol vs. no alcohol) x 2 (expectancy vs. no expectancy) x 2 (sexually coercive vs. noncoercive status) randomized factorial design, male college students were exposed to an audiotape of a date rape. Participants who consumed, or expected to consume, alcohol took significantly longer to determine that the man should refrain from attempting further sexual contact. In addition, nonsexually coercive participants assigned to conditions in which they expected to consume alcohol responded similarly to their sexually coercive counterparts in their responses. The implications of these findings are discussed.

Criterion-related validity of a phallometric test for paraphilic rape and sadism

Eight men admitting to sadistic fantasies or urges (fantasizers), 7 sadistic rapists (sadists), 14 nonsadistic rapists, 31 courtship-disordered men (men displaying exhibitionism, voyeurism, frotteurism, or a combination of these paraphilias), and 20 community controls were compared on their relative phallometric responses to stimuli depicting rape, violent rape, and nonsexual violence. This study extended previous research by including a group of men who admitted to having sadistic fantasies or urges, in contrast to rapists who are likely to deny any such interests because of possible legal or social sanctions, and by including a large comparison group of men with a paraphilia other than sadism. Criterion-related validity was greater after combining the sadistic and nonsadistic rapists: fantasizers, sadists, and rapists did not differ from each other; fantasizers differed from community controls in their relative responses to rape, violent rape, and nonsexual violence; rapists differed from community controls in their relative responses to violent rape and nonsexual violence; and courtship-disordered men differed from community controls in their relative responses to nonsexual violence.