Reduction of Risk Factors for Pedophilic Sexual Offending

Evaluating Child Sexual Abuse Perpetration Prevention Efforts: A Systematic Review

Many child sexual abuse prevention efforts focus on the prevention of victimization, through education of children and parents, bystander training, and policies and practices in youth-serving organizations (e.g. requiring criminal record checks). However, there has been growing attention to child sexual abuse perpetration prevention, targeted at individuals who are at risk of perpetration. We conducted a systematic review of studies reporting outcomes for child sexual abuse perpetration prevention interventions. Only seven studies were identified in our review, with five intended for adults and two intended for children. Four of the five adult studies had significant methodological concerns, precluding strong conclusions from these studies. We concluded that higher-quality evaluations of perpetration prevention efforts are greatly needed. We also identified intrafamilial perpetration prevention, particularly interventions for parents or caregivers, as a critical gap in the literature. Suggestions for child sexual abuse perpetration intervention evaluation and delivery are discussed.

Acceptance of Sexual Interest in Minors in Self-Referred Individuals Under Treatment - An Exploratory Pilot Study

Some therapists/scientists argue that “acceptance” of sexual interest in minors (SIM), i.e., the integration of the sexual preference into the individual self-concept, is a prerequisite for dealing with SIM in a responsible way. However, if one assumes that – even in some persons – SIM might change over time, “acceptance” could also run counter to therapeutic targets because the motivation to change as well as the specific self-efficacy for modifying SIM might be reduced. This exploratory pilot study analyzes the relationship between acceptance of SIM and (1) dynamic risk for contact sexual reoffending, (2) SIM and frequency of the use of child/adolescent (sexual abuse) imagery, (3) frequency of sexual desire/behavior toward children/adolescents, and (4) the change of the level of acceptance of SIM during the course of treatment. The majority of the participants (N = 79) was not exclusively interested in children (85%) and used child pornography but did not commit child sexual abuse (54%). Acceptance of SIM, frequency of the use of child/adolescent (sexual abuse) imagery and frequency of sexual desire/behavior toward children/adolescents are assessed via self-report questionnaires, dynamic risk for contact sexual reoffending is measured by STABLE-2007. Pretreatment data are analyzed via Spearman’s correlation (N = 79). Intragroup analysis compares acceptance of SIM from pre- and posttreatment (n = 35). There was no correlation between acceptance of SIM and dynamic risk for contact sexual reoffending. However, there was a medium, positive correlation between acceptance of SIM and the frequency of the use of legal imagery of children, a positive correlation between the item “My inclination is an integral part of my personality” and the frequency of the use of legal imagery of children, and a positive correlation between acceptance of SIM and the frequency of sexual activities with minors. Acceptance of SIM did not change during the course of treatment. The results suggest that “acceptance” of SIM has to be discussed in a differentiated way, i.e., as possibly being associated with positive and negative outcomes as well.

Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study

Introduction

Studies on characteristics of self-referred men with sexual interest in minors (SIM) and treatment approaches in this group of patients are still relatively rare.

Aim

The aim of this exploratory pilot study was to investigate hypersexuality and impulsivity as 2 dynamic risk factors that could possibly change during treatment in self-referred men with SIM.

Methods

Data were collected at the “Kein Täter Werden (means: not become an offender)” network site in Hamburg. Using self-report questionnaires, the extent of hypersexuality and impulsivity was analyzed with the samples’ pretreatment data via descriptive statistics and compared with nonclinical samples of other studies. The relation between hypersexuality and impulsivity was analyzed via Spearman's correlation coefficient with pretreatment data (N = 77). Intragroup analysis compared hypersexuality and impulsivity from pre- and posttreatment (n = 29).

Main Outcome Measures

Hypersexual Behavior Inventory and Barratt Impulsiveness Scale Version 11.

Results

The degree of generalized impulsivity in the SIM group was comparable to that in nonclinical samples while the degree of hypersexuality was considerably higher than in nonclinical samples. Sixty-four percent of the participants were in the range of clinically relevant hypersexuality. Impulsivity and hypersexuality were weakly positively correlated with each other. During treatment hypersexuality significantly decreased while impulsivity did not differ significantly between before beginning treatment and after (partial) completion.

Conclusion

Hypersexuality, but not impulsivity, was pronounced in the group of self-referred men with SIM and should be targeted in treatment. In order to improve treatment outcome regarding risk reduction in self-referred men with SIM, a focus on treatment approaches that were developed to treat hypersexuality can be expected to be effective while focusing on generalized impulsivity may be less relevant.

Lampalzer U, Tozdan S, von Franqué F, et al. Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study. Sex Med 2021;9:100429.

Exploratory Factor Analysis of Unusual Sexual Interests

BACKGROUND

Unusual sexual interests are largely intercorrelated, yet not much is known about underlying patterns of clusters between various sexual interests.

AIM

To identify underlying clusters of unusual sexual interests using exploratory factor analysis.

METHODS

We conducted exploratory factor analysis with self-reported interest in a wide variety of unusual sexual acts for an online, international sample (N = 669; 61% female), and for women and men separately. Factor regression weights were correlated to self-reported sex life satisfaction, sexual outlet, and psychiatric symptoms.

OUTCOMES

Participants rated the attractiveness of 50 unusual sexual activities, and reported on their sex life satisfaction (Arizona Sexual Experiences Scale), sexual outlet, and symptoms regarding ADHD (Adult ADHD Self-Report Screening Scale for DSM-5), depression, anxiety, and stress (Depression, Anxiety, and Stress Scale).

RESULTS

We identified 5 factors of unusual sexual interests that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia (attraction to dirtiness or soiled things), and fetishism. For women, unusual sexual interests related to more psychiatric symptoms and higher sexual outlet, whereas this relation was less explicit for men.

CLINICAL IMPLICATIONS

Different factors of unusual sexual interests may serve different underlying functions or motivations, for instance related to sexual, and emotional regulation. A better understanding of the nature of unusual sexual interests is important to be able to influence sexual interests that are unwanted or cause damage to others.

STRENGTHS & LIMITATIONS

Strength of this study include its anonymity, the avoidance of sexual orientation effects, and the possibility to indicate only a slight endorsement toward sexual items. Limitations include the sample's generalizability and the truthfulness of online responding.

CONCLUSION

Unusual sexual interests could be clustered into 5 factors that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia, and fetishism. Schippers EE, Smid WJ, Huckelba AL, et al. Exploratory Factor Analysis of Unusual Sexual Interests. J Sex Med 2021;18:1615-1631.

Child Sexual Abuse: The Need for a Perpetration Prevention Focus

In the evolution of efforts to reduce child sexual abuse (CSA) rates in the United States, there has been a gradual shift to add preventive measures to after-the-fact interventions (i.e., interventions and policies implemented after the abuse has already happened, such as services and treatment for victims and punishment, treatment, and management of offenders). Prevention of CSA perpetration, however, is often missing from these efforts, despite decades of experts calling for broader prevention solutions. The current paper describes the scope of the problem of CSA, highlights problems with an over-reliance on after-the-fact interventions, and describes promising perpetration-focused CSA prevention interventions. While most existing preventive efforts focus on teaching children to protect themselves from incurring sexual harm, perpetration prevention efforts may hold more promise by addressing the onset of harmful behavior. As such, perpetration prevention efforts can contribute to a more robust and comprehensive approach to CSA - an approach that focuses on prevention of harm from occurring in the first place, as well as responding once harm has occurred.