Sexual sadism in sexual offenders and sexually motivated homicide

Sexual homicide offenders as repeat and nonrepeat offenders: An empirical study of sexual homicide cases in Mainland China

The comparative examination of different groups of sexual homicide offenders (SHOs) is currently limited. To expand our understanding of Chinese sexual homicides, this study aimed to distinguish between the modus operandi (MO) characteristics of repeat (i.e., with previous arrest and/or conviction) and nonrepeat (i.e., without previous arrest and/or conviction) offenders. Data were gathered from police arrest records, court documents, and published case reports in mainland China, covering a 31-year period (1988-2018). A sample of 86 male SHOs (31 repeat and 55 nonrepeat offenders) was identified and the offenders' MO characteristics were examined. Compared with nonrepeat offenders, repeat offenders were significantly more likely to commit sexual murder in outdoor locations, approach their victims initially using a non-surprise approach, engage in nonvaginal penetration of their victims, use a personal weapon to kill their victims, and move their victims' bodies away from the crime scene. However, repeat offenders were less likely to be arrested immediately after committing the murder. The findings have practical implications for police investigative strategies, such as suspect prioritization.

Blunted startle reactivity in everyday sadism and psychopathy

Two studies examined the amplitude of the startle response as a function of the Dark Tetrad of personality (narcissism, Machiavellianism, psychopathy, and sadism). We measured electromyographic activity of the orbicularis oculi muscle evoked by a startle stimulus while participants viewed images on a computer screen. Both studies revealed a negative correlation between general startle reactivity (averaged across positive, negative, and neutral images) and sadistic tendencies. In Study 2, all four dark traits were negative correlates of general startle reactivity. Study 2 also examined the personality correlates of aversive startle potentiation (ASP; indexed by greater reactivity while viewing negatively-valenced images than positive or neutral images). ASP correlated negatively with a variety of personality measures of psychopathy and sadism, their facets, and related personality tendencies (callousness, risk-taking, and restricted affect). These findings suggest that ordinary people with high levels of callousness and antagonism display physiological evidence of non-reactivity (i.e., blunted acoustic startle in general), whereas psychopathy and sadism are preferentially associated with reduced ASP.

Legal and Policy Implications in Mexico of Changes in ICD-11 Paraphilic Disorders

INTRODUCTION

The World Health Organization (WHO) has made substantial changes to the classification of paraphilic disorders for the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11), recently approved by the World Health Assembly. The most important is to limit paraphilic disorders primarily to persistent and intense patterns of atypical sexual arousal involving non-consenting individuals, manifested through persistent sexual thoughts, fantasies, urges, or behaviors, that have resulted in action or significant distress.

AIM

To analyze the legal, regulatory, and policy implications of the changes in the ICD-11 classification of paraphilic disorders for forensic practice, health systems, adjudication of sex offenders, and the provision of treatment in Mexico.

METHODS

An expert Mexican advisory group was appointed to conduct this evaluation following an assessment guide provided by the WHO.

MAIN OUTCOME MEASURES

The WHO assessment guide covered (i) laws related to sexual behaviors; (ii) the relationship between legal and clinical issues for non-forensic health professionals; (iii) implications of mental disorder classification for forensic practice; (iv) other implications of ICD-11 paraphilic disorders proposals; and (v) contextual issues.

RESULTS

A variety of factors in Mexico make it highly unlikely that appropriate, evidence-based treatments for paraphilic disorders will be provided to those who need them, even if they seek treatment voluntarily and have not committed a crime. Mexican law focuses on the punishment of specific sexual behaviors rather than on underlying disorders. A paraphilic disorder would not be considered sufficient grounds for exemption from criminal responsibility. The application and scope of mental health evaluations in Mexican legal proceedings are quite limited, and individuals who commit sexual crimes almost never undergo forensic evaluations to establish the presence of paraphilic disorders. Psychiatric services may be mandated for sex offenders in highly specific circumstances but cannot exceed the duration of the criminal sentence.

CLINICAL IMPLICATIONS

Evaluation and treatment guidelines should be developed based on international evidence and standards and promulgated for use with individuals with paraphilic disorders in forensic and non-forensic poopulations. The much greater specificity and operationalization of the ICD-11 guidelines as compared with the ICD-10 guidelines provide a better basis for identification and case formulation.

STRENGTHS & LIMITATIONS

Major strengths of this analyses were that it was conducted to facilitate international comparability across several participating countries and the fact that it was conducted by a diverse multidisciplinary group representing various relevant legal, forensic and and clinical sectors. A limitation was that it was only possible to examine relevant federal laws and those of Mexico City rather than those of all 32 Mexican states.

CONCLUSION

The descriptions of paraphilic disorders in the ICD-11 could support substantial improvements in the treatment of individuals with paraphilic disorders and the adjudication of sex offenders in Mexico, but specific changes in Mexican law would be required. Martínez-López JNI, Robles R, Fresán A, et al. Legal and Policy Implications in Mexico of Changes in ICD-11 Paraphilic Disorders. J Sex Med 2019;16:1623-1637.

An Updated Sexual Homicide Crime Scene Rating Scale for Sexual Sadism (SADSEX-SH)

The Sexual Homicide Crime Scene Rating Scale for Sexual Sadism (SADSEX-SH) is a rating scale which dimensionally measures the degree of offender sexual sadism in suspected sexual homicide cases. Scoring is accomplished using crime scene and related investigative information. Preliminary norms for the SADSEX-SH prototype indicate that it correctly classified offenders with and without sexual sadism. This study further assessed SADSEX-SH sensitivity, specificity, and inter-rater reliability by comparing a larger sample of male sexual homicide offenders with (n = 20) and without (n = 20) sexual sadism. Two items generally undetectable at crime scenes were removed from the originally proposed 10-item scale, resulting in a final 8-item version. SADSEX-SH total scores for the two groups significantly differed (7.7 ± 3.5, range = 2-14 vs. 2.6 ± 2.0, range = 0-7, t = 5.58, p < .001). Inter-rater reliability was excellent (intraclass correlation coefficients [ICCs] = 0.6-1.0). Using a revised cutoff score of 6, sensitivity was 70.0% and specificity was 90%. This revised scale may prove useful for investigators, clinicians, and institutional professionals in helping to identify and address sexual sadism in sexual homicide offenders.

The primary motivation of sexual homicide offenders in China: Was it for sex, power and control, anger, or money?

BACKGROUND

Information on sexual homicides in China is scarce, particularly with respect to the offenders' primary motivation for the offence.

AIMS

Our aim was to examine how offence characteristics of sexual murderers relate to different primary motivations.

METHODS

The offender, victim, and offence characteristics of 67 sexual homicides, derived from police data of three regions and published case reports (1994-2017), were explored and compared according to offenders' primary motivation.

RESULTS

Heterosexual sexual homicides were committed by offenders who were mainly driven by power and control, sex, and anger, compared with slightly over half of those who motivated primarily by financial gain. Sexual murderers whose killing was mainly driven by sex, money, and anger were more likely to target strangers, whereas offenders who motivated primarily by power and control were more likely to target an intimate partner. Victim abduction was more frequently seen in offenders who were motivated predominantly by money than other motives. Relative to financial gain as primary motivation, sexual killers who were mainly driven by sex, power and control, and anger were more likely to mutilate their victim.

IMPLICATIONS FOR PRACTICE

This study adds data to a field rarely studied anywhere and hardly at all in China. Findings may offer some help for criminal investigators who need to prioritise their investigative strategies. Once the individual is convicted and sentenced, they may help direct management and/or therapeutic strategies.

Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11)

The World Health Organization is currently developing the 11th revision of the International Classifications of Diseases and Related Health Problems (ICD-11), with approval of the ICD-11 by the World Health Assembly anticipated in 2018. The Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH) was created and charged with reviewing and making recommendations for categories related to sexuality that are contained in the chapter of Mental and Behavioural Disorders in ICD-10 (World Health Organization 1992a). Among these categories was the ICD-10 grouping F65, Disorders of sexual preference, which describes conditions now widely referred to as Paraphilic Disorders. This article reviews the evidence base, rationale, and recommendations for the proposed revisions in this area for ICD-11 and compares them with DSM-5. The WGSDSH recommended that the grouping, Disorders of sexual preference, be renamed to Paraphilic Disorders and be limited to disorders that involve sexual arousal patterns that focus on non-consenting others or are associated with substantial distress or direct risk of injury or death. Consistent with this framework, the WGSDSH also recommended that the ICD-10 categories of Fetishism, Fetishistic Transvestism, and Sadomasochism be removed from the classification and new categories of Coercive Sexual Sadism Disorder, Frotteuristic Disorder, Other Paraphilic Disorder Involving Non-Consenting Individuals, and Other Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals be added. The WGSDSH's proposals for Paraphilic Disorders in ICD-11 are based on the WHO's role as a global public health agency and the ICD's function as a public health reporting tool.

Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations

In the World Health Organization's forthcoming eleventh revision of the International Classification of Diseases and Related Health Problems (ICD-11), substantial changes have been proposed to the ICD-10 classification of mental and behavioural disorders related to sexuality and gender identity. These concern the following ICD-10 disorder groupings: F52 Sexual dysfunctions, not caused by organic disorder or disease; F64 Gender identity disorders; F65 Disorders of sexual preference; and F66 Psychological and behavioural disorders associated with sexual development and orientation. Changes have been proposed based on advances in research and clinical practice, and major shifts in social attitudes and in relevant policies, laws, and human rights standards. This paper describes the main recommended changes, the rationale and evidence considered, and important differences from the DSM-5. An integrated classification of sexual dysfunctions has been proposed for a new chapter on Conditions Related to Sexual Health, overcoming the mind/body separation that is inherent in ICD-10. Gender identity disorders in ICD-10 have been reconceptualized as Gender incongruence, and also proposed to be moved to the new chapter on sexual health. The proposed classification of Paraphilic disorders distinguishes between conditions that are relevant to public health and clinical psychopathology and those that merely reflect private behaviour. ICD-10 categories related to sexual orientation have been recommended for deletion from the ICD-11.