Improving risk assessments for sex offenders: a comparison of three actuarial scales

The impact of testosterone-lowering medication on recidivism in individuals convicted of sexual offenses

INTRODUCTION

Treatment of individuals who have committed sexual offences with Testosterone-Lowering Medication (TLM) is a comparatively intrusive kind of intervention, which regularly takes place in coercive contexts. Thus, the question of efficacy, but also the question of who should be treated, when and for how long, are of great importance.

METHODS

Recidivism rates of TLM-treated high-risk individuals (+TLM; n = 54) were compared with high-risk individuals treated with psychotherapy only in the same forensic outpatient clinic (-TLM; n = 79).

RESULTS

Group differences suggested a higher initial risk of + TLM (e.g. higher ris-assessment, previous convictions). Despite the increased risk, after an average time at risk of six years, +TLM recidivated significantly less often and significantly later than - TLM (27.8% vs. 51.9%). Such an effect was also found for violent (1.9% vs. 15.2%), but not for sexual (5.6% vs. 10.1%) and serious recidivism (5.6% vs. 10.1%), which could be explained partly by the small number of cases. In the course of treatment, TLM proved to be a significant variable for a positive process, whereas a high risk-assessment score indicated a rather negative course. In total, n = 19 individuals had stopped their TLM treatment, of these 31.6% recidivated.

CONCLUSION

The results support the efficacy of TLM, particularly in the group of high-risk offenders.

Forensic Aftercare Facilities and Their Impact on the Releasability of Persons Who Committed Sexual Offenses: A Three Group Comparison

Partly due to a lack of release options for individuals who committed sexual offenses, forensic follow-up treatment has been strengthened latest since 2007. The current study investigates whether the foundation of a professionalized follow-up-treatment has actually improved release options for individuals who committed sexual offenses. Thus, the aim of the present study was to assess the difference in criminogenic needs and recidivism relevant characteristics (e.g., index offense, criminal history, psychiatric diagnoses and risk assessment) between three groups who had been released from forensic psychiatry at different times or under different outpatient follow-up modalities: (1) individuals released prior the foundation of professionalized follow-up-treatment, (2) individuals released after the foundation and received treatment, and (3) individuals released after the foundation but not receiving this special treatment. It was found that with the availability of professionalized forensic followup treatment, persons with higher scores in common risk assessment tools and a longer duration of implacement had been released. Indeed, this indicates an increased risk tolerance among decision makers. However, it was not those who were released after the foundation of the professionalized forensic follow-up treatment but without this specific treatment who showed the lowest initial risk, but those who were released prior to the foundation. Results are discussed in terms of possible explanations and methodological issues.

Machine Learning and Risk Assessment: Random Forest Does Not Outperform Logistic Regression in the Prediction of Sexual Recidivism

Although many studies supported the use of actuarial risk assessment instruments (ARAIs) because they outperformed unstructured judgments, it remains an ongoing challenge to seek potentials for improvement of their predictive performance. Machine learning (ML) algorithms, like random forests, are able to detect patterns in data useful for prediction purposes without explicitly programming them (e.g., by considering nonlinear effects between risk factors and the criterion). Therefore, the current study aims to compare conventional logistic regression analyses with the random forest algorithm on a sample of N = 511 adult male individuals convicted of sexual offenses. Data were collected at the Federal Evaluation Center for Violent and Sexual Offenders in Austria within a prospective-longitudinal research design and participants were followed-up for an average of M = 8.2 years. The Static-99, containing static risk factors, and the Stable-2007, containing stable dynamic risk factors, were included as predictors. The results demonstrated no superior predictive performance of the random forest compared with logistic regression; furthermore, methods of interpretable ML did not point to any robust nonlinear effects. Altogether, results supported the statistical use of logistic regression for the development and clinical application of ARAIs.

Long Term Recidivism Rates Among Individuals at High Risk to Sexually Reoffend

Preventive detention provisions in the US and Canada assume we can identify, in advance, individuals at high risk for sexual recidivism. To test this assumption, 377 adult males with a history of sexual offending were followed for 20 years using Canadian national criminal history records and Internet searches. Using previously collected information, a high risk/high need (HRHN) subgroup was identified based on an unusually high levels of criminogenic needs (n = 190, average age of 38 years; 83% White, 13% Indigenous, 4% other). A well above average subgroup of 99 individuals was then identified based on high Static-99R (6+) and Static-2002R (7+) scores. In the HRHN group, 40% reoffended sexually. STATIC HRHN norms overestimated sexual recidivism at 5 years (Static-99R, E/O = 1.44; Static-2002R, E/O = 1.72) but were well calibrated for longer follow-up periods (20 years: Static-99R, E/0 = 1.00; Static-2002R, E/O = 1.16). The overall sexual recidivism rate for the well above average subgroup was 52.1% after 20 years, and 74.3% for any violent recidivism. The highest risk individuals (top 1%) had rates in the 60%-70% range. We conclude that some individuals present a high risk for sexual recidivism, and can be identified using currently available methods.

Cross-Cultural Validity of Sexual Recidivism Risk Assessments Using Static-99R, STABLE-2007, and the VRS-SO

PURPOSE OF REVIEW

The overrepresentation of certain racial/ethnic groups in criminal legal systems raises concerns about the cross-cultural application of risk assessment tools. We provide a framework for conceptualizing and measuring racial bias/fairness and review research for three tools assessing risk of sexual recidivism: Static-99R, STABLE-2007, and VRS-SO.

RECENT FINDINGS

Most cross-cultural research examines Static-99R and generally supports its use with Black, White, Hispanic, and Asian men. Preliminary research also supports STABLE-2007 with Asian men. Findings are most concerning for Indigenous men, where Static-99R and STABLE-2007 significantly predict sexual recidivism, but with significantly and meaningfully lower accuracy compared to White men. For the VRS-SO and the combined Static-99R/STABLE-2007 risk levels, predictive accuracy was not significantly lower for Indigenous men, for which we discuss several possible explanations. We offer considerations for risk scale selection with Indigenous men and highlight recent guidance produced for cross-cultural risk assessment.

General Criminal Dynamic Risk and Strength Factors Predict Short-Term General Recidivism Outcomes Among People Convicted of Sexual Crime During Community Supervision

There are clinical practice and operational reasons why it may be appropriate to primarily focus on general risk factors when supervising people convicted of sexual crime in the community. General risk domains may be particularly relevant when supervision officers engage in frequent reassessment of acute dynamic risk factors. We tested the ability of a case management tool, the Dynamic Risk Assessment for Offender Re-entry, to discriminate community based, short-term general (all outcome) recidivism versus nonrecidivism among people convicted of sexual crime (n = 562). We tested the predictive discrimination validity of each DRAOR item and then subscale scores in univariate and multivariate models (also controlling for general static risk). DRAOR scores were associated with general recidivism outcomes and effect sizes were generally similar or stronger compared to models with people convicted of nonsexual crime (n = 2854). DRAOR Acute scores were consistently and incrementally related to general recidivism outcomes beyond other scores. In practice, case managers should remain aware that people convicted of sexual crime are at risk for nonsexual recidivism outcomes and assess problematic functioning broadly alongside problems in sexual domains. Clinically, interconnection among domains potentially provides multiple avenues for effective intervention.

Development of a risk assessment tool for Japanese sex offenders: The Japanese Static-99

In Japan, sexual offending, especially paraphilic sexual offending, has become a major problem, and approximately 3000 people are arrested for frotteuristic and voyeuristic behavior each year. Considering the repetitive nature of such behaviors, determining the recidivism risk is imperative. Globally, Static-99 is one of the most widely used actuarial risk assessment tools to predict recidivism among sex offenders. However, sexual offending is largely influenced by social and cultural backgrounds, and whether risk factors identified in the West are applicable to other countries is unknown. Therefore, we developed a Japanese version of the Static-99 and examined its reliability and validity with 167 Japanese paraphilic sex offenders. The results showed good internal consistency (Cronbach's alpha coefficient = 0.88) and predictive accuracy (area under the curve = 0.76). The results indicate that the Japanese Static-99 can be used with Japanese sex offenders. Moreover, risk factors identified in the Western context are applicable to Japanese sex offenders despite the different nature and manifestations of their offending.

Do the Redundant and Locally Dependent Items of the LS/CMI Contribute in Any Meaningful Way to Its Reliability and Its Potential to Predict Criminal Recidivism?

This article studies the effects of local dependence within the items of the first section of the LS/CMI on its reliability. Analysis were done to identify the dependent items namely through their correlations before and after Rasch modeling. Seven items were thus discarded, deemed dependent and redundant, and Cronbach's alpha was calculated with all 43 items and then with the 36 items deemed independent. Test information and predictive validity were also compared. Removing the seven redundant items did not seem to have major effects on the reliability of the LS/CMI or the psychometric information it provided, and no tangible effects were observed on its predictive validity. The reliability of an instrument should be assessed with items that contribute each in its own way. However, it is hazardous to report the reliability of an instrument known to be multidimensional with means meant to be used with unidimensional instruments.

Static-99R Norms and Cross-Cultural Validity for Australian Aboriginal and Non-Aboriginal Men Convicted of Sexual Offences

This study examined Static-99R normative data and cross-cultural validity in a sample of 811 Aboriginal and 3257 non-Aboriginal Australian men (N = 4068) serving custodial orders for sexual offences in New South Wales (NSW), Australia. Aboriginal men scored significantly higher on the Static-99R than non-Aboriginal men (M = 4.39 vs. 2.61) and were more likely to be represented in higher categories of risk. The Static-99R showed good discrimination performance for the total sample (AUC = .76; 95% CI = [.73-.80]) and acceptable calibration to expected reoffending rates for routine samples, with slight tendencies towards overestimation. Discrimination accuracy was lower for Aboriginal men (AUC = .68; 95% CI = [.60-77]) than non-Aboriginal men (AUC = .78; 95% CI = [.74-83]) although was significantly better than chance for both groups. Additional analyses indicated that cross-cultural differences in discrimination were partly associated with variance in sample composition between groups. This is the first Australian study to find evidence for significant predictive validity of the Static-99R with Aboriginal men, and while further research is needed, the results provide initial support for cross-cultural applications of the measure in local criminal justice settings.

Violence risk assessment instruments in forensic psychiatric populations: a systematic review and meta-analysis

BACKGROUND

Although structured tools have been widely used to predict violence risk in specialist mental health settings, there is uncertainty about the extent and quality of evidence of their predictive performance. We aimed to systematically review the predictive performance of tools used to assess violence risk in forensic mental health, where they are routinely administered.

METHODS

In our systematic review and meta-analysis, we followed PRISMA guidelines and searched four databases (PsycINFO, Embase, Medline, and Global Health) from database inception to Nov 1, 2022, to identify studies examining the predictive performance of risk assessment tools in people discharged from forensic (secure) mental health hospitals. Systematic and narrative reviews were excluded from the review. Performance measures and descriptive statistics were extracted from published reports. A quality assessment was performed for each study using the Prediction Model Risk of Bias Assessment Tool. Meta-analysis was conducted on the performance of instruments that were independently externally validated with a sample size greater than 100. The study was registered with PROSPERO, CRD42022304716.

FINDINGS

We conducted a systematic review of 50 eligible publications, assessing the predictive performance of 36 tools, providing data for 10 460 participants (88% men, 12% women; median age [from 47 studies] was 35 years, IQR 33-38) from 12 different countries. Post-discharge interpersonal violence and crime was most often measured by new criminal offences or recidivism (47 [94%] of 50 studies); only three studies used informant or self-report data on physical aggression or violent behaviour. Overall, the predictive performance of risk assessment tools was mixed. Most studies reported one discrimination metric, the area under the receiver operating characteristic curve (AUC); other key performance measures such as calibration, sensitivity, and specificity were not presented. Most studies had a high risk of bias (49 [98%] of 50), partly due to poor analytical approaches. A meta-analysis was conducted for violent recidivism on 29 independent external validations from 19 studies with at least 100 patients. Pooled AUCs for predicting violent outcomes ranged from 0·72 (0·65-0·79; I2=0%) for H10, to 0·69 for the Historical Clinical Risk Management-20 version 2 (95% CI 0·65-0·72; I2=0%) and Violence Risk Appraisal Guide (0·63-0·75; I2=0%), to 0·64 for the Static-99 (0·53-0·73; I2=45%).

INTERPRETATION

Current violence risk assessment tools in forensic mental health have mixed evidence of predictive performance. Forensic mental health services should review their use of current risk assessment tools and consider implementing those with higher-quality evidence in support.

FUNDING

Wellcome Trust.

Outcome Evaluation of a Treatment Program for Men with Paraphilic Disorders Convicted of Sexual Offenses: 10-Year Community Follow-up

Evidence concerning specific paraphilia treatment effectiveness is limited. We present observation data of 127 men convicted of paraphilic sexual offenses who attended inpatient and outpatient follow-up treatment in Czechia. We collected participants' sociodemographic and treatment-related information, including STATIC-99R scores, and used proportional hazards models to analyze variables' effect on recidivism risk. Within the observation period, the general recidivism and sexual recidivism rates were 33.1% and 16.5%, respectively, and the sexual contact recidivism rate was 4.7%. The total STATIC-99 score for those who re-offended was 5.65 (SD = 2.11) and for those who did not was 3.98 (SD = 2.02). Recidivism risk was 7.52 times higher for those diagnosed with exhibitionism than with pedophilia, sadomasochism, or antisocial personality disorder. General recidivism is comparable to others' findings. We attribute the lower sexual contact recidivism rate to the combined effects of psychological and pharmacological treatment, and higher numbers of non-contact offenses to limited antidepressant use.

Prediction of gradual release violations and institutional misconduct with actuarial risk assessment instruments—A retrospective validation study of the OGRS 3 and the SVG-5

Kriminalprognostische Verfahren sind unerlässlicher Bestandteil der Beurteilung von Rückfallwahrscheinlichkeiten im Zuge von Entlassungsentscheidungen. Ihre Eignung zur Vorhersage von Lockerungsmissbräuchen und intramuralen Regelverstößen wurde hingegen bislang kaum untersucht. Die vorliegende Studie prüft die prädiktive Validität der 3. Version der Offender Group Reconviction Scale (OGRS 3) und des Screeninginstrument zur Vorhersage des Gewaltrisikos (SVG-5) an einer Stichprobe von 200 Insassen der Justizvollzugsanstalt Frankenthal. Darüber hinaus werden weitere potenzielle Prädiktoren explorativ untersucht. Für die Prognoseinstrumente ergeben sich überwiegend geringe bis maximal moderate Effektstärken (OGRS 3: Area Under the Curve (AUC) = 0,522 bis 0,556 und SVG-5: AUC = 0,561 bis 0,653). Die vorliegenden Ergebnisse sollten aufgrund methodischer Limitationen allerdings zurückhaltend interpretiert werden. Sie können jedoch als Ausgangspunkt und Grundlage für zukünftige Forschung in diesem Bereich verwendet werden, da die Resultate nahelegen, dass auch Lockerungsmissbräuche und intramurales Fehlverhalten grundsätzlich vorhergesagt werden können.

The Predictive Validity of the Revised Screening Scale for Pedophilic Interests (SSPI-2)

The Revised Screening Scale for Pedophilic Interests (SSPI-2) is a five-item measure that assesses for pedohebephilia (sexual attraction to prepubescent and pubescent children) based on child victim characteristics. We aimed to replicate findings by Seto, Sandler et al. (2017) by examining the predictive validity of the SSPI-2 in an independent sample of 626 men referred for a sexological assessment because of sexual offending against children. SSPI-2 scores were associated with an increased likelihood of sexual recidivism but were not significantly associated with non-sexually violent or non-violent recidivism. When they were entered together, the SSPI-2 did not contribute additional variance to the Static-99R in the prediction of sexual recidivism. Results are consistent with the findings of Seto, Sandler et al. (2017) and suggest that higher scores on the SSPI-2 may be indicative of an increased risk for sexual recidivism in individuals who have sexually offended against children.

Public Perception of Men Who Have Committed Intrafamilial and Extrafamilial Sexual Offences Against Children

This study examined whether the attitudinal responses toward child sexual abuse (CSA) differ due to the person's relationship with the victim (intrafamilial vs. extrafamilial) and/or proximity to the victim (close vs. distant). An online sample of 292 participants completed a measure assessing pre-existing attitudes toward people who commit sexual offenses, before being randomly presented with a vignette describing a CSA case committed by a biological father, biological uncle, babysitter, stranger, or stepfather. Participants then rated the perpetrator's level of dangerousness and pedophilic interest, their own feelings of disgust, and their punitive judgments. Controlling for pre-existing attitudes, the extrafamilial cases (stranger and babysitter) were perceived to be more dangerous (large effects; ds > .50) and more pedophilic than the stepfather (large effects; ds > .60). Also, participants reported greater levels of disgust toward the stranger than both the babysitter and uncle (medium effects; ds > .30). The findings demonstrate the need to account for the established heterogeneity of men who commit CSA when studying the public's attitudinal responses. Methodological limitations and suggestions for future research are also discussed.

Predictive Validity of Static-99R Among 8,207 Men Convicted of Sexual Crimes in South Korea: A Prospective Field Study

The accuracy of risk assessment tools for Asian populations has received relatively little research attention. This study evaluated one of the most widely used static risk assessment tools - Static-99R - for assessing the likelihood of recidivism among men convicted of a sexual crime in South Korea. Overall, this South Korean sample (N = 8207) appeared to have a higher risk (more paraphilic interests, more sexual/general criminality) than the Static-99R normative samples (who were mostly White individuals from Western countries). Despite the differences, Static-99R was able to discriminate recidivists from nonrecidivists in South Korea, with AUC values similar to that observed in the normative samples (e.g., 0.72 for sexual recidivism). In terms of calibration, the observed sexual recidivism rates of the current sample were higher than the international routine/complete normative samples but lower than the high-risk/high-need normative samples (E/O = 0.75 and 1.26, respectively). Consequently, evaluators in South Korea can have reasonable confidence in the ability of Static-99R to rank individuals according to their relative likelihood of sexual recidivism.

Do Sanctions Affect Undetected Sexual Offending?

Undetected sexual offending creates challenges for risk assessment since estimated sexual recidivism rates are based on documented charges or convictions. Courts and other stakeholders may be primarily interested in the true risk for sexual reoffense and not simply risk for detected sexual offenses. Attempts to study and quantify the rate of undetected sexual offending have resulted in a wide variety of estimates. In this study, we explore whether sanctions imposed for detected sexual offenses increase the detection rate of subsequent offenses, and thereby suppress undetected sexual offending in an exceptionally high-risk sample who were ultimately committed as Sexually Violent Persons. Results indicate the detection rate of sexual offenses increased following an initial sanction, subsequently decreasing the proportion of undetected to detected offending. This effect only occurred after the first sanction. Overall, the sample had a high detection rate and spent little time in the community before subsequent arrests. These results differ from other reports that high rates of sexual offenses go undetected.

Comparison of Community and Expert Samples in the Perceived Risk of Individuals Who Have Sexually Offended

Public and clinician attitudes are important to consider when studying the reentry of individuals who sexually offend. Uninformed public attitudes drive the continued use of ineffective policies like registries and residential restrictions in the United States, and experts must assess risk to decide what level of supervision and control to recommend upon release from prison. This study investigated whether actuarial feedback could change participant attitudes about recidivism risk and disposition. Association for the Treatment and Prevention of Sexual Abuse (ATSA) members and a sample from MTurk completed a survey using vignettes to assess recidivism risk and dispositional outcomes of individuals who had sexually offended and varied in their risk to reoffend. They received feedback about the individuals' Static-99R risk levels and adjusted their initial ratings. ATSA members were less punitive than MTurk participants, initially predicted risk that was more consistent with actuarial data, and adjusted when incorrect. MTurk participants held more negative attitudes towards individuals who sexually offend, as measured by the ATS-21. They adjusted their risk ratings more than ATSA members, though their estimates were still higher than the ATSA members after feedback. Implications for US public policy, including the recommendation to use actuarials across the country, are discussed.

Improving Our Risk Communication: Standardized Risk Levels for Brief Assessment of Recidivism Risk-2002R

A Five-Level Risk and Needs system has been proposed as a common language for standardizing the meaning of risk levels across risk/need tools used in corrections. Study 1 examined whether the Five-Levels could be applied to BARR-2002R (N = 2,390), an actuarial tool for general recidivism. Study 2 examined the construct validity of BARR-2002R risk levels in two samples of individuals with a history of sexual offending (N = 1,081). Study 1 found reasonable correspondence between BARR-2002R scores and four of the five standardized risk levels (no Level V). Study 2 found that the profiles of individuals in Levels II, III, and IV were mostly consistent with expectations; however, individuals in the lowest risk level (Level I) had more criminogenic needs than expected based on the original descriptions of the Five-Levels. The Five-Level system was mostly successful when applied to BARR-2002R. Revisions to this system, or the inclusion of putatively dynamic risk factors and protective factors, may be required to improve alignment with the information provided by certain risk tools.

Survey on the Prescription Patterns of Pharmacological Agents in Individuals Who Have Committed Sexual Offenses During Forensic Outpatient Treatment in Germany: How Many Discontinue Testosterone Lowering Medication Under Parole?

BACKGROUND

The number of individuals who sexually offended, and who are continued to be treated with pharmacological agents to reduce sex drive after their release from prison or forensic psychiatry, are not known. Furthermore, figures on the number of those who stop their sexdrive supressing antiandrogen treatment in the outpatient setting are unknown as well. This is of central importance though as it might be associated with an increased risk of recidivism.

AIM

To assess prescription patterns as well as adherence to pharmacological treatment in outpatient clinics in Germany for individuals who have sexually offended and were released from prison or forensic psychiatric hospital.

METHODS

A self-constructed online survey assessing the pharmacological treatment modalities was sent by e-mail to n = 103 forensic outpatient clinics in Germany. Thirty-three (32.0%) completed the questionnaire and reported about 834 patients.

OUTCOMES

Prevalence of the use of different pharmacological agents in the treatment of individuals convicted for sexual offenses as well as the number of patients who have discontinued testosterone-lowering medication (TLM).

RESULTS

Among all institutions, 22.4% (n = 187) of individuals received pharmacological treatment, with 40.1% receiving gonadotropin-releasing-hormone-agonists, 26.2% antipsychotics, 24.6% selective serotonin reuptake inhibitors, 6.4% cyproterone acetate, and 2.7% a combination of gonadotropin-releasing-hormone-agonists and cyproterone acetate. A significant positive correlation was found between the number of patients released from a forensic-psychiatric hospital and the number of patients treated with TLM. Within 1 year 8.6% (n = 16) stopped their TLM during or at the end of the supervision period, most of them against treatment providers advice.

CLINICAL IMPLICATIONS

Substantial regional differences indicate uncertainties regarding the prescription of pharmacological agents for outpatients who have committed sexual offences in Germany. The discontinuiation of TLM within the first year of treatment against treatment providers advise in a substantial proportion of patients could be associated with a serious risk for reoffending.

STRENGTHS & LIMITATIONS

The present survey captures prevalences of the pharmacotherapy in forensic aftercare facilities for individuals who have offended sexually, and is the first to record the number of discontinuations. This is a cross-sectional survey covering only 1 country, but includes a large number of individuals.

CONCLUSION

Even though the number of treated individuals has increased in prisons, the majority of pharmacological treatment is still provided by forensic hospitals, which then translates into the outpatient setting. The number of those who stop taking such medication is a highly relevant topic for both forensic treatment providers and legal decision makers Sauter J, Rettenberger M, Briken P, et al. Survey on the Prescription Patterns of Pharmacological Agents in Individuals Who Have Committed Sexual Offenses During Forensic Outpatient Treatment in Germany: How Many Discontinue Testosterone Lowering Medication Under Parole?. J Sex Med 2022;19:1147-1155.

California Sexually Violent Predator (SVP) Evaluations in the Field: Static-99R and Diagnostic Field Reliability

Tests and diagnoses used in sexually violent predator (SVP) evaluations must be reliable, as reliability is foundational to validity. The current study contained a stratified sample of evaluations of 395 individuals referred as potential SVPs between 2012 and 2017. Each individual was initially evaluated by at least two experts. The sample included three groups: individuals not meeting SVP criteria (N = 200, or 400 evaluations), individuals meeting SVP criteria (N = 95, with 190 evaluations), and individuals where evaluators disagreed (N = 100, with 200 evaluations). The sample also included 200 subsequent independent evaluations on these "disagree" cases. Static-99R score intraclass coefficient (ICC) interrater reliability was good to excellent within each group and overall. Evaluators scored the Static-99R within one point of each other 87% of the time. Cohen's kappa diagnostic agreement for Pedophilic Disorder was substantial. ASPD and substance abuse kappa were in the "fair" range, while OSPD diagnoses in the positive group were at the "moderate" level of agreement. Ethnic differences in diagnoses were consistent with other studies, with equivalent Static-99R ICC values across ethnic groups. There were no significant differences between state civil servants versus contracted experts in Static-99R ratings or final determinations. The results suggest that Static-99R scores have acceptable reliability in these evaluations, and Pedophilic Disorder (the most common paraphilic disorder in our study) and OSPD can be reliably diagnosed. We discuss limitations of the study, as well as the need for care in high-stakes evaluations given the imperfect reliability of psychological measurements.

The Covariation of Sexual Fantasies and Behaviors Among Self-Identified Sexually Aggressive Criminal and Noncriminal Samples

This study examined the association of sexually appetitive fantasies and sexually coercive behaviors among adult men convicted of nonsexual crimes (n = 159) and adult men with no criminal histories (n = 219). Individuals completed the Multidimensional Assessment of Sex and Aggression (MASA) and, on the basis of these reports, were classified whether or not they had ever attempted to assault or coerce someone sexually. Consistent with fewer opportunities to engage in sexual behavior, individuals with criminal histories reported generally less preoccupation, compulsivity, and frequency than did noncriminal individuals. Regardless of criminal history, self-identified sexually coercive men reported significantly more sexually appetitive fantasy and behavior in general and sexually deviant behavior in particular than did noncoercive males. Implications of these findings for research, theory, and dispositional decisions are discussed.

Differentiating Sexual From Other Violent Offence Types for Case Assessment, Planning, and Management

Core components of the Intake Assessment (IA) process in the Canadian federal corrections system were examined to determine whether a simplified algorithmic equation for individuals sentenced for sex crimes could be tailored and differentiated from other violent offence types. Two major offence type categories, namely sexual and other violent were constructed for 2,896 adult male first releases for 2016 to 2017 and 2017 to 2018. A restricted set of static risk indicators, dynamic need ratings, and other actuarial measures as well as whether or not there were any returns to federal custody were extracted for each case. A combined risk index yielded robust predictions of custodial return for sexual and other violent offence types with significant and robust AUCs of 0.77 and 0.71, respectively. Analyses showed that five-level risk groupings could be derived independently for the two offence type categorizations.

Understanding the Latent Structure of Dynamic Risk: Seeking Empirical Constraints on Theory Development Using the VRS-SO and the Theory of Dynamic Risk

The present study is part of a larger project aiming to more closely integrate theory with empirical research into dynamic risk. It seeks to generate empirical findings with the dynamic risk factors contained in the Violence Risk Scale-Sexual Offense version (VRS-SO) that might constrain and guide the further development of Thornton's theoretical model of dynamic risk. Two key issues for theory development are (a) whether the structure of pretreatment dynamic risk factors is the same as the structure of the change in the dynamic risk factors that occurs during treatment, and (b) whether theoretical analysis should focus on individual dynamic items or on the broader factors that run through them. Factor analyses and item-level prediction analyses were conducted on VRS-SO pretreatment, posttreatment, and change ratings obtained from a large combined sample of men (Ns = 1,289-1,431) convicted and treated for sexual offenses. Results indicated that the latent structure of pretreatment dynamic risk was best described by a three-factor model while the latent structure of change items was two dimensional. Prediction analyses examined the degree to which items were predictive beyond prediction obtained from the broader factor that they loaded on. Results showed that for some items, their prediction appeared to be largely carried by the three broad factors. In contrast, other items seem to operate as funnels through which the broader factors' predictiveness flowed. Implications for theory development implied by these results are identified.

An Examination of the Latent Constructs in Risk Tools for Individuals Who Sexually Offend: Applying Multidimensional Item Response Theory to the Static-2002R

Multidimensional item response theory (MIRT) was used to study the construct validity of the Static-2002R, an actuarial scale for the assessment of reoffending among adult men who sexually offended. Using a sample of 2,569 individuals with a history of sexual crime, exploratory factor analysis (EFA) extracted three factors: Persistence/Paraphilia, General Criminality, and Youthful Stranger Aggression. MIRT confirmed the factor structure identified in the EFA model and provided item-level data on discrimination and difficulty. All Static-2002R items showed moderate to very high discrimination and covered a wide range of risk levels (i.e., difficulty). MIRT analyses attested to the construct validity of the scale, as no items were identified as problematic and the resulting factor structure was consistent with that of earlier studies. Considering the stability of results pertaining to the factor structure of the Static-2002R and the advantages of dimensional scoring, we recommend the integration of dimensional scores in the scale.

Predictive validity of Stable-2007 in incarcerated samples

Some are unclear whether risk assessment instruments, specifically dynamic risk instruments, have demonstrated utility in the risk estimation, treatment recommendations, and monitoring change over time in men at risk for or under sentence of Indeterminate Detention (ID) for sexual offenses. We compare two datasets, the first consisting of individuals representing a routine sample of persons convicted of a sexual offense and the second of men representative of a high risk/needs sample. These two distinct samples (n = 442, mean Static-99R score = 2.4; n = 168, mean Static-99R score 4.5) were then also scored on the Stable-2007. For both groups this scoring occurred in an institutional setting. The Stable-2007 predicted sexual recidivism in Sample 1 independently and in conjunction with the Static-99R. In the high-risk sample the results were the same. In both samples a compound outcome variable (Sexual + Violent reoffense) was also calculated with the Stable-2007 predicting the compound outcome variable in Sample 1 but not Sample 2. This is interesting in that it suggests that the Stable-2007 assesses constructs specific to sexual re-offense in higher risk offenders and not general traits of violence or common anti-social behaviour. Limitations and directions for further research are discussed.

Dynamic sexual offense risk assessment using the VRS-SO with indeterminate sentenced men

Indeterminate detention (ID) is a high stakes sanction reserved for exceptionally high risk-high need (HRHN) persons who are deemed to pose an undue risk to public safety. It is one of the most extreme measures that is routinely taken by justice systems to manage sexual violence risk and prevent sexual and violent recidivism. Naturally, risk assessment is most frequently employed as a mechanism to keep dangerous people in custody; but seldom is risk assessment viewed as a possible ticket out for men with an ID designation who have made substantive risk changes and whose risk can be safely managed in the community. This article features applications of a dynamic sexual violence risk assessment and treatment planning tool, the Violence Risk Scale-Sexual Offense version (VRS-SO), with ID individuals and other HRHN men, to assess risk in a dynamic manner to inform risk management efforts and release decisions. VRS-SO data on an ID sample are presented along with clinical illustrations of dynamic risk assessment. Several propositions are made with supporting data from VRS-SO normative research with treated sexual offending samples regarding the use of dynamic tools with ID men and the perils and pitfalls of relying solely on static measures. Ultimately, dynamic risk instruments can be used to track progress and monitor risk change over multiple assessments to inform release and reintegration decisions with ID persons. In this regard, dynamic assessment has the potential to help, rather than hinder, reintegration of ID sentenced persons and can inform safe, fair, and humane decisions.

A cluster analytic examination and validation of adult victim sexual offending subtypes in two Canadian samples

The development and validation of sexual offense perpetrator typologies remains a useful endeavor with implications for theory and correctional/clinical practice. Most such typologies—which rely on factors such as the individual’s motivation for offending—have not been validated empirically. The current study utilized a validated sexual violence risk-needs instrument, the Violence Risk Scale—Sexual Offense version (VRS-SO; Wong, Olver, Nicholaichuk, & Gordon [2003, 2017], Regional Psychiatric Centre and University of Saskatchewan, Saskatoon, Canada), to develop and validate an empirically-derived adult victim sexual offense (AVSO) typology through model-based cluster analysis of dynamic risk-need domains. The study featured two treated samples of men (n = 283 and 169) convicted for contact sexual offenses against adult victims. A three-cluster solution was identified and replicated across the two samples: high antisociality high deviance (HA-HD), high antisociality low deviance (HA-LD), and low antisociality low deviance (LA-LD). External validation analyses demonstrated that HA-HD men had more dense sexual offense histories, were more likely to be diagnosed with a paraphilia, and had the highest rates of sexual recidivism (Sample 2 only). By contrast, the HA-LD men had greater concerns on indexes of nonsexual criminality, particularly high base rates of antisocial personality and substance use disorders, and high rates of general violent recidivism (particularly Sample 1). The findings suggest that the VRS-SO factors may have utility in discriminating between AVSO types to inform sexual offending theory, case formulation, and risk management.

Efficacy of outpatient treatment of sex offenders

The efficacy of sex offender treatment (SOT) is a matter of ongoing discussion and research in forensic psychotherapy. This study evaluates the efficacy of outpatient SOT after discharge from prison. Recidivism rates of participants treated in outpatient departments for sex offenders in Bavaria between 2008 and 2016 (treatment group, TG; n = 353) were compared with those of a matched group of released offenders without treatment (control group, CG; n = 353). The mean follow-up period was 4.5 years. The primary outcome of interest was whether the rates of reoffending differed significantly between the two groups. We compared general and specific rates of reoffending, time to reoffending, and type of reoffending. The groups differed significantly regarding the rates and time of violent reoffending and reoffending overall, but not regarding sexual reoffending respectively the type of sexual reoffending. The results indicate that outpatient SOT is effective in reducing the general but not the specific risk of reoffending.

[Is the use of patient records necessary to assess the risk of sexual, violent and general recidivism?]

INTRODUCTION

Sexual, violent and general recidivism risk scales are widely used in a number of countries. Their psychometric qualities are generally considered to be good. However, in practice they may vary in the quality of prediction of risk of sexual, violent and general recidivism, in particular because of the sources of the information collected. In France, the medical records of incarcerated patients are kept by health-care professionals. Although regulated, the content and quality of these records vary widely from one patient to another. The criminal justice system holds the criminal records of convicted and imprisoned persons. There is no set list of documents contained in these records. For caregivers and researchers, access to criminal records is difficult because of the confidentiality to which legal professionals are subject. The aim of our study was to investigate whether using medical files in addition to structured interviews can improve the assessment and management of the risks of sexual, violent and general recidivism.

MATERIAL AND METHOD

A total of 128 perpetrators of violence were assessed using three scales of risk of sexual, violent and general recidivism. Scores for the items of the scales were compared between (a) those that were based on medical records and an interview, and (b) those based only on an interview.

RESULTS AND DISCUSSION

First, differences in scores between the two groups (assessed through interview only, and assessed through interview and use of medical records) were observed on the RSVP, HCR-20 and LS/CMI scales. Secondly, most of the results indicate that the overall level of risk was perceived as lower when medical records were used, which would, indirectly, lead to a reduction in false positives when evaluating perpetrators of sexual violence. Thirdly, the point-by-point analysis shows that the use of information contained in the medical records reduces the weight of present and future factors (e.g. the physical and psychological stress of recent events), increases the weight of past factors (e.g. history of sexual violence), and can increase the weight of certain factors that can lead to more negative emotions in the assessor (e.g. deviance). These results can be explained by (i) the emotional functioning of the persons assessed (particularly defensive processes or memory difficulties), (ii) the attitude of the aggressor (particularly the presence of emotional and cognitive biases), (iii) the nature of the information (particularly "hot" cognitions or those leading to greater social desirability). The limitations of the study concern the relatively small number of participants, the environment in which the file was transmitted and the very heterogeneous and sometimes relatively incomplete composition of the files.

CONCLUSION

The use of information contained in medical files impacts the results of recidivism risk scales and restores a balance to the factors. In France, risk scales are currently being introduced, although their use is still limited in the health field. However, ethical use of these scales raises the issue of the homogenisation of the content of medical records and access to criminal records in order to enable future research to confirm whether the use of information provided in medical and criminal records can improve the quality of assessment and treatment of offenders.

Spanish Validation of the Child Pornography Offender Risk Tool

The current study examined the validity of the Child Pornography Offender Risk Tool (CPORT) in a sample of 304 men arrested in Spain for child pornography (CP) offenses, distinguishing between CP-exclusive offenders (n = 255) and CP offenders with other criminal involvement (n = 49). In our 5-year fixed follow-up analysis, we observed a 2.3% sexual recidivism rate for the whole sample (2.0% new CP offenses, 0.3% new contact sexual offenses). Receiver operating characteristic (ROC) analyses detected some relative predictive ability of the CPORT for CP recidivism outcomes when the Correlates of Admission of Sexual Interest in Children (CASIC) was used to replace missing CPORT Item 5. Specifically, both CPORT and CASIC total scores might help predict new CP offending among CP-exclusive offenders (area under the curve [AUC] = .57 and .70, respectively). Calibration analyses found that the observed recidivism rates were much lower than the expected recidivism rates presented by the tool developers, and, thus, suggest caution over the use of these norms for applied risk assessment. Our findings provide, to some extent, preliminary evidence of CPORT cross-cultural validity.

Sexbots as Synthetic Companions: Comparing Attitudes of Official Sex Offenders and Non-Offenders

This is the first Italian study to examine views on sexbots of adult male sex offenders and non-offenders, and their perceptions of sexbots as sexual partners, and sexbots as a means to prevent sexual violence. In order to explore these aspects 344 adult males were involved in the study. The study carried out two types of comparisons. 100 male sex offenders were compared with 244 male non-offenders. Also, sex offenders were divided into child molesters and rapists. Preliminary findings suggest that sex offenders were less open than non-offenders to sexbots, showed a lower acceptance of them, and were more likely to dismiss the possibility of having an intimate and sexual relationship with a sexbot. Sex offenders were also less likely than non-offenders to believe that the risk of sexual violence against people could be reduced if a sexbot was used in the treatment of sex offenders. No differences were found between child molesters and rapists. Though no definitive conclusion can be drawn about what role sexbots might play in the prevention and treatment of sex offending, this study emphasizes the importance of both exploring how sexbots are both perceived and understood. Sex offenders in this study showed a high dynamic sexual risk and, paradoxically, despite, or because of, their sexual deviance (e.g. deficits in sexual self-regulation), they were more inclined to see sexbots as just machines and were reluctant to imagine them as social agents, i.e. as intimate or sexual arousal partners. How sex offenders differ in their dynamic risk and criminal careers can inform experts about the mechanisms that take place and can challenge their engagement in treatment and intervention.

Testosterone-Lowering Medication and Its Association With Recidivism Risk in Individuals Convicted of Sexual Offenses

For a particular subgroup of individuals with severe paraphilic disorders and a high risk of sexual recidivism, the combination of sex drive-reducing medications and psychotherapy is a promising treatment approach. The present quasi-experimental study aims at comparing differences in clinical characteristics and dynamic risk factors between persons receiving (+TLM, n = 38) versus not receiving (-TLM, n = 22) testosterone-lowering medications (TLMs). Individuals receiving TLM were more frequently diagnosed with paraphilic disorders. Neither the criminal history nor average risk scores differed between the two groups. In the +TLM, Stable-2007 scores showed a stronger decrease after TLM treatment was started. This accounted especially for the general and sexual self-regulation subscales. Individual variations in risk, however, were not predicted by TLM but were significantly related to treatment duration and Psychopathy Checklist-Revised (PCL-R) Factor I. Paraphilic patients with problems in self-regulatory abilities seem to profit most from pharmacological sex drive-reducing treatment. Furthermore, therapists seem to underestimate deviant sexual fantasies in medicated patients.

A Static-99R Validation Study on Individuals With Mental Disorders: 5 to 20 Years of Fixed Follow-Up After Sexual Offenses

'The Static-99R is one of the most commonly used risk assessment instruments for individuals convicted of sexual offenses. It has been validated for use on many populations, but few studies specifically target and describe individuals with mental disorders. Additionally, research on the discriminative properties (how well the instrument separates recidivists from non-recidivists) of the instrument over longer follow-up periods is scarce. This article evaluated the validity of the Static-99R using a cohort of individuals with mental disorders convicted of sexual offenses in Sweden (N = 146) with fixed 5-year (n = 100), 10-year (n = 91), 15-year (n = 79), and 20-year (n = 36) follow-up periods. A Static-99R cut score of 6 demonstrated the highest Youden index, maximizing sensitivity (72.7%) and specificity (74.2%), with 25.8% of recidivists correctly assumed to reoffend sexually and 95.7% of non-recidivists correctly assumed not to. The Static-99R instrument demonstrated adequate discrimination (AUC = 0.79, CI 95% = 0.70-0.87, and OR = 1.45, CI 95% = 1.14-1.84, p < 0.001, 5-year fixed follow-up), with only marginal differences for 10-, 15-, and 20-year fixed follow-up (AUC = 0.73, 0.74, and 0.74 and OR = 1.31, 1.36, and 1.40, respectively). Calibration (quantifying risk and correspondence with the instrument's norms) was acceptable (Brier = 0.088, P/E = 0.70, E/O = 1.43), with the routine sample norms displaying a decisively better fit to the study cohort compared to the high-risk/high-need sample norms. The results affirm the recommendation that, when in doubt and where there is no recent local norm group large enough available, the Static-99R routine sample found in the evaluators' workbook should be used.

STABLE-2007 Demonstrates Predictive and Incremental Validity in Assessing Risk-Relevant Propensities for Sexual Offending: A Meta-Analysis

STABLE-2007 is a measure of risk-relevant propensities for adult males convicted of a sexual offense. This meta-analysis evaluated the ability of STABLE-2007 and its items to discriminate between recidivists and nonrecidivists, and the extent to which STABLE-2007 improves prediction over and above Static-99R. Based on 21 studies (12 unique samples, N = 6,955), we found that STABLE-2007 was significantly and incrementally related to sexual recidivism, violent (nonsexual) recidivism, violent (including sexual) recidivism, and any crime. Scores on STABLE-2007 items and the three STABLE-2000 attitude items also discriminated between individuals who sexually reoffended and those who did not sexually reoffend. These findings support the use of STABLE-2007 in applied risk assessment practice and the interpretation of STABLE-2007 items as indicators of treatment and supervision targets.

Cross-Validation of the Revised Version of the Violence Risk Appraisal Guide (VRAG-R) in a Sample of Individuals Convicted of Sexual Offenses

The aim of the present study was to examine the psychometric properties of the German version of the revised Violence Risk Appraisal Guide (VRAG), the VRAG-R. Therefore, VRAG-R ratings were made retrospectively in an Austrian sample of 534 individuals convicted of a sexual offense who were followed up with an average of 7.62 years. The VRAG-R showed large effect sizes for the predictive accuracy of violent (AUC = .75) and general recidivism (AUC = .78) and significant but rather small effect sizes (AUC = .63 and .61, respectively) in predicting any sexual and sexual contact recidivism. Furthermore, for the prediction of violent recidivism but not for sexual recidivism the VRAG-R was incrementally predictive beyond the Sex Offender Risk Appraisal Guide (SORAG) and the Static-99. Finally, the VRAG-R absolute recidivism rates for the risk bins showed satisfactory calibration properties. Taken together, the results of the present study support the cross-national utility of the VRAG-R and its use in applied risk assessment settings also in German-speaking countries.

Desistance From Sexual Offending

PURPOSE OF REVIEW

This article reviews the growing body of knowledge on desistance from sexual offending. Although the cessation of offending is a standard observation in criminology and has been demonstrated by people who commit all manner of crimes, it has only recently been considered relevant for individuals convicted of sexual offences.

RECENT FINDINGS

Desistance from crime is a natural human process and has been observed even among those people who commit sexual offences. The clearest distinction between sexual and nonsexual offenders is the way they are treated by the criminal justice system. Desistance can occur in different ways, for different people, and under different circumstances. It can occur naturally, with or without formal therapeutic assistance or criminal justice intervention. Comparatively few sexual offenders truly warrant the restrictive approaches of enhanced community supervision to which so many people are now subject. A growth industry devoted to sustaining the belief that there is something very different (and identifiable) about sexual offenders has resulted in increasingly dangerous trends in our criminal justice system's response to this crime.

Assisting decisions in child protection service institutions with the RIC - The Risk Indication in Child sexual abuse

BACKGROUND

The RIC (Risk Indication in Child sexual abuse) and its screening version (RIC:SV) are actuarial risk assessment instruments, developed at the Austrian Federal Evaluation Centre for Violent and Sexual Offenders and designed for child protection services to assess the likelihood of sexual recidivism in male contact child sexual abusers who still or again live within a family including children.

OBJECTIVE

The RIC was designed to require a minimum of forensic information, with the RIC:SV completely waiving such information.

PARTICIPANTS

Nine factors related to sexual recidivism could be identified by analyzing five-year follow-up data of N = 324 male contact child sexual abusers.

SETTING

The data was collected retrospectively from files between the years 2002 and 2011.

METHOD

Chi-Square Tests and ROC-analyses were calculated.

RESULTS

The RIC and the RIC:SV were found to significantly predict sexual recidivism with AUC values of .84 (RIC) and .78 (RIC:SV). The items of the RIC are: (a) offender has never had a live-in relationship, (b) unstable family background of the offender, (c) impulsivity of the offender, (d) previous psychiatric treatment(s) of the offender, (e) offender has prior prison sentence/s, (f) problems of the offender to accept rules and norms, (g) offender was a stranger to his former victim(s), (h) offender had at least one male victim, and (i) offender has ever committed an extrafamilial contact child sexual abuse offense.

CONCLUSION

The RIC and the RIC:SV need no extensive training to be used. The results may help CPS workers to justify risk related interventions.

Reorienting Locus of Control in Individuals Who Have Offended Through Strengths-Based Interventions: Personal Agency and the Good Lives Model

Having an external locus of control has been associated with a range of well-supported risk correlates of offending behavior. Further, individuals with an internal locus of control orientation are suggested to be more open to engaging in treatment and are also considered more likely to have successful treatment outcomes. In forensic settings, where individuals are subject to external controls and have little personal autonomy, it is important to consider what treatment approaches might be most successful in reorienting individuals’ locus of control. The Good Lives Model (GLM) proposes a strengths-based approach to the rehabilitation of individuals who have offended. Within the GLM, an external locus of control is suggested to be associated with a deficit in the primary good of agency. In this article, we will provide a brief overview of the literature on locus of control and its hypothesized role in offending behavior. We will discuss how an external locus of control orientation is related to personal agency and how strengths-based models, such as the GLM, may assist with reorienting locus of control in individuals who have offended through promoting personal agency.

Neuroanatomical Differences Among Sexual Offenders: A Targeted Review with Limitations and Implications for Future Directions

As sexual assault and child sexual abuse continue to be worldwide public health concerns, research has continued to explore factors associated with sexual offending. Structural and functional neuroanatomical brain differences have been examined in an effort to differentiate sexual offenders and their behavior. This targeted review searched PubMed and Google Scholar for empirical studies using brain imaging techniques to examine possible structural or functional differences among control groups compared with at least one group of sexual offenders with contact offenses. This targeted review summarizes the structural and functional findings of 15 brain imaging studies (i.e., computed tomography, diffusion tensor imaging, magnetic resonance imaging, positron emission tomography, and functional magnetic resonance imaging), which suggest possible differences in brain size and gray matter volume, cortical thickness, white matter connectivity, and specific structural and functional differences among brain regions (fronto-temporal region, amygdala, prefrontal cortex, etc.). The methodological limitations of brain imaging studies and the associated findings with regard to sexual offenders are highlighted, as research indicates that many of the proposed differences in brain structure and function are not unique to this population. We further highlight several limitations to using neuroimaging studies to examine this population of interest, including publication bias, small sample size, underpowered studies, and all-male samples. As these results are mixed and findings are not seemingly unique to sexual offenders, we suggest future sexual offender research may benefit from focusing on more financially feasible options, such as neuropsychological assessment approaches, to assess for and attend to offenders' criminogenic and rehabilitative/therapeutic needs in alignment with the risk-need-responsivity model.

Excusing and Justifying Rape Cognitions in Judgments of Sexually Coercive Dating Scenarios

According to recent analyses, Bumby's RAPE scale of rape-supportive cognitions about women and sexual assault comprises two factors. Excusing rape serves to reduce abusers' culpability for their offending, and ascribing blame to victims, while justifying rape is associated with a sense of sexual entitlement. The distinct effects of these factors on rape judgments have not yet been investigated. We examined whether these belief clusters differentially explained judgments of perpetrator innocence after priming cues related to each of them. We used a cross-sectional design (N = 217) to test our hypotheses. As predicted, we found that excusing rape cognitions contributed to exaggerated innocence judgments when the victim paid the bill on a first date (potentially indicative of romantic or sexual interest). However, contrary to expectations, there was no evidence that participants justified rape when the perpetrator paid the bill. Implications for conceptualizing the functions of rape-supportive cognitions are discussed.

Assessment of relative risk for sexual and violent recidivism with Risk Matrix 2000

Risk Matrix 2000’s ability to assess relative risk for sexual and violent recidivism has been well established through meta-analysis. However, the instrument was originally designed for use in the United Kingdom and has not been widely tested in other parts of Europe, raising questions about how generalizable the results are. This paper assessed the instrument’s ability to assess relative risk for these outcomes in a sample of over 300 Austrian adult males serving a prison sentence for a sexual offense for whom 5-year rates of sexual and violent recidivism were available. Results indicated an ability to assess relative risk that was comparable to that observed in the United Kingdom. In the context of previous results from Germany, the findings of the present study indicate that Risk Matrix 2000 may be appropriately applied in Europe. Analyses explored the added value of using the Sexual and Violence risk scales in conjunction to identify the kinds of criminogenic need that should be addressed in treatment and supervision.

Severe mental illness diagnoses and their association with reoffending in a sample of men adjudicated for sexual offences

The current study examined the relationship between mental illness and recidivism in a sample of 409 men adjudicated for sexual offences who scored higher than average on an established risk assessment tool (Static-99R). Participants were from all provincial correctional systems (except Prince Edward Island) and all regions of the Correctional Service of Canada. Severe mental illness diagnoses, with the exception of some personality disorders, were not associated with recidivism (after an average follow-up of 11 years). While some personality diagnoses were initially related to recidivism, this relationship often disappeared or was attenuated after controlling for substance misuse and risk score on the Static-99R. There were two exceptions: Histrionic and narcissistic personality disorders continued to predict sexual recidivism after controlling for Static-99R and substance misuse history. In sum, the current study suggests that severe mental illness diagnoses are not associated with higher rates of recidivism after accounting for risk score and substance misuse in men with sexual offences, with the exception of histrionic and narcissistic personality disorder diagnoses. For this reason, risk judgements that weigh both known risk factors and severe mental illness may overestimate an individual’s risk to reoffend.

The relevance of sexual biographies in individuals convicted of child sexual abuse offenses for the development of pedosexual interests and sexual recidivism

In the literature concerning the etiology of pedosexual interests, the potential role of early sexual experiences in childhood and adolescence has been discussed. Several studies demonstrated a link between own sexually abusive experiences in childhood and sexual offending later in life which tends to be even stronger for pedosexual offenders. Furthermore, some findings indicate associations between other developmental factors and deviant sexual interests in adulthood. For the present study, sexual biographical data of N = 223 imprisoned men convicted of sexual offenses against children from Austria was analyzed to retrospectively examine whether own sexually abusive experiences and non-abusive forms of early sexual experiences and behaviors are linked to subsequent pedosexual interests and to sexual recidivism. Previous findings concerning the link between own sexually abusive experiences during childhood and subsequent pedosexual interests could partly be replicated. Furthermore, early masturbation behavior characteristics as well as non-abusive prepubescent sexual experiences were linked to indicators of pedosexual interests and also to sexual recidivism. Exclusively pedophilic men showed the strongest accumulation of early sexual experiences and behaviors. Implications of the findings for theory and risk assessment are discussed.

The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders

Objectives: The primary aim of these guidelines is to evaluate the role of pharmacological agents in the treatment and management of patients with paraphilic disorders, with a focus on the treatment of adult males. Because such treatments are not delivered in isolation, the role of specific psychotherapeutic interventions is also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients, including sexual offenders, with paraphilic disorders. The aim of these guidelines is to bring together different views on the appropriate treatment of paraphilic disorders from experts representing different countries in order to aid physicians in clinical decisions and to improve the quality of care.Methods: An extensive literature search was conducted using the English-language-literature indexed on MEDLINE/PubMed (1990-2018 for SSRIs) (1969-2018 for hormonal treatments), supplemented by other sources, including published reviews.Results: Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. The type of medication used depends on the severity of the paraphilic disorder and the respective risk of behaviour endangering others. GnRH analogue treatment constitutes the most relevant treatment for patients with severe paraphilic disorders.Conclusions: An algorithm is proposed with different levels of treatment for different categories of paraphilic disorders accompanied by different risk levels.

Investigating the predictive validity of Static-99/99R scores in a sample of older sexual offenders

There is limited information regarding the use of risk assessment tools with aging offender populations. It is known that the likelihood of offending behaviour decreases with age, a small group of men either continue or begin to offend sexually in the later decades of life. The current study investigated the predictive validity of the Static-99 and the Static-99R, in a sample of convicted Australian sex offenders aged 50 and older. A sample of 118 participants was identified, of which 17 (14.4%) re-offended within a follow-up period ranging from four months to 20 years (M = 9.07 years). There were seven recidivists (13.46%) above the age of 60 years (n = 52) and 10 aged 40 to 59.9 years (n = 66). Both the Static-99 and Static-99R demonstrated moderate predictive validity with both age groups. The limitations of this study are discussed as well as recommendations for future research.

On the Effectiveness of Sexual Offender Treatment in Prisons: A Comparison of Two Different Evaluation Designs in Routine Practice

Although there is less continuity of sexual offending in the life course than stereotypes suggest, treatment should lead to a further reduction of reoffending. Contrary to this aim, a recent large British study using propensity score matching (PSM) showed some negative effects of the core sex offender treatment program (SOTP) in prisons. International meta-analyses on the effects of sex offender treatment revealed that there is considerable variety in the results, and methodological aspects and the context play a significant role. Therefore, this study compared different designs in the evaluation of sex offender treatment in German prisons. PSM was compared with an exact matching (EM) by the Static-99 in a sample of 693 sex offenders from Bavarian prisons. Most results were similar for both methods and not significant due to low base rates. There was a treatment effect at p < .05 on general recidivism in the EM and at p = .06 on serious reoffending in the PSM. For sexual recidivism, EM showed a negative trend, whereas PSM suggested the opposite. Overall, the study underlines the need for more replications of evaluations of routine practice, methodological comparisons, sensitive outcome criteria, and differentiated policy information.

Predicting Sexual Recidivism

The current study focuses on adolescents with sex offense histories and examines sexual reoffending patterns within 2 years of a prior sex offense. We employed inductive statistical models using archival official records maintained by the Florida Department of Juvenile Justice (FDJJ), which provides social, offense, placement, and risk assessment history data for all youth referred for delinquent behavior. The predictive accuracy of the random forest models is tested using receiver operator characteristic (ROC) curves, the area under the curve (AUC), and precision/recall plots. The strongest predictor of sexual recidivism was the number of prior felony and misdemeanor sex offenses. The AUC values range between 0.71 and 0.65, suggesting modest predictive accuracy of the models presented. These results parallel the existing literature on sexual recidivism and highlight the challenges associated with predicting sex offense recidivism. Furthermore, results inform risk assessment literature by testing various factors recorded by an official institution.

Paraphilia and Antisociality: Motivations for Sexual Offending May Differ for American Whites and Blacks

There has been little research on the sexual offending behavior of different racial groups. This study compares the characteristics and risk factors for American, non-Hispanic Whites (n =797) and Blacks (n = 788) who had been convicted of a sexual crime in New Jersey. The results indicated that Whites appeared more paraphilic whereas Blacks displayed higher antisociality. Despite the differences, however, the Static-99R, sexual recidivism risk tool, predicted equally well for both racial groups: Whites (area under the curve [AUC] = .76) and Blacks (AUC = .78). The findings suggest that there may be opportunities to improve treatment for the individuals at risk for sexual offending by tailoring interventions to the distinctive risk-relevant characteristics of Whites and Blacks.

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.