The Characteristics of Persistent Sexual Offenders: A Meta-Analysis of Recidivism Studies

Sexual Offending: Adverse Childhood Experiences, Shame, and Self-Compassion Explain the Variance in Self-Harm and Harm Towards Others?

Research investigating potential pathways from Adverse Childhood Experiences (ACEs) to later self-harming and offending behaviours has inconsistent findings. Past research, however, has not fully explored the interplay between ACEs and modifiable psychological factors, such as shame and self-compassion. The present study explored the relationship between ACE, shame, and self-compassion to identify their role in explaining the variance in later harm in a sample of individuals who have committed sexual offences. Two hundred and fifty adults incarcerated for sexual offences participated. Multiple Regression and Mediation Analyses were applied to establish if ACE, shame and self-compassion explained the variance in harm and explore potential psychological pathways between ACE and harm, with shame and self-compassion as potential modifiable mediators. ACE, shame and self-compassion explained 55% of self-harm and 52% of psychological and physical harm variance. A more complex relationship was indicated for sexual harm, with only 19% of the variance explained by the model. The study increases our understanding of the relationship between variables and potential modifiable pathways between ACEs and later harming behaviours in a sample of individuals with sexual convictions. These modifiable psychological factors could be targeted to increase resilience, post-traumatic growth and reduce the risk of harm in later life.

Convergent and Divergent Validity of the Child Pornography Offender Risk Tool (CPORT) in a Clinical Sample From California

The Child Pornography Offender Risk Tool (CPORT) is a seven-item actuarial risk assessment tool that is used to estimate the potential for sexual recidivism among men convicted of child sexual exploitation material (CSEM; legally referred to as child pornography) offenses. In the current study, we examined the convergent and divergent validity of the CPORT in a clinical sample of 224 men on federal probation in the United States who were convicted of at least one type of CSEM offense. CPORT scores were significantly, moderately, and positively correlated with scores on another sexual offense risk assessment tool, the Risk Matrix 2000 (RM2000/S), showing broad evidence of convergent validity, and was nonsignificantly associated with scores on a general offense risk assessment tool, the Level of Service/Case Management Inventory (LS/CMI), showing evidence of divergent validity. There was also evidence of specific convergent validity; for example, the CPORT item reflecting prior criminal history was most strongly related to the Criminal History domain of the LS/CMI, and CPORT items reflecting sexual interest in children were significantly and strongly associated with self-reported sexual interest in children from the clinical evaluation. We also examined the impact of including clinical information in the scoring of the CPORT. Including this information reduced the amount of missing scores, but the impact on predictive accuracy is not yet known. Implications for clinical practices are discussed.

A randomized controlled add-on trial of fluoxetine and cognitive behavioral therapy for help-seeking men with a sexual interest in children: presentation of the PARACHUTES trial protocol and initial feasibility data

Background

Sexual Interest in Children (SIC) is a major risk factor for sexual offending, yet clinical trials are sparse. The present protocol outlines a randomized controlled trial (RCT) that aims to investigate the effectiveness of fluoxetine and Cognitive Behavioral Therapy (CBT) in help-seeking men with SIC.

Methods

Adult men contacting the Swedish telephone helpline PrevenTell are screened for inclusion and invited to further assessment on site. One hundred and eleven men with SIC (defined as DSM-5 pedophilic disorder or hebephilia) will be randomized (1:1:1 ratio) to receive one of three interventions for 14 weeks: (1) an internet-administered psychoeducational program (iPP), (2) iPP and the addition of fluoxetine 20-40 mg or (3) iPP and the addition of internet-administered CBT (iCBT). Exclusion criteria include severe psychiatric illness, contraindicating treatment and an elevated risk of committing hands-on sexual offences. Symptom intensity is assessed at baseline, pre-treatment, every other week for 12 weeks, and post treatment. The primary outcome measure is the Sexual Interest in Children: Current Assessment Scale (SIC: CAS) that quantifies sexual behaviors associated with SIC as well as perceived distress and impairment. Secondary outcomes include measures of dynamic risk-factors for committing sexual offences.

Results

The data collected during the initial 20 months of recruitment were analyzed to predict the required number of individuals to be screened and estimate the probable length of the data collection phase. As of March 2022 to November 2023, 146 men have called PrevenTell and disclosed a sexual interest in minors. Following pre-screening, 110 men were excluded from participation in the trial. Current SSRI therapy was the primary reason for exclusion (n = 24; 22%), followed by an elevated risk of committing hands-on sexual offences (n = 14; 13%). Among the 31 men who underwent the screening procedure on site, 26 were allocated to either iPP, iPP+fluoxetine, or iPP+iCBT. The recruitment rate indicates that the trial will be concluded within the pre-estimated timeframe.

Discussion

This is the first RCT of treatment with SSRI and iCBT in a population of help-seeking men with SIC. The significance of this trial and its methodological strengths and limitations are discussed.

The Relevance of Hypersexuality and Impulsivity in Different Groups of Treatment-Seekers With and Without (Exclusive) Pedophilia

Hypersexuality and impulsivity are regarded as risk factors for sexual offending against children. Studies exploring these factors in undetected men who offended or are at risk of offending are rare. This study aims to investigate hypersexuality and impulsivity in treatment-seeking men with and without a diagnosis of (exclusive) pedophilia who committed child sexual abuse (CSA), consumed child sexual abuse images (CSAI), or feel at risk of offending sexually. Data were obtained from three child abuse prevention projects in Bamberg, Germany. We employed self-report (BIS-11, HBI), objective measures (TSO), and risk assessment tools (STABLE-2007). We computed Bayesian ordinal logit and binomial generalized linear models to explore differences between groups and to predict lifetime CSA and CSAI. Hypersexuality scores were particularly pronounced in patients with exclusive and non-exclusive pedophilia. Patients without pedophilia scored similarly to nonclinical samples. Impulsivity measures did not consistently differ between groups. We could not predict lifetime CSA and CSAI using impulsivity and hypersexuality measures. Sexual rather than general impulsivity seems to be an issue in men with pedophilia. The motivation to offend in patients without pedophilia is discussed.

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

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

Does Being Over 60 Years Old at Index Offense Impact Sexual Recidivism Risk? A Large-Scale Comparison of Men Released Over the Age of 60

Research has consistently found risk for sexual recidivism drops as men convicted of a sexual offense age. One question that remains, however, is whether this age-related reduction in risk applies to men who commit their sexual offenses at an older age. The current study examined this question in a sample of 939 men who were screened for civil management and released to the community (mean follow-up = 6.33 years, SD = 3.98 years), by comparing the sexual recidivism rates of (a) 238 men convicted of sexual offenses committed over the age of 60 (Over-60 Index group), and (b) 701 men who committed sexual offenses under the age of 60 but who were released to the community over the age of 60 (Under-60 Index group). Even though the Under-60 Index group was significantly higher risk at release, the Over-60 Index group sexually recidivated at a significantly higher rate, a difference largely driven by the small group of men who had committed sexual offenses both under and over the age of 60. The Static-99R was a strong predictor of sexual recidivism regardless of age at sexual offending (i.e., just under 60, just over 60, or both under and over 60). The 2021 Routine Samples norms significantly overpredicted sexual recidivism for the Under-60 Index group and significantly underpredicted sexual recidivism for the Over-60 Index group, indicating that the use of the 2016 High Risk/High Needs norms could be more appropriate for the Over-60 Index group, particularly those men who sexually offended under the age of 60 before sexually offending over the age of 60.

Explaining the Unexplainable: Balancing Responsibility, Expectations, and Identity in Narratives of Sexual Recidivism

When someone is caught and punished for a sexual offense, recidivism prevention is of high priority. While a growing body of qualitative research has investigated the desistance process of those who have sexually offended, few studies have examined the narratives of individuals who have sexually recidivated in order to understand how they make sense of their reoffending. This study aims to fill this gap in the literature by exploring the recidivism process and broader life stories of 16 imprisoned men through semi-structured interviews. The results demonstrate how these men explain their recent "failures," the obstacles they face when doing so, and how they attempt to overcome these obstacles in their narratives. Thus, the analysis in this study is both thematic and narrative. Finally, the findings' practical implications are discussed to show how ambiguity in narratives can be a powerful tool in correctional and clinical interventions.

Sexual Exploitation of Children in Travel and Tourism Perpetration: An Expansion of the Ecosystem Model

The sexual exploitation of children in travel and tourism (SECTT), also referred to as child sex tourism, involves engaging in sexual activity with someone under the age of 18 in the context of travel and/or tourism. Research on the perpetration of SECTT is vastly underdeveloped. The present review considers the operationalization of SECTT, its prevalence, and existing theoretical models. Existing theory on SECTT provides a good overview of environmental factors that contribute to SECTT, but the model is insufficient in fully accounting for individual-level risk factors related to sexual offending against children. The present paper expands an existing theoretical model of SECTT, the ecosystem model, to account for these individual risk factors and considers their interaction with environmental factors. The paper concludes by highlighting different avenues for future research.

Explicit measures for emotional congruence with children are related to sexual interests in a male community sample, but not implicit measures

This study sought to disentangle several phenotypic correlates of pedophilic sexual interests, such as emotional congruence with children and lack of empathy. We utilized Implicit Association Tests and self-report questionnaires for emotional congruence with children and analyzed the psychometric properties of these measures. Further, we analyzed the associations between these measures and self-reported pedophilic sexual interests and empathy. The sample consisted of 110 adult community males (prevalence of sexual interest in children at least to some extent: 5.5%) with or without child-related jobs (43.6% vs. 56.4%) recruited online in the general population. Overall, we found equivocal parameters for reliability of the implicit and explicit measures of emotional congruence with children (α = 0.29 to 0.76). The self-reported emotional congruence with children was only weakly linked to the implicit positive evaluations of children (r = 0.170, p = 0.039), not linked to empathy except for distress in social interactions (r = 0.199, p = 0.019), and moderately linked to deviant sexual interests in children (r = 0.321 to 0.404, p < 0.001), especially in men working with children (R2 = 0.04, p = 0.027). Further studies are warranted to expand the sample to the offender population and explore the more complex network of constructs related to pedophilia.

In the I of the beholder: an attempt to capture the implicit self-concept regarding psychopathy

This article explores the implicit self-concept pertaining to psychopathy. Two online studies showed inconsistent results, with Study 1 (n = 243) suggesting that psychopathy is linked to an implicit self-concept marked by low empathy and Study 2 (n = 230) implying no such relationship. In a sample of offenders and community controls (Study 3a, n = 166), higher scores on the Psychopathy Checklist-Revised (PCL-R) were related to an implicit self-concept of being less rather than more antisocial, and the implicit self-concept showed incremental validity compared to the explicit self-concept. The retesting of an offender subsample (Study 3b, n = 47) yielded no evidence for temporal stability or convergent validity. The implicit self-concept of highly psychopathic individuals thus appears to vary, depending on the social context. Future studies should replicate these results in different samples, using additional external correlates.

The Risk, Need, and Responsivity Relevance of Working Alliance in a Sexual Offense Treatment Program: Its Intersection With Psychopathy, Diversity, and Treatment Change

The current study examined the self-reported working alliance of men attending a high intensity sexual offense treatment program and its associations with psychopathy, sexual violence risk, treatment change, and recidivism, in a Canadian sample of 317 incarcerated men followed up an average of approximately 10 years post release. Working Alliance Inventory (WAI; Horvath & Greenberg, 1989) self-reported total, Task, Bond, and Goal scores were positively correlated with treatment related changes in risk, and inversely associated with Psychopathy Checklist-Revised (PCL-R; Hare, 1991; Wang & Hare, 2003) scores. The Affective facet of the PCL-R, representing the callous-unemotional features of the syndrome, uniquely predicted lower Bond and Goal scores controlling for the other facets. Cox regression survival analyses demonstrated that sexual violence risk predicted increased sexual recidivism while change predicted decreased sexual recidivism controlling for PCL-R total score; however, WAI scores (particularly the Goal component) were also unexpectedly associated with increased sexual recidivism. For violent recidivism, psychopathy, risk, and change incremented the prediction of general violence, while the WAI was not significantly associated with this outcome. A set of parallel analyses, stratified by Indigenous ethnocultural heritage, demonstrated some continuity, but also potential areas of difference, in substantive findings. Risk, need, responsivity implications of the working alliance for the treatment of high psychopathy correctional clientele, and how this may intersect with Indigenous heritage, are discussed.

Evading Detection: Characteristics of Individuals With Extrafamilial Child Sexual Offences and Long Detection Lags

Most child sex offending is unreported and undetected. Despite this, most research relies on the characteristics of those frequently detected and arrested. This study aims to address this disparity by examining a group of men convicted of child sexual abuse (CSA) offences with multiple victims and who evaded detection for long periods of time (n = 170). This sample was compared to a group of men caught quickly for CSA offences against multiple victims (n = 170). The two groups were compared on demographic, lifestyle, sexual deviancy, and criminogenic measures. Individuals with long detection lags had more child victims, including more pre-pubescent and male victims and commenced their sexual offending at a comparatively earlier age. Additionally, individuals with long detection lags were more likely to be non- Indigenous and to show specialization in their sexual offending. These findings have implications for identifying and managing high harm child sexual offenders who evade detection for long periods.

Childhood Adversity and Offense-Supportive Cognitions Among Czech Adults with a Sexual Interest in Violence or Children

Individuals with paraphilic interests in sexual violence or children may be more likely to sexually offend if they possess offense-supportive cognitions. These cognitions may develop in response to childhood adversity. However, this idea is largely based on research in men convicted of sexual offenses and may not generalize to non-incarcerated adults with paraphilic interests. In a sample of 178 adults screened for paraphilic interests in violence or children (from the general Czech population), we hypothesized that childhood sexual abuse and emotional neglect would be associated with offense-supportive cognitions about rape and child molestation. Participants came from a nationally representative sample of Czech adults and were selected if they self-reported high levels of sexual interest in violence and/or children. Participants completed an online survey with self-report measures of sexual orientation, offense-supportive cognitions (Bumby RAPE and MOLEST scales), and childhood sexual abuse and emotional neglect (Childhood Trauma Questionnaire). Controlling for gender, age, and sexual orientation, we found that both rape-supportive cognitions and child molestation-supportive cognitions were significantly associated with higher levels of childhood sexual abuse, but not emotional neglect. These findings indicate that childhood sexual abuse may lead to offense-supportive cognitions among men and women with paraphilia.

Introduction to Special Section: CSA Victimization in Incarcerated Populations

Research suggests that individuals involved in the criminal justice system have higher rates of childhood trauma, including experiences of child sexual abuse (CSA). Studies also suggest that childhood victimization has an impact on the success of mental health treatment for offenders which may contribute to recidivism rates. Accordingly, policymakers and correctional staff can be better informed in choosing appropriate assessments and intervention approaches when they understand the ways in which prior experiences of CSA impact individuals in correctional settings. This special section highlights four novel studies that advance the research examining CSA in incarcerated populations.

[Patient Factors in Offender Treatment: Personality, Therapy Motivation and Outcome]

Using a systematic literature review according to the PRISMA criteria, patient factors of offenders were related to forensic outcomes. Searches were conducted in the PsycInfo and PSYNDEX databases; further relevant studies were taken from the bibliographies of studies that met the selection criteria. Only quantitative empirical studies for the period 1990-2021 were included. Findings from 31 studies on patient factors (personality, therapy motivation, therapy expectation, satisfaction with therapy) are reported. Patient factors could not always be consistently associated with outcomes. The clearest correlations were found between the expression of anti- or dissocial personality traits and/or psychopathy and (negative) therapy outcomes. Traits usually associated with antisocial developments (impulsivity, anger, rage, hostility) in some cases also correlated negatively with therapeutically desirable outcomes. Patient motivation for therapy should generally have a positive impact on the likelihood of successful forensic therapies, but not all relevant studies pointed in this direction. No studies were identified on the relationships between therapy expectancy or satisfaction and outcome. Based on general psychotherapy research, we suggest that offender therapy could benefit from broader approaches to studying therapy effectiveness.

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.

Attachment Theory and Sexual Offending: Making the Connection

PURPOSE OF REVIEW

The purpose of this review is to discuss how attachment theory can be applied to explain sexual violence. Specifically, it discusses how the development of certain risk factors contributes to these behaviors and how attachment-based models can be used to address this issue through prevention and therapeutic interventions.

RECENT FINDINGS

Recent research demonstrates that individuals who commit sexual offenses have higher rates of insecure attachment styles and that these styles are associated with a number of criminogenic risk factors associated with sexual offending. Such risk factors include cognitive processing difficulties, affect dysregulation, and challenges in interpersonal relationships, among others. Fortunately, treatment interventions have been shown to foster more secure attachment styles and reduce these risk factors. Attachment theory is a viable theory to both understand and intervene with those who have committed sexual violence to reduce the risk factors associated with sexual violence.

Self-report psychopathy-III facet scores predict sexual crimes, sexual preferences, and sexual deviance index validity more precisely than total scores

Understanding the profiles of sexual offenders, such as the presence of psychopathic traits, is key to preventing future sexual crimes. The self-report psychopathy-III (SRP-III) is a tool used to assess the characteristics of psychopathy, but improvements on its interpretation are required to maximize its precision. The SRP-III can be interpreted by examining the scores on each of the four facets (interpersonal manipulation, callous affect, erratic lifestyle, antisocial behavior), on each of two factors (factor 1, factor 2), or by examining the total score. Here, we investigate the interpretation of the results from the SRP-III using these three approaches of analysis of the data for predicting types of sexual crimes, sexually deviant preferences (measured via PPG), and the validity of the sexual deviance results. Logistic regressions were carried out using either the four facets, two factors, or the total score of the SRP-III. Data were previously obtained from 198 Canadian men who were convicted of, or who admitted to committing, at least one sexual crime, or who reported experiencing sexually deviant fantasies. We also examined the point-biserial correlations between each of the methods of interpreting the SRP-III results and each of the dependent variables. We find that SRP-III facet scores most precisely predict types of sexual crimes, sexually deviant preferences, and sexual deviance index validity, followed by SRP-III factor scores, and lastly SRP-III total scores. Additionally, significant correlations are only found between SRP-III scores and one dependent variable. Potential reasons for this are discussed. Based on these findings, we recommend that future studies consider facet and factor scores in addition to the standard practice of examining total scores.

Understanding the Risk of Sexual Reoffending in Adult Men: A Network-Based Model

The predominant approach to understand dynamic risk factors of sexual reoffending has been referred to as the Propensities Model (Thornton, 2016). According to this model, dynamic risk factors can be conceptualized as latent constructs whose change alters the risk of sexual reoffending. Despite its strengths and contributions to research, this model does not offer answers to the question of how dynamic risk factors contribute to the risk of sexual reoffending, or of how sustained change in risk might take place. In this paper we introduce the Network-Based Model of Risk of Sexual Reoffending (NBM-RSR), which addresses several limitations and constraints of the Propensities Model and offers empirically testable propositions regarding the nature and development of the risk of sexual reoffending. The NBM-RSR considers risk of sexual reoffending to involve a self-sustaining network of causally connected dynamic risk factors. Consistent with this, an increased risk of sexual reoffending is characterized through a network that contains more and stronger interconnected dynamic risk factors with a higher strength. Sustained change in risk of sexual reoffending occurs when activity in the network exceeds a critical point resulting in a new self-sustaining network. Propositions based on the NBM-RSR are introduced and translated into testable hypotheses. These propositions revolve around (a) risk of sexual reoffending resulting from the construction of a network of causally connected dynamic risk factors, (b) network stability, sudden changes, and critical transitions, and (c) dynamic risk factors' relative influence on risk of sexual reoffending.

Roots of Sexual Abuse: A Pathway Model for Adolescents Who Offend

Theoretical models implicate insecure attachment, peer isolation, hostile masculinity, and the use of sex for coping in sexual perpetration against children. This study builds on previous research and tests the direct and indirect effects of attachment, interpersonal and sexual control problems, and masculine adequacy to explain sex offending against children in adolescents. Structural equation modeling was used to conduct a path analysis using 464 adolescent males. A significant path model was fitted that identified three paths between anxious attachment, social isolation, sexual dyscontrol, masculine adequacy, and offending against a child. The model partially confirms previous research on adolescents who commit sexual abuse. The best fitting model indicates a direct path from anxious attachment to sexual offending against a child, but also indicates two indirect paths, where anxious attachment and committing child sexual abuse was partially mediated by social isolation and masculine adequacy, which, in turn, were negatively associated with each other, and a path including sexual dyscontrol, which was positively associated with both social isolation and masculine adequacy. The results suggest that commission of child sexual abuse by adolescent males is related to individual proclivities, social experiences, and attitudes toward sexuality and masculinity.

Participants' Experiences of Sex Offender Treatment: Searching for Desisting Narrative Identities

Life-course criminology has demonstrated the importance of social relationships and life transitions to understand desistance. Yet, individuals convicted of sexual offenses seem to differ in terms of turning points, where treatment is suggested as salient to their desistance processes. Drawing on 13 teller-focused interviews with adult male incarcerated participants in a new Swedish sex offender program, this paper examines the treatment experience and the under-explored aspect of early desistance, as well as the role of society and social relations in the treatment process, through a practice-oriented lens. The thematic analysis suggests participants started developing desisting narrative identities where micro turning points in treatment contributed to offenses being explained and re-integrated into a sense of the self as an acceptable person. The process, which also enabled active responsibility, seemed to be facilitated by a holistic, person-centered treatment environment. Nonetheless, continued desistance requires adequate attention to social support and stigma management post-release.

A Grounded Theory Model of Relationship Decision-Making in Non-Offending Partners of Individuals Accused of Sexual Offending

Non-offending partners of individuals who have committed sexual offenses often choose to end their relationship given the many negative consequences they face as a result of their partner's offending behavior. Despite a focus on relationships in rehabilitation frameworks and the importance of the relationship for the individual who has offended and their partner, research has thus far failed to examine the process underlying why non-offending partners decide to stay in or leave their relationship following an offense. In this study we developed the first descriptive model of relationship decision-making in non-offending partners. Twenty-three individuals whose current or previous partners were accused of sexual offending were interviewed about affective, behavioral, cognitive, and contextual factors contributing to their decision to stay with or leave their partner. Participants' narrative accounts were analyzed using Grounded Theory. Our resulting model consists of four main periods: (1) background factors, (2) relationship factors, (3) finding out, and (4) relationship decision-making. Clinical implications, limitations, and directions for future research are discussed.

Dynamic Individual Risk Networks: Personalized Network Modelling Based on Experience Sampling Data

Following a network perspective, risk of sexual reoffending can be understood as a construct that emerges from the interactions between risk factors. If these interrelationships are validly mapped out, this leads to an increased understanding of the risk and thus may contribute to more effective and/or more efficient interventions. This paper reports on personalized network modeling mapping the interrelationships of dynamic risk factors for an individual convicted of sexual offenses, using experience sampling (ESM) based on Stable-2007 items. The longitudinal character of ESM enables both the assessment of interrelations between risk factors within a timeframe and the relationships between risk factors over time. Networks are calculated and compared to the clinical assessment of interrelationships between the risk factors.

The Role of Dynamic Risk and Protective Factors in Predicting Violent Recidivism: Intellectual Ability as a Possible Moderator?

This study investigated which risk and protective factors, based on the 14 clinical indicators of the Historical-Clinical-Future Revised, significantly predicted violent recidivism in a sample of 315 male forensic psychiatric patients. Additionally, it was investigated whether these associations were moderated by intellectual ability. Regarding risk factors, a stronger influence of risky network members, and higher levels of hostility, impulsivity, and addiction significantly predicted violent recidivism. Likewise, regarding protective factors, poorer social and labor skills, and a lower degree of patient's acceptance of crime responsibility were significant predictors of violent recidivism. Contrary to our expectations, better coping skills and more insight into risky behaviors that can lead to relapse also contributed significantly to an increased likelihood of violent recidivism. Intellectual ability had no significant moderating effect on the associations between the factors and violent recidivism. The results offer an insight into which factors need to be prioritized during treatment.

Risky Sexual Behavior and Psychopathy: Testing the Relationship in a Non-Clinical Sample of Young Adults in Hong Kong

This study aims to investigate the relationship between risky sexual behavior (RSB) and psychopathy in a non-clinical sample of 714 Hong Kong adults, shedding light on sex differences. Our findings reveal that males exhibit significantly higher mean levels of RSB (general, penetrative, and nonpenetrative), as well as egocentric (Factor 1) and callous (Factor 3) traits of psychopathy, along with increased sexual desire compared to females. Regression analyses indicate that elevated levels of antisociality (Factor 2) and callousness (Factor 3) traits of psychopathy, along with sexual desire, emerge as significant risk factors for engaging in general, penetrative, and nonpenetrative RSB. Intriguingly, higher age and being in a long-term relationship are associated with RSB. The implications of this study suggest potential avenues for reducing, if not entirely preventing, the inclination to engage in RSB in the presence of psychopathic traits.

Paraphilic disorders, psychopathy, and those who sexually offend: a narrative review of treatment modalities

Despite its critical importance, the treatment of paraphilic disorders remains an often-overlooked domain both in clinical research and practice. Challenges have arisen in the morphing understanding of paraphilias and paraphilic disorders, now considered separate concepts, and efforts at developing a more nuanced understanding of these conditions is ongoing, resulting in a muddled history that can frustrate efforts at study and treatment. These populations are by nature more heterogeneous than may first be obvious-particularly among those with comorbid psychopathic traits-and may require a more nuanced and individualized approach based on risk, needs, and responsivity to treatment. Until recently, there were few guidelines to assist clinicians when confronted with these complicated clinical pictures and a sea of discrete studies investigating various biological and non-biological interventions. Treatments range from several variations of psychotherapy and behavioral therapies to SSRIs, anti-androgenic medications, to orchiectomy, all displaying varying degrees of effectiveness and evidence across decades of research. Fortunately, recent efforts to collate these studies supported by a task force of the World Federation of Societies of Biological Psychiatry (WFSBP) have helped form a better-focused and better-evidenced picture of effective treatments and the unique challenges faced by (and with) these populations.

Looping Disruption: A Relational Mechanism Enhancing Treatment Readiness among Individuals Convicted of Sexual Offending?

Many convicted individuals do not enter or complete treatment programs in prisons, which limits effective rehabilitation and prevention of recidivism. Treatment readiness is suggested to be an important construct when addressing this problem. Nevertheless, the underlying processes (e.g., how readiness factors interact) are not well studied, and even less is known regarding readiness in the sub-population of individuals convicted of sexual offenses. This paper aims to open up the "black box" and explore psychosocial and context-specific processes behind treatment readiness from the vantage point of the individuals' lived experiences. In-depth interviews were conducted with 19 adult men convicted of sexual offenses in Swedish prisons, treatment participants (N = 13) as well as non-participants (N = 6). The thematic analysis illustrates readiness obstacles in terms of unintended antagonistic forces in the correctional system operating in the opposite direction of rehabilitative objectives. Nonetheless, a hypothesized relational mechanism, looping disruption, initiated by a non-punitive and supportive response (from prison staff, therapists, close ones, or inmates) to the convicted individual's negative behaviors or emotions, appeared to reverse such negative, punitive loops, contributing to the mobilization of treatment readiness. Implications for theory, policy, and practice are discussed.

Explaining Male Sex Offender Recidivism: Accounting for Differences in Correctional Supervision

PURPOSE

Contrary to public opinion, empirical studies have consistently shown that persons convicted of a sexual offense (PCSO) are less likely to recidivate with a general offense. While researchers often point toward the surreptitiousness of sexual offending to explain low rates of recidivism, this paper tests a novel explanation: SOs recidivate at lower rates than persons convicted of a non-sexual offense (PCNSO) because they are more often revoked to prison before they are able to commit a new crime, perhaps owing to more restrictive post-release supervision guidelines.

METHODS

Using a sample of 196,468 unique male releases, the difference in general and sexual recidivism between PCSO (n = 29,420) and PCNSO was assessed through survival analyses (Cox regression models).

RESULTS

Results demonstrated that PCSO were significantly less likely to be reconvicted for a general crime, but more likely for a sex offense. They were also more likely to be reincarcerated due to a revocation without a new sentence. Accounting for revocations, the difference in reconviction risk lessens between the groups but does not disappear.

CONCLUSIONS

This analysis provides evidence that differences in community supervision are contributing to the difference in recidivism rates between PCSO and PCNSO. Implications and future research are discussed.

Empirically-based dynamic risk and protective factors for sexual offending

This review provides an overview and update of empirical evidence for psychologically meaningful dynamic risk factors and protective factors for sexual offending. Using the review by Mann et al. (2010) as a starting point, we reviewed relevant literature that has appeared since this publication, focusing on meta-analyses, systematic and scoping reviews of dynamic risk factors, recent evaluations of commonly used dynamic assessment tools, and studies of dynamic risk and protective factors in community samples in addition to clinical or forensic samples. Two risk factors previously deemed promising by Mann et al. (2010), hostility towards women and dysfunctional coping (conceptualized as hostile masculinity and emotional regulation deficits, respectively, in this review), could now be considered supported using this review's criteria of three or more studies demonstrating an effect size of 0.15 or greater. No new risk factors were identified. We conducted a broader search of protective factors in recognition of the relative newness of this literature: Positive social support was the only protective factor identified as empirically supported. We also discuss situational risk and protective factors.

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

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

The prevalence of mental disorders among incarcerated adult men convicted of child sexual exploitation material offences

OBJECTIVE

Despite the growing body of research on individuals convicted of child sexual exploitation material (CSEM), relatively little is known about the prevalence of mental disorders in this population. The aim of the present study was to describe the prevalence of mental disorders among individuals convicted of CSEM offenses.

METHODS

This cross-sectional study examined data from 66 individuals serving a sentence for CSEM offenses in the Austrian prison system who underwent a clinical assessment between 2002 and 2020. Diagnoses were based on the German version of the Structured Clinical Interview for Axis I and Axis II disorders.

RESULTS

In the total sample, n = 53 individuals (80.3%) were diagnosed with a mental disorder. Twenty-seven individuals (40.9%) had an Axis I disorder and n = 47 (71.2%) had an Axis II disorder. More than two-thirds of the sample, n = 47 (71.2%), had a personality disorder diagnosis, with cluster B personality disorders being the most frequent mental disorders. More than half of the sample, n = 43 (65.2%), had a diagnosis of pedophilic disorder, of which n = 9 (13.6%) were of the exclusive type. Twenty-eight persons (42.4%) showed evidence of a hypersexual disorder.

CONCLUSIONS

In line with previous research, the present sample of convicted CSEM offenders showed a comparatively high prevalence of personality disorders and paraphilic disorders, particularly pedophilic disorders. Additionally, the rate of hypersexual disorder symptoms was considerably high. These findings should be considered for the development of successful risk management strategies for this population.

Individuals under voluntary treatment with sexual interest in minors: what risk do they pose?

Child Sexual Abuse (CSA) and the production, use, and distribution of Child Sexual Abuse Material (CSAM) are key threats to children's mental health. From the perspective of indicated prevention, it can be assumed that some persons with a sexual interest in children commit such unreported crimes. Accordingly, the German Network kein Täter werden (meaning do not offend) has implemented a confidential treatment service for persons with a sexual interest in minors who voluntarily seek therapy, might or might not have offended but have not yet been detected or have fulfilled all legal requirements (here referred to as non-forensic individuals). However, this offer has been questioned for investing resources in a group which critics consider as low risk. The following study addresses the question of recidivism risks for CSA or viewing CSAM among non-forensic individuals. We found significantly higher rates of CSA/CSAM in our participants' history compared to a German study on a representative sample of males. Regarding CSAM, the recidivism rate of 39% was found to be 11 times higher than the expected recidivism rate based on previous publications. Regarding CSA, the recidivism rate of 14% was not significantly different from the expected rate reported for subjects with a conviction for a sexual contact offense. Among various risk instruments, only the CPORT with CASIC rating was able to predict CSA (AUC = 0.69, 95% CI = 0.55, 0.82) and CSAM (AUC = 0.63, 95% CI = 0.53, 0.73) among individuals with a history of CSAM, but with poor discrimination. We conclude that a large proportion of our sample poses a substantial risk and therefore treatment resources are well invested. However, further studies are needed to improve risk assessment among non-forensic clients.

Actual and Desired Masturbation Frequency, Sexual Distress, and Their Correlates

We investigated the prevalence of problematic masturbation using different criteria. We also investigated if masturbation-related distress was associated with sexual abuse history, family attitudes towards sexuality during childhood, and depression and anxiety symptoms. Here, 12,271 Finnish men and women completed a survey reporting masturbation frequency, desired masturbation frequency, sexual distress, childhood sexual abuse, sex-positive family background, as well as depression and anxiety symptoms. Among both sexes, those whose masturbation frequency did not match with desired frequency experienced more sexual distress. Different conceptualizations of problematic masturbation resulted in different proportions of individuals categorized as having it (i.e., 8.3% of men and 2.7% of women experienced self-perceived problematic masturbation, that is masturbating more than they desired and experiencing sexual distress; 2% of men and 0.6% of women masturbated more frequently than average and meanwhile experienced self-perceived problematic masturbation; 6.3% of men and 2.1% of women masturbated less frequently than average but still experienced self-perceived problematic masturbation). Moreover, among both sexes, self-perceived problematic masturbation was positively associated with childhood sexual abuse, depression, and anxiety, while negatively associated with a sex-positive family background. Our results point to the complexity of defining problematic masturbation. Causes of sexual distress related to masturbation need to be carefully examined case by case to choose an appropriate clinical approach.

Differentiating Between Sexual Offending and Violent Non-sexual Offending in Men With Schizophrenia Spectrum Disorders Using Machine Learning

Forensic psychiatric populations commonly contain a subset of persons with schizophrenia spectrum disorders (SSD) who have committed sex offenses. A comprehensive delineation of the features that distinguish persons with SSD who have committed sex offenses from persons with SSD who have committed violent non-sex offenses could be relevant to the development of differentiated risk assessment, risk management and treatment approaches. This analysis included the patient records of 296 men with SSD convicted of at least one sex and/or violent offense who were admitted to the Centre for Inpatient Forensic Therapy at the University Hospital of Psychiatry Zurich between 1982 and 2016. Using supervised machine learning, data on 461 variables retrospectively collected from the records were compared with respect to their relative importance in differentiating between men who had committed sex offenses and men who had committed violent non-sex offenses. The final machine learning model was able to differentiate between the two types of offenders with a balanced accuracy of 71.5% (95% CI = [60.7, 82.1]) and an AUC of .80 (95% CI = [.67, .93]). The main distinguishing features included sexual behaviours and interests, psychopathological symptoms and characteristics of the index offense. Results suggest that when assessing and treating persons with SSD who have committed sex offenses, it appears to be relevant to not only address the core symptoms of the disorder, but to also take into account general risk factors for sexual recidivism, such as atypical sexual interests and sexual preoccupation.

"I'm Not a Child Molester, But a Victim Myself": Examining Rationalizations Among Male Sex Offenders Who Report Histories of Childhood Sexual Abuse

Persons convicted of sexual offenses (PCSOs) hold distorted attitudes and beliefs, or rationalizations that minimize the severity of their offending. Despite this, knowledge of rationalizations held by PCSOs remains limited, especially for offenders who report being sexually abused as children. The purpose of the study was to qualitatively assess post-conviction rationalizations of PCSOs who reported childhood sexual abuse (n = 40) and those who reported no sexual abuse (n = 40) focusing on account variations-a framework proposed by Scott & Lyman. Offenders were interviewed and assessed for risk and community notification purposes in 2014 in a southern state. The manner in which PCSOs use rationalizations to avert responsibility for their offenses provides insight into their motivations for offending, and therefore, can inform treatment initiatives for PCSOs with and without histories of sexual victimization. Results can help inform differentiated treatment for those with histories of sexual abuse and those without.

Predictive validity on clinical item-level of the HKT-R divided into clinical patient classes

BACKGROUND

Because of the heterogeneity of forensic groups, latent class analysis (LCA) can allow for the formation of stronger homogeneous patient classes, which can improve the predictive validity of forensic risk assessment tools, such as the Historical Clinical Future - Revised (HKT-R), which was used in this study. In particular, dynamic clinical risk and protective items are important in treatment and are obligatory assessed annually for every forensic patient with a TBS measure in the Netherlands. Therefore, this study investigated the predictive validity of the HKT-R at clinical item-level per patient class.

METHOD

A cohort of 332 forensic patients, who were discharged from highly secured Forensic Psychiatric Centers/Clinics (FPCs) in the Netherlands between 2004 and 2008, was followed. LCA was performed to cluster this group of patients based on psychopathology and criminal offenses. The predictive validity of the HKT-R clinical items by class was assessed with official reconviction data two and five years after discharge as outcome measure.

RESULTS

Four classes were identified. The predictive validity of the HKT-R clinical items showed differences between and within classes on admission or discharge, and for predicting violent reoffending after two or five years after discharge.

DISCUSSION

Different risk/protective factors of the HKT-R may play a role for different subgroups of patients. Therefore, this heterogeneity should be considered for any measure or intervention.

Reentry in Practice: Sexual Offending, Self-Narratives, and the Implications of Stigma in Norway

Reentering society after serving a prison sentence involves many challenges and particularly so for one of the most stigmatized groups in modern society: people who have sexually offended. While most research on their reentry has been conducted in countries with Sex Offender Registration and Notification (SORN) laws, this study used Interpretative Phenomenological Analysis (IPA) to qualitatively investigate the accounts and experiences of men released from prison after serving a sex offense conviction in Norway (n = 8). Results showed that despite less restrictive policies and a total absence of SORN laws, the social stigma linked to being convicted of such crimes severely affected the men. To some degree, they all experienced feelings of stress or anxiousness and they withdrew and isolated more. Their narratives highlight a need for increased social support and recognition from others in the reentry process. Subjective and societal consequences as well as practical implications are discussed.

Paraphilic Interests Versus Behaviors: Factors that Distinguish Individuals Who Act on Paraphilic Interests From Individuals Who Refrain

Little is known about distinct factors linked with acting on paraphilic interests or refraining from engaging in paraphilic behaviors. Participants from Canada and the United States (N = 744), aged 19-42 years (M = 29.2; SD = 3.18), were recruited through Amazon's Mechanical Turk. Participants completed questionnaires about their paraphilic interests and behaviors, as well as potential key factors linked to behavioral engagement (i.e., perceptions of consent, sexual excitation/inhibition, impulsivity, moral disengagement, empathy). Results indicated that higher moral disengagement and impulsivity, lower sexual control (i.e., high sexual excitation, low sexual inhibition), and maladaptive understandings of consent were best able to differentiate individuals who reported highly stigmatized (e.g., hebephilia, pedophilia, coprophilia) or Bondage and Dicipline, Dominance and Submission, Sadism and Masochism(BDSM)/Fetish paraphilic interests and engagement in the paraphilic behaviours associated with these interests relative to individuals who did not report such paraphilic interests or behaviors. Moreover, higher moral disengagement, impulsivity, and maladaptive perceptions of consent were best able to differentiate non-consensual paraphilic interests and behaviours (e.g., voyeurism, exhibitionism) compared to individuals who did not report these paraphilic interests or behaviours. These results provide future directions for the exploration of mechanisms that may contribute to engagement in paraphilic behaviors and may be targets for intervention aimed at preventing engagement in potentially harmful paraphilias.

Sexual Fantasies and Harmful Sexual Interests: Exploring Differences in Sexual Memory Intensity and Sexual Fantasy Characteristics

The perpetration of harmful sexual behavior is a global concern, with deviant sexual fantasies identified as a prominent etiological risk factor. However, the concepts of state sexual fantasy characteristics (e.g., vividness and emotionality) and associated trait sexual memory intensity have received minimal investigation concerning harmful sexual interests, formulating the impetus for this research. Two online surveys were conducted in community populations. Study 1 (N = 414) aimed to validate the psychometric properties of a trait sexual memory intensity scale (SMIS) through principal components analysis, confirmatory factor analysis, and evaluation of concurrent validity. Study 2 (N = 820) endeavored to explore associations between state sexual fantasy characteristics and cognitive-behavior variables (e.g., frequency of masturbation to a reported fantasy), and evaluate differences in fantasy characteristics and SMIS scores between participants with and without harmful sexual interests. Collectively, results supported the factor structure, concurrent validity, and internal consistency of the SMIS, while revealing significant associations between the SMIS, sexual fantasy characteristics, and several variables. Significant differences in sexual fantasy characteristics and SMIS scores were evident but variable among harmful sexual interests. Findings encourage the consideration and research of interventions focused on impairing mental imagery and memory in the management of harmful sexual interests.

A Peek into Their Mind? An Exploration of Links Between Offense-Supportive Statements and Behaviors among Men Who Sexually Exploit Children and Adolescents Online

While forensic psychologists have some access to their patients' thoughts when deciding on a diagnosis or appraising risk, others, such as police investigators, must rely on physical evidence and behavioral markers to make sense of a crime. Studies showing that offense-supportive cognitions constitute a risk factor for sexual offending, including offenses that take place on the internet, highlight the need for some access to offenders' thoughts. This exploratory study examines the associations between offense-supportive statements about the sexual exploitation of children and adolescents and proxy behaviors. As part of PRESEL, a collaborative research project between Québec provincial police and academic researchers, the case files of 137 men convicted of using child sexual exploitation material or committing child-luring offenses were analyzed. Results showed that many meaningful risk factors and sexual offending behavioral markers were associated with the cognitive themes Sexualization of children, Child as partner, Dangerous world, Entitlement, and Uncontrollability. The use of encryption was negatively associated with the cognition Virtual is not real while Internet is uncontrollable was associated with fewer contacts with minors over the internet. Findings are useful for understanding the psychological needs that should be targeted in treatment, as well as helping prioritize police workloads.

Correspondence of Child Age and Gender Distribution in Child Sexual Exploitation Material and Other Child Content With Age and Gender of Child Sexual Assault Victims

Accessing child sexual exploitation material (CSEM; child pornography in legal statutes) can indicate sexual interest in children. It logically follows then that the age and gender of the depicted children may reflect specific interests in those age/gender groups, and if so, may correspond to age and gender of any known contact offending victims. We had data on CSEM characteristics and child victims for 71 men convicted of CSEM offenses who also had contact sexual offenses against children; some had also sexually solicited children online. Sixty-four men had 134 prior or concurrent child victims, and 14 men reoffended directly against 17 children during follow-up. There were significant, positive associations (with moderate to large effect sizes) between age and gender of children depicted in CSEM and age and gender of child contact or solicitation victims. Examining future offending, though with only 14 recidivists, all men who sexually reoffended against a girl had more girl CSEM content, and all men who sexually reoffended against a boy had more boy CSEM content. Our results suggest that CSEM characteristics can reflect child preferences. This information can be relevant in clinical settings, police investigations, and community risk management, though it does not rule out interest in, or offending against, victims of other ages or gender. We discuss these findings in the context of other evidence regarding victim cross-over, and suggest future research.

Canada's Aging Federal Prison Population: Health Disparity, Risk, and Compassionate Release for Persons Convicted of Sexual Offenses

ABSTRACT

The Canadian federal prison population is increasingly aging within institutions that were never intended or designed to meet the complex medical and mental health needs of older incarcerated persons. Increasing numbers of incarcerated persons are "aging in place," and many are dying within federal correctional institutions. Persons convicted of sexual offenses comprise a large-and growing-proportion of this aging population. The Correctional Investigator Canada has recently called for an expansion of access to compassionate release for the aging federal prison population, yet little progress has been made. In this article, we explore the significant challenges faced by the aging population in federal institutions, including insufficient access to appropriate care, challenges in application for compassionate release, and how questions of risk may affect the potential for community transfer. Questions of risk overshadow decisions on early release of incarcerated persons, especially those convicted of sexual offenses. Nurses play a central role in the provision of care to aging incarcerated persons and in advocacy for better access to services when a patient's needs cannot be met within the institution. This article presents a call to action for forensic nurses in Canada (and beyond) to advocate for both improved services within federal correctional institutions and for expedited access to compassionate release of aging incarcerated persons, especially those nearing end of life. The significant disparity in access to health care for aging incarcerated persons compared with their nonincarcerated counterparts represents a significant concern.

Consistency and Construct Validity of the Five-Level System for Risk Communication Using Static and Dynamic Tools: An Investigation Using the Static-99R and VRS-SO

This study examined the Council of State Governments' five-level system for risk communication, as applied to the Static-99R and Violence Risk Scale-Sexual Offense Version (VRS-SO). Aims of the system include increasing consistency in risk communication and linking risk categories to psychologically meaningful constructs. We investigated concordance between risk levels assigned by the instruments, and distributions of VRS-SO dynamic needs associated with Static-99R risk levels, among a multisite sample (n = 1,404) of persons who have sexually offended. Concordant categorical risk ratings were assigned in just over a third of cases, suggesting that consistency remains a concern with the system, particularly when conceptually disparate tools are applied. Densities of criminogenic needs varied widely among persons assigned the same risk level by the Static-99R and diverged from the descriptions ascribed by the system. These findings can inform clinical assessments and further refinement of the system.

Exploring the psychometric properties of the externalizing spectrum inventory-brief form in a Swedish forensic psychiatric inpatient sample

BACKGROUND

The Externalizing Spectrum Inventory-Brief Form (ESI-BF) [1] is a 160-item self-report instrument designed for the assessment of externalizing psychopathology, yet few studies to date have evaluated its psychometric properties, structural fit, and criterion validity in forensic psychiatric settings.

METHODS

Here, we investigated these aspects in a sample of forensic psychiatric inpatients (n = 77) from a maximum-security forensic psychiatric hospital in Sweden. We firstly investigated the reliability. Secondly, using confirmatory factor analysis, the structure of the ESI-BF. And thirdly, using a Bayesian approach, assessed how the three ESI-BF subfactors relate to criterion measures of antisocial behaviors, substance use, and lifetime externalizing spectrum diagnoses.

RESULTS

The ESI-BF demonstrated good to adequate reliability and internal consistency, with all but four facet scales exhibiting α and ω values ≥ 0.80. Average inter-item correlations for the facet scales ranged from 0.31 to 0.74. However, all structural models exhibited poor to mediocre fit, with model fit values for the CFI being 0.66, 0.79 and 0.87 and RMSEA values of 0.14, 0.12 and 0.09. for the unidimensional correlated factors and bifactor model, respectively. Regarding criterion validity, all subscales of the item-based ESI-BF three-factor model exhibited robust correlations with the Life History of Aggression total, aggression and antisocial/consequences subscales, with correlations ranging from 0.29 to 0.55. All ESI-BF subfactors demonstrated robust associations, yet with different externalizing outcomes, lending tentative support to its criterion validity.

CONCLUSION

Despite remaining ambiguities regarding its structural fit, the ESI-BF may be promising for assessing externalizing psychopathology in forensic psychiatric populations. However, further investigation of the ESI-BF is needed before any firm conclusions can be drawn about its appropriateness in forensic psychiatric settings.

Grievance-fueled sexual violence

The grievance fueled violence paradigm encompasses various forms of targeted violence but has not yet been extended to the theoretical discussion of sexual violence. In this article, we argue that a wide range of sexual offenses can be usefully conceptualized as forms of grievance fueled violence. Indeed, our assertion that sexual violence is often grievance fueled is unoriginal. More than 40 years of sexual offending research has discussed the pseudosexual nature of much sexual offending, and themes of anger, power, and control – themes that draw clear parallels to the grievance fueled violence paradigm. Therefore, we consider the opportunities for theoretical and practical advancement through the merging of ideas and concepts from the two fields. We examine the scope of grievance in the context of understanding sexual violence, and we look to the role of grievance in the trajectory toward both sexual and nonsexual violence, as well as factors that might distinguish grievance fueled sexual from nonsexual violence. Finally, we discuss future research directions and make recommendations for clinical practice. Specifically, we suggest that grievance represents a promising treatment target where risk is identified for both sexual and nonsexual violence.

What do women with sexual interest in children tell us about the assumed cause of their sexual interest in children, (non-)disclosure, and professional help?-Results of a qualitative content analysis

Research on women with sexual interest in children is still rare, especially regarding women's own theories about the cause of their sexual interest in children, their experiences with (non-)disclosure, and professional help. In the context of a broader online study, we provided 50 women with a sexual interest in children under the age of 14 years (mean age: 33.6, SD = 11.1) with open questions regarding their own theories about what causes their sexual interest in children, experiences with disclosure and non-disclosure, and experiences with and opinions about professional help. Analyses were conducted using an inductive qualitative content analysis method that aimed at ordering and structuring manifest and latent content by categorizing qualitative data. Results revealed that participants mainly think that past experiences caused their sexual interest in children (Σ = 16), e.g., abusive or non-abusive sexual experiences during childhood. Some participants think that their sexual interest in children is a disposition they were born with (Σ = 8). Disclose of sexual interest in children to another person was reported by 56.0% of the present sample and led to rather positive consequences (Σ = 24, e.g., acceptance or support). Those who did not disclose (44.0%) mainly did so due to fear of rejection and/or stigmatization (Σ = 24). A total of 30.0% already sought help due to their sexual interest in children and frequently reported negative experiences (Σ = 15). A frequent statement participants made on how to reach women with sexual interest in children in order to offer professional help was the destigmatization of sexual interest in children (Σ = 14). We recommend that women with sexual interest in children should be taken more seriously among research and in prevention measures.

Psychopathy and dangerousness: An umbrella review and meta-analysis

Psychopathy has traditionally been linked with heightened criminality, but the relationship of psychopathy with increased risk for dangerousness is contested. To address this debated issue, we conducted an umbrella review (PROSPERO CRD42020214761) of all available meta-analyses of psychopathy and indices of 'dangerousness' (e.g., violent or sexual recidivism, self-reported aggression). We searched PsycINFO, Web of Science, PubMed, and Scopus from inception to August 19, 2022, to identify systematic reviews and meta-analyses on psychopathy and dangerousness. Our review included 33 studies, with the quantitative synthesis including 17 effect sizes extracted from 10 studies (N = ∼77,000 participants). Overall, we observed a pooled correlation coefficient r = 0.284 [95% CI = 0.233, 0.336] for the association of psychopathy with dangerousness (equivalent to Cohen's d = 0.592). Despite considerable heterogeneity (I² = 89.9%), leave-one-out analyses had minimal impact. The effect was robust to examination of potential moderators such as study quality and sample ages. However, the relationship was stronger when psychopathy was assessed using self-report compared to clinical rating scales. The association should be interpreted as meaningful in both the short-term and the long-term and suggests that psychopathy is one of the strongest predictors of dangerousness in the realm of psychopathology.

Contribution of a Cluster Approach to Identify the Profiles of Men Sentenced for Sexual Violence According to Their Risk of Reoffending

INTRODUCTION

The aim of this study is to propose a typology of recidivism risk profiles based on the criminogenic needs of a population of men sentenced for sexual violence. Their socio-demographic, criminological, psychological, and psychiatric factors and vulnerabilities are compared. This classification will respond to the need for a better identification of the factors involved in the risk of recidivism of men sentenced for sexual violence, in order to develop more effective management.

METHOD

Several psychological and psychiatric scales (personality traits, impulsivity, cognitive distortions, empathy, and psychiatric disorders) were completed by 86 men incarcerated for sexual violence. Their socio-demographic and criminological characteristics were also recorded, and the investigator rated three recidivism scales for all participants. Results: Cluster analysis led to identification of two significantly different needs groups. In contrast to the "Lower needs" profile (n = 54, 64%), the men with a "Higher needs" profile (n = 32, 36%) were significantly younger and less educated had more adult and extra-familial victims, scored higher on Neuroticism and lower on Conscientiousness and Empathy, and presented with more past and current psychiatric disorders.

DISCUSSION

The overall findings of this study are consistent with the literature on the characteristics of men sentenced for sexual violence with high needs. The assessment and management of men who have committed sexual violence must consider: criminogenic factors, which should be prioritized; past or present psychiatric disorders, which may act as acute risk factors; and non-criminogenic needs, which should not be prioritized, but which may (when linked to criminogenic needs) impact the effectiveness of management.

A Test of Three Different Explanations for Low Stimulus Response Discrimination in Phallometric Testing

Phallometric assessment is used to assess men's sexual interest in children and to assist in risk assessment and treatment planning. A common response pattern, especially when the assessment is conducted in a forensic context, is an indiscriminate pattern of penile responses: No sexual stimulus seems to produce a substantially higher response than another. This indiscriminate response profile could be the result of (1) faking good (in particular, reducing the responses to child stimuli); (2) floor or ceiling effects caused by low or high arousability, or (3) non-exclusivity (the individual is similarly sexually interested in both children and adults). In this study of 2,858 adult male patients who underwent volumetric phallometric assessment for sexual interest in children between 1995 and 2011, we tested these three possible explanations. Results showed support for each of the explanations, but the variance accounted for in response discrimination was quite small when considering each explanation (separately or when considered together). We discuss avenues for future research to better discern the causes of indiscriminate responding in phallometric assessment.

Serious Mental Illness and Sexual Offending in Forensic Psychiatric Patients

The role of serious mental illness among those who sexually offend is not well understood. We investigated clinical and risk-related areas of difference between male forensic psychiatric patients with (n = 86) and without (n = 245) a sexual offense history, including the age at which indications of mental disorder and criminal offending first emerged, from a registry of Ontario patients adjudicated Not Criminally Responsible on account of Mental Disorder (NCRMD) from 1999-2012. We further explored motivations for offending among a subset of patients deemed NCRMD for a sexual offense specifically (n = 41). While no differences were found in the age onset of illness or offending across those with and without a sexual offending history, the former group was rated as having higher levels of historical/static risk for violence. Forensic patients with a sexual offense history were also more likely to offend against a stranger, and less likely to offend against a family member. Sexual index offenses were psychotically-motivated in the majority of cases, but with a meaningful proportion appearing to reflect criminogenic motivations, especially substance use and paraphilic interests. Results suggest greater similarity than difference among forensic patients with and without a sexual offense history, but also highlight an important divergence from the literature showing that victims of sexual offenses are frequently known to the individual committing them.