Sexual offender recidivism among a population-based prison sample

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.

Ramping Up Detention of Young Serious Offenders: A Safer Future?

When youth commit serious violent or sexual offenses, this often generates a call for more severe punishments and longer detention sentences. An important question is whether (long) detention sentences are effective in decreasing recidivism among serious young offenders. To estimate recidivism rates in serious young offenders and elucidate the link between sentencing (in terms of custodial vs. non-custodial and length of imprisonment) and recidivism, three multilevel meta-analyses were conducted. With a systematic literature search, 27 studies and four datasets were traced, involving N = 2,308 participants, yielding 90 effect sizes for overall recidivism, 24 for specifically violent recidivism, and 23 for the association between length of imprisonment and recidivism. The average weighted overall recidivism rate was 44.47% (95% confidence interval [CI]: 37.59-51.46%) over an average period of 8.68 years. The rate of violent recidivism was estimated at 30.49% (95% CI: 20.92-40.52%), over an average period of 11.45 years. Recidivism rates were higher when recidivism was defined as an arrest for any new offense rather than for a specific offense and in studies conducted in the United States versus European studies. Violent recidivism rates were higher in studies with longer follow-up periods. Based on the limited available studies, no difference in recidivism rates following custodial and non-custodial sentences were found, nor an association between length of imprisonment and recidivism. To increase rehabilitation chances for youth offenders, further research is warranted to better understand the impact of sentencing and to ascertain what is needed to make custodial and non-custodial sentences more effective.

Understanding the dark side of personality in sex offenders considering the level of sexual violence

This study examined the relationship between the actual level of physical violence in sexual offenses and dark triad, empathic and impulsive personality traits of their perpetrators. Sixty-four male perpetrators of sexual offenses without any serious mental illness were included. A 5-point Likert-type coding system based on Violence Profile for Current Offense was applied to assess the severity of physical violence of each sexual offense. Personality traits of dark triad (psychopathy, Machiavellianism, narcissism), trait empathy and impulsiveness were also evaluated. Multivariate analyses indicated that non-stranger victim, secondary psychopathy, narcissism and empathy could significantly predict greater involvement of physical violence in a sexual offense. In addition, empathy was negatively correlated with all dark triad traits. Sexual violence should be conceptualized in the form of a continuum, and, considering such an approach, offenders with high secondary psychopathy and narcissism may show preference for sexual assaults that are more violent in nature.

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.

Multidisciplinary Approach to Emergent Sexual Abuse in a Pediatric Emergency Department: A Simulated Child Advocacy Center Model of Care

INTRODUCTION

The purpose of this study was to compare child sexual abuse interview disclosures and judicial outcomes for cases of child and adolescent sexual abuse/assault seen in a pediatric emergency department (PED) before and after the implementation of a simulated child advocacy center (CAC) multidisciplinary model of care.

METHOD

A retrospective chart and legal records review was conducted from both the PED model of care group and the simulated CAC multidisciplinary model of care for judicial outcomes, child sexual abuse interview disclosures, and sexual abuse case characteristics.

RESULTS

The simulated CAC multidisciplinary model of care did not result in increased indictments, pleas, trials, or disclosure of sexual abuse in the sexual abuse interview when compared with the PED model of care. The simulated CAC multidisciplinary model of care did result in a significantly higher rate of sexual abuse interview completion.

DISCUSSION

Demographic risk factors for sexual abuse victimization as well as perpetration have been identified in the literature and were supported by this study. Law enforcement and child protective services were more frequently present in the PED under the simulated CAC multidisciplinary model allowing for improved protection of children.

Older Individuals Convicted of Sexual Offenses: A Literature Review

The population of older individuals convicted of sexual offenses (OSOs) is rapidly increasing. However, we have little understanding of their characteristics (e.g., demographic, psychological, individual, offense, and risk) and needs. To identify any similarities or differences that are unique to older individuals convicted of sexual offending, it is important to compare such characteristics across the adult lifespan. Therefore, the aim of this systematic review was to specify and synthesize the current knowledge of characteristics across the adult lifespan of the population of individuals convicted of sexual offenses. Five databases were searched and 10,680 results were screened, resulting in 100 studies included in the final review. The findings were grouped into four emergent themes: age of onset and prevalence; offender and offense characteristics; age and the risk of reoffending; and treatment. Implications of the findings from this review are discussed in relation to future research and clinical practice.

Estimating the probability of sexual recidivism among men charged or convicted of sexual offences: Evidence-based guidance for applied evaluators

Risk assessment is routinely applied in forensic decision-making. Although relative risk information from risk scales is robust across diverse samples and settings, estimates of the absolute probability of sexual recidivism are not. Nonetheless, absolute recidivism estimates are still necessary in some evaluations. This paper summarizes research and offers guidance on evidence-based practices for assessing the probability of recidivism, organized largely around questions commonly asked in court. Overall, estimating the probability of sexual recidivism is difficult and should be undertaken with humility and circumspection. That being said, research favours empirical-actuarial risk tools for this task, more structured scales, and the use of multiple scales. Professional overrides of risk scale results should not be used under any circumstances. Paradoxically, however, professional judgement is still required in some circumstances. Risk scales do not consider all relevant risk factors, but the added value of external risk factors reaches a point of diminishing returns and may or may not be incremental (or worse, can degrade accuracy). There are reasons actuarial risk scales may both underestimate recidivism (e.g., undetected offending, short follow-ups) and overestimate recidivism (e.g., inclusion of sex offences not of interest in some referral questions, data on declining crime and recidivism rates, newer studies demonstrating overestimation of recidivism). Given all these considerations and the need for humility, in the absence of exceptional circumstances, I would not deviate too far from empirical estimates.

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.

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.

A 24-Year Follow-up Study on Recidivism in Male Mentally Disordered Sexual Offenders With and Without Psychotic Disorders

There is a lack of knowledge on mentally disordered sex offenders (MDSOs) targeting adult victims, especially regarding recidivism patterns and the specific subgroup with psychiatric disorders. This paper presents index offense data, clinical data, and recidivism patterns over up to 24 years in a cohort of 146 MDSOs, with and without psychotic disorders, sentenced in Sweden between 1993 and 1997. At the time of the offense, all offenders were affected by clinical, developmental, and criminal history factors. MDSOs with psychotic disorders only marginally differed from those without, the former being less likely to have been institutionalized during childhood, intoxicated during the index offense, or diagnosed with a personality disorder, substance use disorder, or paraphilic disorder. In the cohort, 3.4% of the MDSOs were reconvicted for a new sex offense over 2 years, 9.6% over 5 years, 13.0% over 10 years, and 17.1% over the entire follow-up period of 24 years. In MDSOs with psychotic disorders, no subjects were reconvicted during the first 2 years, while 2.6% were reconvicted over 5 years, 5.3% over 10 years, and 7.9% over 24 years. Recidivism rates for violent and general reoffenses were 39.0% and 37.7%, respectively, for the cohort of MDSOs, and subjects with psychotic disorders reoffended significantly later in general offenses. In conclusion, MDSOs with psychotic disorders showed the same recidivism pattern as MDSOs without psychotic disorders. Furthermore, recidivism research may preferably focus on follow-up periods of 5-10 years since most offenders appear to recidivate within this timeframe.

Therapie bei Straffälligkeit: Zur Entwicklung der Sozialtherapie im deutschen Justizvollzug

Die Stichtagserhebung der Kriminologischen Zentralstelle (KrimZ) fragt jedes Jahr zum Stichtag am 31. März die Gegebenheiten in allen sozialtherapeutischen Einrichtungen deutschlandweit ab. Inzwischen liegen Daten aus 23 Erhebungsjahren vor und geben Aufschluss über die Entwicklungen der Versorgungslage (Anzahl der Einrichtungen bzw. Haftplätze), bezüglich der demografischen Daten der Gefangenen (Alter, Staatsbürgerschaft, Dauer der Haftstrafe, schwerste Straftat, Vorstrafen), über institutionelle Vorgänge (Aufnahmen, Abgänge und Nachbetreuung) sowie hinsichtlich von Daten zum Personal (Anzahl der Personalstellen und Frauenanteil). Die vorliegenden Auswertungen verdeutlichen die Entwicklungstrends in der Sozialtherapie zwischen 1997 und 2019 und legen nahe, dass nach einem starken Ausbau der sozialtherapeutischen Einrichtungen ab 1969 nun mit 71 Einrichtungen eine Sättigungsgrenze erreicht zu sein scheint. Die inhaftierten Personen werden zunehmend älter, sodass 2019 die über 50-Jährigen die größte Altersgruppe stellen. Schon seit 2003 liegt der Anteil derjenigen, die aufgrund eines Sexualdelikts inhaftiert sind, bei ca. 50 %, was gegenüber anderen Deliktgruppen eine deutliche Mehrheit darstellt. Ein Großteil der Gefangenen hat keine Haftlockerungen, wobei hier eine zunehmend restriktivere Praxis zu erkennen ist. Die Personalausstattung hat sich über die letzten 23 Jahre insofern verändert, als dass mehr Fachdienste und tendenziell weniger Stellen im allgemeinen Vollzugsdienst (AVD) eingerichtet wurden.

@myTabu-A Placebo Controlled Randomized Trial of a Guided Web-Based Intervention for Individuals Who Sexually Abused Children and Individuals Who Consumed Child Sexual Exploitation Material: A Clinical Study Protocol

Background: There is a high demand for evidence-based and cost-effective treatment concepts for convicted individuals who sexually abused children (ISAC) and individuals who consumed child sexual exploitation material (ICCSEM) under community supervision (CS). The @myTabu-consortium developed a guided web-based intervention for convicted ISAC and ICCSEM under CS consisting of six online modules targeting psychological meaningful risk factors. The study aims to evaluate the effectiveness of this guided web-based intervention in reducing dynamic risk factors and the risk to re-offend compared to a placebo condition. Furthermore, these dynamic risk factors are measured before and after every module to evaluate their individual effectiveness to reduce the respective risk factor as well as risk to re-offend. This clinical trial protocol describes the planned methods as well as the intervention concept. Methods: The methodological design is a placebo controlled randomized add-on trial (N = 582) with follow-ups at 8 points in time. The placebo condition controls for attention and expectation effects and comprises the same amount of modules with a comparable temporal effort as the experimental intervention. The trial is conducted as an add-on to community supervision as usually done. Primary outcomes are dynamic risk factors assessed by self-report risk assessment tools and officially recorded re-offenses. Discussion: To the best of our knowledge, the study is the first to compare the (cost-) effectiveness of a guided web-based intervention for convicted ISAC and ICCSEM under community supervision against a placebo condition. Methodological limitations (e.g., potential ceiling- or volunteers-effects) are discussed. Clinical Trial Registration: German Clinical Trial Register (DRKS 00021256). Prospectively registered: 24.04.2020.

Evaluating the legal assumptions of Victoria's Sex Offender Registration Act 2004 from a psychological perspective

The Sex Offender Registration Act 2004 was introduced in Victoria to decrease recidivism and aid in future investigations and prosecutions. This article reviews literature to evaluate four assumptions inherent to the Act: (a) sexual offenders are more dangerous than non-sexual offenders; (b) sexual offenders who target children are more dangerous than those who target adults; (c) recidivism risk can be accurately assessed for sexual offenders who target adults; and (d) the Act is a useful tool for investigations and prosecutions. The findings suggest that there is little evidence that supports the assumptions. Further, given the relatively narrow scope of the Act, it is unlikely to have a positive impact on the safety of the community.

Dynamic Risk Assessment of Sexual Offenders: Validity and Dimensional Structure of the Stable-2007

In this study, the predictive and incremental validity of the Stable-2007 beyond the Static-99 was evaluated in an updated sample of N = 638 adult male sexual offenders followed-up for an average of M = 8.2 years. Data were collected at the Federal Evaluation Center for Violent and Sexual Offenders (FECVSO) in Austria within a prospective-longitudinal research design. Scores and risk categories of the Static-99 (AUC = .721; p < .001) and of the Stable-2007 (AUC = .623, p = .005) were found to be significantly related to sexual recidivism. The Stable-2007 risk categories contributed incrementally to the prediction of sexual recidivism beyond the Static-99. Analyzing the dimensional structure of the Stable-2007 yielded three factors, named Antisociality, Sexual Deviance, and Hypersexuality. Antisociality and Sexual Deviance were significant predictors for sexual recidivism. Sexual Deviance was negatively associated with non-sexual violent recidivism. Comparisons with latent dimensions of other risk assessment instruments are made and implications for applied risk assessment are discussed.

Die Wirksamkeit psychotherapeutischer Behandlung von Sexualstraftätern nach Entlassung aus dem Strafvollzug

Zusammenfassung. Hintergrund: Das zentrale Wirkkriterium forensischer Psychotherapie besteht in der Verringerung des Rückfallrisikos hinsichtlich neuerlicher Straftaten. In der vorliegenden Studie wurde die in Hessen dezentral organisierte psychotherapeutische Versorgung von Personen, die aufgrund sexuell motivierter Straftaten verurteilt wurden, evaluiert. Methoden: Hierfür wurden psychotherapeutisch behandelte Probanden (n = 134) mit psychotherapeutisch nicht behandelten Probanden (n = 134) hinsichtlich der Rückfälligkeit verglichen, wobei die Vergleichbarkeit beider Gruppen mittels eines Matching-Verfahrens bezüglich rückfallrisikorelevanter Merkmale sichergestellt wurde. Der Behandlungserfolg wurde mit Hilfe zweier Rückfalldatenquellen überprüft: Erneut eingegangene Anzeigen bei der Staatsanwaltschaft sowie Wiederverurteilung und erneute Eintragung im Bundeszentralregister (BZR). Ergebnisse: Behandelte Probanden wiesen hinsichtlich allgemein gewalttätiger und sexuell motivierter Rückfälle signifikant niedrigere Anzeigeraten auf (14.2 % bzw. 9.7 %) als die unbehandelten Vergleichsprobanden (26.9 % bzw. 19.4 %), wobei bei den übrigen Rückfallkriterien die Signifikanzgrenze nicht erreicht wurde. Diskussion: Die Ergebnisse der vorliegenden Studie verdeutlichen, dass auch eine dezentral organisierte Versorgungsstruktur grundsätzlich geeignet ist, zur Verhinderung von Rückfällen von entlassenen Sexualstraftätern beizutragen.