Childhood Maltreatment Experiences, Attachment, Sexual Offending: Testing a Theory

Seeking an Integrated Approach to Trauma and Problematic Sexual Behaviors in Adolescents: Learning from Practitioners

More than a third of all sexual crimes are committed by adolescents. In addition, many adolescents struggle with problematic sexual behaviors (PSB) that may not rise to a criminal offense, but cause harm to themselves and those around them. A significant number of these adolescents also have histories of their own trauma; yet there are no treatment models that integrate both PSB and trauma into one comprehensive treatment for this population. This qualitative study's aim was to use the expertise of clinicians who work with adolescents with PSB as well as clients and their caregivers who had completed PSB treatment to understand what they believe are the necessary components and elements needed for an integrated model that seeks to simultaneously address both PSB and the consequences of traumatic experiences. Twenty-six mental health professionals and one former client and his caregiver participated in focus groups (three with clinicians and one with the caregiver and former client) to share their experiences and expertise regarding an integrated model. The thematic analysis procedure yielded six major themes: family, external systems, treatment structure, therapeutic themes, specialized PSB targets, and trauma and PSB integration. Each of these major themes was comprised of subthemes that are presented as well. Implications for practice and future research are discussed, including that clinicians could benefit from guidance and structure to assist them in structuring their interventions to address the multiple needs of their clients that seek to reduce their risk of reoffending while simultaneously enhancing the quality of their lives.

Do insecure adult attachment styles mediate the relationship between childhood maltreatment and violent behavior?

Attachment theory has played an important role in attempts to understand the "cycle of violence," where maltreated children are at increased risk for perpetrating violence later in life. However, little is known empirically about whether adult attachment insecurity in close relationships may partly explain the link between childhood maltreatment and violent behavior. This study aimed to address this gap using data from a prospective longitudinal study of documented childhood abuse and neglect cases and demographically matched controls (ages 0-11 years), who were followed into adulthood and interviewed (N = 892). Participants completed the Relationship Scales Questionnaire assessing adult attachment styles at mean age 39.54. Criminal arrest data were used to determine arrests for violence after the assessment of attachment through mean age 50.54. There were significant direct paths from childhood maltreatment and adult attachment insecurity to violent arrests after attachment measurement. Attachment insecurity partly explained the higher levels of violence in individuals with maltreatment histories. Analyses of maltreatment subtypes and attachment styles revealed that attachment anxiety appeared to mediate paths between neglect and physical abuse and later violence. There were no significant indirect paths from neglect or physical abuse to violence via attachment avoidance. Implications and future directions are discussed.

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.

Attachment Anxiety and Dissociation Mediate Associations Between Polytrauma and Somatization in Kenyan Adolescents

The experience of several potentially traumatic events (PTE) is a risk factor for higher somatization symptoms severity among adolescents. Attachment orientations and dissociation may influence the link between exposure to PTE and somatization symptoms severity. We analyzed the associations between direct exposure to PTE and somatization symptoms in Kenyan adolescents and explored the mediating role of attachment orientations and dissociation symptoms in the associations between direct exposure to PTE with somatization symptoms severity. A sample of 475 Kenyan adolescents completed validated self-report questionnaires. Serial multiple mediation models were tested by conducting a structural equation modeling employing Preacher and Hayes' procedures (2008). Attachment anxiety and dissociation symptoms mediate the association between direct exposure to traumatic events and somatization symptoms. Higher exposure to traumatic events was significantly associated with higher attachment anxiety levels, which was associated with higher levels of dissociation symptoms, which was then associated with higher somatization symptoms severity. High levels of attachment anxiety and dissociation might aggravate somatization symptoms differently according to sex, which might be seen as a psychological distress mechanism subsequent to exposure to multiple PTE in African adolescents.

Developing a trauma focused cognitive behavioral therapy application for adolescents with problematic sexual behaviors: A conceptual framework

Sexual abuse (SA) perpetration is a significant public health problem; SA perpetration is most likely to emerge during adolescence and youth ages 13 to 17 account for a significant portion of all child sexual abuse. While research shows that these youth have high rates of adversity, once they have engaged in problem sexual behavior (PSB), their own trauma histories are often ignored with treatment primarily focused on reducing risk for reoffending. Although sexual re-offense rates among adolescents with PSB are very low, the rates of non-sexual recidivism are considerably higher; with almost half of known youth have reoffended non-sexually, requiring development, implementation, and testing of therapeutic interventions responsive to the indicated risks and unmet needs of adolescents who have engaged in a range of problematic sexual behaviors (PSB-A) and their families. Yet, there are no empirically supported interventions designed specifically to address PSB-A with trauma histories. This article introduces how Trauma-Focused Cognitive Behavioral Therapy can be applied to PSB-A and provides implications for practice and future research.

Family Attachment, Sexuality, and Sexual Recidivism in a Sample of Italian Sexual Offenders: Preliminary Results

OBJECTIVE

The research aims to investigate family communication regarding sexuality and the possible link between insecure attachment, violence in relationships, and the tendency toward sexual sensation-seeking in a sample of Italian sexual offenders.

DESIGN AND METHOD

We evaluated 29 male sexual offenders in two correctional facilities of Southern Lazio (Italy) (mean age = 40.76; SD = 11.16). The participants completed general questions about their family and sexual education and fulfilled the following questionnaires: Compulsive Sexual Behavior Inventory (CSBI), Sexual Sensation-seeking Scale (SSSS), and the High-Risk Situation Checklist, adapted in Italian, as well as the Attachment Style Questionnaire (ASQ), validated in Italian.

RESULTS

Most of the participants had never talked about sex within their family and perceived a severe or abusive education during childhood. In addition, positive correlations emerged between SSSS and the two scales of the CSBI, as well as between insecure attachment style, CSBI, and sexual sensation-seeking. The participants also reported some critical issues regarding the personal perception of high-risk situations linked to sexual relapse.

CONCLUSIONS

The data suggest factors to investigate, such as family education and relationships and the personal perception of sexual recidivism. The results might be effective in treatment and prevention programs among sex offenders.

Positive Caregiving Styles Attenuating Effects of Cumulative Trauma Among Youth Who Commit Sexual Crimes

Among youth who commit sexual crimes, childhood trauma experiences have been linked to a host of outcomes including trauma symptom expression. Furthermore, research has begun assessing differential rates of cumulative adverse childhood experiences (ACEs) between youth who commit sexual and non-sexual crimes. Yet, few studies have comparatively examined rates of cumulative traumatic events using more robust measures of adversity. There is scant research on outcomes associated cumulative trauma among youth who commit sexual crimes including linkages to trauma symptoms and how positive parenting styles (PCSs) can attenuate in this relationship. This study aims to compare cumulative trauma experiences between youth who commit sexual (n = 112) and non-sexual crimes (n = 224). Among youth who commit sexual crimes, we test how PCSs mitigate or moderate the effects of cumulative trauma on trauma symptoms. Results from independent samples t-tests revealed significant group differences on singular and cumulative traumatic experiences, and trauma symptomatology, where youth who commit sexual crimes had higher rates of all. Stepwise linear regressions revealed mitigating effects of maternal PCSs and tests of moderation revealed main and interaction effects, where intermediate positive maternal caregiving styles for youth with higher cumulative trauma were associated with greater trauma symptomatology. Implications and limitations are discussed.

Hypersexuality as a tip of the iceberg of a primary psychopathology: a joined position statement of the Italian Society of Andrology and Sexual Medicine (SIAMS) and of the Italian Society of Psychopathology (SOPSI)

In the last years, hypersexual behavior has been broadly scientifically studied. The interest in this topic, belonging to psycho-sexology and sexual medicine, has been due to its still unclear aetiology, nature, and its manifestation in relationship with several organic and psychopathological conditions. So, the specialist (the psychologist, psychiatrist, endocrinologist, neurologist) may encounter some difficulties in diagnosing and managing this symptom. The first main objective of this position statement, which has been developed in collaboration between the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Psychopathology (SOPSI) is to give to the reader evidence about the necessity to consider hypersexuality as a symptom related to another underlying condition. Following this consideration, the second main objective is to give specific statements, for the biopsychosocial assessment and the diagnosis of hypersexual behavior, developed on the basis of the most recent literature evidence. To develop a psycho-pharmacological treatment tailored on patients' needs, our suggestion is to assess the presence of specific comorbid psychopathological and organic conditions, and the impact of pharmacological treatments on the presence of an excess of sexual behavior. Finally, a suggestion of a standardized psychometric evaluation of hypersexuality will be given.

Why Men Rape: Perspectives From Incarcerated Rapists in a KwaZulu-Natal Prison, South Africa

Sexual offending is a global problem but is particularly prevalent on the African continent and in South Africa. Childhood experiences related to abuse, alcohol use, and criminal activities in the household and community has been associated with an increased risk for violence perpetration in adulthood. Less is known about sexual violence perpetration, especially in the South African context. In this study, the experiences of incarcerated male perpetrators of rape in South Africa are investigated along with the collective social context and individual childhood experiences that potentially contribute to rape perpetration. Eighteen male perpetrators of rape who were inmates at Westville Correctional Services in KwaZulu Natal, South Africa, were interviewed. The semi-structured in-depth qualitative interviews were transcribed, coded and annotated using an interpretive paradigm and thematic analysis approach. Five main themes emerged from the research and included (1) childhood trauma and adverse events, e.g., an absent father, being raised without parents, exposure to criminal or violent behavior, physical abuse, sexual abuse and poverty, (2) understanding rape, e.g., rape as sex by force and without consent, rape as a violent act, rape as sex with a minor, myths about rape (3) substance abuse, e.g., history of alcohol and drug use, and intoxication during rape perpetration, (4) gender roles and avoiding responsibility, e.g., victim blaming, rape as male prerogative, transactional sex, being framed or set-up, ignoring an ancestral call and (5) recidivism. The findings revealed that all rape perpetrators were exposed to at least one childhood trauma type. Family and community violence and criminality was common. Most participants avoided taking responsibility for their actions and blamed the victim and recidivism/prior convictions were often reported. The findings demonstrate the complex personality dynamic involved in the cycle of abuse and the evolution of criminal behavior, starting as a victim and ending as a perpetrator. The findings also highlight the need for interventions aimed at reducing childhood trauma exposure and improving the social and relational context of those at risk for childhood neglect and abuse.

“Hurt people hurt other people”: The link between past trauma and sexual offending

Background

A growing body of research documents the high rates of trauma among individuals who have sexually offended. Yet the relationship between prior victimization and subsequent sexual offending remained unclear. Objective: By including the voices and perspectives of individuals convicted of sexual offenses, we sought to strengthen professionals’ understanding of the connection between victimization and offending.

Method

This qualitative study used an online survey to collect data from individuals convicted of sexual offenses (n = 195) with the aims of understanding their perceptions of the link between trauma and offending and what they would like sex-offense treatment providers to know about this connection.

Results

Using grounded theory, five major themes emerged from the data analysis: Relationship between Trauma Offending (n = 91), Acknowledging the Connection (n = 57), Specific Effects of Trauma (n = 48), Individualized Treatment (n = 34), and Recognition of Humanity (n = 26).

Conclusions

The participants perceived a strong connection between one’s own victimization and subsequent sexual offending. In addition, they offered specific recommendations for treatment providers, including individualizing treatment with an emphasis on humanity and compassion. Implications for trauma-informed practice and policy are discussed.

Trauma and Maternal Caregivers as Risks for Executive Function Deficits Among Youth Who Have Sexually Harmed

Despite robust research linking trauma events to the commission of sexual harm by youth, the majority of victims do not become victimizers, imploring us to study potential interceding influences. Some research indicates that intermediary factors like attachment characteristics, trauma symptomatology, and executive functioning may be critical in understanding sexual harm committed by youth. This study explored relationships between trauma events, trauma symptoms, and attachment characteristics, and their relationship to executive functioning in a sample of 196 youth who committed sexual harm. Results revealed bivariate associations between trauma events, symptomatology, and maternal attachment characteristics. Structural equation modeling revealed numerous direct and indirect effects on the path to deficits in executive functioning, and that sexual abuse, above and beyond other forms of traumatic events, contributed to executive functioning deficits via trauma symptoms. The results are contextualized and implications are discussed.

Alexithymia and Insecure Attachment among Male Intimate Partner Violence Aggressors in the Dominican Republic

The complexity of intimate partner violence and the impossibility of understanding it from single factors have been studied from different biological, psychological, and socio-cultural factors. A cross-sectional study was conducted on 187 men involved in legal proceedings for problems of violence in their intimate partner relationships in the Dominican Republic in order to explore whether insecure attachment represents a risk factor for alexithymia in men with violent behaviors. The attachment style was determinate by the Casullo and Fernández-Liporace Attachment Styles Scale, and alexithymia was assayed using the Latin American Consensual Toronto Alexithymia Scale (LAC TAS-20), a modification of the Toronto Alexithymia Scale (TAS-20). Chi-square test and multiple binary logistic regression analysis were performed to explore the phenomena of alexithymia and attachment styles in the context of a confinement center for male intimate partner offenders in the Dominican Republic. The results showed that insecure attachment represents a risk factor for alexithymia, being highest for avoidant attachment in the population studied. The results also highlight the influence of other factors such as education and maternal–familial relationships as a factor risk for alexithymia.

Criminogenic Needs as Intervening Factors in the Relation Between Insecure Attachments and Youth Sexual Violence

There is a strong theoretical and research base demonstrating the link between attachment styles and adolescent sexual offending. However, this relationship may be best explained by deficit-based mediational pathways including criminogenic needs such as emotional or affect regulation and callousness. Grady, Levenson, and Bolder propose a framework that details criminogenic needs as intermediary variables in the attachment-sexual offending relationship. Using data on adolescents adjudicated of sexual and nonsexual crimes in a Western state (N = 200), two structural equation models (SEM) tested direct and indirect relationships between ambivalent and avoidant attachment styles (in separate models), dysregulation including cognitive and behavioral transitions, emotional control, and inhibited/impulsive behaviors, callousness, delinquency, and offending type (sexual or nonsexual offending). Results revealed statistically significant direct pathways between variables of interest and a multimediational effect of dysregulation and callousness in the relationship between insecure attachments and sexual offending. Treatment, policy, and research implications are discussed.