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Carvalho J, Bradford J, Murphy L, Briken P, Fedoroff P. Measuring Pedophilic Sexual Interest. J Sex Med 2020; 17:378-392. [PMID: 31932255 DOI: 10.1016/j.jsxm.2019.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/25/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Pedophilic sexual interest is an important risk factor in sexual offender recidivism and remains a key component in the clinical assessment of child sexual offenders and people diagnosed with pedophilia. Despite concerns about the absence of universally accepted standardized clinical assessment methods, there are a number of established techniques aimed at assessing people with sexual interest in children. AIM To provide a foundation from which to understand existing methods available for the assessment of people with pedophilic sexual interests, including strengths and limitations of each approach. METHODS A group of clinical experts provide a clinically oriented, narrative review on assessment methods for pedophilic sexual interest, including the rationale behind each method and its implementation. Evidence on validity supporting the techniques, limitations, and ethical issues is also discussed. RESULTS The assessment methods were grouped according to the following categories: self-report, genital psychophysiological assessment, indirect measurement, and behavioral measurement of pedophilic interest. Although most techniques performed well in discriminating child sexual offenders with pedophilic interest from distinct comparison groups, there are several limitations, including the current lack of standardization and the ethical challenges posed by this sensitive area. CLINICAL IMPLICATIONS An understanding of the different measures available for the assessment of problematic sexual interests plays a vital role in forensic clinical determinations of risk of recidivism and in the identification of treatment targets for men who have committed sexual offenses. Several independent but complimentary methods exist to assess sexual interest. Ongoing work on the international standardization of assessment based on methodologically sound research aimed at determining best practices will address some of the shortcomings of these assessments while improving their reliability. STRENGTHS & LIMITATIONS This article provides a general review on a number of methods aimed at assessing pedophilic interest. However, these methods mirror clinical practice largely used within North America and parts of continental Europe. As a result of cultural differences, opposing paradigms on assessment and treatment of pedophilia, and diverse legal regulation between jurisdictions and countries, these practices may not be applicable on an international scale where other special procedures may be required. CONCLUSION A number of techniques have been used within clinical and research settings that vary from self-report to objective measures. Most methods have demonstrated efficacy. Continued work to combine evidence and experience from diverse populations and multiple countries will improve the quality of the methods available. Carvalho J, Bradford J, Murphy L, et al. Measuring Pedophilic Sexual Interest. J Sex Med 2020;17:378-392.
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Affiliation(s)
- Joana Carvalho
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal; HEI-Lab: Digital Human-Environment and Interactions Labs, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal.
| | - John Bradford
- Forensic Division, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Royal Institute of Mental Health Research, Ottawa, ON, Canada; St Joseph's Healthcare, Hamilton, ON, Canada
| | - Lisa Murphy
- Royal Institute of Mental Health Research, Ottawa, ON, Canada; Sexual Behaviours Clinic, The Royal and Division of Forensic Psychiatry, University of Ottawa, Ottawa, Canada
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Paul Fedoroff
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Royal Institute of Mental Health Research, Ottawa, ON, Canada; Sexual Behaviours Clinic, The Royal and Division of Forensic Psychiatry, University of Ottawa, Ottawa, Canada
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Dombert B, Antfolk J, Kallvik L, Zappalà A, Osterheider M, Mokros A, Santtila P. Identifying Pedophilic Interest in Sex Offenders Against Children With the Indirect Choice Reaction Time Task. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2017. [DOI: 10.1027/1015-5759/a000293] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Pedophilia – a disorder of sexual preference with primary sexual interest in prepubescent children – is forensically relevant yet difficult to detect using self-report methods. The present study evaluated the criterion validity of the Choice Reaction Time (CRT) task to differentiate between a sample of child sex offenders with a presumably high rate of pedophilic individuals and three control groups (other sex offenders, non-sex offenders, and community controls, all male; N = 233). The CRT task required locating a dot superimposed on images depicting men, women, girls, or boys and scrambled pictures as quickly as possible. We used two picture sets, the Not Real People (NRP) set and the Virtual People Set (VPS). We predicted sexually relevant pictures to elicit longer reaction times in interaction with the participant group. Both CRTs showed main effects of stimulus explicitness and preferred stimulus gender. The CRT-NRP also yielded an interaction effect of participant group and stimulus maturity while the CRT-VPS showed a tendency in this direction. The overall effect size was moderate. Results offer support for the usefulness of the CRT task in forensic assessment of child sex offenders.
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Affiliation(s)
- Beate Dombert
- Department of Forensic Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Jan Antfolk
- Department of Psychology and Logopedics, Åbo Akademi University, Finland
| | - Lisa Kallvik
- Department of Psychology and Logopedics, Åbo Akademi University, Finland
| | - Angelo Zappalà
- Department of Psychology and Logopedics, Åbo Akademi University, Finland
| | - Michael Osterheider
- Department of Forensic Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Andreas Mokros
- Department of Forensic Psychiatry and Psychotherapy, University of Regensburg, Germany
- Department for Forensic Psychiatry, University Hospital of Psychiatry Zurich, Switzerland
| | - Pekka Santtila
- Department of Psychology and Logopedics, Åbo Akademi University, Finland
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Schmidt AF, Babchishin KM, Lehmann RJB. A Meta-Analysis of Viewing Time Measures of Sexual Interest in Children. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:287-300. [PMID: 27543106 DOI: 10.1007/s10508-016-0806-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 05/26/2016] [Accepted: 06/28/2016] [Indexed: 05/24/2023]
Abstract
Due to unobtrusiveness and ease of implementation, viewing time (VT) measures of sexual interest in children have sparked increasing research interest in forensic contexts over the last two decades. The current study presents two meta-analyses of VT measures adapted to assess pedophilic interest to determine their discrimination between sexual offenders against children (SOC) and non-SOC groups as well as convergent validity (associations with other measures of sexual interest in children). On average, VT measures showed moderate discrimination between criterion groups (fixed-effect d = 0.60, 95 % CI [0.51, 0.68], N = 2705, k = 14) and significant convergent validity with self-reports, penile plethysmography, Implicit Association Tests, and offence behavioral measures ranging from r = .18 to r = .38. VT measures, however, provided better discrimination for adults (fixed-effect d = 0.78, 95 % CI [0.64, 0.92]) than adolescent samples (fixed-effect d = 0.50, 95 % CI [0.40, 0.61]), Q between = 9.37, p = .002. Moreover, compared to absolute scores, using pedophilic difference scores within adult samples substantially increased VT measures' validity (fixed-effect d = 1.03, 95 % CI [0.82, 1.25], N = 414, k = 7). Results are discussed in terms of their theoretical and applied implications for forensic contexts.
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Affiliation(s)
- Alexander F Schmidt
- Department of Psychology, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
| | - Kelly M Babchishin
- Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Robert J B Lehmann
- Institute of Forensic Psychiatry, Charité-University Medicine, Berlin, Germany
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Mackaronis JE, Byrne PM, Strassberg DS. Assessing Sexual Interest in Adolescents Who Have Sexually Offended. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2016; 28:96-115. [PMID: 24879092 DOI: 10.1177/1079063214535818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Adolescents who have sexually offended have unique treatment needs. For mental health professionals to adequately address these unique needs, further research is necessary. To that end, we explored the assessment of sexual interest (which may play an integral role in understanding potential for sexual reoffending) in a sample of 103 male adolescents who have sexually offended. We compared results from a physiological assessment (MONARCH 21 penile plethysmography [PPG]) and an actuarial assessment (Screening Scale for Pedophilic Interest [SSPI]), plus data from an unobstrusive assessment (Affinity, a viewing time measure) in a smaller subsample of 16 male adolescents. One finding that has particular relevance for clinical assessment is that the SSPI may have limited utility with adolescents. We also found evidence for some overlap between data from PPG and viewing time assessments, although whether or not PPG data are ipsatized may affect relationships with other assessment modalities.
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Affiliation(s)
| | - Peter M Byrne
- Monarch Assessment and Treatment Center, Salt Lake City, UT, USA
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Beier KM, Oezdemir UC, Schlinzig E, Groll A, Hupp E, Hellenschmidt T. "Just dreaming of them": The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ). CHILD ABUSE & NEGLECT 2016; 52:1-10. [PMID: 26773897 DOI: 10.1016/j.chiabu.2015.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/14/2015] [Accepted: 12/16/2015] [Indexed: 06/05/2023]
Abstract
The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ) offers diagnostic and therapeutic help to 12-to-18-year-old juveniles with a sexual preference for the prepubescent and/or early pubescent body of children and who apply for treatment on a voluntary basis. The project goal is to prevent primary or recurrent child sexual abuse as well as primary or recurrent use of child abuse images. Treatment aims to enable affected juveniles to obtain control over their conflictual sexual behaviors. In the present article, the origin of the PPJ; its main approach, including the conception of a media campaign; as well as results from the first year of a three-year study are presented. Further, initial characterizations of juveniles taking part in the project for the first 12 months are provided. The results confirmed that the group of 12-to-18-year-old juveniles with a sexual preference for prepubescent and/or early pubescent minors exists as a target group for primary preventive measures and that they can be assessed for their sexual preferences.
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Affiliation(s)
- Klaus M Beier
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Umut C Oezdemir
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Eliza Schlinzig
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Groll
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Elena Hupp
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Hellenschmidt
- Department of Child and Adolescent Psychiatry at Vivantes Hospital in Friedrichshain, Berlin, Germany
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Herrero Ó, Negredo L. Evaluación del interés sexual hacia menores. ANUARIO DE PSICOLOGÍA JURÍDICA 2016. [DOI: 10.1016/j.apj.2016.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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7
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Stinson JD, Becker JV. Pedophilic Disorder. SEXUAL OFFENDING 2016. [DOI: 10.1007/978-1-4939-2416-5_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Abstract
Paraphilias are recurrent, persistent, and intense sexual interests in atypical objects or activities. The most commonly encountered paraphilias in sexological or forensic settings are pedophilia, sexual sadism, exhibitionism, and voyeurism. Paraphilias are often comorbid with other sexual, mood, and personality disorders. Assessment and diagnosis require an integration of multiple sources of clinical information, given the limits and biases of self-report (through clinical interview or questionnaires). Clinicians ideally have access to more objective assessment methods, such as phallometric testing of sexual arousal. The accurate assessment and diagnosis of paraphilias is essential to effective treatment and management.
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Affiliation(s)
- Michael C Seto
- Royal Ottawa Health Care Group, uOttawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada.
| | - Drew A Kingston
- Royal Ottawa Health Care Group, uOttawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
| | - Dominique Bourget
- Royal Ottawa Health Care Group, uOttawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada
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Hempel I, Buck N, Cima M, van Marle H. Review of risk assessment instruments for juvenile sex offenders: what is next? INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2013; 57:208-228. [PMID: 22147101 DOI: 10.1177/0306624x11428315] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Risk assessment is considered to be a key element in the prevention of recidivism among juvenile sex offenders (JSOs), often by imposing long-term consequences based on that assessment. The authors reviewed the literature on the predictive accuracy of six well-known risk assessment instruments used to appraise risk among JSOs: the Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II), Juvenile Sexual Offence Recidivism Risk Assessment Tool-II (J-SORRAT-II), Estimate of Risk of Adolescent Sexual Offence Recidivism (ERASOR), Juvenile Risk Assessment Scale (JRAS), Structured Assessment of Violent Risk in Youth (SAVRY), and Hare Psychopathy Checklist:Youth Version (PCL:YV). Through a systematic search, 19 studies were reviewed. Studies showed differences in the predictive accuracies for general, violent, and sexual recidivism, and none of the instruments showed unequivocal positive results in predicting future offending. Not unexpectedly, the accuracy of the SAVRY and PCL:YV appeared to be weaker for sexual recidivism compared with specialized tools such as the J-SOAP-II or the ERASOR. Because of the rapid development of juveniles, it is questionable to impose long-term restrictions based on a risk assessment only. New challenges in improving risk assessment are discussed.
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Affiliation(s)
- Inge Hempel
- Erasmus Medical Center, Rotterdam, Netherlands.
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11
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Pullman L, Seto MC. Assessment and treatment of adolescent sexual offenders: implications of recent research on generalist versus specialist explanations. CHILD ABUSE & NEGLECT 2012; 36:203-209. [PMID: 22445287 DOI: 10.1016/j.chiabu.2011.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 11/22/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Adolescent sex offenders (ASOs) are commonly considered a special kind of juvenile offender, with distinct risk and etiological factors from other adolescent offenders. However, a growing body of research suggests that ASOs are more similar to other adolescent non-sex offenders than they are different (e.g., Awad, Saunders, & Levine, 1984; Elliott, 1994; France & Hudson, 1993). The purpose of the present article is to review recent literature pertaining to the distinction between generalist and specialist adolescent sex offenders (ASOs). METHOD This article summarizes the findings from Seto and Lalumière's (2010) meta-analysis on theoretically derived risk and etiological factors for adolescent sexual offending. Based on these findings, recommendations for the assessment and treatment of this population are made. RESULTS The results of Seto and Lalumière's (2010) meta-analysis suggests the majority of ASOs are generalist offenders who are similar to other adolescent non-sex offenders, while a minority of ASOs are specialist offenders, who have unique risk and etiological factors including childhood sexual abuse/maltreatment and atypical sexual interests. CONCLUSIONS A clear distinction has been shown between generalist ASOs and specialist ASOs. Assessment measures and treatment targets geared toward one of these groups may be less effective with the other group, which means that this distinction is clinically important. It is expected that if treatment is matched to ASO type, sexual and nonsexual recidivism will be reduced and positive changes in other clinically important areas will be evident.
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Affiliation(s)
- Lesleigh Pullman
- Department of Psychology, University of Ottawa, Ottawa, ON, Canada
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12
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Dwyer RG, Letourneau EJ. Juveniles who sexually offend: recommending a treatment program and level of care. Child Adolesc Psychiatr Clin N Am 2011; 20:413-29. [PMID: 21683910 DOI: 10.1016/j.chc.2011.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Specialized interventions for juveniles who have committed sex offenses have been widely available for 25 years. These interventions initially were based largely on adult sex offender interventions, with little consideration of developmental and other differences that distinguish juveniles from adult offenders. More recently, interventions have been developed that address youth-specific factors associated with problem sexual behaviors and that include a stronger family focus. This article reviews the history of intervention approaches, summarizes specialized evaluation methods and addresses the assessment of juvenile recidivism risk.
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Affiliation(s)
- R Gregg Dwyer
- Forensic Psychiatry Program, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA.
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Crooks VL, Rostill-Brookes H, Beech AR, Bickley JA. Applying rapid serial visual presentation to adolescent sexual offenders: attentional bias as a measure of deviant sexual interest? SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2009; 21:135-148. [PMID: 19164098 DOI: 10.1177/1079063208328677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Attentional bias toward child images is assessed among adolescent sexual offenders and nonsexual offenders using the rapid serial visual presentation (RSVP) method, which measures the effects of "attentional blink." Twenty adolescent sexual offenders against children and 26 nonsexual offenders are asked to identify a child or animal image and then a second image in streams of 10 images. A stronger attentional blink effect is expected for offenders against children after viewing child rather than animal images. However, the expected differences between offender groups are not found. It is questioned whether the RSVP images can elicit a response in adolescent sexual offenders indicative of DSI. The clinical utility of applying the RSVP assessment with adolescents rather than adults is also queried because (a) adolescents' cognitive abilities may not allow them to conceptualize and concentrate on the assessment in its present form and (b) deviant sexual interest may be evident to different degrees in adolescent sexual offenders.
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Affiliation(s)
- V L Crooks
- University of Birmingham, United Kingdom
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