General and victim-specific empathy: associations with actuarial risk, treatment outcome, and sexual recidivism

Empathy deficit in male patients with schizophrenia and its relationships with impulsivity and premeditated violence

Objective

To explore the pattern of empathy characteristics in male patients with schizophrenia (SCH) and to examine whether empathy deficit is associated with impulsivity and premeditated violence.

Methods

One hundred and fourteen male SCH patients were enrolled in this study. The demographic data of all patients were collected and the subjects were divided into two groups, namely, the violent group, including 60 cases, and the non-violent group, comprising 54 cases, according to the Modified Overt Aggression Scale (MOAS). The Chinese version of the Interpersonal Reactivity Index-C (IRI-C) was used to evaluate empathy and the Impulsive/Predicted Aggression Scales (IPAS) was employed to assess the characteristics of aggression.

Results

Among the 60 patients in the violent group, 44 patients had impulsive aggression (IA) and 16 patients had premeditated aggression (PM) according to the IPAS scale. In the violent group, the scores of the four subfactors of the IRI-C, i.e., perspective taking (PT), fantasy (FS), personal distress (PD), and empathy concern (EC), were significantly lower than in the non-violent group. Stepwise logistic regression showed that PM was independent influencing factor for violent behaviors in SCH patients. Correlation analysis revealed that EC of affective empathy was positively correlated with PM but not with IA.

Conclusion

SCH patients with violent behavior had more extensive empathy deficits compared with non-violent SCH patients. EC, IA and PM are independent risk factors of violence in SCH patients. Empathy concern is an important index to predict PM in male patients with SCH.

Sexual victimization experience, acknowledgment labeling and rape empathy among college men and women

OBJECTIVE

Sexual victimization experience is a health concern among college students and rape empathy may help address it. Empathy with a rape victim was examined based on sexual victimization experience, acknowledgment (i.e., labeling experience "sexual assault," "rape"), and gender.

METHOD

Undergraduates (n = 531) completed measures of sexual victimization experience and rape empathy.

RESULTS

Acknowledged victims reported greater empathy than unacknowledged victims and nonvictims, but the latter two groups did not differ. Unacknowledged female victims reported greater empathy than unacknowledged male victims, but no gender difference emerged for acknowledged victims or nonvictims. Victimized men were less likely than victimized women to acknowledge their experience.

CONCLUSIONS

The association found between acknowledgment and empathy may inform efforts to address sexual victimization (e.g., prevention, victim support), and men should not be overlooked. Unacknowledged victims and greater acknowledgment rates among women than men may have contributed to previously reported gender differences in rape empathy.

Theory of Mind in Offending: A Systematic Review

Theory of mind (ToM) impairment is associated with poor social functioning in some psychological disorders (e.g., autism and schizophrenia). ToM deficits have also been linked with offending behavior in the theoretical literature. However, no review has examined the empirical evidence for such a link. We carried out a systematic review to provide a critical overview of studies involving ToM ability in offenders. We included studies published in English that used an instrument to measure at least one aspect of ToM. Twenty-eight eligible studies were identified and coded. Our findings reveal a generally mixed literature. Taking study quality into account, our findings suggest that offenders and nonoffenders do not differ in their first-order ToM. For second-order ToM, findings are mixed, even when only the highest quality studies are examined. Studies exploring advanced ToM showed mixed results overall, though the highest quality research appeared to indicate that offenders have impairments in advanced ToM which means that they may have difficulty understanding various mental states such as pretense, white lies, irony, double bluffs, and sarcasm. We suggest that well-controlled future studies, which also measure other facets of ToM (e.g., distinguishing between cognitive and affective ToM or examining ToM content), are needed to fully understand the role of ToM in offending.

Dropout and recidivism are partly explained by emotional decoding and perspective taking deficits of intimate partner violence perpetrators

Professionals and researchers have dedicated important efforts to understanding the underlying factors that explain the failure to complete interventions (dropout) and the recidivism of men convicted of intimate partner violence (IPV) against their female partners. There is a growing interest in measuring emotional decoding and empathic deficits in IPV perpetrators to better understand dropout and recidivism proneness, due to their direct impact on behavioral regulation. In the current study, we first aimed to examine whether the emotional decoding abilities of facial expressions and empathic abilities (cognitive and emotional), as well as their interrelationships in IPV perpetrators (n = 561), would explain dropout, treatment attendance, and recidivism (risk and official) once treatment ended. Our results allowed us to conclude that emotional decoding abilities and perspective taking (cognitive empathy) were significantly and negatively associated with dropout and recidivism. Two moderation models were significant. On the one hand, participants with low emotional decoding abilities presented lower intervention doses the lower their perspective taking. Furthermore, the percentage of participants that reoffended was higher among individuals with low and moderate perspective taking who dropped out. Therefore, our study highlights the importance of conducting emotional decoding and empathic assessments during the initial stages of intervention programs to clearly outline the therapeutic needs of IPV perpetrators. This would allow designing coadjuvant and complementary training programs that can support the main interventions by increasing treatment adherence and, in turn, reducing the risk of recidivism.

The Psychometric Assessment of Empathy: Development and Validation of the Perth Empathy Scale

Empathy, the ability to infer and share others' affective states, plays a vital role in social interactions. However, no existing scale comprehensively assesses empathy's cognitive and affective components across positive and negative emotional valence domains. This article explores the latent structure of the empathy construct and attempts to remedy past measurement limitations by developing and validating a new 20-item self-report measure, the Perth Empathy Scale (PES). In Study 1 (N = 316), factor analyses revealed a coherent empathy construct comprised of cognitive and valence-specific affective components. Study 2 (N = 331) replicated this factor structure, showed measurement invariance between males and females, and highlighted the importance of assessing negative and positive emotions in empathy. The PES showed convergent and discriminant validity from comparisons with alexithymia and other empathy measures. Overall, this article empirically establishes a conceptually clear structure of the multidimensional empathy construct, which the PES reliably and validly measures.

How effective are interventions at enhancing empathy for service users with an intellectual disability who engage in sexually abusive behaviour? A review of the literature

BACKGROUND

Sexual offending has been attributed to empathy deficits, implicating interventions targeting empathy as a potential mechanism for reducing sexually harmful behaviour. However, there is less known about how appropriate and effective interventions are for individuals with intellectual disabilities. This review aims to provide a comprehensive synthesis of research findings in this area.

METHOD

Four databases were searched, yielding 13 studies meeting the inclusion criteria which were appraised using the CCAT.

RESULTS

CBT group treatments adapted from mainstream treatment programmes for people with intellectual disabilities were widely used, demonstrating improvements in empathy and reductions in sexually abusive behaviour overall.

CONCLUSIONS

Studies are limited by sample sizes, lack of control groups and inconsistent definitions of intellectual disabilities and sexually abusive behaviour. Future research should include evaluation of models other than CBT, further assessment of empathy-specific interventions and understanding of the mechanism underpinning empathy change.

Understanding Empathy, Self-Esteem, and Adult Attachment in Sexual Offenders and Partner-Violent Men

The assessment and treatment of emotional variables is a priority in the rehabilitation of offenders. Although theoretical proposals suggest a clear relationship between violence and self-esteem, attachment, and empathy, the research carried out to date has reached contradictory results due mainly to differences in the measurements used, the reliability of self-reports, or even to problems with the definition of the constructs. The present study analyzed these three variables in a prison sample of sexual offenders (n = 48) and partner-violent men (n = 68), using the Interpersonal Reactivity Index, the Rape Empathy Measure, the Rosenberg Self-Esteem Scale, and the Adult Attachment Questionnaire. Results confirmed the low utility of nonspecific empathy, the predominance of high self-esteem, and the difficulty of identifying an insecure attachment. The implications of the use of these variables in the treatment of offenders, and the need to improve the assessment tools, are discussed.

Impulsivity and Empathy in Dating Violence among a Sample of College Females

The predictive factors of violence between married couples or adolescents are well-known. However, less is known about the factors relating to intimate violence among college students. This study examined sociodemographic variables (age, duration of relationship, and relationship satisfaction), impulsivity, and empathy as predictors of dating violence, using data from 474 female college students from the University of Mostar, Bosnia and Herzegovina. The sample completed online the Conflict Tactics Scale 2 Short Form, the Interpersonal Reactivity Index, and the Short Impulsive Behavior Scale. The results indicated a higher prevalence of victimization than perpetration for psychological aggression. The obtained data showed that younger women and those in longer relationships, as well as those unsatisfied with their relationship, are more prone to experience psychological victimization or perpetration. Relationship satisfaction was also shown to be a predictor of physical perpetration causing injury. Impulsivity facets were found to have a differential weight in explaining dating violence. Empathy was shown to be a significant predictor of dating victimization, specifically "perspective taking" for psychological victimization and empathic concern for sexual victimization. These results suggest the need to develop specific interventions and prevention programs focused on relationship satisfaction, impulsivity, and empathy.

A narrative review of research on clinical responses to the problem of sexual offenses in the last decade

Research on the treatment and programs for people who have committed sexual offenses has greatly increased in the past decade. The aim of this review is to discuss research that has been published over that period (2010-2019) that is relevant for treatment providers. The articles included in this review were found through PsycINFO and PubMed (Medline) using the keywords "treatment or therapy" and "sex offen*". The inclusion criteria were publications that discuss treatment of persons who have committed sexual offenses (written in the English language only). Any articles that examined only special populations were excluded, such as those that examined persons who committed sexual offenses who were female, had intellectual disabilities, deafness, juveniles, etc., because these groups will likely have needs and responsivity factors that differ from the "average" natal-born male sex offender. Results showed that several meta-analyses indicate that treatment is effective in reducing sexual recidivism. The most frequently used treatment for sex offenders is cognitive behavioral therapy, which is often provided in conjunction with pharmacological treatment to reduce sexual impulsivity and/or sex drive. This review is limited to the specific key search terms. The findings of this review support the use of treatment and a community reintegration approach when treating persons who have committed sexual crimes to prevent sexual recidivism.

The Role of Forensic Factors and Potential Harm to the Child in the Decision Not to Act Among Men Sexually Attracted to Children

To date, sexual abuse prevention efforts have largely focused on tertiary prevention strategies designed to prevent recidivism among forensic samples of men with a history of sex offending behavior. The present study used mixed methodology to investigate the role of several forensic and related factors on the decision not to commit a sex offense among two groups of community men who self-reported a sexual attraction to children: those who reported a history of acting on their attractions (Acted, n = 29) and those who reported never acting on their attractions (Not Acted, n = 71). Participants from both groups described in their own words the factors that contributed to their decision not to act on their attractions. They also responded to quantitative and qualitative questions regarding the influence and role of the following factors on their decision not to act: (a) the possibility of jail or punishment, (b) mental health treatment, and (c) not wanting to hurt the child. Results were compared across groups, and across prompted and unprompted responses. Analyses highlighted harm to the child as a particularly salient factor in the decision not to act among men in the community at risk for sexually offending. The present study suggests that investigating potential protective factors may be an important direction for future research among samples of community men at risk for both first-time and repeat offenses against children.

Factors Predicting Desistance From Reoffending: A Validation Study of the SAPROF in Sexual Offenders

The present study aims at validating the German version of the Structured Assessment of PROtective Factors (SAPROF) for violence risk in a representative sample of incarcerated adult male sexual offenders. Sexual offenders ( n = 450) were rated retrospectively with the SAPROF using the database of the Federal Evaluation Centre for Violent and Sexual Offenders (FECVSO) in the Austrian Prison System. Interrater reliability and predictive validity of the SAPROF scores concerning desistance from recidivism were calculated. Concurrent and incremental validity were tested using the combination of the SAPROF and the Sexual Violence Risk-20 (SVR-20). Interrater reliability was moderate to excellent, and predictive accuracy for various types of recidivism was rather small to moderate. There was a clear negative relationship between the SAPROF and the SVR-20 risk factors. Whereas the SAPROF revealed itself as a significant predictor for various recidivism categories, it did not add any predictive value beyond the SVR-20. Although the SAPROF itself can predict desistance from recidivism, it seems to contribute to the risk assessment in convicted sexual offenders only to a limited extent, once customary risk assessment tools have been applied. Implications for clinical use and further studies are discussed.

Exploring Neural Correlates of Empathy in Juveniles Who Have Sexually Offended

To effectively address the needs of youth who perpetrate sexual violence and reduce rates of recidivism, a better understanding of the mechanisms of juvenile sexual offending is needed. Current literature identifies various factors that are believed to put youth at risk for sexual offending, two of which are empathy deficits and childhood sexual abuse (CSA). The extent to which empathy deficits contribute to juvenile sexual offending, however, is often debated, though studies have not yet explored a neurobehavioral model of this mechanism. This pilot study used functional magnetic resonance imaging (fMRI) to explore the neural correlates of empathy in juveniles who sexually offend (JSOs), and the possible role of CSA. A total of 38 males (ages 12-20) were enrolled, including 11 healthy control subjects and 27 JSOs, of which, 11 had a history of CSA. Participants underwent clinical assessment and completed an empathy task during fMRI. Using both whole-brain and region-of-interest analysis, results of the fMRI data showed no statistical differences in engagement of brain regions associated with empathy between controls and all JSOs. There were also no significant differences between JSOs with and without a history of CSA. These null findings pose implications for guiding future research studies with larger samples and more statistical power, and may support the need to further explore empathy-related explanatory models and interventions for JSOs. Neuroimaging may demonstrate to be a useful tool to identify individualized risk factors and aid in tailoring interventions for this population.

Treatment Gain in Violent Offenders: The Relationship Between Proximal Outcomes, Risk Reduction and Violent Recidivism

This study examines whether change in dynamic risk factors and other treatment targets over the course of violent offender treatment is associated with a reduction in violent recidivism. Data from 82 adult male violent offenders who attended a prison-based violence treatment programme were collected via retrospective file review. Therapeutic change was assessed by comparing pre- and post-treatment Violence Risk Scale (VRS) scores, ratings of denial and minimisation of violence, level of victim awareness, and motivation to change. Completion of offender treatment is found to be associated with significant change on all proximal outcome measures (i.e. reduction in dynamic risk and minimisation of violence, and increased victim empathy). However, these changes do not translate into reductions in reoffending; only one measure of within-treatment change - enhancement of victim awareness - is (negatively) associated with recidivism. These results suggest that caution is required when considering the impact of change in a restricted range of treatment targets on violent recidivism. Future research should focus on identifying reliable indicators of within-treatment change to aid idiographic assessments of violence risk and to elucidate mechanism of change.

Empathy Impairments in Intimate Partner Violence Perpetrators With Antisocial and Borderline Traits: A Key Factor in the Risk of Recidivism

Antisocial, borderline, and narcissistic personality traits have been described as characteristics of intimate partner violence (IPV) perpetrators. Furthermore, deficits in cognitive empathy and impairments in emotional decoding processes may at least partially explain conduct disorders and social dysfunction in general. However, previous research has not explored potential associations between empathy deficits and the aforementioned traits or whether they are reflected in recidivism in IPV perpetrators. Accordingly, the main aim of this study was to explore associations between empathy deficits, antisocial, borderline, and narcissistic traits and the risk of recidivism in this population. The sample consisted of 144 IPV perpetrators (mean age = 41 years). High antisocial and borderline personality traits in this sample were associated with a high risk of recidivism, these relationships being moderated by poor empathy skills. Moreover, in IPV perpetrators with both antisocial and borderline personality traits, the risk of recidivism was higher than in those with only one of these traits. In contrast, narcissistic traits were unrelated to the risk of recidivism and impairments in empathy. The results of our study highlight the importance of empathy deficits and may help professionals to develop specific intervention programs focusing on improving empathy skills in antisocial and borderline IPV perpetrators.

Protective strengths, risk, and recidivism in a sample of known sexual offenders

The relationship between protective strengths and risk, as assessed by the Inventory of Offender Risk, Needs, and Strengths, was examined with respect to the recidivism rate and type of reoffense in a sample of 110 adult males incarcerated for sexual offenses. The sample included offenders who were completing a prison-based sexual offense treatment program during the last 18 months of their incarceration. Approximately 40% of the sample recidivated in some way, including 6% sexually, within the 6-year follow-up time. Self-perceived protective strengths were significantly valid predictors for sexual, violent, and general recidivism. In regression analyses, protective strengths accounted for a unique portion of the variance in sexual recidivism while controlling for overall risk. Consistent with research on the importance of protective strengths with other offender types, the continued study and inclusion of protective strengths in the assessment and treatment of sexual offenders is warranted.

Empathy: A Review of the Concept

The inconsistent definition of empathy has had a negative impact on both research and practice. The aim of this article is to review and critically appraise a range of definitions of empathy and, through considered analysis, to develop a new conceptualisation. From the examination of 43 discrete definitions, 8 themes relating to the nature of empathy emerged: “distinguishing empathy from other concepts”; “cognitive or affective?”; “congruent or incongruent?”; “subject to other stimuli?”; “self/other distinction or merging?”; “trait or state influences?”; “has a behavioural outcome?”; and “automatic or controlled?” The relevance and validity of each theme is assessed and a new conceptualisation of empathy is offered. The benefits of employing a more consistent and complete definition of empathy are discussed.