A Systematic Review of Behavioral Health Interventions for Sex Offenders With Intellectual Disabilities

Associations Between Self-Regulation, Experiences of Childhood Adversity, and Problematic Sexual and Aggressive Behaviors

Problems with self-regulation are often theoretically and empirically linked to sexually abusive behavior, as is also true of experiences of early childhood abuse and maltreatment. Questions remain regarding how indicators of dysregulation and self-regulatory deficits interact and are associated with prior maltreatment. In the current study, a range of variables potentially indicative of emotional, cognitive, interpersonal, and behavioral dysregulation and adverse childhood experiences (ACEs) were examined using the frame of the multimodal self-regulation theory among 156 adult men residing in secure forensic care who were receiving treatment for prior sexual offenses. Data were subjected to principal components analysis, resulting in four components that described varying aspects of dysregulated behavior and experiences: Problematic Sexual Behavior (PSB)-Impulsivity, Serious Mental Illness (SMI)-Aggression, ACEs-Suicidality, and Paraphilic Interests-Behavioral Stability. One component comprised of variables associated with maltreatment was associated with impulsivity and PSBs, as well as SMI and violence via linear regression analysis. Theoretical and clinical implications are discussed.

Forensically relevant challenging behaviors and the genetics domain

Impulsive and aggressive behaviors along with intellectual disabilities often manifest in the context of genetic disorders and are a persisting challenge to professionals in the forensic psychiatric and psychological setting. The following chapter comprises an overview of relevant factors in the gene-context-behavior interaction such as monoamine oxidase A activity and specific epileptic phenomena. It presents several examples of monogenetic disorders with behaviors from the aggression spectrum and summarizes emerging strategies for treatment and clinical management thereof. The final part focuses on challenges and future developments in this field with relevance for the judicial and forensic systems. It is concluded that the relationship between a genetic syndrome and forensically relevant and/or violent behaviors should typically be addressed within a multidisciplinary framework that also includes the application of modern genetic techniques.

Barriers in Accessing Social Welfare Benefits for Families of Children With Intellectual and Developmental Disorders in Rural Karnataka: A Situation Analysis

BACKGROUND

Several government schemes exist for the welfare of families having children with intellectual and developmental disorders (IDDs) in India. However, these schemes are often not utilized. An understanding of the barriers to access these social welfare benefits, especially in rural areas of India, can aid in planning social action toward the implementation of these schemes.

METHODS

A situation analysis of the resources and potential barriers to access social welfare benefits for families of children with IDD was conducted in a rural community. Stakeholder interviews were conducted with families of children with IDD (n = 20), government officials responsible for implementing education at the state level (n = 5), local officials responsible for facilitating social welfare benefits (n = 5), and nongovernmental organization (NGO) working in the area of children with IDD (n = 3). Qualitative thematic analysis was used to understand the barriers to access social welfare benefits for the families of children with IDD.

RESULTS

Barriers encountered by families of children with IDD, local officials, and NGOs included lack of awareness about the available welfare schemes, unavailability of social welfare facilities in the local areas, lack of social auditing in the provision of social welfare schemes to the needy, and stringent process of application and regulation for financial aid under the National Trust schemes.

CONCLUSION

There are multiple barriers to access social welfare benefits for families having children with IDD in rural Karnataka. There is a strong need to empower families, sensitize local officials, and advocate for social policies to effectively implement National Trust schemes in rural areas of Karnataka.

The effectiveness of cognitive-behavioural therapy group-based interventions for men with intellectual disabilities and sexual offending histories: a meta-analysis

BACKGROUND

Data from sex offender treatment programmes (SOTP) on the re-offending of convicted sex offenders from the prison service in England and Wales was recently reviewed and found to be associated with no change in sexual reoffending. While this result is at variance with a number of other reviews it does give rise to concern as most programmes for individuals with intellectual disabilities adopt similar treatment methods. It is therefore important to consider the treatment outcomes for this client group by conducting a meta-analysis to examine treatment effects.

METHOD

A systematic search of PsychINFO, EMBASE, MEDLINE and CINAHL was conducted in February 2019 using specific inclusion and exclusion criteria. Eighteen papers were identified, and their quality was assessed using a risk of bias framework. Scores on cognitive distortions, sexual knowledge and victim empathy measures as well as reports of further sexually abusive behaviour were pooled together to run a meta-analysis which yielded effect sizes for each outcome.

RESULTS

A large treatment effect was found for reducing cognitive distortions and increasing victim empathy, with a moderate effect found for improvements in sexual knowledge. This meta-analysis also found that 11.5% of individuals with intellectual disabilities who have completed these programmes will go on to display further sexually abusive behaviours.

CONCLUSIONS

The findings suggest that cognitive distortions are significantly reduced following treatment, there are also significant improvements in sexual knowledge and victim empathy. A rate of 11.5% for further reported sexually abusive behaviour during follow up periods was found, which is higher than the rate found for mainstream SOTP completers. Problems regarding the recording of sexually abusive behaviour are considered.

“From an old life to a new life”: Group therapy for cognitive disorders and affective deficits in adolescents who have committed sexual offenses

The purpose of the current article is to shed light on the unique population of adolescents who have committed sexual offenses, suffering from cognitive disorders, by presenting the disorders and challenges that characterize these youngsters and discussing the issues that are relevant to the therapeutic process of sexual offenses. In our article we show the correlations and adaptations that we made to provide these boys with the most effective treatment possible, both to enable them to undergo an optimal process and to lower their risk level for recidivism.

A realist analysis of treatment programmes for sex offenders with intellectual disabilities

BACKGROUND

The resources used in treatment for sex offenders with intellectual disabilities have had much research attention, but less has been written about how participants are expected to respond (programme mechanisms).

METHODS

A realist evaluation of seven programmes from the UK, Canada, USA, Switzerland and Germany was conducted. In semi-structured interviews, programme designers elucidated how they are intended to work. The data analysis was driven by the realist concern to expose programme mechanisms and intended outcomes.

RESULTS

Two main outcomes are increasing risk management capacities and cultivating prosocial identities. These are achieved through developing insights into a person's risks, work on (sexual) self-regulation skills, sexual boundaries and personal values and by developing meaningful social roles and positive relationships.

CONCLUSIONS

Over time, there have been changes to some of the treatment resources used. However, there were little differences in terms of the intended programme mechanisms and outcomes, which remained surprisingly consistent.