Psychopathology of incarcerated sex offenders

Factors Associated With Contact Sexual Offending Among a Non-Forensic Sample of Women With Sexual Interest in Children - Results From an Anonymous Online Survey

This study aimed at assessing the extent to which factors associated with male child sexual offending may also be applicable to women with a self-identified sexual interest in children. Participants (n = 42) took part in an anonymous online survey covering questions about general characteristics, general sexuality, sexual interest in children, and previously-perpetrated contact child sexual abuse. Group comparisons between women who reported committing contact child sexual abuse compared to those who had not were conducted in terms of sample characteristics. Furthermore, the two groups were compared regarding the factors of high sexual activity, use of child abuse material, indication of ICD-11 pedophilic disorder diagnosis, exclusivity of sexual interest in children, emotional congruence with children, and childhood maltreatment. Our results revealed that high sexual activity, indication of ICD-11 pedophilic disorder diagnosis, exclusivity of sexual interest in children, and emotional congruence with children were associated with previous contact child sexual abuse perpetration. We recommend further research on potential risk factors relating to child sexual abuse on the part of women.

The Relation Between the Paraphilias and Anxiety in Men: A Case-Control Study

Despite a multitude of theoretical views, it is still unclear how individuals develop and sustain paraphilic interests (e.g., sexual attraction to children, interest in non-consensual violence). It is also not clear from these views why many paraphilic interests, and especially many paraphilias and paraphilic disorders, are much more common in men than in women. One possible factor affecting male's higher rate of paraphilias is anxiety, because anxiety can potentiate sexual arousal in men. We speculated that paraphilic interests could develop when feelings of anxiety are recurrently generated by atypical sexual stimuli, and when that anxiety repeatedly potentiates sexual arousal, reinforcing sexual response to atypical stimuli. It follows that men with paraphilic interests are susceptible to anxiety disorders, because an anxiety disorder would facilitate the hypothesized developmental process. We conducted a retrospective file review of 1048 consecutive patients (944 male patients retained for analysis) referred to an outpatient sexual behavior clinic at a psychiatric hospital to investigate the link between paraphilias and anxiety. Male patients with a paraphilia had 1.64 greater odds than male patients without a paraphilia of having been diagnosed with an anxiety disorder, but they also had elevated rates of many other types of disorders. Therefore, there does not seem to be a specific link between paraphilias and anxiety in this sample. The discovery of a general link between the paraphilias and psychological disorders in men opens new avenues for studying the developmental origins and consequences of male paraphilic interests.

Explicit and Implicit Self-Esteem, Narcissism, and Recidivism Risk in a Sample of Men Who Have Sexually Offended Against Children

The relationship between implicit and incongruent explicit and implicit (i.e., discrepant) self-esteem, narcissism, and sexual offending against children requires further research. We examined the relationships between self-esteem, narcissism, and risk of violent (including sexual) recidivism and compared sexual offenders against children (n = 28) and non-sexual offenders (n = 44) on these measures. All participants were adult men. In both groups, greater narcissism was associated with greater risk. Among sexual offenders against children, contrary to theoretical accounts and previous research findings, higher explicit self-esteem was associated with greater risk. However, further analysis indicated that explicit self-esteem may only be relevant to recidivism risk insofar as it reflects narcissism. Neither implicit nor discrepant self-esteem were related to recidivism risk in either group. Group comparisons indicated that sexual offenders against children had lower explicit self-esteem and narcissism than non-sexual offenders. In summary, our findings suggest that although sexual offenders against children have lower explicit self-esteem and narcissism than other offenders, within this group, higher explicit self-esteem and greater narcissism may be associated with greater risk. Taken together, previous and current findings suggest that including measures of narcissism in psychological assessment batteries administered to sexual offenders against children could be beneficial. Our findings also further question the wisdom of targeting low self-esteem in correctional treatment programs aimed at reducing recidivism.

The Association Between Sexually Aggressive Cognitions and Pathological Personality Traits in Men

Sexual aggression, harassment, and sexually aggressive cognitions (victim blaming, sexual entitlement) are serious societal problems. Although research has examined attributes of individuals who engage in overt sexual assault, few studies have focused on individual characteristics of those who perpetuate problematic negative beliefs surrounding sexual assault. This study sought to examine the relationship between pathological personality and sexually aggressive cognitions among 242 community men. Results showed that traits including antagonism, disinhibition, and negative affectivity were associated with sexually aggressive cognitions. These results have implications for understanding sexual aggression and the role personality plays in perpetuating sexually aggressive attitudes.

Five-Factor Model of Personality and Sexual Aggression

Despite several studies have used the five-factor model (FFM) of personality as theoretical background, few studies have been conducted on the topic of the FFM and sexual aggression. This study explored how the big five dimensions and features of emotional adjustment characterize different forms of sexual violence. Twenty-six male students reporting sexual aggression against women (nonconvicted offenders), 32 convicted rapists, and 33 convicted child sexual molesters were evaluated. Participants completed the Five-Factor Inventory (NEO-FFI), the Brief Symptom Inventory (assessing state emotional adjustment), the Sexual Experiences Survey (perpetration form), and the Socially Desirable Response Set Measure. Results showed that individuals convicted for rape and child sexual abuse presented significantly more neuroticism than nonconvicted sexual offenders; child sex molesters presented significantly less openness than rapists and nonconvicted sexual offenders; and nonconvicted sexual offenders presented significantly less conscientiousness than convicted offenders. Regarding emotional adjustment, convicted rapists revealed marked psychopathological features in relation to child molesters. In addition, convicted rapists and nonconvicted sexual offenders presented significantly more hostility than child sexual molesters. Findings suggested that some of the big five traits as well as state features characterizing emotional adjustment may characterize different types of sexual offenders.

Characteristics of Female Solo and Female Co-Offenders and Male Solo Sexual Offenders Against Children

Studies have highlighted differences in the victim choice, offender, and offense characteristics of female and male sexual offenders. However, little is known about how solo and co-offending females differ from solo male sexual offenders. We compared the characteristics of 20 solo and 20 co-offending females (co-offended with a male and/or female accomplice), and 40 male sexual offenders against children. We found that solo female offenders showed the most evidence of personal problems, including depression and sexual dissatisfaction. Compared with male offenders, female co-offenders showed poorer self-management, but better sexual self-regulation. Male offenders had a greater history of offending and showed more evidence of sexual abuse supportive cognitions relative to both solo and co-offending females. These results are consistent with the need for a gender-specific approach to working with sexual offenders and may have implications for understanding the often complex treatment needs of these clients.

Attachment and Personality Disorders Among Child Molesters: The Role of Trust

The present study investigated multivariate associations between attachment styles and personality disorders (PDs)-and the mediating role of trust-in a sample of child molesters ( n = 84) and a matched control group from the general community ( n = 80). Among child molesters, canonical correlation analysis revealed that two variates resembling avoidant and anxious attachment dimensions were associated with PD traits. Attachment avoidance was related to schizoid, schizotypal, and avoidant PDs, with a marginal contribution of antisocial PD. Attachment anxiety was related to borderline and histrionic PDs, with a marginal contribution of obsessive-compulsive PD. Paranoid and dependent PDs contributed to both variates. In the control group, a more general association between attachment insecurity and PDs emerged. Finally, mistrust significantly explained the associations between attachment and PDs in both samples. Future studies should examine whether treatment for PDs in child molesters could benefit from a focus on attachment and trust.

Attraction Versus Action in Pedophilic Desire: The Role of Personality Traits and Childhood Experience

OBJECTIVE

Comparison of pedophilic individuals who do and do not refrain from sexually engaging with children may offer critically important information regarding the differential contributors to pedophilic attraction versus behavior. This study compared 5 traits that are potentially contributory to pedophilic attraction or behavior in both minor-attracted persons (MAPs) who refrain from sexually engaging with minors (nonacting MAPs) and those who have acted on pedophilic attractions and subsequently entered the criminal justice system (forensic MAPs).

METHODS

Subjects included 195 nonacting MAPs, 50 forensic MAPs, and 60 healthy controls. Data on nonacting MAPs were drawn from an online survey, and data on the other 2 groups were based on prior in-person evaluations. Measures included the Millon Clinical Multiaxial Inventory-II (MCMI-II), Barratt Impulsiveness Scale (BIS-11), the MAP Questionnaire, and the Sexual History Questionnaire (SHQ).

RESULTS

Both MAP groups scored higher than healthy controls on the domains of socially inhibited personality traits, propensity toward cognitive distortions, and subjects' own childhood sexual abuse (CSA). Forensic MAPs scored higher than nonacting MAPs on the CSA domain, but the 2 MAP groups differed little on the other 2 domains. Forensic MAPs also scored higher than the other 2 groups on the antisocial domain, whereas nonacting MAPs did not differ from controls on this measure. Nonacting MAPs scored higher than controls on impulsivity.

CONCLUSIONS

Antisocial personality traits may be a primary driver of pedophilic behavior that is unrelated to pedophilic attraction. Socially inhibited personality traits and propensity toward cognitive distortions are associated with pedophilic attraction, although the direction of causation is not clear. CSA seems to increase the risk of both attraction and behavior.

Non-Homicidal and Homicidal Sexual Offenders: Prevalence of Maladaptive Personality Traits and Paraphilic Behaviors

This study aims to examine the psychopathological profile of non-homicidal sexual offenders (NHSOs) and homicidal sexual offenders (HSOs). Using an incarcerated sample of 96 NHSOs and 74 HSOs in a federal penitentiary in Canada, these offenders are compared in terms of their offending process, maladaptive personality traits, and paraphilic behaviors. A number of cross-tabular and sequential logistic regression analyses are performed. Relative to their counterpart, findings indicate that a higher percentage of HSOs select a victim of choice, report deviant sexual fantasies, mutilate their victim, and admit to their offense upon apprehension, whereas a higher percentage of NHSOs select victims with distinctive characteristics. In addition, a higher percentage of HSOs manifest paranoid, schizotypal, borderline, histrionic, narcissistic, obsessive-compulsive, and impulsive personality traits, and overall odd and eccentric personality traits compared with NHSOs. Similarly, a higher percentage of HSOs engage in exhibitionism, fetishism, frotteurism, homosexual pedophilia, sexual masochism, and partialism compared with NHSO. These findings are discussed with their implications for offender profiling.

An Examination of the Gender Inclusiveness of Current Theories of Sexual Violence in Adulthood: Recognizing Male Victims, Female Perpetrators, and Same-Sex Violence

Although the majority of adulthood sexual violence involves a male perpetrator and a female victim, there is also substantial evidence that members of both genders can be victims and perpetrators of sexual violence. As an alternative to viewing sexual violence within gender-specific terms, we advocate for the use of a gender inclusive conceptualization of sexual aggression that takes into account the factors that contribute to sexual victimization of, and victimization by, both men and women. The goal of the current review is to examine the need and importance of a gender inclusive conceptualization of sexual violence and to discuss how compatible our current theories are with this conceptualization. First, we examine evidence of how a gender-specific conceptualization of sexual violence aids in obscuring assault experiences that are not male to female and how this impacts victims of such violence. We specifically discuss this impact regarding research, law, public awareness, advocacy, and available victim treatment and resources. Next, we provide an overview of a number of major sexual violence theories that are relevant for adult perpetrators and adult victims, including neurobiological and integrated biological theories, evolutionary psychology theory, routine activity theory, feminist theory, social learning and related theories, typology approaches, and integrated theories. We critically examine these theories' applicability to thinking about sexual violence through a gender inclusive lens. Finally, we discuss further directions for research, clinical interventions, and advocacy in this area. Specifically, we encourage sexual violence researchers and clinicians to identify and utilize appropriate theoretical frameworks and to apply these frameworks in ways that incorporate a full range of sexual violence.

Mental illness and sexual offending

Transinstitutionalization (ie, the criminalization of those with mental illness) is relevant to individuals committing sexual offenses. Mental illness can affect the treatment and risk management of individuals committing sexual offenses. In this article the current literature on mentally disordered sexual offenders is described, including how psychosis, mood disorders, anxiety disorders, attention-deficit/hyperactivity disorder, and dementing disorders may affect treatment and management.

Suicide attempts and self-harm behaviors in psychiatric sex offenders

Suicidality and self-harm behaviors among sex offenders remain underreported in the clinical literature and are often misunderstood in this complex population. The present study aims to identify rates of suicide attempts and self-injurious behaviors in a sample of 1,184 psychiatric inpatients, 462 of whom are sexual offenders. Between-group comparisons revealed significant differences in history of suicide attempts and self-harm behaviors, with sexual offenders evidencing greater rates of both. Significant psychiatric correlates of suicide attempts and self-harm behaviors among sex offenders varied by group and included a variety of psychiatric symptom presentations. These are compared with the general literature on suicide risk and the sex offender population. Implications for treatment of these behaviors in a sex offender population are discussed.

Early maladaptive schemas in convicted sexual offenders: preliminary findings

Core cognitive schemas may play a role in the vulnerability for sexual offending. Identifying these schemas could help to conceptualize sexual crimes and rehabilitate convicted sexual offenders. The aim of this preliminary study was to explore the relationship between early maladaptive schemas (EMSs) and sexual offending, as well as how rapists and child sex molesters differ in terms of these schemas. Thirty-two men convicted for rape, 33 convicted for child sexual abuse, and 30 non-offenders were evaluated using the Young Schema Questionnaire (YSQ-S3) and the Brief Symptom Inventory (BSI). Results showed that participants convicted for child sexual abuse presented significantly more schemas from the disconnection/rejection, impaired autonomy/performance, other directness, and over vigilance/inhibition domains than non-offenders, whereas rapists presented more schemas from the impaired autonomy/performance domain than non-offenders. Differences between sex offenders showed that child molesters presented more schemas of pessimism than rapists. Preliminary findings suggested that EMSs may impact sex offender's perceptions about themselves and about the world. Schema-focused therapy (Young, 1990, 1999) may thus be an acceptable approach to sex offender's psychological assessment and intervention.

Exploring clinical and personality characteristics of adult male internet-only child pornography offenders

Despite the dramatic increase in the number of convicted child pornography offenders, little is known about their potential clinical needs. The few studies that do explore this subgroup of sex offenders suggest clinical heterogeneity compared with other sex offender subgroups. However, research designs used in many studies have limited generalizability, have examined primarily treated or treatment samples, and have not included comparisons with nontreatment, community samples of men. The current study addresses such limitations by using nontreatment samples and multiple comparison groups to examine mean scales score differences on a commonly used clinical and personality assessment, the Personality Assessment Inventory (PAI). The sample, drawn from an admissions cohort of federal offenders, those Internet-only Child Pornography Offenders (ICPOs; n = 35) and those with a history of child molesting exclusively (child molesters, n = 26). They were compared with each other and the male normative sample from the PAI. Results indicate that interpersonal deficits and depression featured most prominently in the profiles of the ICPOs. Consistent with prior research, they also obtained lower scores on aggression and dominance compared with the child molesters and the male normative sample. Implications for future research, training, and clinical practice with incarcerated ICPOs are offered.

Relating sexual sadism and psychopathy to one another, non-sexual violence, and sexual crime behaviors

Sexual sadism and psychopathy have been theoretically, clinically, and empirically linked to violence. Although both constructs are linked to predatory violence, few studies have sought to explore the covariation of the two constructs, and even fewer have sought to conceptualize the similarities of violence prediction in each. The current study considered all four Psychopathy Checklist-Revised (PCL-R) facets and employed well-defined, validated measures of sadism to elucidate the relation between sadism and psychopathy, as well as to determine the role of each in the prediction of non-sexual violence and sexual crime behaviors. Study 1 assessed 314 adult, male sex offenders using archival ratings, as well as the self-report Multidimensional Inventory of Development, Sex, and Aggression (the MIDSA). Study 2 used archival ratings to assess 599 adult, male sex offenders. Exploratory and confirmatory factor analyses of crime scene descriptions yielded four sexual crime behavior factors: Violence, Physical Control, Sexual Behavior, and Paraphilic. Sadism and psychopathy covaried, but were not coextensive; sadism correlated with Total PCL-R, Facet 1, and Facet 4 scores. The constructs predicted all non-sexual violence measures, but predicted different sexual crime behavior factors. The PCL-R facets collectively predicted the Violence and Paraphilic factors, whereas sadism only predicted the Violence factor.

Personality disorders in men with sexual and violent criminal offense histories

Little is known about personality disorders (PDs) in offenders with histories of both sexual and (nonsexual) violent offenses. This study aimed to identify possible differences of PD profiles across three different offender groups with both sexual and violent (S+V), only sexual (S), and only violent (V) offenses. Nonviolent (N) offenders were used as a comparison group. Typing of individuals according to their offensive histories was performed on the basis of 259 psychiatric court reports that included the Structured Clinical Interview (SCID)-II for PD diagnostics. Men from the S+V group committed significantly more acts of rape and sexual coercion than the mere sexual offenders. Furthermore, S+V offenders showed the highest rates of PDs overall (68.3%), with every second offender being diagnosed with an antisocial PD and every third offender with a borderline PD. In summary, the results suggest that S+V offenders form a group of individuals with remarkable differences regarding PD profiles, the relatively highest frequencies of conduct disorders, familial addictive problems, and PDs overall.

Differentiating offenders by index offense and personality inventories: the characteristics of adult probationers in Israel

The current study examines the differences between four groups of offenders (N = 230) according to the type of crime they committed: domestic violence, sex offenses, traffic violations, and nonspecific violence offenses. The study was conducted on the offenders undergoing treatment in the Israeli Adult Probation Service. A comparison between the groups included an examination of the differences in aggression levels, anxiety levels, and two Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales-the Psychopathic Deviate (PD-4) and the Antisocial Practices (ASP) scales. The findings provide a glimpse of the features that characterize each group, in relation to each other and in relation to the body of literature. The domestic violence group differed from the other groups in most of the research variables. They were found to have low anxiety levels and high aggression levels. Together with other findings that pointed to antisocial practices and attitudes, this group constitutes a population that is violent and aggressive to a far greater extent compared with the other groups. Sex offenders were found to be a unique group that does not fit in the "classic offenders" category. They were found to have low aggression levels and high anxiety levels and their scores on PD-4 and ASP scales were low compared with the other groups. The traffic group was characterized with typically low levels of anxiety and high levels of physical aggression. This group also obtained high scores on ASP scale and the measure that examined confrontation with authority figures. Finally, study findings did not indicate characteristics that typify the nonspecific violence offenses.

Illuminating a neglected clinical issue: societal costs of interpersonal dependency and dependent personality disorder

OBJECTIVES

To determine the degree to which patients with high levels of trait dependency or dependent personality disorder (DPD) engage in behaviors that harm themselves and others (e.g., domestic violence, child abuse).

METHOD

Six domains of literature were reviewed: (a) dependency as a risk factor for physical illness; (b) health care utilization and expenditures; (c) global and domain-specific functional impairment; (d) violence toward others; (e) victimization by others; and (f) self-harm.

RESULTS

High levels of trait dependency and DPD are associated with elevated risk for physical illness, partner and child abuse, and suicidality, as well as with high levels of functional impairment and increased health care expenditure.

CONCLUSIONS

Contrary to clinical lore, trait dependency and DPD are associated with behaviors that lead to myriad negative consequences for the dependent person, those close to them, and society as a whole. These patterns have noteworthy implications for assessment and treatment of dependent patients and suggest that DPD should be included as a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition.

From Dysfunction to Adaptation: An Interactionist Model of Dependency

Contrary to clinical lore, a dependent personality style is associated with active as well as passive behavior and may be adaptive in certain contexts (e.g., in fostering compliance with medical and psychotherapeutic treatment regimens). The cognitive/interactionist model conceptualizes dependency-related responding in terms of four components: (a) motivational (a marked need for guidance, support, and approval from others); (b) cognitive (a perception of oneself as powerless and ineffectual); (c) affective (a tendency to become anxious when required to function autonomously); and (d) behavioral (use of diverse self-presentation strategies to strengthen ties to potential caregivers). Clinicians' understanding of the etiology and dynamics of dependency has improved substantially in recent years; current challenges include delineating useful subtypes of dependency, developing valid symptom criteria for Dependent Personality Disorder in DSM-5 and beyond, and working effectively with dependent patients in the age of managed care.

Sexual assault and rape perpetration by college men: the role of the big five personality traits

A sample of 521 college men completed the Revised NEO Personality Inventory and an expanded version of the Sexual Experiences Survey to examine whether variation in the Big Five personality traits in a normal, college population provides any insight into the nature of sexual assault and rape perpetrators. Rape perpetrators reported lower levels of Agreeableness and Conscientiousness when compared to both sexual assault perpetrators and nonperpetrators, and lower levels of Extraversion when compared to nonperpetrators. Rape perpetrators also endorsed lower levels of tendermindedness, excitement-seeking, warmth, positive emotions, feelings, altruism, competence, and dutifulness, and higher levels of vulnerability. Contrary to expectation, overall personality profiles followed remarkably comparable patterns for sexual assault and nonperpetrators, suggesting that sexual assault perpetrators were more similar to nonperpetrators than to rape perpetrators. Findings suggest that individuals who perpetrate sexual offenses, particularly rape, differ from nonperpetrators on dimensions of normal personality. Clinical and research implications are discussed.

Psychometric properties of the Coolidge Correctional Inventory in a sample of 3,962 prison inmates

The present study reports on the preliminary psychometric characteristics of a new personality and neuropsychological, 250-item, self-report measure, the Coolidge Correctional Inventory (CCI), in an archival de-identified sample of 3,962 prison inmates. The median internal reliability for the 33 CCI scales and subscales was alpha = .79 (range: alpha = .49 to .93). A prevalence estimate, based on the polythetic criteria in DSM-IV-TR, of at least one personality disorder was 61% of the entire sample, and the prevalence of ADHD was estimated to be 16%. Drug and alcohol problems were also highly prevalent (60%). These results appear to support the preliminary reliability and validity of the CCI and also reveal a high rate of psychopathology and neuropsychological dysfunction among prison inmates.

Empathy and recognition of facial expressions of emotion in sex offenders, non-sex offenders and normal controls

Research conducted on empathy and emotional recognition in sex offenders is contradictory. The present study was aimed to clarify this issue by controlling for some affective and social variables (depression, anxiety, and social desirability) that are presumed to influence emotional and empathic measures, using a staged multicomponent model of empathy. Incarcerated sex offenders (child molesters), incarcerated non-sex offenders, and non-offender controls (matched for age, gender, and education level) performed a recognition task of facial expressions of basic emotions that varied in intensity, and completed various self-rating scales designed to assess distinct components of empathy (perspective taking, affective empathy, empathy concern, and personal distress), as well as depression, anxiety, and social desirability. Sex offenders were less accurate than the other participants in recognizing facial expressions of anger, disgust, surprise and fear, with problems in confusing fear with surprise, and disgust with anger. Affective empathy was the only component that discriminated sex offenders from non-sex offenders and was correlated with accuracy recognition of emotional expressions. Although our findings must be replicated with a larger number of participants, they support the view that sex offenders might have impairments in the decoding of some emotional cues conveyed by the conspecifics' face, which could have an impact on affective empathy.

Drug consumption among sexual offenders against females

This article aims to evaluate the role of drug consumption among sexual offenders against females. Three groups of participants (N = 133) comprising sexual offenders against girls, pubertal females, and women were examined with reference to history of drug and/or alcohol use, impulsivity level, sexual addiction, and recidivism risk. Sexual offenders against women were found to have significantly more difficulties with drug use, higher impulsivity level, and to be younger than the sexual offenders against girls and pubertal females. The combination of drug consumption and higher level of impulsivity may contribute to sexual aggression against adult females.

Personality disorders in a sample of paraphilic and nonparaphilic child molesters: a comparative study

This article renders the results of research that investigated personality disorders in a sample of paraphilic and nonparaphilic child molesters. The sample contained 36 paraphilic child molesters and a matched comparison group of 34 nonparaphilic child molesters. The analyses of the research results show that four personality disorders discriminate between both groups. Only the obsessive-compulsive personality disorder contributes significantly to the explanation of paraphilic child molestation. This result also contributes to the development and differentiation of the treatment of paraphilia-related disorders. For several child molesters, psychological approaches to the treatment of sexual offending (e.g., cognitive-behavioral treatment, psychotherapy in general) are limited and cannot be expected to immediately reduce risk. Interest has been expressed in medical approaches to reduce recidivism, in combination with psychotherapy.

Personality and coping in young inmates: a cluster typology

OBJECTIVE

Firstly, to identify groups of inmates according to personality. Secondly, to differentiate types of personality through coping strategies, psychopathology, criminal records and social factors.

METHOD

A cross-sectional design was used to study psychosocial, correctional, personality and clinical characteristics in inmates. The group was composed of 106 male inmates. The measures used to evaluate personality, clinical and psychosocial variables were a standard protocol and three self-report questionnaires: the Millon Clinical Multiaxial Inventory-II, the Minnesota Multiphasic Personality Inventory-2 and the Coping Responses Inventory-Adult Form. A cluster analysis, ANOVA and Kruskall-Wallis test were conducted.

RESULTS

Four clusters were identified. The secondary type was characterized by an impulsive, suspicious, hostile personality, by anxiety, a low tolerance of frustration, and by the use of cognitive avoidance coping. The controlled-healthy type showed a less pathological and more self-controlled personality. The primarytype was similar to secondary, but with lower tendency to impulsivity. The inhibited-affected type was shown to have an avoidant personality, greater tendency to symptomatology and also to use acceptance-resignation and emotional discharge coping.

CONCLUSION

The four groups of young inmates identified showed profiles with different degrees of psychopathological risk and also different coping profiles.

Cognitive mediational deficits and the role of coping styles in pedophile and ephebophile Roman Catholic clergy

This study was designed to examine hypothesized differences between sex offending and nonoffending Roman Catholic clergy on cognitive mediation abilities as measured by the Rorschach Inkblot Test (H. Rorschach, 1921/1942). This study compared 78 priest pedophiles and 77 priest ephebophiles with 80 nonoffending priest controls on the Inkblot test using J. E. Exner's (2003) Comprehensive System. The three groups were compared on seven variables that constitute Exner's Cognitive Mediation cluster. Additionally, the groups' coping styles were compared to examine the interaction of coping style and cognitive mediational abilities. We found interactions between coping style and offending status across most of the cognitive variables indicating impairment in the mild to pathological ranges. Moreover, significantly higher unusual thinking styles (Xu%) and significantly lower conventional thinking styles (X+%) in offenders compared to nonoffenders. Those with an Extratensive style (n=31) showed significantly higher distorted thinking when compared to the Introversive (n=81), Ambitent (n=73), and Avoidant (n=50) coping styles. This study suggests that offenders display significantly higher distorted thinking styles than do nonoffenders. Possible reasons for these discrepancies and the role of coping styles in abusive behaviors were discussed.

Pharmacological treatments for paraphilic patients and sexual offenders

PURPOSE OF REVIEW

This review addresses testosterone-lowering and other psychotropic medications for the treatment of paraphilic patients or sexual offenders.

RECENT FINDINGS

Randomized controlled studies are still lacking, and only a few new studies were reported during the past year. On the other hand, there is substantial scientific knowledge about the wide range of psychiatric comorbidity associated with paraphilias and in sexual offenders. Empirically based treatment of these patients, especially of impulsivity, anxiety and mood disorders, may also ameliorate sexual impulsivity.

SUMMARY

Medication interventions, either substantially lowering serum testosterone or treating axis I comorbidities, show definite promise as a significant component of the management of sexual offenders. Pharmacotherapy should be combined with other therapeutic treatment modalities, most commonly cognitive-behaviour based psychotherapy and intensive community supervision.

Mental health problems in juvenile justice populations

The limited literature on mental health problems in juvenile justice population has reported that most youth in juvenile justice hold psychiatric pathology. Although conduct disorder and substance abuse are the most prevalent conditions in this population, many other diagnoses can be found at alarmingly high rates; research on other diagnoses (eg, autism, psychosis) is limited. This finding underscores the necessity of implementing adequate diagnostic assessment within forensic settings and of developing interventions programs that take into account the presence of psychiatric problems.

Aggression and anxiety in rapists and child molesters

This study expands the empirical and theoretical understanding of the distinction between those who perpetrate sexual assaults against children (child molesters) and those who perpetrate them against adults (rapists). Two questionnaires were completed by 88 incarcerated, male sexual offenders (45 child molesters and 43 rapists): the Spielberger state trait anxiety inventory and the Buss-Durkee hostility inventory. It was found that the rapists' level of aggression was significantly higher than that of the child molesters. No significant differences in anxiety levels were found between the two groups. The results are discussed in terms of their relevance to theory and clinical practice.