Diagnostic and risk profiles among civilly committed sex offenders in Washington State

Since 1990, 17 states have passed legislation allowing for the civil commitment of a small number of sex offenders who are deemed at a particularly high risk for reoffense. Despite the very public and controversial nature of these laws, little is known about the individuals who are detained pursuant to them. The current article presents data on 190 civilly committed and detained sexually violent predators in Washington State. These sexual offenders suffer from a variety of mental illnesses. The modal offender is diagnosed with both an Axis I and an Axis II disorder. Furthermore, these offenders are at moderate to high risk for reoffense and present with a significant degree of psychopathy.     

Intimate partner violence and post-traumatic stress disorder symptoms in women: what we know and need to know

This article presents a review of knowledge regarding post-traumatic stress disorder (PTSD) in women experiencing intimate partner violence. Knowledge related to the prevalence and predictors of PTSD in battered women, the association between PTSD and physical health, and the emerging science regarding PTSD and physiological and immune parameters is addressed. Primary recommendations for future research includes the need for longitudinal and intervention research that incorporates a range of psychosocial and physiologic health outcomes.     

The psychological effects of solitary confinement on prisoners in supermax units: reviewing what we know and recommending what should change

This article examines the psychological consequences of short- and long-term solitary confinement for prisoners in the United States subjected to administrative or disciplinary segregation. Particular attention is paid to the use of secure housing units, alternatively known as control units or supermax units. These correctional entities allow for the isolation of convicts under conditions that offer little sensory stimulation and minimal opportunities for interaction with other people. The circumstances typically found in these units and the heightened potential for the abuse of prisoners are described. The connections between internment and mental illness-as well as isolation and race, gender, and class-are explored. A set of recommendations for the reform of secure housing is presented.     

Crime profiles and conditional release performance of psychopathic and non‐psychopathic sexual offenders

Purpose. This study investigated the influence of psychopathy and sex offender subtype on criminal history, probability of being granted conditional release, and performance while on conditional release in a diverse group of violent offenders. We predicted that psychopathic sexual offenders would be associated with relatively prolific violent and sexual offending, a high probability of successful conditional release applications despite their past behaviour (resulting from ‘putting on a good show’ in a parole hearing), and poor performance in the community. Methods. Information was gathered via a correctional file review of 310 Canadian male federal offenders. Offenders were categorized into groups based on their sexual offence history (non‐sex offender, rapist, child molester, or mixed rapist/molester) and Psychopathy Checklist – Revised (PCL‐R; Hare, 2003) ratings. Their offences (sexual, violent, or non‐violent) and their complete conditional release histories were coded. Results. Psychopathy was associated with more violent and non‐violent, but not sexual, offences. A significant interaction between psychopathy and offender subtype revealed that psychopathy was associated with a greater number of sex offences within child molesters. High‐psychopathy offenders (both sexual and non‐sexual offenders) were about 2.5 times more likely to be granted conditional release than non‐psychopathic offenders. Conclusions. Psychopathy is associated with more prolific sexual offending among child molesters and – despite their extensive criminal histories and high recidivism rate – a great proficiency in persuading parole boards to release them into the community. Specialized education and training in dealing with psychopathic offenders is urgently needed.     

Comparing females acquitted by reason of insanity,convicted, and civilly committed in Florida 1977–1984

Females who had been acquitted by reason of insanity (N=41), convicted of comparable offenses (N=41), and involuntarily hospitalized without criminal involvement (N=41) were matched for age and race. The psychiatric histories of the acquitted and civilly committed women were similar, and significantly more extensive than the convicted group. The acquitted women had been arrested significantly more often than the civilly committed women but less frequently than the convicted women. Total length of stay (hospitalization or imprisonment) reflected a similar pattern, with civilly commited women hospitalized for the shortest period, acauitted women an intermediate period, and convicted women the longest. Regression-based prediction of length of stay reflected a number of common predictors for the acquitted and convicted women, with offense type one of the most powerful for both groups.     

Sexualization and lifestyle impulsivity: clinically valid discriminators in sexual offenders

Following clinical observations in this study a comparison was undertaken between nonsexualized rapists, sexualized rapists, and pedophilic child molesters in terms of psychometric measures, criminological data, and DSM-IV diagnoses following the authors' hypotheses that nonsexualized and sexualized rapists differ in respect of psychiatric comorbidity and criminal history and sexualized rapists and pedophilic child molesters are more similar as regards to psychiatric comorbidity (anxiety, depression, and aggression) and criminal history variables than nonsexualized and sexualized rapists are. Preliminary findings confirmed the hypotheses: the authors found significant differences between paraphilic and sexualized sex offenders on one hand--regardless whether they had offended against minors or adults--and a group of sex offenders exhibiting a history of high lifestyle impulsivity on the other hand. From a psychiatric clinical point of view, paraphilic or sexualized rapists could be shown to resemble more the pedophilic child molesters. Therapeutic approaches should take these findings into account.     

The relationship between physical and sexual abuse and drug use in a sample of juvenile detainees in Florida and a sample of committed youthful offenders in Colorado

The relationships between child physical and sexual abuse and illicit drug use are little understood and underinvestigated. Data gathered from a study of youths located in two different institutions for detained (Florida) and committed (Colorado) youthful offenders permitted an examination of this issue. The results indicate the youths' physical and sexual abuse experiences are significantly and positively related to their use of illicit drugs. The implications of these findings for further research are drawn.     

Optimizing risk mitigation in management of sexual offenders: a structural model

Sexual violence is an insidious and pervasive problem that insinuates itself into all aspects of contemporary society. It can neither be mitigated nor adequately controlled through current socio-legal practices. A more promising approach must embrace four integrated elements: (1) public policy, (2) primary prevention, (3) statutory management, and (3) secondary intervention. In the present paper we tackle the 3rd and 4th elements by proposing an integrated model for reducing and managing sexual violence among known sex offenders. Relying on the highly effective Risk-Need-Responsivity (RNR) model as the core of our Sex Offender Risk Mitigation and Management Model (SORM³), we draw together evidence based practices from clinical interventions and risk assessment strategies. Developed by Andrews & Bonta (2006), RNR has a strong empirical track record of efficacy when applied to diverse samples of offenders, including sex offenders (Hanson, Bourgon, Helmus, & Hodgson, 2009). We offer a detailed structural model that seeks to provide a more seamless integration of risk assessment with management and discretionary decisions, including a primary focus on RNR-based post-release aftercare. We end with the mantra that sex offender treatment alone will never effectively mitigate sexual violence in society, since the problem is not confined to the handful of offenders who spend time in prison and are offered some limited exposure to treatment. Any truly effective model must go well beyond the management of those known to be violent and embrace a comprehensive and integrated approach that begins by recognizing the seeds of sexual violence sown by society. Such a public health paradigm places victims - not offenders - at the center, forcing society to come to address the full gamut of hazards that fuel sexual violence.     

We all want it, but we don't know what it is: toward a standard of affordability for health insurance premiums

The 2010 Patient Protection and Affordable Care Act (P.L. 111-148), or ACA, requires that U.S. citizens either purchase health insurance or pay a fine. To offset the financial burden for lower-income households, it also provides subsidies to ensure that health insurance premiums are affordable. However, relatively little work has been done on how such affordability standards should be set. The existing literature on affordability is not grounded in social norms and has methodological and theoretical flaws. To address these issues, we developed a series of hypothetical vignettes in which individual and household sociodemographic characteristics were varied. We then convened a panel of eighteen experts with extensive experience in affordability standards to evaluate the extent to which each vignette character could afford to pay for one of two health insurance plans. The panel varied with respect to political ideology and discipline. We find that there was considerable disagreement about how affordability is defined. There was also disagreement about what might be included in an affordability standard, with substantive debate surrounding whether savings, debt, education, or single parenthood is relevant. There was also substantial variation in experts' assessed affordability scores. Nevertheless, median expert affordability assessments were not far from those of ACA.     

Attachment styles and psychological profiles of child sex offenders in Ireland

When 29 child sex offenders, 30 violent offenders, 30 nonviolent offenders, and 30 community controls were compared, a secure adult attachment style was 4 times less common in the child sex offender group than in any of the other three groups. Ninety-three percent of sex offenders had an insecure adult attachment style. Compared with community controls, the child sex offender group reported significantly lower levels of maternal and paternal care and significantly higher levels of maternal and paternal overprotection during their childhood. Compared with all three comparison groups, the child sexual offenders reported significantly more emotional loneliness and a more external locus of control. With respect to anger management, the child sexual offenders' profile more closely approximated those of nonviolent offenders and community controls than that of violent offenders.     

Prevalence of mental disorders among sexual offenders in forensic psychiatry and prison

The objective of this study was to compare the prevalence of mental disorders among sexual offenders in forensic psychiatry (SF) with the prevalence of such disorders among sexual offenders in prison (SP) and violent offenders in prison (VP). In a cross-sectional study, 40 of 47 SF detained in forensic psychiatry in Baden-Wuerttemberg, Germany, could be included. They were compared with 30 SP and 26 VP. All study participants were interviewed by means of SCID I and SCID II and assessments of functioning (GAF, BSS). There was a high prevalence of mental disorders (DSM-IV: Axis I) in all three groups (SF: 80%, SP: 63%, VP: 73%). Among SP and VP, this was attributed mainly to substance use disorders. The prevalence and comorbidity of personality disorders was significantly higher in the group of the SF (prevalence: SF: 85%, SP: 27%, VP: 39%). In a psychopathological view, SP were all together more similar to the imprisoned non-sexual delinquent VP than to the SF.     

Revisiting the use of pornography by sexual offenders: Implications for theory and practice

Abstract

Summary: This article examines the extant research on the use of pornography by sexual offenders and some of the debates engendered by such use. The analyses should assist in clarifying a number of issues of concern for all who work in the field of sexual offending.     

Sexual fantasy in paedophile offenders: Can any model explain satisfactorily new findings from a study of Internet and contact sexual offenders?

Purpose. There is widespread acceptance that sexual fantasy plays a role in sexual offences but little clarity as the nature of this relationship. This paper seeks to understand better the role of fantasy in offending behaviour through the study of sexual fantasy in Internet child pornography offenders when compared with contact offenders. Differences in the patterns of sexual fantasy associated with the different offender types are explored in order to understand how fantasy content is associated with contact offences with children and desisting from such direct acting out. Methods. Participants were all convicted of child sexual offences and recruited with the help of the probation and prison services. Out of these, 16 were Internet‐only offenders, 25 were contact offenders with no history of Internet offending and 10 were offenders with a mixed contact and Internet offending history. A variety of self‐completion questionnaires including fantasy were completed on an individual basis together with a detailed interview. Results. The most common sexual fantasies were typical adult‐male heterosexual fantasies though a variety of child‐oriented and other fantasies were also common. Contact offenders reported fewer girl‐oriented sexual fantasies although the groups did not differ in terms of terms of boy‐oriented fantasies. There was evidence that confrontational fantasies were commoner among contact offenders than Internet offenders. There are relationships between early sexual experiences and fantasy but peer sexual contacts seemed to be important rather than sexual abuse. Conclusion. Generally, the contact offenders seem to have less sexual fantasy pertinent to their offending than did Internet offenders. Fantasy deficit may be involved in contact offending against children.     

The highs and lows of working with sexual offenders: A New Zealand perspective

Abstract

The positive effects on clinicians responsible for the treatment of sexual offenders are little understood. The few available studies have focused upon the negative sequelae of this work. The current study of clinicians working therapeutically with sexual offenders at a community-based organization aimed for a more balanced picture of the effects of sex offender treatment provision. Using qualitative methods, both negative and positive aspects of this work emerged within three main themes: taking an optimistic perspective, working for community outcomes and supportive agency culture. Although the study revealed many challenges for therapists, these were found to be counterbalanced against rewards, affording a high degree of personal and professional fulfilment from working within this field.     

They know not what they do: Unguided and misguided discretion in Pennsylvania capital cases

Interviews with capital jurors demonstrate that jurors base their decisions on incorrect assumptions regarding the early release of defendants, decide the punishment prematurely, and fail to understand jury instructions. The 74 interviews from the Pennsylvania portion of the Capital Jury Project add insights into the cumulative and relative impact of these three problems with jurors' decision making. Every juror demonstrated at least one of these shortcomings. Underestimating the length of a life sentence was related to considering death the only acceptable punishment and prematurely deciding on death, and the most strongly related to voting for death.     

Assessing reconviction,reoffending and recidivism in a sample of UK sexual offenders

Purpose. The rate of sexual reconviction for sexual offenders is known to be low. Sexual reconviction, however, is currently the most commonly used outcome measure in sex offender treatment evaluation studies. It is expected that sex offender treatment programmes will reduce the likelihood of reconviction amongst participants. A low base rate of sexual reconviction means that any reduction in reconviction (which could be attributed to treatment) will be small and unlikely to be statistically significant. This study aimed to assess other offence‐related outcomes for sexual offenders, in addition to reconviction. Methods. The sample comprised 173 sexual offenders who had completed a community sex offender treatment programme. Follow‐up information was collected forthe sample from programme files containing multi‐agency information. Official reconviction rates were also calculated using both Home Office and police data. Results. Collecting evidence of any offence‐related sexual behaviour during this study multiplied the sample's sexual reconviction rate by a factor of 5.3. Conclusions. The results show that broadening the outcome measure under observation indicates a higher level of offence‐related sexual behaviour displayed by sexual offenders than reflected by reconviction data. These results have implications for the outcomes measured in treatment evaluation research for sexual offenders.     

Evaluation of a national prison-based treatment program for sexual offenders in England and Wales

Treatment efficacy is described for a sample of sexual offenders who had undertaken treatment in United Kingdom prisons (N = 647) and for a retrospectively selected comparison group (N = 1,910). The outcomes under observation in this study were sexual, sexual and/or violent, and general reconviction. Treatment impact was also examined in relation to offenders' risk of reconviction. The treatment group had slightly lower 2-year sexual reconviction rates than the comparison group, but these differences were not statistically significant. Significant differences were found between the treatment and comparison group for sexual and/or violent reconviction. Further analysis suggested that treatment produced a reduction in the probability of sexual and/or violent reconviction (p <.05) when other relevant variables were controlled for. General reconviction rates were consistently lower in the treatment group, but these differences were not significant.