The relationship between schemas and offence supportive attitudes in mentally disordered sexual offenders

Abstract

The study of schemas in sexual offenders is a relatively new approach in attempts to understand the deviant beliefs and attitudes of sexual offenders. Emerging findings suggest that offence supportive attitudes may be the product of an offender's underlying schemas. This study aims to establish the relationship between offence supportive attitudes and schemas in a sample of mentally disordered sexual offenders (MDSOs). Thirty-one male sexual offenders held within low through high security forensic mental health units were assessed using the Young Schema Questionnaire - Short Version 3 and the Questionnaire on Attitudes Consistent with Sex Offending. Correlational analyses suggested a pattern of relationships in which Insufficient Self-control, Entitlement and Enmeshment arose as the schemas associated with most offence supportive attitudes. This supports a relationship between schemas and offence supportive attitudes in MDSOs and is consistent with the literature to date. Implications for further research and treatment are considered.     

Social networks of sexual offenders

Abstract

Despite the extensive research attention directed toward criminal peer groups, there has been little attention to the peer groups of sexual offenders. Sexual offenders are often considered to be loners who offend in isolation, but cases of sex crimes involving peer support are not difficult to find, e.g., child sex rings, gang rapes. To examine the role of peers in sexual offending, sexual offenders and nonsexual offenders were asked whether they knew other people who have committed sexual crimes. In comparison to the nonoffender community comparison group, the sexual offenders reported considerably more association and identification with sexual offenders. The associations also tended to be offence specific, such that child molesters knew other child molesters and rapists knew other rapists. These findings have important implications for the assessment and treatment of sexual offenders.     

Correctional outcomes of offenders with mental disorders

While there is now a considerable literature on the extent of mental disorder (MD) within correctional settings, there is much less research on the correctional outcomes of offenders with a mental disorder (OMDs). This study contributes to that knowledge base by comparing the profiles and institutional and community outcomes of federally-sentenced Canadian offenders with, and without, a MD and examines the correctional response to their management. Results showed that OMDs had higher risk and need ratings and were more likely to be serving their current sentence for a violent offense. Outcomes for OMDs were poorer as reflected by higher rates of institutional charges and transfers to segregation, and higher rates of recidivism on release. This difference holds for the recidivism analysis, even when variables related to risk are controlled. The results demonstrate the complex needs of OMDs and points to the requirement for correctional agencies to provide specialized interventions that address both their mental health and criminogenic needs. Future research is required to examine whether type of diagnosis, particularly the degree of antisocial orientation, contribute to these poorer outcomes.     

Effect sizes in the treatment of sexual offenders

This article considers the benefits of sexual offender treatment in terms of the magnitude of the effect size produced by these interventions. Comparisons are made of the effect sizes with those generated by treatment of other offenders, by treatment for mental health problems, and by treatment for physical health problems. In all cases, effect sizes with sexual offenders are comparable to (and in some cases better than) effect sizes for the treatment of the other groups. As a final note, it is suggested that using a harm reduction index to estimate effect sizes for treatment with sexual offenders would produce more meaningful results.     

Sexual offenders with serious mental illness: prevention, risk, and clinical concerns

Individuals with serious and persistent mental illness who have also engaged in illegal sexual behavior present a unique challenge for our legal and clinical systems. Frequently, these individuals may engage in problematic sexual behaviors which result in hospitalization rather than incarceration, and an overburdened and resource-deficient public community mental health system is ill-equipped to address the seriousness of these sexual behaviors. We have a rather limited understanding of how prevention programs, intervention strategies, and risk assessment would work with this population. Here we evaluate data from a sample of 245 inpatient psychiatric sexual offenders in a forensic mental health setting and compare these with what information has already been presented in some of the literature. Through an examination of seriously mentally ill sexual offenders and their clinical presentation, legal history, and risk management concerns, we illustrate a variety of tertiary prevention needs. Future directions in the area of prevention and risk management for seriously mentally ill sexual offenders are also discussed.     

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.     

Short-term outcomes for offenders with mental illness released from incarceration

Using data on 247 offenders with mental illness, this analysis seeks to identify characteristics that distinguish those who are returned to prison or a psychiatric hospital with those who remain in the community. Sociodemographic, mental health, criminal history, and service variables are compared across a range of outcome categories with a focus on those reinstitutionalized and those reincarcerated. Those returning to institutions have somewhat different mental health service and criminal justice histories than the engaged/community group. In particular, the group that is reincarcerated is more likely released from misdemeanor sentences, and the group being released from felony sentences is more likely to be found in a psychiatric hospital after release from correctional custody. These findings have implications regarding the cumulative effects of engagement with the criminal justice system and the process through which persons with mental illness and a criminal history cycle through institutions.     

Conceptualizing nursing research with offenders: another look at vulnerability

In this article, vulnerability is examined as it applies to the conduct of nursing research with offenders. As a group, offenders present with a multitude of acute and chronic physical and mental health care needs; they are subject to discrimination, stigmatization, and marginalization; and as such, they often experience dual, multiple, or overlapping vulnerabilities. As research participants, they are especially vulnerable to coercion, as a direct consequence of their dependency status within the correctional system. Embracing a research agenda that focuses on offenders as a vulnerable population is fraught with ambiguities not generally encountered in other settings. The ethical conduct of research with vulnerable populations reflects a contemporary research problem that requires ongoing discourse within the nursing community and the health care community at large.     

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.     

Mentally ill offenders in prison: the Belgian case

According to the EUPRIS-study on mental health in prisons (2007), available data on mental disorders in prison are scarce. Therefore, this study aims at summarizing and discussing the available knowledge on incarcerated mentally ill offenders concerning: (1) the screening and assessment for detecting mental health; (2) the psychiatric expertise in order to evaluate the mental status; and (3) the development and provision of forensic psychiatric treatment and care. These findings will be applied to the current situation in Belgium, which is a particularly interesting case. Belgium is currently facing difficulties concerning a large population of interned mentally ill offenders residing in correctional establishments.Implications with regard to the penal code, general or mental health legislation, screening, assessment, and treatment could deliver interesting viewpoints on how this problem could be tackled more effectively. Therefore, the findings will be discussed with reference to the international scientific and policy debate, focusing on ethical implications.     

Elderly sexual offenders admitted to a maximum-security forensic hospital

The purpose of the study was to determine the clinical and demographic characteristics of elderly sexual offenders at a maximum-security forensic hospital. Charts of male elderly patients charged with sexual offenses were reviewed to obtain clinical and demographic data. The majority of sexual offenders had mood or psychotic disorders. Almost one third had a history of violent or assaultive behavior. 57% had significant medical history. A history of violence and sexual assaultive behavior may be risk factors for future sexual offenses.     

Clinical assessment of adult sexual offenders with learning disabilities

Abstract

Assessment and treatment of adults with learning disabilities who commit sexual offences presents a number of challenges. Much of the professional forensic and psychiatric literature on work with this group concentrates on the development of interventions based on theoretical models of sexual offending originating from the mainstream criminal justice system and have often been adapted and applied to people with learning disabilities. Currently, there is very little evidence to demonstrate the effectiveness or validity of the adaptation and application of mainstream models to this population. The efficacy of such adapted models used to describe sexual offending in people with learning disabilities clearly has an impact of any intervention informed by them. In particular, some researchers suggest that key factors such as cognitive distortions are evident in sexual offenders with learning disabilities; there is, however, no research relating to the prevalence of these or other key factors within the general population of people with learning disabilities. The present literature review highlights some of the clinical issues with a particular focus on the assessment of deviant sexual interest. Specifically, the literature is confused with inconsistencies relating to the definition of the group, the extent and nature of offending and a lack of standardized methodology for assessment and comparison. Consideration is given to the particular needs of this group and the implications for research and treatment.     

Sexual fantasies and sensation seeking among psychopathic sexual offenders

Abstract

This study investigated the relationship between psychopathy, sensation seeking behavior and sexual fantasies in a sample of 199 participants from a maximum security forensic hospital. Psychopathy, measured by the Psychopathy Checklist – Revised (PCL-R), and several sensation seeking and sexual fantasy measures were utilized. Results indicated that, in agreement with previous research, sexually deviant psychopaths are more likely to offend against adults than children. Likewise, psychopaths showed some tendency to score significantly higher on sexual sensation seeking measures than nonpsychopathic sexual offenders. Furthermore, a relationship between psychopathy and overall sexual fantasies existed but there were not specific patterns among psychopaths and nonpsychopaths with regard to specific categories of sexual fantasies.     

Case study of three generations of incarcerated sexual offenders

In an attempt to better understand sexual offenders, this study with the aid of a genogram utilizing a grounded theory approach examined the experiences of three generations of incarcerated sexual offenders. The offenders in this study described experiences characterizing a continuum of failure to control their own criminal offences and perpetuity of their chronic conduct despite its serious consequences including imprisonment. One implication of those findings is that some incarcerated chronic sexual offenders possess a predisposition towards a sexual addiction and accordingly, a biological inheritance and environmental factors contribute to their conduct. Therefore, it is recommended for correctional systems including supervisory care that mandatory treatment within a medical model of confinement as opposed to a punitive model be established in order to curve recidivism and victimization levels. A longitudinal study should be conducted consisting of family members who are violent sexual offenders.     

Issues in the treatment of asian sexual offenders

Abstract

This aper considers the scant literature in the field of child sexual abuse in Asian families, and reports the authors' involvement with four male Asian sexual offenders. The therapeutic approach used with the offenders is described, and clinical themes arising from their treatment are identified. Issues and difficulties in therapy are discussed, in particular personal issues arising for the therapists. It is concluded that Asian sexual offenders are a group who have been neglected in the literature and in treatment, partly, perhaps, because they are infrequently referred to treatment services in comparison with non-Asian sexual offenders. Particular therapeutic issues relating to the treatment of immigrant Asians who do not speak English are raised and further research needs are identified in relation to this patient group.     

Self-reported versus diagnosed paraphilias in outpatient sexual offenders

Literature has repeatedly reaffirmed sexual deviance as a risk factor for sexual recidivism, making it an important subject to examine. Yet, not all studies confirm the relevance of sexual deviance and there is a lack of consensus regarding the assessment of it. In the current study, 499 Dutch adult male subjects, admitted for sexual misconduct (possession of child abuse material, child molestation and other types of inappropriate sexual behaviour) to an outpatient forensic treatment facility, were compared regarding sexual paraphilias using self-reports from clients and official DSM-IV-TR diagnoses assessed by professionals. Analyses revealed a relatively low similarity between self-reports and diagnoses, self-reports generating considerably more information. Furthermore, correlating the paraphilias revealed paedophilia associated minimally with the other paraphilias. Lastly, the different types of offenders varied significantly in number of self-reported and diagnosed paraphilias, with the miscellaneous group presenting the most. Considering these outcomes may help assessment and target treatment goals in forensic psychiatry.     

Attachment,anger and anxiety of male sexual offenders

Abstract

Common factors underlie sexual and non-sexual aggression, and they co-occur at high rates. This study reports on whether Dutton et al.'s model of partner abuse (1994) also predicts sexual offender status. Incarcerated sexual offenders (n?=?144) and non-sexual offenders (n?=?34) completed a voluntary, anonymous survey of attachment, anger and anxiety measures. Sexual offenders produced significantly higher insecure attachment (p?=?0.001), anger (p?<?0.05) and generalized anxiety (p?<?0.01) scores than non-sexual offenders. Intended multivariate analyses were prohibited by multicollinearity between predictors. Although insecure attachment, anxiety and anger distinguish sexual from non-sexual offenders, their predictive power in a multivariate model is yet to be determined. Awareness of the co-occurrence of sexual and non-sexual violence would improve assessment and treatment approaches for professionals in both arenas.     

Elderly sexual offenders: two unusual cases*

The aim of this case report is to describe two cases of sexual abuse by elderly subjects for which the Judge commissioned an expert psychiatric-forensic opinion. The elderly are generally believed to commit nonviolent crimes, whereas the two cases we observed feature forcible rape committed by elderly offenders, who showed no form of mental disease and had rationally planned their offense. They had never previously committed similar acts and had no history of homosexuality; both had been married for many years before the death of their wives and had adult children. Finally, no previous episodes of rape emerged in their personal histories during interrogations. The sociocultural context in which the crimes were committed was identical and arouses interest as regards both the method employed and how the crimes were discovered. The legal authorities then commissioned accurate investigations including medicolegal and psychiatric-forensic evaluations of the offenders and their victims.