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.     

The decontamination of German history: Jürgen Habermas and the ‘Historikerstreit’ in West Germany

The ‘Historikerstreit’ in West Germany was opened by the non-historian Habermas who sought to expose what he saw as a ‘scandalous’ revision of aspects of the history of German fascism on the part of leading conservative historians like Nolte, Hillgruber and Stürmer. Habermas sees this revisionism in the wider context of the perceived need to foster a new German nationalism as a means of legitimation. The attempt to decontaminate German history would seem to derive from the need to resist the demands for political realignment in West Germany and to establish a strong pedigree of German anti-communism which takes in National Socialism and its membership of the Anti-Comintern Pact as well as West Germany's membership of NATO. Habermas's critique of conservative historians and the non-rational assumptions of their philosophy of history is essentially linked to his critique of Nietzsche, Heidegger, Derrida and Foucault and his identification of a common paralyzing influence on discourse.     

Book Reviews

The Way the Modern World Works: World Hegemony to World Impasse. Peter J. Taylor, 1996. Chichester and London: John Wiley. 276 pp.; £18.99 paperback. ISBN 0 471 96586 3

Imagineering Atlanta: The Politics of Place in the City of Dreams. C. Rutheiser, 1996. London: Verso. 324 pp.; £14.00 paperback. ISBN 1 85984 800 1

Represénter la ville, coll.. A. Bailly, C. Baumont, J. Huriot and A. Sallez, 1995. Paris: Economica. 112 pp.; £7.00 paperback. ISBN 2 7178 2956 3

Continental Trading Blocs: The Growth of Regionalism in the World Economy. R. Gibb and W. Michalak (Eds), 1994. Chichester: John Wiley. 302 pp.; £45.00 hardback. ISBN: 4719 49 094

Mapping Desire. D. Bell and G C. Valentine (Eds), 1995. London: Routledge. 370 pp.; £15.99 paperback. ISBN 0 415 1164 1     

Application of a Maritime Framework to Space: Deep Space Conflict and Warfare Scenario

This article considers how Klein’s argument for the use of a maritime framework for space warfare is buoyed by the consideration of deep space conflict both in application to terrestrial wars and in its own right. It describes the greater alignment of Corbett’s work with this deep space medium than with the orbital medium considered by Klein. Through this analysis, it suggests that possible futures need to consider the deep space medium, making Corbett/Klein’s model superior to other possible approaches.     

Carbon Monoxide Poisoning and Death in a Large Enclosed Ventilated Area

A 55‐year‐old man with a medical history of tobacco use suddenly collapsed while power washing an empty indoor pool in a hotel. The decedent was transported to the local hospital where he was pronounced. A postmortem examination revealed atherosclerotic heart disease and bilateral pulmonary edema and congestion. A postmortem blood carbon monoxide (CO) level was 27% saturation, and a CO performed on hospital admission blood was 49% saturation. CO poisoning is a common cause of toxicological morbidity and mortality in the United States. The circumstances most often occur in an enclosed environment and may be intentional or unintentional. CO poisoning has been reported in open, well‐ventilated spaces, but rarely results in death. A warning label was present on the engine clearly stating the dangers of CO emission. However, there was a false sense of security due to the large size of the pool room and the presence of industrial blowers that were being used for ventilation.     

A life sentence really? The resettlement of ex-prisoners with convictions for sexual offences

About a year ago I was due to carry out in-depth research interviews with men who had committed sexual offences and who, having served their prison sentence, had been released into the community. When I spoke about this upcoming work with others the usual response was a version of ‘rather you than me’, or inquisitiveness about the arrangements for speaking with this group. As one friend said, ‘You'll be talking to them from behind some glass won't you?’.     

Adenoid Cystic Carcinoma of the Trachea Resulting in Fatal Asphyxia

Primary malignant tumors of the trachea are uncommon. The authors report a case of a 72‐year‐old female who died from asphyxia due to an undiagnosed obstructing adenoid cystic carcinoma of the trachea. The decedent became unresponsive while eating cereal and was pronounced upon arrival at the local hospital. The autopsy revealed a near occlusive tumor mass just superior to the bifurcation of the distal trachea. There was no evidence of aspiration. The death was the result of asphyxia due to obstruction of the trachea by an adenoid cystic carcinoma. This case demonstrates that an obstructive tumor mass may remain undiagnosed until an obstructive episode results in a sudden death.     

Personality disorder and violence in the national household population of Britain

Background: Antisocial personality disorder (ASPD) is strongly associated with violence but the effects of other personality disorder (PD) categories are uncertain. Purpose: To investigate associations between 10 DSM-IV PD categories and effects of co-occurring disorders on self-reported violence. Method: Cross-sectional survey of 8397 adults aged 16–74 years in households in Great Britain. Results: ASPD contributed strongly to the burden of violence in the British population. Paranoid and obsessive–compulsive PD made additional independent contributions, and narcissistic PD contributed to intimate partner violence. The prevalence of violence correlated with the number of PD categories. Comorbid alcohol dependence further increased the risk. Conclusions: Risk of violence increases with increasing severity of PD, measured by the number of PD categories, and with co-occurring alcohol dependence. Not all PD categories are associated with violence, and avoidant PD was protective. Identification of targets for future interventions may be obscured using a classification based solely on severity.     

An empirical examination of product counterfeiting crime impacting the U.S. military

Counterfeit parts in the U.S. Department of Defense (DOD) supply chain threaten national security by compromising critical military operations and placing the lives of military service members at risk. With the goal of illustrating the nature of the risk as it relates to types of counterfeit parts, how they entered the supply chain, and were identified and processed through the criminal justice system, we assemble and analyze open-source information on criminal schemes involving counterfeits in the DOD supply chain. We utilize the Product Counterfeiting Database (PCD) to capture every indicted scheme linked to the DOD and describe characteristics of the schemes, offenders, and victims. These data provide empirical insights into the counterfeiting of parts and equipment in the DOD supply chain. We conclude with an overview of key issues to consider when weighing opportunities for product counterfeiting as well as implications for policy and practice.