Hormone therapy

Question 1

What is the rationale behind hormone therapy?

Answer 1

-Used to treat violent and sexual offenders
-idea behind it is that criminal behaviour is from bio approach
-Increased T correlates with aggression (males more)
-If bio influences reduced in sex offenders then might impact social and psychological

Question 2

Why is chemical castration used over other forms of treatment for sex offenders?

Answer 2

• prev treatments too unethical
  -neurosurgery - targeted hypothalamus which produces T
  -surgical castration not ethical - irreversible

Question 3

Why is hormones therapy used with criminals?

Answer 3

-TLM linked with reduction in recidivism
-hormone imbalance (chemical messengers) leads to uncontrollable phys urges
-want to maintain normal sexual drive
-effects can be reversed
-used with those with paraphilia or patterns of sexual arousal that need interventions

Question 4

Who is treated by hormone therapy?

Answer 4

-Aggressive offenders (reduce T so helps with impulsive beh)
-Sex offenders (reduces sexual drive and desire, deviant thoughts)
-Those in mental faculties

Question 5

How is hormone therapy conducted?

Answer 5

-Injections (dose varies)
-Daily weekly, monthly depending on freq of thoughts
-Life long
-Dose reduced after assessment to assess risk
-If stop then beh may return
-Monitoring (lie detector, qus, ring around penis)

Question 6

What are anti-androgens?

Answer 6

-inhibit the production of androgens through pituitary gland
OR
-block body’s ability to make use of androgens
-lowers T so decrease in sexual urges
-Induce enzyme that breaks down T

Question 7

What are two example of anti-androgens?

Answer 7

-MPA
-CPA

Question 8

What do lutenizing hormones do?

Answer 8

-stimulate leydig cells which secret T

Question 9

What does antigonadatropic and antiandrogenic mean?

Answer 9

-Anti-gonadatropic = supresses LH
-Anti=androgenic = blocks the action of T

Question 10

What is MPA?

Answer 10

-Female hormone
-synthetic progesterone
-Antigonadatropic (surpress LH)
-Inhibits LH produced by pituitary which reduces T and sexual aggression, sex drive and paraphilic beh

Question 11

How and where is MPA used?

Answer 11

-USA
-Injected 7-10 days, intramuscularly
-300-400 mg

Question 12

Side effects of MPA

Answer 12

-Nightmares, weight gain, breast enlargement, leg cramps, depression, osteoporosis

Question 13

What is CPA?

Answer 13

-synthetic form of progesterone
-Antigonadatropic and antiandrogenic properties
-Weakly surpresses LH’s and FSH’s
-Blocks action of T at the testes

Question 14

How and where is CPA used?

Answer 14

-Canada
-Administered orally
-divided doses of 100mg, up to 300mg
-works in 1-3 weeks

Question 15

What are the side effects of CPA?

Answer 15

-Liver damage, fatigue, transient depressive states, weight gain, psychosis
-Reduce sex drive and sexual fantasies

Question 16

Evaluation

Answer 16

EACH/DESSERT

Question 17

Evidence (for)

Answer 17

-Federoff et al: 15% on MPA reoffended, 68% not on MPA
-Turner et al: TLM successful in reducing sexual drive
-Emory: Depo-povera lowered sexual interest
-Berlin et al and P.Gagne: MPA reduction in libido, effects reversible

Question 18

Evidence (against)

Answer 18

-Dolan: meta-analysis. Compared hormones and CBT. Recidivism less for CBT than hormone

Question 19

Applications

Answer 19

Can use hormone therapy to prevent sex offenders in real life from offending when released

Question 20

Comparisons and credibility (8w, 1s)

Answer 20

-CBT better (Ireland) Treats cause which is thoughts
-Voluntary: only effective if take and motivation
-Root cause: only dealing with sympt
-Social control: evasive. control sexual deviancy
-labelling: when out of prison, no job, low motivation
-ethical issues: side effects CBT not invasive
-Practical issues: 7-10 days responsible for own treatment
-might have other mental conditions which need mood stabilizers and NT’s. Deal with first. Don’t know if hormone or other treatment
-Practical: any GP, CBT need therapist

Question 21

How good is the research

Answer 21

-Meta-analysis: (Dolan 30 studies) high v large sample.
-low IV: fully numerical so less depth
-lov IV: chose studies so biased
-secondary data: not for the purpose of this study, any flaws in data impact on the findings of meta-analysis