Hormone therapy Flashcards
What is the rationale behind hormone therapy?
-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
Why is chemical castration used over other forms of treatment for sex offenders?
- prev treatments too unethical
-neurosurgery - targeted hypothalamus which produces T
-surgical castration not ethical - irreversible
Why is hormones therapy used with criminals?
-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
Who is treated by hormone therapy?
-Aggressive offenders (reduce T so helps with impulsive beh)
-Sex offenders (reduces sexual drive and desire, deviant thoughts)
-Those in mental faculties
How is hormone therapy conducted?
-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)
What are anti-androgens?
-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
What are two example of anti-androgens?
-MPA
-CPA
What do lutenizing hormones do?
-stimulate leydig cells which secret T
What does antigonadatropic and antiandrogenic mean?
-Anti-gonadatropic = supresses LH
-Anti=androgenic = blocks the action of T
What is MPA?
-Female hormone
-synthetic progesterone
-Antigonadatropic (surpress LH)
-Inhibits LH produced by pituitary which reduces T and sexual aggression, sex drive and paraphilic beh
How and where is MPA used?
-USA
-Injected 7-10 days, intramuscularly
-300-400 mg
Side effects of MPA
-Nightmares, weight gain, breast enlargement, leg cramps, depression, osteoporosis
What is CPA?
-synthetic form of progesterone
-Antigonadatropic and antiandrogenic properties
-Weakly surpresses LH’s and FSH’s
-Blocks action of T at the testes
How and where is CPA used?
-Canada
-Administered orally
-divided doses of 100mg, up to 300mg
-works in 1-3 weeks
What are the side effects of CPA?
-Liver damage, fatigue, transient depressive states, weight gain, psychosis
-Reduce sex drive and sexual fantasies
Evaluation
EACH/DESSERT
Evidence (for)
-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
Evidence (against)
-Dolan: meta-analysis. Compared hormones and CBT. Recidivism less for CBT than hormone
Applications
Can use hormone therapy to prevent sex offenders in real life from offending when released
Comparisons and credibility (8w, 1s)
-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
How good is the research
-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
