hormone treatments

Question 1

who does hormone treatment tend to focus on?

Answer 1

• sex offenders

Question 2

SSRIs and sex offenders

Answer 2

• if paraphilia’s are considered to be part of OCD disorders then specific serotonin re-uptake as treatment e.g. sertraline
• the side effects of SSRIs are not as serious as anti-androgen, and hormone therapy is the focus, not SSRIs as drug treatment.

Question 3

supporting evidence for SSRIs

Answer 3

Greenberg and Bradbury 1997

Question 4

opposing evidence for SSRIs

Answer 4

Bradbury and Kaye 1999
- suggested that SSRIs may not work because paraphilia’s related to OCD disorders, but because 5HT (serotonin) has a role in ‘neurobiology of sexual behaviour’

Question 5

anti-androgens
(CPA)

Answer 5

• CPA has anti-androgenic, antigonadotropic and progestational effects
• it quickly reduces sexual drive and deviant fantasies but is only accessible in Canada (Bradbury & Kaye 1999)
• there are side effects, such as liver dysfunction and adrenal suppression
• it is as effective as castration in reducing recidivism related to offenders.

Question 6

hormonal agents that are not anti-androgens
(MPA)

Answer 6

• MPA is a hormone agent and is the most used one in USA.
• side effects include weight gain, decreased sperm production and gall bladder dysfunctions.
• MPA brings reduction in sexual drive and deviant sexual fantasy, and possibly aggression.

Question 7

hormonal agents that are not anti-androgens
(LHRH)

Answer 7

• LHRH analogues are used to treat paraphilia’s and act as a pharmacological castration because they exhaust the HPA
• Bradbury and Kaye 1999 suggest that these hormones are likely to be important in treating severe deviation.

Question 8

review of sexual offender treatment programmes
(Perkins et al 1998)

Answer 8

• Perkins et al (1998) reviewed treatment programmes for sexual offenders in the UK.
• a review is useful as it can show what treatments are being used
• BUT from 1998 - likely to have been changes since
• the hormone treatments are what are focused on in this summary of the review.
• Perkins et al commented that more clinical trials are needed using randomised controlled design trials.