Lecture 8: Assessment and treatment of sexual offenders

Question 1

Types of sexual offending

Answer 1

• Exhibitionism = exposing yourself
• Frottage = rubbing against someone without consenting
• Voyeurism = secretly watching someone in sexual way
• Rape
• Child sexual abuse
• Sexual homicide = murder with sexual elements

Question 2

Sub-types of rape

Answer 2

Broken down by motivation that drives offence:

• Angry
• Opportunistic
• Sexual (sadistic and non-sadistic)

Can be broken down into victim is:

• Stranger
• Acquittance
• Marital
• Gang rape/multiple perpetrator rape

Question 3

Sub-types of child sexual abuse

Answer 3

Often broken down by relation of abuser to victim:

• Extrafamilial
• Intrafamilial

Can be broken down into:

• Approach (planned)
• Opportunistic = normally offending for emotional or antisocial reason
• Internet
• Females

Question 4

Motivation-facilitation model

Answer 4

• Seto (2017)
• Starts with kind of motivation e.g. paraphiliac or high sex drive
• Motivates them to be prone to offending but doesn’t mean they will
• What decide whether the offend:
• -> State factors e.g. alcohol, negative emotion
• -> Trait factors e.g. antisocial
• -> Situational factors

Question 5

Reoffending/recidivism

Answer 5

• Higher reoffending with extrafamilial because not confined to one victim
• Higher with boy victims because indicates sexual interest higher as not driven by non-sex related variable

Question 6

Risk assessment

Answer 6

-Split into low, medium, high, very high risk

Question 7

Static risk factors

Answer 7

Static factors:

• Largely historical factors
• Non-changeable aspects of individual
• Young when first offend
• Suggested that its what these factors indicate that show the risk

Question 8

STATIC-99

Answer 8

• Hanson and Thornton (1999)
• Most used risk assessment for static factors
• Never married
• Young age (cut of 25)
• Prior sexual offence
• Non-contact sexual offences
• Stranger, unrelated, male victims
• As years increase risk levels increase, however unsure what actual things need treating = where dynamic factors come in

Question 9

Dynamic risk factors

Answer 9

• Factors that can change/fluctuate
• E.g. employment instability, sexual preoccupation
• What is addressed in treatment
• Tend to be broken down into:
• -> Stable = enduring (but changeable) characteristics linked to the offending behaviour e.g. beliefs
• -> Acute = rapidly changing characteristics affected by situation. Indicate re-offence may occur within short period of time e.g. arousal due to alcohol
• Some factors can be stable and acute

Question 10

Dynamic risk domains

Answer 10

• Mann, Hanson and Thornton (2010) characterised risk factors into most important
• Sexual deviance e.g. sexual interest in children
• Distorted attitudes e.g. hostility towards women
• Socio-affective issues e.g. lack of intimate adult relationships
• Self-management issues e.g. self-management issues

Question 11

Dynamic risk assessment

Answer 11

• STABLE-2007 and ACUTE-2007 (Hanson et al, 2007)
• Most powerful acute factors:
• -> Hostility
• -> Sexual preoccupation
• -> Victim access
• -> Rejection of supervision = marker for being anti-social
• When assessment includes 1+ these tools judges have greater confidence in assessment
• According to DSM-5 if enduring, persistent and necessary for sexual enjoyment can be regarded as paraphilia - if causes sig distress/impaired function can be considered paraphilic disorder

Question 12

Paraphilias

Answer 12

• Transvestism
• Frotteurism = paraphilic interest in rubbing
• Fetishes
• Paedophilia

Question 13

Paraphilias: sexual arousal

Answer 13

• Psychological, physiological, behaviour responses to internal or external target of sexual interest
• Subjective sexual arousal = cognitive realising = assess through self report
• Objective sexual arousal = physiological = can measure phallometric assessment
• Act upon sexual arousal = behavioural = can assess using case file info

Question 14

Self-report assessment for paraphilia

Answer 14

• Directly ask individual how much they are interested in various sexual categories
• Mostly use questionnaire
• Example = multiphase sex inventory:
• -> 300 yes/no times
• -> 20 scales related to sexual interest
• -> Good test-retest reliability and internal consistency

Benefits:

• -> Rich detail
• -> Easy to administer and analyse

Criticisms:

• -> Assumes info consciously accessible
• -> Sensitive topic = prone to social desirability responding

Question 15

Phallometric assessment of paraphilia

Answer 15

• PPG
• Measure volumetric changes of penis in response to sexual stimuli
• Stimuli can be visual, auditory or fantasy

Benefits:

• -> Objective
• -> Research shown best measure for distinguishing child abusers from non-sex offenders and rapists

Criticisms:

• -> Invasive
• -> In some countries seen as unethical
• -> Assumes erection equates to sexual arousal = not the case, especially in older men
• -> Prone to faking and suppression

Question 16

Indirect measures of paraphilia

Answer 16

• RT based computer tasks

- Based on idea that pressurised automatic response evokes genuine indications one interest

Question 17

Types of indirect measures of paraphilia

Answer 17

Task relevant

• Viewing time
• IAT
• Go/No-Go Association task

Task irrelevant

• Emotional stroop
• Choice reaction time
• Rapid serial visual processing

Question 18

Types of indirect measures of paraphilia: Viewing time

Answer 18

• Task relevant
• Oldest
• Records how long image viewed whilst being rates on sexual attractiveness scale
• Meta analysis:
• -> VT showed a moderate ability to discriminate child abusers from comparison group

Question 19

Types of indirect measures of paraphilia: IAT

Answer 19

• Task relevant
• Assesses the strength of association between target categories and attribute categories
• If someone has interest to children they should be responding faster to children with sex words
• Meta-analysis:
• -> Child sex IAT can distinguish child abusers from comparison groups
• -> Correlates with other measures of sexual interest e.g. PPG

Problems:

• Only involves 2 target and 2 attribute categories so can only assess some relative association
• Not clear what the association is

Question 20

Types of indirect measures of paraphilia: Go/No-Go Association Task

Answer 20

• Variant of IAT = addresses some issues of IAT
• Involves ppts responding to target stimuli and withholding responses to non-target stimuli
• Can measure associations towards single target
• Can measure absolute associations

Question 21

Promising development in measuring paraphilia

Answer 21

• Eye tracking
• Pupil dilation = pupils of non-offending men dilate to images of women but not to men, children, neutral scenes
• Mouse tracking = can detect real-time biases for sexually preferred stimuli in non-offending males
• Virtual reality = can have situations with children more ethically

Question 22

Evaluation of indirect measures of paraphilia

Answer 22

Strengths:

• Responses based on uncontrollable, automatic processes
• Less prone to faking
• Possible to access consciously inaccessible preferences

Limitations:
-Rich and detailed info not obtained

Question 23

RNR principles

Answer 23

• Risk = match treatment intensity with risk level
• Need = target relevant criminogenic risk factors
• Responsivity = tailor treatment to ensure maximum benefit

Question 24

Sex offender treatment

Answer 24

• Based on behavioural strategies including cognitive, social learning, modelling and skill building
• Goals of treatment:
• -> Address dynamic risk factors
• -> Understand progression to the offence
• -> Develop self-management plan
• -> Typically delivered as group therapy

Question 25

Treatment of dynamic factors

Answer 25

- Deviant interest = aversive reconditioning and fantasy management = works out what's triggering it - Distorted attitudes and cognition = cognitive restructuring and schema therapy - Intimacy/relationships = CBT, role-playing - Anger and hostility = anger management therapy and CBT - Self-regulation issues = identifying new coping strategies, mindfulness

Question 26

Behavioural progression

Answer 26

- Series of events and situations, combined with cognitive and emotional states that lead to sexual offending - = offence chain - Can help device a case formulation = taking all different piece of information to understand how things led to other things in the offence - Case formulation aims to describe a person’s presenting problems and use theory to make explanatory inferences about the causes and maintaining factors (which informs treatment)

Question 27

Self-regulation plan

Answer 27

- Once they have gone through treatment and identifies what risk factors are - Establish goals promoting offence-free life - Develop coping strategies for internal and external risk factors - Ensure cognitive and emotional aspects are present - Include support network - Be concrete but generalisable

Question 28

Self-regulation model

Answer 28

- Ward and Hudson (1998) - Everyone is goal driven and trying to regulate how they approach/attain goals - Life experiences effects what we dont want to do - In case of offending = might have motivation e.g. interest in children but dont want to offence so avoid triggering situations = have an avoidance goal - But might regulate is passively = under-regulation or disinhibition pathway = lack internal skills - May regulate is activity = mis-regulation pathway, uses bad strategies e.g. fantasy - Others will have same motivation with the desire to offend - -> May meet goal automatically = might circumstances, have scripts - -> OR may meet goal explicitly = planning - Once identify style can create better treatment plan

Question 29

Good lives model

Answer 29

- Ward and Stewart (2003) - Strengths based approach to treatment and highly influential Theoretical assumptions: - All humans are goal directed organisms that seek primary good - Primary goods = actions, experiences and activities that are intrinsically beneficial e.g. life, knowledge - Secondary goods = way people go about acquiring primary goods

Question 30

The good lives model and sexual offending

Answer 30

- Sexual offending occurs when individuals try to obtain these goods but in antisocial way because lack internal/external resources to achieve primary goods - Dynamic risk factors are internal obstacles that affect the prosocial acquisition of primary goods 4 problems in acquiring goods: - Means used to secure goods = such as seeking 'relatedness' via child sexual abuse - Lack of scope = focussing only on a few goods - Presence of conflict among goods sought = relatedness via sex offending conflicts with inner peace - Lack of capacity to secure goods = lacking social skills to establish and maintain a relationship

Question 31

Does sex offender treatment work?

Answer 31

- Found it does work - Treated = 9.7% risk of reoffending - Untreated = 14.6% risk of reoffending

Question 32

Self Regulation Model

Answer 32

-Ward and Hudson (1998) -model proposes people behave in a way that is goal-directed = act to achieve a desired state or to avoid an undesired state 4 paths: - Avoidant-passive pathway = individual has desire to commit sex crime = they try not to offend but are under regulated or disinhibited = can't cease behavioural pattern that has developed - avoidant-active pathway = have a goal of avoiding committing sex crime = will enagge in actions such as substance abuse in order to not commit a crime, but often leads to a sex crime as a result - approach automatic pathway = goal of committing sex crime = cognitive and behavioural patterns well established --> sex crime - approach-explicit pathway = individual has childhood history that led to sex crimes = engage in detailed grooming behaviours