Week 11 RF-Treating Disturbed Emotion Regulation in Sexual Offenders Flashcards
What are the costs of Sexual Offending?
-Recognised as an international public health problem by World Health Organisation
Costs of sexual abuse to victim:
-Physical and psychological harm
-Teenage pregnancy
-Problematic parenting behaviours
-Adjustment problems in the victim’s later offspring
-Other costs include to public health and criminal justice services, loss of work days, reduced productivity
What are the Risk Factors for Sexual Offending? (Hanson & Harris, 2000, 2001; Thornton, 2002)
-Risk factors: factors that help to predict recidivism (reoffending), that is, whether a person convicted of a sexual offence will commit another offence in the future
-Pedophilia is not illegal because that’s the attraction not the offence and the offence doesn’t necessarily mean pedophilia
Four domains of risk factors that predict sexual offence recidivism:
1. Socio-affective function (e.g., intimacy deficits, emotion-regulation)
2. Self-management (e.g., impulsivity, recklessness + also relates to problem solving)
3. Offence supportive attitudes (e.g., children enjoy sex-also relate to distorted attitudes towards women e.g., only viewing them for sex purposes)
4. Deviant sexual interests (e.g., sexually attracted to minors)
Risk, Need, Responsivity:
-Treatment should be proportionate to risk, treatment should target needs related to offending, consider how responsive people are to diff. treatment
What is Sex Offender Treatment?
Aim: to reduce the risk that an individual will commit another offence again in the future
Sex Offender Treatment Program (SOTP):
-Delivered to sexual offenders in England and Wales
-Other similar programs delivered in other countries
-Typically cognitive behavioural approach
-Focus on reducing ‘risk factors’ related to sexual offence recidivism
Does Sex Offender Treatment work?
-Unclear!
-Meta-analyses suggest that sex offender treatment does reduce sexual recidivism
-10.1 % in treated vs. 13.7 % in untreated offenders (Schmucker & Lösel, 2015) (10.1% and 13.7% is about how many go out to commit sexual offences again)
-A report for the Ministry of Justice suggests that sex offender treatment may increase sexual recidivism (10.0% compared with 8.0%)
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/623877/sotp-report-print.pdf
What has gone wrong with Sexual Offenders Treatment?
-Need to consider what is targeted in treatment and how
-Survey of sex offender treatment programs suggests that treatment my be targeting factors that are unrelated to sexual offence recidivism e.g., denial, victim empathy
-Other factors that are related to recidivism are often not targeted e.g., deviant sexual interests, self-regulation
-Gannon et al. 2019: treatment is effective but need to consider method of delivery, e.g., talking therapies may be useful for addressing certain risk factors, who delivers treatment, training etc.
What is the new suite of treatment programmes?
-Movement away from treatment based on offence type
New treatment programmes include Horizon and Kaisen:
-cognitive behavioural model
-delivered to people depending on level of risk
-People with specific needs may attend more specialised modules:
Healthy Sex Programme for people with paraphilic sexual interests
-Effectiveness of these programmes remains unclear, undergoing evaluation by HMPPS
-Also used for violent offences or domestic partner violence
-Would be good to look over a 5-10 year period to determine the effectiveness of reduced recidivism
How is emotion regulation a risk factor for sexual offending?
-Known risk factor for sexual offence recidivism, theory and research suggests a causal role but may not be effectively targeted in treatment (Gillespie et al., 2012)
-Ability to implement intentional cognitive control over emotions
What are emotions?
-Spontaneous, not consciously provoked
-Provide positive and negative valence
-Goal-directed
-Involve multi-system changes (behavioural, autonomic, physiological)
What are the 2 main strategies for sexual reoffending?
Reappraisal:
Form of cognitive change, think in different way about same situation
-Dependent on higher order brain processes
-e.g., an interview = an opportunity, not a test
Emotion Suppression:
-Form of response modulation, inhibit emotionally expressive behaviours
-Effects on expressive behaviour and physiology
-e.g., poker face
Neural Correlates of Conscious Self-regulation of Emotion (Beauregard et al., 2001): What was measured?
Measured brain activation in healthy male participants while viewing erotic film excerpts
Participants asked to either:
-Respond in normal manner
-Inhibit sexual arousal
What is the Potential Role of Mindfulness?
-Recommended for inclusion in sex offender treatment to address problems in emotion regulation (Gillespie et al., 2012)
-Origins in Buddhism and Eastern traditions
-Paying attention in the present moment, non- judgementally (Jon Kabat-Zinn, 1994)
-Three interacting components contribute toward enhanced self-regulation
What is Mindfulness meditation?
-Can be developed through a variety of meditation exercises e.g., mindful breathing, body scan meditation
Increasingly incorporated in to Western medicine:
-Mindfulness-Based Stress Reduction (Grossman et al., 2004)
-Mindfulness-Based Cognitive Therapy (Teasdale et al., 2000)
-But, limited support in forensic samples
Emotion Regulation, Mindfulness and alexithymia: Specific or general impairments in sexual, violent and homicide offenders? (Gillespie et al., 2018): What was measured?
-Few studies have examined specific problems in emotion regulation
397 offenders recruited from 15 prisons in Northern and central Italy:
-Homicide (N = 86; 21.7%)
-Violent, non-sexual (N = 159; 40.1%)
-Sexual (N = 68; 17.1%)
Is it Generalised or Specific Impairments?
-Sex offenders showed specific impairment in acceptance of emotional states
More pervasive difficulties in the violent group:
-Higher levels of anger
-Greater emotional non-acceptance
-Evidence of alexithymia, difficulties identifying emotions
-Some mindfulness problems, non-judgement, acting with awareness
-Homicide groups may be relatively in charge of emotions
How is emotion regulation not just sex offenders?
-Emotion regulation = shared risk factor for sexual and violent offending
-Supports move toward providing similar treatment to sexual and violent offenders
-Use of specialised modules for those who need them (risk, need, responsivity)
-Potential benefits of mindfulness based modules
What are the Existing mindfulness based studies?
Fix and Fix (2013):
-Reviewed reported benefits of meditation but noted methodological limitations
Samuelson et al. (2007):
-2000 offenders took part in mindfulness based stress reduction
-Exercises include body scan, stretching exercises, sitting meditation
-Reported benefits across hostility, self-esteem and mood
Verheul et al. (2003):
-Benefits of Dialectical Behavior Therapy in borderline personality disorder
-Mindfulness represents important component of DBT
-Development of acceptance based techniques for regulating emotions
-Issues in reliability and trust (Fix & Fix, 2013)
-DBT is good for reducing self-harm (good even if not related to mindfulness)
