Discriminant Factors for Adolescent Sexual Offending: On the Usefulness of Considering Both Victim Age & Sibling Incest

Understanding the pathways and circumstances of juvenile sexual offending is of utmost importance. However, juvenile sexual offenders (JSO) represent an especially diverse group of individuals, and several categorizations have been proposed to obtain more homogeneous subgroups. Victim age-based and family relation-based categorizations are particularly promising because they seem theoretically and clinically relevant. Empirical results however are still inconsistent, and most studies have not considered these two dimensions jointly. 

The first goal of this study was to further examine the value of subgrouping JSO according to the age of their victim. A second goal was to determine the supplementary value, if any, of considering sibling incest. Based on a sample of 351 male JSO, it was first confirmed that sexual abuse of children was more strongly related to asociality (social skill deficits) than sexual abuse of peers, the latter being more closely associated with antisociality (general delinquency). 

The relevance of considering mixed-type JSO (with both child and peer victims) separately was also confirmed. More importantly, multivariate statistical analyses demonstrated that adding sibling incest to the equation was useful. JSO of intra-familial child were significantly more likely to have been victimized during their own childhood compared to JSO with extra-familial victims. Nevertheless, adolescents who had committed sibling incest obtained middle ground results on most variables (except for crime severity), suggesting that they constitute a distinct but not extreme, subgroup. 

This study confirmed the utility of using both the age and the family relation with the victim in characterizing juvenile sexual offending.

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By:  Joyal CC1, Carpentier J1, Martin C1.

• 1Psychology Department, Université du Québec à Trois-Rivières, C.P. 500, Trois-Rivières, Quebec, Canada, G9A 5H7; Research Center, Institut Philippe-Pinel de Montréal, Quebec, Canada; International Center for Comparative Criminology, Université de Montréal, Quebec, Canada. 
• Child Abuse Negl. 2016 Feb 19;54:10-22. doi: 10.1016/j.chiabu.2016.01.006.

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Childhood Sexual Abuse in Adolescents Adjudicated for Sexual Offenses: Mental Health Consequences and Sexual Offending Behaviors

Most studies on the mental health consequences of childhood sexual abuse (CSA) focus predominantly on CSA survivors who do not commit sexual offenses. 

The current study examined the effects of CSA on 498 male adolescents adjudicated for sexual offenses who represent the small portion of CSA survivors who engage in sexual offenses. The prevalence of internalizing symptoms, parental attachment difficulties, specific sexual offending behaviors, and risk for sexually offending were compared among participants with and without a history of CSA. 

Results indicated that participants with a history of CSA were more likely to be diagnosed with major depression and posttraumatic stress disorder than those who did not report a history of CSA. A history of CSA was also positively correlated with risk for sexually offending and with specific offense patterns and consensual sexual behaviors. No significant differences emerged on parental attachment difficulties. 

These results highlight that adolescents adjudicated for sexual offenses with a history of CSA present with differences in sexual and psychological functioning as well as markedly different offending patterns when compared with those without a CSA history. Clinical implications and future directions are discussed.

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By:  Hugo B. Morais1,2, Apryl A. Alexander1, Rebecca L. Fix1, Barry R. Burkhart1⇑

¹Auburn University, AL, USA

²University of Arkansas for Medical Sciences, Little Rock, AR, USA

Barry R. Burkhart, Department of Psychology, Auburn University, 222 Cary Hall, AL 36849-5234, USA. Email: BURKHBR@auburn.edu

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Pharmacological Interventions for Those Who Have Sexually Offended Or Are at Risk of Offending

BACKGROUND:

Sexual offending is a serious social problem, a public health issue, and a major challenge for social policy. Victim surveys indicate high incidence and prevalence levels and it is accepted that there is a high proportion of hidden sexual victimisation. Surveys report high levels of psychiatric morbidity in survivors of sexual offences.Biological treatments of sex offenders include antilibidinal medication, comprising hormonal drugs that have a testosterone-suppressing effect, and non-hormonal drugs that affect libido through other mechanisms. The three main classes of testosterone-suppressing drugs in current use are progestogens, antiandrogens, and gonadotropin-releasing hormone (GnRH) analogues. Medications that affect libido through other means include antipsychotics and serotonergic antidepressants (SSRIs).

OBJECTIVES:

To evaluate the effects of pharmacological interventions on target sexual behaviour for people who have been convicted or are at risk of sexual offending.

SEARCH METHODS:

We searched CENTRAL (2014, Issue 7), Ovid MEDLINE, EMBASE, and 15 other databases in July 2014. We also searched two trials registers and requested details of unidentified, unpublished, or ongoing studies from investigators and other experts.

SELECTION CRITERIA:

Prospective controlled trials of antilibidinal medications taken by individuals for the purpose of preventing sexual offences, where the comparator group received a placebo, no treatment, or 'standard care', including psychological treatment.

DATA COLLECTION AND ANALYSIS:

Pairs of authors, working independently, selected studies, extracted data, and assessed the risk of bias of included studies. We contacted study authors for additional information, including details of methods and outcome data.

MAIN RESULTS:

We included seven studies with a total of 138 participants, with data available for 123. Sample sizes ranged from 9 to 37. Judgements for categories of risk of bias varied: concerns were greatest regarding allocation concealment, blinding of outcome assessors, and incomplete outcome data (dropout rates in the five community-based studies ranged from 3% to 54% and results were usually analysed on a per protocol basis).Participant characteristics in the seven studies were heterogeneous, but the vast majority had convictions for sexual offences, ranging from exhibitionism to rape and child molestation.Six studies examined the effectiveness of three testosterone-suppressing drugs: cyproterone acetate (CPA), ethinyl oestradiol (EO), and medroxyprogesterone acetate (MPA); a seventh evaluated two antipsychotics (benperidol and chlorpromazine). Five studies were placebo-controlled; in two, MPA was administered as an adjunctive treatment to a psychological therapy (assertiveness training or imaginal desensitisation). Meta-analysis was not possible due to heterogeneity of interventions, comparators, study designs, and other issues. The quality of the evidence overall was poor. In addition to methodological issues, much evidence was indirect.

PRIMARY OUTCOME:

recividism. Two studies reported recidivism rates formally. One trial of intramuscular MPA plus imaginal desensitisation (ID) found no reports of recividism at two-year follow-up for the intervention group (n = 10 versus one relapse within the group treated by ID alone). A three-armed trial of oral MPA, alone or in combination with psychological treatment, reported a 20% rate of recidivism amongst those in the combined treatment arm (n = 15) and 50% of those in the psychological treatment only group (n = 12). Notably, all those in the 'oral MPA only' arm of this study (n = 5) dropped out immediately, despite treatment being court mandated.Two studies did not report recidivism rates as they both took place in one secure psychiatric facility from which no participant was discharged during the study, whilst another three studies did not appear directly to measure recividism but rather abnormal sexual activity alone.

SECONDARY OUTCOMES:

The included studies report a variety of secondary outcomes. Results suggest that the frequency of self reported deviant sexual fantasies may be reduced by testosterone-suppressing drugs, but not the deviancy itself (three studies). Where measured, hormonal levels, particularly levels of testosterone, tended to correlate with measures of sexual activity and with anxiety (two studies). One study measured anxiety formally; one study measured anger or aggression. Adverse events: Six studies provided information on adverse events. No study tested the effects of testosterone-suppressing drugs beyond six to eight months and the cross-over design of some studies may obscure matters (given the 'rebound effect' of some hormonal treatments). Considerable weight gain was reported in two trials of oral MPA and CPA. Side effects of intramuscular MPA led to discontinuation in some participants after three to five injections (the nature of these side effects was not described). Notable increases in depression and excess salivation were reported in one trial of oral MPA. The most severe side effects (extra-pyramidal movement disorders and drowsiness) were reported in a trial of antipsychotic medication for the 12 participants in the study. No deaths or suicide attempts were reported in any study. The latter is important given the association between antilibidinal hormonal medication and mood changes.

AUTHORS' CONCLUSIONS:

We found only seven small trials (all published more than 20 years ago) that examined the effects of a limited number of drugs. Investigators reported issues around acceptance and adherence to treatment. We found no studies of the newer drugs currently in use, particularly SSRIs or GnRH analogues. Although there were some encouraging findings in this review, their limitations do not allow firm conclusions to be drawn regarding pharmacological intervention as an effective intervention for reducing sexual offending.The tolerability, even of the testosterone-suppressing drugs, was uncertain given that all studies were small (and therefore underpowered to assess adverse effects) and of limited duration, which is not consistent with current routine clinical practice. Further research is required before it is demonstrated that their administration reduces sexual recidivism and that tolerability is maintained.It is a concern that, despite treatment being mandated in many jurisdictions, evidence for the effectiveness of pharmacological interventions is so sparse and that no RCTs appear to have been published in two decades. New studies are therefore needed and should include trials with larger sample sizes, of longer duration, evaluating newer medications, and with results stratified according to category of sexual offenders. It is important that data are collected on the characteristics of those who refuse and those who drop out, as well as those who complete treatment.

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By:   Khan O1, Ferriter M, Huband N, Powney MJ, Dennis JA, Duggan C.

• 1The Priory Group, Chadwick Lodge, Chadwick Drive, Eaglestone, Milton Keynes, Buckinghamshire, UK, MK6 5LS. 

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The Adolescence–Adulthood Transition and Desistance from Crime: Examining the Underlying Structure of Desistance

Describing and explaining desistance in special categories of juvenile offenders, such as chronic, serious, violent, and sexual offenders, represents a challenge for researchers and practitioners alike. In fact, there is little agreement as to how to best define and measure desistance from crime. In the current study, four conceptualizations of desistance are examined with a sample of 349 incarcerated juvenile offenders. Based on longitudinal data measured from age 12 to 23, desistance was examined through four modeling strategies. 

Results highlighted inconsistencies in classifying offenders as desisters/persisters across the modeling strategies used. Of importance, following the transition into adulthood, evidence suggests that most of these individuals were not on a life-course pattern of serious, violent, and sexual offending but rather at different stages of desistance. Based on the study findings, a unified model of desistance is proposed to describe and explain desistance from crime among juvenile offenders.

Below:  Offending trajectories of adjudicated youth from 12 to 23 years old

Full article at:  http://goo.gl/57fVHa

By:  

Patrick Lussier 

, Evan McCuish

, Raymond R. Corrado

 

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Criminal History & Future Offending of Juveniles Convicted of the Possession of Child Pornography

Most child pornography is distributed online. It is estimated that 3% to 15% of child pornography consumers are juveniles. 

The present study analyzed a consecutive sample of 54 male juveniles convicted of the possession of child pornography. Demographic characteristics, criminal history, and subsequent offending were assessed from criminal files and official reports. Juvenile possessors of child pornography were compared to three different groups of juveniles: Juvenile possessors of other illegal pornography (n = 42), juveniles who committed a sexual contact offense against a child (n = 64), and juveniles who committed a sexual contact offense against a peer or adult (n = 104). Juvenile possessors of child pornography were found to have downloaded the illegal material more frequently and over a longer time period than juvenile possessors of other illegal pornography. 

Furthermore, juvenile possessors of child pornography differed from juveniles who had committed a sexual contact offense in terms of demographics and showed fewer previous and subsequent offending than juveniles who sexually offended against a peer or adult. 

We conclude that juvenile possessors of child pornography need a specific target intervention focusing on dysfunctional Internet use and sexually deviant arousal.

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By: Aebi M1, Plattner B2, Ernest M2, Kaszynski K3, Bessler C2.

• 1Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland maebi@ppkj.uzh.ch.
• 2Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland.
• 3Illinois Institute of Technology, Chicago, IL, USA. 

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Female Adolescent Sexual & Nonsexual Violent Offenders: A Comparison of the Prevalence & Impact of Risk & Protective Factors for General Recidivism

This study adds to the scarce literature on female adolescent sexual offenders by examining differences between female adolescent sexual and nonsexual violent offenders in the prevalence and impact of dynamic risk and protective factors for general recidivism.

The sample consisted of female adolescents who were convicted for a sexual offense (FSOs; n=31) or nonsexual violent offense (FNSOs; n = 407), and for whom the Washington State Juvenile Court Assessment was completed.

In FSOs, considerably more protective and fewer risk factors were present than in FNSOs in almost all domains (i.e., school, relationships, family, attitude and aggression). In addition, differences in the impact of risk/protective factors on general recidivism were found. In FSOs, risk/protective factors in the family and aggression domains were especially important, whereas in FNSOs, risk/protective factors in the attitude domain were especially important.

The results of this study indicate that treatment programs developed for mainstream female offenders may also be useful for female sexual offenders in reducing general recidivism. Furthermore, the results are of importance for determining the main focus of treatment for both mainstream and sexual female adolescent offenders.

Table 3
Background Characteristics and recidivism rates for the female adolescent sexual and nonsexual offenders
	FSOs	FNSOs	F
	(n = 31)	(n = 407)
Ethnicity:
European Americans	80.7 %	48.7 %	12.07**
African Americans	3.2 %	17.0 %	4.06*
Hispanic Americans	6.5 %	8.4 %	.14
Other	3.2 %	9.1 %	1.25
Unknown	6.5 %	17.0 %	2.34
Average age:
At the time of the assessment	15.10 (SD = 1.56)	15.40 (SD = 1.34)	1.46
At first offense	13.42 (SD = 1.79)	13.58 (SD = 1.60)	.30
Recidivism rates:
Total Recidivism	23 %	36 %	2.24
Felony Recidivism	10 %	18 %	1.37
Violent Felony Recidivism	3 %	6 %	.38

*p < .05, **p < .01

Table 4
Prevalence of dynamic risk and protective factors in female adolescent sexual and nonsexual offenders
	Dynamic risk factors			Dynamic protective factors
	FSOs	FNSOs	F	FSOs	FNSOs	F
	(n = 31)	(n = 407)		(n = 31)	(n = 407)
School	4.39	6.90	7.16 a	7.00	4.69	11.54 a
Relationships	1.94	3.40	17.13 a	4.77	3.33	14.05 a
Family	5.45	10.00	16.70 a	13.58	9.67	22.73 a
Alcohol/drugs	.68	1.01	2.03	1.52	1.30	1.97
Attitude	5.55	7.36	3.93 b	8.74	6.62	5.44 a
Aggression	3.10	5.30	16.07 a	5.39	2.64	28.69 a
Skills	4.42	5.58	1.56	9.71	7.98	3.67 b
Total score	25.52	39.56	16.86 a	50.71	36.22	19.77 a

a Significant after controlling for the false discovery rate using the method of Benjamini and Hochberg (1995), using a .05 level for the false discovery rate

b trend-significant after controlling for the false discovery rate using the method of Benjamini and Hochberg (1995), using a .10 level for the false discovery rate

Full article at: http://goo.gl/bBX3zZ

By: Claudia E. van der Put

Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 94208, Amsterdam, 1090 GE, The Netherlands

  

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