Frank Schilling

Dynamic Risk Assessment in Sexual Offenders Using STABLE-2000 and the STABLE-2007: An Investigation of Predictive and Incremental Validity

The predictive accuracy of STABLE-2000 and STABLE-2007 was examined within a prospective research design in a German-speaking sample of 263 adult male prison-released sexual offenders followed up for an average of 6.4 years. The STABLE-2007 was significantly related to all outcomes (AUC = 0.67-0.71), whereas the STABLE-2000 demonstrated only weak predictive accuracy for sexual reoffense (AUC = 0.62). Supporting the results of the construction sample, the STABLE-2007 incrementally added to the predictive accuracy of the STATIC-99 for violent and general reoffense (conviction and incarceration). Moreover, the STABLE-2007 total scores and the nominal risk/need categories made significant incremental contributions over the SORAG for predicting sexual reoffense.

The Severe Sexual Sadism Scale: Cross-Validation and Scale Properties

The Severe Sexual Sadism Scale (SSSS) is a screening device for the file-based assessment of forensically relevant sexual sadism. The SSSS consists of 11 dichotomous (yes/no) items that code behavioral indicators of severe sexual sadism within sexual offenses. Based on an Austrian sample of 105 sexual offenders, the present study replicated the 1-dimensional scale structure of the SSSS, as evidenced by confirmatory factor analysis. More specifically, the scale was commensurate with the 1-parameter logistic test model (Rasch model). Reliability was estimated to be good. Criterion validity for the clinical diagnosis of sexual sadism was good. With a cutoff value of 7 points, sensitivity and specificity were estimated at 56% and 90%, respectively.

Sadism in Sexual Offenders: Evidence for Dimensionality

Recurrent and intense sexual fantasies and urges that circle around the infliction of pain or humiliation on another human being may predispose individuals toward acts of sexual aggression against nonconsenting victims. Consequently, sexual sadism is a paraphilia with particular relevance for forensic psychology and psychiatry. Using behavioral indicators derived from crime scene actions as well as clinical data, we sought in the present study to identify the latent structure of the disorder. We analyzed data from a national sample of male sexual offenders from Austria (N = 1,020). In addition to latent profile analysis, 3 conceptually different taxometric methods were applied. The results of the analyses were more in accordance with a dimensional interpretation than with a categorical distinction. That is, sadistic conduct in sexual offenses is likely an extreme form of coercion, but not a qualitatively different entity. The implications with respect to the current debate on the diagnostic criteria for sadism are discussed.

Sadism and violent reoffending in sexual offenders

A diagnosis of sadism in sexual offenders is commonly regarded as indicative of high risk for violent reoffending. The purpose of the current two studies was to evaluate whether sadism is indeed associated with higher rates of violent (including sexual) reoffending. In Study 1 (meta-analysis), the rate of violent and sexual recidivism was assessed across seven samples of male sex offenders (total N = 2,169) as a function of diagnoses of sexual sadism. In Study 2 (N = 768) the outcome (violent recidivism yes/no) was regressed on sadism, along with behavioral indicators of sexually sadistic offending, and scores from violence risk assessment instruments. In Study 1 (meta-analysis), the overall risk of sadists compared with nonsadists with respect to violent (including sexual contact) reoffending was slightly elevated (by a factor of 1.18), yet not significantly increased. Similarly, the risk of sexual reoffending among sadists was slightly, but not significantly, higher than among nonsadists (factor 1.38). According to Study 2, only a measure of sadistic behavior, not the clinical diagnosis, was associated with violent reoffending. This association, however, was not present once age and customary risk assessment instruments for violence risk were included in the regression. A clinical diagnosis of sexual sadism and behavioral measures of sadism are related to the risk of violent reoffending in sexual offenders. These associations, however, are weak and do not hold once variables relevant for the prediction of violence are controlled for. At the individual level, the risk for future violence in sadists can therefore be adequately described by customary risk assessment instruments.

Über die Treffsicherheit der standardisierten Risikoeinschätzungsverfahren Static-99 und Stable-2007 bei aus einer Sicherungsmaßnahme entlassenen Sexualstraftätern

ZusammenfassungDie Vorhersagegüte der Risikoeinschätzungsverfahren Static-99 und Stable-2007 wurde an einer Stichprobe von entlassenen österreichischen Maßnahmenpatienten (Nu2009=u200996) nach §xa021 Abs.xa02 öStGB (in Deutschland: Maßregelpatienten) überprüft. Die prädiktiven Validitätsindizes für neuerliche Sexualstraftaten (etwa 7xa0Jahre nach Entlassung) lagen für den Static-99 bei einem Wert für die „area under the curve“ (AUC)u2009=u20090,86 und für den Stable-2007 bei AUCu2009=u20090,71. Sie waren damit vergleichbar mit den korrespondierenden Werten für entlassene Strafgefangene (Nu2009=u2009274). Der Stable-2007 zeigte sich als Verfahren zur Einschätzung dynamisch-veränderbarer Risikomerkmale gegenüber dem Static-99 inkrementell valide. Mittels Static-99 und Stable-2007 gebildeten Risiko-/Bedürfnislevel-Kategorien konnten in der Gruppe der Untergebrachten Hochrisikotäter identifiziert werden, die trotz positiver Entlassungsprognose und umfangreicher Nachsorgemaßnahmen in 50u2009% der Fälle innerhalb eines Fünfjahresbeobachtungszeitraums mit einem Sexualdelikt wiederverurteilt waren. In den ersten 3 von 5xa0Kategorien hingegen fanden sich so gut wie keine Rückfälle, was möglicherweise eine spezifische Wirksamkeit der Maßnahmen innerhalb dieser Gruppen nahelegt. Die Daten sprechen insgesamt für die Anwendbarkeit der Verfahren auch im Zuge von Entscheidungen bei in einer Sicherungsmaßnahme untergebrachten Sexualstraftätern.AbstractThe accuracy of the recidivism risk assessment instruments Static-99 and Stable-2007 for sexual offenders was examined in a population of released male forensic sexual offenders hospitalized under mandatory treatment in Austria (Nu2009=u200996). The Static-99 with an area under the curve (AUC) u2009value of 0.86 and the Stable-2007 (AUCu2009=u20090.71) were significantly related to sexual reoffending after nearly 7 years time at risk, thus revealing a predictive power comparable with offenders released from prison (Nu2009=u2009274). Also the Stable-2007 incrementally supplemented the predictive accuracy of the Static-99. Static-99/Stable-2007 risk/need categories identified a high risk group with a 50u2009% chance for sexual reconviction within 5 years after release despite a favorable risk assessment as the precondition for release and post-release risk management. On the other hand, there was virtually no relapse in the three lowest risk categories suggesting a specific effect of the mandatory treatment at least in these offender categories. The data suggest that the instruments are valid not only for offenders released from prison but also for forensic sexual offenders.

Ermittlung des relativen und absoluten Rückfallrisikos mithilfe des Static-99 in einer deutschsprachigen Population entlassener Sexualstraftäter

ZusammenfassungAn 1142 aus der Strafhaft entlassenen Sexualstraftätern aus dem österreichischen Strafvollzug wurde prospektiv das statistisch-aktuarische Prognoseinstrument Static-99 angewandt. Neben den üblichen Validitätsindizes, die für die Vorhersage des sexuell motivierten Rückfalls je nach Tätergruppe beim Wert der „area under the curve“ (AUC) zwischen 0,69 und 0,77 lagen, wurden absolute (beobachtete und mittels logistischer Regression errechnete) und relative Risikoparameter („hazard ratio“) ermittelt. Der Tätertypus erwies sich dabei als eine über die Vorhersagekraft des Static-99 hinaus relevante Variable, nicht allerdings – und das im Gegensatz zu jüngeren internationalen Daten – das Täteralter. Relative und absolute Risikomaße für die deutschsprachige Version des Static-99 werden angegeben; die Verwendung eigener Normwerte für die Gruppe der sexuellen Kindesmissbrauchstäter wird empfohlen.AbstractThe predictive accuracy of the German version of Static-99 was examined prospectively in a sample of 1,142 sexual offenders released from Austrian prisons. The Static-99 was found to have moderate to good validity for the prediction of sexual recidivism, depending on the offender subsample (area under the curve, AUCu2009=u20090.69u2009−u20090,77). The absolute and relative risk estimates for Static-99 were also calculated. Offender type but not age was found to incrementally add to the predictive accuracy of Static-99. Therefore, absolute recidivism rates are provided separately for the child molester subgroup. At this point in time it is recommended that Static-99 should be used rather than Static-99R for the German version of Static-99 when assessing the risk of imprisoned sexual offenders.

Predicting reoffense in pedophilic child molesters by clinical diagnoses and risk assessment.

A Diagnostic and Statistical Manual of Mental Disorders (DSM)-based diagnosis of pedophilia has so far failed to predict sexual reoffense in convicted child molesters, probably because of its broad and unspecific conceptualization. In this study, therefore, we investigated the prognostic value of the subtype exclusive pedophilia and a series of customary risk assessment instruments (SSPI, Static-99, Stable-2007, VRS:SO) and the PCL-R in a sample of prison released pedophilic sexual offenders. First, we examined the convergent validity of risk assessment instruments (N = 261). Then, we calculated the predictive accuracy of the measures and diagnosis for sexual recidivism by ROC analyses and subsequent Cox regression (N = 189). Also, predictive values with more clinical immediacy were calculated (sensitivity, specificity, PPV and NPV). The VRS:SO, the SSPI, and the Static-99 significantly predicted sexual recidivism, as did a diagnosis of exclusive pedophilia. Also, the VRS:SO predicted sexual reoffense significantly better than the Stable-2007, the Static-99/Stable-2007 combined score, and the PCL-R. When used combined, only the VRS:SO and a diagnosis of exclusive pedophilia added incremental validity to each other. Our findings support that the clinical diagnosis of an exclusive pedophilia based on DSM criteria and VRS:SO defined risk factors can reliably discriminate higher from lower risk offenders, even within the select subgroup of pedophilic child molesters.