Ian Stringer

Sexual recidivism: A review of static, dynamic and actuarial predictors

The need for accurate risk assessment of sexual offence recidivism has never been greater. It is widely accepted that actuarial risk instruments outperform clinical judgement and the literature has recently witnessed a surge of empirically derived actuarial measures. However, in spite of the increased levels of predictive accuracy, actuarial measures have been criticized as being unrepresentative, lacking specificity, and being heavily reliant on static risk factors without taking into account dynamic risk, psychological emotional states and treatment effects. Rather than offering a critique of the actuarial movement, this paper offers a summary of static and dynamic risk factors associated with sexual offence recidivism as identified from the literature. Implications of incorporating dynamic factors into risk assessments and actuarial measures are discussed.

Treatment And Sexual Offence Recidivism

Cognitive-behavioral treatment has emerged as the principle type of sex offender treatment targeting deviant arousal, increasing appropriate sexual desires, modifying distorted thinking, and improving interpersonal coping skills. However, treatment effectiveness in reducing sexual offence recidivism continues to be questioned. This is despite the fact that since 1995, five meta-analytical studies have claimed positive treatment effects in reducing sexual offence recidivism. However, many treatment studies have been criticized for weaknesses in their methodologies. In addition, methodological differences between studies make it difficult to determine treatment efficacy. This review found that since 1995, 19 treatment studies have been published, and a third of the 18 studies demonstrating positive treatment effects used sound methodological techniques. Additional treatment studies are needed that utilize sound methodological principles to establish the most effective way of reducing sexual reoffending.

Risk Scales And Factors Predictive Of Sexual Offence Recidivism

Accurate assessments of levels of risk posed by sexual offenders are in high demand as decisions concerning whether an offender should be released into the community can have severe consequences both for the offender and the public. This article reviews factors predictive of sexual offence recidivism and the 12 most widely used actuarial risk assessment instruments for sexual offenders. It was found that 10 out of the 12 actuarial and clinical measures available are better at distinguishing general recidivism than sexual offence reoffending. Ten assessments predominately use static risk factors, and 7 do not consider treatment effects. Hence, the validity of these instruments for use with sex offenders is in question. It is argued that the use of both static factors and variations of dynamic risk factors, using the actuarial approach, will predict those offenders who will reoffend and distinguish them from those who are not likely to reoffend. Evidence-based dynamic risk factors that are sensitive to sexual reoffending are identified.

Treating Sexual Offenders With Learning Disabilities in the Community A Critical Review

This study offers a critical review of a treatment group for sexual offenders with learning disabilities. The participants were diverted from criminal proceedings due to their level of cognitive functioning and attended a 7-month treatment program comprising of four main components: sex education, cognitive distortions, offending cycle, and relapse prevention. A number of psychometric assessments were administered immediately before and after intervention. Although no significant differences were found in attitudes toward sexual offending following treatment, the trend was for improvements in sex knowledge and honesty of sexual interest. Improvements in socialization skills (leisure time and interpersonal skills) were significant. No further incidents of sexual offending have been reported during a 12-month follow-up. A number of explanations for the nonsignificant improvement in attitudes are considered and recommendations for future treatment evaluation studies are made. The development of specific questionnaires and treatment programs for sexual offenders with learning disabilities is discussed.

Limitations in actuarial risk assessment of sexual offenders: a methodological note

The assessment of risk of recidivism in sexual offenders is fundamental to clinical practice. It is widely accepted that, compared with actuarial measures of risk, unaided clinical judgment has generally been found to be of low reliability. Consequently, the literature has shown a surge in actuarial measures. However, a major difficulty in assessing risk in sex offenders is the low base rate, leading to an increased likelihood of making a false positive predictive error. To overcome this, risk assessment studies are increasingly using the receiver operating characteristic (ROC), which displays the relationship between level of risk and decision choice. This note summarises the methodological issues in measuring predictive accuracy in assessing risk of re‐offending in sexual offenders, and identifies from the literature both static and dynamic risk factors associated with sexual offence recidivism.

Psychosexual characteristics of sexual offenders and the relationship to sexual reconviction.

Abstract The purpose of this study was to determine if the Multiphasic Sex Inventory (MSI) could be used to predict sexual reconviction. The MSI was administered to 119 convicted male sex offenders. Reconviction data were analysed using the receiver operating characteristic (ROC) over 2-, 5- and 10-year follow-up periods. The MSI scales Sexual Obsession and Paraphilia (Atypical Sexual Outlet) obtained good accuracy in predicting sexual reconviction over 2- and 5-year follow-up periods. A confirmatory factor analysis of the MSI scales yielded a four-factor solution: Sexual Deviance, Sexual Desirability, Dysfunctional/Justification, and Normal. The Sexual Deviance factor demonstrated good accuracy in predicting sexual reconviction at 2-year follow-up while the Normal factor was a poor predictor of sexual reconviction. Compared against an actuarial risk assessment measure for sexual offenders, the Sexual Obsession, Sexual/Social Desirability, and Sexual Dysfunction scales, and Sexual Deviance factor made a statistically significant contribution independent of the risk scale in predicting sexual reconviction. It is argued that rather than using the MSI solely as an assessment measure of psychosexual characteristics of sexual offenders in treatment programmes, it can be used to provide additional information as part of an assessment of risk of sexual reconviction.

Personality characteristics associated with reconviction in sexual and violent offenders

The purpose of this study was to examine personality characteristics associated with reconviction and to explore the accuracy of the Special Hospitals Assessment of Personality and Socialization (SHAPS) in predicting reconviction. The SHAPS was administered to a group of sexual and violent offenders (n = 121) who were followed up over 2, 5 and 10 year periods. Reconviction data were analysed using the Receiver Operating Characteristic (ROC). Of the 10 SHAPS scales, the Impulsivity scale produced the most promising results and consistently obtained the highest accuracy in predicting violent and general reconviction. The predictive accuracy of the SHAPS scales was compared against three actuarial risk measures, Static-99, Risk Matrix-2000 Sexual and Violent scales. The strength of correlations and accuracy of the SHAPS Impulsivity scale in predicting violent and general reconviction is comparable to that of the Risk Matrix 2000/Violent actuarial risk measure. However, the SHAPS scales added little to the actuarial measures in a regression equation. The actuarial scales were better at predicting sexual reconviction compared with the SHAPS scales. The implications of assessment and treatment using the SHAPS are discussed.

Treating sexual offenders with intellectual limitations in the community

Purpose – This study summarises the results of a cognitive‐behavioural treatment group for sexual offenders (n=14) with intellectual limitations in the community.Design/methodology/approach – All participants were convicted sex offenders serving probation orders or prison licences who attended a 14‐month treatment programme designed for sex offenders with intellectual limitations. The programme comprised of five main components: sex education; cognitive distortions; offending cycle; victim empathy; and relapse prevention. All participants completed psychometric measures specifically designed for people with intellectual limitations before and immediately after completing the treatment programme. The four core measures include: Victim Empathy; Sexual Attitudes and Knowledge Assessment (SAK); Questionnaire on Attitudes Consistent with Sexual Offenders (QACSO); and Sex Offences Self‐Appraisal Scale (SOSAS).Findings – Post assessment results reveal significant improvements in sexual offence related attitudes;...

Differentiating between pathological demand avoidance and antisocial personality disorder: a case study

Purpose The purpose of this paper is to explore the different clinical features of pathological demand avoidance (PDA) and antisocial personality disorder (ASPD) presented in the form of a single case study. The study highlights the potential of misdiagnosis and conceptual confusions to practitioners in forensic settings between the two conditions when working with offenders with personality disorders. Design/methodology/approach A case formulation using the “five Ps” method based on the personal history of an incarcerated male is presented and the clinical similarities and differences between PDA and ASPD are delineated. These differences and similarities are evaluated and applied to offender management including intervention options. Findings There are considerable similarities between ASPD and PDA making the two conditions difficult to separate. Both diagnostic criteria identify childhood behavioural problems, aggression, destructiveness, conduct disorder (CD), manipulation and non-compliance as indications of the disorder. For example, the criteria for later adult ASPD are the presence of childhood antisocial behaviour and CD. However, these behaviours may also be suggestive of the attention deficit hyperactivity disorder and non-compliance that are part of PDA. Violent behaviours and aggression can also be perceived in a similar way. Misdiagnosis of PDA as ASPD reduces the efficiency of treatment programmes. Originality/value The implications of these findings could prove useful in the successful risk management of offenders with PDA. Given the similar behavioural characteristics between PDA and ASPD, the prevalence of PDA among offenders may be higher than observed. The aim of this study is to raise awareness of potential conceptual complications and clinical confusions between the two conditions with a view to aid offender management through case formulation. A large scale study into offenders with PDA would draw attention to the prevalence of the condition as well as its association with offending behaviour.