Martin Rettenberger

Prospective Actuarial Risk Assessment: A Comparison of Five Risk Assessment Instruments in Different Sexual Offender Subtypes

This study examines the predictive validity of the most commonly used risk assessment instruments for sexual offenders: Static-99, Rapid Risk Assessment for Sexual Offense Recidivism, Sex Offender Risk Appraisal Guide, Sexual Violence Risk—20, and Psychopathy Checklist—Revised in a prospective research design. Although risk assessment is part of a regime leading to various efforts to reduce risk by treatment and aftercare, all instruments show good predictive validity. However, depending on the instrument, recidivism category, and subgroup, the predictive accuracy varies markedly. Furthermore, the authors fail to demonstrate predictive validity for sexual violent reoffences—for the whole sample and for all subgroups. The results, nevertheless, support the utility and predictive validity of actuarial risk assessment complementary to treatment efforts to reduce risk. On the other hand, forensic practitioners have to be aware of the limitations of actuarial risk assessment methods, in particular as regards to variable predictive accuracy for different sexual offender subgroups and reoffence categories.

International Perspectives on the Practical Application of Violence Risk Assessment: A Global Survey of 44 Countries

Mental health professionals are routinely called upon to assess the risk of violence presented by their patients. Prior surveys of risk assessment methods have been largely circumscribed to individual countries and have not compared the practices of different professional disciplines. Therefore, a Web-based survey was developed to examine methods of violence risk assessment across six continents, and to compare the perceived utility of these methods by psychologists, psychiatrists, and nurses. The survey was translated into nine languages and distributed to members of 59 national and international organizations. Surveys were completed by 2135 respondents from 44 countries. Respondents in all six continents reported using instruments to assess, manage, and monitor violence risk, with over half of risk assessments in the past 12 months conducted using such an instrument. Respondents in Asia and South America reported conducting fewer structured assessments, and psychologists reported using instruments more than psychiatrists or nurses. Feedback regarding outcomes was not common: respondents who conducted structured risk assessments reported receiving feedback on accuracy in under 40% of cases, and those who used instruments to develop management plans reported feedback on whether plans were implemented in under 50% of cases. When information on the latter was obtained, risk management plans were not implemented in over a third of cases. Results suggest that violence risk assessment is a global phenomenon, as is the use of instruments to assist in this task. Improved feedback following risk assessments and the development of risk management plans could improve the efficacy of health services.

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.

Self‐Reported Indicators of Hypersexuality and Its Correlates in a Female Online Sample

INTRODUCTION Hypersexual behavior has been a controversial and much disputed issue in the field of sexual medicine. However, only little attention has been paid to hypersexual behavior in women. Therefore, to date there is limited knowledge on the behavioral patterns of hypersexuality in women. AIMS The purpose of the present study was to examine which sexual behavioral patterns are associated with self-reported indicators of hypersexuality in a female online sample. The second aim was to evaluate the association between hypersexuality and sexual risk behavior in women. METHODS In total, 988 women participated in an online survey. Logistic regression analysis was conducted to examine the association between sexual behavioral patterns and hypersexuality. Furthermore, correlation analyses were calculated in order to identify the relationship between sexual risk behavior and hypersexuality. MAIN OUTCOME MEASURES Indicators of hypersexual behavior were measured by the Hypersexual Behavior Inventory (HBI). In addition, current and present impersonal sexual activities were investigated. Sexual risk behavior was assessed using the Sexual Sensation Seeking Scale (SSSS). RESULTS High masturbation frequency, number of sexual partners, and pornography use were associated with a higher degree of hypersexual behavior in women. Furthermore, the HBI total score was positively correlated to sexual risk behavior. CONCLUSION The results of the current study do not support the idea of previous research that hypersexual women are typically engaged in more passive forms of sexual behavior. Rather female hypersexuality seems to be more characterized by impersonal sexual activity. An association between hypersexual behavior and sexual risk behavior was identified. The implications of these findings for potential prevention strategies and therapeutic interventions are discussed.

The Predictive Accuracy of Risk Factors in the Sexual Violence Risk-20 (Svr-20)

The Sexual Violence Risk–20 (SVR-20) is the most commonly used structured professional judgment guideline for sexual offender risk assessment and risk management planning. Using a prospective longitudinal research design the authors evaluated the predictive accuracy of the SVR-20, of its subscales, and of the individual items in relation to different recidivism criteria and offender subgroups by analyzing a total sample of 493 sexual offenders released from the Austrian Prison System. Findings indicate good predictive accuracy for the prediction of sexual recidivism for the total sample (area under the receiver operating characteristic curve [AUC] = .72) as well as for the rapist subgroup (n = 221, AUC = .71) and the child molester subsample (n = 249, AUC = .77). However, the results also revealed some inconsistency in the predictive power of the SVR-20 depending on recidivism criterion and offender subgroup. Furthermore, it can be pointed out that the subscales and individual items substantially differ in their association with future sexual and nonsexual violence.

The Utility of Risk Assessment Instruments for the Prediction of Recidivism in Sexual Homicide Perpetrators

To examine the predictive accuracy of four well established risk assessment instruments (PCL-R, HCR-20, SVR-20, and Static-99) in an important subgroup of sexual offenders, these instruments were assessed retrospectively based on information from forensic psychiatric court reports in a sample of 90 released male sexual homicide offenders (out of an original sample of 166) in Germany. Follow-up information about criminal reconvictions after release were obtained from the federal criminal records. Total scores as well as subscales and single items of these risk assessment instruments did not predict sexual recidivism, and only some of them had moderate predictive power regarding nonsexual violent recidivism. Possible explanations for these unexpected results are the retrospective study design with missing information about influences during the long duration of detention and time after release, the small sample size as well as the possibility that the risk assessment instruments investigated were valid for general sex offender samples, but not for the particular subgroup of offenders with sexually motivated homicides.

The Contribution of Age to the Static-99 Risk Assessment in a Population-Based Prison Sample of Sexual Offenders

The Static-99 is the actuarial risk assessment instrument most commonly used and best validated for sexual offenders. Some research has indicated that the original version of the instrument does not sufficiently cover the influence of age-related decreases in recidivism risk of sexual offenders. Therefore, an age-corrected version, the Static-99R, has been proposed. It includes four age categories compared with only two in the original instrument. The purpose of this study was to examine the influence of several age-related variables on the predictive accuracy of the German version of the Static-99 using a population-based sample of prison-released sexual offenders (N = 1,077). The results indicated that—for the prediction of sexual reoffenses in a population-based prison sample—the original Static-99 performed better than the age-corrected Static-99R. Theoretical and empirical implications for research as well as recommendations for applied risk assessment settings are discussed.

Actuarial risk assessment in sexually motivated intimate-partner violence.

The present study is the first independent cross-validation of the Ontario Domestic Assault Risk Assessment (ODARA) and the Domestic Violence Risk Appraisal Guide (DVRAG) using an incarcerated high-risk sample (N = 66) of offenders released from the Austrian Prison System who have committed at least one sexually motivated offense against their actual or former intimate partners. The mean follow-up period was approximately 55 months. Both instruments showed evidence for their reliability and predictive accuracy, supporting the cross-cultural transferability of these risk assessment instruments. For the prediction of domestic violence recidivism, ODARA and DVRAG yield good predictive accuracy (area under the receiver operating characteristic curve, AUC = .71), and for general criminal and general violent recidivism, both instruments exhibit moderate effect sizes (AUC = .66-.71). Also, the results provide evidence for the discriminant validity of the ODARA. When examining the association between individual ODARA items and recidivism, only a few items were found to be related to domestic violence recidivism. The integration of the Psychopathy Checklist-Revised (PCL-R) does not add any incremental predictive accuracy to the ODARA, suggesting that ODARA items capture antisocial and psychopathic traits sufficiently even in incarcerated high-risk offenders.

Eine Validierungsstudie der deutschen Version des Hypersexual Behavior Inventory (HBI)

Hypersexuality is characterized by recurrent and intense sexual fantasies, sexual urges, or sexual behaviors resulting in clinically significant personal distress or impairment in social, occupa-tional, or other important areas of functioning. The Hypersexual Behavior Inventory (HBI, Reid et al., 2011) is a 3-factor measure (coping, control and consequences) developed to assess hypersexual behaviour. The aim of the present study was to investigate the psychometric properties of the German version of the HBI. In a sample consisting of 1 749 men and women the questionnaire was used as part of an online survey. The questionnaire showed good reliability and validity. A confirmatory factor analysis supported the 3-factor structure of the original English version. The results and potential benefit of the HBI in research and clinical practice are discussed.

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, AUC = 0.69 − 0,77). 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.