S. Margretta Dwyer

Treatment outcome study: Seventeen years after sexual offender treatment

Long-term recidivism rates of 180 male sexual offender treatment completers and almost completers (persons who had been in treatment 2 years plus and had only a few goals to complete) were compared in this study. All men in this study were followed after treatment from 6 months to 17 years by interviews, anonymous questionnaires, and/or criminal record checks. The treatment center, located in Minneapolis, checked all criminal records in Minnesota and surrounding states or country: North Dakota, South Dakota, Wisconsin, Iowa, and Canada. Seventeen men had reoffended sexually and five others had reoffended criminally (theft, DWI, etc.) but not sexually. Only those finishing treatment or nearly finishing treatment were addressed in this study, recognizing that self-selection and program screening may have contributed to the statistical success of this outpatient program. The anonymous questionnaire addressed issues regarding the offenders original offenses and the success or nonsuccess of treatment techniques as judged by them. Data regarding problematic areas still existing in their lives were collected. Of these 180 treated men, 108 men also appeared, or telephoned in, for personal interviews (using a second structured questionnaire, as opposed to the anonymous one mailed to each patient). They were interviewed six times each during the 17 years. The personal interviews yielded other aspects of data used to cross-validate the questionnaires and the criminal record checks. Total sexual recidivism was 9.0%. Data thus indicate that treatment was successful for 91% of these men. The need for more sophisticated research about what constitutes successful treatment is addressed in the discussion.

Brain Abnormalities and Violent Behavior

Abstract Introduction: It is difficult to rationally discuss the question of whether violent behaviour is a disorder because violent actions engender very strong emotional reactions in the public. But there are good reasons to believe that a variety of social and biological factors predispose the individual toward criminal behaviour. This study concerns the question, whether there is an association between violent behaviour and brain abnormalities. Method: Ninety-six mentally ill offenders of a high security prison consecutively underwent magnetic resonance imaging of the brain (MRI). The number of sex offenders was 62.5%. Fourteen offenders were excluded because they had a neurological disease, a psychotic disorder, a severe organic mental disorder or they were older than 60 years. All scan reports were in narrative format, and they were reviewed and coded according to presence or absence of brain abnormality. Neuroradiologists were blind to clinical diagnoses and offence history. Offenders were distributed either to a “high violent group” or to a “no or low violent group.” There was no significant difference in age between both groups. Results: In the included sample (n = 82; 50 sex offenders) 48.8% had MRI abnormalities. In the high violent group 65.5% showed MRI abnormalities. In the low violent group 16.6% had MRI abnormalities. This difference is significant (p = 0.001). The high violent sex offender group showed a MRI abnormality rate of 59.4%, and the low violent sex offender group 22.2%. The difference is significant (p = 0.011). There is no significant difference in MRI abnormality rate between the sex offender and the “non sex offender.” Conclusions: The results indicate that there is an association between unspecified brain anomalies and high violent behaviour in the whole sample as well as in the sex offender group. There is no association between sexual offence and unspecified brain abnormalities. Modern brain imaging techniques such as magnetic resonance imaging should be included in the diagnostic procedure of mentally ill offenders.

The Psychosocial Development of Sex Offenders: Differences between Exhibitionists, Child Molesters, and Incest Offenders

A number of studies have shown that there are differences between how offenders who have committed different crimes perform in therapy. This article aims to shed some light on these differences by exploring differences in the psychosocial development of exhibitionists extra-familial child molesters, and incest offenders. Eighty-one men completed the Measures of Psychosocial Development at intake into an outpatient sex offender treatment program. Profile analysis indicated that exhibitionists tended to have issues of trust, shame, and immediate gratification, which were similar to those experienced by extra-familial child molesters. Incest offenders showed consistently higher levels of development than the other two groups. These findings have implications for the ability of offenders to develop therapeutic alliances, the intervention strategies that would be effective, and the ultimate effects of those interventions.

Sex Offender Treatment: A Six-Month To Ten-Year Follow-Up Study

In an attempt to assess the effectiveness of a community-based sex offender treatment program, questionnaires were sent to 153 former male patients. It was expected that only the 110 patients who had completed or almost completed treatment would return questionnaires. A total of 61 patients returned the form. Program components utilized during treatment were analyzed and data on current offending urges were obtained. The patterns and characteristics patients had before and after treatment were analyzed for behavioral changes as well as recidivism. Recidivism data were self-report as well as computer checked in cooperation with the state law enforcement agency. Retrospective review shows clinical improvement by most patients in all areas of treatment. Recidivism rate for the entire population (n=153) was 3.7%. This preliminary study indicates that a significant number of treatment modalities are effective for outpatient sex offenders.

Treatment Outcome Research Cross-Referencing a Six-Month To Ten-Year Follow-Up Study On Sex Offenders

Assessing the long-term behavioral effects of sex offender treatment was undertaken by interviewing a total of 70 sex offenders. A structured interview process was used, along with pre- and post-testing for 5 time periods. Participants were asked to indicate their ability and confidence on 10 variables regarding risks of offending at 6 months, 1, 2, 3, and 4 years post-treatment. Trends indicate overall improvement and increased ability to maintain a new life-style free from offending behavior. These self-report data corresponded with results on the Tennessee Self Concept Scale, the BEM Sex Role Inventory and the Derogatis Sexual Functioning Inventory. Four years after treatment, participants reported total confidence for not reoffending. They stated that they felt they had control over their sexual misconduct even though their sexual urges still remained a problem. Most felt less need to use their maintenance plan, although they used it when needed.

Predicting Reoffense for Community-Based Sexual Offenders: An Analysis of 30 Years of Data

This study contributes to the area of risk prediction by exploring whether the Static-99R is useful for predicting reoffense in community-based samples, and for noncontact offenders with and without identified victims. A total of 744 participants drawn from an outpatient sex offender treatment program in a large metropolitan area were followed for a period of up to 30 years. Multiple Cox Regressions were run; covariates included length of treatment, status in treatment, Static-99R items, and number of technical probation violations. Overall, reoffending was an infrequent occurrence in this sample regardless of how it was defined, with sexual reoffenses identified in 13% of the sample and any criminal reoffense identified in 20% of the sample. Consistent with previous research, the Static-99R was a better predictor of sex-related reoffenses than of nonsexual reoffenses. However, in no case were more than a couple of the items significantly related to reoffending and these items differed depending on reoffense definition.