Risk Assessment in the 21 st Century: Towards an Integrative Model of Risk in Sexual Offending

1. Risk Assessment in the 21st Century: Towards an Integrative Model of Risk in Sexual Offending Anthony Beech, University of Birmingham Email: a.r.beech@bham.ac.uk

2. Key Publications • Beech, A.R. & Ward, T. (2004). The integration of etiology and risk in sex offenders: A theoretical model. Aggression and Violent Behavior, 10, 31-63. • Ward, T., & Beech, T. (2006). An integrated theory of sexual offending. Aggression and Violent Behavior, 11, 44-63. • Ward, T., & Beech, A.R. (in preparation). An Integrated Theory of Sexual Offending. Chichester: Wiley.

3. Risk Prediction • Hart, Laws and Kropp (2003) note that ‘risk is a hazard that is incompletely understood and whose occurrence can be forecast only with uncertainty’ • But although Monahan (1981) flagged up the importance of investigating contextual, proximal and temporal dynamic as antecedents, or operating as protective factors against crime, ‘this area of research has proven difficult to develop and remains largely unexplored’ (Eccleston, Brown & Ward, 2002, p. 81). RMA talk

4. Some definitions • Most (actuarial) risk prediction instruments designed for sexual offenders rely almost exclusively on static factors (those factors that cannot change), such as previous offence history, lack of long term relationships and general criminality • Some prediction instruments for general offending have introduced a dynamic/ changeable component of risk (Bonta, 1996), which has now starting to be incorporated in sex offending risk assessment RMA talk

5. Some definitions 2 • Dynamic factors have been split into two categories by Hanson and Harris (2001) in the sex offender field • Stable dynamic factors are defined as those factors which are stable over time, but which are potentially amenable to change in therapy • Acute dynamic factors are those factors which change and fluctuate, such as mood state and substance abuse and which can signal the onset of offending, and hence are those factors that may signal that an individual is highly likely to commit an offence in the near future. RMA talk

6. THE DEVELOPMENT OF AN AETIOLOGICAL MODEL OF RISK Specifically we (Tony Ward and myself) have attempted to link what is currently known about risk in terms of • Developmental adversity • Static risk factors • stable dynamic • acute dynamic risk factors • In to an aetiological model of risk informed by theoretical ideas RMA talk

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9. Key assumptions • Static (historical) risk factors act as markers for vulnerability • Stable dynamic risk factors actually denote psychological vulnerabilities (Mrazek & Haggerty, 1994) • Stable dynamic risk factors are really the surface representation of underlying traits indicative of deeper causal properties of a person’s neuropsychological functioning • Acute dynamic risk factors would be better viewed as triggering events/ contextual risk factors) • Triggering events push stable dynamic (trait) factors into states of acute dynamic risk RMA talk

10. DEVELOPMENTAL VARIABLES AND RISK • Developmental variables: • Attachment problems  • Abuse history • Rejection RISK? • Attachment problems may lead to difficulties in appropriate relationships with adults • Individuals with a preoccupied attachment style may seek approval from others and sexualise attachment relationships and may therefore lead to engagement in sexual activity with children • Individuals with a fearful/ disorganised style may seek intimacy through impersonal sexual encounters • Individuals with a dismissing style will be more likely to demonstrate hostility to others, making them more likely to rape RMA talk

11. DEVELOPMENTAL VARIABLES AND RISK • Developmental variables: • Attachment problems • Abuse history  • Rejection RISK? • The long-term effects of sexual abuse can be • disturbed adult sexual functioning • poor social adjustment • confusion over sexual identity • inappropriate attempts to reassert masculinity and recapitulation of the abuse experience • psychological disorder • marked risk for the development of alcohol and drug misuse RMA talk

12. DEVELOPMENTAL VARIABLES AND RISK • Developmental variables: • Attachment problems • Abuse history • Rejection  RISK? • Erratic and rejecting parenting behaviours, which alienate the children from the possibility of forming secure attachment bonds, distinguish the family context in which sexual offenders grow up (Marshall, 1989) • Family backgrounds of sexual offenders are typified by neglect, violence and disruption • An affectionless control style of parenting is reported to be highly prevalent among the sex offenders • Evidence that low parental care is associated with childhood abuse and childhood disturbance in child abusers RMA talk

13. VULNERABILITY FACTORS Historical markers: Static factors Historical markers Psychological dispositions · Psychological dispositions: Dynamic factors • Developmental variables: • Attachment • problems • Abuse • Rejection RISK? • Here we note the usefulness of Mrazek & Haggety’s (1994) proposal that some risk factors • Act as marker variables simply identifying the potential risk for a disorder • While others play a causal psychological role RMA talk

14. PSYCHOLOGICAL DISPOSITIONS Historical markers: Static factors Historical markers Psychological dispositions · Psychological dispositions: Dynamic risk domains • Developmental variables: • Attachment • problems • Abuse • Rejection RISK? • The psychological dispositions from the risk literature (Hanson & Harris, 2001; Thornton, 2002) measure • sexual interests/ sexual self-regulation • attitudes supportive of sexual assault • interpersonal functioning • Impulsive/ emotional lability problems RMA talk

15. Historical/Static Factors that Act as Marker Variables of Psychological Problems RMA talk

16. KEY CONVERGENCE OF RISK AND THEORY THAT STARTS TO SPEAK TO WHAT DYNAMIC RISK DOMAINS ARE Dynamic Risk Domains (Thornton 2000) • [Deviant] sexual interest • Pro-offending attitudes • Socio-affective functioning • Self-management problems Ward and Beech’s (2006) Integrated Theory of sexual abuse UNDERPINNING NEUROPSYCH SYSTEMS • Emerge from problems other systems • Perception and memory system • Emotion and Motivation system • Action selection and control system RMA talk

17. Motivation/Emotional System • Associated with orbitofrontal, some limbic (amygdala), and brainstem (locus ceruleus, ventral tegmental areas, substantial nigra, raphe nuclues) brain structures • Allow goals and values to influence both perception and action selection rapidly and to adjust motivational [and emotional] states to fit changing environmental circumstances (Pennington, 2002) • Problems in an individual’s genetic inheritance, or negative individual experiences, may lead to defects in the motivational/emotional system

18. The Limbic system and the amygdalanote connections to basal ganglia and thalamus (action selection control) and hippocampus (perception and memory systems)

19. Motivation/Emotional System Problems • Problems that might arise from malfunctions in the motivation/emotional system would include feelings of: • Inadequacy • Loneliness • Lack of empathy • Hostility • Maps broadly onto the kinds of problems that have been described as stable dynamic risk factors • Thornton (2002) Domain 3 - social and emotional functioning • Intimacy deficits - Hanson & Harris’ STABLE 2000

20. Action Selection and Control System • Associated with the frontal cortex, the basal ganglia, and parts of the thalamus • Major functions of this system is to; • Help to plan, implement, and evaluate action plans • and to control behaviour, thoughts, and emotions in service of higher-level goals • Essential for evaluation of goals (and associated primary goods or values)

21. Basal ganglia and the thalamus

22. Action Selection and Control System Problems • Problems that might arise from malfunctions in action control and selection system essentially span self-regulation problems such as • Impulsivity • failure to inhibit negative emotions • inability to adjust plans to changing circumstances and poor problem solving skills. • Maps broadly onto the kinds of problems that have been described as stable dynamic risk factors • Self-management problems (Domain 4) (Thornton, 2002) • Sexual self-regulation and general self-regulation - STABLE 2000

23. Perception and memory system • Associated primarily with the hippocampal formation and the posterior neocortex. • Major functions of this system is to process incoming sensory information and to construct representations of objects and events, and make them available to the motivational/emotional and the action selection and control systems

24. The hippocampus

25. Perception and memory system problems • Problems in perceptual and memory system can lead to maladaptive beliefs, attitudes, and dysfunctional interpretations of interpersonal encounters, i.e., involve information processing and its internal and external management. • Can be seen to contain representations or knowledge of world, others and self. • These problems can be seen as stable dynamic risk factors • Attitudes supportive of sexual assault (STABLE 2000) • Distorted attitudes (Thornton, 2002) (cognitive distortions)

26. Interaction between neuropsychological systems • Cognitive model of emotional processing (Beck, 1996) - maladaptive beliefs that are chronically activated (i.e., frequently available to guide information processing) are also likely cause activation of the motivational/emotional system leading to problematic goals and emotions • Interactions between all three systems thoughts, feelings, lack of impulse control/ emotional dysregulation leads to deviant sexual arousal • Core idea is that offending (like all action) requires integrated functioning of the three systems: essentially generates goals/desires (values), beliefs/knowledge, and planned behaviour

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31. IMPLICATIONS OF THE MODEL 1 • Reformulation of stable dynamic/ acute dynamic risk factors • contribution of the model is the redefinition of stable and acute dynamic risk factors • We suggest that the usual definitions do not make psychological sense and argue for their replacement by the trait/ stable dynamic (i.e., dispositional), state/acute dynamic, and contextual risk factors distinctions • With this reformulation the process by which psychological dispositions become acute risk factors when triggered by contextual risk events is rather straightforward RMA talk

32. IMPLICATIONS OF THE MODEL 2 • Integration of static and dynamic risk factors • In the model historical factors are hypothesised to function as historical markers of underlying vulnerabilities, while stable dynamic risk factors are psychological markers for the same dispositions (i.e., stable dynamic factors) • This aspect of our approach suggests that future of risk assessment should more clearly integrate these two methods of risk assessment • That is, recognise that they represent two ways of measuring the same dispositions RMA talk

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