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Who are Child Molesters?. Males vs. FemalesWorking DefinitionsChild MolestersHeterosexualHomosexualBisexualIncestPedophilia ?Mixed" Offenders Effects of child molestation. Scientific Study (of Anything). Formal Measurement Systematic, Controlled Falsifiable hypothesis testing for... Ex
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1. Pedophilia: Research on Men Who Have Sex with Children workshop for psychiatric residents
Dr. Grant Harris
August, 2004
(www.mhcp-research.com)
2. Who are Child Molesters? Males vs. Females
Working Definitions
Child Molesters
Heterosexual
Homosexual
Bisexual
Incest
Pedophilia
�Mixed� Offenders
Effects of child molestation
3. Scientific Study (of Anything) Formal Measurement
Systematic, Controlled
Falsifiable hypothesis testing for...
Explanation
Prediction
Consilience
Objective?
4. Who are Child Molesters? History and Geography
Perpetration vs. Victimization
Incidence and Prevalence
Offense Topographies
Offender Typologies
�Mixed� Offenders
5. Clinical Characteristics of Child Molesters Personality
Mental Disorder
Substance Abuse
Emotionality
Sexuality
6. Measurement of Sexual Preference Instrumentation
Child Molester Studies
Admitters vs. Not
Validity and Reliability
Faking
Limitations
7. Measuring Men�s Sexual Interests:
11. Phallometry and Pedophilia Procedures
Scoring and Interpretation
Stimuli
Faking
Diagnostics
Ethics
New Methods
12. Research on the Prediction of Recidivism among Sex Offenders
13. Prediction of Violence Before Mid-80�s Examples
Baxstrom (Steadman, 1973)
Quinsey & Ambtman, 1979
Pasewark, Bieber, Bosten, Kiser, & Steadman, 1982
Monahan (1981)
14. Predictors of Violence in Offenders Big: Psychopathy, Juvenile delinquency, Childhood aggression, Employment problems, Didn�t live with natural parents
Medium: Youthfulness, Criminal history, Adult violence, Antisocial personality, Prior psych admissions, Never married, Alcohol
Small: Clinical opinion, IQ
Not: Psychological distress, Remorse, Violent offense, Mood disorder, NGRI/NCR
Inverse: Low self esteem; Psychosis
15. Prediction Among Child Molesters Child molester recidivism (Quinsey, 1986)
3 consistent predictors of sexual recidivism
Number of previous sexual offenses
Male victims
Unrelated victims
Frisbie & Dondis (1965)
1509 child molesters �sexual psychopaths�
3 above, + younger, more psychopathic
16. Sex Offender Recidivism Hanson & Bussiere (1996) Meta- Analysis of Predictors of Sexual Recidivism
Strongest predictors had to do with sexual deviancy
preference for children measured phallometrically
Sexual criminal history
Prior sexual offenses
early onset of sexual offending
Male victim
Stranger victim
Extrafamilial victim
17. Hanson & Bussiere Meta-Analysis (cont) Predictors (cont)
Demographic
Age (-ve)
Never married
Criminal lifestyle
Total prior offenses
Antisocial personality disorder
Clinical Presentation
Failure to complete treatment
18. Hanson & Bussiere Meta-Analysis (cont) Surprising nonpredictors
Being sexually abused as a child
Length of treatment
Treatment motivation
Denial of offense
Depression
Social skills
19. Characteristics of Psychopaths Glibness/Superficial charm
Grandiose sense of self-worth
Pathological lying
Conning/manipulative
Lack of remorse or guilt
Shallow affect
Callous/Lack of empathy
Failure to accept responsibility
Criminal versatility
Promiscuous sexual behaviour
Many short-term marital relationships
20. Characteristics of psychopaths Need for stimulation
Parasitic lifestyle
Poor behavioural controls
Early behaviour problems
Lack of realistic longterm goals
Impulsivity
Irresponsibility
Juvenile delinquency
Revocation of conditional release
21. Combining Predictors Clinical vs. Actuarial Prediction
Grove & Meehl 1996 �We know of no social science controversy for which the empirical studies are so numerous, varied, and consistent as this one.� (p.318)
Mossman 1994
22. Development of the VRAG 618 �mentally disordered offenders�
Predictor Variables
Demographic
Criminal
Psychiatric
Childhood
23. Development of the VRAG
7 years average time at risk
31% committed a new violent offense
Definition of violent offense
24. Development of the VRAG
Analyses
Multiple regression
Divided sample into halves
Univariate analyses
Nuffield weighting system
25. Violence Risk Appraisal Guide Psychopathy Checklist Score
Elementary school maladjustment
Age at index offense*
DSM III personality disorder
Separation from parents before age 16
Failure on prior conditional release
History of nonviolent offenses
26. Violence Risk Appraisal Guide Never married
DSM III schizophrenia*
Victim injury in index offense*
History of alcohol abuse
Male victim in index offense
29. How good is the instrument? What if we change the followup period?
3.5 years Baserate = 15%
7 years Baserate = 31%
10 years Baserate = 43%
30. How good is the instrument? What if we count only more serious or more frequent violent offenses?
Count only things more serious than one assault or one armed robbery (>50 on our offense severity scale)
29% serious violent recidivism
Equal accuracy in all cases
31.
32. Replications (n=35)
33. Prediction of Violence Among Sex Offenders Do we need a special instrument?
Higher rates of recidivism among sex offenders
What do we want to predict?
34. The Sex Offender Risk Appraisal Guide (SORAG) Psychopathy Checklist Score
Elementary school maladjustment
Age at index offense*
DSM III personality disorder
Separation from parents before age 16
Failure on prior conditional release
History of nonviolent offenses
35. The Sex Offender Risk Appraisal Guide (SORAG) Never married
DSM III schizophrenia*
History of alcohol abuse
History of violent offenses
History of sex offense convictions
Male or adult victim (ever)
Phallometric deviance
36. The VRAG for Sex Offenders Rice & Harris, 1997
159 new sex offenders
10 yr baserate= 58%
r=.44
Barbaree & Seto, 1998
Hanson & Harris, 1998
37. Any prediction of true �sexual predators�? Survival analyses
Sexual Recidivism
Psychopaths vs. not
Sexually deviant vs. not
Interaction- �True sexual predators�
(Rapists vs. child molesters)
39. Penetanguishene 1998 Study N= 417 sex offenders with an opportunity to reoffend
100 federal sex offenders from Kingston Pen
98 federal sex offenders from Abbotsford Regional Psychiatric Centre
219 sex offenders assessed in Oak Ridge
approx. 119 were inpatients
approx. 100 were outpatients
40. Summary Prediction Accuracy
Risk is long-term
Psychopathy and Sexual Deviance
Incest Offenders
Treatment
Evaluation
41. Implications for Criminal Justice Policy
Dangerous Offenders
Dangerous Mentally Disordered Offenders
Longterm Offenders
Sexual Predators
42. Illustrative VRAG ROC areas
43. The future of prediction efforts Improving performance of actuarial tools
Constant followup
No missing items
Reliably scored
Actual items vs. approximations
44. Optimizing ROC areas E.g. VRAG predicting violent recidivism:
Area
Mean followup, all subjects .73
No missing data (N= 46) .80
Exact 3 yr. followup + .84
no missing data
45. Using the SORAG and other actuarial methods The basis for decisions
The basis for policy
Procedural fairness
Therapeutic jurisprudence
Testifying in court and in other forums
The legal criteria for expertise
The adversarial process
46. The Psychosocial History Essential for assessment and planning
Multiple sources
Collateral sources
Biography not Autobiography
A standardized clinical task
47. Conclusions We can do a good job of predicting violence
Must use an actuarial approach to combine variables
Reliability
Predictive validity
Norms, percentiles, SEM
Probabilistic statement
Can improve public safety without detaining more patients
48. Research on Father-Daughter Child Molesters: Implications for Explanation and Assessment -What we�re talking about is a kind of incest that virtually no one would condone or joke about-What we�re talking about is a kind of incest that virtually no one would condone or joke about
49. What is incest? Legal definition: Criminal Code of Canada
Every one commits incest who, knowing that another person is by blood relationship his or her parent,child, brother, sister, grandparent or grandchild, as the case may be, has sexual intercourse with that person. (�brother� and �sister� include half-brother and half-sister)
Research/clinical definition:
No need for blood relationship
No need for sexual intercourse
Research mostly involves children < approx. 16 Universality of incest taboos
-Incest avoidance is a fundamental organizing principle of every human societyUniversality of incest taboos
-Incest avoidance is a fundamental organizing principle of every human society
50. Human Incest: Frequency (legal) Overall, how prevalent is incest? Depends how we define it, of course, and how we measure it. But it is thankfully relatively rare in the general population. Toronto 1994-1996 2736 sexual assault incident reports, only 65 instances of incest. Of course, no number except 0 is small enough.
--incest charges in 1961 in England and Wales-- Remember, we�re talking about the criminal definition of incest here!
--notice how few are mother-son and none are grandmother-son!Over a 10 yr. Period, there were in all 15 trials of females for incest as against 1372 males!Overall, how prevalent is incest? Depends how we define it, of course, and how we measure it. But it is thankfully relatively rare in the general population. Toronto 1994-1996 2736 sexual assault incident reports, only 65 instances of incest. Of course, no number except 0 is small enough.
--incest charges in 1961 in England and Wales-- Remember, we�re talking about the criminal definition of incest here!
--notice how few are mother-son and none are grandmother-son!Over a 10 yr. Period, there were in all 15 trials of females for incest as against 1372 males!
51. Incest avoidance among non-humans Animal studies
Many animals avoid incest by
juvenile dispersal
sex differences in the age of maturation
lack of sexual interest in individually recognized relatives
Mammalian Examples
Rhesus monkeys
Deer mice
Prairie dogs Juvenile dispersal = young all move away, or 1 sex moves
Most mammals have incest avoidance mechanisms
-Rhesus monkeys: When a male rhesus monkey matures, he will copulate with females of the same age as his mother, but not with his mother
-Deer mice: If individually caged at weaning and subsequently placed in opposite-sexed pairs at maturity, littermates are considerably more reluctant to mate than are strangers
-Prairie dogs: In nature, a yearling female prairie dog will come into estrus in the absence of her father but will delay first estrus if he is still around Juvenile dispersal = young all move away, or 1 sex moves
Most mammals have incest avoidance mechanisms
-Rhesus monkeys: When a male rhesus monkey matures, he will copulate with females of the same age as his mother, but not with his mother
-Deer mice: If individually caged at weaning and subsequently placed in opposite-sexed pairs at maturity, littermates are considerably more reluctant to mate than are strangers
-Prairie dogs: In nature, a yearling female prairie dog will come into estrus in the absence of her father but will delay first estrus if he is still around
52. The puzzle of father-daughter sexual assault
Deleterious effects of inbreeding
Especially among first and second degree relatives
Costs to females versus costs to males -Inbreeding depression: Abundant data from many animal species including humans demonstrate that matings of close relatives produces offspring of reduced fertility and viability...Everyone carries a few rare deleterious recessive genes that are not normally expressed, and some of these rare recessives, duplicated by immediate descent in close kin, become homozygous in the progeny of inbreeding�. There is also an increase in close kin in the variance of the genetic liability to multifactorial conditions, thus increasing the risk of common congenital malformations and of mental retardation ..Thus, there is a substantial selection pressure in natural populations to avoid inbreeding�Studies of parent-child and brother-sister incest among humans show that they are very much more likely than offspring of unrelated parents to suffer abnormality, mental retardation,and death. Offspring of 2nd degree relatives, much less but still lots higher than unrelated. By the time we get to 3rd degree (eg. 1st cousins), not much elevated over unrelated. So, is it just a coincidence then that marriage laws tend to draw the line at around 3rd degree relatives? True even in societies who don�t know what the data say..
-And the cost of incest to females is much higher than for males. Because males can mate an almost unlimited number of times, he can afford to engage in risky sexual behaviors- risky, that is, from the point of view of the likelihood of producing offspring who themselves survive to reproduce. He can afford to engage in incestuous matings-- if the offspring survive to reproduce, he has gained a lot. If not (or even if so) he can engage in other nonincestuous matings where the offspring have a greater chance of survival to reproduce -But for females, incestuous matings are very costly as she can only have a limited number of pregnancies and can only rear a very limited number of children. So, more reason for females to avoid incest than for males
-Inbreeding depression: Abundant data from many animal species including humans demonstrate that matings of close relatives produces offspring of reduced fertility and viability...Everyone carries a few rare deleterious recessive genes that are not normally expressed, and some of these rare recessives, duplicated by immediate descent in close kin, become homozygous in the progeny of inbreeding�. There is also an increase in close kin in the variance of the genetic liability to multifactorial conditions, thus increasing the risk of common congenital malformations and of mental retardation ..Thus, there is a substantial selection pressure in natural populations to avoid inbreeding�Studies of parent-child and brother-sister incest among humans show that they are very much more likely than offspring of unrelated parents to suffer abnormality, mental retardation,and death. Offspring of 2nd degree relatives, much less but still lots higher than unrelated. By the time we get to 3rd degree (eg. 1st cousins), not much elevated over unrelated. So, is it just a coincidence then that marriage laws tend to draw the line at around 3rd degree relatives? True even in societies who don�t know what the data say..
-And the cost of incest to females is much higher than for males. Because males can mate an almost unlimited number of times, he can afford to engage in risky sexual behaviors- risky, that is, from the point of view of the likelihood of producing offspring who themselves survive to reproduce. He can afford to engage in incestuous matings-- if the offspring survive to reproduce, he has gained a lot. If not (or even if so) he can engage in other nonincestuous matings where the offspring have a greater chance of survival to reproduce -But for females, incestuous matings are very costly as she can only have a limited number of pregnancies and can only rear a very limited number of children. So, more reason for females to avoid incest than for males
53. Rice & Harris (2002) 82 �incest� offenders:
52 molested their own biological daughters
30 molested stepdaughters or other non-genetically related �daughters�
37 of the above also had extrafamilial female victims
102 extrafamilial offenders vs. females
54. Characteristics of intra- and extra-familial child molesters
Offender sexually abused as a child 35%
Incest in offender�s family 17%
Had drug or alcohol problems 33% -Offender sexually abused as a child is measured by self-report after the offender is apprehended
-Mostly similar to findings in review paper by Williams & Finkelhor (1990) and their empirical study of 1995-Offender sexually abused as a child is measured by self-report after the offender is apprehended
-Mostly similar to findings in review paper by Williams & Finkelhor (1990) and their empirical study of 1995
55. Father-daughter and other child molesters - In general, incest offenders lower risk on everything than nonincest
- In general, genetic lower risk than other incest
-In general, genetic & step lower risk than mixed- In general, incest offenders lower risk on everything than nonincest
- In general, genetic lower risk than other incest
-In general, genetic & step lower risk than mixed
56. Father-daughter and other child molesters - In general, incest offenders lower risk on everything than nonincest
- In general, genetic lower risk than other incest
-In general, genetic & step lower risk than mixed- In general, incest offenders lower risk on everything than nonincest
- In general, genetic lower risk than other incest
-In general, genetic & step lower risk than mixed
57. % with deviant preferences 3 slides
1. Results did NOT support hypotheses- Biological fathers were least deviant
Not surprisingly, fathers who molested children inside and outside the home were the most deviant
Next slide
2. How did they compare to extrafamilial child molesters?
Next slide
3. How did they compare to controls?3 slides
1. Results did NOT support hypotheses- Biological fathers were least deviant
Not surprisingly, fathers who molested children inside and outside the home were the most deviant
Next slide
2. How did they compare to extrafamilial child molesters?
Next slide
3. How did they compare to controls?
58. Mean VRAG and SORAG scores and rates of violent recidivism
59. VRAG/SORAG predicting recidivism (ROC areas)
60. Incest Offenders Importance of risk assessment
Importance of careful history
Importance of sexual deviance
Incest avoidance -- where is it?
61. Four explanatory factors Sexual preferences and pedophilia
Failure of incest avoidance
Mate deprivation; opportunity
Psychopathy, antisociality
62. Practical Implications Similar to other child molesters:
Importance of careful history
Don�t assume no extrafamilial victims
Importance of sexual deviance
Importance of risk assessment
Instruments developed for other offenders work just as well for incest offenders
-Idea of having fathers look after daughters and be more involved in child-rearing?
-Idea of having fathers look after daughters and be more involved in child-rearing?
64. Sex Offenders with Developmental Disabilities: Sexual Preferences and Risk Assessment Background
Our study
Method
Results
History
Phallometric
Recidivism
Discussion
Summary, Implications, and Conclusions
65. Background Sex offenses overrepresented in developmentally disabled (Hawk et al., 1993)
especially offenses against males ()
especially against children
66. Developmentally Disabled vs. Other Sex Offenders 58 Developmentally Disabled Sex Offenders
Matched to sex offenders of normal IQ ...
� on general offense type (n = 45)
Mean age 29.8 (17.0)
65% DD Programs vs. 87% Oak Ridge
67. IQ
68. Nonviolent Criminal History
69. Violent Criminal History
70. Violent Sexual History
71. Neurological Problems (%)
72. Prenatal/perinatal problems
73. Difficult Child/Aggression
74. Childhood Abuse Score
75. Male Victims
76. Victims under age 5
77. Total Number of Victims
78. Phallometric Testing
79. Phallometric Response < 5 (z)
80. Sexual Deviance - Age
81. Sexual Deviance - Activity
82. Recidivism
83. Discussion Why are developmentally handicapped child molesters more likely to choose male victims?
The maternal immune hypothesis (Blanchard, 2001)
Why are developmentally disabled offenders more likely to pick younger victims?
84. Child Molesters� Paradoxical Sexual Interests?
85. Child Molesters� Paradoxical Sexual Interests Pragmatic Questions
Phallometric testing
Viewing time, ratings, attitude/value questions
Screening method
Theoretical Questions
Critical features?
Size, body shape, skin texture, behavioral, ...
Neoteny?
86. Phallometry and �Older� Stimuli
87. CMs by Victim Age; Female Stimuli; Standardized
88. Waist - Hip Ratio of Female Stimuli IRR: r = .83
Younger Adult Women: .691
Older Adult Women: .790
Pubescent Girls: .800
Girls 5-11 years: .819
Girls under 5 years: .888
89. Aggregate Correlations: Non-Offenders
90. Aggregate Correlations: Child Molesters (n=36)
91. Child Molesters by Victim Ages Victims 12 years or older (n=18): r (Phall::WHR) = -.40
All Victims under 12 years (n=18): r (Phall::WHR) = .10
92. A Tentative Hypothesis About Male Sexual Preferences and Pedophilia
93. Altered WHR and Mean Ratings
94. Non Offenders -- Altered WHR Attractiveness Ratings Between Subjects: E(r/Ho) = 1.0 r = .27
Signed Ranks: p <.10
95. Has the Effectiveness of Sex Offender Treatment Been Established?
96. What Has Been Established
About Offender Treatment:
Effectiveness can be Achieved
Principles of Risk, Need, Responsivity
Ineffective interventions
Possibility of Harm
97. What has Been Established
About Risk Assessment
Power of static historical predictors
Absence of �Clinical� predictors
Contribution of treatment?
98. What has been established about the causes of sex offending
Sexual deviance?
Antisociality?
Social skill or emotional deficits?
Cognitive distortions?
99. What has been Established
About Sex Offender Treatment
Refusing, declining, quitting, being ejected predicts recidivism�
Volunteering, persisting, complying, completing predicts success.
Opportunity increases recidivism
100. General versus Specific Effects
Selection
Expectancy
Bias
� And Other Threats to Internal Validity
101. What has not been Established
About Sex Offender Treatment
Size of Specific Effect *
Elements of Specific Effect *
Offender Types *
*(if there is one)
102. Sex Offender Treatment and Knowledge Practice:
Over 30 years, two random studies
Refusers or ?? preferred controls
Offender groups
Treatment types and elements
Nonstandardized outcomes
103. Improving Knowledge Practice
Revise the standards?
The role of meta-analysis -- what it can and can�t do...
? Low power and sampling error
? General knowledge practice failure
104. Why does it matter; who cares whether the effects are general or specific?
Preventing even one victim is worthwhile
A placebo effect is still an effect
Rigorous standards discourage therapy and evaluation
105. Why does the size of the specific effect matter?
Possibility of harm -- victims plus...
Resources are limited
Opportunities are limited
A treatment implies a theory
106. Conclusions:
Poor adherence to good KP
Random designs
Barbaree & Seto
Not established <> No effect� But,�
We should not give up... But,...
And we�re makin� progress