Juvenile Sexual Offenders: Analysis & Management of Risk

1. Juvenile Sexual Offenders:Analysis & Management of Risk The Field Center for Children’s Policy, Practice & Research University of Pennsylvania 05 December 2006 Robert Prentky Research Department Justice Resource Institute Bridgewater, MA rprentky@jri.org

2. K.R.U.

3. When Things Go (really) Awry

4. Immanuel Kant, 250 years earlier “From the crooked timber of humanity, No straight thing can be made”

5. Invisible, Insidious, Incurable Out of a benign sense of obligation to prevent the “worst” of the worst from re-occurring, we may, unwittingly, unleash demons from which “no straight thing can be made” Twin Curses: • Protracted severe abuse & neglect • Emotional Detachment

6. Affective Risk Factors Emotional disconnectedness / loneliness Low self-esteem & vulnerability to feeling humiliated Absence of empathy Inability to express positive feelings Inability to manage strong negative feelings

7. Emotional Detachment

8. Perry, Pollard, Blakley, Baker, & Vigilante (1995) “The child who has been emotionally neglected early in life will exhibit profound attachment problems which are extremely insensitive to any replacement experiences later, including therapy. Examples of this include feral children, children in orphanages and, often, the remorseless, violent child,” (p. 276-277).

9. Amid the extraordinary diversity and heterogeneity of expressions of sexually coercive behavior, there appears to be only 1 least common denominator:the relative inability to develop and sustain healthy attachments with peers

10. Disordered Attachment(Levy & Orlans, 1999) • Behavior: Oppositional & defiant, impulsive & destructive, hyperactive, self-destructive • Emotions: Intense anger and/or depression, fearful & anxious • Thoughts: Negative core beliefs about one’s self and one’s relationship with others, attention & learning problems • Relationships: Untrusting & manipulative, unable to give or receive genuine affection, poor perspective-taking • Moral: Lack of empathy & compassion, little capacity for remorse, asocial or antisocial values.

11. Critical Outcomes of Disordered Attachment • Impulsive (inability to regulate or control emotions) • Intense emotions (anger, depression or anxiety) • Profound lack of trust • Incapacity for empathy & perspective-taking • Incapacity for reciprocal love • Relationships are superficial and loveless

12. What is the Magnitude of this Problem?

13. Lyons-Ruth, 1996 “Of the 1 million substantiated cases of serious abuse and neglect in the United States each year, about 800,000 of those children have severe attachment disorder”

14. Gallup, Moore, & Schussel, 1995 The actual number of cases of serious abuse and neglect may be 10-16 times higher (8 million - 12.8 million), increasing the number of children with severe attachment disorder to 6,400,000 - 10,240,000

15. The Nexus of Caregiver Instability & Sexual Abuse(Prentky, Knight, Sims-Knight, Straus, Rokous, & Cerce, 1989) A study of 82 adult sex offenders File Coded Variables: Self-Report: Physical Abuse longest time spent with caregivers Neglect total # of caregivers Sexual Abuse total # of changes in caregivers Sexual Deviation in Family total time with bio mother total time with bio father total time spent with caregivers longest time spent in institutions total # of changes in institutions

16. Outcome Variables • Severity of sexual aggression • Severity of nonsexual aggression • Total # of sexual offenses • Total # of nonsexual, victim-Inv. offenses

17. β=0.31** Caregiver Inconstancy Sexual Aggression β=0.43*** Institutional History General Aggression β=0.24* Physical Abuse & Neglect Total Offenses: Sexual β=0.-0.26* β=0.32** Sexual Deviation & Abuse in Family Total Offenses: Non-Sexual * p< .05, ** p <.005, *** p <.001

18. Prediction of Sexual Aggression(Using CI & SDA)

19. Mother Violence β=.29 Caregiver Instability Father Violence β=.18 Emotional Abuse β=.30 Physical Abuse β=.22 Sexual Abuse β=.09

20. Health β=.77 School Problems β=.40 Caregiver Instability Aggression β=.77 Depression β=.59 Juv. Antisocial Behaviorβ=.83 Ineptness β=.26 Anxiety β=.30

21. Research Project:Assessment for Safe and Appropriate Placement (ASAP) Mission: The Massachusetts ASAP Program evaluates children and juveniles who engage in firesetting and sexually abusive behaviors. The mandate [Rosenberg Law] is to improve the management and care of these children by the Department of Social Services (DSS) and to reduce victimization of other children.

22. ASAP Research Project (Prentky, 2006) • Only youth with a history of sexual behavior problems • Supported by DSS and NIJ • Study Timeline: • February, 1998 (ASAP Evaluations Began) • July, 2001 (Began Data Collection) • June, 2003 (Phase 1 Completed N=250) • November, 2004 (Phase 2 Completed N=720) • November, 2005 (Phase 3 Completed Stopped Data Collection) • Final sample: N = 822 • Boys = 667; Girls = 155

23. Adverse Early Life Experiences & Short-Term Outcome

24. Child Abuse & Sexual BehaviorsLegend SA: Severity of Sexual Abuse PA: Severity of Physical Abuse SA & PA: Severity of Sexual and Physical Abuse LS: Number of changes in Living Situations LS & SA: Living Situation and Severity of Sexual Abuse LS, SA, & PA: Living Situation, Severity of Sexual Abuse, and Severity of Physical Abuse

25. Child Abuse & Sexual Aggression(yellow – p < .01, .005, or .001)

26. Child Abuse & Sexual Aggression(yellow – p < .01, .005, or .001)

27. Child Abuse & Paraphilias(yellow – p < .01, .005, or .001)

28. Take Home Message • Sexual abuse and physical abuse, either alone or in combination, were not significantly correlated with different types of sexual abuse. • However, when changes in living situation was added to either or both of the above very significant relationships were noted.

29. So What’s the “Story” with Sexual Abuse ???

30. A youth’s history of having been a victim of sexual abuse / assault is generally NOT predictive of sexual re-offense (e.g., Hagan & Cho, 1996; Langstrom, 2002; Rasmussen, 1999; Worling & Curwen, 2001)

31. Studies finding sex abuse history predictive of sexual re-offense in juveniles

32. Studies finding sex abuse history predictive of sexual re-offense in juveniles

33. Worling & Langstrom, 2003 “…all of the available data indicate thatadolescents who have offended sexually and also acknowledge a history of child sexual abuse are at no greater risk of sexual assault recidivism,” p.355

34. The Silver Bullet is Tarnished Recapitulation Ho of the 1980’s: “cycle-of-abuse” “vampire syndrome”

35. Abuse-Specific Considerations:Morbidity Factors(Burton, 2000; 2003; Prentky, 1999) Sexual abuse becomes critical under certain conditions or in the presence of other factors (Kaufman & Zigler, 1987) 1. Age of onset 2. Duration 3. Severity 4. Relationship to offender

36. Abuse-Specific: Victim Age Ho: juveniles who victimize children are more likely to have been sexually abused than those who victimize peers • Awad & Saunders, 1991 (20% vs. 4%) • O’Brien, 1991 (40% vs. 29%)

37. Abuse-Specific: Victim Gender Ho: juveniles who victimize males are more likely to have been sexually abused than those who victimize females • Becker & Stein (32% male vs. 18% female) • Worling, 1995 (75% male vs. 25% female)

38. Victim Age / Gender Confound • Assaults against peers or adults: female victims • Assaults against children: roughly 2/3 include male victims

39. Treatment Confound? Juvenile offenders with known histories of sexual abuse more likely to be treated? And thus at reduced risk?

40. Developmental & Constitutional Considerations self-esteem, resilience, ego strength, capacity for introspection (Friedrich, 1998)

41. Child Sexual Abuse:A Kaleidoscopic Risk Predictor whereas, Delinquency, reflects an invariant, stable pattern of behavior. Child Sexual Abuse, reflects idiosyncratic patterns of abusive experiences that interact with other concurrent life experiences, some mitigating and some aggravating, producing highly variable degrees of risk

42. To Further Complicate Matters:Neurobiology of Child Abuse

43. Effects of Child Abuse on the Developing Brain A wide range of replicated experiments have demonstrated that child abuse can cause permanentdamage to the neural structure and function of the developing brain.

44. Abuse-induced Stress Persistently high levels of stress & trauma induced hormones during childhood may permanently alter brain development, especially the hippocampus

45. Why the Hippocampus? • It develops slowly. • It is one of the few brain regions that continues to develop after birth. • It has a higher density of cortisol receptors than almost any other area of the brain.

46. How does stress damage the new brain? • Prolonged or excessive exposure to cortisol can significantly change the shape of the largest neurons in the hippocampus, and can kill them. • Cortisol can suppress production of new granule cells (small neurons), that normally continue to develop after birth.

47. Severe, Prolonged Abuse in Childhood Damage to limbic structures, associated with physiologicaleffects (hyporeactivity) that may impair: Socialization; Capacity for identifying with others; Internalization of values (i.e., conditionability)

48. De Bellis & Colleagues, 1999 (Univ. Of Pittsburgh Medical Center) • 44 children & adolescents with PTSD and 61 matched controls • “brain volume robustly and positively correlated with age of onset of PTSD and negatively correlated with duration of abuse” • “symptoms of intrusive thoughts, avoidance, hyperarousal or dissociation correlated negatively with brain volume…”

49. Teicher, 2002 “Human brains evolved to be molded by experience, and early difficulties were routine during our ancestral development. Is it plausible that the developing brain never evolved to cope with exposure to maltreatment and so is damaged in a nonadaptive manner?”

50. Teicher:“This seems most unlikely” “The logical alternative is that exposure to early stress generates molecular and neurobiological effects that alter neural development in an adaptive way that prepares the adult brain to survive & reproduce in a dangerous world.”