Adolescent sex offenders: Is phallometry developed for adult sex offenders valid for adolescents

1. Adolescent sex offenders: Is phallometry developed for adult sex offenders valid for adolescents? 28th Annual Research & Treatment ATSA Conference, Dallas TX Thursday October 1, 2009 3:00-3:35 p.m. Marnie E. Rice & Grant T. Harris Mental Health Centre Penetanguishene Penetanguishene, ON CANADA riceme@mcmaster.ca http://www.mhcp-research.com

2. Outline Previous research on phallometry and adolescent offenders Our study Method Results Implications for assessment and treatment of adolescent sex offenders

3. Previous research on phallometry with adolescent offenders More deviant responding for perpetrators with male victims only cf. those with female only and both sex victims (Hunter et al., 1994) Among adolescents who offended against children, those with any male victim had more deviant pedophilic indices than young adult rapists or young adult nonoffenders, and pedophilic indices of adolescent offenders against children did not differ from those of young adult offenders against children (Seto et al., 2000) Adolescents who had victimized at least 1 male responded more to stimuli involving male peer consent, male peer rape, male child rape, and female child rape than those with only female victims (Murphy et al., 2001) Re: Hunter, Goodwin, & Becker, 1994: 98 juvenile sex offenders Seto, Lalumiere & Blanchard� Murphy, Dilillo, Haynes, & Steere, 2001- sample of 71 juveniles referred to a sex offender evaluation & treatment facility H & M-B: Only 15 studies (out of 115) were of adolescent offenders (some of the others had some adolescents, but not predominantly). Sexual deviancy was not necessarily assessed using phallometry�in fact, only 1 study for sure (Gretton, unpublished), but could be more Re: Hunter, Goodwin, & Becker, 1994: 98 juvenile sex offenders Seto, Lalumiere & Blanchard� Murphy, Dilillo, Haynes, & Steere, 2001- sample of 71 juveniles referred to a sex offender evaluation & treatment facility H & M-B: Only 15 studies (out of 115) were of adolescent offenders (some of the others had some adolescents, but not predominantly). Sexual deviancy was not necessarily assessed using phallometry�in fact, only 1 study for sure (Gretton, unpublished), but could be more

4. Other relevant previous research Having any male child victims is an item on the SSPI, a measure of sexual interest in prepubescent children (Seto et al., 2004) Deviant preferences (and antisocial orientation) are major predictors of sexual recidivism for both adult and juvenile offenders (Hanson & Morton- Bourgon, 2005)

5. Clift, Rajlic, & Gretton, 2009 132 male adolescent sex offenders Offenders with male child victims had higher child deviance indices than offenders with female nonchild victims Post-treatment child deviance indices significantly related to sexual recidivism

6. Hypotheses Adolescent offenders with male child victims will have more deviant responses than those with only female child victims Pedophilic indices and phallometric profiles of adolescent child molesters will not differ from those of adult child molesters, but will differ from those of adult nonoffenders Phallometric preferences of adolescent offenders will predict recidivism Could also have a hypothesis about reliability- Becker et al found some evidence for�see Collie & Ward for referenceCould also have a hypothesis about reliability- Becker et al found some evidence for�see Collie & Ward for reference

7. Our study Participants 61 sex offenders under age 18 at 1st phallometric test (YSO�s) Comparisons were 69 matched sex offenders over the age of 18 at 1st phallometric test (ASO�s): 61 were men selected because they were the next case in alphabetical order to their experimental matches Only 53 of the above men were given at least one of the same tests as the experimental matches, so 8 additional men were selected Data for �Normals� came from other studies -incest offenders were not excluded- there were 2 exclusive incest offenders in each group IQ was not an exclusion criterion -incest offenders were not excluded- there were 2 exclusive incest offenders in each group IQ was not an exclusion criterion

8. Phallometric measures Assessments for child molesters Given only to sex offenders known or suspected to have molested a child<13 4 different stimulus sets altogether 2 sets visual stimuli only (nudes or partial nudes) (Quinsey et al., 1975; Harris et al., 1996) 2 sets aural stimuli (or aural plus visual) (Quinsey & Chaplin, 1988; Blanchard et al., 2001)

9. Phallometric measures Assessment for rapists Given only to sex offenders known or suspected to to have offended against a female>12 1 stimulus set comprising stories about consenting or nonconsenting sex with women, or nonsexual beating of women (Quinsey & Chaplin, 1982)

10. More about phallometric data Different proportions of participants in each group given each test No subjects dropped due to low responding Responses were recorded in mm penile circumferential expansion, then later transformed to z scores Deviant age preference index (zChild-zAdult/Consenting) Preference for particular age-gender categories (zMalechild-zAdult/Consenting; zFemalechild-zAdult/Consenting) Rape index (zRape-zConsenting)

11. Data analyses For age preference stimuli, first analyzed each stimulus set separately Found stimulus sets were not all equal in mean deviance index and were given to different numbers of participants in each group

12. Data analyses So calculated age deviance indices 2 ways- Using just stimulus set given to most participants (30 YSO�s, 28 ASO�s) Using each participant�s most deviant of all age stimulus sets he was administered (48 YSO�s, 48 ASO�s) Results similar

13. Results Sample characteristics Phallometric profiles Deviance indices Recidivism Deviance indices and recidivism

14. P<.05, all 69 controls (but doesn�t make any difference to what�s significant if do only groupinga Only female child also includes those with a female nonchild victim (14-17 or 18ov) Sex includes hands-on and hands-off, but makes virtually no difference to results if use only hands-on (Then it�s 75%, 96%) Note that I corrected this slide after changing data for cb32445, but didn�t (yet) rerun analysesP<.05, all 69 controls (but doesn�t make any difference to what�s significant if do only groupinga Only female child also includes those with a female nonchild victim (14-17 or 18ov) Sex includes hands-on and hands-off, but makes virtually no difference to results if use only hands-on (Then it�s 75%, 96%) Note that I corrected this slide after changing data for cb32445, but didn�t (yet) rerun analyses

16. CM Set 1 Should I add the offenders from the original study? Decided no, it�s too busy and doesn�t add anything(Applies to all slides) Normals come from Quinsey et al. 1975 paper� don�t have original data, just estimated these from figure in paper. Note that calculating ddagecvnorpub from data in table (approximated from Q et al. 1975, cf-adultf= 1.17-2.89=-1.72. Mean age of normals was approx.26 Descriptive Statistics Confidence intervals around means for yso�s N Minimum Maximum Mean Std. Deviation SEof mean= sd/sqrtn CI=1.96*SEmean 2*SEmean neut 30 8.55 10.17 9.2943 .33221 .0606532 .12 (different from normals) pubm 28 9.06 11.59 9.7060 .53614 .1013209 .1986 .20 (different from normals, close for comparisons) Chldm 28 9.12 11.34 9.5946 .51531 .0973844 .20 (different from both) mund5 28 8.98 11.86 9.6161 .61551 .1163205 .23 Adulm 28 8.91 11.22 9.5025 .53760 .1015969 .20 (different from normals) pubf 30 9.39 11.51 10.5807 .60740 .110896 .21734 .22 (just barely different from normals) chldf 30 9.28 11.17 10.1003 .50162 .0915832 .18 (not different from either) fund5 29 9.15 12.05 9.9576 .65740 .1220762 .24 adulf 30 8.92 11.98 10.6700 .89572 .163536 .32 (different from both) Chund5 (different from normals) 30 yso�s, 28 controls, 21 �normals� comprising 10 nonsex offending patients and 11 community normalsShould I add the offenders from the original study? Decided no, it�s too busy and doesn�t add anything(Applies to all slides) Normals come from Quinsey et al. 1975 paper� don�t have original data, just estimated these from figure in paper. Note that calculating ddagecvnorpub from data in table (approximated from Q et al. 1975, cf-adultf= 1.17-2.89=-1.72. Mean age of normals was approx.26 Descriptive Statistics Confidence intervals around means for yso�s N Minimum Maximum Mean Std. Deviation SEof mean= sd/sqrtn CI=1.96*SEmean 2*SEmean neut 30 8.55 10.17 9.2943 .33221 .0606532 .12 (different from normals) pubm 28 9.06 11.59 9.7060 .53614 .1013209 .1986 .20 (different from normals, close for comparisons) Chldm 28 9.12 11.34 9.5946 .51531 .0973844 .20 (different from both) mund5 28 8.98 11.86 9.6161 .61551 .1163205 .23 Adulm 28 8.91 11.22 9.5025 .53760 .1015969 .20 (different from normals) pubf 30 9.39 11.51 10.5807 .60740 .110896 .21734 .22 (just barely different from normals) chldf 30 9.28 11.17 10.1003 .50162 .0915832 .18 (not different from either) fund5 29 9.15 12.05 9.9576 .65740 .1220762 .24 adulf 30 8.92 11.98 10.6700 .89572 .163536 .32 (different from both) Chund5 (different from normals) 30 yso�s, 28 controls, 21 �normals� comprising 10 nonsex offending patients and 11 community normals

17. CM Set 2 Normals are the 15 used in the viewing time study�Harris et al, 1996 Note that viewing time paper says there were only 7 stimulus categories with 2 stimuli each, but that must be an error. The data are from Standard 2 which has 3 age categories for children of each sex� so must have been 6 stimuli in the �child� categories for each sex, and they were collapsed in the paperNormals are the 15 used in the viewing time study�Harris et al, 1996 Note that viewing time paper says there were only 7 stimulus categories with 2 stimuli each, but that must be an error. The data are from Standard 2 which has 3 age categories for children of each sex� so must have been 6 stimuli in the �child� categories for each sex, and they were collapsed in the paper

18. CM Set 3 Took out construction sample sex offenders (they don�t really add anything), but kept slide at end� I have the actual data from Grant for both the sex offenders and the nonsex offenders (including community normals and nonsex offenders) in case I want to use the sex offenders. The normals are described in Quinsey & Chaplin�88 and also in Harris et al;, 1992, but n�s are different (14 in Q & C, 15 in H et al., and 16 in data Grant gave me---why?) There were 16 �normals�, mean age was 27 The standard error of the mean (SEM) is the standard deviation of the sample mean estimate of a population mean. (It can also be viewed as the standard deviation of the error in the sample mean relative to the true mean, since the sample mean is an unbiased estimator.) SEM is usually estimated by the sample estimate of the population standard deviation (sample standard deviation) divided by the square root of the sample size (assuming statistical independence of the values in the sample): SEM=sd/SQRTn where sd is the sample standard deviation (i.e., the sample based estimate of the standard deviation of the population), and n is the size (number of observations) of the sample. So, 95% confidence intervals are 1.96 times the standard error. Thus, the normals (nonsex offenders and community normals from the constructions sample) are significantly different from the young sex offenders on neutrals (only the under 18's- they are lower on neutrals), consenting adult female, approx. .33 for passCF (yes, sig), .266 (actually .261-yes, sig) for CoercCF, .20 for VioCF (yes, sig.), .12 (actually .1234) for NSVCF (sig different from under 18's but not comparison sex offenders), .26 for PassCM yes, sig different from under 18's but not quite for the comparisons), .16 for CoercCM (actually .159)- yes, significantly different from both sex offender groups, .16 for VioCM (sig. for under 18's but not for comparisons), .12 for NSVCM (sig for under 18's- they like NSV less than normals!), .23 for ConsentM (surprisingly, significantly different from both under 18's and comparisons, but in opposite directions!)*** Are the yso�s and comparisons different? Descriptive Statistics Normals: N Min Max Mean Standard Error Std. Deviation Neutralz 16 -1.17 .13 -.5256 .07327 .29307 ConsAdFz 16 .66 3.00 2.3162 .14296 .57183 PassCFz 16 -.41 1.43 .3338 .16710 .66841 CoerCFz 16 -.64 1.21 -.0406 .13316 .53266 VioCFz 16 -.83 .83 -.2206 .10354 .41416 NSVCFz 16 -1.03 .09 -.5006 .06296 .25186 PassCMz 16 -.63 1.13 -.0763 .13136 .52546 CoerCMz 16 -.74 .50 -.2563 .08125 .32500 VioCMz 16 -.76 .56 -.3356 .08343 .33371 NSVCMz 16 -.87 .13 -.5125 .06085 .24341 ConsAdMz 16 -.76 1.30 -.1738 .11693 .46770 Valid N (listwise)16 Took out construction sample sex offenders (they don�t really add anything), but kept slide at end� I have the actual data from Grant for both the sex offenders and the nonsex offenders (including community normals and nonsex offenders) in case I want to use the sex offenders. The normals are described in Quinsey & Chaplin�88 and also in Harris et al;, 1992, but n�s are different (14 in Q & C, 15 in H et al., and 16 in data Grant gave me---why?) There were 16 �normals�, mean age was 27 The standard error of the mean (SEM) is the standard deviation of the sample mean estimate of a population mean. (It can also be viewed as the standard deviation of the error in the sample mean relative to the true mean, since the sample mean is an unbiased estimator.) SEM is usually estimated by the sample estimate of the population standard deviation (sample standard deviation) divided by the square root of the sample size (assuming statistical independence of the values in the sample): SEM=sd/SQRTn where sd is the sample standard deviation (i.e., the sample based estimate of the standard deviation of the population), and n is the size (number of observations) of the sample. So, 95% confidence intervals are 1.96 times the standard error. Thus, the normals (nonsex offenders and community normals from the constructions sample) are significantly different from the young sex offenders on neutrals (only the under 18's- they are lower on neutrals), consenting adult female, approx. .33 for passCF (yes, sig), .266 (actually .261-yes, sig) for CoercCF, .20 for VioCF (yes, sig.), .12 (actually .1234) for NSVCF (sig different from under 18's but not comparison sex offenders), .26 for PassCM yes, sig different from under 18's but not quite for the comparisons), .16 for CoercCM (actually .159)- yes, significantly different from both sex offender groups, .16 for VioCM (sig. for under 18's but not for comparisons), .12 for NSVCM (sig for under 18's- they like NSV less than normals!), .23 for ConsentM (surprisingly, significantly different from both under 18's and comparisons, but in opposite directions!)*** Are the yso�s and comparisons different? Descriptive Statistics Normals: N Min Max Mean Standard Error Std. Deviation Neutralz 16 -1.17 .13 -.5256 .07327 .29307 ConsAdFz 16 .66 3.00 2.3162 .14296 .57183 PassCFz 16 -.41 1.43 .3338 .16710 .66841 CoerCFz 16 -.64 1.21 -.0406 .13316 .53266 VioCFz 16 -.83 .83 -.2206 .10354 .41416 NSVCFz 16 -1.03 .09 -.5006 .06296 .25186 PassCMz 16 -.63 1.13 -.0763 .13136 .52546 CoerCMz 16 -.74 .50 -.2563 .08125 .32500 VioCMz 16 -.76 .56 -.3356 .08343 .33371 NSVCMz 16 -.87 .13 -.5125 .06085 .24341 ConsAdMz 16 -.76 1.30 -.1738 .11693 .46770 Valid N (listwise)16

19. CM Set 4 This is the Blanchard et al. 2001 aural plus visual set and we have no data for normals (and can�t use theirs either) Data for 7 controls: Descriptive Statistics N Minimum Maximum Mean Std. Deviation SEmean=sd/sqrt n C!=1.96*SEmean 2*SEmean dneut 7 9.05 9.58 9.2557 .21046 .008 .016 (difference is sig) dadulm 7 8.94 11.20 9.5400 .75987 .2868 .58 ns dchldm 7 9.27 11.57 10.2643 .85506 .3226 .64 ns Dchldf 7 9.99 11.10 10.6071 .50619 .1909 .38 difference is sig. Dadulf 7 9.57 11.34 10.4114 .67775 .25575 .51 ns Valid N (listwise) 7 So only significant differences are for neutrals and child females This is the Blanchard et al. 2001 aural plus visual set and we have no data for normals (and can�t use theirs either) Data for 7 controls: Descriptive Statistics N Minimum Maximum Mean Std. Deviation SEmean=sd/sqrt n C!=1.96*SEmean 2*SEmean dneut 7 9.05 9.58 9.2557 .21046 .008 .016 (difference is sig) dadulm 7 8.94 11.20 9.5400 .75987 .2868 .58 ns dchldm 7 9.27 11.57 10.2643 .85506 .3226 .64 ns Dchldf 7 9.99 11.10 10.6071 .50619 .1909 .38 difference is sig. Dadulf 7 9.57 11.34 10.4114 .67775 .25575 .51 ns Valid N (listwise) 7 So only significant differences are for neutrals and child females

20. Rape Set Normals came from Quinsey, Chaplin & Varney, 1981� n=15, but note that for data on deviance indices, had 44 normals from Harris et al., 1992 Only those with nonchild victim tested Clearly, under 18�s are different from normals , but not much different from comparisonsNormals came from Quinsey, Chaplin & Varney, 1981� n=15, but note that for data on deviance indices, had 44 normals from Harris et al., 1992 Only those with nonchild victim tested Clearly, under 18�s are different from normals , but not much different from comparisons

21. Deviance indices- Means, n�s and 95% CI�s

22. Age Deviance indices and victim choice

23. Phallometric child gender preferences and victim choice Phallometric child gender preferences were related to victim choice: Within each group, those with a male victim <13 had more deviant boy-related preferences than those with only girl victims

24. Recidivism Mean time at risk= just over 4 yrs. But lots of variablility Only had data for 32 YSO�s (13 sexual recidivists=41%), 42 comparisons (9 sexual recidivists= 21%) for sexual recid Violent recid: Young Offenders: 45% (17/38) Comparisons: 48% (22/46) For sexual recidivism, yso�s marginally more likely to recidivate (p<.10) using chi-square, 2-tailed test Mean time at risk= just over 4 yrs. But lots of variablility Only had data for 32 YSO�s (13 sexual recidivists=41%), 42 comparisons (9 sexual recidivists= 21%) for sexual recid Violent recid: Young Offenders: 45% (17/38) Comparisons: 48% (22/46) For sexual recidivism, yso�s marginally more likely to recidivate (p<.10) using chi-square, 2-tailed test

25. Recidivism and Deviance Age Deviance index was related to violent recidivism for YSO�s: r=.39 ,n=27, p<.05 Age Deviance index was related to sexual recidivism for YSO�s: r=.40 ,n=23, p<.05 No sig. correlations for ASO�s or for either group for rape index

26. Summary Phallometric testing is valid for adolescent sex offenders: They respond very similarly to adult sex offenders They respond very differently from nonsex offenders and community normals Phallometric age preferences of YSO�s predict violent and sexual recidivism Recidivism rates of adolescent offenders are at least as high as those of adult sex offenders

27. Implications Phallometric testing is likely the best measure of sexual deviance among adolescent sex offenders just as it is among adult sex offenders Pedophilia exists among adolescents just as it does among adult sex offenders Makes sense to continue to develop stimulus sets most suitable for adolescent offenders SSPI???SSPI???