Parole officers' experiences of the symptoms of secondary trauma in the supervision of sex offenders

The work of parole officers who supervise sex offenders rarely comes to the public's attention unless something goes wrong. Research suggests that those providing postrelease supervision of convicted sex offenders likely experience trauma as a result of their work and that little support is available to respond to their emotional needs. This manuscript explores parole officers' and parole officer supervisors' experiences of the symptoms of secondary trauma, defined as the emotional and cognitive experiences of hearing stories that recount one or more traumatic events. The qualitative study described here builds on existing literature by providing a detailed exploration, presented in their own words, of the experiences of specialist parole officers, about how they cope with the symptoms of secondary trauma, and about what they need to help them continue to do the job that the public and the politic want done well. Recognizing and understanding the symptoms of secondary trauma among supervising officers have important implications for maintaining a healthy workforce and for providing effective management of sex offenders in the community.

A revision of the sexual coercion in intimate relationships scale for young adults in China

The Sexual Coercion in Intimate Relationships Scale (SCIRS; 34 items) assesses the severity of sexual coercion (SC) in committed intimate relationships, but it does not validly screen out valid target cases or accurately assess prevalence. This study aims to revise the SCIRS to facilitate research in China. There were 927 college students in active dating relationships, from 5 large Chinese cities, who participated in the study. The results showed that the revised SCIRS (33 items) measured 3 constructs-Emotional Manipulation (17 items), Defection Threat (7 items), and Violence Threat (7 items)-and that the reliability and validity properties were satisfactory. The advantages of the revision and the limitations of this study are discussed.

Knowledge of juvenile sex offender registration laws predicts adolescent sexual behavior

Because juveniles can now be registered as sex offenders, we conducted a pilot study to investigate awareness of these policies and sexual behavior histories in a convenience sample of 53 young adults (ages 18 to 23, 79% women). These preliminary data revealed that 42% percent of participants were unaware that youth under the age of 18 can be registered as sex offenders, and when informed that they can be, participants were unaware of the breadth of adolescent sexual behavior that warrants registration. Furthermore, those unaware of juvenile registration policies, compared to those who were aware, were marginally more likely to have had sex prior to age 18. Thus, youth most at risk of registration were least aware of this possibility, suggesting that juvenile registration likely does little to deter many behaviors that are considered to be juvenile sex offenses.

[Validity of the psychophysiological diagnosis of paraphylia]

Author presents an analysis of the results of the examination of 113 sex offenders using clinical-psychopathological, sexological and psychophysiological (polygraph testing) methods. The data analysis revealed that the results of verbal and visual psychophysiological stimulation allowed to diagnose a sexual disorder in people with paraphylia in 80% and 69.6% cases, respectively. The experimental-practical validity of the psychophysiological diagnosis was 0.63 that corresponded to the high level of validity. The study enabled to define highly probable and probable criteria of the paraclinical diagnosis of paraphylia that should be interpreted by a sexologist with the account of the results of other methods (clinical, experimental-psychological).

Prevalence and overlap of childhood and adult physical, sexual, and emotional abuse: a descriptive analysis of results from the Boston Area Community Health (BACH) survey

Abuse is associated with a wide variety of health problems, yet comprehensive population-based data are scant. Existing literature focuses on a single type of abuse, population, or lifestage. Using a racially/ethnically diverse community-based sample, we document the prevalence of physical, emotional, and sexual abuse by lifestage and gender, assess variation in abuse by sociodemographics; establish overlap of abuses; and examine childhood abuse relationships with abuse in adulthood. Prevalence of abuse ranges from 15% to 27%; women report more adulthood emotional abuse and lifetime sexual abuse than men; reports of abuse can vary by race/ethnicity and poverty status, particularly in women; there is overlap between types of abuse; and a history of childhood abuse is associated with a greater risk of abuse as an adult.

Ovulation, in vivo emotion regulation problems, and sexual risk recognition deficits

OBJECTIVE

To examine associations between menstrual cycle phase, negative mood, sexual risk recognition deficits (assessed via an analogue risk vignette), and in vivo emotion dysregulation.

PARTICIPANTS

Participants were 714 college women recruited between February 2007 and December 2009.

METHODS

Participants were randomly assigned to a negative or neutral mood induction and instructed to identify sexual risk during an audiotaped sexual coercion vignette. Participants reported menstrual cycle information, in vivo emotional nonacceptance, and attention during the vignette.

RESULTS

In the negative mood condition, ovulation was associated with longer risk recognition latencies relative to the luteal and follicular phases of the menstrual cycle. Increased in vivo emotional nonacceptance and decreased attention to the vignette mediated associations between ovulation and risk recognition deficits in the negative mood condition.

CONCLUSIONS

Sexual assault risk reduction programs could provide psychoeducation regarding negative mood during ovulation and emphasize emotional acceptance and attention to external stimuli when distressed.

Disgust, mental contamination, and posttraumatic stress: unique relations following sexual versus non-sexual assault

Disgust and mental contamination (or feelings of dirtiness and urges to wash in the absence of a physical contaminant) are increasingly being linked to traumatic event exposure and posttraumatic stress (PTS) symptomatology. Evidence suggests disgust and mental contamination are particularly relevant to sexual assault experiences; however, there has been relatively little direct examination of these relations. The primary aim of the current study was to assess disgust and mental contamination-based reactivity to an individualized interpersonal assault-related script-driven imagery procedure. Participants included 22 women with a history of traumatic sexual assault and 19 women with a history of traumatic non-sexual assault. Sexual assault and PTS symptom severity predicted greater increases in disgust, feelings of dirtiness, and urges to wash in response to the traumatic event script. Finally, assault type affected the association between PTS symptom severity and increases in feelings of dirtiness and urges to wash in response to the traumatic event script such that these associations were only significant among sexually assaulted individuals. These findings highlight the need for future research focused on elucidating the nature of the relation between disgust and mental contamination and PTS reactions following various traumatic events.

Prevalence and predictors of self-reported sexual abuse in severely obese patients in a population-based bariatric program

BACKGROUND

Sexual abuse may be associated with poorer weight loss outcomes following bariatric treatment. Identifying predictors of abuse would enable focused screening and may increase weight management success.

METHODS

We analyzed data from 500 consecutively recruited obese subjects from a population-based, regional bariatric program. The prevalence of self-reported sexual abuse was ascertained using a single interview question. Health status was measured using a visual analogue scale (VAS). Multivariable logistic regression was performed to identify sexual abuse predictors.

RESULTS

The mean age was 43.7 y (SD 9.6), 441 (88.2%) were females, 458 (91.8%) were white, and the mean body mass index (BMI) was 47.9 kg/m(2) (SD 8.1). The self-reported prevalence of past abuse was 21.8% (95% CI 18.4-25.4%). Abused subjects had worse health status (VAS score 53.1 (SD 21.2) versus 58.0 (SD 20.1), P = 0.03). BMI was not associated with abuse (P > 0.5). Age, sex, BMI, and covariate-adjusted independent predictors of abuse included alcohol addiction (adjusted odds ratio 15.8; 95% CI 4.0-62.8), posttraumatic stress disorder (4.9; 2.5-9.5), borderline personality (3.8; 1.0-13.8), depression (2.4; 1.3-4.3), and lower household income (3.4; 1.6-7.0).

CONCLUSIONS

Abuse was common amongst obese patients managed in a population-based bariatric program; alcohol addiction, psychiatric comorbidities, and low-income status were highly associated with sexual abuse.

[Specific aspects and management of psychiatric conditions in correctional settings]

Correctional psychiatry is a patient-centered medicine, similar to that practiced anywhere else, independent, governed by the same objectives (deliver the highest standard of care) and the same obligations (respect patients' dignity, their informed consent and the confidentiality they are entitled to). However, it has been a victim of its own success. As correctional psychiatry was expanding, so was the psychiatric morbidity among inmates. Consequently, the initial clinical hypothesis, which was based on the integrative function of correctional psychiatry, created in the early eighties, comes up against the segregating impact of an intramural specialty practice.

An exploratory study of the effects of teacher attractiveness on undergraduates' perceptions of teacher-student sexual involvement

This study explored whether the attractiveness of a teacher affected perceptions of teacher sexual misconduct. Respondents (120 female and 108 male undergraduates) read scenarios depicting teacher sexual misconduct varied by gender dyad (male teacher-female student and female teacher-male student) and two levels of attractiveness (very attractive or ordinary looking). The attractiveness of the teacher had little impact on respondents' perceptions. Significant interactions emerged on most variables between respondent gender and gender dyad. Specifically, male respondents tended to view the female teacher-male student dyad as less negative than the male teacher-female student dyad. Female respondents generally did not make a distinction based on the gender dyad.

Denying denial in children with sexual behavior problems

Denial in some form is almost always present in the assessment and therapy of children with sexual behavior problems. Although it can be a major element in the therapeutic interaction, denial has received scant attention, both in teaching programs and professional literature. It is as if the clinical community is "denying denial." Despite its seemingly resistant nature, denial can be used to produce impressive inroads in data collection and in developing insight. This article offers an in-depth look at the construct of denial, especially its expression among children with sexual behavior problems. It will be argued that a more informed understanding of denial dynamics can creatively inform and direct treatment of children and adolescents with sexual behavior problems and considerably improve treatment outcome.

Believing doesn't make it so: forensic education and the search for truth

The American Academy of Psychiatry and the Law (AAPL) was organized in 1969, in large part through the efforts of Dr. Jonas Rappeport. The founders of AAPL emphasized that an important purpose of the organization was to advance knowledge in the area of psychiatry and the law. The science of forensic psychiatry has since been vigorously debated. In 2005, Congress enacted a statute authorizing the National Academy of Sciences (NAS) to conduct a study on the state of the forensic sciences in the United States. As a result of this legislation, a forensic science committee was formed, and the report, "Strengthening Forensic Science in the United States: A Path Forward," was produced, emphasizing the need for research in the forensic disciplines, particularly those that rely on more subjective assessments. The committee also identified two important factors relevant to standards of evidence admissibility: the scientific methodology used and the impact of bias on the interpretation of data. In this article, I apply the NAS committee's findings to the field of forensic psychiatry, with specific recommendations to assist educators in achieving more objective assessment methodologies, critical in forensic education and the search for truth.

Body image among victims of sexual and physical abuse

This study tries to understand the differences in body experience between victims of sexual abuse and physical abuse. Ninety-eight women completed questionnaires that measured personal information, body-image aberration, body sensitivity and control, and body investment. Findings indicated that victims of sexual abuse demonstrate less body maintenance and protection in addition to greater injury to body sensitivity and control than victims of physical abuse. Moreover, comparing victims of sexual abuse to physical abuse, findings revealed that only victims of sexual abuse report body-image aberrations. Thus, sexual and physical abuse should be addressed discretely because each has differential effects on bodily attitudes of victims.

Discrepant responding across self-report measures of men's coercive and aggressive sexual strategies

Researchers have worked to refine the measurement of women's experiences with sexual victimization. Less is known about the validity and reliability of measures that assess men's use of sexual coercion and aggression. These studies explore the consistency of men's responses to two distinct, but similar, measures of sexual coercion and aggression. The two measures both assess historical use of verbal coercion, sexual assault involving drugs or alcohol, and sexual assault through threat or force. Study 1 used college men as participants (N = 398), whereas Study 2 used a mixed sample of college and community men (N = 184). In both studies, participants' responses were largely inconsistent across the two measures. This article explores potential measurement issues that may account for the observed reporting discrepancies and offers suggestions for future research.

Risk factors for posttraumatic stress disorder in female help-seeking victims of sexual assault

Posttraumatic stress disorder (PTSD) is common in the aftermath of rape and other sexual assault, but the risk factors leading to PTSD following rape have been shown to differ from those related to PTSD following nonsexual assault. This prospective study examined risk factors for PTSD severity in 148 female help-seeking victims of sexual assault. Approximately 70% of the victims experienced significant levels of traumatization, with 45% reporting symptoms consistent with a probable PTSD diagnosis. Regression analyses showed that relationship with the assailant, number of assailants, the nature of the assault, perceived positive social support, support satisfaction, feeling let down by others, and prior exposure to sexual trauma did not significantly predict PTSD severity at the final level of analysis. In accordance with suggestions by Dancu, Riggs, Hearst-Ikeda, and Shoyer (1996), it is suggested that this is partly caused by a very high degree of traumatization in the sample. Instead, previous nonsexual traumatic experiences and negative affectivity accounted for 30% of the variance in PTSD severity. Although more research is needed on risk factors of assault-related PTSD, these findings suggest that although sexual assault is associated with a high degree of PTSD severity, prior nonsexual victimization and high levels of negative affectivity appear to further increase the vulnerability toward developing symptoms of assault-related PTSD.

Risk factors for domestic violence during pregnancy: a meta-analytic review

This article presents the results of a meta-analysis of the existing research literature, in an effort to increase our understanding of the prevalence of domestic violence (DV) among pregnant women, and of risk factors associated with DV during pregnancy. Across 92 independent studies, the average reported prevalence of emotional abuse was 28.4%, physical abuse was 13.8%, and sexual abuse was 8.0%. Composite odds ratio effect sizes were calculated for the demographic, behavioral, and social risk factors identified by 55 independent studies. Both victimization and perpetration risk factors were analyzed. Abuse before pregnancy and lower education level were found to be strong predictors of abuse during pregnancy. Pregnancy being unintended by either the victim or the perpetrator, lower socioeconomic status, and being unmarried were found to be moderate predictors of abuse during pregnancy.

Associations between attitudes toward violence and intimate partner violence in South Africa and Tanzania

Attitude change approaches are common in the prevention of intimate partner violence (IPV) among adolescents. This study examined associations between perpetration or victimization and attitudes toward IPV with data from a longitudinal randomized controlled trial (RCT) of an HIV prevention intervention among school students in three sites in South Africa and Tanzania. Data analyses were confined to students from the control group only, and to those with experience with romantic relationships. Boys and those more involved with violence reported more violence-supportive attitudes. For Cape Town (and to some extent Mankweng), the results of prospective prediction are consistent with the notion of a bidirectional attitudes-behavior interrelationship. For Dar es Salaam attitudes predicted behavior prospectively; however, prediction in the opposite direction was not confirmed. These results indicate that attitude change strategies may be useful complementary to structural approaches also in global South settings, although their effectiveness may vary.

Factors contributing to perceptions about policies regarding the electronic monitoring of sex offenders: the role of demographic characteristics, victimization experiences, and social disorganization

The purpose of this article is to explore factors contributing to perceptions about electronic monitoring policies governing sex offenders. Guided by Tannenbaum's theory of attribution and Shaw and McKay's theory of social disorganization, the authors examine the influence of demographic characteristics, victimization experiences, and neighborhood characteristics on perceptions about policies regarding the electronic monitoring of sex offenders. Ordinary least squares regression and logistic regression analyses of stratified telephone survey data reveal that factors associated with favorable views on the use of global positioning satellite monitoring for registered sex offenders appear to stem primarily from individuals' demographic characteristics. Experiential and neighborhood factors do provide some influence over individuals' views of electronic monitoring policies for sex offenders. Theoretical and policy implications are discussed.

Attitudes supportive of sexual offending predict recidivism: a meta-analysis

Attitudes supportive of sexual offending figure prominently in theories of sexual offending, as well as in contemporary assessment and treatment practices with sex offenders. Based on 46 samples (n = 13,782), this meta-analysis found that attitudes supportive of sexual offending had a small, yet reasonably consistent, relationship with sexual recidivism (Cohen's d = .22). To the extent that differences were observed, attitudes predicted recidivism better for child molesters than for rapists. There was no difference in the predictive accuracy of attitudes assessed at pretreatment or at posttreatment. The current study indicates that attitudes supportive of sexual offending is a psychologically meaningful risk factor for sex offenders. However, given that many different constructs have been designated as sex offender attitudes, further research and theory is needed to understand how these various constructs contribute to recidivism.

Adolescent and young adult male sex offenders: understanding the role of recidivism

The current review explores the complex paths that can lead to adolescent and young adult males becoming sexually abusive. Because sexual abuse is an ongoing issue in our society that is often oversimplified, this article distinguishes between the various risk factors that predict sexually abusive behavior and types of sex offenders, particularly recidivistic offenders. It is imperative to focus on adolescents and young adults who sexually abuse because they represent a particularly important intervention point in preventing sexual abuse in comparison to older age groups and address the importance of differentiating among youths who sexually abuse, particularly between one-time offenders and recidivistic offenders. Implications for addressing these differences are discussed.

The need for trauma-sensitive language use in literacy and health literacy screening instruments

The authors recently began a research study, funded by the National Institute of Mental Health, aimed at increasing the understanding of the ways in which limited literacy affects the lives of people with serious mental illness. In preparing for the study, the authors reviewed many health literacy screens and assessments for their appropriateness in public urban mental health settings. The Rapid Estimate of Adult Literacy in Medicine and the Test of Functional Health Literacy in Adults, perhaps the most frequently used assessments of health literacy, involve assessments that include lists of words that the test-taker must choose from or read. Each of these instruments includes language that is potentially triggering for trauma survivors, particularly those with posttraumatic stress disorder (PTSD). The research participants for the current project are consumers of mental health services, and thus, the authors believe it is essential to remove the problematic language, given that the likelihood of a diagnosis of PTSD and/or a history of abuse is higher than average among this population. However, the authors argue that this issue applies to anyone who administers these instruments, because sexual assault and abuse, as well as PTSD diagnoses, are certainly not confined to those who seek mental health services. The authors' aim is not only to call attention to the use of triggering language in existing literacy and health-related assessments and research instruments, but also to advocate that others take similar steps toward embracing more sensitive language by removing or replacing words that may cause unnecessary stress, anxiety, or pain to those who are at increased risk of retraumatization.

Adult attachment as a criminological construct in the cycle of violence

This study investigates whether the criminological construct of attachment plays a role in the link between family violence victimization experiences in childhood and adult violent behavior. Data collected from undergraduate students was used to estimate the independent effect of adult attachment type on the victimization-violence link and it was used to examine main effects and interactions between family violence-adult attachment types on adult violent behavior. Consistent with past research, results revealed significant associations between direct experiences of victimization and violent behavior. Multivariate analyses using interaction terms also found significant interactions, indicating moderation effects, which were further investigated. Results revealed that social learning theory may be useful in explaining violence among those who have experienced high victimization, whereas social control theory may be useful in explaining adult violence for those who have experienced low or no levels of violence early in life. Given this study's findings, further research to examine the means by which family violence victimization experiences develop into violent behavioral patterns is recommended.