Assessment of psychiatric disorders among sex offenders: Prevalence and associations with criminal history

Psychiatric disorders and management of sexual offenders in the prison psychiatric consultation unit of Marseille

Since 2017, complaints of sexual violence have increased in France. At the same time, the management of sexual offenders has been at the center of international public health policies. The prevalence of mental disorders among sexual offenders is an essential field of research. There are some published studies on the prevalence of psychiatric disorders in sexual offenders in detention, but there are few recent published studies among French individuals who were detained. Our objectives were to determine the prevalence of psychiatric disorders among persons detained for sexual offenses and the level of care received according to their diagnosis. For this purpose, we carried out a retrospective observational study from January 2017 to October 2021 of all adult sexual offenders, whether accused or convicted, who were seen in the psychiatric consultation unit of Les Baumettes prison, Marseille, France. The primary outcome measure was the psychiatric diagnosis entered in the medical records. One hundred forty-two patients were included in analysis. All patients were men, and the majority (n = 97, 68.3%) of these patients presented with at least one psychiatric disorder, principally a personality disorder (31.7%). 10.6% presented with a schizophrenic disorder, 4.9% a bipolar disorder, 3.5% a depressive disorder, 5.6% pedophilic paraphilia, and 25.4% an addictive disorder. Their management and comorbid addictions were analyzed in subgroups for each psychiatric disorder. Patients appeared to receive an appropriate level of care for their diagnosed disorder. It seems important to develop structured assessment of recidivism risk for better management of sexual offenders.

Older adults sex offender: Five case series in a Brazilian population

Sexual assault perpetrated by older adults is still an underreported crime and is not fully understood. To describe a series of cases of sexual assault by Brazilian older adults and discuss the associated factors based on the literature. This is a cross-sectional descriptive analysis of five cases of older adults accused of sexual assault in the Forensic Psychiatry sector of the Medical Legal Institute (Coroner's Office) in the City of Belo Horizonte'. This review focuses on five cases involving male defendants with a mean age of 59.75 years; two with previous psychiatric treatment, and one with a previous criminal record. Their victims were prepubescent children, four of them female. Psychiatric conditions related to forensic diagnosis included dementia, schizophrenia, alcohol-related substance use disorder, paraphilia, and one without a psychiatric diagnosis. The final forensic report on all five cases found that two of the older adults diagnosed with a mental disorder in two were considered to have a mental illness that completely impaired the cognitive and volitional domains; two other adults were diagnosed with mental health disturbance that partially impaired these domains; and the last adult was diagnosed and found without mental health impairment. While the incidence of sexual crimes committed by older adults is low, the absolute number of cases has expected to rise due to population aging. Assessing the factors related to this type of crime is therefore an initial step to understanding and formulating preventive strategies.

Serious Mental Illness and Sexual Offending in Forensic Psychiatric Patients

The role of serious mental illness among those who sexually offend is not well understood. We investigated clinical and risk-related areas of difference between male forensic psychiatric patients with (n = 86) and without (n = 245) a sexual offense history, including the age at which indications of mental disorder and criminal offending first emerged, from a registry of Ontario patients adjudicated Not Criminally Responsible on account of Mental Disorder (NCRMD) from 1999-2012. We further explored motivations for offending among a subset of patients deemed NCRMD for a sexual offense specifically (n = 41). While no differences were found in the age onset of illness or offending across those with and without a sexual offending history, the former group was rated as having higher levels of historical/static risk for violence. Forensic patients with a sexual offense history were also more likely to offend against a stranger, and less likely to offend against a family member. Sexual index offenses were psychotically-motivated in the majority of cases, but with a meaningful proportion appearing to reflect criminogenic motivations, especially substance use and paraphilic interests. Results suggest greater similarity than difference among forensic patients with and without a sexual offense history, but also highlight an important divergence from the literature showing that victims of sexual offenses are frequently known to the individual committing them.

Non-intimate Relationships and Psychopathic Interpersonal and Affective Deficits as Risk Factors for Criminal Career: A Comparison Between Sex Offenders and Other Offenders

Sex-offenders are at risk of criminal recidivism. For the treatment to be truly effective, it must be individualized. For this purpose, an accurate assessment should focus on criminological, psychological, and psychopathological features. The present study compared sex offenders with other offenders on historical experiences (i.e., problems with violence, anti-social behaviors, problems with personal relationships, problems with substance use, traumatic experiences, and parenting style). In addition, given the association between life events and psychopathy, we explored whether the relation between life events and crime type (sexual crime vs. other types of crime) might be moderated by psychopathy traits (interpersonal and affective deficits and antisocial behavior). Eighty-eight sex offenders (76% of whom child molesters) and 102 other offenders were included. The Historical, Clinical and Risk Management - 20 item Version 3 (HCR-20V3) and Psychopathy Checklist-Revised (PCL-R) were administered. The scores of the HCR-20V3 Historical scale items were computed to assess life events. The scores of the PCL-R factors, F1 Interpersonal affective deficits and F2 Antisocial behavior, were recorded. The presence of a history of problems with non-intimate relationships was the only significant risk factor for sexual crime compared with other crimes. Interpersonal and affective deficits provided an increased likelihood of being sex offenders as compared with other offenders when problems with non-intimate relationships were possibly/partially or certainly present.

DSM-5 personality trait facets amongst child molesters: an exploratory comparison with other types of offenders

Background

DSM-5 provided a dimensional model of personality disorders which may be more clinically informative for the assessment and management of prisoners than a categorical one, as diagnoses of personality disorders alone cannot explain the type of violence. The role of DSM-5 personality facets is however understudied in child molesters, and no study compared these clinical features between individuals who have committed sex crime against children and those who have committed other types of crime. The present study compared DSM-5 personality trait facets between prisoners who had committed sex crime against children, prisoners who had committed property crime (i.e., robbery, fraud) and those who had committed crime against the person (i.e., homicide, assault or violence not implying a sexual element). A further aim was to explore which facets were associated with sex crime against children as compared with the other types of crime, controlling for socio-demographics (age, gender), psychiatric comorbidity (presence of any psychiatric diagnoses) and general psychopathy traits.

Methods

One hundred sixty-seven prisoners participated (91 had committed sex crime against children, 25 property crime, and 51 committed a crime against the person) and completed the Personality Inventory for the DSM-5 and the Psychopathy Checklist-Revised.

Results

Prisoners who had committed sex crime against children reported higher Restricted Affectivity traits than those who had committed property crime and crime against the person and higher Irresponsibility traits than those who had committed property crime. The results of a multinomial logistic regression analysis showed that on the one hand being a man, having a higher age, and the presence of a psychiatric comorbidity were more likely to be related to sex crime than property crime, on the other hand higher Irresponsibility personality traits, being a man, and the presence of a psychiatric comorbidity were more likely to be related to sex crime against children than crime against the person.

Conclusions

The Irresponsibility facet might be specific to child molesters and can differentiate this group from offenders who have committed other crime types. This facet might be considered a key target of a tailored assessment and treatment planning during clinical practice with child molesters.

Unraveling the Personality Profile of the Sexual Murderer

Although sexual homicide offenders (SHOs) evince personality disorders, few prior studies have examined all personality disorders or utilized control groups of offenders. Drawing on data from 616 adult male sex offenders including 85 who were SHOs, the current study examined the personality profile of the SHOs, by comparing them with a group of violent nonhomicidal sex offenders (VNHSOs) and a group of nonhomicidal sex offenders (NHSOs) on clinical diagnostics of personality disorders and various crime characteristics. The personality profile of SHOs is comprised primarily of Schizoid and Borderline Personality Disorders, and these offenders were significantly likely to select a victim, use a weapon, and use drugs and alcohol before their offenses, but less likely to force their victim to engage in sexual acts or humiliate them. The comorbidity of Schizoid, Borderline, and Antisocial Personality Disorder features presents unique personality dysfunction that facilitates the lethal sexual violence of SHOs relative to their nonhomicidal sexual offender peers.

The prevalence of mental disorders in incarcerated contact sexual offenders

OBJECTIVE

Mental disorders in sexual offenders are relevant in terms of risk assessment and psychotherapeutic and pharmacological treatment.

METHODS

The present cross-sectional study was conducted between 2001 and 2017 and included 1511 sexual offenders who were assessed at the Federal Evaluation Center for Sexual and Violent Offenders in the Austrian Prison System. All sexual offenders were assessed with the Structured Clinical Interview for Axis I (SCID I) and Axis II disorders (SCID II).

RESULTS

N = 1250 (92.9%) sexual offenders were diagnosed with a mental disorder, whereby the great majority received multiple diagnoses. The most frequently found disorders were alcohol misuse (40.0%), paraphilic (43.3%), and personality disorders (53.6%) with a special emphasis on Cluster B personality disorders (47.8%). While sexual offenders against children were more likely to be diagnosed with paraphilic disorders, sexual offenders against adults were more likely to be diagnosed with a personality disorder.

CONCLUSION

Prevalence rates of mental disorders in sexual offenders are considerable. Besides specific risk reducing treatment, the psychological and social sequelae of the mental disorder have to be addressed in interventions in order to reach an effective and sustainable risk reduction.

Does emotion matter? The role of alexithymia in violent recidivism: A systematic literature review

BACKGROUND

Several variables have been evidenced for their association with violent reoffending. Resultant interventions have been suggested, yet the rate of recidivism remains high. Alexithymia, characterised by deficits in emotion processing and verbal expression, might interact with these other risk factors to affect outcomes.

AIM

Our goal was to examine the role of alexithymia as a possible moderator of risk factors for violent offender recidivism. Our hypothesis was that, albeit with other risk factors, alexithymia increases the risk of violent reoffending.

METHOD

We conducted a systematic literature review, using terms for alexithymia and violent offending and their intersection.

RESULTS

(a) No study that directly tests the role of alexithymia in conjunction with other potential risk factors for recidivism and actual violent recidivism was uncovered. (b) Primarily alexithymia researchers and primarily researchers into violence have separately found several clinical features in common between aspects of alexithymia and violence, such as impulsivity (total n = 24 studies). (c) Other researchers have established a relationship between alexithymia and both dynamic and static risk factors for violent recidivism (n = 16 studies).

CONCLUSION

Alexithymia may be a possible moderator of risk of violent offence recidivism. Supplementing offenders' rehabilitation efforts with assessments of alexithymia may assist in designing individually tailored interventions to promote desistance among violent offenders.

Psychopathological features in a sample of substance-abusing individuals with criminal history: Towards a definition of a personality prototype of an 'Addict with Criminal Conduct'

BACKGROUND

The relationship between substance use disorders and criminal activity is strong, and one that is not easily resolved in the criminal justice system. A better understanding of personality traits among substance misusers who commit offences could support better treatment efforts.

AIMS

The aim of this study is to explore associations between the psychopathology of people addicted to substances who have also committed crimes.

METHODS

We recruited 263 substance-dependent individuals (80% male, 20% female) from a cohort of people attending regional community services in Italy. They all completed an extensive evaluation of their current mental health and personality traits. Their official criminal records were obtained, and the psychopathology of those who had a criminal record compared with those who did not.

RESULTS

The criminal group was more likely to perceive the external world as hostile and to consider others as responsible for their own problems and difficulties; in addition, substance-dependent individuals with criminal records showed more personality traits within the psychopathy range and fewer in the dependent personality range than the substance abusers who had never committed crimes.

CONCLUSIONS

These findings allow us to hypothesise that substance abusers who also have criminal convictions may have a specific personality profile. If further research were to confirm this, then it could have important implications for identifying people for particular treatment pathways and developing more effective treatments. Copyright © 2016 John Wiley & Sons, Ltd.

Some Epidemiological Characteristics of Perpetrators and Victims of Incest in Contemporary Ghana: Analysis of Media Reports

In Ghana, incest is considered sinful, taboo, and illegal. However, recent media reports show that incest has become a daily reality in Ghana. This study is a situational analysis of the pattern of incest in Ghana as reported in the media from January 2008 through July 2015. Qualitative content analysis was conducted on 48 incest news reports in Ghana. The findings showed that father-daughter incest was most frequent across the study period. Forty-seven females aged 3 to 25 years and a male aged 3 years were identified as victims. Generally, the incest lasted between 1 day and 13 years before disclosure. Perpetrators employed psychological and/or physical methods to coerce their victims. Marital difficulties, diabolical control, and seduction by victim featured prominently as alleged motives behind the abuse. The study observes that the recent increase in father-daughter incest warrants an immediate shift of research attention onto men's mental health in Ghana.