The incidence of depressive symptomatology in juvenile sex offenders with a history of abuse

The Impact of Types and Extent of Trauma on Depressive Affect Among Male Juvenile Sexual Offenders

High levels of depression have been found among incarcerated youth, which suggests that mental health problems are associated with delinquent behavior and are part of a constellation of risk factors that contribute to youth entering the juvenile justice system. In this project, we investigated trauma and mental health issues among male youth in residential treatment, and addressed the following questions: (a) Does childhood trauma predict current depression for male juvenile sexual offenders? (b) If so, do different types of traumas predict depressive affect better than others? and, (c) Does extent of trauma exposure predict depression? Data on incarcerated male juvenile sexual offenders were analyzed ( n = 379). Multiple regressions of various types of traumas and cumulative trauma and depression were conducted. Emotional abuse was the strongest predictor of depressive affect for this sample, and multiple exposures to trauma were the second strongest predictor.

Child Sexual Abuse and Negative Affect as Shared Risk Factors for Sexual Aggression and Sexual HIV Risk Behavior in Heterosexual Men

Previous research has suggested that sexually aggressive behavior and sexual HIV risk behavior are associated. Childhood sexual abuse (CSA) is a well-established risk factor for both types of problematic sexual behavior. Negative affect (i.e., anxiety, depression, and anger) is a less well-studied risk factor, but it has been theorized to relate to both sexual aggression and HIV risk behavior. Thus, this study sought to (1) confirm the relationship between sexual aggression and HIV risk behavior, (2) establish CSA and negative affect as shared risk factors for sexual aggression and HIV risk behavior, and (3) evaluate whether negative affect mediates the relationship between CSA and sexual aggression and between CSA and HIV sexual risk in a sample of heterosexual men. We recruited 18- to 30-year-old heterosexual men (N = 377) from urban sexually transmitted infection clinics. Men completed measures of sexual HIV risk history (number of partners and condom use), sexual aggression history, CSA history, and trait negative affect (anger, anxiety, and depression). Structural equation modeling was used to examine hypothesized direct and indirect relationships. In the final SEM model, sexual aggression history and sexual HIV risk behavior were correlated. CSA was associated with both types of problematic sexual behavior. Anxiety significantly mediated the relationship between CSA and sexual aggression and between CSA and sexual HIV risk behavior (χ ²[1300] = 2121.79, p < .001; CFI = 0.905; RMSEA [90% CI] = .044 [.041-.047]). Sexual aggression appears to be part of a constellation of sexual risk behaviors; thus, it may be possible to develop prevention programs that target both sexual HIV risk and sexual aggression. CSA is a shared risk factor for sexual aggression and HIV risk behavior through the pathway of anxiety. Thus, anxiety might be one promising target for intervention.

The Prevalence and Circumstances of Child Sexual Abuse among Latina Women

This study examined the prevalence and circumstances of child sexual abuse in a community sample of Latina women, 18 to 50 years of age. Chi-square tests of independence and t -test procedures were used to assess the prevalence, characteristics of the victim, assault, perpetrator, disclosure, and long-term effects. One in three Latina women reported incidents of sexual abuse, regardless of acculturation or citizenship status. More than one third of the women also experienced revictimization, with more than 80% of initial incidents occurring from the age of 7 years. The majority of the experiences occurred in private locations, by young male perpetrators, known to the victim. Four women were forced to marry perpetrators of their abuse. Treatment implications and community-based interventions for Latina survivors of child sexual abuse are discussed.

Internalizing and externalizing problems, depression, and self-esteem in non-detained male juvenile offenders

BACKGROUND

High rates of mental disorders have been found in detained juvenile offenders, whereas the role of psychopathology in non-detained offenders is less clear. Therefore, the present study compared psychopathology in male non-detained delinquent juveniles and two matched samples from the community and an adolescent psychiatric clinic.

METHODS

125 male adolescents aged 11 to 19 years (m = 16.2 years, SD = 1.5 years) from an outpatient adolescent forensic clinic were compared to a community sample from the Zurich Adolescent Psychology and Psychopathology Study (ZAPPS) and a referred sample from a psychiatric clinic matched for age and nationality. All subjects responded to questionnaires measuring internalizing and externalizing problems, depressive symptoms and self-esteem.

RESULTS

The sample of non-detained juvenile offenders showed similar rates of self-reported internalizing and externalizing problems when compared to the community sample, whereas the clinic sample displayed an increased rate of various disturbances. Similar results were found also for self-esteem. In agreement with these findings, non-detained juvenile offenders less frequently had a psychiatric diagnosis after full clinical assessment when compared to the clinical sample. However, a diagnosis of conduct disorders and a lower IQ range was found more frequently in non-detained juvenile offenders. Offenders with serious delinquent acts and involving weapons showed higher depression scores than the rest of the offenders.

CONCLUSION

In non-detained assessment situations before court examination, juvenile offenders present rather normal behaviour. Their lack of awareness of potential behavioural problems should be considered during assessment and treatment of this group of offenders.

Maltreatment and depression in adolescent sexual offenders with an autism spectrum disorder

This study examined the self-reported presence and severity of abuse, neglect, and depressive symptoms for 43 adolescents adjudicated delinquent due to a sexual offense. Twenty-seven of the adolescent sexual offenders were also diagnosed with an autism spectrum disorder, and 16 did not carry an autism spectrum disorder diagnosis. Both groups reported moderate to high levels of abuse and neglect. Adolescent sexual offenders with an autism spectrum disorder reported significantly higher depressive symptoms than those without an autism spectrum disorder. Furthermore, of the group with an autism spectrum disorder, those reporting severe levels of emotional abuse and/or emotional neglect were more likely to also have depressive symptoms. Results suggest a need to tailor treatment programs to match the unique needs of sexual offenders.

Sexual assaulters in the United States: prevalence and psychiatric correlates in a national sample

This study presents sociodemographic characteristics and psychiatric correlates of a representative sample of sexual assaulters in the United States. Data were drawn from a nationally representative survey, the National Epidemiologic Survey on Alcohol and Related Conditions. Face-to-face interviews of more than 43,000 adults were conducted between the 2001-2002 period, based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. The prevalence of committing sexual assault in the U.S. was 0.15 %. Sexual assaulters had significantly lower education than their counterparts. Sexual assaulters were significantly more likely to report a wide range of antisocial behaviors. Multivariate logistic regression analyses indicated strong associations between sexual assault and lifetime psychiatric disorders often associated with impaired impulse control, such as antisocial personality disorder, conduct disorder, and cocaine use disorder. In addition, psychotic disorders were consistently associated with sexual assault. Our findings indicate that sexual assault could represent a behavioral manifestation of a broader spectrum, including impairment of impulse control and psychotic disorders.

Reliability and predictive validity of the Ohio State University TBI identification method with prisoners

OBJECTIVES

Evaluate the psychometric properties of indices of lifetime exposure to traumatic brain injury (TBI) among prisoners.

PARTICIPANTS

Convenience samples recruited from male (N = 105) and female (N = 105) state prison facilities.

DESIGN

Assess test/retest reliability and criterion-related validity.

PRIMARY MEASURES

Summary indices of the number, severity, timing, and effects of lifetime exposure to TBI calculated from data elicited via a structured interview.

RESULTS

Test/retest reliability ranged from acceptable to high. Factor analysis showed that indices of lifetime exposure could be characterized by (1) age of onset (especially childhood onset), (2) combinations of number and likely severity of injuries, and (3) number of symptoms and functional effects. Age at injury, number of TBIs with loss of consciousness, and symptoms persisting contributed independently to the prediction of common cognitive and behavioral consequences of TBI.

CONCLUSION

These results provide further support for the reliability and validity of summary indices of lifetime exposure to TBI when elicited via a structured interview.

Empathy and recognition of facial expressions of emotion in sex offenders, non-sex offenders and normal controls

Research conducted on empathy and emotional recognition in sex offenders is contradictory. The present study was aimed to clarify this issue by controlling for some affective and social variables (depression, anxiety, and social desirability) that are presumed to influence emotional and empathic measures, using a staged multicomponent model of empathy. Incarcerated sex offenders (child molesters), incarcerated non-sex offenders, and non-offender controls (matched for age, gender, and education level) performed a recognition task of facial expressions of basic emotions that varied in intensity, and completed various self-rating scales designed to assess distinct components of empathy (perspective taking, affective empathy, empathy concern, and personal distress), as well as depression, anxiety, and social desirability. Sex offenders were less accurate than the other participants in recognizing facial expressions of anger, disgust, surprise and fear, with problems in confusing fear with surprise, and disgust with anger. Affective empathy was the only component that discriminated sex offenders from non-sex offenders and was correlated with accuracy recognition of emotional expressions. Although our findings must be replicated with a larger number of participants, they support the view that sex offenders might have impairments in the decoding of some emotional cues conveyed by the conspecifics' face, which could have an impact on affective empathy.

Use of Satiation Therapy in the Treatment of Adolescent-Manifest Sexual Interest in Male Children

Satiation therapy was employed as an adjunctive therapy in the residential treatment of a 19-year-old male sexual offender with treatment-refractory sexual interest in prepubescent male children. Satiation therapy was administered on a 14-day cycle according to an “A-B-A-B” treatment design. Self-reported sexual interest, sexual fantasy, and emotion data were collected three times daily over the course of 64 days. Results support the effectiveness of the intervention in differentially reducing sexual interest in young males relative to interest in male peers. Concomitantly, the client evidenced a shift toward the predominance of sexual fantasies of male peers over those involving male children. Experienced anger proved to be a predictor of relative sexual interest in male children. Analyses suggested that diurnal changes in mood, sexual interest, and sexual fantasy made him more vulnerable to sexual acting-out in the evening or night. Implications for relapse prevention planning are discussed.

A preliminary study on findings of psychopathy and affective disorders in adult sex offenders

The construct of psychopathy has often been considered mutually exclusive to the presence of genuine depressive or anxiety symptomotology. This article addresses the hypothesized reasons for this dichotomous relationship. In this study, 68 civilly committed adult male sex offenders were evaluated using a variety of psychological measures to determine if psychopathic individuals in this group would demonstrate clinically significant affective symptoms. Results indicate that the men in this sample endorsed high rates of psychopathy on the PCL-R, with 42% of these expressing concurrent symptoms of depression and 26% manifesting symptoms of an anxiety disorder. Relationships between affective symptoms and PCL-R factor scores and qualitative differences between these constructs in child molesters and rapists are also discussed.

Preventing violence and trauma in the next generation

Research in recent times has clearly demonstrated that violence is predictable and preventable; however, the primary prevention of abusive and violent behavior will not occur without personal, interpersonal, and social change. This article reviews the empirical research supporting hypotheses for primary prevention of many risks associated with children becoming abusive.

The Millon Adolescent Clinical Inventory: Is it Valid and Reliable for Mexican American Youth?

In this study, we examined the internal consistency reliability, construct-related validity, and mean base rate scores of the Millon Adolescent Clinical Inventory (MACI; Millon, Millon, & Davis, 1993) Personality and Clinical scales in a sample (N = 131) of juvenile offending, educationally at-risk, and substance-dependent Mexican American youth. Overall, the MACI scales demonstrated good reliability estimates. Using methods derived from contrast analysis (Westen & Rosenthal, 2003), the scales performed as would be expected based on predictions derived from Millon's (1969, 1981) theory. In addition, the scales differentiated in an expected fashion among the 3 groups. The results of this study provide preliminary support for the use of the MACI among Mexican Americans.

Epidemiology and treatment of juvenile sexual offending

The juvenile sex offender is defined as a youth who commits any sexual act with a person of any age against the victim's will, or in an aggressive, exploitative, or threatening manner. The term 'child molester' refers to those who choose only, or primarily, child victims. In this article, we mostly focus on adolescents aged between 13 and 18 years. To reduce sex crimes and the risk of adolescent sexual re-offending, effective treatment strategies have to be implemented for adolescent sexual offenders. Supervision and treatment recommendations for juvenile sex offenders initially emerged from the literature on adult sex offenders. Treatment must include behavioral therapy, family therapy, and psychosocial interventions. Pharmacotherapy is not always a first-line treatment. Antidepressants (especially selective serotonin reuptake inhibitors) offer promise in the treatment of adolescent sexual offending but further controlled studies are needed. In some rare situations, however, especially when severe paraphilic behaviors (such as pedophilia) are present, an hormonal intervention such as cyproterone acetate treatment may be needed.

Strengthening community-based programming for juvenile sexual offenders: key concepts and paradigm shifts

The past decade has been witness to a sharp increase in residential placement of adjudicated delinquent youth, including juvenile sexual offenders. It is argued that this trend has fiscal implications and may be clinically contraindicated for less characterologically disturbed and dangerous youth. The authors advocate greater investment of public funds in the development and refinement of community-based intervention programs. It is believed that clinically and legally integrated programming, using newer social-ecological methodologies and supports, offers promise of reducing the number of youth who require residential placement, shortening residential lengths of stay and improving the transition of residentially treated youth back into community settings. Key concepts relevant to bolstering community-based programming for juvenile sexual offenders are identified and discussed. Two programs are described, and program evaluation data reviewed, in support of the viability of innovative community-based approaches to the management of this population.

Recidivism and resilience in juvenile sexual offenders: an analysis of the literature

The majority of research that exists studying juvenile sex offenders (JSOs) is dominated by the predilection that identifying risk factors associated with recidivism will benefit both the JSOs and treatment providers. Further, the majority of existing treatments are guided by research that has identified what makes JSOs more likely to reoffend. Absent from the majority of the literature is an examination of the strengths and positive characteristics demonstrated by JSOs that may prove useful in both reducing recidivism and increasing the likelihood of achieving positive outcomes (i.e., demonstrating resilience). Research examining known risk factors for sexual and nonsexual recidivism is described. Next, literature on resilience is reviewed, followed by a discussion of this literature in the context of treatment for JSOs. Finally, future directions of research are presented.

Characteristics of youth who sexually offend

Sexual abuse by juveniles is widely recognized as a significant problem. As communities have become more aware of juvenile sex offending they have responded with increasingly severe responses. This is despite recidivism data suggesting that a relatively small group of juveniles commit repeat sexual offenses after there has been an official response to their sexual offending. Research has shown that juveniles who commit sexual offenses are a heterogeneous mix, varying according to a wide range of variables. This article provides an overview of the characteristics of youths who have committed sex offenses. Factors that will be discussed include types of offending behaviors, family environment, histories of child maltreatment, social skills and interpersonal relationships, sexual knowledge and experiences, academic and cognitive functioning, and mental health.

The importance of offense characteristics, victimization history, hostility, and social desirability in assessing empathy of male adolescent sex offenders

Empathy has been a focus of work with sex offenders; however, there are a limited number of studies supporting this as a deficit. The study investigated the reliability and validity of 3 scales of the Interpersonal Reactivity Index (IRI)--Empathic Concern [EC], Perspective-Taking [PT], and Personal Distress [PD]--within a clinical sample. These scales were also used to examine the differences in empathy among groups of sex offenders. One hundred and twenty-three male adolescent sex offenders (ages 12-19) completed a battery of psychometric measures that included the IRI during a sex-offender-specific assessment. Moderate internal consistency and convergent validity was established for IRI scales. Age and social desirability were related to IRI scores. Victim empathy was not related to IRI scores. Justifications and acceptance of sexual and interpersonal violence were negatively correlated to EC and positively correlated to PD. Those who committed violent offenses reported more EC and PT; however, a generally hostile temperament was negatively related to these scales. Group differences were not found when contrasted with respect to a history of sexual or physical victimization or denial. Researchers using the IRI with male adolescent sex offenders should be cautious of the influence of age and socially desirable responding.

Juvenile sex offenders: toward the development of a typology

Adolescent males who sexually offended against prepubescent children were contrasted with those who targeted pubescent and postpubescent females. As hypothesized, path analyses revealed that the former group had greater deficits in psychosocial functioning, used less aggression in their sexual offending, and were more likely to offend against relatives. Theorized relationships between developmental risk factors, personality mediators, and sexual and nonsexual offense characteristics were assessed in both groups of juvenile sex offenders. Deficits in psychosocial functioning were found to mediate the influence of childhood exposure to violence against females on adolescent perpetration of sexual and nonsexual offenses. Additional univariate analyses were conducted to further explore some associations among early risk factors, personality mediators, and outcomes. Childhood physical abuse by a father or stepfather and exposure to violence against females were found to be associated with higher levels of comorbid anxiety and depression. Noncoercive childhood sexual victimization by a male nonrelative was found to be associated with sexual offending against a male child. Clinical and theoretical implications of the findings are discussed.

Childhood abuse and premilitary sexual assault in male Navy recruits

Three samples of male U.S. Navy recruits (N = 7,850) were surveyed to determine whether a history of childhood physical abuse (CPA) or childhood sexual abuse (CSA) was predictive of premilitary rape of women and whether these relationships were mediated by alcohol problems and number of sex partners. In the 3 samples, 11.3%, 11.6%, and 9.9% of men reported committing premilitary rape. When demographic factors were controlled for, both CPA and CSA were independently and additively predictive of rape in each sample, with men who experienced both forms of abuse showing the highest risk of committing rape. Additional analyses revealed that alcohol problems and number of sex partners significantly mediated the relationship between childhood abuse (CPA and CSA) and rape perpetration.

An evaluation of residential treatment for sexually aggressive youth

This longitudinal study investigated the effectiveness of a one and one-half year long residential treatment program for 26 boys aged 11-15 with histories of sexually aggressive behavior. The clients were assessed with self-report and staff-report measures at the beginning and end of treatment and at several time points in between; also, aggressive acts were tabulated during a one-year follow-up period. There was evidence of improved functioning on 10 of the 12 measures. During the follow-up, 27% of the sample committed an aggressive act, and 8% committed a sexually aggressive act. On most of the measures, improvement occurred gradually over the course of treatment, and on some measures most of the improvement occurred late in the placement.

Adolescent sexual offender recidivism: success of specialized treatment and implications for risk prediction

OBJECTIVE

To evaluate the success of specialized community-based treatment for reducing adolescent sexual reoffending and explore the predictive utility of variables assessed regarding sexual and nonsexual recidivism.

METHOD

Recidivism data (criminal charges) were collected for 58 offenders participating in at least 12 months of specialized treatment at the SAFE-T Program. Data were also collected for a comparison group of 90 adolescents who received only an assessment (n = 46), refused treatment (n = 17), or dropped out before 12 months (n = 27). Follow-up interval ranged from 2 to 10 years (M = 6.23, SD = 2.02). Offenders completed a battery of psychological tests to provide standardized data regarding social, sexual, and family functioning.

RESULTS

Recidivism rates for sexual, violent nonsexual, and nonviolent offenses for treated adolescents were 5.17%, 18.9%, and 20.7%, respectively. The Comparison group had significantly higher rates of sexual (17.8%), violent nonsexual (32.2%), and nonviolent (50%) recidivism. Sexual recidivism was predicted by sexual interest in children. Nonsexual recidivism was related to factors commonly predictive of general delinquency such as history of previous offenses, low self-esteem, and antisocial personality.

CONCLUSIONS

Results support the efficacy of treatment for adolescent sexual offenders and are consistent with the notion that sexual recidivism is predicted by unique factors unrelated to general (nonsexual) reoffending.

Practice parameters for the assessment and treatment of children and adolescents who are sexually abusive of others. American Academy of Child and Adolescent Psychiatry Working Group on Quality Issues

The assessment and treatment of children and adolescents with sexually abusive behavior requires an understanding of normal sexual development. A multiplicity of biological and psychosocial factors determines the child's sexual development, gender role, sexual orientation, patterns of sexual arousal, sexual cognitions, sexual socialization, and the integration of sexual and aggressive patterns of behavior. The individual's sexuality evolves in concert and as a result of interaction with family, ethnic, social, and cultural influences. These parameters summarize what we know about the epidemiology and phenomenology of sexually abusive youths and provide guidelines for the assessment and the selection of treatment interventions for these youths. Essential considerations in the assessment and treatment of sexually abusive youths, as well as the different categories of sexually abusive youths which should be recognized and which influence treatment decisions, are presented. The spectrum of currently available psychosocial and biological treatments will be summarized.

Factors associated with sexual behavior problems in young sexually abused children

OBJECTIVE

To identify variables associated with the presence of sexual behavior problems in young sexually abused children.

METHOD

Data were gathered from the clinical records of 100 sexually abused boys and girls ages 3-7 years enrolled in two treatment programs. Information was coded systematically on approximately 350 areas related to the child and family's history and functioning, the sexual abuse experience, and treatment outcome. The children were grouped and compared according to their presenting sexual behavior into three categories: (1) developmentally "expected"; (2) "sexualized/self-focused"; and (3) problematic "interpersonal" sexual behavior.

RESULTS

Bivariate and multivariate analyses highlighted five variables which were predictive of sexual behavior problems among sexually abused children. Sexual arousal of the child during his/her sexual abuse, the perpetrator's use of sadism, and a history of physical and emotional abuse differentiated between those children with and without "interpersonal" sexual behavior problems. Who the child blamed for his/her sexual abuse further contributed to the distinction between children whose sexual behavior was exclusively "self-focused" (sexualized) versus "interpersonal."

CONCLUSIONS

The five major predictor variables, as well as other variables identified in this study, have potential utility in assessing child risk for negative outcomes and determining referral priorities for sexual abuse treatment. Given that sexual arousal and who the child blames for the abuse are prominent variables associated with sexual problems and self-blame, clinicians will need to ensure that sexually abused children and their caregivers are given specific opportunities to deal with these areas in the supportive context of treatment. Children with sexual behavior problems differ not only in the type and level of sexual behavior they exhibit but in most other areas as well, suggesting a need for differential assessment and individualized treatment approaches.

Parent-adolescent relationships, physical disciplinary history, and adjustment in adolescents

Physical discipline occurs within the context of the parent-child relationship, yet it is often not examined within this important context. The current study examined whether negative effects of physical discipline on older adolescent adjustment are mediated by the overall parent-child relationship. The sample consisted of 253, mostly Caucasian, middle-class, adolescent participants (mean age = 18.4, 67% female). Physical punishment history, parent-adolescent relationships, and adjustment were assessed with self-report instruments. For females, relationships with parents partially mediated the association between physical punishment and adjustment. Physical punishment was negatively associated with both adjustment and parent-adolescent relationships. For males, physical punishment was not related to adjustment. Parent-adolescent relationships were positively associated with adjustment for both females and males. Physical punishment by fathers was negatively associated with father-son relationships. The results suggest the importance of exploring links between physical punishment and adjustment within the context of parent-child relationship, as well as examining males, females, mothers, and fathers separately.

Ethnic differences in circumstances of abuse and symptoms of depression and anger among sexually abused black and Latino boys

OBJECTIVE

The present study was designed to examine the extent to which ethnic differences in the circumstances of abuse would be related to psychological outcomes and whether the relationship of ethnicity to psychological outcomes would be independent of ethnic differences in the circumstances of abuse.

METHOD

Ethnic difference in the circumstances of the abuse, depression, and anger, as measured by the Children's Depression Inventory and the State-Trait Anger Expression Inventory, were assessed in 60 Black and Latino sexually abused males aged 13 to 18 years. Factors related to levels of depression and anger in these two groups were also identified.

RESULTS

Latino males were more likely to have been sexually abused by an extended family member, experienced more genital fondling and were exposed to more sexually abusive behaviors. Blacks were more likely to be abused by an immediate family member. Black males had higher anger scores than Latino males, but, there were no ethnic differences in depression scores. Both ethnicity and the relationship to the perpetrator were significantly related to scores on the State-Trait Anger Expression Inventory, however, ethnicity was also significantly related to anger scores irrespective of the relationship to the perpetrator.

CONCLUSIONS

Ethnic differences in the circumstances of abuse were related to psychological outcome and the relationship of ethnicity to anger scores was independent of ethnic differences in the circumstances of abuse.

Alcohol, drugs, and violence in children's lives

This chapter reviews the current state of knowledge concerning the interrelationship between the cycle of alcohol and other drugs (AOD) use and the cycle of violence. This issue is framed in terms of two questions. The first is the extent to which AOD use by the perpetrator is related to the perpetration of violence toward children, defined here as including both physical and sexual abuse. The second question is whether the experience of abuse during childhood is related to the subsequent development of the abuse of alcohol and other drugs. The review indicates that parental AOD abuse is related to physical and sexual abuse. However, because most perpetrators are not parents, the relationship is not yet clear. The data do support the link between experiencing childhood violence and the development of later AOD abuse. Theoretical explanations for each link are reviewed and mediating variables are identified. The review concludes with a presentation of methodological issues and the directions for future research.

Juvenile sexual offending: one-year period prevalence study within Oxfordshire

An epidemiological survey using a postal questionnaire revealed a 1-year period prevalence rate of 1.5 official juvenile sexual offenders per 1,000 males aged 12-17 within Oxfordshire (.85 per 1,000 12-17 year olds overall). The majority of sexually abusive youth were male, with a family history of neglect, physical, and/or sexual abuse. Behavioral and psychological problems were common.

Child and adolescent sex abuse perpetrators: a review of the research literature

This paper reviews the existing literature on selected issues in relation to child and adolescent sex abuse perpetrators. The relatively recent recognition of this phenomenon and the multiple problems of definition in this field may have affected the figures for incidence and prevalence. Among known cases a high proportion of young sex abuse perpetrators have suffered earlier adversities such as sexual and physical victimisation, dysfunctional family relationships and peer isolation. Despite a slender research data base on which to draw, treatment programmes for this client group have proliferated and many of these have not been adequately evaluated. There is a pressing need for the adoption of agreed definitions of outcome targets and measures and establishing longterm outcome studies with this group of children and adolescents.

Ethnic differences in psychological functioning among black and Latino sexually abused girls

Psychological assessments were conducted for Black and Latino sexually abused girls aged 8 to 13 years. Latino girls received significantly higher scores for depression than the Black girls. These differences in depression appeared to be related to ethnic differences in the circumstances of the abuse. Latino girls were abused at a younger age; more likely to be abused by a relative; and more likely to have had a sibling abused. Latinos were also more likely to report high levels of family conflict and somewhat lower levels of maternal support. Ethnicity was also found to be related to psychological functioning independently of the impact of other factors such as the circumstances of the abuse. Cultural and social factors that may influence psychological functioning subsequent to sexual abuse among Black and Latino girls are identified and discussed.

Adolescent sibling-incest offenders: differences in family and individual functioning when compared to adolescent nonsibling sex offenders

Adolescent male sex offenders who assaulted younger siblings (n = 32) were compared to those who offended against nonsibling children (n = 28). Data were based on responses to the Assessing Environments (III) Scale, Family-of-Origin Scale, Youth Self-Report, Buss-Durkee Hostility Inventory, Tennessee Self-Concept Scale, and the Beck Depression Inventory. Unlike many earlier studies of adolescent sex offenders, sexual offending/victimization histories were based on information collected from regular meetings rather than intake files or initial interviews; offenders' age, socioeconomic status (SES), and social desirability were examined to avoid potential confounds of these variables; victim age and gender were analyzed to ensure that comparisons between sibling and nonsibling offenders were not confounded by victim age or gender; and internal consistencies of the variables were verified with a larger clinical sample (n = 209). Adolescent sibling-incest offenders reported significantly more marital discord, parental rejection, physical discipline, negative family atmosphere, and general dissatisfaction with family relationships. Offenders against siblings were also more often victims of childhood sexual abuse and were more likely to have a younger child in their families. Results are discussed with respect to the etiology and treatment of adolescent sibling-incest offenders.

Adolescent sexual offenders: potential for a healthier lifestyle

Sexual victimization by adolescents is a serious problem of growing societal concern. As a result of such sexual offenses, family functioning and adolescent development may be compromised. Advanced practice psychiatric/mental health nurses can promote a healthier lifestyle for adolescent sexual offenders through assessment, early identification, and intervention to address the specific needs of the adolescents and their families and reduce the risk of sexual reoffense. The purpose of this paper is to explore the issues related to adolescent sexual offenders and their families, provide nurses with the knowledge to promote a healthier lifestyle for this population, and discuss implications for nursing practice, education, and research.