Sexual and other axis I diagnoses of 60 males arrested for crimes against children involving the Internet

The prevalence of mental disorders among incarcerated adult men convicted of child sexual exploitation material offences

OBJECTIVE

Despite the growing body of research on individuals convicted of child sexual exploitation material (CSEM), relatively little is known about the prevalence of mental disorders in this population. The aim of the present study was to describe the prevalence of mental disorders among individuals convicted of CSEM offenses.

METHODS

This cross-sectional study examined data from 66 individuals serving a sentence for CSEM offenses in the Austrian prison system who underwent a clinical assessment between 2002 and 2020. Diagnoses were based on the German version of the Structured Clinical Interview for Axis I and Axis II disorders.

RESULTS

In the total sample, n = 53 individuals (80.3%) were diagnosed with a mental disorder. Twenty-seven individuals (40.9%) had an Axis I disorder and n = 47 (71.2%) had an Axis II disorder. More than two-thirds of the sample, n = 47 (71.2%), had a personality disorder diagnosis, with cluster B personality disorders being the most frequent mental disorders. More than half of the sample, n = 43 (65.2%), had a diagnosis of pedophilic disorder, of which n = 9 (13.6%) were of the exclusive type. Twenty-eight persons (42.4%) showed evidence of a hypersexual disorder.

CONCLUSIONS

In line with previous research, the present sample of convicted CSEM offenders showed a comparatively high prevalence of personality disorders and paraphilic disorders, particularly pedophilic disorders. Additionally, the rate of hypersexual disorder symptoms was considerably high. These findings should be considered for the development of successful risk management strategies for this population.

The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder

OBJECTIVES

The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD.

METHODS

An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews.

RESULTS

Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD.

CONCLUSIONS

An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.

Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study

Introduction

Studies on characteristics of self-referred men with sexual interest in minors (SIM) and treatment approaches in this group of patients are still relatively rare.

Aim

The aim of this exploratory pilot study was to investigate hypersexuality and impulsivity as 2 dynamic risk factors that could possibly change during treatment in self-referred men with SIM.

Methods

Data were collected at the “Kein Täter Werden (means: not become an offender)” network site in Hamburg. Using self-report questionnaires, the extent of hypersexuality and impulsivity was analyzed with the samples’ pretreatment data via descriptive statistics and compared with nonclinical samples of other studies. The relation between hypersexuality and impulsivity was analyzed via Spearman's correlation coefficient with pretreatment data (N = 77). Intragroup analysis compared hypersexuality and impulsivity from pre- and posttreatment (n = 29).

Main Outcome Measures

Hypersexual Behavior Inventory and Barratt Impulsiveness Scale Version 11.

Results

The degree of generalized impulsivity in the SIM group was comparable to that in nonclinical samples while the degree of hypersexuality was considerably higher than in nonclinical samples. Sixty-four percent of the participants were in the range of clinically relevant hypersexuality. Impulsivity and hypersexuality were weakly positively correlated with each other. During treatment hypersexuality significantly decreased while impulsivity did not differ significantly between before beginning treatment and after (partial) completion.

Conclusion

Hypersexuality, but not impulsivity, was pronounced in the group of self-referred men with SIM and should be targeted in treatment. In order to improve treatment outcome regarding risk reduction in self-referred men with SIM, a focus on treatment approaches that were developed to treat hypersexuality can be expected to be effective while focusing on generalized impulsivity may be less relevant.

Lampalzer U, Tozdan S, von Franqué F, et al. Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study. Sex Med 2021;9:100429.

Women and Pornography: A Voyeuristic Perspective With Special Reference to Coimbatore

Tamil Nadu is an Indian state with different cultural trends in marriage, including endogamy, post-marital residence, spousal differences in age and education, and the extent of women’s say in the timing of marriage and choosing a partner, and disbursal of dowries. Even today, sex remains a topic of controversy, linked to immoral and voyeuristic values, especially in a patriarchal heteronormative society. With limited research available on the experiences of women watching porn, the researchers attempted to know and understand how the women of Coimbatore viewed pornography, simply from a voyeuristic perspective. In-depth interviews were conducted with 10 women (natives and residents of Coimbatore), from diversified backgrounds. Discussions related to porn consumption, meanings, risks, dangers, experiences, and pleasures associated with it were initiated. The findings of the study offered basic insights into the topics discussed, which may be helpful in normalizing women’s experiences, thus promoting a healthier and more open discourse about pornography consumption among Coimbatore women.

Correlates of Chronic Suicidal Ideation Among Community-Based Minor-Attracted Persons

Elevated suicidal risk has been documented in adults who are sexually attracted to minors but the topic has not been adequately investigated, particularly outside the context of the criminal justice system. In this study, risk factors for chronic suicidal ideation were assessed in 333 community-based minor-attracted persons (95% male) via an online survey. Chronic suicidal ideation was endorsed by 38.1% of the participants but was associated neither to history of sexually engaging with a child nor to prior contact with the criminal justice system. In bivariate logistic regression analyses, significant unadjusted correlates included young age, less education, prior mental health treatment, weaker attraction to adult women, history of sexual abuse in the participants' own childhood, and the psychosocial effect of perceived stigma against pedophilia. In multivariable analysis, all these factors except education were uniquely associated with suicidal ideation. These results identify meaningful clinical risk factors and treatment targets in this population.

Compulsive sexual behavior and sexual offending: Differences in cognitive schemas, sensation seeking, and impulsivity

BACKGROUND AND AIMS

People from the community seeking treatment in frameworks such as Sexaholics Anonymous (SA) and sex offenders are preoccupied with sex, sexual fantasies, and behaviors. The rates of compulsive sexual behavior disorder (CSBD), however, are reported to be substantially lower among sex offenders than SAs. In this study, we examined differences between SAs and sex offenders in CSBD and in processes that might be at the core of CSBD - maladaptive schemas about the self and others, impulsivity, and sensation seeking.

METHODS

The study comprised 103 sex offenders, 68 SAs, and 81 violence offenders who served as controls aged 18-74 years, who completed self-report measures regarding CSBD, maladaptive schemas, impulsivity, and sensation seeking.

RESULTS

SAs were higher on CSBD, maladaptive schemas, impulsivity, and sensation seeking than sex offenders. Sex offenders were higher on CSBD and impulsivity than violence offenders. Among all groups, maladaptive schemas were linked with higher CSBD.

CONCLUSIONS

High rates of CSBD among SAs might partially be accounted by differences in maladaptive schemas. We discuss the implication of the study to the understanding of CSBD, sexual offences, and therapy for CSBD and sexual offending.

Characteristics and treatment of internet child pornography offenders

In the realm of sexual offenses, there has been a decrease in hands-on offenses, but an increase in online offenses against children. The current issue is whether online and offline sexual offenders are alike or differ. This literature review investigates the differences among individuals who have committed child pornography offenses, individuals who have committed contact offenses against children, and individuals who have committed both. This review discusses the various typologies that have been proposed of those who have committed online offenses against children, the diagnostic implications of having committed child pornography offenses, and the current state of treatment and prevention of individuals who have committed online sex offenses against children. The studies examined were found from psychology databases, listserv links, and references of those collected articles. Only articles in English were included in the review. Overall, Internet child pornography offenders (ICPOs) tend to score significantly differently from contact offenders on various psychological measures. These findings may imply that ICPOs have different treatment needs than contact offenders.

Internet sex addiction: a licence to lust?

In this article we ask what kind of phenomenon is internet sex addiction. From the perspectives of two practising psychiatrists, one of whom has worked in a weekly sexual disorders clinic for 12 years, and an anthropologist we explore whether a moral panic is emerging over sexual behaviour and the internet, and whether internet sex addiction forms part of any such panic. We ask whether many individuals who diagnose themselves as addicted to internet-based sex do so more out of a media-activated sensibility than a clinical reality. We also consider what developments in DSM-5 hold for this area.

Sexual Crime in India: Is it Influenced by Pornography?

PURPOSE

Studies on whether pornography poses a greater risk for sexually aggressive behavior have revealed conflicting results. This study aims to examine the relationship between the consumption of pornography and the subsequent increase in sexual violence, thus testing the hypothesis that increase in consumption of pornography is related to increased sexual crime, in the Indian scenario.

MATERIALS AND METHODS

The current study explored the association between reported incidence of crime over a period of four decades - 1971-2008 (time periods being divided into: Pre-liberalization and post-liberation - India adopted liberalization policy in 1992) and availability of pornography over internet with a particular focus on crime against women (such as rape, sexual harassment, and crime against women).

RESULTS

Comparison of pre-liberalization and post-liberalization growth of rape rates was not significant. Though there were statistically significant positive correlations between the number of internet users and sexual crime rates, the association was non-significant after controlling for the effects of population growth using regression analysis.

CONCLUSION

Results presented needs to be interpreted with extreme care and caution. Nevertheless, the results from this study suggest that easy access to pornography did not have a significant impact on rape rates and crime rate against women.

Characteristics of French users of child pornography: description of a cohort subjected to forensic evaluation

Child pornography is a form of sexual exploitation of children. The virtual aspect of this offence appears to be encouraged by the internet. It is important to know the profiles of the people downloading these images. The aim of our study was to identify the characteristics of people who are drawn to child pornography. Our study was based on psychiatric assessments carried out at the request of the law courts. The feeling of loneliness and poor social integration are evoked by a lot of users of child pornography. Generally, they have no criminal record.

Diagnosis, assessment, and treatment of hypersexuality

This article reviews the current evidence base for the diagnosis, assessment, and treatment of hypersexual conditions. Controversy concerning this diagnosis is discussed. Terminology and diagnostic criteria, as well as psychological, psychopharmacological, and other treatment approaches, are presented.