Moderators of Sexual Recidivism as Indicator of Treatment Effectiveness in Persons With Sexual Offense Histories: An Updated Meta-analysis

The present meta-analysis is an update of the meta-analysis by Schmucker and Lösel [Campbell Syst. Rev. 2017; 13: 1-75], which synthesized evidence on sexual recidivism as an indicator of treatment effectiveness in persons with sexual offense histories. The updated meta-analysis includes 37 samples comprising a total of 30,394 individuals with sexual offense histories, which is nearly three times the sample size reported by Schmucker and Lösel (2017: 28 samples, N = 9781). In line with Schmucker and Lösel (2017), the mean treatment effect was small with an odds ratio of 1.54 [95% CI 1.22, 1.95] (p < .001). A moderator analysis suggested three predictors of importance, i.e., risk level, treatment specialization, and author confounding. Greater treatment effectiveness was suggested in high- and medium-compared to low-risk individuals and in specialized compared to non-specialized treatments. Authors affiliated with treatment programs reported larger effectiveness than independent authors. These findings were overall in line with Schmucker and Lösel (2017), though the effects of risk level and treatment specialization were stronger in the current meta-analysis. The findings of the updated meta-analysis reinforce the evidence for the first and second principle of the Risk-Need-Responsivity model. The results may support researchers and decision-makers in interpreting the current evidence on sexual recidivism as an indicator of treatment effectiveness, and, based on that, implement and carry out informative, methodologically sound evaluations of ongoing treatment programs in persons with sexual offense histories.

Dynamic Protective Factors Relevant to Sexual Offending

PURPOSE OF REVIEW

Focusing on protective factors rather than risk factors potentially better aligns assessment with strengths-based treatment. We examine research into the assessment of protective factors to see whether it can play this role relative to sexual offending.

RECENT FINDINGS

Structured asses sment of protective factors is well developed relative to violent offending but only recently studied relative to sexual offending. Nevertheless, multiple measures of protective factors have now been trialed with men who have committed sexual offenses and shown to predict reduced recidivism. Although research into individual scales is limited, overlapping content between scales suggests that protective factors aligning with constructs of Resilience, Adaptive Sexuality, and Prosocial Connection and Reward are all relevant to sexual offending. Protective factors relevant to sexual offending are sufficiently well identified that they can usefully be used for treatment need assessment, treatment planning during therapy, and case management. They can also make some contribution to risk assessment. The Structured Assessment of PROtective Factors against Sexual Offending (SAPROF-SO) is currently the most comprehensive measure of protective factors relevant to sexual offending.

Machine Learning and Risk Assessment: Random Forest Does Not Outperform Logistic Regression in the Prediction of Sexual Recidivism

Although many studies supported the use of actuarial risk assessment instruments (ARAIs) because they outperformed unstructured judgments, it remains an ongoing challenge to seek potentials for improvement of their predictive performance. Machine learning (ML) algorithms, like random forests, are able to detect patterns in data useful for prediction purposes without explicitly programming them (e.g., by considering nonlinear effects between risk factors and the criterion). Therefore, the current study aims to compare conventional logistic regression analyses with the random forest algorithm on a sample of N = 511 adult male individuals convicted of sexual offenses. Data were collected at the Federal Evaluation Center for Violent and Sexual Offenders in Austria within a prospective-longitudinal research design and participants were followed-up for an average of M = 8.2 years. The Static-99, containing static risk factors, and the Stable-2007, containing stable dynamic risk factors, were included as predictors. The results demonstrated no superior predictive performance of the random forest compared with logistic regression; furthermore, methods of interpretable ML did not point to any robust nonlinear effects. Altogether, results supported the statistical use of logistic regression for the development and clinical application of ARAIs.

Long Term Recidivism Rates Among Individuals at High Risk to Sexually Reoffend

Preventive detention provisions in the US and Canada assume we can identify, in advance, individuals at high risk for sexual recidivism. To test this assumption, 377 adult males with a history of sexual offending were followed for 20 years using Canadian national criminal history records and Internet searches. Using previously collected information, a high risk/high need (HRHN) subgroup was identified based on an unusually high levels of criminogenic needs (n = 190, average age of 38 years; 83% White, 13% Indigenous, 4% other). A well above average subgroup of 99 individuals was then identified based on high Static-99R (6+) and Static-2002R (7+) scores. In the HRHN group, 40% reoffended sexually. STATIC HRHN norms overestimated sexual recidivism at 5 years (Static-99R, E/O = 1.44; Static-2002R, E/O = 1.72) but were well calibrated for longer follow-up periods (20 years: Static-99R, E/0 = 1.00; Static-2002R, E/O = 1.16). The overall sexual recidivism rate for the well above average subgroup was 52.1% after 20 years, and 74.3% for any violent recidivism. The highest risk individuals (top 1%) had rates in the 60%-70% range. We conclude that some individuals present a high risk for sexual recidivism, and can be identified using currently available methods.

Dynamic Individual Risk Networks: Personalized Network Modelling Based on Experience Sampling Data

Following a network perspective, risk of sexual reoffending can be understood as a construct that emerges from the interactions between risk factors. If these interrelationships are validly mapped out, this leads to an increased understanding of the risk and thus may contribute to more effective and/or more efficient interventions. This paper reports on personalized network modeling mapping the interrelationships of dynamic risk factors for an individual convicted of sexual offenses, using experience sampling (ESM) based on Stable-2007 items. The longitudinal character of ESM enables both the assessment of interrelations between risk factors within a timeframe and the relationships between risk factors over time. Networks are calculated and compared to the clinical assessment of interrelationships between the risk factors.

Outcome Evaluation of a Treatment Program for Men with Paraphilic Disorders Convicted of Sexual Offenses: 10-Year Community Follow-up

Evidence concerning specific paraphilia treatment effectiveness is limited. We present observation data of 127 men convicted of paraphilic sexual offenses who attended inpatient and outpatient follow-up treatment in Czechia. We collected participants' sociodemographic and treatment-related information, including STATIC-99R scores, and used proportional hazards models to analyze variables' effect on recidivism risk. Within the observation period, the general recidivism and sexual recidivism rates were 33.1% and 16.5%, respectively, and the sexual contact recidivism rate was 4.7%. The total STATIC-99 score for those who re-offended was 5.65 (SD = 2.11) and for those who did not was 3.98 (SD = 2.02). Recidivism risk was 7.52 times higher for those diagnosed with exhibitionism than with pedophilia, sadomasochism, or antisocial personality disorder. General recidivism is comparable to others' findings. We attribute the lower sexual contact recidivism rate to the combined effects of psychological and pharmacological treatment, and higher numbers of non-contact offenses to limited antidepressant use.

Consistency and Construct Validity of the Five-Level System for Risk Communication Using Static and Dynamic Tools: An Investigation Using the Static-99R and VRS-SO

This study examined the Council of State Governments' five-level system for risk communication, as applied to the Static-99R and Violence Risk Scale-Sexual Offense Version (VRS-SO). Aims of the system include increasing consistency in risk communication and linking risk categories to psychologically meaningful constructs. We investigated concordance between risk levels assigned by the instruments, and distributions of VRS-SO dynamic needs associated with Static-99R risk levels, among a multisite sample (n = 1,404) of persons who have sexually offended. Concordant categorical risk ratings were assigned in just over a third of cases, suggesting that consistency remains a concern with the system, particularly when conceptually disparate tools are applied. Densities of criminogenic needs varied widely among persons assigned the same risk level by the Static-99R and diverged from the descriptions ascribed by the system. These findings can inform clinical assessments and further refinement of the system.

Attending to the Positive: A Retrospective Validation of the Structured Assessment of Protective Factors-Sexual Offence Version

Sexual recidivism risk assessment tools focus almost exclusively on risk factors associated with increased rates of recidivism and do not attend to protective factors that might mitigate reoffense risk. The present study investigated the predictive validity of the Structured Assessment of Protective Factors - Sexual Offence version (SAPROF-SO), developed to assess hypothesised protective factors against sexual recidivism in adult males. The SAPROF-SO pilot version contains 24 items across two domains: Personal and Professionally Provided Support. SAPROF-SO scores were rated retrospectively from a review of archived case files of 210 men with convictions for child sexual offenses, using the SAPROF-SO pilot manual and a supplementary retrospective scoring guide developed for the current study. SAPROF-SO Total and Personal domain scores were significantly predictive of sexual recidivism after an average follow-up period of 12.24 years (AUC = .81), and to a lesser extent, violent and general recidivism. SAPROF-SO Total and Personal scores additionally provided significant incremental validity over Static-99R scores in the prediction of sexual recidivism. Results support the predictive validity of protective factors for reduced sexual recidivism and invite future research examining how to integrate the SAPROF-SO alongside contemporary sexual recidivism risk assessment tools.

Reliability and Factor Structure of the Sex Offender Treatment Intervention and Progress Scale

Assessment of risk of sexual recidivism has progressed from tools containing only static factors to tools including dynamic (i.e., changeable) risk factors. The psychometric properties and factor structure of one such scale, the Sex Offender Treatment Intervention and Progress Scale (SOTIPS) were explored. Seven hundred and thirty-one men assigned probation for sexual crimes in New York City and Maricopa County, Arizona were administered SOTIPS three times: intake into probation, six months later, and six months after that. SOTIPS showed good internal consistency (Time 1 ω = .87, Time 2 ω = .89, and Time 3 ω = .91), and acceptable inter-rater reliability (for the 26 cases rated in the same month, ICC =.821). An exploratory factor analysis did not result in the original factor structure proposed by the developers; instead, SOTIPS showed two factors: sexual risk and antisocial opposition. This factor structure required the averaging of two items to avoid collinearity. SOTIPS showed temporal invariance indicating that its factor structure and its association to underlying latent variables are consistent over time.

Public Perception of Men Who Have Committed Intrafamilial and Extrafamilial Sexual Offences Against Children

This study examined whether the attitudinal responses toward child sexual abuse (CSA) differ due to the person's relationship with the victim (intrafamilial vs. extrafamilial) and/or proximity to the victim (close vs. distant). An online sample of 292 participants completed a measure assessing pre-existing attitudes toward people who commit sexual offenses, before being randomly presented with a vignette describing a CSA case committed by a biological father, biological uncle, babysitter, stranger, or stepfather. Participants then rated the perpetrator's level of dangerousness and pedophilic interest, their own feelings of disgust, and their punitive judgments. Controlling for pre-existing attitudes, the extrafamilial cases (stranger and babysitter) were perceived to be more dangerous (large effects; ds > .50) and more pedophilic than the stepfather (large effects; ds > .60). Also, participants reported greater levels of disgust toward the stranger than both the babysitter and uncle (medium effects; ds > .30). The findings demonstrate the need to account for the established heterogeneity of men who commit CSA when studying the public's attitudinal responses. Methodological limitations and suggestions for future research are also discussed.

Predictive Validity of Static-99R Among 8,207 Men Convicted of Sexual Crimes in South Korea: A Prospective Field Study

The accuracy of risk assessment tools for Asian populations has received relatively little research attention. This study evaluated one of the most widely used static risk assessment tools - Static-99R - for assessing the likelihood of recidivism among men convicted of a sexual crime in South Korea. Overall, this South Korean sample (N = 8207) appeared to have a higher risk (more paraphilic interests, more sexual/general criminality) than the Static-99R normative samples (who were mostly White individuals from Western countries). Despite the differences, Static-99R was able to discriminate recidivists from nonrecidivists in South Korea, with AUC values similar to that observed in the normative samples (e.g., 0.72 for sexual recidivism). In terms of calibration, the observed sexual recidivism rates of the current sample were higher than the international routine/complete normative samples but lower than the high-risk/high-need normative samples (E/O = 0.75 and 1.26, respectively). Consequently, evaluators in South Korea can have reasonable confidence in the ability of Static-99R to rank individuals according to their relative likelihood of sexual recidivism.

Comparison of Community and Expert Samples in the Perceived Risk of Individuals Who Have Sexually Offended

Public and clinician attitudes are important to consider when studying the reentry of individuals who sexually offend. Uninformed public attitudes drive the continued use of ineffective policies like registries and residential restrictions in the United States, and experts must assess risk to decide what level of supervision and control to recommend upon release from prison. This study investigated whether actuarial feedback could change participant attitudes about recidivism risk and disposition. Association for the Treatment and Prevention of Sexual Abuse (ATSA) members and a sample from MTurk completed a survey using vignettes to assess recidivism risk and dispositional outcomes of individuals who had sexually offended and varied in their risk to reoffend. They received feedback about the individuals' Static-99R risk levels and adjusted their initial ratings. ATSA members were less punitive than MTurk participants, initially predicted risk that was more consistent with actuarial data, and adjusted when incorrect. MTurk participants held more negative attitudes towards individuals who sexually offend, as measured by the ATS-21. They adjusted their risk ratings more than ATSA members, though their estimates were still higher than the ATSA members after feedback. Implications for US public policy, including the recommendation to use actuarials across the country, are discussed.

Improving Our Risk Communication: Standardized Risk Levels for Brief Assessment of Recidivism Risk-2002R

A Five-Level Risk and Needs system has been proposed as a common language for standardizing the meaning of risk levels across risk/need tools used in corrections. Study 1 examined whether the Five-Levels could be applied to BARR-2002R (N = 2,390), an actuarial tool for general recidivism. Study 2 examined the construct validity of BARR-2002R risk levels in two samples of individuals with a history of sexual offending (N = 1,081). Study 1 found reasonable correspondence between BARR-2002R scores and four of the five standardized risk levels (no Level V). Study 2 found that the profiles of individuals in Levels II, III, and IV were mostly consistent with expectations; however, individuals in the lowest risk level (Level I) had more criminogenic needs than expected based on the original descriptions of the Five-Levels. The Five-Level system was mostly successful when applied to BARR-2002R. Revisions to this system, or the inclusion of putatively dynamic risk factors and protective factors, may be required to improve alignment with the information provided by certain risk tools.

Exploring Risk for Sexual Recidivism and Treatment Responsivity Through the Lens of Early Trauma

Adverse childhood experiences (ACE) are common in the histories of individuals who have sexually offended. Many risk factors for sexual recidivism resemble symptoms of early trauma, and early trauma may present a responsivity barrier to engagement in offense-focused treatment. Using the ACE scale, the current study aimed to (i) examine relationships between ACE scores and static and dynamic risk assessment scores, (ii) examine whether ACE scores differ between treatment completers versus noncompleters, and finally (iii) examine whether ACE scores predict treatment noncompletion. ACE scores were retrospectively coded from files of adult men receiving community-based assessment and/or treatment in New Zealand for sexual offenses against children (N = 491; n = 185-411 for individual analyses). Although effect sizes were generally small, static risk and general self-regulation dynamic risk factors correlated positively with ACE scores, ACE scores were higher for treatment noncompleters versus completers, and higher dynamic risk assessment scores and ACE scores increased the odds of treatment noncompletion. Implications for future research and enhancing treatment responsivity are discussed.

Balancing Political and Criminogenic Needs: Evaluating the New Zealand Department of Corrections' Response to Men Assessed With a Below Average Risk for Sexual Recidivism

Current research provides little evidence for the effectiveness of treatment in reducing sexual offence recidivism amongst low-risk populations. However, in real-world correctional settings, program delivery rarely occurs in a vacuum, treatment may be politically mandated and unidimensional measures of program success may preclude recognition of broader benefits. The current study investigated the effectiveness of a low-intensity treatment program, both in terms of participants' recidivism outcomes and in terms of broader organizational/systems impacts. The results demonstrated low base rate recidivism across both program participants (n = 311) and a comparison group of men who were assessed as demonstrating similar static sexual offence recidivism risk (n = 391), and little evidence of reduced recidivism following treatment. However, program administration led to many potential participants being identified as demonstrating higher levels of dynamic risk and overridden to more intensive treatment options (n = 101). Given evidence that such options do effectively reduce recidivism in higher risk populations, these findings may suggest an overall positive net effect.

California Sexually Violent Predator (SVP) Evaluations in the Field: Static-99R and Diagnostic Field Reliability

Tests and diagnoses used in sexually violent predator (SVP) evaluations must be reliable, as reliability is foundational to validity. The current study contained a stratified sample of evaluations of 395 individuals referred as potential SVPs between 2012 and 2017. Each individual was initially evaluated by at least two experts. The sample included three groups: individuals not meeting SVP criteria (N = 200, or 400 evaluations), individuals meeting SVP criteria (N = 95, with 190 evaluations), and individuals where evaluators disagreed (N = 100, with 200 evaluations). The sample also included 200 subsequent independent evaluations on these "disagree" cases. Static-99R score intraclass coefficient (ICC) interrater reliability was good to excellent within each group and overall. Evaluators scored the Static-99R within one point of each other 87% of the time. Cohen's kappa diagnostic agreement for Pedophilic Disorder was substantial. ASPD and substance abuse kappa were in the "fair" range, while OSPD diagnoses in the positive group were at the "moderate" level of agreement. Ethnic differences in diagnoses were consistent with other studies, with equivalent Static-99R ICC values across ethnic groups. There were no significant differences between state civil servants versus contracted experts in Static-99R ratings or final determinations. The results suggest that Static-99R scores have acceptable reliability in these evaluations, and Pedophilic Disorder (the most common paraphilic disorder in our study) and OSPD can be reliably diagnosed. We discuss limitations of the study, as well as the need for care in high-stakes evaluations given the imperfect reliability of psychological measurements.

Why are individuals over age 60 still committed as sexually violent persons?

Civilly committed sexually violent persons (SVPs) are a select group of individuals designated as high risk for future sexual violence. Despite risk reduction in older age, SVP programs are seeing aging client populations, with many individuals remaining committed after age 60 (60+). Recent research found a sexual recidivism rate of 7.5% for 60+ individuals released from an SVP civil commitment program. The current paper follows up by examining reasons why individuals remain committed after age 60. It compares SVPs discharged after age 60 to those who are 60+ but remain civilly committed. Results of bivariate analyses reveal older SVPs who remain committed have significantly higher actuarial risk scores and are more likely to be of minority race. Multivariate logistic regression analyses found actuarial risk scores (Static-99R) predicted continued commitment, after controlling for other relevant variables. Barriers to community reintegration and suggestions for multi-disciplinary case management for older SVPs are discussed.

An Examination of the Latent Constructs in Risk Tools for Individuals Who Sexually Offend: Applying Multidimensional Item Response Theory to the Static-2002R

Multidimensional item response theory (MIRT) was used to study the construct validity of the Static-2002R, an actuarial scale for the assessment of reoffending among adult men who sexually offended. Using a sample of 2,569 individuals with a history of sexual crime, exploratory factor analysis (EFA) extracted three factors: Persistence/Paraphilia, General Criminality, and Youthful Stranger Aggression. MIRT confirmed the factor structure identified in the EFA model and provided item-level data on discrimination and difficulty. All Static-2002R items showed moderate to very high discrimination and covered a wide range of risk levels (i.e., difficulty). MIRT analyses attested to the construct validity of the scale, as no items were identified as problematic and the resulting factor structure was consistent with that of earlier studies. Considering the stability of results pertaining to the factor structure of the Static-2002R and the advantages of dimensional scoring, we recommend the integration of dimensional scores in the scale.

Improving Risk Communication: Developing Risk Ratios for the VRAG-R

We developed a set of risk ratios for the Violence Risk Appraisal Guide-Revised (VRAG-R) to broaden the range of risk communication options available when using this tool and to provide information needed for future efforts to apply The Council of State Governments Justice Center's standardized five-level risk framework to the scale. A slightly reduced version of the VRAG-R normative data set was used for the analyses (N = 1,238). Contrary to previous research developing risk ratios, logistic regression provided a more accurate estimate of observed violent recidivism rates than Cox regression for both total VRAG-R scores and VRAG-R decile bins. Further analyses indicated the relationship between the VRAG-R and violent recidivism was consistent over a 15-year follow-up period. Due to the difficulties with interpreting odds ratios, the final risk ratios were computed using rate ratios derived from a logistic regression model using a 5-year fixed follow-up period. These risk ratios, and templates for how the ratios might be used in an assessment report, are presented in the appendices.

Dynamic sexual offense risk assessment using the VRS-SO with indeterminate sentenced men

Indeterminate detention (ID) is a high stakes sanction reserved for exceptionally high risk-high need (HRHN) persons who are deemed to pose an undue risk to public safety. It is one of the most extreme measures that is routinely taken by justice systems to manage sexual violence risk and prevent sexual and violent recidivism. Naturally, risk assessment is most frequently employed as a mechanism to keep dangerous people in custody; but seldom is risk assessment viewed as a possible ticket out for men with an ID designation who have made substantive risk changes and whose risk can be safely managed in the community. This article features applications of a dynamic sexual violence risk assessment and treatment planning tool, the Violence Risk Scale-Sexual Offense version (VRS-SO), with ID individuals and other HRHN men, to assess risk in a dynamic manner to inform risk management efforts and release decisions. VRS-SO data on an ID sample are presented along with clinical illustrations of dynamic risk assessment. Several propositions are made with supporting data from VRS-SO normative research with treated sexual offending samples regarding the use of dynamic tools with ID men and the perils and pitfalls of relying solely on static measures. Ultimately, dynamic risk instruments can be used to track progress and monitor risk change over multiple assessments to inform release and reintegration decisions with ID persons. In this regard, dynamic assessment has the potential to help, rather than hinder, reintegration of ID sentenced persons and can inform safe, fair, and humane decisions.

An Exploratory Study of Recidivism Risk Assessment Instruments for Individuals Convicted of Sexual Offenses in Singapore

The predictive validity of risk assessment instruments for persons who have committed sexual offenses has improved tremendously in the last four decades, but the progress has been limited to Western offender populations. The aim of this study was to examine the predictive validity of Static-99R, Stable-2007, Sexual Violence Risk-20, Version 2 (SVR-20 v2), Psychopathy Checklist-Revised (PCL-R), and Level of Service/Case Management Inventory (LS/CMI) in predicting recidivism of persons convicted on sexual offenses in Singapore. Retrospective data of 134 such persons were used to code the various instruments. Receiver operating characteristic analyses revealed that combined Static-99R/Stable-2007 new standardized risk ratings, SVR-20 v2 total scores and risk ratings, PCL-R total scores, as well as LS/CMI total scores and risk ratings predicted sexual recidivism. All the aforementioned instruments' total scores and risk ratings (if applicable) predicted any recidivism. However, risk profiles of this sample differed significantly from the normative Western samples.

A Static-99R Validation Study on Individuals With Mental Disorders: 5 to 20 Years of Fixed Follow-Up After Sexual Offenses

'The Static-99R is one of the most commonly used risk assessment instruments for individuals convicted of sexual offenses. It has been validated for use on many populations, but few studies specifically target and describe individuals with mental disorders. Additionally, research on the discriminative properties (how well the instrument separates recidivists from non-recidivists) of the instrument over longer follow-up periods is scarce. This article evaluated the validity of the Static-99R using a cohort of individuals with mental disorders convicted of sexual offenses in Sweden (N = 146) with fixed 5-year (n = 100), 10-year (n = 91), 15-year (n = 79), and 20-year (n = 36) follow-up periods. A Static-99R cut score of 6 demonstrated the highest Youden index, maximizing sensitivity (72.7%) and specificity (74.2%), with 25.8% of recidivists correctly assumed to reoffend sexually and 95.7% of non-recidivists correctly assumed not to. The Static-99R instrument demonstrated adequate discrimination (AUC = 0.79, CI 95% = 0.70-0.87, and OR = 1.45, CI 95% = 1.14-1.84, p < 0.001, 5-year fixed follow-up), with only marginal differences for 10-, 15-, and 20-year fixed follow-up (AUC = 0.73, 0.74, and 0.74 and OR = 1.31, 1.36, and 1.40, respectively). Calibration (quantifying risk and correspondence with the instrument's norms) was acceptable (Brier = 0.088, P/E = 0.70, E/O = 1.43), with the routine sample norms displaying a decisively better fit to the study cohort compared to the high-risk/high-need sample norms. The results affirm the recommendation that, when in doubt and where there is no recent local norm group large enough available, the Static-99R routine sample found in the evaluators' workbook should be used.

STABLE-2007 Demonstrates Predictive and Incremental Validity in Assessing Risk-Relevant Propensities for Sexual Offending: A Meta-Analysis

STABLE-2007 is a measure of risk-relevant propensities for adult males convicted of a sexual offense. This meta-analysis evaluated the ability of STABLE-2007 and its items to discriminate between recidivists and nonrecidivists, and the extent to which STABLE-2007 improves prediction over and above Static-99R. Based on 21 studies (12 unique samples, N = 6,955), we found that STABLE-2007 was significantly and incrementally related to sexual recidivism, violent (nonsexual) recidivism, violent (including sexual) recidivism, and any crime. Scores on STABLE-2007 items and the three STABLE-2000 attitude items also discriminated between individuals who sexually reoffended and those who did not sexually reoffend. These findings support the use of STABLE-2007 in applied risk assessment practice and the interpretation of STABLE-2007 items as indicators of treatment and supervision targets.

Estimating Lifetime and Residual Risk for Individuals Who Remain Sexual Offense Free in the Community: Practical Applications

Although individuals with a history of sexual crime are often viewed as a lifelong risk, recent research has drawn attention to consistent declines in recidivism risk for those who remain offense free in the community. Because these declines are predictable, this article demonstrates how evaluators can use the amount of time individuals have remained offense free to (a) extrapolate to lifetime recidivism rates from rates observed for shorter time periods, (b) estimate the risk of sexual recidivism for individuals whose current offense is nonsexual but who have a history of sexual offending, and (c) calculate yearly reductions in risk for individuals who remain offense free in the community. In addition to their practical utility for case-specific decision making, these estimates also provide researchers an objective, empirical method of quantifying the extent to which individuals have desisted from sexual crime.

Assisting decisions in child protection service institutions with the RIC - The Risk Indication in Child sexual abuse

BACKGROUND

The RIC (Risk Indication in Child sexual abuse) and its screening version (RIC:SV) are actuarial risk assessment instruments, developed at the Austrian Federal Evaluation Centre for Violent and Sexual Offenders and designed for child protection services to assess the likelihood of sexual recidivism in male contact child sexual abusers who still or again live within a family including children.

OBJECTIVE

The RIC was designed to require a minimum of forensic information, with the RIC:SV completely waiving such information.

PARTICIPANTS

Nine factors related to sexual recidivism could be identified by analyzing five-year follow-up data of N = 324 male contact child sexual abusers.

SETTING

The data was collected retrospectively from files between the years 2002 and 2011.

METHOD

Chi-Square Tests and ROC-analyses were calculated.

RESULTS

The RIC and the RIC:SV were found to significantly predict sexual recidivism with AUC values of .84 (RIC) and .78 (RIC:SV). The items of the RIC are: (a) offender has never had a live-in relationship, (b) unstable family background of the offender, (c) impulsivity of the offender, (d) previous psychiatric treatment(s) of the offender, (e) offender has prior prison sentence/s, (f) problems of the offender to accept rules and norms, (g) offender was a stranger to his former victim(s), (h) offender had at least one male victim, and (i) offender has ever committed an extrafamilial contact child sexual abuse offense.

CONCLUSION

The RIC and the RIC:SV need no extensive training to be used. The results may help CPS workers to justify risk related interventions.

The Council of State Governments Justice Center Approach to Increasing Risk-Level Consistency in the Application of Risk Assessment Instruments

Correctional and forensic mental health settings potentially have multiple risk assessment instruments administered on a single client. Because of the various methods of determining risk categories, risk-level consistency can become an issue. The Council of State Governments Justice Center developed a Five-Level System that can be applied to most risk assessment instruments. Using the Level of Service Inventory-Revised and two created risk assessment instruments, the present study assessed if the Five-Level System (vs. normative percentile categories) demonstrated greater agreement between the two instruments, and, if so, the percentage of greater agreement. The Five-Level System demonstrated 4% to 5% greater agreement for both risk-level placement and recidivism rates. The implications of this greater consistency among risk assessment instruments is an increased fairness in making risk-level assignments.

A Principled Approach to the Construction of Risk Assessment Categories: The Council of State Governments Justice Center Five-Level System

Consistent risk category placement of criminal justice clients across instruments will improve the communication of risk. Efforts coordinated by the Council of State Governments (CSG) Justice Center led to the development of a principled (i.e., a system based on a given set of procedures) method of developing risk assessment levels. An established risk assessment instrument (Level of Service Inventory-Revised [LSI-R]) was used to assess the risk-level concordance of the CSG Justice Center Five-Level system. Specifically, concordance was assessed by matching the defining characteristics of the data set with its distribution qualities and by the level/category similarity between the observed reoffending base rate and the statistical probability of reoffending. Support for the CSG Justice Center Five-Level system was found through a probation data set (N = 24,936) having a greater proportion of offenders in the lower risk levels than a parole/community data set (N = 36,303). The statistical probabilities of reoffending in each CSG Justice Center system risk level had greater concordance to the observed Five-Level base rates than the base rates from the LSI-R original categories. The concordance evidence for the CSG Justice Center Five-Level system demonstrates the ability of this system to place clients in appropriate risk levels.

Assessment of relative risk for sexual and violent recidivism with Risk Matrix 2000

Risk Matrix 2000’s ability to assess relative risk for sexual and violent recidivism has been well established through meta-analysis. However, the instrument was originally designed for use in the United Kingdom and has not been widely tested in other parts of Europe, raising questions about how generalizable the results are. This paper assessed the instrument’s ability to assess relative risk for these outcomes in a sample of over 300 Austrian adult males serving a prison sentence for a sexual offense for whom 5-year rates of sexual and violent recidivism were available. Results indicated an ability to assess relative risk that was comparable to that observed in the United Kingdom. In the context of previous results from Germany, the findings of the present study indicate that Risk Matrix 2000 may be appropriately applied in Europe. Analyses explored the added value of using the Sexual and Violence risk scales in conjunction to identify the kinds of criminogenic need that should be addressed in treatment and supervision.

Critical considerations in the development and interpretation of common risk language

Existing risk communication procedures are marred by various well-documented problems and inconsistencies. The Council of State Governments' Justice Center (United States) developed a five-level system for risk and needs communication, to standardize these procedures and to provide a common risk language. Introduction of a common language could constitute a dramatic shift in criminal justice processes, with wide-ranging impacts. This article provides a critical review of the system and its suitability for application to various risk assessment functions. Issues discussed include: applicability to specialist and generalist offending behavior, the characteristics of suitable instruments, statistical and conceptual priorities, barriers to precision in language, and conceptual issues related to changes in risk level. A thorough understanding of each of these issues is necessary to apply the system to new contexts and populations, and facilitate straightforward and precise risk communication. Absent further elaboration of the system, many problems with risk communication will persist.

Men With Intellectual Disabilities Who Have Offended Sexually

PURPOSE OF REVIEW

We review extant and new research focusing on assessment and treatment of men with intellectual disabilities (ID) who have offended sexually. New research findings are applied and integrated with classic assessment and treatment approaches, providing an overview of evidence-based practices.

RECENT FINDINGS

New research has explored healthy sexuality among people with intellectual disabilities, including making evidence-based sexual information cognitively accessible for people with ID. Research has begun to include men with ID in studies of actuarial risk assessment and dynamic treatment needs and identify forms of sexual deviation. New research has identified the need for access to treatment materials better tailored to clients' cognitive level, as well as understanding normal sexuality among people with ID. The recent research further develops our understanding of men with ID who offended sexually and demonstrates similarities between men with and without ID who have offended sexually. The new research findings provide evidence-based support and guidance for clinicians working with this set of clients and suggest optimism for more positive outcomes as studies from across the globe are focusing on working with men with ID who have offended sexually.

Paraphilia and Antisociality: Motivations for Sexual Offending May Differ for American Whites and Blacks

There has been little research on the sexual offending behavior of different racial groups. This study compares the characteristics and risk factors for American, non-Hispanic Whites (n =797) and Blacks (n = 788) who had been convicted of a sexual crime in New Jersey. The results indicated that Whites appeared more paraphilic whereas Blacks displayed higher antisociality. Despite the differences, however, the Static-99R, sexual recidivism risk tool, predicted equally well for both racial groups: Whites (area under the curve [AUC] = .76) and Blacks (AUC = .78). The findings suggest that there may be opportunities to improve treatment for the individuals at risk for sexual offending by tailoring interventions to the distinctive risk-relevant characteristics of Whites and Blacks.

Predictive Validity of the Static-99 and Static-99R in Switzerland

This study evaluated the validity of the Static-99 and Static-99R in assessing sexual recidivism in Switzerland, based on a sample of 142 male sex offenders. Both tools showed predictive validity, but the Static-99R had better discrimination (OR = 1.82, AUC = .81) and calibration (Brier = .078, P/E = 0.96) than the Static-99. A cut score of four on the Static-99R maximized sensitivity (92.9%) and specificity (60.2%). However, although most offenders (98.7%) with a score < 4 did not commit sexual offenses in the 5-year follow-up period, only one in five (20.3%) offenders with a score ≥ 4 actually recidivated. Furthermore, the predicted number of recidivists in the well above average risk category (Static-99R ≥ 6) was 24% higher than expected in routine samples. The results suggest that the Static-99R may be a useful screening tool to identify low-risk individuals but offenders with scores ≥ 4 should be subjected to a more thorough assessment.

The Predictive Properties of Psychiatric Diagnoses, Dynamic Risk and Dynamic Risk Change Assessed by the VRS-SO in Forensically Admitted and Released Sexual Offenders

Psychiatric diagnoses, static risk factors, and criminogenic needs at time of admission and release were examined in a mentally ill sample of psychiatrically detained sexual offenders. Although clinically found to be at low or even very low risk at discharge, 12% reoffended sexually over an average follow-up of 7 years. Psychotic disorders were present in only 5% of offenders, whereas 93% had a personality disorder diagnosis and 76% a paraphilic disorder diagnosis. Only exhibitionism and alcohol misuse were associated with relapse. Static risk factors captured by the Static-99 also did not significantly predict recidivism; however, the VRS-SO-a structured risk assessment tool that assesses criminogenic needs and changes in risk from treatment or other change agents, rated retrospectively on the present sample-predicted sexual recidivism as well as any new imprisonment or psychiatric placement. In particular, the sexual deviance factor of the VRS-SO had large in magnitude predictive associations with sexual reoffending, while treatment related changes assessed on this factor were significantly related to non-reoffending. Findings corroborate the advantages of structured risk assessment and structured change monitoring, particularly for complex clientele such as mentally ill sexual offenders.

Three Central Dimensions of Sexual Recidivism Risk: Understanding the Latent Constructs of Static-99R and Static-2002R

The most commonly used risk assessment tools for predicting sexual violence focus almost exclusively on static, historical factors. Consequently, they are assumed to be unable to directly inform the selection of treatment targets, or evaluate change. However, researchers using latent variable models have identified three dimensions in static actuarial scales for sexual offenders: Sexual Criminality, General Criminality, and a third dimension centered on young age and aggression to strangers. In the current study, we examined the convergent and predictive validity of these dimensions, using psychological features of the offender (e.g., antisocial traits, hypersexuality) and recidivism outcomes. Results indicated that (a) Sexual Criminality was related to dysregulation of sexuality toward atypical objects, without intent to harm; (b) General Criminality was related to antisocial traits; and (c) Youthful Stranger Aggression was related to a clear intent to harm the victim. All three dimensions predicted sexual recidivism, although only General Criminality and Youthful Stranger Aggression predicted nonsexual recidivism. These results indicate that risk tools for sexual violence are multidimensional, and support a shift from an exclusive focus on total scores to consideration of subscales measuring psychologically meaningful constructs.

The case against categorical risk estimates

Risk estimates can be communicated in a variety of forms, including numeric and categorical formats. An example of the latter is "low/medium/high risk." The categorical format is preferred by judges and practitioners alike, and is mandated by the most commonly utilized forensic risk assessment instruments (the HCR-20 and the Static-99). This article argues against the practice of communicating risk in categorical terms on empirical and normative grounds. Empirically, there is no consensus about what level of risk corresponds to a particular category, such as "high risk." Moreover, recent studies indicate that categorizing an otherwise continuous risk estimate does not add incremental predictive validity to the risk estimate. Normatively, categorization obscures what is fundamentally a value judgment about the relative costs and benefits of correct (e.g., true positive) and incorrect (e.g., false positive) outcomes. Such a judgment is inherently non-scientific and invades the province of the jury. Indeed, categorical risk estimates are in principle no different than "dangerousness predictions," which are simply binary and which have been denounced by the field. The fact that alternative risk communication formats have limitations does not justify continuing the pervasive practice of communicating categorical risk estimates.

Sex Offender Risk Assessment: Where Are We and Where Are We Going?

PURPOSE OF REVIEW

Risk assessment is one of the most ubiquitous tasks in the criminal justice system, informing virtually every decision made about offenders. This review, intended for researchers and practitioners, outlines some of the most important recent advances, emerging issues, and recommendations in sex offender risk assessment.

RECENT FINDINGS

The underlying nature and purpose of risk scales is reviewed, with implications for how we should evaluate them. Limits of recidivism probability estimates are discussed, and efforts to advance a common language for describing risk levels are highlighted. Advances in risk communication and field validity are summarized. The utility of protective risk factors in risk assessments is debated. Emerging areas in assessing offender change and assessments with child pornography offenders are discussed. Despite critical advances in the last few years, there are still important gaps in knowledge, particularly for risk communication, field implementation, offender change, and child pornography offenders.