Forensic sexology: paraphilic serial rape (biastophilia) and lust murder (erotophonophilia)

"We Boil at Different Degrees": Factors Associated With Severity of Attack in Sexual Killing

Degree of injury, as measured by the Homicide Injury Scale (HIS), was examined to advance understanding of the dynamics of sexual killing. A total of 350 nonserial, male sexual killers were included, and the different ways that the sexual element of their offenses and the act of killing were connected was accounted for by determining that cases were either directly sexual (the sexual element and killing were closely bound), or indirectly sexual (killing was not a source of sexual stimulation). The two groups, direct and indirect sexual killers, were each subjected to multiple linear regression analyses to examine the group-specific relationship between level of injury and predictor variables previously found to be associated with increased severity of attack. No differences in the mean total HIS scores between the indirect and the direct cases were found, suggesting a comparable emotional intensity between the groups. However, given that the groups differed in terms of the functional role of fatal violence, severity of attack could not be sufficiently explained as driven by anger. In line with this hypothesis, different predictors appeared to be associated with increased degree of injury sustained by victims of indirect compared with direct sexual killers. As such, situational components appear to play a role in the behavior of indirect sexual killers, whereas the behavior of direct perpetrators tends to be linked with the enactment of existing deviant fantasies. The role of anger in sexual homicide is discussed further, and overall, it is argued that irrespective of whether violence was initially driven by anger, evidence of sexual arousal to severe violence must be scrutinized within sexual homicide research as well as in psycholegal contexts.

Juvenile Sexual Murderers: Examination and Classification of the Crime-Commission Process

This study aims to empirically explore the crime-commission process of juvenile sexual homicide offenders (SHOs). First, a comparison between the crime-commission process of juvenile and adult SHOs is undertaken, while as a second step, this study also provides an empirical classification specific to juvenile SHOs. The sample used in this study consists of 55 juvenile SHOs and 281 adult SHOs. A sequential binomial regression was used to compare at the multivariate level the two groups of offenders, while a latent class analysis was used to examine the relationships between each step of the crime-commission process of juvenile SHOs. Our findings suggest that the crime-commission process of juvenile SHOs present differences when compared with adult SHOs. Moreover, we identified four different patterns in juvenile sexual homicide: explosive opportunistic, sadistic, overcontrolled anger, and predator. Theoretical and practical implications in terms of criminal investigations as well as offenders' management and treatment are discussed.

The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders

Objectives: The primary aim of these guidelines is to evaluate the role of pharmacological agents in the treatment and management of patients with paraphilic disorders, with a focus on the treatment of adult males. Because such treatments are not delivered in isolation, the role of specific psychotherapeutic interventions is also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients, including sexual offenders, with paraphilic disorders. The aim of these guidelines is to bring together different views on the appropriate treatment of paraphilic disorders from experts representing different countries in order to aid physicians in clinical decisions and to improve the quality of care.Methods: An extensive literature search was conducted using the English-language-literature indexed on MEDLINE/PubMed (1990-2018 for SSRIs) (1969-2018 for hormonal treatments), supplemented by other sources, including published reviews.Results: Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. The type of medication used depends on the severity of the paraphilic disorder and the respective risk of behaviour endangering others. GnRH analogue treatment constitutes the most relevant treatment for patients with severe paraphilic disorders.Conclusions: An algorithm is proposed with different levels of treatment for different categories of paraphilic disorders accompanied by different risk levels.

The Sexual Murderer Is a Distinct Type of Offender

The current study investigates the question of the specificity of sexual homicide offenders by comparing three types of crimes: sexual homicide, nonsexual homicide, and violent sexual assault. The comparison is based on victim, offender and modus operandi characteristics throughout 102 variables. The sample has been taken from a French national police database including 1,736 cases. Among these cases, there are 463 nonsexual homicides, 173 sexual homicides and 1,100 violent sexual assaults. Bivariate and multivariate analyses are performed to highlight the differences. Major differences are observed between, on one hand, sexual homicides and, on the other hand, nonsexual homicides and violent sexual assaults. These differences focus mainly on the offender and modus operandi characteristics. By analyzing specifically the type of observed differences, this research suggests that the sexual murderer and his crime should be analyzed through the lens of a unique type of crime. Findings present implications in terms of correctional practices, offender treatment, and rehabilitation.

Sexual Interests of Child Sexual Exploitation Material (CSEM) Consumers: Four Patterns of Severity Over Time

This study analyzed the evolution over time of the activity of consumers of child sexual exploitation material (CSEM). To this end, images and metadata were extracted from the hard drives of 40 individuals convicted of possession of child pornography and analyzed. A sample of these images ( N = 61,244) was categorized by the age of the subjects depicted and-using the Combating Paedophile Information Networks in Europe (COPINE) scale-by severity of the acts depicted. Collecting activity was observed to follow four patterns. The most prevalent pattern was a progressive decrease in the age of the person depicted and a progressive increase in the severity of the sexual acts. In light of the results, we propose four explanations of the nature of, and variations in, child-pornography collections.

Dysfunctional anger and sexual violence

Sexual offenses with or without aggression attract attention from the popular media and the scientific community. Empirical research suggests a relationship between anger and sexual violence. This article describes the key themes of dysfunctional anger and sexual violence, and how dysfunctional anger relates to sexual fantasies, sexual offending, and sexual recidivism. The implications of the findings for clinical practice and future research are discussed.

SOME THOUGHTS ON THE PSYCHOLOGICAL ROOTS OF THE BEHAVIOR OF SERIAL KILLERS AS NARCISSISTS: AN OBJECT RELATIONS PERSPECTIVE

This article documents the definition and context of serial murder. The main theoretical framework adopted is object relations theories which have been particularly renowned for drawing close attention to the process and development of the early dyadic mother-infant relationship as a primary departure point for understanding both healthy and pathological psychic development. These theories have been especially comprehensive in depicting the inner world of the infant as magical and terrifying, fractured and kaleidoscopic. Within the context of narcissistic dynamics, one aspect of human behavior may be described as nonpathological and the basis for healthy ambitions and ideals, while another may be identified as pathological and destructive so that individuals behave in grandiose and murderous ways. Some of these individuals are sadistic serial killers who enjoy the sexual thrill of murdering and who are both pathological and destructive narcissists. This study examines the psychological roots of the behavior of sexually motivated male serial killers, and why they do what they do. The context of serial murder is presented, with a refined definition of sexually motivated serial murder. The development of narcissism is described as this forms the basis for understanding such behavior.

Trans-metatarsal amputation as a complication of child sexual abuse

A case of chronic physical abuse and acute sexual abuse via anal penetration complicated with disseminated intravascular coagulation (DIC), acute respiratory distress syndrome (ARDS), and subsequent bilateral trans-metatarsal amputation is reported. A 13-year-old male presented with old cigarette burns on his chest and acute anal laceration. Four days after laceration repair, he developed DIC and ARDS. The child had to undergo bilateral trans-metatarsal amputation. Due to the systemic defects of the child protection system in Turkey, sexual and physical abuse were recognized by medical personnel 45 days after admission, child protective services never got involved, and prosecution failed to punish the perpetrator(s) of this extreme victimization. This is the only reported case of bilateral trans-metatarsal amputation due to sexual abuse complicated with DIC and ARDS. Social and medico-legal management of sexual abuse is suboptimal in Turkey. Within that context, professionals should be trained on how to recognize, assess, diagnose and manage victims of child abuse and neglect.

A study of the psychosexual characteristics of sex killers: can we identify them before it is too late?

Thirty-three sex killers were compared to 80 sexual aggressives, 23 sadists, and 611 general sex offenders on sexual history and preferences, substance abuse crime, violence, mental illness, personality, neurological and endocrine abnormalities. Compared to other groups, sex killers started their criminal careers earlier, more often had been to reform school, were members of criminal gangs, set fires, and were cruel to animals. They tended so show more sadism, fetishism, and voyeurism. They more often collected pornography, but they did not use it in their offenses. They more often abused drugs and some suffered from drug induced psychoses. Their most common diagnosis was antisocial personality disorder, but only 15.2% met criteria for psychopathy. Sex killers showed most signs of neuropsychological impairment, grades failure, and learning disabilities. Results suggest that greater emphasis be placed on studying adolescent sex offenders and conduct disordered children which may help identify potential sex killers.

Profiles in the offending process of nonserial sexual murderers

The aim of this study was to investigate specific pathways in the offending processes of nonserial sexual murderers and to examine possible relationships with different precrime, per-crime, and postcrime factors. Included in this study were 36 offenders who have committed at least one sexual murder against a female victim and they were classified using cluster analysis. Participants using the sadistic pathway planned their offenses and used physical restraints during the offenses. Furthermore, they mutilated and humiliated their victims. Finally, they hid the bodies of the victims. Participants using the anger pathway had not premeditated the homicide. Mutilation, humiliation, and physical restraints were less predominant with these participants than with those using the sadistic pathway. Moreover, these offenders were more likely to leave the bodies at the crime scenes after the killings occurred. These two profiles are compared with empirical studies addressing sexual homicide.

Social, neuroradiologic, medical, and neuropsychologic correlates of sexually aberrant behavior after traumatic brain injury: a controlled study

OBJECTIVE

To identify social, neuroradiological, medical, and neuropsychological correlates of sexually aberrant behavior (SAB) after traumatic brain injury (TBI).

DESIGN

A controlled study using a retrospective file review.

SETTING

A brain injury unit providing inpatient and outpatient rehabilitation services.

PARTICIPANTS

A sample of males (n = 25) exhibiting SABs and a control group (n = 25) matched for gender, severity of injury, age at injury, and time after injury.

MAIN OUTCOME MEASURES

A protocol that recorded data on demographic, injury, radiological, medical, and neuropsychological variables.

RESULTS

The SAB group had a significantly higher incidence of postinjury psychosocial disturbance in areas of nonsexual crime and failure to return to work than the matched TBI group. There were no significant differences between the two groups in the incidence of premorbid psychosocial disturbance or postinjury radiological, medical, or neuropsychological variables.

CONCLUSIONS

The study results caution against simplistic explanations of SAB as the product of damage to the frontal-lobe systems or premorbid psychosocial disturbance. Furthermore, the results suggest that a wide-ranging assessment of people with TBI who exhibit SABs is required, because results of neuropsychological examination alone cannot be considered conclusive. Future research into the etiology of SABs could examine additional factors such as lack of insight, lack of empathy, and premorbid history of family dysfunction.

Sex offending as a psychosocial sequela of traumatic brain injury

OBJECTIVE

To describe the nature and extent of sexual offending after traumatic brain injury (TBI).

DESIGN

Retrospective file review.

SETTING

A brain injury unit providing inpatient and outpatient rehabilitation services.

PARTICIPANTS

A review of five years of admissions to the Brain Injury Rehabilitation Unit (N = 477) identified a sample of 29 males who committed 128 incidents of sex offending.

MAIN OUTCOME MEASURES

A protocol to record data on demographic, injury, radiological, and psychosocial variables and offending behaviors.

RESULTS

Of the total population of 445 clients with TBI, 6.5% (n = 29) were identified as having committed some form of sexual offense. Alcohol was a factor in only three (2.3%) of the incidents, and only two clients had a preinjury history of sexual offending. The most common offenses were the "touching" offenses, followed by exhibitionism and overt sexual aggression. Staff members were the most common targets of the offenses, followed by members of the general public, other people with TBI, and family members.

CONCLUSIONS

Sex offending is a significant clinical problem among a small minority of men after TBI. The absence of alcohol and preinjury histories of sexual offending suggest that the brain injury and contingent sequelae were a significant etiological factor underlying the offenses. A number of implications for the clinical management of clients with sexually aberrant behaviors is identified and discussed.

Head injury and sexual dysfunction

An extensive review of the head injury and human sexuality literature was completed, to augment an understanding of the impact of traumatic head injury on sexual functioning. Despite clinical evidence that sexual dysfunction after head injury is prevalent and of great import, sexual concerns have been neglected in much of the post-traumatic head injury and rehabilitation literature. Characteristics of head injury concerning cerebral physiology, post-traumatic sequelae, and the effects on sexual functioning are examined. Rehabilitation and family/spouse literature was also examined for information on sexuality. The majority of this article reviews research on sexual sequelae after head injury, such as impulsiveness/inappropriateness, changes in libido and sexual frequency, global sexual difficulties, and specific sexual dysfunctions. Treatment models for the sexual problems after head injury are also reviewed and found to be limited in number. Treatment issues and suggestions are addressed. This article provides information about the sexual problems of head-injured patients to facilitate the development of diagnostic and intervention programmes.