The factor structure of static actuarial items: its relation to prediction

Factor structure of the J-SOAP-II among Black and White male youth: A confirmatory and exploratory factor analysis

The Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II) is a tool used to aid clinicians in assessing the sexual and criminal reoffense risk of male youths who have committed a sex offense. Despite its popularity, the factor structure has not been thoroughly assessed. The present study used confirmatory factor analysis (CFA) to test the factor structure of the four subscales of the J-SOAP-II in a group of youths aged 12-18 who were confined for sexual offenses (N = 909), and whether the fit is affected by youth race. The results showed a poor fit to the data. An ad-hoc goal was added, to propose a new factor structure using exploratory factor analysis (EFA) on one half of the data, and CFA on the second half of the data. The EFA identified three-factors: Sexual Offending and Victimization History, Risk for General Delinquency, and Antisocial Beliefs and Attitudes. This three-factor model, provided an improved, but not good, fit, indicating that further modifications to the J-SOAP-II are required to meaningfully capture risk-relevant latent constructs.

The Etiology of Risk in Sexual Offenders: A Preliminary Model

Sexual offender risk assessment practice is considered by many to be atheoretical. The identification of the most predictive risk factors and tools has typically overshadowed questions about etiology. To gain insight into the origins of criminal behavior among sexual offenders, we developed and validated an etiological model of risk based on the theoretical framework of Beech and Ward. Our model focused on persistence rather than onset, and encompassed both the sexual and nonsexual criminal activity of these offenders. It comprised two pathways. The first was characterized by sexual victimization, social isolation, and early deviant sexual fantasies. It led to a prolific involvement in sexual criminality (especially toward children) and predicted sexual recidivism. The second pathway was characterized by externalization problems, sexual promiscuity, and physical/psychological victimization, and was associated with nonsexual offending and serious sexual offenses directed (mostly) toward women. It predicted all types of recidivism.

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.

Gender Considerations in Violence

The role of gender in violence is poorly understood. Research has shown that gender has an important and, at times, distinct role in the prediction of violence. However, this gender disparity diminishes in the setting of mental illness. The risk assessment of violence in women is largely based on research in violent men. There are distinct characteristics in female violence compared with male violence. Attention to these characteristics may lead to the development of gender-dependent tools that can be used to evaluate violence risk.

Risk tools for the prediction of violence: 'VRAG, HCR-20, PCL-R'

Many instruments have been introduced as measures of violence risk prediction. Studies on risk assessment displayed two major approaches - clinical risk evaluation and actuarial measures - and three tools were mostly used: (1) Violence Risk Appraisal Guide, (2) Historical-Clinical-Risk-20 item scale and (3) Psychopathy Checklist-Revised. Although these tools are commonly used in clinical practice, they differ in their uses, benefits and limitations, and their ability to predict future violence. Subsequently, this paper aim to provide the readers an in-depth description that specifies these aspects, as well as a comparison of these tools in order to help readers decide which tool to use.

Latent Constructs of the Static-99R and Static-2002R

The most commonly used risk assessment tools for predicting sexual violence focus almost exclusively on static, historical factors (e.g., characteristics of prior offences). Consequently, they are assumed to be unable to directly inform the selection of treatment targets or evaluate change. In this article, we argue that this limitation can be mitigated by using latent variable models as a framework to link historical risk factors to the psychological characteristics of offenders. Accordingly, we conducted a factor analysis of the 13 nonredundant items from the two most commonly used risk tools for sexual offenders (Static-99R and Static-2002R) to identify the psychological information contained in these tools. Three factors were identified: (a) persistence/paraphilia, a construct related to sexual criminality, especially of the pedophilic type; (b) youthful stranger aggression, a construct centered on young age and offence seriousness; and (c) general criminality, a construct that reflected the diversity and magnitude of criminal careers. These constructs predicted sexual recidivism with similar accuracy, but only youthful stranger aggression and general criminality predicted nonsexual recidivism. These results indicate that risk tools for sexual violence are multidimensional, and support a shift from a focus on atheoretical risk markers to the assessment of psychologically meaningful constructs.

An exploration of the latent constructs of the STATIC-99

Although actuarial instruments are ubiquitously used in the field of sex offender recidivism risk assessment, there is limited empirical information about the underlying constructs from which they are derived. The following study utilized a nonparametric item response theory procedure, a Mokken analysis, and nonlinear factor analysis (Normal Ogive Harmonic Analysis Robust Method) to explore the underlying constructs of the STATIC-99 scores obtained for male sexual offenders (N = 451) referred for an evaluation to determine if they met criteria for civil commitment under a state's Sexually Violent Persons Law. The results from the analyses indicated that the STATIC-99 comprises the two previously identified constructs associated with sexual deviancy and antisocial behaviors as well as a third, additional construct, associated with the items pertaining to age and past marital-type relationships. These findings support Hanson and Thornton's assertion that sexual offender recidivism risk is multifactorial and not the result of a single underlying trait. Implications for future research are discussed.

Childhood sexual victimization, pedophilic interest, and sexual recidivism

OBJECTIVE

The goal of the current study was to examine the extent to which child sexual abuse (CSA) and particular characteristics of CSA are associated with pedophilic interest and sexual recidivism.

METHODS

Subjects were 462 adult male sexual offenders who had been incarcerated in Canadian federal prisons.

RESULTS

Compared to sexual offenders who had not been sexually abused, those who had been sexually abused before age 16 sexually offended against significantly younger victims and had significantly more indicators of pedophilic interest. This was the case whether we examined self-reported or officially documented CSA. Offenders who had been sexually abused exclusively by a male had significantly more indicators of pedophilic interest than those who had been sexually abused exclusively by a female. These findings are consistent with past research and theory suggesting that CSA may play a role in pedophilia and sexual offending against children. CSA exclusively by a female abuser predicted higher rates of sexual recidivism than abuse by a male or both a male and female abuser. Among offenders with victims 15 years old or younger, a closer relationship between offender and abuser predicted higher rates of sexual recidivism. The relationship between CSA and sexual recidivism was significantly moderated by actuarial risk. More specifically, CSA predicted higher rates of sexual recidivism among higher risk offenders, but CSA did not predict sexual recidivism among lower risk offenders. This novel finding raises the possibility that CSA may play a role in sexual recidivism for some offenders.

CONCLUSION

If future research replicates this CSA by risk interaction and identifies the constructs and processes involved, CSA may be worth considering in risk assessment and treatment.

Criminal recidivism and mortality among patients discharged from a forensic medium secure hospital

BACKGROUND

One of the goals in forensic psychiatric care is to reduce the risk of recidivism, but current knowledge about the general outcome of forensic psychiatric treatment is limited.

AIMS

To analyse the rate of criminal recidivism and mortality after discharge in a sample of patients sentenced to forensic psychiatric treatment in a Swedish county.

METHODS

All offenders in Örebro County, Sweden, sentenced to forensic psychiatric treatment and discharged during 1992-2007 were included: 80 males and eight females. Follow-up data was retrieved from the Swedish National Council for Crime Prevention, the National Cause-of-Death register and clinical files. Mean follow-up time was 9.4 years.

RESULTS

The mean age at discharge was 40 years. Schizophrenia, other psychoses and personality disorders were the most prevalent diagnoses. Thirty-eight percent of those still alive and still living in the country re-offended and were sentenced to a new period of forensic psychiatric treatment or incarceration during follow-up. Four male re-offenders committed serious violent crimes. Substance-related diagnosis was significantly associated with risk of recidivism and after adjustment for diagnoses, age and history of serious violent crime, the Hazard Ratio was 4.04 (95% CI 1.51-10.86, P = 0.006). Of all included patients, 23% had died at the end of follow-up (standardized mortality rate 10.4).

CONCLUSIONS

Since repetition of serious violent crimes was unusual, results indicate a positive development subsequent to treatment for those alive at follow-up.

CLINICAL IMPLICATIONS

The high mortality rate suggests that more attention should be paid in evaluation of the patients' somatic and psychiatric health during and after care in order to prevent premature death.

Construct validity of the Violence Risk Scale--Sexual Offender Version for measuring sexual deviance

Previous studies have identified sexual deviance as a particularly strong predictor of sexual recidivism in sex offenders. The present study examined the construct validity (i.e., convergent and discriminant validity) of the three dynamic factor domains (Sexual Deviance, Criminality, Treatment Responsivity) of the Violence Risk Scale- Sexual Offender version (VRS-SO) as well as the Screening Scale for Pedophilic Interests (SSPI; for comparison purposes) with respect to phallometric measures of sexual deviance. VRS-SO and phallometric data were collected from 124 federally incarcerated sex offenders from a maximum security forensic psychiatric facility. The Sexual Deviance factor and SSPI were positively correlated to varying degrees with computed arousal indexes (Percent Full Erection, difference scores) for child stimuli but were not significantly correlated with nondeviant arousal, supporting the convergent and discriminant validity of these measures, respectively. Convergent validity also appeared stronger for sex offender subtypes with child victims. Criminality and Treatment Responsivity did not correlate with male stimuli, although they were positively correlated with arousal to female profiles. The VRS-SO Sexual Deviance factor and some phallometric indexes of deviant arousal (e.g., female children) were predictive of sexual recidivism whereas the SSPI was not. The pattern of findings across analyses broadly supports the construct validity of the VRS-SO in assessing sexual deviance.

A profile of pedophilia: definition, characteristics of offenders, recidivism, treatment outcomes, and forensic issues

Pedophilia has become a topic of increased interest, awareness, and concern for both the medical community and the public at large. Increased media exposure, new sexual offender disclosure laws, Web sites that list the names and addresses of convicted sexual offenders, politicians taking a 'get tough' stance on sexual offenders, and increased investigations of sexual acts with children have increased public awareness about pedophilia. Because of this increased awareness, it is important for physicians to understand pedophilia, its rate of occurrence, and the characteristics of pedophiles and sexually abused children. In this article, we address research that defines the various types and categories of pedophilia, review available federal data on child molestation and pornography, and briefly discuss the theories on what makes an individual develop a sexual orientation toward children. This article also examines how researchers determine if someone is a pedophile, potential treatments for pedophiles and sexually abused children, the risk of additional sexual offenses, the effect of mandatory reporting laws on both physicians and pedophiles, and limitations of the current pedophilic literature.

Different actuarial risk measures produce different risk rankings for sexual offenders

Percentile ranks were computed for N=262 sex offenders using each of 5 actuarial risk instruments commonly used with adult sex offenders (RRASOR, Static-99, VRAG, SORAG, and MnSOST-R). Mean differences between percentile ranks obtained by different actuarial measures were found to vary inversely with the correlation between the actuarial scores. Following studies of factor analyses of actuarial items, we argue that the discrepancies among actuarial instruments can be substantially accounted for by the way in which the factor Antisocial Behavior and various factors reflecting sexual deviance are represented among the items contained in each instrument. In the discussion, we provide guidance to clinicians in resolving discrepancies between instruments and we discuss implications for future developments in sex offender risk assessment.