Child Sexual Abuse-Challenging Conditions for Adult Oral Health: A Qualitative Study

The aim was to analyze perceptions of oral health in adults who have been exposed to child sexual abuse. Eleven participants (10 women), 19 to 56 y of age, who had experienced sexual abuse as children were purposively selected and interviewed in-depth. The participants were encouraged to describe how they perceived the effect of the sexual abuse on their oral health as adults. The interviews were recorded digitally and transcribed verbatim. The collected material was analyzed according to qualitative content analysis. The theme "challenging conditions for maintaining oral health" was identified, comprising 2 categories: first, "the emotional significance," with the subcategories 1) emotional barriers and 2) powerful relief, and second, "the obstacles to oral health," with the subcategories 1) daily self-care with complications and 2) dental appointments with difficulties. The findings indicate that the experience of sexual abuse during childhood can have a negative impact on oral care in adulthood. The informants stated that oral health was of utmost importance but also associated with strong emotions. There were obstacles to maintenance of oral health that were difficult to surmount.Knowledge Transfer Statement:The study provides access to the attitudes of survivors of child sexual abuse regarding oral health and the needs and obstacles that they experience. This is important knowledge for dental professionals to optimize dental care.

Covariates of the Severity of Aggression in Sexual Crimes: Psychopathy and Borderline Characteristics

Whereas risk assessment literature on sexual offending has primarily focused on prediction of subsequent sexual crimes, and not the severity of those crimes, the first aim of the present study was to identify variables that predict the amount of damage to victims in sexual crimes compared with those that predict general aggressiveness. The second aim was to ascertain whether adding emotional instability measurements, as in borderline personality disorder (BPD), would add incremental variance to that captured by the facets of the Psychopathy Checklist-Revised (PCL-R). Trained raters assessed on the PCL-R, BPD, and measures of severity of sexual and nonsexual violence 302 adults who had sexually offended. PCL-R's Antisociality and two externalizing BPD factors (one from the standard and one from the alternative criteria) were significant predictors of violence both in sexual and nonsexual crimes. In contrast, deficits in the PCL-R's Affective facet (2) predicted victim damage in sexual contexts only, whereas the Lifestyle Impulsivity facet (3) of the PCL-R predicted violence in nonsexual contexts only. These findings suggest that adding measures of emotional dysregulation to commonly used instruments like the PCL-R, which assesses callousness and antisociality, may be beneficial for predicting violence.

Attachment and Personality Disorders Among Child Molesters: The Role of Trust

The present study investigated multivariate associations between attachment styles and personality disorders (PDs)-and the mediating role of trust-in a sample of child molesters ( n = 84) and a matched control group from the general community ( n = 80). Among child molesters, canonical correlation analysis revealed that two variates resembling avoidant and anxious attachment dimensions were associated with PD traits. Attachment avoidance was related to schizoid, schizotypal, and avoidant PDs, with a marginal contribution of antisocial PD. Attachment anxiety was related to borderline and histrionic PDs, with a marginal contribution of obsessive-compulsive PD. Paranoid and dependent PDs contributed to both variates. In the control group, a more general association between attachment insecurity and PDs emerged. Finally, mistrust significantly explained the associations between attachment and PDs in both samples. Future studies should examine whether treatment for PDs in child molesters could benefit from a focus on attachment and trust.

The Perceived Role of General Self-Regulation and Prosocial Support on the Decision Not to Act Among Men Sexually Attracted to Children

Recent research highlights potential differences between groups of men sexually attracted to children regarding child molestation behavior, attitudes toward sex with children, and the decision not to act on their attractions. The present study furthered this line of research by investigating the roles of general self-regulation and prosocial support on the decision not to act among 69 men sexually attracted to children. Mixed-methods analysis of survey results provided mixed evidence regarding their relevance to refraining from engaging in child molestation behavior. Quantitative results suggested that self-control, but not prosocial support, showed a major influence on participants' decision not to act. Qualitative results offered a more nuanced understanding of the roles of both of these factors in participants' decisions. Overall, findings support an approach for investigating men sexually attracted to children that focuses on differences between men who do and do not act on their attractions, as well as on the active decision to refrain from engaging in child molestation behavior. Implications for research and clinical practice are highlighted.

The Revised Screening Scale for Pedophilic Interests: Predictive and Concurrent Validity

This study examined the predictive and concurrent validity of the Screening Scale for Pedophilic Interests (SSPI) and its recent revision (SSPI-2), using a large sample of 2,416 sex offenders deemed not to be in need of civil management in New York State. Both SSPI and SSPI-2 scores were significantly and positively related to sexual rearrest, but the SSPI-2 provided greater discrimination in rearrest within 5 years across possible scores. Neither measure significantly added to the prediction of sexual rearrest provided by the Static-99R. We also found evidence of concurrent validity, as both measures were positively and significantly correlated with clinician ratings of sexual preoccupation, emotional identification with children, and sexual offense-related cognitions (convergent validity), but were not significantly related to clinician ratings of self-regulation problems, noncompliance with supervision, or antisocial personality (divergent validity). Overall, the results suggest that the SSPI-2 is a specific and useful screening measure of pedophilic sexual interests among sex offenders with child victims.

Measurement Matters: Comparing Old and New Definitions of Rape in Federal Statistical Reporting

National statistics on the incidence of rape play an important role in the work of policymakers and academics. The Uniform Crime Reports (UCR) have provided some of the most widely used and influential statistics on the incidence of rape across the United States over the past 80 years. The definition of rape used by UCR changed in 2012 to include substantially more types of sexual assault. This article draws on 20 years of data from the National Incident-Based Reporting System to describe the impact this definitional change will have on estimates of the incidence of rape and trends over time. Drawing on time series as well as panel random effects methodologies, we show that 40% of sexual assaults have been excluded by the prior definition and that the magnitude of this error has grown over time. However, the overall trend in rape over time (year-to-year change) was not substantially different when comparing events meeting the prior definition and the subgroups of sexual assault that will now be counted.

Child Pornography Possessors and Child Contact Sex Offenders: A Multilevel Comparison of Demographic Characteristics and Rates of Recidivism

Considerable debate surrounds the topic of whether possessing or distributing online images of child pornography (CP) represents a new type of crime perpetrated by conventional sex offenders (e.g., child contact [CC] sex offenders), or whether individuals who commit these crimes differ from contact sex offenders in meaningful ways. The current study compares groups of Internet (CP) and CC sexual offenders, with each group's sexual offending history exclusively confined to its offense category. T tests were used to conduct bivariate comparisons of group demographics and criminal histories. Rates of recidivism were examined using survival curves and Cox proportional hazard regression models. Results showed significant differences on demographic and criminal history variables, with CP offenders demonstrating a lower frequency of prior criminal offending and substance abuse, and higher rates of pre-incarceration employment and level of education. Rates of recidivism were significantly different between the two groups, with CP offenders showing lower rates of re-offense for most measures of recidivism. When controlling for background characteristics and the timing of the event, CC offenders were at much greater risk for having an arrest for a new crime or a non-sexual violent crime than CP offenders. Treatment and policy implications are discussed, along with suggestions for future research.

Characteristics of females who sexually offend: a comparison of solo and co-offenders

Although recent typologies of female sexual offenders have recognized the importance of having a co-offender, the clinical characteristics of solo and co-female sexual offenders remain poorly understood. The aim of this study was to compare solo (n = 20) and co- (n = 20) female sexual offenders on a variety of clinical characteristics. It was found that although solo and co-offenders reported similar developmental experiences and psychological dispositions, differences were found in environmental niche, offense preceding, and positive factors. Specifically, solo offenders demonstrated a greater presence of personal vulnerabilities including mental health and substance abuse difficulties. Co-offenders reported a greater presence of environmentally based factors, including a current partner who was a known sex offender and involvement with antisocial peers. It is suggested that these results have implications for understanding assessment and intervention needs for these groups of sexual offenders.

Visual Reaction Time™ as a predictor of sexual offense recidivism

In this study, we investigated the use of Visual Reaction Time™ (VRT™) for sexual interest in children to predict recidivism of sexual offenses among men who sexually abused children and men with other sexually deviant behaviors. The authors hypothesized that study participants with a higher VRT™ to stimuli of children would be more likely to sexually reoffend compared with those with a lower VRT™ to stimuli of children. Participants included 621 adult males on parole or probation for acting on a range of sexual paraphilias who sought outpatient treatment or evaluation at two separate therapists' practices. Sample 1 consisted of 284 adult males followed up (by the lead author) during a 15-year period, while Sample 2 consisted of 337 adult males followed up (by the second author) during a 7-year period. A discrete-time hazard model found VRT™ to children to be significantly related to sexual recidivism. The researchers found that VRT™ to children measured at intake held up in its predictive ability over a 15-year period. When the participants were divided into three groups based on their VRT™, of the 97 participants who measured at least one standard deviation lower than the mean VRT™, 0% reoffended. The 432 participants in the medium-VRT™ group had an estimated recidivism rate of 7% after 15 years and the 92 participants who measured at least one standard deviation higher than the mean had an estimated recidivism rate of 27%.

Prevalence and nature of child sexual abuse in the Netherlands: ethnic differences?

In most epidemiological prevalence studies of child sexual abuse, the role of ethnicity remains unclear. This study examined the prevalence and nature of child sexual abuse in four non-Western ethnic minority groups and compared them with a native Dutch group. A sample of 3,426 young adults (aged 18-25) completed a structured, online survey on experiences of child sexual abuse. A total of 42.9% (n = 1,469) participants reported at least one form of child sexual abuse victimization before the age of 18. Surinamese and Turkish respondents' prevalence rates did not differ from the native Dutch youth. However, the Dutch Antillean respondents reported significantly higher rates of child sexual abuse on specific forms of abuse, whereas the Moroccan respondents reported lower rates compared with their native Dutch peers. With this study, we have more insight into the differences-however small they may be-between ethnic groups and native Dutch youth regarding child sexual abuse.

Sexual and general offending trajectories of men referred for civil commitment

Policies aimed at managing high-risk offenders, which include sex offenders, often assume they are a homogeneous population. These policies also tend to assume the pattern of offending is the same for all sex offenders, and is stable. This study challenges these assumptions by examining the life course offending trajectories of 780 convicted adult male sexual offenders. The men were referred to the Massachusetts Treatment Center for civil commitment between 1959 and 1984. The changing number of both sexual and any offenses were examined by age using Group-Based Trajectory Modeling. We identified a four-trajectory model for all offending and a four-trajectory model for sexual offending. The identified groups varied in several offending patterns including criminal onset, length of criminal careers, age of peak offending, and time of entry into the treatment center. Late adult onset of sex offending was found to be associated with child molestation, whereas early-onset trajectories were associated with rape. Implications for future research and policy are discussed.