Sexual Abuse: A Journal of Research and Treatment最新文献

It is important that therapists manage adequately their romantic and sexual feelings toward clients as it can negatively affect the psychotherapeutic relationship and may even pose a risk of sexual abuse. This study explores how psychotherapists in Flanders (Belgium) manage such feelings, by conducting both a survey (using 105 of 786 respondents for analyses, as they reported romantic feelings) and focus groups (with a total of 36 participants). Results show that most therapists never consider starting a romantic relationship with a client. They reflect profoundly on their feelings, dwell on possible consequences, while maintaining strict boundaries. Although therapists themselves highly recommend referring the client to a colleague if feelings become too intense, this rarely happens in practice. Most therapists consider talking about their romantic and sexual feelings towards clients as something very important, but only a third have disclosed their feelings in supervision, peer-supervision, or in personal therapy. Therapists indicate there is still hesitance about this due to fear of condemnation.

Accessing child sexual exploitation material (CSEM; child pornography in legal statutes) can indicate sexual interest in children. It logically follows then that the age and gender of the depicted children may reflect specific interests in those age/gender groups, and if so, may correspond to age and gender of any known contact offending victims. We had data on CSEM characteristics and child victims for 71 men convicted of CSEM offenses who also had contact sexual offenses against children; some had also sexually solicited children online. Sixty-four men had 134 prior or concurrent child victims, and 14 men reoffended directly against 17 children during follow-up. There were significant, positive associations (with moderate to large effect sizes) between age and gender of children depicted in CSEM and age and gender of child contact or solicitation victims. Examining future offending, though with only 14 recidivists, all men who sexually reoffended against a girl had more girl CSEM content, and all men who sexually reoffended against a boy had more boy CSEM content. Our results suggest that CSEM characteristics can reflect child preferences. This information can be relevant in clinical settings, police investigations, and community risk management, though it does not rule out interest in, or offending against, victims of other ages or gender. We discuss these findings in the context of other evidence regarding victim cross-over, and suggest future research.

Educator sexual misconduct is a serious problem in the United States (U.S.), with a 2004 Department of Education report estimating that 9.6% of K-12 students in the U.S. had experienced either verbal, visual, or physical educator misconduct at some point during their school career. However, since that report almost 20 years ago, there have been few large-scale studies examining the extent of the problem. As such, the current study, which uses a large sample from recent high school graduates in four U.S. states, offers updated data on the nature and scope of sexual misconduct in educational settings. Overall, 11.7% of the 6632 participants reported having experienced at least one form of educator sexual misconduct during Grades K-12, with 11% reporting sexual comments and less than 1% reporting other forms of sexual misconduct (e.g., receiving sexual photos/messages, being kissed, touched sexually, or engaging in sexual intercourse/oral sex). Those who reported misconduct showed significantly more difficulties in current psychosocial functioning than those who did not report educator misconduct. Academic teachers most often perpetrated the abuse (63%), followed by coaches and gym teachers (20%). Educators who engaged in sexual misconduct were primarily male (85%), whereas students who reported experiencing educator misconduct were primarily female (72%). Rates of disclosure to authorities were very low (4%) and some sexual grooming behaviors like gift giving (12%) and showing special attention (29%) were reported. These findings will be discussed as they pertain to the prevention of sexual misconduct within educational settings.

The link between Compulsive Sexual Behavior (CSB) and atypical sexual interests is elusive. This study aimed to provide preliminary insights into the relationship between both aspects. The study sample comprised 61 self-identified straight men. CSB was measured through a composite self-report index assessing symptoms of CSB, whereas sexual interests -atypical and normophilic- were assessed objectively through penile plethysmography. The CSB index had small, non-significant correlation with greater sexual response to different sexual stimuli (r_{general sexual responsiveness}=.127 [95% CI: -.137, .384]). In terms of overall sexual interest, increased scores on the CSB index had small, non-significant correlation with a higher preference for younger sexual stimuli (r = -.098 [95% CI: -.499, .215]) and persuasive sex (r = .10 [95% CI: -.168, .316]). Finally, CSB had a moderate correlation with sexual response when presented with stimuli depicting "female toddler coercive" (r = .27 [95% CI: -.083, .544]). We conclude that our findings do not support the hypotheses that CSB is significantly related to an increased arousability across sexual stimuli. The study findings also suggest that CSB may be, to a small degree, predisposed to experience sexual attraction toward children. Given the preliminary nature of the study, these conclusions warrant further research. Alternative explanations for the study findings related to the particular components of CSB that may be related to typical and atypical sexual interests are also considered.

In order to treat individuals with pedophilia¹ who are at risk of committing offenses, disclosure of the attraction must first take place. The aim of this study was to understand processes of initial recognition of pedophilic attraction, disclosure, and help-seeking. We conducted a qualitative content analysis of online posts from self-identified individuals with pedophilia, finding four categories: (1) Awareness and Initial Self-View (with emotions including denial, shame, and fear), (2) Disclosure (typically made to family, friends, or therapists, but also done online in an anonymous way), (3) People's Reactions to Disclosure (ranging from rejection to support), and (4) Current Self-View (including minimization, distortions, despair, resignation, and non-offending/anti-contact commitment). Our findings highlight the internal process experienced by individuals with pedophilia when first recognizing their attraction to minors, what is involved in disclosure, the importance of others' reactions after disclosure, and the factors that can reinforce a non-offending commitment. Clinical and social implications are discussed.

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.

The prevalence rates of paraphilic interests and disorders in the general population have been understudied, in large part due to the lack of a standardized assessment measure. As a result, the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 provides little information regarding the prevalence of paraphilic disorders. The present study involved the development of a self-report measure, Paraphilic Interests and Disorders Scale (PIDS), that can be used to assess for the eight paraphilic interests/disorders in the DSM-5 for use with general population samples. Study 1 established the content validity of the PIDS using feedback from 22 experts in the field, and recommendations from these experts were utilized to modify the measure. In Study 2, the PIDS was piloted on 100 individuals in the general population, which supported the feasibility of implementation and its limited-efficacy. While the PIDS requires further psychometric support, the current research suggests the PIDS is a promising tool to gather self-report, population-based data on DSM-5 paraphilic interests and disorders.

Child sexual abuse is a preventable public health problem that is addressed primarily via reactive criminal justice efforts. In this report, we focus on the cost of incarcerating adults convicted of sex crimes against children in the United States. Specifically, we summarize publicly available information on U.S. state and federal prison and sex offender civil commitment costs. Wherever possible, we used government data sources to inform cost estimates. Results indicate the annual cost to incarcerate adults convicted of sex crimes against children in the United States approaches $5.4 billion. This estimate does not include any costs incurred prior to incarceration (e.g., related to detection and prosecution) or post-release (e.g., related to supervision or registration). Nor does this estimate capture administrative and judicial costs associated with appeals, or administrative costs that cannot be extricated from other budgets, as is the case when costs per-prisoner are shared between prisons and civil commitment facilities. We believe information on the substantial funding dedicated to incarceration will be useful to U.S. federal, state, and local lawmakers and to international policymakers as they consider allocating resources to the development, evaluation and dissemination of effective prevention strategies aimed at keeping children safe from sexual abuse in the first place.

Problems with self-regulation are often theoretically and empirically linked to sexually abusive behavior, as is also true of experiences of early childhood abuse and maltreatment. Questions remain regarding how indicators of dysregulation and self-regulatory deficits interact and are associated with prior maltreatment. In the current study, a range of variables potentially indicative of emotional, cognitive, interpersonal, and behavioral dysregulation and adverse childhood experiences (ACEs) were examined using the frame of the multimodal self-regulation theory among 156 adult men residing in secure forensic care who were receiving treatment for prior sexual offenses. Data were subjected to principal components analysis, resulting in four components that described varying aspects of dysregulated behavior and experiences: Problematic Sexual Behavior (PSB)-Impulsivity, Serious Mental Illness (SMI)-Aggression, ACEs-Suicidality, and Paraphilic Interests-Behavioral Stability. One component comprised of variables associated with maltreatment was associated with impulsivity and PSBs, as well as SMI and violence via linear regression analysis. Theoretical and clinical implications are discussed.

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.