| 1. |
- Bengtson, S, et al.
(author)
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Unguided clinical and actuarial assessment of re-offending risk: a direct comparison with sex offenders in Denmark
- 2007
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In: Sexual abuse : a journal of research and treatment. - : SAGE Publications. - 1079-0632. ; 19:2, s. 135-153
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Journal article (peer-reviewed)abstract
- Meta-analyses suggest that actuarial risk assessments outperform unguided clinical judgment for prediction of recidivism in criminal offenders. However, there is a lack of direct comparisons of the predictive accuracy of clinical judgment and actuarial risk scales for sexual offenders. We followed up 121 male sex offenders (≥18 years) subjected to pre-trial forensic psychiatric assessment in Denmark in 1978-1992 (mean post-detainment time=16.4 years) to compare the predictive validity of unstructured clinical judgment of recidivism risk with that of the well-established Static-99 (Hanson and Thornton, Law and Human Behavior 24:119-136, 2000) and an extension of the Static-99, the Static-2002 (Hanson and Thornton, Notes on the development of Static-2002 (Rep. No. 2003-01), Public Safety and Emergency Preparedness Canada, Ottawa, Canada, 2003). The predictive accuracy of unguided judgment did not exceed chance for any sexual, severe sexual or any violent (sexual or non-sexual) reconviction (AUCs of the ROC curve=0.52, 95%CI=0.41-0.63; 0.50, 95%CI=0.34-0.67; and 0.57, 95%CI= 0.40-0.73, respectively). In contrast, all three outcomes were predicted significantly better than chance by the Static-99 (AUC=0.62, 95%CI=0.52-0.72; 0.72, 95%CI= 0.59-0.84; and 0.71, 95%CI=0.56-0.86) and the Static-2002 (AUC=0.67, 95%CI= 0.57-0.77; 0.69, 95%CI=0.56-0.83; and 0.70, 95%CI=0.55-0.86). Static-99 out-performed clinical judgment for sexual recidivision (χ2=5.11, df=1, p<.05). The Static-2002 was significantly more accurate for the prediction of any sexual recidivism as compared to unguided clinical judgment but its advantage fell just short of statistical significance for severe sexual recidivism (χ2=3.56, df=1, p=0.06). When tested for recidivism within 2 years, none of the three prediction methods yielded results significantly better than chance for any outcome. This direct trial of the unguided clinical method argues against its continued use for risk assessment of sexual offenders.
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| 2. |
- Carlstedt, Anita, et al.
(author)
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Does Victim Age Differentiate Between Perpetrators of Sexual Child Abuse? A Study of Mental Health, Psychosocial Circumstances, and Crimes
- 2009
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In: Sexual Abuse. - : SAGE Publications. - 1079-0632 .- 1573-286X. ; 21:4, s. 442-454
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Journal article (peer-reviewed)abstract
- To test the theory that sexual offenders who abuse very young children (0-5 years) have more severe mental health and psychosocial problems than those who victimize older children, authors compared psychiatric diagnoses, social circumstances, and crime-related data in all sexual offenders against minors referred to forensic psychiatric investigation in Sweden during a 5-year period. Thirty-one men had committed index crimes involving victims between the ages of 0 and 5 years (Group 1), 90 had 6- to 11-year-old victims (Group 2), and 41 had 12- to 15-year-old victims (Group 3). All three offender groups were characterized by severe mental health problems, in many cases fulfilling American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for both Axis I and Axis II diagnoses, but these problems did not differ between groups. Neither did social situation or sexual orientation. Offenders with 0- to 5-year-old victims significantly more often abused both boys and girls. Frequencies of retrospectively diagnosed childhood-onset behavior disorders were high in all three offender groups. The authors' data did not support previous findings of increasingly severe mental health problems with decreasing victim age.
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| 3. |
- Fazel, S, et al.
(author)
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Risk factors for criminal recidivism in older sexual offenders
- 2006
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In: Sexual abuse : a journal of research and treatment. - : SAGE Publications. - 1079-0632. ; 18:2, s. 159-167
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Journal article (peer-reviewed)abstract
- Sexual offenders constitute a substantial proportion of the older male prison population. Recent research findings, with potential consequences for risk management, indicate that recidivism risk might be lower in older sexual offenders. We followed up all adult male sexual offenders released from prison in Sweden during 1993-1997 (N =1,303) for criminal reconviction for an average of 8.9 years. We studied rates of repeat offending (sexual and any violent) by four age bands (<25, 25-39, 40-54, and 55 +years), and examined whether risk factors for recidivism remained stable across age groups. Results showed that recidivism rates decreased significantly in older age bands. In addition, the effect of certain risk factors varied by age band. These findings on recidivism rates in older sexual offenders concur with studies from the United Kingdom, United States, and Canada and may suggest some generalizability in Western settings. Further research is needed to address underlying mechanisms.
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| 4. |
- Kjellgren, Cecilia, et al.
(author)
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Adolescent sexual offenders: a total survey of referrals to social services in sweden and subgroup characteristics.
- 2006
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In: Sexual Abuse. - 1079-0632 .- 1573-286X. ; 18:4, s. 357-372
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Journal article (peer-reviewed)abstract
- Sampling methodology (e.g. population-based vs. clinical samples, anonymous self-reports vs. data collected as part of mandated treatment) affects the validity of conclusions drawn from research addressing the etiology of adolescent sexual offending. Studies of unselected samples allow testing of the generalizability of etiological models suggested from investigation of selected clinical or forensic populations. Further, representative epidemiological data on adolescent sexual offending is needed for policy-making and the planning of services. We conducted a national survey of all adolescent sexual offenders (ASOs, 12-17 years) referred to Social Services during 2000. Social workers at all child and adolescent units in Social Service authorities throughout Sweden (N=285, 99% response rate) completed a questionnaire about new ASO referrals in 2000. The National Board of Health and Welfare commissioned the survey and questionnaire items tapped offender, offence, and victim characteristics. A total of 197 boys and 2 girls aged 12-17 years were referred to Social Services because of sexually abusive behavior in 2000. Focusing specifically on males, this yielded a one-year incidence of .060% (95% confidence interval = .052-.068). Forty-six percent of male ASOs abused at least one child younger than age 12 years (child offenders) whereas the rest had abused peer or adult victims (peer offenders). Forty-two percent of male ASOs had ever committed sexual offences together with at least one other offender (group offenders). Child- vs. peer offenders and group vs. single offenders, suggested typologies in the literature, were compared to explore potential subtype-specific risk factors and correlates. The results suggested a higher proportion of group ASOs than previously reported and stronger support for subdividing ASOs into child vs. peer offenders than into group vs. single ASOs.
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| 5. |
- Langstrom, N, et al.
(author)
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Psychiatric disorders and recidivism in sexual offenders
- 2004
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In: Sexual abuse : a journal of research and treatment. - : SAGE Publications. - 1079-0632. ; 16:2, s. 139-150
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Journal article (peer-reviewed)abstract
- Research on psychiatric morbidity in sexual offenders (SOs) has mostly been based on small, selected samples. We studied psychiatric disorders and their relationship with criminal recidivism in a nationwide, representative cohort of SOs. Data on ICD-9 and -10 psychiatric and neurologic morbidity diagnosed during hospital admissions 1987-1997, but prior to sexual offending, were retrieved for all adult male SOs released from Swedish prisons 1993-1997 (N = 1215). Preoffending disorder prevalence and associations between morbidity and criminal reconvictions during a 5-year postdetainment follow-up were explored. Alcohol use disorder was the most frequent diagnosis, followed by drug use disorder, personality disorder, and psychosis. Morbidity requiring admission to hospital was more common in rapists as compared to child molesters. Alcohol use disorder, drug use disorder, personality disorder, and psychosis all increased the risk for sexual recidivism whereas alcohol use disorder and personality disorder predicted violent nonsexual recidivism. Controlling for sociodemographic confounds changed the risk estimates only marginally. Because disorders were identified among only those who had been admitted to psychiatric hospitals as inpatients, underestimation of true prevalence rates was inevitable. However, our findings support psychiatric consultation for improved assessment and management of mental health needs and recidivism risk in SOs.
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| 6. |
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| 7. |
- Storey, Jennifer, et al.
(author)
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Utilization and implications of the Static-99 in practice
- 2012
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In: Sexual abuse. A Journal of Research and Treatment. - : SAGE Publications. - 1079-0632 .- 1573-286X. ; 24:3, s. 289-302
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Journal article (peer-reviewed)abstract
- The Static-99 is the most commonly used risk assessment instrument for sexual violence in North America and its results can affect highly consequential decisions made in the criminal and civil justice systems. Despite its influence, few studies have systematically examined how the Static-99 is used by clinicians in practice. The current study compares the Static-99 ratings of clinicians to those of researchers for 100 adult males who completed an outpatient sex offender treatment program and were followed up over an average of about 4 years. Results showed good agreement between the ratings of clinicians and researchers for total scores on the Static-99, as well as for most individual items. Ratings by clinicians tended to be slightly lower than those made by researchers. The predictive validity of ratings made by clinicians and researchers was very similar and moderate in terms of effect size. In 30 cases, clinicians used discretion to "override" or adjust the Static-99 ratings when making final risk judgments, but the predictive validity of the clinical adjusted ratings was worse than that of the original Static-99 ratings made by clinicians. The need for quality assurance and training are discussed along with the need for clear empirically supported guidelines regarding overrides. © The Author(s) 2012.
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