Assessing female sexual offenders' motivations and cognitions : an exploratory study

Semi-structured interviews eliciting cognitions and motivations were carried out with 15 incarcerated female child sexual abusers (nearly 50% of the current UK female sexual offender prison population). Qualitative analysis indicated that four of the five motivational schemas (implicit theories) suggested by Ward (Ward, 2000; Ward & Keenan, 1999) to underlie male sexual offenders' cognitions could be clearly identified in women, these were: Uncontrollability (UN, identified in 87% of participants), Dangerous world (DW, 53%), Children as sexual objects (CSO, 47%) and Nature of harm (NH, 20%). Entitlement, the final implicit theory (IT), commonly found in males, was not identified in any participants in the sample. Further analysis indicated that there were four main motivational types of offender based on combinations of these ITs. These were: (1) presence of DW/CSO, indicating sexual motivation and cognitions with fear of violence; (2) presence of DW/no CSO, indicating fear of violence with no sexual cognition or motivation; (3) presence of CSO/no DW, indicating sexual motivation and cognition; the NH IT also strongly featured in this group; and (4) presence of UN/no DW or CSO, indicating lack of control, sometimes with sense of protection for the victim. Suggestions are made on how the results can inform theoretical developments in the field as well as policy and practice.

The structural properties of sexual fantasies for sexual offenders : a preliminary model

While the phenomenon of sexual fantasy has been researched extensively, little contemporary inquiry has investigated the structural properties of sexual fantasy within the context of sexual offending. In this study, a qualitative analysis was used to develop a descriptive model of the phenomena of sexual fantasy during the offence process. Twenty-four adult males convicted of sexual offences provided detailed retrospective descriptions of their thoughts, emotions and behaviours—before, during and after their offences. A data-driven approach to model development, known as Grounded Theory, was undertaken to analyse the interview transcripts. A model was developed to elucidate the structural properties of sexual fantasy in the process of sexual offending, as well as the physiological and psychological variables associated with it. The Sexual Fantasy Structural Properties Model (SFSPM) comprises eight categories that describe various properties of sexual fantasy across the offence process. These categories are: origin, context, trigger, perceptual modality, clarity, motion, intensity and emotion. The strengths of the SFSPM are discussed and its clinical implications are reviewed. Finally, the limitations of the study are presented and future research directions discussed.

What were they thinking? An exploration of child sexual offenders' beliefs using a lexical decision task

Cognitive distortions have been afforded a key role in the offending behaviour of child sexual offenders. While the mechanisms underlying cognitive distortions are not fully understood, they are generally thought to reflect entrenched beliefs that distinguish child sexual offenders from other individuals. We investigated this hypothesis using a robust experimental technique called the lexical decision task. Child sexual offenders, offender controls, and non-offender controls completed a lexical decision task in which they responded to words that completed sentences in either an offence-supportive or nonoffence-supportive manner. Contrary to predictions, child sexual offenders did not respond faster to words that were consistent with offence-supportive beliefs, relative to controls. However, they did show accelerated recognition for word stems supporting external locus of control beliefs. These results highlight the need to use cognitive experimental methods to study child sexual offenders' beliefs, and the importance of investigating potential alternative drivers of cognitive distortions.

The effects of visual priming on information processing in child sexual offenders

Child sexual offenders are hypothesized to hold offence-supportive beliefs that set them apart from others. The current study seeks support for this view via a cognitive-experimental approach. Child sexual offenders and offender controls were exposed to pictures of semi-clothed children (priming condition) or clothed, mature adults (control condition). Participants then read ambiguous sentences describing children's actions that could be interpreted in a sexualized manner. Next, participants completed a surprise recognition test in which half the sentences were re-presented in an unambiguously sexual form, and half in an unambiguously non-sexual form. Contrary to hypotheses, primed and/or control child sexual offenders did not show a memory bias for sexualized sentences, suggesting that they did not interpret the original sentences in line with offence-supportive beliefs. Results raise questions about whether child sexual offenders universally hold abnormal beliefs that facilitate their offending. Results also highlight the need for further experimental research within this field.

What's in a measure? A multi-method study of child sexual offenders' beliefs

The hypothesis that child sexual offenders (CSOs) hold distorted, offence-supportive beliefs is usually investigated using interview and questionnaire techniques. However, in light of various problems associated with the use of these techniques, researchers are increasingly turning to cognitive-experimental approaches. To date, no study has examined potential differences in the nature of the beliefs that are revealed using interview, questionnaire, and experimental methods. In this study, data is gathered using these three methods and the results triangulated. CSOs are interviewed and the content categorised into five belief types. CSOs and offender controls then complete a questionnaire measure of offence-supportive beliefs and an experimental task (Rapid Serial Visual Presentation-Modified, or RSVP-M), which uses sentence reading times to explore content held in cognitive structures. As hypothesised, CSOs showed evidence of holding distorted beliefs according to the interview and questionnaire measures. Against predictions, however, CSOs did not show evidence of holding distorted belief structures on the RSVP-M task. In fact, the three methods showed no agreement regarding the belief types each CSO was deemed to hold. These results raise important questions about the phenomena and potential artefacts measured by each method.

Empathy and adolescent sexual offenders : a review of the literature

A significant proportion of sexual offenses has been found to be committed by adolescent offenders. Although there is overlap in the backgrounds of adolescent sexual offenders and juvenile delinquents, in recent times there has been an increased effort to identify and treat adolescent sexual offenders as a distinct population. Adolescent sexual offenders are thought to be empathy deficient, with empathy development a commonly defined treatment goal. There is confusion, however, as to whether such empathy deficits are general in nature, are towards certain groups of people, or are own victim-specific. This article provides a review of the literature concerning empathy and adolescent sexual offenders and, based on this assessment, recommendations are made for future research.

Rehabilitation, etiology, and self-regulation : the comprehensive good lives model of treatment for sexual offenders

In this paper, we draw upon two sets of theoretical resources to develop a comprehensive theory of sexual offender rehabilitation named the Good Lives Model-Comprehensive (GLM-C). The original Good Lives Model (GLM-O) forms the overarching values and principles guiding clinical practice in the GLM-C. In addition, the latest sexual offender theory (i.e., the Integrated Theory of Sexual Offending; ITSO) provides a clear etiological grounding for these principles. The result is a more substantial and improved rehabilitation model that is able to conceptually link latest etiological theory with clinical practice. Analysis of the GLM-C reveals that it also has the theoretical resources to secure currently used self-regulatory treatment practice within a meaningful structure.

Beliefs, values, and action : the judgment model of cognitive distortions in sexual offenders

In this paper, we present the Judgment Model of Cognitive Distortions (JMCD), a new model of cognitive distortions that spans multiple levels of analysis and contains different types of judgments. This model proposes that cognitive distortions tend to cluster together in what we have termed Thematic Networks (TN): judgments about beliefs, values, and actions. We argue that the three sets of judgments cover all types of cognitive distortions apparent in sexual offenders including those revolving around content (i.e., asserting characteristics to people, the offender, the world) and cognitive operations (i.e., denial, minimization, rationalizations). Following a description of the JMCD, we demonstrate how it can account for the cognitive schemata identified in sexual offenders by researchers and clinicians. The paper concludes with a brief discussion of the clinical and research implications of the JMCD.

Health risk appraisal for older people 4: case finding for hypertension, hyperlipidaemia and diabetes mellitus in older people in English general practice before the introduction of the Quality and Outcomes Framework

Early intervention can help to reduce the burden of disability in the older population, but many do not access preventive care. There is uncertainty over what factors influence case finding in older patients in general practice.

A randomized trial of effects of health risk appraisal combined with group sessions or home visits on preventive behaviors in older adults

Background. To explore effects of a health risk appraisal for older people (HRA-O) program with reinforcement, we conducted a randomized controlled trial in 21 general practices in Hamburg, Germany. Methods. Overall, 2,580 older patients of 14 general practitioners trained in reinforcing recommendations related to HRA-O-identified risk factors were randomized into intervention (n = 878) and control (n = 1,702) groups. Patients (n = 746) of seven additional matched general practitioners who did not receive this training served as a comparison group. Patients allocated to the intervention group, and their general practitioners, received computer-tailored written recommendations, and patients were offered the choice between interdisciplinary group sessions (geriatrician, physiotherapist, social worker, and nutritionist) and home visits (nurse). Results. Among the intervention group, 580 (66%) persons made use of personal reinforcement (group sessions: 503 [87%], home visits: 77 [13%]). At 1-year follow-up, persons in the intervention group had higher use of preventive services (eg, influenza vaccinations, adjusted odds ratio 1.7; 95% confidence interval 1.4–2.1) and more favorable health behavior (eg, high fruit/fiber intake, odds ratio 2.0; 95% confidence interval 1.6–2.6), as compared with controls. Comparisons between intervention and comparison group data revealed similar effects, suggesting that physician training alone had no effect. Subgroup analyses indicated favorable effects for HRA-O with personal reinforcement, but not for HRA-O without reinforcement. Conclusions. HRA-O combined with physician training and personal reinforcement had favorable effects on preventive care use and health behavior.