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Current Psychiatry Reports Jun 2023We offer reflections on practitioner service provision for sex offenders when working in remote communities. The social ecological model framework is used to capture the... (Review)
Review
PURPOSE OF REVIEW
We offer reflections on practitioner service provision for sex offenders when working in remote communities. The social ecological model framework is used to capture the influence on practitioner working at an individual, relationship, community, and societal level.
RECENT FINDINGS
The social construction and geographic conditions of sexual offending within remote communities present myriad challenges for professionals working in these isolative settings in which they are embedded. Challenges include being the sole expert in a community, unavoidable dual relationships, community anxieties, and restrictive guidelines and assessment measures. Despite the challenges presented to practitioners operating in remote communities, many opportunities are available for building local and international peer relationships, connecting with the community, individualized treatment for clients, and flexibility in the adaptation of best practice to fit the needs of remote communities while maintaining ethical integrity.
Topics: Humans; Criminals; Sex Offenses
PubMed: 37162660
DOI: 10.1007/s11920-023-01424-w -
International Journal of Environmental... Feb 2022The purposes of this study were to determine whether youth who have experienced sexual victimization (SV) have lower self-efficacy to refuse sex and to identify...
The purposes of this study were to determine whether youth who have experienced sexual victimization (SV) have lower self-efficacy to refuse sex and to identify intervention strategies for rape survivors to mitigate further health-risks and harm. Cross-sectional data from the 2014 Kampala Youth Survey ( = 1134) of youth aged 12 to 18 years recruited from Uganda Youth Development Link drop-in centers were used to conduct the analyses. Multivariable statistics were computed to determine the correlates (i.e., sex, education, homelessness, problem drinking, and SV) for (1) self-efficacy to refuse sex, (2) self-efficacy to refuse sex while drinking, and (3) regretting sex due to alcohol use. Among participants, 16.9% reported SV (79% were female and 21% were male). In the final adjusted model, self-efficacy to refuse sex while drinking was only associated with homelessness (OR: 0.52; 95% CI: 0.36, 0.74). Previous SV was not associated with lower self-reports of self-efficacy to refuse sex compared to those who had not experienced SV. Additionally, SV was not associated with increased reports of regrets for sex attributed to alcohol use. Alcohol prevention strategies for the most at-risk youth, including homeless youth, are warranted to improve self-efficacy to refuse sex among youth living in the slums of Kampala.
Topics: Adolescent; Alcohol Drinking; Child; Crime Victims; Cross-Sectional Studies; Emotions; Female; Ill-Housed Persons; Humans; Male; Poverty Areas; Rape; Self Efficacy; Sex Offenses; Sexual Behavior; Survivors; Uganda; Vulnerable Populations
PubMed: 35206104
DOI: 10.3390/ijerph19041915 -
Clinical Psychology Review Apr 2011Substance abuse has often been associated with committing sex offenses. In this article, the following will be reviewed: 1) studies that assessed substance abuse in sex... (Review)
Review
Substance abuse has often been associated with committing sex offenses. In this article, the following will be reviewed: 1) studies that assessed substance abuse in sex offenders; 2) differences in substance abuse among different types of sex offenders; 3) differences in substance abuse between sex offenders and nonsexual offenders and substance abuse in the normal population; 4) sex offenders' intoxication at the time of the offense; and 5) differences in intoxication at the time of the offense among different types of sex offenders. Studies will be discussed according to the method they used to assess substance abuse, i.e., file research, screening instruments or semi-structured interviews. This review shows that about half of the sex offenders has a history of substance abuse, a quarter to half of the sex offenders has a history of alcohol misuse and that about one fifth to a quarter of the sex offenders has a history of drug misuse. Furthermore, about a quarter to half of the sex offenders appeared to be intoxicated at the time of the offense. The review results in recommendations for future research. Because of the high prevalence of substance abuse in sex offenders it is advisable to routinely screen for substance abuse and, if necessary, to treat substance abuse.
Topics: Criminals; Humans; Prevalence; Sex Offenses; Substance-Related Disorders
PubMed: 21183264
DOI: 10.1016/j.cpr.2010.11.006 -
Trauma, Violence & Abuse Oct 2023When youth commit serious violent or sexual offenses, this often generates a call for more severe punishments and longer detention sentences. An important question is... (Review)
Review
When youth commit serious violent or sexual offenses, this often generates a call for more severe punishments and longer detention sentences. An important question is whether (long) detention sentences are effective in decreasing recidivism among serious young offenders. To estimate recidivism rates in serious young offenders and elucidate the link between sentencing (in terms of custodial vs. non-custodial and length of imprisonment) and recidivism, three multilevel meta-analyses were conducted. With a systematic literature search, 27 studies and four datasets were traced, involving = 2,308 participants, yielding 90 effect sizes for overall recidivism, 24 for specifically violent recidivism, and 23 for the association between length of imprisonment and recidivism. The average weighted overall recidivism rate was 44.47% (95% confidence interval [CI]: 37.59-51.46%) over an average period of 8.68 years. The rate of violent recidivism was estimated at 30.49% (95% CI: 20.92-40.52%), over an average period of 11.45 years. Recidivism rates were higher when recidivism was defined as an arrest for any new offense rather than for a specific offense and in studies conducted in the United States versus European studies. Violent recidivism rates were higher in studies with longer follow-up periods. Based on the limited available studies, no difference in recidivism rates following custodial and non-custodial sentences were found, nor an association between length of imprisonment and recidivism. To increase rehabilitation chances for youth offenders, further research is warranted to better understand the impact of sentencing and to ascertain what is needed to make custodial and non-custodial sentences more effective.
Topics: Adolescent; Humans; Criminals; Law Enforcement; Recidivism; Sex Offenses; Meta-Analysis as Topic
PubMed: 36062897
DOI: 10.1177/15248380221119514 -
Current Opinion in Psychiatry Jan 2008To review the most recent literature on the relationship between personality disorders and violent behavior. The review does not aim to address the issue of a possible... (Review)
Review
PURPOSE OF REVIEW
To review the most recent literature on the relationship between personality disorders and violent behavior. The review does not aim to address the issue of a possible etiological connection between previously being the victim of violent acts and later developing a personality disorder.
RECENT FINDINGS
Recent data suggest that personality disorders, especially antisocial and borderline, are strongly related to the manifestation of violent acts. Substance abuse is another strong factor which could act either independently or additively. Biological factors seem to constitute a risk factor for violent behavior independently of personality. Although intelligence does not seem to be related to violence, some patients may manifest specific cognitive deficits. The ethical and legal questions posed by the above correlations are difficult to answer, and research has not yet provided enough data on this issue.
SUMMARY
The most recent data support the relationship between antisocial personality and violence, especially when substance abuse is also present, although the presence of confounding factors in the diagnostic criteria suggest caution in the interpretation of the literature.
Topics: Adolescent; Adult; Antisocial Personality Disorder; Borderline Personality Disorder; Child; Comorbidity; Cross-Sectional Studies; Domestic Violence; Female; Homicide; Humans; Male; Personality Disorders; Risk Factors; Sex Factors; Sex Offenses; Violence
PubMed: 18281846
DOI: 10.1097/YCO.0b013e3282f31137 -
Psychiatria Polska Dec 2022The search for effective methods of treating sex offenders is essential in order to reduce the risk of their subsequent sexual offences. This article presents Jeffrey... (Review)
Review
The search for effective methods of treating sex offenders is essential in order to reduce the risk of their subsequent sexual offences. This article presents Jeffrey Young's concept of Schema Therapy with a discussion on the appropriateness of its use in the treatment of those who engage in problematic sexual behaviour directed against sexual freedom. Such behaviours are prohibited by law and are connected to committing crimes set out in Chapter XXV of the Penal Code (including rape, exploitation of helplessness, abuse of dependence relation, sexual act with a minor under 15 years of age). The article presents the main assumptions of schema therapy. Then, with reference to the main assumptions of this therapeutic approach, a theoretical model of schema therapy in the context of violent sexual behaviour is proposed and discussed. The authors also attempted to analyze the mechanism of formation and perpetuation of deviant criminal behaviors in the context of key constructs of this approach, such as: early maladaptive schemas, schema modes, and coping styles. As Schema Therapy has proven to be effective in treating chronic personality aspects of disorders, often underlying the sexual pathology of the sex offenders, this approach seems to be a promising trend for such a difficult population of people.
Topics: Humans; Criminals; Schema Therapy; Sex Offenses; Rape; Sexual Behavior
PubMed: 37098197
DOI: 10.12740/PP/143847 -
Psychiatria Danubina Dec 2019The aim of the study was to compare the characteristics of sex offenders today, and those who committed a sex crime fifteen years ago, in regard to their...
BACKGROUND
The aim of the study was to compare the characteristics of sex offenders today, and those who committed a sex crime fifteen years ago, in regard to their psychiatric-forensic aspects.
SUBJECTS AND METHODS
Data from the University psychiatric hospital Vrapče, Center for forensic psychiatry on court people sent for psychiatric and forensic evaluation, who were accused of sex offense in two time frames (1998-2001 and 2010-2016) were analysed. In total there were 50 and 57 male subjects sent for an evaluation.
RESULTS
In both groups rape was the most prevalent offence, and both groups had the same prevalence of abuse, earlier psychiatric treatment and the majority of offenders were diagnosed with dissocial personality disorder and other personality disorders. Paedophilia was diagnosed in only a minority (14% and 7% respectively) of cases. The latter group (2010-2016) committed more sex offences against children, more often were with no mental disorder and less often had alcohol dependence and mental retardation. Up to one third of the later group were not giving their defence, compared to 4% of the former group.
CONCLUSIONS
Changes in court case law and psychiatrists' usage of diagnostic criteria have influenced the prevalent diagnoses in sex offenders. Paraphilias are not often diagnosed in sex offenders because they do not confirm the act, and in recent years more often use not to give their defence (which makes reaching the diagnosis more challenging).
Topics: Adolescent; Adult; Aged; Alcoholism; Child; Criminals; Croatia; Female; Forensic Psychiatry; Humans; Intellectual Disability; Male; Mental Disorders; Middle Aged; Sex Offenses; Young Adult
PubMed: 32160179
DOI: No ID Found -
Journal of Interpersonal Violence Sep 2022This paper describes the post-incarceration reintegration experiences of military veterans convicted of sex offenses and identify potential interventions to ease...
This paper describes the post-incarceration reintegration experiences of military veterans convicted of sex offenses and identify potential interventions to ease reintegration for this population. Participants were a convenience sample of 14 veterans who were on sex offender (SO) registries and 21 community stakeholders involved in supporting persons during re-entry. Subjects were identified purposively and through snowball sampling, in Massachusetts. We employed semi-structured qualitative interviews of participants, followed by analysis including process mapping to identify barrier and facilitation points. We used both a grounded thematic approach and codes, guided by the Behavioral Model for Vulnerable Populations. We found re-entry barriers include older age, stigma, lack of social support, inadequate information about sexual offense levels, limited housing options and access to mental health treatment to reduce sexual impulses, and re-entry information tailored to SOs. Re-entry facilitators include access to SO treatment, knowledge about services, self-efficacy, ability to self-advocate, and social support. Interventions to aid successful re-entry include pre-release counseling and classes tailored to SO needs, re-entry planning including housing resources, sexual deviance treatment, and referral to legal counseling to assist with altering assigned SO level. Specific needs and resources unique to veterans should be integrated into reentry plans. Convicted SOs often lack information and assistance to prepare for life after release, putting them at increased risk of homelessness, emotional difficulties, and financial hardship. Failure to recognize the unique needs of this population, and to leverage resources, creates a public health risk as it increases the likelihood that SOs will recidivate. Veterans who are SOs have unique resources available to them through the Veterans Administration such as SO treatment and peer-support specialists. Nevertheless there are additional steps that could be beneficial, such as timely provision of information, creating more opportunities for treatment, and providing more housing options.
Topics: Criminals; Ill-Housed Persons; Humans; Sex Offenses; United States; United States Department of Veterans Affairs; Veterans
PubMed: 34039087
DOI: 10.1177/08862605211016344 -
Violence Against Women Nov 2011
Topics: Crime Victims; Female; Humans; Male; Rape; Sex Offenses; Violence; Women's Health
PubMed: 22416286
DOI: 10.1177/1077801211435285 -
PLoS Medicine Dec 2018Sex workers are at disproportionate risk of violence and sexual and emotional ill health, harms that have been linked to the criminalisation of sex work. We synthesised... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Sex workers are at disproportionate risk of violence and sexual and emotional ill health, harms that have been linked to the criminalisation of sex work. We synthesised evidence on the extent to which sex work laws and policing practices affect sex workers' safety, health, and access to services, and the pathways through which these effects occur.
METHODS AND FINDINGS
We searched bibliographic databases between 1 January 1990 and 9 May 2018 for qualitative and quantitative research involving sex workers of all genders and terms relating to legislation, police, and health. We operationalised categories of lawful and unlawful police repression of sex workers or their clients, including criminal and administrative penalties. We included quantitative studies that measured associations between policing and outcomes of violence, health, and access to services, and qualitative studies that explored related pathways. We conducted a meta-analysis to estimate the average effect of experiencing sexual/physical violence, HIV or sexually transmitted infections (STIs), and condomless sex, among individuals exposed to repressive policing compared to those unexposed. Qualitative studies were synthesised iteratively, inductively, and thematically. We reviewed 40 quantitative and 94 qualitative studies. Repressive policing of sex workers was associated with increased risk of sexual/physical violence from clients or other parties (odds ratio [OR] 2.99, 95% CI 1.96-4.57), HIV/STI (OR 1.87, 95% CI 1.60-2.19), and condomless sex (OR 1.42, 95% CI 1.03-1.94). The qualitative synthesis identified diverse forms of police violence and abuses of power, including arbitrary arrest, bribery and extortion, physical and sexual violence, failure to provide access to justice, and forced HIV testing. It showed that in contexts of criminalisation, the threat and enactment of police harassment and arrest of sex workers or their clients displaced sex workers into isolated work locations, disrupting peer support networks and service access, and limiting risk reduction opportunities. It discouraged sex workers from carrying condoms and exacerbated existing inequalities experienced by transgender, migrant, and drug-using sex workers. Evidence from decriminalised settings suggests that sex workers in these settings have greater negotiating power with clients and better access to justice. Quantitative findings were limited by high heterogeneity in the meta-analysis for some outcomes and insufficient data to conduct meta-analyses for others, as well as variable sample size and study quality. Few studies reported whether arrest was related to sex work or another offence, limiting our ability to assess the associations between sex work criminalisation and outcomes relative to other penalties or abuses of police power, and all studies were observational, prohibiting any causal inference. Few studies included trans- and cisgender male sex workers, and little evidence related to emotional health and access to healthcare beyond HIV/STI testing.
CONCLUSIONS
Together, the qualitative and quantitative evidence demonstrate the extensive harms associated with criminalisation of sex work, including laws and enforcement targeting the sale and purchase of sex, and activities relating to sex work organisation. There is an urgent need to reform sex-work-related laws and institutional practices so as to reduce harms and barriers to the realisation of health.
Topics: Female; Health Status; Humans; Male; Occupational Health; Qualitative Research; Sex Offenses; Sex Work; Sex Workers; Sexually Transmitted Diseases
PubMed: 30532209
DOI: 10.1371/journal.pmed.1002680