The Role of Substance Abuse in Psychotic Versus Personality Disordered Offenders Detained Under the Dutch Entrustment Act (TBS): An Exploratory Study

Mentally disordered patients that abuse drugs or alcohol have a larger number of criminal convictions. Early starters who had their first conviction before the age of 18, especially, more often have a diagnosis of substance abuse and are more often intoxicated at the time of the offense compared to late starters. The present study involved four groups of Dutch patients (n = 137): three groups of violent offenders (psychotic and personality disordered patients) and one group of non-delinquent psychotic patients from general psychiatry. All data were retrieved retrospectively. The results showed that early starters were intoxicated more often, started with substance abuse at an earlier age and more often had a diagnosis of substance abuse at the time of the index offense than late starters. Personality disordered offenders were intoxicated more often and more often had a prior diagnosis of substance abuse at the time of the offense than psychotic offenders. To a limited extent, psychotic offenders with a diagnosis of a substance-related disorder or intoxication at the time of the offense had a more extensive criminal history than personality disordered offenders. Substance abuse has an aggravating effect on criminogenic behavior, depending on the age at first conviction and diagnosis.     

Sexual Offenders Against Children: The Influence of Personality and Obsessionality on Cognitive Distortions

Sexual offenders against children are generally inadequate in their social functioning and diverse in their psychopathology. The degree to which this inadequate functioning and psychopathology influences therapeutic interventions brings into question the belief that generic nonclinical programmatic treatment work is always appropriate for such a cohort. The Sex Offenders Assessment Package (SOAP) measures inadequate social functioning and sexual deviance, but has not been linked to broader individual differences and generic psychopathology. We collected information examining the relationship between the SOAP and standard measures of personality (the NEO-FFI) and obsessive-compulsiveness (MOCI) in a sample of 200 sexual offenders against children seen by the Probation Service. Factor analysis was used to reduce the SOAP to three reliable factors: emotional distress, cognitions supporting sex with children, and concern for others. These factors correlated respectively with higher Neuroticism and lower Extroversion; greater obsessive-compulsiveness on the MOCI, and trait Agreeableness, irrespective of whether or not one corrected for socially desirable responding. When partial correlation controlled for the influence of Neuroticism on the correlation between cognitions supporting sex with children and the MOCI, there was no change in the association between these variables. These results show that negative affect and obsessional tendencies are important underlying influences on the feelings and behavior of sexual offenders, that the obsessionality of the group is not attributable to Neuroticism, and suggest useful additional foci to enhance the treatment of this diverse clinical group.     

Therapist Style in Sexual Offender Treatment: Influence on Indices of Change

This paper describes the results of our review of the broad process literature as well as summarizing two studies examining the influence of the therapist in generating changes in treatment targets among sexual offenders. We conclude that displays of empathy and warmth by the therapist as well as the provision of rewards for progress and some degree of directiveness, maximize the benefits derived from the procedures employed in treating sexual offenders. We also suggest the need for flexibility and encourage program designers not to so overly detail their treatment manuals that the influence of the therapist is minimized.     

Drug treatment services for adult offenders: the state of the state

We conducted a national survey of prisons, jails, and community correctional agencies to estimate the prevalence of entry into and accessibility of correctional programs and drug treatment services for adult offenders. Substance abuse education and awareness is the most prevalent form of service provided, being offered in 74% of prisons, 61% of jails, and 53% of community correctional agencies; at the same time, remedial education is the most frequently available correctional program in prisons (89%) and jails (59.5%), whereas sex offender therapy (57.2%) and intensive supervision (41.9%) dominate in community correctional programs. Most substance abuse services provided to offenders are offered through correctional programs such as intensive supervision, day reporting, vocational education, and work release, among others. Although agencies report a high frequency of providing substance abuse services, the prevalence rates are misleading because less than a quarter of the offenders in prisons and jails and less than 10% of those in community correctional agencies have daily access to these services through correctional agencies; in addition, these are predominantly drug treatment services that offer few clinical services. Given that drug-involved offenders are likely to have dependence rates that are four times greater than those among the general public, the drug treatment services and correctional programs available to offenders do not appear to be appropriate for the needs of this population. The National Criminal Justice Treatment Practices survey provides a better understanding of the distribution of services and programs across prisons, jails, and community correctional agencies and allows researchers and policymakers to understand some of the gaps in services and programs that may negatively affect recidivism reduction efforts.     

An International Perspective on the Rights of Juvenile Offenders or "Children Living in Exceptionally Difficult Conditions"

Substance user treatment providers, researchers, policy makers, and educators working in the juvenile justice field may be unaware of international policies governing the protection of youthful offenders. This presentation reviews the international rights of detained and incarcerated youth outlined in a variety of United Nations documents. Adolescents in contact with criminal justice systems have the right to the "highest attainable standard of health, both physical and mental."’ When substance abuse is involved they have the right to receive appropriate community-based treatment. Periods of contact with the criminal justice system may be one among very few opportunities to provide services for youth and these opportunities should not be wasted.     

Attempted cessation of heroin use among men approaching mid-life

Aims:?To analyse the reasons for ceasing or continuing heroin use in mid-life and examine the contribution of drug treatment and social factors to this process. Methods:?A semi-structured qualitative interview discussing drug-using history was conducted with Glasgow men who had previously received treatment for drug problems. Findings:?Successful cessation occurred after repeated attempts and repeated treatments, often in the context of major life changes. Relapse occurred because of quitting without adequate mental preparation; returning to old haunts and life circumstances, life difficulties, the tedium of a life without heroin, and inability to cope with normal emotions previously blocked by heroin use. Men's lives could be understood as a set of tensions between the deviant subculture of heroin injecting and the conventional neighbourhood. The balance of these tensions affected men's behaviour and generally there needed to be both a push away from the subculture and a pull towards the neighbourhood for long-term cessation to occur. Conclusions:?Treatment of heroin dependence may be better regarded as the management of a chronic problem, rather than as a single intervention with a quantifiable outcome. Treatment needs to consider both the benefits and problems of heroin use and the benefits and problems of conventional living.     

Comparing Offenders against Women and Offenders against Children on Treatment Outcome in Offenders with Intellectual Disability

Background Several studies have shown the positive effects of sex offender treatment for men with intellectual disabilities who have perpetrated sex offences or inappropriate sexual behaviour. The present study investigates the process of treatment change and compares two groups of offenders against adults and offenders against children. Method Participants comprised of 15 men who had offended against adult women and 15 who offended against children. All were treated for 36 months. Groups were compared with repeated measures using the Questionnaire on Attitudes Consistent with Sexual Offending. Results At baseline, offenders against women had higher scores than offenders against children on the Rape scale while on the offences against children scale the opposite was the case. Both groups showed significant improvement with scores reducing to levels consistent with non‐offenders by 36 months. Significant improvements were still recorded from 18 to 36 months of treatment. Re‐offending across both groups was 23%. Conclusion Sex offender treatment can produce significant reductions in cognitive distortions in sex offenders with intellectual disabilities. The importance of continuing treatment for longer than 12 months was endorsed by the results.     

An Actuarial Procedure for Assessing Risk with Juvenile Sex Offenders

Assessments of juvenile sexual offenders that are intended to aid in dispositional decisions occur at a multitude of decision points within the juvenile justice system. Despite the ubiquity of decisions that include considerations of risk, relatively little empirical work has been done on the development and validation of a risk assessment procedure for these young offenders. In this article, we discuss our initial efforts in developing and validating an actuarial risk assessment protocol for juvenile sex offenders using a sample of 96 adolescents that had been admitted, treated, and discharged from the Joseph J. Peters Institute. We conclude with a critical discussion of problems associated with evaluating risk in this population, and of deficiencies and revision requirements in the present protocol.     

Comparisons of daily stress, coping, problem behavior, and cognitive distortions in adolescent sexual offenders and conduct-disordered youth

Adolescent sexual offenders (ASOs) were compared with conduct-disordered youth (CDs) and control adolescents (CAs) on measures of stress, coping, problem behavior, and cognitive distortions. CDs scored higher than ASOs on socialized aggression, aggressive coping, avoidance coping, and coping by engaging in sexual behavior. Measures of coping and problem behaviors successfully classifed approximately 80% of ASOs and CDs. ASOs and CDs were similar to each other and higher than CAs on negative automatic thoughts, coping by seeking diversions and being with friends, and problem behaviors including hyperactivity, anxiety, and conduct disorder. Reports of daily stress were similar for all groups, suggesting that clinical groups coped less adequately despite similar stressors.     

Childhood Attachment,Childhood Sexual Abuse,and Onset of Masturbation Among Adult Sexual Offenders

Written autobiographies of 48 incarcerated adult male sexual offenders (22 rapists, 13 intrafamilial child molesters, and 13 extrafamilial child molesters) were used to generate retrospective self-report measures of their childhood maternal and paternal attachment, childhood sexual abuse experiences, and onset of masturbation. Contrary to expectation, the offenders as a combined group more often reported secure than they did insecure childhood maternal and paternal attachment. There were no differences between the three offender subgroups with respect to maternal attachment; however the rapists and the intrafamilial child molesters were more likely to report insecure paternal attachment than were the extrafamilial child molesters. There were no differences between these offender subgroups in the frequency with which childhood sexual abuse was reported. However, offenders with insecure paternal attachment were more likely to report having been sexually abused than were those with secure paternal attachment. Sexually abused offenders in turn reported earlier onset of masturbation than did those who were not sexually abused. These results are consistent with contemporary attachment models linking insecure childhood attachment to childhood sexual abuse, and with traditional conditioning models linking childhood sexual abuse, early masturbation, and sexual offending.