Article

Sex offender treatment and legislation.

Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, and National Institute for the Study, Prevention and Treatment of Sexual Trauma, Baltimore, MD, USA.
The journal of the American Academy of Psychiatry and the Law (Impact Factor: 0.93). 02/2003; 31(4):510-3.
Source: PubMed

ABSTRACT The current issue of the Journal contains three articles related to sex offenders. The first, by Scott and Holmberg, discusses legislation that mandates either "chemical or surgical castration." The second, by Saleh and Guidry, reviews diagnostic and treatment considerations. The third, by Scott and Gerbasi, discusses sex offender registration and community notification. Much of the relevant sex offender legislation, including that pertaining to testosterone-lowering treatments, has been enacted in response to intense public passion. When it comes to the issue of sex offenders, there is a pressing need to develop a coherent body of evidence-based forensic concepts and knowledge that can rationally inform both clinical practice and future public policy. That may require a closer collaboration between both the criminal justice and legislative sectors, and the scientific-medical communities. The three papers published in this issue provide useful information that may assist toward such a goal.

1 Follower
 · 
74 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The relationship of surgical castration to sexual recidivism in a sexually violent predator/sexually dangerous person (SVP/SDP) population is reviewed. A review of the literature on castrated sex offenders reveals a very low incidence of sexual recidivism. The low sexual recidivism rates reported are critiqued in light of the methodologic limitations of the studies. Better designed testicular/prostate cancer studies have demonstrated that, while sexual desire is reduced by orchiectomy, the capacity to develop an erection in response to sexually stimulating material is not eliminated. The relevance of this literature to SVP/SDP commitment decisions and ethics is discussed. Two vignettes of castrated, high-risk sex offenders illustrate how to address risk reduction. Two tables are presented: the first outlines individual case data from a difficult-to-obtain report, and the second summarizes the most frequently cited castration studies on sexual recidivism. Orchiectomy may have a role in risk assessments; however, other variables should be considered, particularly as the effects can be reversed by replacement testosterone.
    The journal of the American Academy of Psychiatry and the Law 02/2005; 33(1):16-36. · 0.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Megan's Law, an effort to enhance community safety by requiring sex offenders to register and to notify their communities, often for life, has been enacted in all jurisdictions of the United States. Although the ostensible intent of the law is nonpunitive, many registrants feel it infringes on their freedom. Nevertheless, the law has passed constitutional scrutiny. Megan's Law pertains principally to convicted sex offenders, including those adults and juveniles who have entered guilty pleas. This article reveals that many jurisdictions require individuals found not guilty by reason of insanity (NGRI) to register if the offense in question falls under Megan's Law. Thus, insanity acquittees run the risk of interminable supervision. We discuss a recent challenge to the Arkansas registration law and the decision's implications for planning forensic mental health testimony.
    The journal of the American Academy of Psychiatry and the Law 02/2008; 36(1):117-22. · 0.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment and management of paraphilia, with a focus on the treatment of adults males. Because such treatments are not delivered in isolation, the role of specific psychosocial and psychotherapeutic interventions was also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients with paraphilia. The aim of these guidelines is to improve the quality of care and to aid physicians in clinical decisions. The aim of these guidelines was to bring together different views on the appropriate treatment of paraphilias from experts representing different continents. To achieve this aim, an extensive literature search was conducted using the English language literature indexed on MEDLINE/PubMed (1990-2009 for SSRIs) (1969-2009 for antiandrogen treatments), supplemented by other sources, including published reviews. Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for its efficacy, safety, tolerability and feasibility. An algorithm was proposed with six levels of treatment for different categories of paraphilias.
    The World Journal of Biological Psychiatry 06/2010; 11(4):604-55. DOI:10.3109/15622971003671628 · 4.23 Impact Factor

Preview

Download
0 Downloads
Available from