Psychopathy, Treatment Change, and Recidivism in High-Risk, High-Need Sexual Offenders

Correctional Service of Canada.
Journal of Interpersonal Violence (Impact Factor: 1.64). 06/2005; 20(5):549-68. DOI: 10.1177/0886260504271583
Source: PubMed


The present study investigated 154 consecutive admissions to the Regional Treatment Center (Ontario) Sex Offender Treatment Program with reference to psychopathy and outcome. Ratings of treatment behavior, as well as clinical judgments as to whether risk was reduced, were coded based on treatment reports. With reference to Psychopathy Checklist-revised (PCL-R) scores, survival analyses indicated that high scorers recidivated at significantly higher rates than low scorers. However, offenders who received high PCL-R scores and lower scores on measures of treatment behavior recidivated at the same rate as low scorers on the PCL-R. Furthermore, among high PCL-R offenders, those rated as lower risk at post treatment in fact reoffended at a lower rate than those whose risk was rated as unchanged, although this difference failed to reach significance. Findings are discussed in light of the clinical and research literature.

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    • "In relation to sexual offenders, psychopathy has been shown to be particularly inimical to positive treatment outcomes. It has been shown to relate to higher rates of treatment dropout and faster sexual and violent recidivism (Barbaree, 2005; Gretton et al., 2001; Hildebrand et al., 2004; Langton et al., 2006; Looman et al., 2005; Olver & Wong, 2006, 2009). Most worryingly, those psychopathic individuals who appeared to be doing better in treatment were in one study found to be more likely to recidivate than those who were rated as having poorer treatment behaviour (Seto & Barbaree, 1999). "
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    ABSTRACT: Psychopathy is a disorder that is partly defined by with maladaptive interpersonal behaviour and has significant effects on treatment outcomes. A previous study (Draycott et al., ) found that higher levels of psychopathy led to a specific interpersonal 'trajectory' amongst patients in a secure psychiatric treatment programme during the first 9 months of their admission. In that programme, more psychopathic patients became increasingly dominant over time, and less psychopathic patients became increasingly hostile. This study is a longer-term follow-up and extension of that study, extending the window of observation to 33 months of treatment. It was found that the more psychopathic patients' increased dominance returned to baseline levels by 33 months, as did the less psychopathic patients' increased hostility. This suggests that treatment for this group is not idiopathic but leaves unanswered the question as to what these divergent trajectories represent. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    Personality and Mental Health 01/2015; 9(2). DOI:10.1002/pmh.1292 · 1.10 Impact Factor
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    • "For example, adults with psychopathic traits, which include CU traits, often are able to manipulate and exploit others and this may act as a barrier to treatment success (Salekin, Worley, & Grimes, 2010). Further, in some adult offender samples, more positive engagement in treatment has been associated with increases in recidivism after release for those high on psychopathic traits (Looman et al., 2005; Seto & Barbaree, 1999). As a result, it is possible that youth with CU traits, like adults with psychopathy, are able to form therapeutic alliances but they may be superficial and unrelated to positive treatment outcome. "
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    ABSTRACT: The current study tested factors that could influence both youth and therapist-reported therapeutic alliance in 58 male adolescents ranging in age from 15 to 18 years old (M = 16.81, SD = 1.02) who were adjudicated for a delinquent offense and identified as needing mental health treatment. Therapeutic alliance was assessed through self-report by both the adolescent and therapist. Callous-unemotional (CU) traits and antisocial history were assessed through self-report and official record review respectively. Results indicated that the number of previous offenses was negatively associated with adolescent-reported therapeutic alliance but this was qualified by an interaction between antisocial history and CU traits. In those low on CU traits, there was a negative but non-significant association between number of previous offenses and the quality of the therapeutic alliance, whereas the association was significant and positive for those high on CU traits. In addition, CU traits were associated with violent institutional infractions during treatment. Thus, the combination of high CU traits and a high number of previous offenses seemed to reflect a group of adolescents who reported more positive therapeutic alliances but still had violent institutional infractions. These results provide support for tailored interventions for youth high on CU traits which consider the quality of the therapeutic relationship.
    International Journal of Forensic Mental Health 04/2013; in press(2). DOI:10.1080/14999013.2013.787559 · 1.05 Impact Factor
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    • "These researchers found that in comparison to EF child molesters, IF child molesters had more age-appropriate sexual attractions which made them more prone to having non-deviant, age-appropriate sexual fantasies . Phallometric studies have revealed that rapists may not have a preference for depictions of aggressive sex over consensual sexual intercourse (Looman & Marshall, 2005) which suggests that some rapists may entertain non-deviant sexual interests and fantasies. Finally, Looman (2001) found that high-risk rapists readily admitted their deviant sexual fantasies to a greater extent than lower-risk rapists and child molesters suggesting that reports of sexual fantasy may differ not only between different types of offenders but also by levels of risk. "
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    ABSTRACT: High-risk sexual offenders are a complex and heterogeneous group of offenders about whom researchers, clinicians, and law enforcement agencies still know relatively little. In response to the paucity of information that is specifically applicable to high-risk offenders, the present study investigated the potential influence of sexual fantasy, sexual paraphilia, and psychopathy on the offending behaviour of 139 of the highest risk sexual offenders in one province of Canada. The sample included 41 child molesters, 42 rapists, 18 rapist/molesters, 30 mixed offenders, and 6 "other" sexual offenders. Two offenders could not be categorized by type due to insufficient file information. Data analyses revealed significant differences between offender types for a number of criminal history variables including past sexual and nonsexual convictions, number of victims, weapon use, and age of offending onset. Further, there were significant differences between offender types for sexual fantasy themes, paraphilia diagnoses, and levels of psychopathy. For example, results revealed that offenders' sexual fantasies were significantly more likely to correspond with the specific type of index sexual offence that they had committed. Further, offenders scoring high in psychopathy were significantly more likely to have a sadistic paraphilia than offenders with either low or moderate psychopathy scores. Results from the current study provide a refined and informed understanding of sexual offending behaviour with important implications for future research, assessment, and treatment, as well as law enforcement practices when working with high-risk sexual offenders.
    International Journal of Law and Psychiatry 02/2013; 36(2). DOI:10.1016/j.ijlp.2013.01.007 · 1.19 Impact Factor
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