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

ABSTRACT 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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Article: Psychopathy, treatment change, and recidivism in high-risk, high-need sexual offenders

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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.
    04/2013; in press(2). DOI:10.1080/14999013.2013.787559
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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. DOI:10.1016/j.ijlp.2013.01.007 · 1.19 Impact Factor
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    • "From the limited treatment outcome literature, we have learned that inappropriate interventions may be associated with increased recidivism among psychopathic offenders (Rice, Harris, & Cormier, 1992), that they are less likely to benefit from and more likely to drop out of certain types of treatment programs such as therapeutic communities (Ogloff, Wong, & Greenwood, 1990), and that the interpersonal and emotional features of psychopathy may be associated with poor treatment response (Olver & Wong, 2011). More recent studies, however, have reported reductions in sexual or violent recidivism among psychopathic offenders who displayed positive treatment behavior (Langton, Barbaree, Seto, & Peacock, 2006), who were assessed as having lowered their risk in treatment (Looman, Serin, Abracen, & Marquis, 2005), or evaluated as having made risk-related treatment gains (Olver & Wong, 2009). Lower rates of violence were also reported in a sample of psychopathic civil psychiatric patients who received larger doses of outpatient mental health services (Skeem, Monahan, & Mulvey, 2002). "
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    ABSTRACT: The relationships of psychopathy, therapeutic change, and violent recidivism were examined in a sample of 152 high-risk violent offenders treated in a high-intensity violence reduction program at the Regional Psychiatric Centre (RPC) in Saskatoon, SK. The Violence Risk Scale (VRS; Wong & Gordon, 1999-2003) and Psychopathy Checklist-Revised (PCL-R; Hare, 1991, 2003) were rated on the sample. As an extension on a prior psychometric study of the VRS (Lewis, Olver, & Wong, 2012), the associations of therapeutic change scores, obtained from pre- and posttreatment ratings of VRS dynamic items, and violent recidivism were examined among high-risk psychopathic offenders (mean PCL-R >25) over approximately 5 years' follow-up. Positive therapeutic change correlated negatively with the PCL-R, particularly Factor 1 and the Affective facet, and was significantly associated with reductions in violent recidivism after controlling for psychopathy. The association of change to violent outcome decreased, however, when controlling for the Affective facet. Taken together, the present results suggest that risk-related treatment changes demonstrated by high-risk psychopathic offenders can be predictive of reductions in violent recidivism, and that reliable measurements of therapeutic change may be informative about treatment outcome in a high-risk violent offender group. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
    Personality Disorders: Theory, Research, and Treatment 10/2012; 4(2). DOI:10.1037/a0029769 · 3.54 Impact Factor
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