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The Characteristics of Persistent Sexual Offenders: A Meta-Analysis of
R. Karl Hanson and Kelly E. Morton-Bourgon
Public Safety and Emergency Preparedness Canada
A meta-analysis of 82 recidivism studies (1,620 findings from 29,450 sexual offenders) identified deviant
sexual preferences and antisocial orientation as the major predictors of sexual recidivism for both adult
and adolescent sexual offenders. Antisocial orientation was the major predictor of violent recidivism and
general (any) recidivism. The review also identified some dynamic risk factors that have the potential of
being useful treatment targets (e.g., sexual preoccupations, general self-regulation problems). Many of
the variables commonly addressed in sex offender treatment programs (e.g., psychological distress,
denial of sex crime, victim empathy, stated motivation for treatment) had little or no relationship with
sexual or violent recidivism.
Keywords: sexual offenders, recidivism, forensic, meta-analysis
Sexual offenses are among the crimes that invoke the most
public concern. Community surveys have found that 5% to 20% of
men admit to at least one instance of sexual aggression (Grotpellier
& Elliott, 2002; Koss, 1987; Lisak & Miller, 2002), and official
records indicate that 1% to 2% of the adult male population will
eventually be convicted of a sexual crime (California Office of the
Attorney General, 2004; P. Marshall, 1997). The observed sexual
recidivism rate is typically 10% to 15% after 5 years (Hanson &
Bussie`re, 1998), but for some offenders, the rate is much higher
(Harris et al., 2003). Identifying the characteristics of persistent
sexual offenders is important for understanding this highly trou-
bling behavioral disorder, as well as for the practical task of
administrating policies directed toward high risk sexual offenders
(e.g., treatment, civil commitment, community notification).
There is now a general consensus that sexual recidivism is
associated with at least two broad factors: (a) deviant sexual
interests and (b) antisocial orientation/lifestyle instability (Hanson
& Bussie`re, 1998; Quinsey, Lalumie`re, Rice, & Harris, 1995;
Roberts, Doren, & Thornton, 2002). Deviant sexual interests refer
to enduring attractions to sexual acts that are illegal (e.g., sex with
children, rape) or highly unusual (e.g., fetishism, autoerotic as-
phyxia). Although all sexual offending is socially deviant, men
who commit such acts do not necessarily have enduring prefer-
ences for such behavior (Hudson & Ward, 1997; W. L. Marshall,
Antisocial orientation refers to antisocial personality, antisocial
traits (such as impulsivity, substance abuse, unemployment), and a
history of rule violation. There is a strong association between rule
violation and impulsive, reckless behavior, such as excessive
drinking, frequent moves, fights, and unsafe work practices (Caspi
et al., 1994; Gottfredson & Hirschi, 1990). Antisocial orientation
facilitates sexual offending because individuals will not commit
sexual crimes unless they are (a) willing to hurt others, (b) can
convince themselves that they are not harming their victims, or (c)
feel unable to stop themselves. Rapists are more likely than child
molesters to have an antisocial orientation (Firestone, Bradford,
Greenberg, & Serran, 2000; see review by West, 1983), but indi-
cators of hostility and lifestyle instability are associated with
sexual recidivism in both groups (Prentky, Knight, Lee, & Cerce,
1995; Rice, Quinsey, & Harris, 1991).
Contemporary theories posit that a variety of factors are asso-
ciated with the development of sexual offending (Knight & Sims-
Knight, 2003; Malamuth, 2003; Ward & Siegert, 2002). These
models suggest that adverse family environments provide the
breeding grounds for sexual offending. Lacking nurturance and
guidance, the potential sexual offender develops problems in social
functioning (e.g., mistrust, hostility, and insecure attachment) that,
in turn, are associated with social rejection, loneliness, negative
peer associations and delinquent behavior. The form of sexuality
that develops in the context of pervasive intimacy deficits is likely
to be impersonal and selfish and may even be adversarial. Further
contributing to the risk of sexual offending are beliefs that permit
nonconsenting sex. Attitudes allowing nonconsenting sex can de-
velop through the individuals’ trying to understand their own
R. Karl Hanson and Kelly Morton-Bourgon, Public Safety and Emer-
gency Preparedness Canada.
Kelly Morton-Bourgon is now with the Department of Justice, Canada,
The views expressed are those of the authors and are not necessarily
those of Public Safety and Emergency Preparedness Canada. We thank the
following researchers who provided raw data or findings not included in
other reports: S. Brown, H. Gretton, G. Harris, N. Långstro¨m, C. Langton,
R. Lieb, J. Marques, M. Miner, L. Motiuk, T. Nicholaichuk, J. Proulx, J.
Reddon, M. Rice, G. Schiller, L. Studer, L. Song, and D. Thornton. We
greatly appreciate the help of R. Broadhurst, R. Dempster, R. Kropp, L.
Hartwell, A. Hills, N. Morvan and L. Rasmussen in locating unpublished
documents. We also thank Dale Arnold, Jim Bonta, Guy Bourgon, Don
Grubin, Amy Phenix, Vern Quinsey, Marnie Rice and David Thornton,
who provided comments on an earlier version of this study.
Correspondence concerning this article should be addressed to R. Karl
Hanson, Corrections Research, Public Safety and Emergency Preparedness
Canada, 340 Laurier Avenue West, Ottawa, Ontario K1A 0P8, Canada.
Journal of Consulting and Clinical Psychology Copyright 2005 Public Safety and Emergency Preparedness Canada
2005, Vol. 73, No. 6, 1154 –1163 DOI: 10.1037/0022-006X.73.6.1154
experiences and adopting the attitudes of their significant others
(friends, family, abusers).
Such a model suggests that, apart from sexual deviancy and
lifestyle instability, there may be three additional characteristics of
persistent sexual offenders: (a) negative family background, (b)
problems forming affectionate bonds with friends and lovers, and
(c) attitudes tolerant of sexual assault. Examination of the most
commonly used rating scales for sexual offenders indicate that
these factors have considerable credibility among those conducting
sexual offender evaluations (Beech, Fisher, & Thornton, 2003).
The research evidence addressing some of these factors is sur-
prisingly weak. Hanson and Bussie`re’s (1998) meta-analytic re-
view found that the average correlation between sexual recidivism
and sexual abuse as a child was r ⫽⫺.01 (based on 5 studies), and
the correlation between recividism and deviant sexual attitudes
was r ⫽ .09 (4 studies). The relationship between sexual recidi-
vism and intimacy deficits (apart from marital status) has not been
the target of a systemic review.
Recidivism studies are important because sexual offenders are
likely to have many problems, not all of which are related to sexual
offending. For example, sexual offenders are at increased risk for
anxiety and depression (Raymond, Coleman, Ohlerking, Chris-
tensen, & Miner, 1999), but such problems have not been associ-
ated with sexual recidivism (Hanson & Bussie`re, 1998). Similarly,
Hanson and Bussie`re’s quantitative review found that sexual re-
cidivism was unrelated to the seriousness of the index offense
(e.g., victim injury, intercourse) and clinical presentation variables
(e.g., denial, victim empathy, motivation for treatment).
Hanson and Bussie`re’s (1998) meta-analysis made an important
contribution by summarizing the available evidence concerning
recidivism risk factors for sexual offenders. Most of their findings,
however, concerned static, historical factors. Static factors are
useful for long-term recidivism prediction, but those interested in
understanding (and changing) recidivism risk are interested in
dynamic (changeable) risk factors, also called “criminogenic
needs” (Andrews & Bonta, 2003), “stable dynamic risk factors”
(Hanson & Harris, 2000b) or “causal psychological risk factors”
(Beech & Ward, 2004).
The purpose of the present study was to update Hanson and
Bussie`re’s (1998) meta-analysis in light of the ongoing research on
sexual-offender risk assessment. Rather than repeat all the vari-
ables from Hanson and Bussie`re, in the present study, we consid-
ered only findings that (a) were considered important to the un-
derstanding and management of sexual offenders and (b) were
weak or controversial in the earlier review (e.g., denial, victim
damage). The review focused on sexual recidivism but also con-
sidered nonsexual violent and general (any) recidivism. Sexual
offenders are more likely to reoffend with a nonsexual offense than
with a sexual offense (Hanson & Bussie`re), and an important
question is whether the predictors of sexual recidivism are sub-
stantially different from the predictors of nonsexual recidivism.
Computer searches of PsycLIT, the National Criminal Justice Reference
Service of the United States, and the library of Public Safety and Emer-
gency Preparedness Canada were conducted by using the following key
terms: child molester, exhibitionism, exhibitionist, failure, frotteur, incest,
indecent exposure, paraphilias(c), pedophile, pedophilia, predict(ion),
rape, rapist, recidivate, recidivism, recidivist, relapse, reoffend, reoffense,
sex(ual) offender, sexual assault, sexual deviant. Additional sources in-
cluded the reference lists of empirical studies and previous reviews, recent
issues of relevant journals (e.g., Criminal Justice and Behavior, Sexual
Abuse: A Journal of Research and Treatment), and letters sent to 34
established researchers in the field of sexual offender recidivism.
Included were studies that examined offenders who were released after
an index sexual offense and for whom the recidivism rate (sexual, violent,
or any) was reported after a follow-up period. Researchers assessing
offender characteristics were blind to recidivism status. Studies needed to
include sufficient statistical information, and at least 5 subjects for all
marginal totals were required for dichotomous variables.
As of January, 2003, our search yielded 115 usable documents (e.g.,
published articles, books, government reports, conference presentations).
In 15 cases, the analyses were based on raw data or analyses provided by
the original researchers. When the same data set was reported in several
articles, all the results from these articles were considered to come from the
same study. Consequently, the 115 documents represented 82 different
studies (country of origin: 35 United States; 26 Canada; 12 United King-
dom; 2 Austria; 2 Sweden; 2 Australia; and 1 each from France, the
Netherlands, and Denmark). Of these studies, 41 (50%) were unpublished.
The studies were produced between 1943 and 2003 (median ⫽ 1996); the
average sample size was 359 (median ⫽ 174, range ⫽ 12–1,407). Thirty-
five studies were the same as those included in Hanson and Bussie`re’s
(1998) review, 10 studies contained updated information (e.g., longer
follow-up periods, new analyses), and 37 studies were new.
Most of the studies examined mixed groups of adult sexual offenders (72
mixed-offense types, 7 child molesters, 2 rapists, 1 exhibitionist; 67 pre-
dominantly adults, 15 adolescents; all male). All the offenders had com-
mitted offenses that meet contemporary definitions of sexual crimes (i.e.,
old studies containing homosexuals were excluded). Most of the offenders
were released from institutions (41 institution only, 17 community only, 22
institution and community, and 2 unknown). The offenders in 31 studies
came from treatment programs. When demographic information was pre-
sented, the offenders were predominantly Caucasian (in 40 of 43 studies).
Effect sizes were recorded for four outcome criteria: (a) any sexual
recidivism (vs. no recidivism or only nonsexual recidivism— 605 effect
sizes); (b) violent nonsexual recidivism (vs. no recidivism, sexual recidi-
vism, or nonviolent recidivism—248 effect sizes); (c) any violent recidi-
vism—sexual or nonsexual—(vs. no recidivism or only nonviolent recid-
ivism—339 effect sizes); and (d) any recidivism (vs. no recidivism— 428
The most common sources of recidivism information were national
criminal justice records (48), provincial or state records (32), records from
treatment programs (18) and self-reports (13). Other sources (e.g., child-
protection records, parole files) were used in 20 studies. In 34 studies,
multiple sources were used. The source of the recidivism information for
10 studies was unknown. The recidivism criterion was arrest in 25 studies,
reconviction in 24 studies, and reincarceration in 3 studies. Twenty-six
studies used multiple criteria (e.g., arrest, parole violations, noncriminal
justice-system reports). Recidivism was assessed solely from self-reports in
2 studies, and, in 2 studies, the recidivism criterion was unknown. The
follow-up period ranged from 12 months to 330 months, with a mean of
76.0 months (SD ⫽ 56.8).
Each study was coded separately by the two authors, who used a
standard list of variables and explicit coding rules (available on request).
Variables were first coded into specific individual variables (e.g., sexual
interest in boys), which were then subsumed into general categories (e.g.,
sexual deviancy). The general categories were as follows:
CHARACTERISTICS OF PERSISTENT SEXUAL OFFENDERS
1. Sexual deviancy: deviant sexual interests, such as children, rape,
and other paraphilias, as well as sexual preoccupations and
2. Antisocial orientation: antisocial personality (e.g., antisocial per-
sonality disorder, psychopathy, Minnesota Multiphasic Person-
ality Inventory Scale 4), antisocial traits (e.g., lifestyle instabil-
ity, substance abuse, hostility), and a history of rule violation
(e.g., childhood criminality, history of nonsexual crime, violation
of conditional release);
3. Sexual attitudes: tolerance of sexual crime, support for adult–
child sex, and low sex knowledge;
4. Intimacy deficits: poor social skills, negative social influences,
conflicts in intimate relationships, emotional identification with
children, and loneliness;
5. Adverse childhood environment: conflicts with and separation
from parents, neglect, and physical and sexual abuse;
6. General psychological problems: internalization of psychologi-
cal problems (e.g., anxiety and low self-esteem, as well as major
mental illness); and
7. Clinical presentation: denial, minimization, lack of victim em-
pathy, low motivation for treatment, and poor progress.
Only one finding per individual variable was coded per sample on the
basis of (a) sample size and (b) completeness of information. If the sample
sizes and descriptive detail were equivalent, the median value was used.
Because many of the variables were intended to be dynamic (changeable),
posttreatment findings were privileged over pretreatment findings except
when the posttreatment finding was based on an insufficient number of
Interrater reliability was calculated for approximately 10% of the sample
(n ⫽ 10), by using kappa for dichotomous and categorical variables and
two-way random effects model intraclass correlation coefficients, or ICC
(type absolute agreement) for ordinal and interval variables (Design 2 in
Orwin, 1994). The agreement for the sample characteristics (e.g., adults or
adolescents, treated or not) was perfect for 14 variables, excellent (
ICC ⬎ .85) for 6 variables, and fair (
⬎ .50) for 3 variables: Did the
recidivism criteria include parole violations, arrests, or nonjustice system
reports? Kappa was low (–.11) for 1 variable (did the recidivism criteria
include reconvictions?); for 8 of the 10 studies, the raters agreed that the
researchers counted convictions, but each rater identified a different study
where he or she thought conviction records had not been consulted.
The interrater reliability of the effect sizes was .83 for a single rater and
.90 for the average of two raters. In the 10 reliability studies, Rater 1
identified 134 findings, and Rater 2 identified 131 findings, with agreement
on 245 of the 265 findings (92.5%). The actual agreement would be greater
because judges conferred on their final rating. Most differences involved
simple omissions or clerical errors.
Index of Predictive Accuracy
The effect size indicator was the standardized mean difference, d,
defined as follows: d ⫽ (M
, where M
is the mean of the deviant
is the mean of the nondeviant group, and S
is the pooled-within
standard deviation (Hasselblad & Hedges, 1995). In other words, d mea-
sures the average difference between the recidivists and the nonrecidivists,
and compares this difference to how much recidivists differ from each
other, and how much nonrecidivists differ from each other. The formula for
calculating d can be found in Hanson and Morton-Bourgon (2004).
The d statistic was selected because it is less influenced by recidivism
base rates than correlation coefficients—the other statistic commonly used
in meta-analyses. According to Cohen (1988), d values of .20 are consid-
ered “small;” those of .50, “medium;” and .those of .80, “large.” The value
of d is approximately twice as large as the correlation coefficient calculated
from the same data. When the 95% confidence interval for d does not
contain zero, it can be considered statistically significant at p ⬍ .05. When
the confidence intervals for two predictors do not overlap, they can be
considered significantly different from each other ( p ⬍ .05).
Aggregation of Findings
Two methods were used to summarize the findings: median values
(Slavin, 1995) and weighted mean values (Hedges & Olkin, 1985). The
averaged d value, d., was calculated by weighing each d
by the inverse of
d. ⫽ 共
where k is the number of findings, w
, and v
is the variance of the
(fixed effect model). The variance of the weighted mean was
used to calculate 95% confidence intervals:
Var共d.兲 ⫽ 1/共
兲; 95% C.I. ⫽ d. ⫾ 共Var关d.兴兲
Weighting d values by the inverse of their variance means that findings
from small samples are given less weight than findings from large samples.
was calculated from 2 ⫻ 2 tables, the variance of d
estimated by using Formula 6 from Hasselblad and Hedges (1995):
a ⫹ .5
b ⫹ .5
c ⫹ .5
d ⫹ .5
was calculated from other statistics (t, ROC areas, means, etc.),
the variance of d
was estimated by using Formula 3 from Hasselblad and
To test the generalizability of effects across studies, Hedges and Olkin’s
(1985) Q statistic was used:
The Q statistic is distributed as a
with k – 1 degrees of freedom (k is the
number of studies). A significant Q statistic indicates that there is more
variability across studies than would be expected by chance. Outliers were
excluded from each category if the single extreme value accounted for
more than 50% of the total variance (Q).
On average, the observed sexual recidivism rate was 13.7%
(n ⫽ 19,267; 73 studies), the violent nonsexual recidivism rate was
14.3% (n ⫽ 6,928; 24 studies), the violent recidivism rate (includ-
ing sexual and nonsexual violence) was 14.3% (n ⫽ 11,361; 29
studies) and the general (any) recidivism rate was 36.2% (n ⫽
12,708; 56 studies). Studies that specified in advance the number
of recidivists and nonrecidivists were excluded from the rate
calculations (e.g., Dempster, 1998). The average follow-up time
HANSON AND MORTON-BOURGON
was 5– 6 years. These figures should be considered underestimates
because not all offenses are detected.
The 82 studies produced 1,620 effect sizes (total of 29,450
sexual offenders). The average effect size for the published studies
(M ⫽ .23, SD ⫽ .40, n ⫽ 555) was the same as in the unpublished
studies (M ⫽ .22, SD ⫽ .35, n ⫽ 1,065), t(1618) ⫽ .50, p ⫽ .62.
The correlation between sample size and effect size was positive
(r ⫽ .12, n ⫽ 1,620, p ⬍ .001). (A negative correlation is expected
when there is selective reporting of significant findings.) The
correlation remained significantly positive after removing 103 d
values estimated as zero because they were reported as
Effect sizes were not related to publication date (r ⫽ .001) or to
the thoroughness with which researchers tracked recidivism infor-
mation (r ⫽ .026). The thoroughness of the recidivism search was
rated on a 7-point scale (1 ⫽ self-report only,4⫽ one method
searches, and 7 ⫽ multiple sources including national criminal
records). The effect sizes were the same whether recidivism was
measured by arrests (M ⫽ .23, SD ⫽ .34, n ⫽ 1,001) or convic-
tions (M ⫽ .21, SD ⫽ .39, n ⫽ 542; t(1541) ⫽ 1.14, p ⫽ .25). The
effect sizes for adult offenders (M ⫽ .23, SD ⫽ .36, n ⫽ 1,319)
were similar to effect sizes for adolescents (M ⫽ .21, SD ⫽ .37,
n ⫽ 301; t(1618) ⫽ 1.11, p ⫽ .27). The coding did not permit
comparisons between rapists and child molesters.
Comparisons Across Categories of Risk Predictors
Table 1 presents the association with recidivism for the seven
broad categories of risk factors. These broad comparisons were
based on one individual finding per study (see coding manual and
Hanson and Morton-Bourgon (2004) for further information about
the individual predictors). The strongest predictors of sexual re-
cidivism were those related to sexual deviancy (d. ⫽ .30) and
antisocial orientation (d. ⫽ .23). The general category of sexual
attitudes was also significantly related to sexual recidivism, but the
effect was small (d. ⫽ .17, 95% confidence interval of .04 to .28)
and contained significant variability. The effects were not signif-
icant for child molester attitudes, low sex knowledge, or other
deviant sexual attitudes (e.g., prudish attitudes toward
The general category of intimacy deficits showed a small, sig-
nificant relationship to sexual recidivism (d. ⫽ .15), with substan-
tial variation among its subcomponents. Of the subcomponents of
intimacy deficits, relatively larger effects were found for conflicts
in intimate relationships (d. ⫽ .36, 4 studies) and emotional
identification with children (d. ⫽ .42, 3 studies) than for social
skills deficits (d. ⫽⫺.07, 6 studies) or loneliness (d. ⫽ .03, 6
studies). The general categories of adverse childhood environment
(d. ⫽ .09), general psychological problems (d. ⫽ .02), and clinical
presentation (d. ⫽⫺.02) had little or no relationship with sexual
Antisocial orientation (antisocial personality, antisocial traits,
history of rule violation) was the major predictor of violent non-
sexual recidivism (d. ⫽ .51), violent (including sexual) recidivism
(d. ⫽ .54) and any recidivism (d. ⫽ .52). Almost all of the
individual indicators of antisocial orientation were significantly
related to nonsexual violent, violent, and general recidivism; most
of the relationships were moderate to large. Among the strongest
individual predictors of any recidivism were general problems
with self-regulation (d. ⫽ .75, 6 studies, which included measures
of impulsivity, lifestyle instability, and Factor 2 of the Psychopa-
thy Checklist Revised, or PCL-R (Hare et al., 1990), a history of
nonviolent crime (d. ⫽ .68, 9 studies), psychopathy (PCL-R total
scores; d. ⫽ .67, 9 studies), and a history of nonsexual crime (d. ⫽
.63, 8 studies).
Few variables other than antisocial orientation were predictive
of nonsexual violent or general (any) recidivism. Sexual attitudes
showed a small relationship with general recidivism (d. ⫽ .24).
Sexual deviancy was unrelated to violent nonsexual recidivism (d.
⫽⫺.05) and general (any) recidivism (d. ⫽ .04).
The same major predictors were found for adolescent sex of-
fenders as for adult sexual offenders. For adolescent sex offenders,
sexual recidivism was predicted by sexual deviance (d. ⫽ .36 ⫾
.24, 95% confidence interval of .12 to .60, 7 studies; n ⫽ 734) and
antisocial orientation (d. ⫽ .19 ⫾ .17, 14 studies; n ⫽ 1,958).
Antisocial orientation also predicted violent nonsexual recidivism
(d. ⫽ .33 ⫾ .19, 5 studies; n ⫽ 825), any violent recidivism (d. ⫽
.46 ⫾ .26, 3 studies; n ⫽ 559), and any recidivism (d. ⫽ .41 ⫾ .13,
10 studies; n ⫽ 1,400) among adolescent sex offenders.
Possible Dynamic Risk Factors for Sexual Recidivism
Table 2 presents some of the most promising targets for inter-
vention. All of these findings were based on at least 5 studies with
a combined sample of at least 1,000, with no significant variability
between studies. The most confidence can be placed in those
findings with narrow confidence intervals (large sample size).
Readers should be cautioned, however, that the findings based on
Factors Associated With Recidivism Among Sexual Offenders
Type of recidivism
Sexual Violent nonsexual Violent Any
Sexual deviancy .30 ⫾ .08 (5,053; 32) ⫺.05 ⫾ .17 (1,385; 10) .19 ⫾ .08 (3,155; 17) .04 ⫾ .08 (6,555; 19)
Antisocial orientation .23 ⫾ .04 (23,012; 65) .51 ⫾ .07 (8,283; 24) .54 ⫾ .05 (13,065; 28) .52 ⫾ .04 (15,988; 43)
Sexual attitudes .16 ⫾ .12 (2,370; 14) .17 ⫾ .22 (732; 6) .14 ⫾ .11 (1,598; 9) .24 ⫾ .10 (1,053; 9)
Intimacy deficits .15 ⫾ .11 (2,852; 22) .12 ⫾ .21 (822; 6) .12 ⫾ .12 (1,197; 8) .10 ⫾ .10 (1,715; 15)
Adverse childhood environment .09 ⫾ .08 (7,259; 27) ⫺.02 ⫾ .17 (2,256; 7) .14 ⫾ .08 (5,041; 14) .11 ⫾ .07 (5,044; 15)
General psychological problems .02 ⫾ .10 (3,208; 19) .21 ⫾ .14 (2,089; 8) .00 ⫾ .10 (1,974; 10) ⫺.04 ⫾ .11 (1,658; 11)
Clinical presentation ⫺.02 ⫾ .09 (5,094; 24) .16 ⫾ .20 (2,090; 5) .09 ⫾ .09 (3,849; 12) .12 ⫾ .08 (4,714; 18)
Note. Values are averaged d values, followed by their 95% confidence interval and (in parentheses) the total sample size and the number of studies (k).
CHARACTERISTICS OF PERSISTENT SEXUAL OFFENDERS
the minimum inclusion criteria (5 studies, 1,000 subjects) could
still be substantially changed by new, large studies with divergent
The promising dynamic risk factors included variables related to
sexual deviancy (any deviant sexual interest, sexual preoccupa-
tions), antisocial personality (antisocial personality disorder, psy-
chopathy as measured by PCL-R), and antisocial traits (general
self-regulation problems, employment instability, hostility). The
potentially misleading risk factors were negative family back-
ground, internalization of psychological problems, and poor clin-
ical presentation (e.g., denial, low motivation for treatment).
The different approaches used to assess deviant sexual interests
included self-report (d. ⫽ .38 ⫾ .18, 5 studies; n ⫽ 780), phallo-
metric assessments (d. ⫽ .24 ⫾ .12, 13 studies; n ⫽ 2,180),
offense history (d. ⫽ .15 ⫾ .18, 3 studies; n ⫽ 1,042), and
structured clinical ratings relying on multiple sources of informa-
tion (d. ⫽ .42 ⫾ .19, 8 studies; n ⫽ 947), such as the Sexual
Deviance item from Sexual Violence Risk–20 (Boer, Hart, Kropp,
& Webster, 1997). For the 6 studies that presented dichotomous
ratings of sexual deviancy, 65.5% of the sexual recidivists (n ⫽
261) were classified as sexual deviant compared with 42.3% of the
nonrecidivists (n ⫽ 749). Sexual preoccupations were assessed
through either self-report questionnaires (d. ⫽ .35 ⫾ .18, 3 studies;
n ⫽ 3,911) or structured clinical ratings (d. ⫽ .68 ⫾ .45, 3 studies;
n ⫽ 208). The structured clinical ratings showed greater predictive
accuracy than the other assessment approaches, but the confidence
intervals overlapped for all measures.
Most sexual offenders were not caught for another sexual of-
fense (13.7%); on average, they were more likely to recidivate
with a nonsexual offense than a sexual offense (overall recidivism
rate of 36.2%). The major predictors of general (any) and violent
recidivism were variables related to antisocial orientation, such as
antisocial personality, antisocial traits, and a history of rule viola-
tion. These are the same risk factors that predict general and
violent recidivism among mentally disordered offenders (Bonta,
Law, & Hanson, 1998) and unselected groups of offenders (Gen-
dreau, Little, & Goggin, 1996).
The variables that predicted sexual recidivism were similar, but
not identical, to the predictors of nonsexual recidivism. Sexual
deviancy and antisocial orientation were the major predictors of
sexual recidivism for both adult and adolescent sexual offenders.
Sexual deviancy was unrelated to nonsexual recidivism. For the
general categories of deviant sexual attitudes and intimacy deficits,
some of the individual variables were related to sexual recidivism
(e.g., emotional identification with children, conflicts in intimate
relationships) and some were not (e.g., loneliness). Such variabil-
ity suggests that further research is needed to uncover those
aspects of attitudes and social functioning most associated with
persistent sexual offending.
The present results also suggest that the factors that initiate
sexual offending may not be the same as the factors associated
with persistence. Negative family backgrounds and internalization
of psychological problems are common among sexual offenders
(Lee, Jackson, Pattison, & Ward, 2002; Raymond et al., 1999;
Smallbone & Dadds, 1998), but these factors were unrelated to
sexual recidivism. The prototypic sexual recidivist is not upset or
lonely; instead, he leads an unstable, antisocial lifestyle and rumi-
nates on sexually deviant themes. There is some evidence, how-
ever, that sexual offenders are more likely than other groups to
respond to stress through sexual acts and fantasies (deviant or
otherwise; Cortoni & Marshall, 2001; McKibben, Proulx, & Lusig-
nan, 1994) thereby creating discrete time periods where they are at
increased risk of sexual recidivism (Hanson & Harris, 2000b).
The distinction between sexual recidivists and nonrecidivists
invites comparisons with Moffitt’s (1993) distinction between
adolescence-limited and life-course persistent delinquents. In Mof-
fitt’s typology, the life-course persistent offenders have behavior
problems in childhood, engage in interpersonal violence, and have
Selected Predictors of Sexual Recidivism
Variable Mean d Median dQ Total (k)
Possible dynamic risk factors
Any deviant sexual interest .31 ⫾ .10 .36 21.91 2,769 (16)
Sexual preoccupations .39 ⫾ .16 .51 8.31 1,119 (6)
Antisocial personality disorder .21 ⫾ .10 .29 13.01 3,267 (12)
Psychopathy Checklist—Revised .29 ⫾ .09 .25 14.36 2,783 (13)
General self-regulation problems .37 ⫾ .11 .34 22.85 2,411 (15)
Employment instability .22 ⫾ .09 .15 20.88 5,357 (15)
Hostility .17 ⫾ .13 .16 12.69 1,960 (9)
Potentially misleading risk factors
Force/violence in sex offending .09 ⫾ .07 .00 29.28 7,221 (25)
Neglect or abuse during childhood .10 ⫾ .09 .00 27.43 5,490 (18)
Sexual abuse during childhood .09 ⫾ .10 .02 24.44 5,711 (17)
Loneliness .03 ⫾ .13 .02 5.79 1,810 (6)
Low self-esteem .04 ⫾ .16 .03 10.12 1,424 (10)
Lack of victim empathy ⫺.08 ⫾ .13 ⫺.01 0.92 1,745 (5)
Denial of sexual crime .02 ⫾ .17 ⫺.02 11.72 1,780 (9)
Low motivation for treatment at intake ⫺.08 ⫾ .13 ⫺.04 13.83 1,786 (12)
Poor progress in treatment (post) .14 ⫾ .17 .11 9.35 1,118 (7)
Note. Each mean is followed by its 95% confidence interval. Total is number of subjects; k is the number of
studies. All Q values were not significant, p ⬎ .05.
HANSON AND MORTON-BOURGON
many sexual partners (Sluyter et al., 2003)—all characteristics that
predicted sexual and nonsexual recidivism in the present study.
These characteristics can be considered common manifestations of
low self-control (e.g., Gottfredson & Hirschi, 1990), but they have
also been considered as an evolutionary adaptation to stressful
childhood environments (Belsky, Steinberg, & Draper, 1991; Mof-
fit, Caspi, Belsky, & Silva, 1992). The substantial overlap in the
characteristics of persistent sexual and persistent nonsexual of-
fenders suggests that those concerned with the assessment and
management of sexual offenders could profit from the substantial
literature on the assessment and treatment of general criminal
offenders (e.g., Andrews & Bonta, 2003; Gendreau, French, &
For those involved in applied risk assessments with sexual
offenders, the review confirms sexual deviancy and antisocial
orientation as major predictors of sexual recidivism and extends
the range of relevant variables to include some potentially change-
able characteristics: sexual preoccupations, lifestyle instability/
impulsivity, pro-offending attitudes, and intimacy deficits. Read-
ers will notice, however, that the predictive accuracy of most of the
characteristics was small. Consequently, prudent evaluators need
to consider a range of potential risk factors in an overall evalua-
tion. The best methods for combining risk factors into an overall
evaluation remain an active topic of scientific debate (Berlin,
Galbreath, Geary, & McGlone, 2003; Hanson, Morton, & Harris,
Another outstanding research question is whether changes on
the potentially dynamic factors are actually associated with reduc-
tions in recidivism risk. In general, evaluations of treatment
progress showed little relationship to recidivism, with an average
d. of .14. Nevertheless, there were some recent examples in which
ratings of progress in treatment were significantly related to recid-
ivism (Beech, Erikson, Friendship, & Ditchfield, 2001, d ⫽ .50;
Marques, Day, Wiederanders, & Nelson, 2002, d ⫽ .55). Both of
these studies used highly structured approaches to evaluating treat-
ment gains and were informed by recent empirical research.
Evaluators may also note that many of the variables used in
clinical assessments had little or no relationship with recidivism
(e.g., denial, low victim empathy, low motivation for treatment).
The lack of relationship may be linked to the difficulty of assessing
sincere remorse in criminal justice settings. It is also possible that
evaluators looking for risk factors have little to gain from listening
to offenders’ attempts to justify their transgressions. Psychother-
apists often consider full disclosure desirable, and courts are le-
nient toward those who show remorse; few people, however, are
inclined to completely reveal their faults and transgressions. Re-
search has even suggested that full disclosure of negative personal
characteristics is associated with negative social outcomes, includ-
ing poor progress in psychotherapy (Kelly, 2000). Consequently,
resistance to being labeled a sexual offender may not be associated
with increased recidivism risk, even though it does create barriers
to engagement in treatment. Offenders who minimize their crimes
are at least indicating that sexual offending is wrong.
The present findings may also be useful to those wishing to
improve treatment programs for sexual offenders. On average,
sexual offenders who attend treatment are less likely to recidivate
than are comparison groups (Hall, 1995; Hanson et al., 2002), but
it is easy to locate well-controlled studies that find no effect for
sexual offender treatment (e.g., Marques, Wiederanders, Day, Nel-
son, & van Ommeren, 2005). For general offenders, treatment is
effective only when it targets criminogenic needs (i.e., character-
istics associated with offending; Dowden & Andrews, 2000). A
review of the core treatment targets of sexual offender treatment
programs (McGrath, Cumming, & Burchard, 2003, Table 9.1)
suggests that most programs direct considerable resources toward
characteristics that have little or no relationship with recidivism
(e.g., offense responsibility, victim awareness, and empathy). An
important question is whether programs that target the major
predictors of sexual offense recidivism (e.g., lifestyle instability,
deviant sexual interests, sexual preoccupations) are more effective
than programs that target other factors.
Meta-analyses provide broad overviews and can easily neglect
potentially important differences between studies. The definitions
of constructs varied across studies, as did the samples. The present
study focused on mixed groups of sexual offenders, and there was
no effort to identify distinct predictors for specific subgroups (e.g.,
rapists, exhibitionists). Nevertheless, the findings were remarkably
consistent. For 70% of the individual findings, the amount of
variability across studies was no more than would be expected by
chance ( p ⬍ .05). Furthermore, there was substantial consistency
within many of the categories of predictors, with almost all of the
variables being significant (e.g., sexual deviancy, history of rule
violation) or nonsignificant (e.g., general psychological problems,
clinical presentation; see Hanson & Morton-Bourgon, 2004).
There is still substantial variability across studies that remains to
be explained, but it appears that research is getting closer to
identifying the constructs that are, and are not, related to recidi-
vism among sexual offenders. Hopefully these research gains can
be used to promote effective interventions and just social policies
for sexual offenders.
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Received July 20, 2004
Revision received May 2, 2005
Accepted May 4, 2005 䡲
CHARACTERISTICS OF PERSISTENT SEXUAL OFFENDERS