The imperfect fit: Fetal alcohol spectrum disorder as the basis to commit individuals involuntarily as sexually violent predators/persons.

Prenatal alcohol exposure produces a broad range of primary disabilities that lead to adverse life course outcomes in children raised in adverse environments. Inappropriate sexual behaviors are a commonly occurring secondary disability, with a large minority of individuals with fetal alcohol spectrum disorder (FASD) displaying sexual aggression. Adults with FASD who commit repeated criminal sexual acts may be subject to legal proceedings for indefinite involuntary civil confinement as sexually violent predators/persons (SVP) in certain jurisdictions in the United States. Studies about the diagnostic practices among psychologists and psychiatrists retained by states to evaluate individuals as SVP do not recognize FASD as a mental disorder, despite the likelihood that hundreds of individuals petitioned for involuntary commitment suffer from FASD. Establishing an FASD diagnosis may provide exculpatory evidence to refute a government petition that an individual suffers from a mental condition that affects emotional or volitional capacity by predisposing the person to committing criminal sexual behavior. This article provides a framework for identifying, assessing, and deciding whether individuals with the FASD diagnosis suffer from the legally defined mental disorder that is necessary to indefinitely confine individuals as SVP.

Illuminating the dark figure of sexual recidivism.

Detected or reported ("observed") rates of sexual reoffending have long been recognized as underestimating the occurrence of actual sexual recidivism. Past attempts to bridge the gap between the two rates have been unsuccessful. Scurich and John try to reverse this course by presenting a simulation model to estimate the predicted actual sexual recidivism rates among individuals convicted of sexual offenses based on three parameters; they also apply these data to calibrate the sexual recidivism rates from four sexual recidivism studies. The accuracy of the predicted actual sexual recidivism rates is wholly dependent upon the reliability of the inputs to the model. This analysis relies upon scientific studies and literature to delve into the precision of the parameters of Scurich and John in relation to the accuracy of their predicted actual sexual recidivism rates and the validity of the calibration process. The results reveal that some of the assumptions by Scurich and John about the parameters are supported empirically, while others are not. Overall, the simulation model parameters suffer from significant deficiencies that likely produce inaccurate predicted actual sexual recidivism rates. Moreover, the methodologies of the comparison studies used in the calibration process do not actually meet the requirements of the analytic strategy of Scurich and John, which effectively invalidates their findings. Until computational strategies are employed that account for linear and nonlinear effects of model parameters, closing the gap between observed and actual sexual recidivism rates will remain elusive.

Sexually violent predator risk assessments with the violence risk appraisal guide-revised: A shaky practice.

Twenty-two jurisdictions in the United States permit the involuntary civil confinement of sexual offenders upon expiration of their criminal sentence and, if committed, these individuals face possible lifetime commitment. One of the legal requirements that psychologists must address in sexually violent predator evaluations is the likelihood that an individual will engage in dangerous sexual behavior and consideration of the probabilities for sexual recidivism contained in actuarial experience tables best address this inquiry. Clinicians find it increasingly difficult to affirm the likelihood threshold in the face of decreasing base rates and score-wise probability estimates for sexual recidivism reported in contemporary actuarial experience tables. The Violence Risk Appraisal Guide-Revised (VRAG-R) has been promoted to assess sexually violent predators because it has been presented as a more accurate predictor of sexual recidivism and the results more likely satisfy the legal standard of sexual dangerousness. This article conducts an in-depth analysis of the predictive and psychometric properties of the VRAG-R that are most relevant to the fit of the VRAG-R when addressing the sexual dangerousness standard proscribed by SVP laws. Recommendations for future research are offered to improve the fit of the VRAG-R to the legal inquiry of sexual dangerousness and implications for using the current iteration of the VRAG-R in forensic practice are discussed.

Throwing the baby out with the bath water: is it time for clinical judgment to supplement actuarial risk assessment?

The assessment of the potential for sexual violence is one of three prongs that must be met to satisfy the requirements for civil confinement of dangerous sex offenders in the 21 U.S. jurisdictions that have these laws. In a recent issue of The Journal, Sreenivasan et al. argued that, because of a host of methodological problems, actuarial risk assessment methods in general and the Static-99 and its progeny in particular are insufficient for accurate assessment of risk for dangerous sex offenders. They propose using a combination of clinical judgment with actuarial science as a solution. This analysis and review of Sreenivasan et al. reveals and corrects flaws in the arguments they employed to support their position and shows how the combination of actuarial science with clinical judgment is more error prone than the actuarial approach only, and cannot be forensically defended in court. Recommendations on reporting Static-99R data in expert testimony are provided, taking into account the limitations of the instrument.