Professional perspectives on sexual sadism.

Significant controversy surrounds the diagnosis of sexual sadism. Research suggests that many characteristics attributed to sexual sadists fail to differentiate sexual offenders with and without this diagnosis. Furthermore, when there are differences between sadists and nonsadists, "sadistic" features are frequently associated with nonsadists. Finally, diagnosticians appear to use idiosyncratic methods to diagnose sexual sadism. These findings raise concerns about the reliability and validity of a diagnosis of sexual sadism, particularly with respect to how professionals conceptualize this diagnosis. This study examines how professionals understand the relative importance of behaviors associated with sadistic versus nonsadistic sexual offending. Professionals rated behaviors according to their "essentialness" for this diagnosis. Results show that professionals rated behaviors associated with three out of four conceptualizations of sexual sadism as significantly more essential to making a diagnosis of sexual sadism, compared to behaviors associated with nonsadistic sexual offending. Results suggest that professionals reliably discriminate between sadistic and nonsadistic offense behaviors.

Forecasting recidivism in mentally ill offenders released from prison.

Little research has focused on assessing the risk of mentally ill offenders (MIOs) released from state prisons. Here we report findings for 333 mentally ill offenders released from Washington State prisons. Logistic regression identified sets of variables that forecasted felony and violent reconviction as accurately as state-of-the-art risk assessment instruments. Sums of simple recoded versions of these variables predicted reoffense as well as complex logistic regression equations. Five of these 9 variables were found to be relative protective factors. Findings are discussed in terms of the value of stock correctional variables in forecasting risk, the need to base actuarial risk assessments on local data, the importance of protective factors in assessing MIO risk, and the need for dynamic, situational, and clinical variables that can further sharpen predictive accuracy of emergent risk in the community.

Recidivism and use of services among persons with mental illness after release from prison.

OBJECTIVE: Despite large numbers of mentally ill offenders in prisons, few studies of mentally ill offenders released from prison have been conducted. This study describes such a population of mentally ill offenders, the postrelease services they received, new offenses they committed, and factors associated with recidivism. METHODS: The authors reviewed electronic files and archived medical charts from the state corrections department to identify mentally ill offenders who left Washington state prisons in 1996 and 1997. Data on the individuals identified were then provided by several public agencies. Summary statistics were computed on subjects' characteristics and postrelease outcomes, and logistic regression analysis was used to identify variables that predicted convictions of new felonies and new crimes against persons. RESULTS: A total of 337 mental ill offenders were identified. Men and women differed with regard to offenses, diagnoses, rates of drug abuse, and use of mental health resources. Although most subjects (73 percent) received postrelease social or mental health services, few received clinically meaningful levels of service during the first year after release. Charges for new crimes or supervision violations were common (70 percent of subjects), but only 10 percent committed new felonies against persons, and 2 percent committed very serious crimes. Youth, frequency of past felonies, and variables such as misbehavior in prison were associated with new offenses. CONCLUSIONS: Whether community mental health treatment affects recidivism cannot be assessed fairly in the absence of higher levels of service during the first months after release. This study also identifies actuarial risk factors that predict new offenses at a level comparable to that of published risk assessment instruments. Commission of less serious offenses that usually precede felonies may provide an early warning of risk for new felonies and an opportunity for strategic intervention. The low rate of serious violence in the community by mentally ill offenders released from prison suggests that the risk of violence may be a weak and potentially counterproductive rationale for community support and mental health treatment of mentally ill offenders.

Comparative effects of acupuncture in Japan and the United States on dental pain perception.

The effect of low frequency electrical acupunctural stimulation on the perception of induced dental pain were compared in two cultural settings. Twenty Japanese and 20 American subjects (consisting of 10 Caucasians and 10 second or third generation Japanese) were tested in two functionally identical laboratories, one at Tottori University in Yonago, Japan and the other at the University of Washington. Each subject underwent a control and an acupuncture session on separate days wtih subjects counterbalanced for carry-over order effects. Sensory decision theory (SDT) analysis demonstrated a significant reduction in perceptual capability and an increased bias against reporting stimuli as painful following the acupuncture as treatment which was performed bilaterally at traditional facial points. No significant differences between groups in alteration of perceptual capability, bias or pain threshold were demonstrated, indicating that the cultural and racial differences studied did not influence responses to acupuncture in a laboratory setting.