Longitudinal relations of prematurity and fetal growth restrictions with hyperactivity/inattention and aggression/delinquency.

BACKGROUND: It is the aim of this study to analyze the longitudinal relationship between premature birth and low birth weight and the reciprocal influence between hyperactive/inattentive behavior and aggressive/delinquent behavior problems in children from early to late childhood. METHODS: This study contains data from the German Erlangen-Nuremberg Development and Prevention Study. It applies prospective longitudinal path analyses on data obtained from postnatal pediatric assessments as well as later psychosocial behavior assessments by teachers and parents on N = 667 children, out of which n = 83 children (12.44%) were born preterm/small for gestational age. RESULTS: The results show direct effects of birth complications at the beginning of preschool on hyperactivity/inattentiveness (teacher rating: ß = 0.28; p = 0.017; parent rating: ß = 0.32; p = 0.005), but not on aggression/delinquency (teacher rating: ß = 0.002; p = 0.427; parent rating: ß = 0.12; p = 0.324). Reciprocal effects between aggression/delinquency and hyperactivity/inattentiveness were stable at the end of elementary school, but not at the end of preschool across informants. CONCLUSION: Our results support a differentiated view on the potential development of behavior problems after birth complications and the demand for early prevention measures. IMPACT STATEMENT: Our results extend to the existing body of research by providing insight into the longitudinal effects of prematurity and fetal growth restrictions on hyperactive and aggressive/delinquent behavioral problems throughout a rather long period of development in childhood. The results show direct effects of birth complications on the development of hyperactivity for boys, but not for girls across informants. No direct effects of birth complications on aggression/delinquency are found. Our findings speak against too simple views on behavioral consequences of birth complications and thus can relieve too anxious parents, however close monitoring of the behavioral development of respective children is indicated.

The mental health trajectories of male prisoners and their female (ex-)partners from pre- to post-release.

BACKGROUND: There are high rates of mental disorders among prisoners. Prisoners are also likely to have difficulties with intimate relationships, perhaps related to the imprisonment, but their mental health may be relevant. There is a dearth of research on intimate relationship qualities and mental health of offenders and their partners over time. AIMS: To explore mental health and relationship trajectories among men in prison, and their partners, before the men's release, through a time 6 months post-release, and then again 8 years later, and to test associations between relationship quality and mental health. METHOD: Data stem from the Economic and Social Research Council (ESRC)-funded longitudinal 'Families and Imprisonment Research' (FAIR) project on paternal imprisonment and family resilience. Inclusion criteria for the study were men serving a short- to medium-term prison sentence who were within 4 months of release; with a current or ex-partner with whom they have at least one child; and for whom there were data on mental health and relationship factors during imprisonment, and at 6 months and 8 years post-release. Similar data were also obtained for their (ex-)partners. RESULTS: The main sample comprised 39 men and 39 women who were in the same 'family set' for the first two waves, and after 8 years, 26 men and 30 women were retained. Just over 40% of the men and their (ex-)partners each disclosed that they had a mental health problem preceding his release. Proportions fluctuated slightly over time, with some dissonance between self-perceived disorder and self-ratings on a symptoms rating scale. Twenty-nine couples sustained their relationship during the transition between prison and release, but after 8 years, only four remained together. There was little evidence of association between measures of mental health and relationship quality among either the men or their partners. CONCLUSIONS: The findings challenge assumptions about the extent to which partners can play fully supportive roles in a former prisoner's transition from institutional life back into the community, as partners are also likely to be experiencing difficulties during this time. Thus, former prisoners and their families should be afforded equal access to support and assistance during offender rehabilitation.

When sexual offender treatment in prison-based social-therapeutic treatment is not completed: Relationship to risk factors and recidivism after release.

BACKGROUND: Various studies have demonstrated that people who do not complete sex offender treatment have higher recidivism rates than completers or untreated controls. The mechanism behind this association, however, remains unclear. One explanation is that responsivity issues are more prevalent in high-risk offenders, making treatment failure and recidivism more likely, especially if treatment intensity is insufficient to match criminal needs. In addition, dropout may have a negative effect on offenders by increasing feelings of frustration or self-doubt. AIMS: To retest for a link between treatment discontinuation and recidivism by sex offenders and analyse the mechanisms mediating the link between treatment discontinuation and their recidivism. We hypothesise that non-completion has a negative effect on recidivism after controlling for a priori differences in risk of recidivism. METHODS: We analysed data from all sex offenders released from Bavarian prisons between 2004 and 2015 who had participated in prison-based social-therapeutic treatment and compared non-completers (n = 100) to offenders ending treatment as planned (n = 428). Criminal risk, offence characteristics, and treatment-related propensities were measured by a comprehensive assessment instrument, including the Static-99. Recidivism data were obtained from Federal Official Records with an average time-at-risk of 9.43 years (SD = 3.29). RESULTS: Treatment non-completion was significantly associated with recidivism after controlling for criminal risk, offence characteristics and treatment duration. This was mainly accounted for by men who had spent at least two years in treatment before premature termination and return to an ordinary prison setting. CONCLUSIONS: Our findings aid understanding the potentially negative impact of discontinuing social-therapeutic treatment for male sex offenders; termination after substantial commitment may be particularly problematic. Future research should encompass large enough sample sizes to study details behind staff or prisoner decisions to return the prisoner to ordinary prison conditions and to mitigate harms by loss of privileges.

Psychosocial prevention programs against radicalization and extremism: a meta-analysis of outcome evaluations / Programas de prevención psicosocial contra la radicalización y el extremismo: meta-análisis de las evaluaciones de los resultados

Politically, religiously, and otherwise motivated radicalization and violent extremism is a topic of high priority in many countries. Therefore, beyond intelligence and police measures, there is a strong increase of psychosocial prevention programs in this field. However, little is known about their effectiveness. We aimed to fill this research gap by conducting a systematic international review and meta-analysis of outcome evaluations. We screened about 14,000 reports on the topic of extremism prevention, but in spite of broad criteria of eligibility, we only found nine more or less well-controlled outcome evaluations from seven countries. Six programs addressed religious/ethnic extremism, one targeted nationalist/separatist extremism, and one different types of extremism. Most evaluations had a quasi-experimental pre-post design, only one contained a randomized controlled trial (RCT). Overall, programs had a significant mean positive effect on behavioral and psychosocial outcomes related to extremism (d = 0.50, SE = 0.12). Regarding the specific effects of the programs on psychosocial aspects such as for example extremist attitudes alone, we found similar results (d = 0.56, SE = 0.11). We found stronger effects for programs with target groups from mixed ethnic backgrounds and approaches addressing both at-risk individuals and participants from the general population. Despite these promising results, the low internal validity of most evaluations and small number of eligible studies limit generalization. More high-quality evaluations are clearly needed. These would help to allocate resources in an evidence-oriented manner and provide a better understanding of the mechanisms of successfully preventing radicalization and violent extremism

La radicalización y el extremismo violento por causas políticas, religiosas o de otro tipo es un tema prioritario en muchos países. Además, más allá de las medidas de servicios de inteligencia y policiales, hay un aumento de los programas de prevención psicosocial en este campo. Sin embargo, no se sabe mucho de su eficacia. Para llenar este vacío en la investigación llevamos a cabo una revisión sistemática internacional y un meta-análisis de la evaluación de los resultados. Revisamos alrededor de 14,000 informes sobre prevención del extremismo, pero a pesar de que utilizamos un criterio de selección de artículos amplio solo encontramos nueve evaluaciones de resultados más o menos bien controladas de siete países. Seis programas abordaban el extremismo religioso/étnico, uno el nacionalista/separatista y uno consistía en un ensayo controlado aleatorizado (ECA). En general, los programas mostraron un efecto promedio positivo y significativo en los resultados comportamentales y psicosociales relacionados con el extremismo (d = 0.50, SE = 0.12). En cuanto a los efectos específicos de los programas en las dimensiones psicosociales, tal como las actitudes extremistas, encontramos unos efectos similares (d = 0.56, SE = 0.11). Hallamos efectos mayores en los programas con grupos diana de antecedentes étnicos mixtos y enfoques que se dirigían tanto a sujetos en riesgo como a participantes de la población general. A pesar de unos resultados prometedores, la escasa validez interna de la mayoría de las evaluaciones y el bajo número estudios que cumplían los criterios de selección limitan la generalización. En consecuencia, se necesitan más estudios con diseños de buena calidad. Estos ayudarían a asignar los recursos sobre la base de evidencia científica y proporcionarían una mejor comprensión de los mecanismos de prevención con éxito del extremismo violento y la radicalización

Adrenocortical Activity and Aggressive Behavior in Children: A Longitudinal Study on Risk and Protective Effects.

Most research on aggression and delinquency concentrates on risk factors. There has been less attention for protective factors and mechanisms, in particular with regard to biosocial influences. Based on theories of autonomous arousal and stress reactance the present study addresses the influence of adrenocortical activity as a risk and/or protective factor in the development of antisocial behavior in children. We also investigated relations to anxiousness and family stressors. In a prospective longitudinal study of 150 German boys, the first measurement took place at preschool age and contained an assessment of cortisol after waking up and 30 min later. Aggressiveness and anxiousness of the children were assessed by the kindergarten teachers with the Social Behavior Questionnaire. After 6 years, the children's behavior was rated by the teachers in middle school. Variable-oriented data analyses revealed a significant correlation between the total amount of cortisol after waking up and 30 min later (AUC G ) and anxiousness both cross-sectionally and longitudinally, but not with aggressiveness. A family stress index correlated positively with aggressiveness but neither with cortisol nor with anxiousness. There were significant correlations between aggressiveness and anxiousness at kindergarten age and the respective behavior problems 6 years later. In a linear regression analysis on aggression only family stress had a significant effect but anxiousness not. Moderator analyses on aggressiveness with anxiousness and AUC G or on AUC G with anxiousness and aggressiveness did not show any significant interactions. Longitudinally, only aggression significantly predicted aggression 6 years later in a linear regression. In addition to variable-oriented analyses, we also applied a person-oriented approach to investigate specific patterns of behavior. Children who were high in both aggressiveness and anxiousness had the highest cortisol level and those with low anxiousness and high aggressiveness the lowest. The groups with different patterns of externalizing and internalizing problems at preschool age showed significant differences in aggression 6 years later. Our results underline the need for complex pattern analyses on cortisol, aggression, and anxiousness in children and for a differentiated consideration of emotional reactive aggression and unemotional instrumental aggression.

Predicting Attrition and Engagement in the Treatment of Young Offenders.

Premature treatment termination in offender treatment is linked to negative consequences for clients, practitioners, and the criminal justice system. Therefore, identifying predictors of treatment attrition is a crucial issue in offender rehabilitation. Most studies on this topic focus on adult offenders; less is known about adolescent offenders. In our study, therapy attrition and engagement were predicted via logistic and linear regression to examine the link between pretreatment variables, engagement, and treatment failure in 161 young offenders treated in a social-therapeutic unit in Germany. Engagement could be predicted by motivation, disruptive childhood behavior, low aggressiveness, and higher age. In turn, low motivation, substance abuse, and young age predicted attrition, but their impact diminished when engagement was added to the model with only substance abuse remaining significant. The effect of substance abuse on attrition disappeared, when the offender's initial motivation was high. Implications for assessment and treatment planning are discussed.

On the Effectiveness of Sexual Offender Treatment in Prisons: A Comparison of Two Different Evaluation Designs in Routine Practice.

Although there is less continuity of sexual offending in the life course than stereotypes suggest, treatment should lead to a further reduction of reoffending. Contrary to this aim, a recent large British study using propensity score matching (PSM) showed some negative effects of the core sex offender treatment program (SOTP) in prisons. International meta-analyses on the effects of sex offender treatment revealed that there is considerable variety in the results, and methodological aspects and the context play a significant role. Therefore, this study compared different designs in the evaluation of sex offender treatment in German prisons. PSM was compared with an exact matching (EM) by the Static-99 in a sample of 693 sex offenders from Bavarian prisons. Most results were similar for both methods and not significant due to low base rates. There was a treatment effect at p < .05 on general recidivism in the EM and at p = .06 on serious reoffending in the PSM. For sexual recidivism, EM showed a negative trend, whereas PSM suggested the opposite. Overall, the study underlines the need for more replications of evaluations of routine practice, methodological comparisons, sensitive outcome criteria, and differentiated policy information.

The impact of contextual family risks on prisoners' children's behavioural outcomes and the potential protective role of family functioning moderators.

Research suggests that children of prisoners have an increased risk for behavioural and emotional problems. However, in a resilience approach, one should expect heterogeneous outcomes and thus apply a contextualized perspective. As this is rarely acknowledged in empirical research, the present study sought to fill this gap using data from the Fragile Families and Child Wellbeing study on 801 children of imprisoned fathers. We explored the extent to which cumulative family risks measured during the first year of life (e.g., poverty and mental health problems) predicted behavioural outcomes at age 9 and whether potentially protective aspects of family functioning moderated the impact of these risk factors. Cumulative risk significantly predicted behavioural outcomes, but the associations were weak. No strong evidence of moderation was found. At low risk, mother-child closeness moderated behavioural outcomes. There was also some evidence of moderation by accumulated protective factors. Potential implications for policy and practice and challenges for further research are discussed.

School bullying and drug use later in life: A meta-analytic investigation.

The main aim of this article is to investigate whether there is a significant long-term association between bullying at school and drug use later in life. A meta-analysis is presented based on results from major prospective longitudinal studies with available unadjusted and adjusted effect sizes. Results are based on thorough systematic searches of the literature across 19 databases and 63 journals. The unadjusted summary effect size suggests that youth who bully are at least twice as likely compared with noninvolved students to use drugs later in life (OR = 2.22, 95% CI: 1.60-3.07). The adjusted summary effect size is markedly reduced to an OR of 1.41 (95% CI: 1.20-1.66) suggesting that a lot of variation in the final model is explained by other contributing factors, while bullying has a significant yet small effect over and above the contribution of these factors. Contributing factors include childhood risks falling within the individual, family, and school domains that are significantly associated with both the predictor and the outcome. It is concluded that school bullying, drug use, and other problem behaviors are intercorrelated; thus, highlighting the need to create a meaningful holistic framework for the prevention of drug problems and other associated mental, emotional, and behavioral maladies. Implications for policy and practice arising from these findings are discussed.

Domestic violence perpetrator programs in Europe, Part I: A survey of current practice.

Most research on domestic violence perpetrator programs has been carried out in North America. It does not yet provide a clear picture on what works with these offenders and cannot be generalized to other cultural and legal systems. Therefore, in Part I of this article, we present the results of a survey of 54 programs that were in place in 19 European countries that addressed the programs' practice and effects. The survey captured data about program design, delivery, administration, infrastructure, and other features. Most programs applied cognitive-behavioral, profeminist, or psychodynamic treatment, or a combination of multiple treatment types. There was a wide disparity in approaches to handling domestic violence perpetrators, and a particular dearth of high-quality evaluation throughout the continent. Possible explanations for this disparity and avenues for improvement are discussed, related to a systematic review of European outcome evaluations (Part II).

Domestic violence perpetrator programs in Europe, Part II: A systematic review of the state of evidence.

In Part II of this article, we present the results of a systematic review of European evidence on the effectiveness of domestic violence perpetrator programs. After searching through 10,446 titles, we discovered only 12 studies that evaluated the effectiveness of a perpetrator program in some systematic manner. The studies applied treatment to a total of 1,586 domestic violence perpetrators, and the sample sizes ranged from 9 to 322. Although the evaluations showed various positive effects after treatment, methodological problems relating to the evaluation designs do not allow attribution of these findings to the programs. Overall, the methodological quality of the evaluations is insufficient to derive firm conclusions and estimate an effect size. Accordingly, one cannot claim that one programmatic approach is superior to another. Evaluation of domestic violence perpetrator treatment in Europe must be improved and programs should become more tailored to the characteristics of the participants.

Time course analysis of motor excitability in a response inhibition task according to the level of hyperactivity and impulsivity in children with ADHD.

Short interval intracortical inhibition (SICI) of motor cortex, measured by transcranial magnetic stimulation (TMS) in a passive (resting) condition, has been suggested as a neurophysiological marker of hyperactivity in attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to determine motor excitability in a go/nogo task at stages of response preparation, activation and suppression in children with ADHD, depending on the level of hyperactivity and impulsivity. Motor evoked potentials were recorded in 29 typically developing children and 43 children with ADHD (subdivided in two groups with higher and lower levels of hyperactivity/impulsivity; H/I-high and H/I-low). In the H/I-high group, SICI was markedly reduced in the resting condition and during response preparation. Though these children were able to increase SICI when inhibiting a response, SICI was still reduced compared to typically developing children. Interestingly, SICI at rest and during response activation were comparable, which may be associated with their hypermotoric behaviour. In the H/I-low group, response activation was accompanied by a pronounced decrease of SICI, indicating reduced motor control in the context of a fast motor response. In summary, different excitability patterns were obtained for the three groups allowing a better understanding of dysfunctional response activation and inhibition processes within the motor cortex in children with ADHD.

Direct protective and buffering protective factors in the development of youth violence.

This article discusses conceptual issues and reviews knowledge about direct and buffering protective factors in the development of youth violence. Direct protective factors predict a low probability of violence, whereas buffering protective factors predict a low probability of violence in the presence of risk (and often interact with risk factors). Individual, family, school, peer, and neighborhood factors are reviewed. Heterogeneity of variables, measurement, contexts, study design, sample, and other characteristics limit generalizations. However, there were various evidence-based candidates for having a direct protective or buffering protective effect such as above-average intelligence, low impulsivity/easy temperament, enhanced anxiety, prosocial attitudes, high heart rate, close relationship to at least one parent, intensive parental supervision, medium SES of the family, sound academic achievement, strong school bonding, a positive school/class climate, nondeviant peers, and living in a nondeprived and nonviolent neighborhood. The probability of violence decreases as the number of protective factors increases (a dose-response relationship). Implications for future research and practice concern adequate research designs to detect nonlinear relationships; conceptually and methodologically homogeneous studies; differentiated analyses with regard to age, gender, and other characteristics; and greater integration of longitudinal correlational research with (quasi-)experimental intervention studies.

The predictive efficiency of school bullying versus later offending: a systematic/meta-analytic review of longitudinal studies.

BACKGROUND: Although bullying and delinquency share similar risk factors, no previous systematic review has ever been conducted to examine possible links between school bullying and criminal offending later in life. AIMS: To investigate the extent to which bullying perpetration at school predicts offending later in life, and whether this relation holds after controlling for other major childhood risk factors. METHOD: Results are based on a thorough systematic review and meta-analysis of studies measuring school bullying and later offending. Effect sizes are based on both published and unpublished studies; longitudinal investigators of 28 studies have conducted specific analyses for our review. RESULTS: The probability of offending up to 11 years later was much higher for school bullies than for non-involved students [odds ratio (OR) = 2.50; 95% confidence interval (CI): 2.03-3.08]. Bullying perpetration was a significant risk factor for later offending, even after controlling for major childhood risk factors (OR = 1.82, 95% CI: 1.55-2.14). Effect sizes were smaller when the follow-up period was longer and larger when bullying was assessed in older children. The age of participants when outcome measures were taken was negatively related with effect sizes. Finally, the summary effect size did not decrease much as the number of controlled risk factors increased. CONCLUSIONS: School bullying is a strong and specific risk factor for later offending. Effective anti-bullying programmes should be promoted, and could be viewed as a form of early crime prevention. Such programmes would have a high benefit : cost ratio.

Bullying at school as a predictor of delinquency, violence and other anti-social behaviour in adulthood.

BACKGROUND: Although bullying at school is an important topic, its long-term relation to anti-social development is rarely investigated. AIM: To study the relation between bullying in youth and anti-social outcomes in adulthood. METHODS: A group of 63 males (bullies and victims over-sampled) from the Erlangen-Nuremberg Bullying Study were investigated at ages 15 and 25. Bullying was assessed with the Olweus Bully/Victim Questionnaire. Outcome measures included self-reported delinquency, violence, aggressiveness, drug use, impulsivity and psychopathy. In addition to bivariate correlations, hierarchical regressions were used to control for family and individual risk factors. RESULTS: Bullying was a strong predictor of nearly all anti-social outcomes. Physical bullying was more predictive than verbal/indirect bullying. Controlling for family risks and externalising/internalising problems reduced effect sizes, but bullying remained a sound predictor. Victimisation was not related to anti-social outcomes. CONCLUSIONS: Bullying seems to be a key risk marker for anti-social development. Therefore, studies on whole-school anti-bullying programmes and child-oriented or family-oriented strategies of crime prevention should be more integrated.

Personality rather than clinical variables determines quality of life after major colorectal surgery.

PURPOSE: Clinical factors, especially the presence of a stoma, have been presumed to be the major determinants of quality of life after colorectal surgery. We investigated the relative influence of other variables, e.g., patient's personality, sense of coherence, and coping strategies, to determine the validity of this long-held assumption. METHODS: We investigated 79 patients undergoing major colorectal surgery. Quality of Life was assessed with the Short Form-36 and Gastrointestinal Quality of Life Index questionnaires at three and 12 months postsurgery. Additionally, baseline psychologic data on personality and sense of coherence were assessed. The results were analyzed in both a bivariate manner and by multivariate hierarchical regression analysis. RESULTS: In the bivariate analysis, clinical parameters had a small and temporary effect on quality of life, if any. In the multivariate model the character of the underlying disease and the presence of a stoma did not affect quality of life significantly. In contrast, emotional lability, extraversion, and sense of coherence had a strong and lasting influence, accounting for 49 percent of variance (Delta R2) for emotional quality of life, 22 percent for physical and 32 percent for disease-specific Quality of Life. CONCLUSION: Personality exerts a strong and lasting effect on quality of life after colorectal surgery. This effect by far exceeds the influence of common clinical variables.

Quality of life and patient's expectations after closure of a temporary stoma.

INTRODUCTION: Little is known about the changes in quality of life following reversal of a temporary loop ileostomy after rectal cancer surgery. We therefore conducted a prospective study assessing physical symptoms, quality of life, problems in everyday life, and patient's expectations and complaints. MATERIALS AND METHODS: We investigated 35 patients who received a temporary stoma after colorectal surgery between 15/11/2002 and 15/11/2003. The patients were followed up for 1 year. Quality of life was assessed using the Short-Form 36 (SF-36) and the Gastrointestinal Quality of Life Index (GLQI). In addition, we performed a semi-structured interview that assessed quality of life, function, patient's expectations, and complaints. RESULTS: The interviews showed a significant improvement in body image and leisure activities while the questionnaires showed no change in qol. Conversely, there was a significant increase in gastrointestinal problems that persisted until 1 year after primary surgery. An increasing proportion of patients stated that they felt worse than they expected after stoma closure. That was accompanied by an increased number of complaints about the hospital and the medical staff. CONCLUSION: Although from the surgeon's point of view, stoma closure is only a minor procedure, it causes significant functional problems for the patients that lead to considerable dissatisfaction. Other than usually presupposed, there is no general improvement in quality of life and everyday life after stoma closure. Therefore, thorough preoperative counseling about the consequences of stoma reversal is mandatory.

Does sexual offender treatment work? A systematic review of outcome evaluations / ¿Es efectivo el tratamiento de los delincuentes sexuales? Una revisión sistemática de los resultados evaluados

The article reports a systematic review of controlled outcome evaluations of psychosocial and organic sexual offender treatment. A comprehensive search of the literature in five languages revealed 80 independent comparisons between treated and untreated groups of sexual offenders (N= 22,181). The majority of studies confirmed a positive treatment effect. Overall, 11.1% of treated offenders and 17.5% of controls showed sexual recidivism (37% difference). Findings for violent and general recidivism were similar. Studies on surgical castration showed the strongest effect; however, this was confounded with methodological and offender characteristics. Hormonal medication, cognitive-behavioural, and behavioural approaches also revealed a positive effect. Non-behavioural treatments did not show a significant impact. Other moderators such as small sample size, authors’ affiliation with the program, program completion versus dropout, or type of outcome measure had a significant impact. Methodological study characteristics explained the largest proportion of effect size variance. Overall, findings are promising but more differentiated evaluations of high quality are needed (AU)

Este artículo presenta una revisión sistemática de los resultados de evaluaciones controladas acerca del tratamiento psicosocial y orgánico de los delincuentes sexuales. Un estudio exhaustivo de la literatura destacó 80 comparaciones independientes entre grupos de delincuentes sexuales tratados y no tratados (N= 22.181). La mayoría de los estudios mostraron un efecto positivo. En conjunto, los delincuentes tratados reincidieron el 11,1%, mientras que los no tratados llegaron al 17,5% (es decir, un 37% de diferencia). Los hallazgos en reincidencia violenta y no violenta fueron parecidos. Los efectos más grandes los obtuvo la castración quirúrgica, aunque ciertas variables metodológicas y de los sujetos contaminan ese dato. Los tratamientos no conductuales no mostraron ser efectivos. Otras variables moderadoras como el tamaño pequeño de la muestra, la relación de los autores de los informes con el programa, acabar o no el mismo, o el tipo de resultado analizado tuvieron un efecto significativo. Las características metodológicas de los estudios explicaron la mayor parte de varianza de los resultados. En conjunto, los resultados son prometedores, aunque se necesitan evaluaciones diferentes de alta calidad (AU)

Does sexual offender treatment work? A systematic review of outcome evaluations.

The article reports a systematic review of controlled outcome evaluations of psychosocial and organic sexual offender treatment. A comprehensive search of the literature in five languages revealed 80 independent comparisons between treated and untreated groups of sexual offenders ( N = 22,181). The majority of studies confirmed a positive treatment effect. Overall, 11.1% of treated offenders and 17.5% of controls showed sexual recidivism (37% difference). Findings for violent and general recidivism were similar. Studies on surgical castration showed the strongest effect; however, this was confounded with methodological and offender characteristics. Hormonal medication, cognitive-behavioural, and behavioural approaches also revealed a positive effect. Non-behavioural treatments did not show a significant impact. Other moderators such as small sample size, authors' affiliation with the program, program completion versus dropout, or type of outcome measure had a significant impact. Methodological study characteristics explained the largest proportion of effect size variance. Overall, findings are promising but more differentiated evaluations of high quality are needed.