Promotive, Mixed, and Risk Effects of Individual Items Comprising the SAPROF Assessment Tool With Justice-Involved Youth.

The Structured Assessment of PROtective Factors for violence risk (SAPROF) is a widely used structured professional judgment (SPJ) tool. Its indices have predictive validity regarding desistance from future violence in adult correctional/forensic psychiatric populations. Although not intended for applied use with youth, SAPROF items lend themselves to an investigation of whether their operationalizations capture only strengths or also risks. With 229 justice-involved male adolescents followed for a fixed 3-year period, promotive, risk, and mixed effects were found. Most SAPROF items exerted a mixed effect, being associated with higher and lower likelihoods of violent and any reoffending at opposite ends of their trichotomous ratings. Summing items weighted using their promotive and risk odds ratios produced statistically significant improvements in predictive accuracy, improvements found also with a cross-validation sample of 171 justice-involved youth. The nature of strengths and implications for the development of SPJ tools and training in their use were discussed.

A proof of concept study of promotive, mixed, and risk effects using the SAVRY assessment tool items with youth with sexual offenses.

There is currently a lack of consensus about the nature of strengths in forensic assessments. With 273 justice-involved male youth and a fixed 3-year follow-up, this study adopted the approach of Farrington and colleagues to investigating the nature of associations between trichotomized variables, representing risks and strengths, and outcomes using pairs of odds ratios (ORs) and percentage point changes from base rates. Items from the Structured Assessment of Violence Risk in Youth (SAVRY), a structured professional judgment tool used to assess risk and protective factors in justice-involved youth, were employed for this purpose. In the literature, the accuracy of SAVRY summed totals for its Risk Factor item sets (each item rated using a trichotomy) has been generally in the moderate range in predicting future violence. But the total for its summed Protective Factor items (each rated using a dichotomy) has been less consistently encouraging. In this study, contrary to their labels, the majority of SAVRY Risk and Protective Factors (rated using trichotomies) exerted a risk effect at one end of their trichotomy (risk item ratings of 2, protective item ratings of 0) and a promotive effect at the other end (risk item ratings of 0, protective factor ratings of 2) for a new violent (including sexual) offense and any new offense. Subsets of items conservatively weighted using ORs (capturing risk and strength) were statistically significantly more accurate in predicting outcomes than their originally rated counterpart subsets. Implications for understanding the nature of strengths and for applied assessment practices are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Protective factors in the prediction of criminal outcomes for youth with sexual offenses using tools developed for adults and adolescents: Tests of direct effects and moderation of risk.

Interest in protective factors in risk assessment work with adjudicated populations is increasing and evidence suggests that protective factors in structured professional judgment (SPJ) tools predict the absence of one or more types of recidivism with some evidence also of incremental validity in recidivism-desistance prediction models with risk scales. But, there is little evidence of interactions, demonstrated using formal tests of moderation, between scores on risk- and protective factor-focused applied assessment tools, despite the documentation of interactive protective effects with nonadjudicated populations. In this study, with 273 justice-involved male youth and a fixed 3-year follow-up, direct effects of medium size were found for sexual recidivism, violent (including sexual) recidivism, and any new offense with totals for tools developed for adult offending populations (modified versions of the actuarial risk-focused Static-99 and the SPJ protective factor-focused Structured Assessment of PROtective Factor [SAPROF]) and tools developed for adolescent offending populations (the actuarial risk-focused Juvenile Sexual Offense Recidivism Risk Assessment Tool-II [JSORRAT-II] and the SPJ protective factor-focused DASH-13). As well, incremental validity and interactive protective effects, in the small-to-medium size range, were found for the prediction of violent (including sexual) recidivism using various combinations of these tools. The value-added information provided by strengths-focused tools indicated by these findings suggest their inclusion in comprehensive risk assessments in applied practice has promise for improving prediction and also intervention and management planning with justice-involved youth. The findings also highlight the need for further research on developmental considerations and practical questions about how to integrate strengths with risks to inform such work empirically. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Childhood Sexual Abuse, Attachments in Childhood and Adulthood, and Coercive Sexual Behaviors in Community Males.

Associations between self-reported coercive sexual behavior against adult females, childhood sexual abuse (CSA), and child-parent attachment styles, as well as attachment with adult romantic partners, were examined among 176 adult community males. Attachment style with each parent and with romantic partners was also investigated as a potential moderator. Using hierarchical multiple regression analysis, avoidant attachment with mothers in childhood (and also with fathers, in a second model) accounted for a significant amount of the variance in coercive sexual behavior controlling for scores on anxious ambivalent and disorganized/disoriented attachment scales, as predicted. Similarly, in a third model, avoidance attachment in adulthood was a significant predictor of coercive sexual behavior controlling for scores on the anxiety attachment in adulthood scale. These main effects for avoidant and avoidance attachment were not statistically significant when CSA and control variables (other types of childhood adversity, aggression, antisociality, and response bias) were added in each of the models. But the interaction between scales for CSA and avoidance attachment in adulthood was significant, demonstrating incremental validity in a final step, consistent with a hypothesized moderating function for attachment in adulthood. The correlation between CSA and coercive sexual behavior was .60 for those with the highest third of avoidance attachment scores (i.e., the most insecurely attached on this scale), .24 for those with scores in the middle range on the scale, and .01 for those with the lowest third of avoidance attachment scores (i.e., the most securely attached). Implications for study design and theory were discussed.

A prospective investigation of factors that predict desistance from recidivism for adolescents who have sexually offended.

Current approaches to violence risk assessment are focused on the identification of factors that are predictive of future violence rather than factors that predict desistance. This is also true for the popular tools designed to predict adolescent sexual recidivism. Research on strengths-based variables with adolescents who have sexually offended that could serve a protective function is only recently underway. In the current prospective study, scores from clinician-completed assessments using the Estimate of Risk of Adolescent Sexual Offense Recidivism (ERASOR) and the parent-completed form of the Behavioral and Emotional Rating Scale (BERS-2) were evaluated in a sample of 81 adolescent males with at least one sexual offense. As expected, the ERASOR was significantly correlated with sexual recidivism over an average 3.5-year follow-up. In terms of a protective function, the Affective Strength scale of the BERS-2 was significantly negatively correlated with sexual recidivism, although it did not have incremental validity over and above the ERASOR. The BERS-2 School Functioning scale was significantly negatively correlated with nonsexual recidivism. The results are discussed in terms of previous findings and theoretical work on attachment in sexual offending behavior and implications for risk assessment practice.

Development of Vermont assessment of sex offender risk-2 (VASOR-2) reoffense risk scale.

The present study aimed to revise the Vermont Assessment of Sex Offender Risk (VASOR) Reoffense Risk Scale, a commonly used sex offender risk assessment tool. The revised tool was named the VASOR-2. Among models tested to revise the scale, a logistic regression model showed the best balance between simplicity of use, goodness of fit, and internal validity (as tested with K-10 cross-validation), and maximized predictive accuracy. Predictive accuracy was tested using four meta-analytically combined data sets drawn from Canada and Vermont (N = 1,581). At 5-year fixed follow-up, the predictive accuracy for sexual recidivism for VASOR-2 (AUC = .74) was similar to the VASOR (AUC = .71). The findings show the VASOR-2 is well calibrated with observed recidivism rates for all but the highest risk sex offenders. The instrument showed good interrater reliability (ICC = .88). An advantage of the VASOR-2 is that it has fewer items and simpler scoring instructions than the VASOR. Norms are presented for a contemporary, nonselected, routine sample of Vermont sex offenders (n = 887).

Mental health diagnoses and recidivism in paroled offenders.

Although the issue of mental illness among offender populations has received attention in the last number of years, there are a number of issues related to mental illness among such groups that require more study. One such topic relates to the association between mental illness, actuarially assessed risk of recidivism, and observed rates of reoffending. In the present investigation, file information was reviewed to determine the presence of a variety of mental health conditions. Actuarially based risk assessment data were also collected for participants as well as information regarding suspension, new charges, and convictions. A sample of 136 offenders housed in a halfway house operated by Correctional Service of Canada was included in the present investigation. Results indicated very high rates of serious mental illness in this high-risk population. Offenders with borderline personality disorder and attention deficit hyperactivity disorder were significantly more likely to recidivate or be suspended. Suspensions refer to administrative decisions to place an offender in jail due to problematic behaviour (typically involving a breach of his release conditions or new charges/convictions). Offenders with a diagnosis of paraphilic disorder were significantly less likely to recidivate or be suspended. Results are discussed in light of the available literature.

Personality traits as predictors of inpatient aggression in a high-security forensic psychiatric setting: prospective evaluation of the PCL-R and IPDE dimension ratings.

The Dangerous and Severe Personality Disorder (DSPD) initiative in England and Wales provides specialized care to high-risk offenders with mental disorders. This study investigated the predictive utility of personality traits, assessed using the Psychopathy Checklist-Revised (PCL-R) and the International Personality Disorder Examination, with 44 consecutive admissions to the DSPD unit at a high-security forensic psychiatric hospital. Incidents of interpersonal physical aggression (IPA) were observed for 39% of the sample over an average 1.5-year period following admission. Histrionic personality disorder (PD) predicted IPA, and Histrionic, Borderline, and Antisocial PDs all predicted repetitive (2+ incidents of) IPA. PCL-R Factor 1 and Facets 1 and 2 were also significant predictors of IPA. PCL-R Factor 1 and Histrionic PD scores were significantly associated with imminence of IPA. Results were discussed in terms of the utility of personality traits in risk assessment and treatment of specially selected high-risk forensic psychiatric patients in secure settings.

Treatment of sexual offenders with psychopathic traits: recent research developments and clinical implications.

This article provides a review of recent literature related to the treatment of psychopathy in forensic settings, with particular focus on studies with sexual offenders. The lack of empirical support for the position that psychopaths are untreatable is noted, and data suggesting optimism is discussed. Research demonstrating an interaction between psychopathy and substance abuse and between psychopathy and sexual deviance is also presented. Both substance abuse disorders and inappropriate arousal are frequently encountered in high-risk groups of sexual offenders. These topics are of relevance, in that the question of whether treatment is beneficial with high-risk sexual offenders, including those who are psychopathic, cannot be answered unless groups presenting with typical concurrent disorders (paraphilias, substance abuse, dependence) are discussed. It is argued that, although the evidence is still preliminary, there is reason for optimism with reference to whether psychopathic sexual offenders are responsive to treatment, including offenders presenting with concurrent disorders.

Further investigation of findings reported for the Minnesota sex offender screening tool-revised.

Among a number of widely used risk assessment instruments with adult sexual offenders, the Minnesota Sex Offender Screening Tool-Revised (MnSOST-R) has been subject to relatively few evaluation studies. Only two independent research groups have published replication studies in the peer-reviewed literature with data not provided by the MnSOST-R's developers, and the results regarding the accuracy of predicting sexual recidivism have been mixed. In this article, important differences between the Barbaree et al. and Langton et al. studies are presented. Analyses reported for the various subsets comprising these two samples indicate that coding discrepancies in the Barbaree et al. study account for the different findings, with a moderate level of predictive accuracy using the Receiver Operating Characteristic curve ultimately found for the MnSOST-R in both data sets.

Different actuarial risk measures produce different risk rankings for sexual offenders.

Percentile ranks were computed for N=262 sex offenders using each of 5 actuarial risk instruments commonly used with adult sex offenders (RRASOR, Static-99, VRAG, SORAG, and MnSOST-R). Mean differences between percentile ranks obtained by different actuarial measures were found to vary inversely with the correlation between the actuarial scores. Following studies of factor analyses of actuarial items, we argue that the discrepancies among actuarial instruments can be substantially accounted for by the way in which the factor Antisocial Behavior and various factors reflecting sexual deviance are represented among the items contained in each instrument. In the discussion, we provide guidance to clinicians in resolving discrepancies between instruments and we discuss implications for future developments in sex offender risk assessment.

The factor structure of static actuarial items: its relation to prediction.

Principal components analysis was conducted on items contained in actuarial instruments used with adult sex offenders, including: the Rapid Assessment of Sex Offender Risk for Recidivism (RASORR), the Static-99, the Violence Risk Appraisal Guide (VRAG), the Sex Offender Risk Appraisal Guide (SORAG), and the Minnesota Sex Offender Screening Tool-Revised (MnSOST-R). In a data set that included child molesters and rapists (N = 311), six interpretable components were identified: Antisocial Behavior, Child Sexual Abuse, Persistence, Detached Predatory Behavior, Young and Single, and Male Victim(s). The RRASOR was highly correlated with Persistence, and the VRAG and SORAG were highly correlated with Antisocial Behavior. Antisocial Behavior was a significant predictor of violent recidivism, while Persistence and Child Sexual Abuse were significant predictors of sexual recidivism.

Sex offenders' response to treatment and its association with recidivism as a function of psychopathy.

This study examined the relationship between recidivism and ratings of response to specialized cognitive behavioral treatment conducted in a prison setting among 418 sex offenders released to the community for an average follow-up period of over 5 years. As well as testing for a main effect for treatment ratings, the potential role of psychopathy assessed using the Psychopathy Checklist--Revised (PCL-R) as a moderator of response to treatment was investigated. Ratings of response to treatment failed to predict either serious (violent including sexual) or sexual recidivism. For the more inclusive outcome of serious recidivism, there was no significant interaction between psychopathy and treatment ratings; however, the ubiquitous effect of psychopathy on recidivism was found to be significant. For sexual recidivism, psychopathy was not significant as a main effect, but a significant interaction between psychopathy and treatment ratings was found. Among sex offenders with PCL-R scores of 25 or higher, those with ratings reflecting a more negative response to treatment recidivated sexually at a faster rate than others. This interaction effect was not significant when treatment noncompleters were removed from the data set. The results were discussed in terms of the methodology involved in the assessment of response to treatment among sex offenders.

The development of sexual aggression through the life span: the effect of age on sexual arousal and recidivism among sex offenders.

There is a strong belief in the field that sexual aggression persists unabated into old age. If libido is one of the important determinants of sexual aggression, as has been theorized, and if libido decreases with aging, then it follows that sexual aggression should show similar aging effects. The present study examines the effects of age on sexual arousal and sexual recidivism in sex offenders. In the first study, 1431 sex offenders' erectile responses were measured using volumetric phallometry during presentations of visual and auditory depictions of prepubescent, pubescent, and adult males and females. The maximum degree of arousal was plotted over the age of the offender at the time of the test. Age was a powerful determinant of sexual arousal and a line-of-best-fit indicated that arousal decreased as a reciprocal of the age-at-test. In the second study, 468 sex offenders released into the community were followed for an average period of over five years. The effects of age-at-release were examined using Kaplan-Meier survival curves plotted for subjects in different age-at-release cohorts. Results indicated that offenders released at an older age were less likely to recommit sexual offenses and that sexual recidivism decreased as a linear function of age-at-release. Age-related decreases were confirmed while controlling for other risk factors using Cox regression analysis. The implications of reductions in sexual aggression with age are discussed in relation to our understanding of the etiology of sexual aggression and our use of actuarial risk assessments.