Does the Paraphilia Scale Work for Everyone? Confirmatory Factor Analysis and Measurement Invariance Across Gender and Sexual Orientation Groups.

We conducted three studies to examine the factor structure and measurement invariance of the Paraphilia Scale, a measure of paraphilic interests used in multiple studies. In the first study, we conducted a confirmatory factor analysis (CFA) testing different a priori models with a community sample of 1,040 adults previously reported by Seto et al. (2021), and found support for a hierarchical four-factor model: An agonistic continuum involving coercion or physical pain (biastophilia, sexual sadism, masochism), chronophilias (pedophilia, hebephilia), courtship disorders (voyeurism, exhibitionism, and frotteurism), and fetishism (object fetishism, transvestic fetishism, urophilia-coprophilia). This factor structure was replicated in a second study comprising a combined sample of 400 mTurk participants and 870 university students. The third study analyzed the community sample and found evidence of configural invariance but not scalar or metric invariance across gender (man or woman) and sexual orientation for gender (heterosexual or other sexual orientation). This indicates that the factor structure of the Paraphilia Scale is robust for gender and sexual orientation for gender, but factor loadings differ across these groups, as do the loadings of individual items on the four factors. Implications for research on gender and sexual orientation differences in paraphilic interests are discussed.

Measurement invariance of the Youth Self-Report across youth who have committed sexual and nonsexual offenses.

Justice-involved youth experience high rates of mental health problems that require proper screening and assessment in order to effectively intervene. The Youth Self-Report (YSR) is a general psychopathology rating scale that measures several dimensions of psychopathology and is commonly used in clinical assessments, including with justice-involved youth. Yet, the underlying factor structure of the YSR has not been examined specifically in a sample of justice-involved youth. We examined the factor structure of the YSR using confirmatory factor analysis with a sample of 961 male youth involved with the justice system (12-18 years of age). Measurement invariance of the YSR was also examined across groups of youth who committed a sexual offence and those who committed a nonsexual offence. The eight-factor model presented with optimal fit to the data, consistent with previous research with nonjustice involved samples, and the model demonstrated strong measurement invariance across youth who committed both types of offenses (sexual and nonsexual). Youth who committed nonsexual offenses reported significantly higher degrees of rule-breaking behavior and lower degrees of social problems than youth who committed sexual offenses. The current findings provide strong psychometric evidence that supports the use of the YSR with justice-involved male youth. As such, clinicians and researchers can be confident in using the YSR as a mental health screening tool with male youth involved with the justice system who have committed various offenses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sexual Sadism Disorder and Coercive Paraphilic Disorder: A Scoping Review.

BACKGROUND: Valid and reliable diagnostic criteria are essential in forensic psychiatry and sexual medicine due to the severe implications of potential misdiagnoses. One challenge in this field is the poor operationalization of sexual sadism disorder (SSD) and coercive paraphilic disorder (CP+) definitions. AIM: The aim of this scoping literature review is to provide a comprehensive overview of the key conceptual differences between SSD and CP+, as well as consider pragmatic and clinically useful approaches to their diagnostic formulation. METHODS: Arksey and O'Malley's methodological framework was followed. A literature search of Medline, PsychInfo, Web of Science, and Cumulative Index to Nursing and Allied Health Literature electronic databases was conducted. Publications in English describing the construct and/or operational definition of SSD or CP+ were included. Full-text studies were reviewed by 2 authors and data was charted and synthesized qualitatively. RESULTS: The initial search provided 1,271 records, after which 120 full-text papers were considered for eligibility and 48 studies were ultimately included. The most common sources of definitions for SSD and CP+ were the Diagnostic and Statistical Manual of Mental Disorders (n = 53) and the International Classification of Disease (n = 12). There was more variation of terms used for CP+ than SSD. Both CP+ and SSD are critiqued by reviewed literature for having low validity, reliability, and consistency, as well as being conflated with sexual crime. SSD is better described due to having diagnostic criteria and validated diagnostic tools. CLINICAL IMPLICATIONS: Currently, clinicians rely mostly on the DSM to diagnose SSD or CP+. As applications of SSD and CP+ definitions vary, interpretations may not be generalizable between clinicians. Furthermore, specific diagnoses may be practically unhelpful and unreliable. It may therefore be beneficial for treatment to be determined by risk of harm. In addition to these concerns, the stigma associated with SSD and CP+ may also impact treatment. STRENGTHS & LIMITATIONS: Strengths of this study include duplicate review and charting to increase methodological rigor, transparent reporting to minimize publication bias, and encompassing a comprehensive scope. Limitations include the weaknesses of low strength of reviewed literature and risk of publication bias. CONCLUSION: Despite their significant implications, the definitions of SSD and CP+ are inconsistent and lack reliability. Future research is necessary to develop stronger diagnostic criteria and tools. Liu A, Zhang E, Leroux EJ et al. Sexual Sadism Disorder and Coercive Paraphilic Disorder: A Scoping Review. J Sex Med 2022;000:1-11.

Youth Perspectives on Seeking Psychotherapy: A Concurrent Mixed Methods Study.

OBJECTIVE: Psychotherapy is the recommended first line of treatment for depression among youth; however, few youth seek professional support. This study compares barriers and facilitators to seeking psychotherapy among both youth who have and have not seen a psychotherapist. The study further explores reasons youth discontinue psychotherapy. METHODS: A concurrent mixed methods study design was used. Eligible participants completed a survey (N=104) and a subset of participants completed a semi-structured interview (N=60). The survey and interview data were analyzed concurrently using a triangulation design. RESULTS: Surveys were conducted among youth who had experienced psychotherapy (N=53) and youth who had not (N=51). The majority of participants were female. Common reasons for not seeking psychotherapy included wanting to handle their problems on their own (87.6%), thinking their problems would improve on its own (87.6%), and not knowing who to see (74.3%). Several barriers were common across the two groups, including stigma, concerns about the therapeutic relationship, and a preference for self-management. Common facilitators included improving coping skills and addressing functional impairment. There was some overlap between the barriers to seeking psychotherapy and the reasons for discontinuing, although aging out of youth-oriented service also constituted a termination factor. CONCLUSIONS: : As this study highlights the multiple factors that influence youth's psychotherapy-seeking behavior, a widespread, multi-level approach is needed to address barriers and facilitators at the individual level, but also at the community, policy, and organizational levels. Strategies such as increasing service availability and quality are needed to increase service seeking and improve retention.

OBJECTIF: La psychothérapie est le traitement de première intention recommandé pour la dépression chez les jeunes, toutefois, peu de jeunes recherchent un soutien professionnel. La présente étude compare ce qui fait obstacle et ce qui facilite la recherche de psychothérapie chez les jeunes qui ont vu ou pas un psychothérapeute. L'étude explore en outre les raisons pour lesquelles les jeunes cessent la psychothérapie. MÉTHODES: Une étude concomitante à méthodes mixtes a été utilisée. Les participants admissibles ont rempli un sondage (N = 104) et un sous-ensemble de participants a répondu à une entrevue semi-structurée (N = 60). Les données du sondage et de l'entrevue ont été analysées simultanément à l'aide d'une méthode de triangulation. RÉSULTATS: Les sondages ont été menés auprès des jeunes qui avaient l'expérience de la psychothérapie (N = 53) et des jeunes qui ne l'avaient pas (N = 51). La majorité des participants était de sexe féminin. Les raisons communes de ne pas rechercher la psychothérapie étaient notamment vouloir régler leurs problèmes par eux-mêmes (87,6 %), croire que leurs problèmes allaient se régler d'eux-mêmes (87,6 %), et ne pas savoir qui consulter (74,3 %). Plusieurs obstacles étaient partagés par les deux groupes, dont les stigmates, des préoccupations quant à la relation thérapeutique, et une préférence pour la gestion autonome. Ce qui facilitait communément était notamment améliorer les compétences d'adaptation et remédier à la déficience fonctionnelle. Il y avait un chevauchement entre les obstacles à la recherche de psychothérapie et les raisons d'y mettre fin bien que le fait de vieillir hors de la zone des services pour les jeunes constitue un facteur d'abandon. CONCLUSIONS: Comme cette étude mentionne les multiples facteurs qui influencent la recherche de thérapie chez les jeunes, il faut une approche étendue multi-niveaux pour aborder obstacles et facilitateurs au niveau individuel, mais aussi à l'échelle communautaire, politique et organisationnelle. Des stratégies comme accroître la disponibilité et la qualité des services sont nécessaires pour hausser la recherche des services et améliorer le maintien en place.

A Meta-analysis Comparing Male Adolescents Who Have Sexually Offended Against Intrafamilial Versus Extrafamilial Victims.

This meta-analysis examined whether theoretically and clinically relevant differences exist between male adolescents who have sexually offended against intrafamilial victims (AIV) and male adolescents who have sexually offended against extrafamilial victims (AEV). A total of 26 independent samples (8 published and 18 unpublished) that compared a total of 2169 AIV and 2852 AEV were analyzed. The results of this meta-analysis indicate that categorizing male adolescents who commit sexual offenses based on their relationship to victims is a meaningful distinction. We found that AIV presented with greater atypical sexual interests, increased sexual regulation issues, more severe family dysfunction, more extensive childhood maltreatment histories, and greater internalizing psychopathology than AEV. Conversely, AEV presented with more indicators of antisociality than AIV, suggesting that extrafamilial sexual offending might fit better with a generalist explanation of adolescent sexual offending. Findings highlight the value of assessing family dysfunction and maltreatment history, sexual development and regulation, and general delinquency factors to better understand adolescents who have committed a sexual offense.

The Association of Childhood Sexual Abuse With Non-Paraphilic and Paraphilic Sexual Behaviors Among Adolescents Who Have Sexually Offended.

A history of childhood sexual victimization (CSV) is one of the most commonly examined factors in research on male adolescent sexual offending. Although CSV has been extensively researched in relation to the onset and maintenance of adolescent sexual offending, few studies have investigated the association of CSV with domains of adolescent sexuality outside of sexual offending. Understanding how CSV may be associated with the non-paraphilic, and paraphilic, sexual behaviors of adolescent males who commit sexual offenses has important implications for promoting healthy sexuality among this population. In a sample of 162 male adolescents (M age = 15.2 years, SD = 1.3) adjudicated for a sexual offense, we tested the association of CSV with a range of non-paraphilic (e.g., age of first consensual sex) and paraphilic (e.g., use of paraphilic pornography) sexual behavior variables. The results indicated CSV was associated with greater engagement in risky non-paraphilic sexual behaviors, as well as paraphilic sexual behaviors. CSV was also associated with specific offense characteristics, replicating previous research findings. The current study is a first step toward understanding the broader sexual context of adolescents who commit sexual offenses.

Taxometric analyses of pedophilia utilizing self-report, behavioral, and sexual arousal indicators.

Pedophilia refers to the recurrent, intense sexual interest in prepubescent children who, by definition, have not developed any secondary sex characteristics. Researchers have begun to investigate whether persons with pedophilia are qualitatively different from those without pedophilia (pedophilia is a taxon) or if people vary in their level of sexual interest toward children (pedophilia is dimensional). Two relatively small studies have previously attempted to address this question, but produced conflicting results. The present study built on these studies with a substantially larger sample of 2,227 men who committed sexual offenses and were assessed at a sexual behavior clinic. The present study also examined a broader range of measures more closely approximating the diagnostic criteria for pedophilic disorder, including phallometric assessment of sexual arousal patterns. The results of 3 taxometric analyses did not find support for the assertion that pedophilia is a taxon. (PsycINFO Database Record

Victim Age and the Generalist Versus Specialist Distinction in Adolescent Sexual Offending.

More knowledge is needed about the etiology and treatment needs of adolescent sex offenders. The current study compared adolescents who had offended against children (defined as below the age of 12 and at least 5 years younger than the adolescent), adolescents who have offended against peers or adults, and adolescents who had victims in both age groups. Based on Seto and Lalumière's meta-analytic findings, participants were compared on theoretically derived factors, including childhood sexual abuse, atypical sexual interests, sexual experience, social competence, psychiatric history, and general delinquency factors (past criminal history, substance abuse history, and offense characteristics). The study sample consisted of 162 court-referred male adolescent sexual offenders aged 12 to 17 years. Of the six identified domains, groups significantly differed on five of them; the exceptions were variables reflecting social competence. The results further support the validity of distinguishing adolescent sex offenders by victim age.

Examining the developmental trajectories of adolescent sexual offenders.

The aim of the current study was to assess the validity of the sex-plus versus sex-only categorization method for distinguishing between different types of adolescent sex offenders (ASOs; Butler & Seto, 2002). It is hypothesized that this categorization method has utility when attempting to distinguish between generalist and specialist ASOs (Seto & Pullman, 2014). Additionally, further classification of ASOs was attempted using a well known juvenile delinquency classification scheme, early-onset versus late-onset offenders (Moffitt, 1993). The current study was an archival analysis of clinical files from a sample of 158 male ASOs seen for clinical assessment at a Metropolitan Family Court Clinic. Results indicate that sex-plus offenders are more antisocial, exhibit more psychiatric issues, and have greater deficits in general social skills compared to sex-only offenders. Conversely, sex-only offenders were found to have more atypical sexual interests, and were more likely to have greater deficits in romantic relationships compared to sex-plus offenders. Due to a power related limitation, little support was found for the use of the early-onset versus late-onset classification scheme with ASOs. Overall, these results provide further support to the validity of a sex-only versus sex-plus distinction. Given these results mirror those found in the generalist/specialist literature regarding the etiology of ASOs, sex-only and sex-plus offenders may indeed have different etiological pathways: sex-plus offenders are more driven by general antisociality factors, as the generalist perspective suggests, and sex-only offenders are more driven by special factors, as the specialist explanations suggest.