A brief history of behavioral and cognitive behavioral approaches to sexual offenders: Part 1. Early developments.

This is the first of two papers which briefly outline the development of behavioral and cognitive behavioral treatment of sexual offenders from the mid-1800s to 1969. We first consider the historic role of Sigmund Freud and note that a broad scientific interest in deviant sexual behaviour was well established by 1900. In the early to mid-20th century, two psychologies were prominent in the development of behaviorial approaches, those of John B. Watson and Alfred Kinsey. Behavior therapy for a variety of problems emerged in the 1950s and soon found application to deviant sexuality. The development of penile plethysmography helped to focus interest on deviant sexual preference and behavior. While nonbehavioral approaches to sexual offenders paralleled these developments, a combination of behavioral and cognitive behavioral treatments began to emerge in the late 1960s which ultimately developed into the approaches more commonly seen today.

A brief history of behavioral and cognitive behavioral approaches to sexual offender treatment: Part 2. The modern era.

This paper is the second in our attempt to highlight the major influences, trends, and emerging issues in cognitive behavioral approaches to treating sexual offenders. In this paper the developments from 1970 until the present are covered.

Olfactory aversion: notes on procedure, with speculations on its mechanism of effect.

The use of a self-administered noxious agent to suppress deviant sexual arousal is the focus of this paper. A recommended procedure for the use of olfactory aversion is described. Data from two publications by the author, wherein different noxious agents had been used, are presented and discussed. Several explanations for the mechanism of effect in olfactory aversion have been offered. Two of these, one using a nausea-producing agent and one using a pain-producing agent are described. The procedure using the pain-producing agent is the simplest to implement, the least ambiguous, and offers the least cumbersome explanation for the behavioral effect observed in olfactory aversion. However, a conditioning explanation is probably too simple. Several examples of cognitive mediation in conditioning procedures are presented and discussed.

Harm reduction or harm facilitation? A reply to Maletzky.

The concept of harm reduction applied to sexual offending is very upsetting to some clinicians. This paper attempts to anchor harm reduction within the larger framework of relapse prevention. It is argued that reducing harm more accurately represents what clinicians do with sexual offenders rather than preventing or eliminating relapses. There are numerous common misconceptions about harm reduction with sexual offenders and explanations are provided for each of these. Finally, it is argued that harm reduction acknowledges that sexual abuse and all forms of interpersonal violence are actually public health issues. Adoption of this viewpoint, however, requires acceptance of a more humanistic perspective rather than a medical, psychological, legal, or political solution to a grievous social problem.

Validity of physiological measures of pedophilic sexual arousal in a sexual offender population: a critique of Hall, Proctor, and Nelson.

It is argued that methodological problems in Hall, Proctor, and Nelson's (1988) comparison of phallometric data on child molesters and rapists include confounding of stimulus category and duration, omission of neutral stimuli and a normal control group, failure to employ relative measures of sexual preference, and failure to exclude subjects who did not respond to the sexual stimuli. Quinsey and Laws maintain that, although these methodological problems preclude accepting the conclusions drawn in Hall et al.'s article, the problems illustrate the need to develop common methodological standards for phallometric research on sexual offenders.

Sexual fantasy alternation: procedural considerations.

Leonard and Hayes (1983) reported several clinical trials of the sexual fantasy alternation procedure, a form of orgasmic reconditioning. Due apparently to unfamiliarity with several essential components of the procedure, their results were equivocal and they questioned the clinical utility of the technique. In this report the Leonard and Hayes study is evaluated on the issues of subject selection, evaluation of pre-treatment baseline data, prediction for direction and magnitude of effect, mechanisms of effect and ethical concerns. It is concluded that, if clinicians respect certain basic conventions, the sexual fantasy alternation procedure is considerably more orderly than the authors believe.

A comparison of the measurement characteristics of two circumferential penile transducers.

The measurement characteristics of two transducers which record penile circumference changes were compared. The subject wore two transducers simultaneously while viewing a section of an erotic film. Examination of the data revealed discrepancies in measurement between the two units, but these differences were shown to be statistically nonsignificant. Various measurement characteristics of the devices such as durability, ease of handling, and cost are discussed and recommendations are made to guide the worker in choosing a unit most suitable for clinical and research applications.

Plasma testosterone levels in the rapist.

Plasma testosterone level was measured in 52 rapists and 12 child molesters who had completed the Buss-Durkee Hostility Inventory, the Megargee Overcontrolled Hostility Scale, and the Michigan Alcoholism Screening Test. The rapists were classified according to the degree of violence during the commission of the rape. The ranges and means of the plasma testosterone level for the rapist and child molester controls were within normal limits. The group of rapists who were judged to be most violent had a significantly higher mean plasma testosterone level than normals, child molesters, and other rapists in this study. Mean Buss-Durkee hostility rating scores for rapists were significantly higher than the mean for normals, but there was no correlation between individual hostility scores and plasma testosterone levels. There was no correlation between age, race, or length of incarceration and plasma testosterone level.

A comparison of students studying-behavior produced by daily, weekly, and three-week testing schedules.

Time spent in contact with academic course materials as a function of two testing schedules was measured using college undergraduates in an introductory educational psychology course. A within-subject (ABAB) design was employed with all subjects to allow for both individual and group analyses. A study room equipped with an adjacent observation room enabled visual and auditory monitoring of student study behavior. Academic materials were exclusively available to students in the study room and records of durations and distribution of student study time were made by an observer behind a one-way mirror. Daily testing produced consistent duration of study behavior with regular attendance at the study room; weekly and three-week testing produced sporadic bursts of study behavior and frequent instances of non-attendance. The amount of study behavior occurring in weekly and three-week testing conditions increased as the test time drew near (scalloping). Results suggest that daily testing supports more consistent study patterns than do the two larger intertest intervals investigated.

Instructional control of an autonomic sexual response.

Four of seven human male subjects developed full penile erections when exposed to erotically stimulating motion pictures. Changes in penile size were detected by a mercury strain gauge transducer and automatically recorded on a continuous paper record. When instructed to inhibit penile erection in the presence of such effective stimulus films, every subject was able to reduce his erection by at least 50%. This inhibition was apparent as long as the instructions were in effect; when the instructions were removed and the film reshown, the erection returned almost to its maximum state. This was true whether the films were presented as few as three or as many as nine times in succession. When instructed to develop an erection in the absence of a film, every subject was able to do so, each reaching a peak of about 30% of his maximum. Such erections had longer latencies to the peak produced and lower maximum levels than those elicited by a film.

Social facilitation of responses during a stimulus paired with electric shock.

Key-pecking responses of a pigeon were maintained by a variable-interval schedule of food reinforcement. The responses were suppressed during the occasional presentation of a warning stimulus paired with electric shock. The presence of a second pigeon emitting the same response for food reinforcement reduced the suppression that otherwise occurred during the warning stimulus when the second pigeon was absent. These results reveal that the social facilitation phenomenon can be used to restore behavior that is suppressed by a conditioned aversive stimulus.