A diagnosis of exclusive pedophilia and scores on the VRS:SO can reliably discriminate higher from lower risk sex offenders. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.
Featured Article | Law and Human Behavior | 2015, Vol 39, No. 6, 571-580
Predicting Reoffense in Pedophilic Child Molesters by Clinical Diagnosis and Risk Assessment
Reinhard Eher, Federal Evaluation Center for Violent and Sexual Offenders, Vienna, Austria, University of Ulm
Mark E. Oliver, University of Saskatchewan
Isabelle Heurix, Federal Evaluation Center for Violent and Sexual Offenders, Vienna, Austria
Frank Schilling, Federal Evaluation Center for Violent and Sexual Offenders, Vienna, Austria
Martin Rettenberger, Johannes Gutenberg-University Mainz and Centre for Criminology, Wiesbaden, Germany
A Diagnostic and Statistical Manual of Mental Disorders (DSM)– based diagnosis of pedophilia has so far failed to predict sexual reoffense in convicted child molesters, probably because of its broad and unspecific conceptualization. In this study, therefore, we investigated the prognostic value of the subtype exclusive pedophilia and a series of customary risk assessment instruments (SSPI, Static-99, Stable-2007, VRS:SO) and the PCL-R in a sample of prison released pedophilic sexual offenders. First, we examined the convergent validity of risk assessment instruments (N 261). Then, we calculated the predictive accuracy of the measures and diagnosis for sexual recidivism by ROC analyses and subsequent Cox regression (N 189). Also, predictive values with more clinical immediacy were calculated (sensitivity, specificity, PPV and NPV). The VRS:SO, the SSPI, and the Static-99 significantly predicted sexual recidivism, as did a diagnosis of exclusive pedophilia. Also, the VRS:SO predicted sexual reoffense significantly better than the Stable-2007, the Static-99/Stable-2007 combined score, and the PCL-R. When used combined, only the VRS:SO and a diagnosis of exclusive pedophilia added incremental validity to each other. Our findings support that the clinical diagnosis of an exclusive pedophilia based on DSM criteria and VRS:SO defined risk factors can reliably discriminate higher from lower risk offenders, even within the select subgroup of pedophilic child molesters.
Pedophilia, risk assessment, VRS:SO
Summary of the Research
“Contemporary research and clinical practice underscores the importance of discerning subgroups of child molesters on the basis of an underlying pedophilic preference. Indeed, prior meta-analytic reviews (e.g., Hanson & Bussière, 1998) have identified pedophilia, as with other paraphilias, to be an important marker of sexual re-offense risk. Closer scrutiny of primary sources included in past reviews, however, reveals that operationalizations of pedophilia are frequently inconsistent and unclear, while the magnitudes of association between clinical diagnoses of pedophilia and recidivism are often far from compelling” (p. 571).
“In light of the extant findings reviewed, it would be conceivable that a broad diagnostic category such as the presence or absence of a DSM diagnosed pedophilia would have little predictive value among child molesters, and instead, that measures of deviance and other relevant risk factors would hold the greatest prognostic promise. Although we acknowledge the necessity of diagnosing child abusers by DSM criteria, it is crucial for risk assessment to incorporate risk factors specifically known for the subgroup of pedophiles. And while the predictive validity of various operationalizations of pedophilia have been examined with respect to sexual violence, to our knowledge, no study to date has examined the validity of individual risk factors among the subgroup of pedophilic child sexual abusers” (p.573).
The present study consisted of a sample of 261 adult male child sex abusers that fit the criteria for a DSM-IV-TR diagnosis of pedophilia and who were evaluated between 2002 and 2011 at an Austrian prison. These participants represented a “subsample of child sex abusers with one or more hands-on sexual offenses against minors aged 14 years or under” (p. 573). Re-offense data were collected from participants’ criminal histories and were analyzed by a forensic psychologist who was kept blind to the purpose of the study.
Instruments used to assess risk of sexual re-offense were: a DSM-IV-TR diagnosis of pedophilia, a diagnosis of exclusive pedophilia, the Screening Scale of Pedophilic Interests (SSPI), the Psychopathy Checklist-Revised (PCL-R), the Static-99 and Static 99-R, the Stable-2007, and the Violence Risk Scale: Sexual Offender Version (VRS:SO).
The data first measured the convergent validity of the risk assessment instruments and then examined the predictive accuracy of the measure for sexual recidivism along with the clinical diagnosis of exclusive pedophilia.
Results indicated that the VRS:SO, Static-99-R, SSPI and a diagnosis of exclusive pedophilia all significantly predicted sexual recidivism. Further, the VRS:SO predicted sexual re-offense significantly better than the Stable-2007 and the combined score of the Staict-99/Stable-2007. “Also, both the VRS:SO static and dynamic score, as well as the VRS:SO total score were significantly better in predicting sexual re-offense than the PCL-R” (p.575).
The most accurate predictor of sexual recidivism was the combined score of the VRS:SO and a diagnosis of exclusive paraphilia. Both instruments, and the VRS:SO independently, were more likely to reliably discriminate higher from lower risk offenders, even within the subgroup of pedophilic child molesters.
Translating Research into Practice
“The present findings offer preliminary support for the capacity of clinical assessments of pedophilic men to discriminate higher risk from lower risk men, even within this select subgroup of pedophilic offenders. Among the instruments examined, the VRS:SO demonstrated particularly strong predictive accuracy for sexual recidivism, including an independent and incremental contribution for this outcome over and above the diagnosis of exclusive pedophilia. This study serves as an international replication and independent validation of the VRS:SO in a sample of Austrian pedophilic child molesters. Building on the results of Beggs and Grace (2010) in a New Zealand sample, the results thus provide support for the validity and reliability of this tool in another international jurisdiction” (p.579).
Other Interesting Tidbits for Researchers and Clinicians
“Future research will hopefully examine changes in VRS:SO ratings and their relationship to possible changes in recidivism in a treated sample within our jurisdiction. Such an examination, in turn, will further inform to what extent the assessment and treatment integration functions of the tool are realized in such a sample and setting (p.579).
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Authored by Sarah Hartigan
Sara Hartigan is a second year Forensic Psychology Master’s student at John Jay and hope to obtain a Ph.D. in Clinical Forensic Psychology in the future. My main areas of interest include clinical evaluations and developing treatment interventions within the forensic population.