ارزیابی خطر جنسی برای افراد دارای معلولیت ذهنی
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|35153||2010||صفحه PDF||سفارش دهید||5520 کلمه|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Research in Developmental Disabilities, Volume 31, Issue 3, May–June 2010, Pages 760–767
Given that sexually offensive behavior on the part of people with intellectual disabilities has been identified as a significant problem, we developed a risk assessment questionnaire, that takes not only various static and dynamic factors into account but also environmental risk variables. Psychologists and staff members completed this Risk Inventarization Scale on Sexually Offensive Behavior of Clients with Intellectual Disabilities for 56 intellectually disabled clients with sexually offensive behavior problems. The scale contains static client variables (rated using two- or five-point likert scales and open questions) and both dynamic client and environmental variables (rated using a five-point likert scale). Factor analyses of the dynamic client and environmental variables revealed three subscales: quality of supervision, offending behavior and emotional and social stability. Reliability analyses showed sufficient to good reliability for both the total scale (r = 0.82) and the identified subscales (quality of guidance r = 0.94; offending behavior r = 0.75, and emotional and social stability r = 0.58). Correlational analyses of the quality of guidance subscale showed high positive correlations with such static variables as values and norms, living conditions, and criminal offenses in early youth. Because both dynamic and environmental variables can be altered, the implications for treatment of the sexually offensive behavior of clients with intellectual disabilities are discussed further.
Historically, societal ignorance and denial of sexuality in people with an intellectual disability (ID) have resulted in minimal or lack of treatment for sex offenders with an ID (Timms & Goreczny, 2002). The prevalence of sexual offense among people with an ID has been found to range from 4% to 40% (e.g., Gross, 1985 and Walker and McCabe, 1973). With respect to recidivism Klimecki, Jenkinson, and Wilson (1994) have found a rate of 41.3% among offenders with an ID. The rates of prevalence and recidivism for sex offenders with an ID vary and are hard to predict, caused by different definitions of the sexual behavior, respondents and settings (Lindsay, 2009). Given that sexually offensive behavior on the part of people with ID has been identified as a significant problem, an increased research emphasis has been placed upon sexual offenders with IDs over the past few years. Recent research among intellectually disabled sex offenders has shown appropriate assessment to be an important facet of their management and treatment (Keeling, Beech, & Rose, 2007). Specifically, the identification of predictors of recidivism appears to be crucial for the identification of appropriate and effective treatment (Andrews & Bonta, 1998). The predictors of recidivism for sexual offenders in general typically fall into two categories of factors: static versus dynamic risk factors. Examples of static factors that have been found to contribute to sexual recidivism are ID, deviant sexual experiences, antisocial behavior, impulsivity, high sexual arousal, and sexual preoccupation. Examples of dynamic factors that have been found to contribute to sexual recidivism are the presence of cognitive distortions, poor social skills, deviant sexual fantasies, and low levels of empathy. Whereas static risk factors are believed to be characteristics that cannot be altered or changed (Harkins & Beech, 2007), dynamic risk factors are believed to be more responsive and amenable to intervention and are therefore typically the focus of treatment (Beech et al., 2002 and Harris and Tough, 2004). With respect to the population of sex offenders with an ID, studies have indeed shown static risk factors to contribute to sexually offense (e.g., Day, 1994, Lambrick and Glaser, 2004 and Lindsay, 2002). Other studies have shown dynamic risk factors such as relationship difficulties, communication difficulties, deviant sexual interests, and susceptibility to the influence of others to contribute to sexual offense among the population of intellectually disabled sex offenders (e.g., Caparulo, 1991, Fortune and Lambie, 2004 and Lindsay et al., 1999). Comparative studies of sex offenders who are intellectually disabled or not show sexual offenders with an ID to be less likely to know their victims than sexual offenders with no ID (Day, 1994). Intellectually disabled sex offenders are also more likely to commit different types of offenses with different types of victims than those who are not intellectually disabled (Lindsay, 2002). Sex offenders with an ID have been found themselves to have suffered more sexual and physical abuse when compared to sexual offenders with no ID; they also have deficits in a number of areas of psychological functioning including social and attention problems (Fortune & Lambie, 2004). Other comparative studies show a tendency for both to be impulsive ( Parry & Lindsay, 2003), both to be involved in a range of delinquent behaviors and non-sexual offenses in addition to sexual offenses, and substance abuse to be a common activity for both ( Fortune & Lambie, 2004). In order to identify clear predictors of recidivism among sex offenders who are known to have an ID, several authors have developed actuarial risk measures. Most of the risk measures are a modification of guidelines for the assessment of mainstream sex offenders (Wilcox, 2004): the Sex Offender Risk Appraisal Guide (SORAG) (Quinsey, Harris, Rice, & Cormier, 1998), the Rapid Risk Assessment for Sex Offender Recidivism (RRASOR) (Hanson, 1997), the Static-99 (Hanson & Thornton, 1999), and the Sex Offender Need Assessment Rating (SONAR) (Hanson & Harris, 2001) that takes both static and dynamic factors into account. The aforementioned measures have been used in several studies with sex offenders with ID and most of them (i.e., the SORAG, RRASOR, and Static-99) have been shown to successfully predict both general and sexual recidivism (Lindsay & Beail, 2004). As the level of functioning of the offender becomes lower, risk assessment may also include environmental risk variables. Attention has only recently been devoted to the influence of these environmental variables and, in particular, so-called environmental allowance of offensive behavior on the part of intellectually disabled sex offenders (Lindsay et al., 2004 and Taylor et al., 2003). Boer, Tough, and Haaven (2004) have identified several environmental risk factors including attitudes towards intellectually disabled sex offenders, communication among supervisory staff, monitoring of the offender by staff, and victim access. The main purpose of our study was to develop and evaluate the internal consistency of a risk assessment questionnaire, the RISC-V, that takes not only various static and dynamic factors into account but also environmental risk variables. The questionnaire was administered to a relatively large sample (n = 56) of direct-care staff members and psychologists working in a residential facility with intellectually disabled clients with sexually offensive behavior problems. Next to this, a component analysis was conducted to investigate the structure underlying the data and for purposes of data reduction. Finally, we explored associations between various dynamic client and environmental risk variables and the static characteristics (age, sex, living conditions, employment conditions, cognitive level of functioning, social–emotional level of functioning, extent of internalized values and norms, psychiatric disorders, sexually offensive behavior, violence (during abuse), other criminal acts (i.e., behavior not allowed by law), previous contact with the police, convictions, criminal offenses in early youth, most recent abuse, consequences of most recent abuse, abuse of children, abuse of women, abuse of men, self-victim of sexual abuse in the past, and self-victim of physical abuse in the past) of the intellectually disabled clients with sexually offensive behavior.
نتیجه گیری انگلیسی
In the present study, the reliability of the RISC-V, a questionnaire that takes not only static and dynamic client variables into account but also environmental risk variables, was evaluated for 56 intellectually disabled clients with sexually offensive behavior. The environmental risk variables were derived in part from research by Lindsay et al. (2004) and Boer et al. (2004) and in part from the expertise of three clinicians with extensive experience in the area of the diagnosis and treatment of intellectually disabled people with sexually offensive behavior. A component analysis of the dynamic client and environmental variables revealed three different subscales, namely quality of supervision, offending behavior, and emotional and social stability. Overall, the RISC-V was found to have a moderate to good internal reliability. The subscales also showed moderate to good reliabilities, and the quality of supervision subscale was found to be highly reliable. Furthermore, we explored associations between, on the one hand, the dynamic and environmental variables and, on the other hand, the static characteristics of the clients with sexually offensive behavior. Three of the static characteristics discriminated particularly well among the intellectually disabled clients with sexually offensive behavior studied here: internalized values and norms, living conditions, and criminal offenses in early youth. Given that most sexual offenders with ID have a history of institutionalization (Brown & Stein, 1997) the static characteristic ‘living condition” is important. Earlier studies of Worling and Cruwen (2000) showed that recidivism rates of treatment groups were significantly lower than that of the same sample who where only assessed, dropped out or refused treatment. However, in our study no association was found between the living condition and offending behavior, but there was an association between living condition and quality of supervision: clients who undergo regular treatment were associated with higher scores on quality of supervision compared with clients who undergo intensive treatment. Poor quality of supervision is an unexpected result given the expertise that we would expect on these latter groups. The results for the variable offenses committed in early youth are consistent with the results of an earlier study of Seghorn and Ball (2000); they have outlined some of the areas requiring assessment in relation to sexual offenders. With respect to intellectual disabled sex offenders they recommended, next to interpersonal and communication skills, that a criminal history and a sex offense history are both important elements for the assessment of sex offenders with ID. Also other researchers (Lindsay, 2002 and Thompson and Brown, 1997) suggest that developmental adversities associated with the onset of sexual offense behavior such as trauma, disruption of attachment bonds and family dysfunction are also features of the life histories of sexual offenders with ID. In our study traumatic events such as self-victim of sexual abuse or physical abuse in the past did not significant differed across the subscale offensive behavior. Finally, clients with lower levels of internalized values and norms showed more offensive behavior, compared with clients with a higher level of internalized values and norms, prior sexual abuse of the sex offender him/herself. Van Vugt et al. (2008) compared the moral development of solo juvenile male sex offenders without ID and juvenile maile non-offenders without ID. Although no differences in moral judgement were found, a delay in moral judgement proved to be associated with cognitive distortions.