From inner-city mean streets to serene suburban cul-de-sacs, from bar stools to pulpits, and from state houses to the state prisons, sex offenders uniformly inspire fear and loathing. On occasion, rapists, child molesters, and their ilk also stir up unexpected irony. Consider this turn of events. On June 9, scientists and clinicians from throughout North America ended a 3-day meeting in Washington, D.C., where they discussed the state of knowledge about sexually coercive acts.
Although intriguing lines of research were described, conference participants readily admitted their ignorance about crucial issues. There was no consensus on what causes individuals to become sexual criminals, how best to predict which of them will offend again after release from prison, or even whether current treatment programs for sex offenders are effective.
Fair enough. On June 10, however, the Supreme Court begged to differ. Prison-based rehabilitation programs for sex offenders work so well, the high court ruled, that states can impose penalties on convicts who refuse such treatment.
The 5-to-4 decision addressed the case of Robert G. Lile, a convicted rapist who wouldn’t enter treatment in a Kansas prison because the program, which has served as a model for prisons in more than a dozen other states, requires men to admit in writing to past offenses. Lile sued prison officials, citing his constitutional right against self-incrimination.
The Supreme Court’s majority opinion stated that once a man is in prison, he can’t claim protection from self-incrimination. Thus, prison rehabilitation programs can require him to accept responsibility for past crimes in the name of changing his behavior.
Legal pronouncements of this sort can’t wipe away scientific uncertainty about sex offenders and potential treatments, though. It doesn’t help that little is known about the mental and biological development of sexual desire in law-abiding citizens, notes psychologist Robert A. Prentky of the Justice Resource Institute in Bridgewater, Mass. Prentky organized the June conference, which was sponsored by the New York Academy of Sciences.
The small number of researchers trying to understand sexual offenders responds far more to sensational crimes and events, such as the scandal over sex abuse by members of the Catholic clergy or the particulars of a horrific case in the news, than to a systematic agenda for studying sexual development, Prentky says.
“This is a young, difficult, sensitive, controversial area of science,” remarks psychologist Jim Breiling of the National Institute of Mental Health in Bethesda, Md.
Researchers agree that no one becomes a rapist or a child molester without earlier influences. One challenge is to delineate the psychological developments that usher men toward such acts. Researchers generally don’t study the much smaller number of female sex offenders.
The work of psychologist Neil M. Malamuth of the University of California, Los Angeles has focused attention on two personality characteristics that may set men up to become sexually aggressive and, ultimately, to rape.
Malamuth and his coworkers discovered this pair of attributes in groups of college men who found rape acceptable. These men say that they would carry out acts of forced sex and rape if no one would ever find out about it and they wouldn’t be punished. This attitude about rape also appears in many convicted rapists, Malamuth found in earlier work.
He refers to the first characteristic he identified in the college group as hostile masculinity. It includes self-centered arrogance, manipulation and force in dealing with women, unusually high sensitivity to rejection by women, use of sex to achieve dominance, and lack of empathy.
The second characteristic is a penchant for having impersonal sex with one partner after another. The students who approach sex in this assembly-line fashion often report being nonconformists, having been exposed to family violence as a child, and having had early sexual experiences.
In contrast, psychologist Raymond Knight of Brandeis University in Waltham, Mass., identifies three different psychological factors in his studies of rape-inclined college men and convicted rapists. He finds that these men typically describe themselves as highly impulsive, emotionally callous toward others, and consumed by sexual thoughts and promiscuity, says Knight.
The research by Malamuth and Knight shows promise, comments psychologist Mary P. Koss of the University of Arizona in Tucson. “By fostering hostility toward women and a need for impersonal sex, a boy’s family environment might flip the switch toward a pursuit of sexually coercive behaviors,” says Koss.
Many questions remain about what makes someone become a sex offender. Hostile masculinity and a sex life devoid of intimacy may stem from a single trait known as psychopathy, says psychologist Marnie E. Rice of Canada’s Mental Health Center in Penetanguishene, Ontario. People who score high on psychopathy scales ruthlessly pursue self-gratification by manipulating and deceiving others without a shred of remorse. Psychopaths break the law in many ways, from theft and stalking to rape and murder.
However the psychological models shake out, attention-deficit hyperactivity disorder (ADHD) appears to play a largely unappreciated role in the lives of sex offenders, according to psychiatrist Martin P. Kafka of McLean Hospital in Belmont, Mass. “I’ve treated about 700 sex offenders, and the guys with ADHD invariably have the highest sex drives,” Kafka says.
Many of these men weren’t diagnosed with ADHD until adulthood. Kafka suspects that they received much punishment during childhood for their impulsiveness, inattention, and inability to sit still.
Knight also sees evidence for a link between ADHD and sex offending. More than half of the men in his studies had previously received ADHD diagnoses.
Although convicted sex offenders raise justifiable concerns about public safety, studies indicate that many of them don’t return to their criminal ways. Researchers are attempting to come up with statistical tools that courts can use to decide who should stay behind bars and who should go free.
Data from several long-term studies of 4,724 sex offenders released from prisons in the United States and Canada after 1980 show that after 10 years, one in five had been arrested for a new sexual offense, says psychologist R. Karl Hanson of the Department of the Solicitor General of Canada in Ottawa. After 20 years, that figure rose to slightly more than one in four. Among men who had victimized children in their own families, an even lower fraction–about 1 in 10–committed a new sexual offense during the first 20 years after release from prison.
Hanson, however, estimates that close to half the released sex offenders eventually commit another sex crime. “Most of their offenses are never reported to the authorities,” he says.
In the legal world, however, overall reconviction rates count for little. Courts ask mental-health clinicians for opinions on whether a particular sex offender remains dangerous enough to keep in prison or to commit to a psychiatric hospital. Since 1990, 16 states have passed laws permitting courts to send men deemed to be “sexually violent predators” to psychiatric facilities against their will after discharge from prison. The Supreme Court has upheld such laws.
A growing number of scales that measure a sex offender’s risk for committing further crimes appear to be superior to clinicians’ judgments, Hanson remarks.
Studies of the predictive accuracy of 10 such scales have been conducted so far. These scales assign varying mathematic weights to concrete aspects of an offender’s past crimes, such as the number of offenses, age of victims, and whether victims were family members.
All the scales do significantly better than clinicians do at identifying sex offenders who later reoffend, Hanson says. A small number of mental-health workers, however, tag future offenders more accurately than others do, so some people wield a special expertise in this area that has yet to be plumbed by researchers.
Additional data may boost the power of predictive scales, Hanson adds. Such information might include a man’s marital status, whether he becomes sexually aroused when looking at pictures or hearing recordings depicting rape, and the presence of psychiatric conditions, such as antisocial personality disorder.
There’s tremendous pressure for clinicians to devise treatments that turn sex offenders into law-abiding citizens. However, research has yet to show more than a modest advantage for current treatments over simply leaving sex offenders alone, Prentky says.
“It’s devilishly hard to identify treatment-related changes in a person’s risk for committing sexual offenses,” Hanson asserts.
Consider a combined analysis, directed by Hanson, of 15 earlier studies that had tracked a total of 3,016 sex offenders released from prison. After an average of 4 to 5 years, 10 percent of those who had completed any rehabilitation program had been arrested for another sex offense, compared with 17 percent of those who had received no treatment.
That’s a much smaller advantage for the treated group than either researchers or clinicians would like.
Psychologist Grant Harris of Canada’s Mental Health Center is unconvinced of even that minor difference. The investigations considered by Hanson overestimate treatment effects, in Harris’ view. In studies he examined, the prisoners who had received treatment had acknowledged their crimes, an admission that already lowered their likelihood of reoffending, he says. Members of comparison groups had explicitly refused treatment and usually denied having committed any crimes, making them poorer prospects for behavior change.
There’s another side to that coin, Harris adds. Psychopathic sex offenders often deceive clinicians into thinking that they’ve benefited from treatment so that they can be released from prison, and then they commit more sex crimes. “It’s possible in our business to do harm,” Harris says.
There’s no standard form of treatment for sex offenders. Psychologically oriented programs use individual and group therapy to teach men to think about sex and intimacy in new ways. Another approach employs structured group encounters, without therapists, among sex offenders and former offenders. These groups try to break through denials and rationalizations about past crimes.
The few psychiatrists involved in sex-offender treatment also prescribe medications that dim sexual desire or motivation. One class of drugs blocks activity of the male sex hormone, testosterone. Others boost the brain’s transmission of the chemical messenger serotonin. For the latter group of drugs, the decreased sexual desire is regarded as an unwanted side effect in their most common use–for depression.
While the scientists have little information about the factors underlying sexual offenses or treatments for sexual offenders, the legal world seems intent on taking action. In its next term, the Supreme Court will rule on the constitutionality in two states of so-called Megan’s laws, which require community notification of the backgrounds and addresses of released sex offenders.
In the Name of God
Surveys widen scope of religious abuse
Revelations of long-standing sexual abuse of children by priests, and the sheltering of these men by their bishops, have rocked the Catholic church. This isn’t just a Catholic problem, though. “Catholic priests do not have a corner on the child-abuse market,” says Bette L. Bottoms of the University of Illinois at Chicago. “Physical and sexual abuse is perpetrated by religious authorities of various faiths.”
Bottoms bases her argument on two national surveys that she directed. Data from 2,136 mental-health professionals, published in 1995, include descriptions of 417 cases of church-related child abuse that had been reported to the clinicians by their clients. Most cases included corroborating evidence, such as admissions of guilt by perpetrators when confronted by their victims. In her more recent survey, responses came from officials at more than 400 police agencies, district attorney’s offices, and social service agencies. Bottoms will present those findings at a scientific meeting in August.
Although reports of sexual abuse most often concerned priests, abusers could also be nuns, ministers, rabbis, native healers, and authority figures in other religious groups. Priests had sexually abused both boys and girls, Bottoms says.
It’s thus unlikely that homosexual preferences lie at the root of priests’ sexual misconduct, in her view.
Reports of sexual abuse were no more common overall than those of nonsexual abuse, Bottoms finds. These include withholding medical care for religious reasons and inflicting severe physical punishments purported to rid a child of evil. Many childhood or adolescent victims of both sexual and nonsexual crimes were adults before they first reported the abuse.
In contrast, the surveys uncovered no child abuse by satanic cults, a practice that received much publicity a few years ago. “More children are abused in the name of God than in the name of Satan,” Bottoms contends.