Sexual Violence
:
Bill Holcomb
:
Sexual Violence
:
Hogrefe Publishing
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9781616763336
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1
:
CHF 19.80
:
:
Angewandte Psychologie
:
English
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102
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Wasserzeichen/DRM
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PC/MAC/eReader/Tablet
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PDF
This book presents both a compact summary of the voluminous research on sexual violence and a practical, evidence-based 'how-to' treatment guide for mental health practitioners working in clinics and institutions that treat men who are sexually coercive and violent toward others. Those needing intervention may be college students, individuals seeking outpatient help, family batterers, or those who sexually abuse women and children. They may have been arrested for sex crimes or be incarcerated or on probation in sex offender treatment program, though most will never have been arrested. This clearly written and well-structured resource will help clinicians deal with all. The book first reviews research on the prevalence of sexually abusive behavior, along with diagnostic issues, assessment strategies, and risk assessment approaches, and then presents current integrated theories on the causes of sexually violent behavior. The primary focus, however, is the specific emotional and behavioral targets of treatment and the therapist skills and strategies that are effective in reducing sexual victimization. Cultural factors that influence treatment are identified and effective prevention programs for sexual violence are also described and evaluated.
2.2 A Comprehensive Model of Prediction
A weakness in the development of the HMC model, according to Knight and Sims-Knight (2003), is that the testing of the model did not include good measures of developmental antecedents or delinquency. Knight and Sims-Knight (2003) have used the Multidimensional Assessment of Sex and Aggression (Knight, Prentky,& Cerce, 1994) with different populations of criminals, noncriminals, and juveniles to test Malamuth’s model. They propose that prediction of violent sexual behavior by three paths better accounts for sexual aggression compared to the two paths in the HMC model. These three paths could be described as:
1. Sexual drive/preoccupation;
2. Antisocial behavior;
3. Callousness/unemotionality.
The major contribution of this modal is the further clarification of early child antecedents of these three paths. In this model, physical /verbal abuse contributes directly to antisocial behavior and to callousness/unemotional responsiveness that indirectly also contributes to antisocial behavior, which then leads to sexual coercion. Sexual abuse in childhood has a separate influence on sexual coercion through sexual fantasies and aggressive sexual fantasies (the sexual drive/preoccupation path). Sexual abuse in childhood becomes more salient as a precursor of sexual preoccupation if certain sexual abuse factors are present in the coercive person’s early history. These factors include degree of penetration, amount of coercive force, number of perpetrators, and age of sexual abuse.
2.3 An Integrated Theory of Sexual Offending
One more comprehensive theory of sexual coercion is important to mention. Ward and Beech (2008) have described their Integrated Theory of Sexual Offending (ITSO). This theory proposes a network of causal factors including biological, ecological, and basic core neuropsychological systems. The biological influences include genetics and evolutionary mechanisms. The ecological niche factors involve social learning influences from cultural and personal circumstances, and the physical environment. Neuropsychological functioning is a third factor that influences motivation and emotions, behavioral controls, action selection, and perception, and memory. Thus, genetics, social learning, and neuropsychological functioning all interact to lead to sexual offending with accompanying, deviant arousal, offense-related thoughts and fantasies, negative or positive emotional states, and social difficulties.
The social learning experiences of the sexually coercive individual are of special interest. Ward and Beech (2008) refers to this component as the ecological niche. The ecological niche of a person is the set of potentially adverse personal circumstances, cultural influences, and physical environments that the person experiences. The psychological system of the person is set by these biological and social learning experiences. Ward and Beech (2008) describe both distal and proximal influences. Once psychological vulnerabilities are acquired, the person will have the propensity not to cope well with environmental stresses. For example, the effects of childhood sexual abuse can lead to psychological disorders and alcohol and substance abuse. In addition, the long-term effects of sexual victimization can include disturbed adult sexual functioning, poor social adjustment, confusion over sexual identity, and inappropriate attempts to reassert masculinity with the potential for abusing others. Also, the experience of war can contribute to the diminution of behavioral controls (Henry, Ward,& Hirshberg, 2004).
At the heart of this theory is the recognition of the importance of neuropsychological functioning. The neuropsychological functioning of a person has direct influence on motivational/emotional responses, action selection, control systems, and perception and memory. Some of the dynamic variables that have been linked to sexual offending are seen as difficulties of motivation/emotion expression that are controlled by the cortical, limbic, and brainstem structures of the brain. For example, someone brought up in an impoverished environment may have difficulties identifying his emotions and the emotions of others, especially in stressful situations. This may contribute to the development of antisocial or aggressive behavior. This person may also not have developed the social skills necessary to establish strong interpersonal relationships, and as a result may have significant intimacy skills and attachment problems. Behavioral controls and action selection are associated with the functioning of the frontal cortex, the basal ganglia, and parts of the thalamus. Characteristics seen with sex offenders could be seen as deficits in selfmanagement and self-regulation that are influenced by these brain structures. Some of these deficits include impulsivity, failure to control the expression of negative emotions, not being flexible with adjusting plans based on changing circumstances, and poor problem-solving skills.
Other important areas of perception and memory are influenced by the hippocampal formation and the posterior neocortex. Disturbances in memory and perception can lead to maladaptive cognitions and beliefs and inappropriate interpretation of social interactions. These faulty perceptions and distorted memories can then serve as filters of social information. Some researchers have identified stable dynamic indicators such as cognitive distortions as precursors of sexual offending (Hanson& Harris, 2000; Thornton, 2002).
2.4 A Theory of Interacting Proximal and Distal Predictive Factors
It appears that Ward and Beech’s theory (2008) is built on the early theorizing of Marshall and Barbaree (1990). In this modal, sexual abuse of children occurs because of the interacting of proximal and distal factors. Adverse happenings in early childhood have an important influence on later sex offending. These adverse advents include poor parenting, inconsistent and harsh discipline, and physical and sexual abuse. These adverse events lead to distorted internal psychological modals used by the person. These distortions lead to inadequate understanding of relationships, especially with regard to sex and aggression, which i
Acknowledgments
6
Dedication
6
Table of Contents
8
1 Description of the Problem
10
1.1 Definition
11
1.2 Epidemiology
12
1.3 Effects of Sexual Violence on Victims
13
1.4 Sexual Coercion in the Community
14
1.5 Course and Prognosis of Sexual Violence
17
1.5.1 Differences Between Sexually Violent Persons
17
2 Theoretical Models to Explain Sexual Violence
19
2.1 Hierarchical-Mediational Confluence Model (HMC)
19
2.2 A Comprehensive Model of Prediction
20
2.3 An Integrated Theory of Sexual Offending
20
2.4 A Theory of Interacting Proximal and Distal Predictive Factors
21
2.5 Facilitators of Sexual Violence
22
2.5.1 Pornography and Sexual Violence
23
2.5.2 Alcohol Use and Sexual Violence
25
2.6 The Influence of Early Childhood Abuse and/or Neglect
30
2.7 Prevention
30
3 Diagnosis
33
3.1 Differential Diagnosis
33
3.1.1 Unreliability of Paraphilia Diagnoses
33
3.1.2 Problems with DSM IV-TR Criteria of Paraphilia
34
3.1.3 Significant Problems with the Diagnosis of Sadism
35
3.2 Co-Morbidity and Co-Occurring Diagnoses
37
3.3 Sexual Coercion and Hypersexuality
39
3.3.1 Sexual Coercion and Sex Hormones
40
3.4 Assessment Strategies
40
3.4.1 Psychosocial Evaluation
40
3.4.2 Psychometric Testing
41
3.4.3 Risk Assessment
42
3.4.4 Assessment of Sexual Fantasies
43
3.4.5 Polygraph and Viewing Time Procedures
44
4 Treatment
46
4.1 Does Treatment Work?
46
4.2 Reformulated Relapse Prevention
50
4.3 Different Pathways and Different Treatments
51
4.4 A Treatment Program That Does Work
52
4.5 Important Therapist Skills
52
4.5.1 Empathy
53
4.5.2 Genuineness
55
4.5.3 Warmth
55
4.5.4 Acceptance
55
4.5.5 Confidence
56
4.5.6 Supportiveness
56
4.5.7 Emotional Expressivity
56
4.5.8 Self-Disclosure
56
4.5.9 Open-Ended Questions
57
4.5.10 Flexibility of Style
57
4.5.11 Positive Attitudes
57
4.5.12 Rewarding
58
4.5.13 Humor
58
4.6 Support Versus Confrontation Versus Collusion
58
4.7 Motivational Interviewing
60
4.8 Schema Therapy and Cognitive Distortions
63
4.9 Targets of Treatment
66
4.9.1 Self-Esteem
66
4.9.2 Acceptance of Responsibility
67
4.9.3 Pathways to Offending
68
4.9.4 Victim Empathy
69
4.9.5 Social Skills
70
4.9.6 Healthy Attachment
70
4.9.7 Emotional Regulation
71
4.9.8 Deviant Sexual Fantasies
72
4.9.9 Self-Management Plans
76
4.10 A Special Population—Individuals with Developmental Disabilities
78
4.11 Best Practices in Treatment of Sexually Violent Persons
80
4.12 Cultural Considerations in Sex Offender Treatment
81
4.13 Summary and Conclusions
83
5 Case Vignettes
85
Case #1 (Joe)
85
Case #2 (John)
86
Case #3 (MM)
86
Case #4 (JC)
87
6 Further Reading
89
7 References
90
