Download Evaluation of the Adolescent Sex Offender Michael Adler, Ed.D

March 30, 2014
Evaluation of
the Adolescent
Sex Offender
Michael Adler, Ed.D.,
Licensed Psychologist
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American Society for
Adolescent Psychiatry
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March 30, 2014
Background
 Clinical
Director Chesapeake Treatment
Center/New Directions Program
 Program Director Glass Health
Programs/Hickey School Mental Health
and Services Hickey School
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Holland’s Self Directed Search
 Department
of Juvenile Services
 Intake Probation Aftercare Services
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Background information
commonly available
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Social History Investigations, Educational History
Formal charges, Juvenile Court Offense, formal
charges, informal charges, type of offense,
disposition, records, placement and treatment
histories including, facility incident reports, reports
to CPS
Police reports, victim statements, medical
screenings
Previously completed psychiatric, psychological
evaluations, cognitive and personality test results
Records of previous treatment, treatment
response, hospitalizations, medications
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Sample Test Battery
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Clinical Interview
Reynolds Adolescent Depression Scale-2nd edition
Thematic Apperception Test
Trauma Symptom Checklist for Children
BASC2 Behavior Assessment System for Children
Adolescent version 2nd edition-Self Report-ages 12-21
Adolescent Cognition Scale(Revised)Abel, Becker
and Kaplan
Adolescent Sexual History Inventory
JSOAP II (Juvenile Sex Offender Assessment Protocol)
ERASOR2 (The Estimate of Risk of Adolescent Sexual
Offense Recitivism)
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Test Battery Continued
 Phase
Sexual Attitudes Questionnaire
 Bumby Cognitive Distortions Scale
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BASC-Adaptive Scales
 Interpersonal
Relations
 Relations with Parents
 Self Esteem
 Self-Reliance
 Personal Adjustment
 Flat Line Profile
 Faking Good/Faking Bad
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Critical Items
This area presents items that may be of particular interest when responses include True,
Sometimes, Often, or Almost always.
Item
Response
3. Nothing goes my way.
True
24. I never seem to get anything right.
True
33. Nobody ever listens to me.
True
38. I just don't care anymore.
False
73. Other kids hate to be with me.
Often
81. I feel like my life is getting worse and worse.
Often
98. No one understands me.
Often
111. I feel sad.
Sometimes
122. I hear voices in my head that no one else can hear.
Sometimes
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Validity Index Item Summary
Items contributing to Validity Indexes (except
Response Pattern) with Caution or Extreme
Caution ratings are presented below.
F INDEX
Item
Response
1. I like who I am.
False
13. My classmates don't like me.
True
21. Nothing is fun anymore.
True
43. Other children don't like to be with me.
True
68. Nothing about me is right.
True
86. People act as if they don't hear me.
Almost always
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RADS 2 Test Results
Score
Summary
Table
Scale
Raw Score
T-Score
Dysphoric Mood
Anhedonia/Negative
Affect
Negative Self
Evaluation
Somatic Complaints
Depression Total
16
22
51
62 (significant)
%Rank
60
81
21
66 (significant)
92
13
72
44
59
32
80
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RADS-Critical Items
 Loneliness
 Social
withdrawal
 Self-injurious
 Self-reproach
 Self-deprecation
 Helplessness
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JSOAP-Sexual Drive
Preoccupation Scale (items 1-8)
 Prior
legally charged sex offenses
 Number of sexual abuse victims
 Male child victim
 Duration of sexual offense
 Degree of planning in sexual offenses
 Sexualized aggression
 Sexual drive and preoccupation
 Sexual victimization history
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Impulsive Antisocial
Behavior Scale(items 9-16)
 Care
giver consistency, Pervasive anger
 School behavior problems
 History of conduct disorder
 Juvenile antisocial behavior
 Charged/arrested before age 16
 Multiple types of offenses
 Physical assault and exposure to family
violence
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Intervention Scale
(items 17-23)
 Accepting
responsibility for offense(s)
 Internal motivation for change
 Understands risk factors
 Empathy
 Remorse and guilt
 Cognitive distortions
 Quality of peer relationships
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Community (Items 24-28)
Stability/Adjustment Scale
 Management
of sexual urges and desire
 Management of anger
 Stability of current living situation
 Stability in school
 Evidence of support systems
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Sample JSOAP II report
 On
the JSOAP II Protocol, Juvenile Sex
Offender Assessment Protocol on the static
scales which are historical and based on an
individual’s history or pattern of past sexually
offending behaviors James had a score of 1
out of a possible 16 in the sexual
drive/preoccupation scale. This placed
James at low risk to sexually reoffend.
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Sample JSOAP II Report
 On
the scale of Impulsive Antisocial
Behavioral Scale items 9-16 James had a
score of 10 out of a possible 16 points which
places him at moderate to high(62.5%) risk to
sexually reoffend. On this scale items
associated with problems with pervasive
anger, school behavioral problems and being
arrested prior to age 16 were problems areas
for him related to his risk to reoffend.
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Sample JSOAP II Report
 Individuals
with high scale 2 Impulsive
Antisocial Behavioral Scale scores are 3
times more likely to sexually reoffend
compared to low scale 2 individuals. James’s
overall score of11 out of a possible 32 points
(34%)on items 1-16 on the Static/Historical
Scale places him as moderate risk to reoffend
sexually.
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Sample JSOAP II Report
 The
dynamic scales include the items 17
through 28 on this protocol and can change
over time based on the individual’s
adjustment to treatment interventions and
treatment progress. On the dynamic scales
(Intervention Scale) 17-23 James had a score
of 8 out of a possible 14 points making him at
moderate to high (57%) risk sexually offend.
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Sample JSOAP II Report
 On
the Community Stability Scales, items 2428 James had a score of 2 out of 10
suggesting that he is at low risk to reoffend.
Items addressed on this scale included
management of sexual urges, management of
anger, stability of current living situation,
stability in school and evidence of support
systems.
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Sample JSOAP II Report
 James
was also at low to almost moderate
risk to sexually reoffend on all of the Dynamic
Scales items, 17-28 on this protocol having a
score of10 out of a possible 24 points.
James’s overall JSOAP score of 21 out of a
possible 56 (41%) places him at moderate
risk to sexually offend.
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Sample JSOAP II Report
 The
major areas of concern on this protocol
were James’s school stability problems,
management of his anger, quality of peer
relationships, accepting responsibility for his
offense and understanding of the risk factors.
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ERASOR-Estimate of Risk of
Adolescent Offense Recitivism
Sexual Interests or attitudes
1. Deviant sexual interests(younger children,
violence or both
 2.Obsessive sexual interest and
preoccupations with sexual thoughts
 3. Attitudes of supportive offending
 4. Unwillingness to alter deviant sexual
interests/attitudes
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Erasor
 Historical
Sexual Assaults
 Psychosocial Functioning
 Family Environment Functioning
 Treatment
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Trauma Symptom Checklist
for Children (TSCC)
 Validity
Scales
 Underresponse
 Hyperesponse
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TSCC-Clinical Scales
 Anxiety
 Depression
 Anger
 Posttraumatic
Stress
 Dissociation
 Sexual
Concerns
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TSCC-Sexual Concerns
Subscales
 Sexual
Preoccupation-(SC-P)
 Sexual Distress-(SC-D)
 Elevations on Sexual Concerns Subscales
associated with being prematurely
sexually traumatized-sexual abuse,
exposure to pornography, witnessing
sexual behavior, or sexual assault by a
peer
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TSCC
 Elevations
on SC-P suggest preoccupation
associated with childhood sexual abuse
 Elevations on SC-D suggest distress or
conflict associated with sexual matters or
experiences-high scores on this scale
suggest sexual fears or ego-dystonic
sexual feelings and behaviors. This scale
highly correlated with Anxiety Scale
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TSSC-Dissociation Subscale
 Derealization
 Mind
going blank
 Emotional numbing
 Pretending to be somebody else
 Daydreaming
 Memory problems
 Dissociative avoidance
 More severe identity disturbance and
fugue states not included
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TSCC-Dissociative Subscale
 Overt
Dissociation (DIS-O)- high scores in
DIS-O-symptoms include emotional
detachment and reduce response to
external environment
 Fantasy (DIS-F)- involves fantasy or role
playing rather more than classic
dissociation-Daydreaming included in
Fantasy-high scores here suggest being
over involved in fantasy to exclusion of
real world
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TSCC-PTSD Subscale
 This
subscale should be looked at with
Anxiety and Dissociation subscales
 Intrusive thoughts, sensations of past
memories of painful events, nighmares,
fears of men or women and cognitive
avoidance of negative memories and
events.
 Scale includes more intrusive symptoms
than avoidance and hyperarousal
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TSCC Items-(Never, Sometimes,
Lots of times, All the time)
 Can’t
stop thinking about sex
 Having sex feelings in my body
 Touching my private parts too much
 Feeling scared of men or women
 Washing myself-feeling dirty on the inside
 Wishing bad things never happened
 Going away in my mind trying not to think
 Scary ideas or pictures pop into my head
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TSCC-Critical Items
 Wanting
to hurt myself (20)
 Wanting to hurt other people(21)
 Feeling scared of men/woman (25)
 Not trusting people as they want sex(34)
 Getting into fights(36)
 Feeling someone might kill me(50)
 Wanting to kill myself(52)
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Taking a Sexual History
 Age
of first girlfriend and age of
adolescent sex offender
 Age of first kiss and both consenting
partners
 Longest relationship
 History of physical abuse
 History of sexual abuse
 Age onset of sexual intercourse with
consenting partner
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Sexual History
 Anatomical
knowledge of sexual
intercourse
 History of sexual intercourse
 Use and types of birth control protection
 Awareness of condoms, STD’s, birth
control pills and abstinence
 Masturbation History and Frequency
 Exposure to sex education curriculums
 History of Pornography exposure
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Sexual History
 Number
of consenting intercourse
partners and ages
 Frequency of use of birth control
 Ever masturbated to excess or to the
point of pain or discomfort
 Increased exposure to pornography,
internet, cell phones, filming of sex
offenses, sexting, movies, videos, cable tv
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Sexual History
 Exhibitionism,
fetishism, masochism,
sadism, or voyeuristic behaviors,
crossdressing
 Sexual orientation
 Forced or coerced to observe others
engaging in sexual behaviors
 History of sexual contacts with males and
females
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Adolescent Sex Offender
Characteristics
 Grabs
attention of society “NIMB”
 Institutional Status-”Low” peers and staff
 Fuels low self esteem
 Social isolation more important than social
competence skills
 LD designation/awareness of deficits
 Early exposure to pornography
 Overly sexualized exposure experiences
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Thematic Apperception
Test
 Themes
 Authority
figures/parental expectations
surrounding achievement
 Depression/Self injurious
 Thought Disturbance/Reality Testing
 Resolution
 Relationship with objective personality
measures and behavioral presentation
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Federal Bureau of Prisons
 Level
of Pathology
 Initial mental health evaluations
 Substance use
 Possession of child or other pronographic
materials/increased underserved
population
 Community Reintegration
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Paraphilic Disorder DSM-5
A
paraphilia that is currently causing
distress or impairment to the individual
and a pariphilia whose satisfaction has
entailed personal harm, or risk of harm to
others.
 A paraphilia is a necessary but not a
sufficient condition for having a paraphilic
disorder and a paraphilia by itself may not
require or justify clinical intervention.
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Paraphilic Disorders DSM-5
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Voyuerisitc Disorder
Exhibitionistic Disorder
Frotteruistic Disorder
Sexual Masochism Disorder
Sexual Sadism Disorder
Pedophililc Disorder
Fetishistic Disorder
Transvestic Disorder
Other Specified Paraphilic Disorder
Unspecified Paraphilic Disorder
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Abel, Becker and Kaplan-Revised
Adolescent Cognition Scale
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Revised Adolescent Cognition
Scale
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DJS Statistical Report on Female Offenders –February
2012
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Youth Placed in Out-of-Home Program by
DJS during Calendar Year 2010*
Abuse History Females Males
History of Physical/ Sexual Abuse 45.8% 13.4%
History of Neglect 27.1% 24.6%
Source: MCASP Needs Assessment: Social History Items 8 and 9.
*Approximately 9.4% of the cohort was missing MCASP data.
History of Physical or Sexual Abuse (during lifetime) and History of Neglect (during
lifetime)
Nearly half (46%) of females placed in an out-of-home program in CY 2010
reported a history of physical or sexual abuse during
their lifetime. This compares to 13% of males reporting the same abuse history.
Percentages of females and males reporting a history of neglect were similar for
juveniles placed in an out-of-home placement in
CY 2010. Females had a slightly higher percentage (27%) than males (25%)
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DJS Intake Data Annual
Report 2010
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Males-all counties-122 general sex offenses-200 felony
sex offenses
Females-all counties- 6 general sex offenses-15 felony
sex offenses
Intake levels-informal, legally insufficient, closed
Formalized to SAO
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Sex Offender Legal Terms
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Sexual predator: offender who has been convicted of a sexually violent offense and has
been deemed by a court likely to do it again.
Sexually violent offender: offender who has been convicted of a sexually violent offense.
Sexually violent offense: 1st or 2nd degree rape or attempted rape; 1st, 2nd, or 3rd degree
sexual offense.
1st degree rape: Vaginal intercourse by force or threat of force, along with an aggravating
factor, like causing or putting in fear of serious physical injury or disfigurement, suffocating,
kidnapping, etc.
2nd degree rape: Vaginal intercourse by force or threat of force, or with mentally disabled
victim, or with victim under 14 and perpetrator 4 years older.
1st degree sexual offense: Sexual act by force or threat of force, along with an aggravating
factor, like causing or putting in fear of serious physical injury or disfigurement, suffocating,
kidnapping, etc. Sexual act is oral sex, anal sex, or penetration by an object, but does not
include vaginal intercourse.
2nd degree sexual offense: Sexual act by force or threat of force, or with mentally disabled
victim, or with victim under 14 and perpetrator 4 years older. Sexual act is oral sex, anal sex,
or penetration by an object, but does not include vaginal intercourse.
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Sex Offender
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3rd degree sexual offense: Sexual contact without the consent of the victim, along with an
aggravating factor, like causing or putting in fear of serious physical injury or disfigurement,
suffocating, kidnapping, etc. Sexual contact is intentionally touching genitalia, the anus or
other intimate area. It includes penetration by a part of the body except the penis or
mouth.
Also includes sexual contact with mentally disabled victim, victim under age 14 and
perpetrator 4 years older, a sexual act with victim 14 or 15 and perpetrator 21, vaginal
intercourse with victim 14 or 15 and perpetrator 21.
4th degree sexual offense: Not considered a sexually violent offense. Sexual contact without
consent of victim, sexual act with victim 14 or 15 and perpetrator 4 years older; vaginal
intercourse with victim 14 or 15 and perpetrator 4 years older. Sexual contact is intentionally
touching genitalia, the anus or other intimate area. It includes penetration by a part of the
body except the penis or mouth.
Child Sexual Offender: An offender who has been convicted of any of the above offenses
with a victim less than 15 years old, i.e., any sexually violent offense (1st or 2nd degree rape;
1st, 2nd, or 3rd degree sexual offense), or a 4th degree sexual offense. Also includes
offenders convicted of sexual abuse of a minor who is a family member or living in the
household.
Offender: An offender who has been convicted of certain other offenses related to sexual
offending, like kidnapping or false imprisonment of a minor, violations of the child
pornography and prostitution laws, etc.
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References
 Briere,J.
Trauma Symptom Checklist for
Children (1996). Professional Manual.
Odessa, Fl. Psychological Assessment
Resources.
 Briere, J., and Lanktree, C. B.(1995). The
Trauma Symptom Checlist for Children
(TSCC): Preliminary psychometic
characteristics. Unpublished manuscript,
Department of Psychiatry. University of
Southern California School of Medicine.
51
 Diagnostic
March 30, 2014
and statistical manual of
mental disorders. Fifth Edition (DSM-5).
American Psychiatric Association, 2013.
 Pratt, H.D., Patel, D.R., Greydanus, D.E.,
Dannison, L., Walcott, D., Sloane, M.A.,
(2001). Adolescent Sexual Offenders:
Issues for Pediatricians. International
Pediatrics; 16 (2).
 Reynolds, C.R., Kamphaus, R.W., (2005)
Behavior assessment system for children,
2nd edition, Pearson, Inc.
52
 Reynolds,
March 30, 2014
W. (1987). Reynolds Adolescent
Depression Scale, 2nd edition.
Psychological Assessment Resources,
Odessa, Fl.
 Righthand, S., Prentky, R. A., Knight, R. A.,
Carpenter, E., Heckler, J.E., and Nangle,
D. (Manuscript in preparation). Factor
structure and validation of the Juvenile
Sex Offender Assessment Protocol (JSOAP).
53
 Seto,
M.C., Lalumiere, M.L., What is so
special about male adolescent sexual
offening? : A review and test of
explanation through meta-analysis.
American Psychological Association:
Psychological bulletin (2010).
Vol.136.No4.526-575.
July 7, 2017