Sexual offending creates a significant public health issue (Mann, Hanson & Thornton, 2010), whereby having a better understanding of the underlying factors related to sexual offending will result in more effective prevention, assessment, and intervention (Seto, 2019). Various factors are identified as aetiological factors for sexual offending, or risk factors for recidivism, including adverse childhood experiences (ACEs), problematic personality traits, intimacy deficits, deviant sexual preferences, and sexual preoccupation (Hanson & Morton-Bourgon, 2005; Mann et al., 2010).
 
Personality disorders (PDs) are highly prevalent among Individuals Who Have Previously Sexually Offended (IPSO; Chen, Chen & Hung, 2016; Craissati & Blundell, 2013), with this relationship being recognised in the UK by the development of the Offender Personality Disorder (OPD) pathway in 2011. However, there are issues regarding the current screening procedure in that it predominantly screens for antisocial and borderline PDs, meaning that a proportion of IPSO with a range of other PDs may be being missed. Furthermore, the prevalence of PDs among IPSO housed in UK prison establishments has not yet been explored.
 
Another factor which is thought to contribute to the aetiology of sexual offending is Sexual Preoccupation (SP; Seto, 2019; Ward & Beech, 2017), which is one of the most strongly present treatment needs among IPSO in the UK (Hocken, 2014). Nonetheless, it is the only risk factor that is not currently addressed by psychological treatment programs for IPSO in the UK (Lievesley, 2019). A tentative link has been reported between PD and SP among IPSO, with sexually preoccupied IPSO presenting with a different personality profile compared to those without SP (Berman-Roberts, 2015). Given that these individuals have acted upon their sexual thoughts and engaged in illegal sexual behaviour, it is imperative to learn more about the underlying mechanisms of SP in order to inform and enhance assessment and treatment (Jardin et al., 2017), which is the main aim of this thesis.
 
Additionally, ACEs are an integral part of understanding sexual offending (Hanson & Morton-Bourgon, 2005; Levenson, 2014), and are also implicated in the aetiology of PD and SP (Courtois & Weiss, 2018; Zanarini, 2000), whereby PD symptomology and SP may be better understood as functional responses deployed as ways of coping with these experiences. ACEs are now considered to be a public health ‘'crisis' (Anda, Butchart, Felitti & Brown, 2010), and studies have recently explored the prevalence of ACEs among prisoners in Scotland and Wales (Carnie, Broderick, Cameron, Downie & Williams, 2017; Ford et al., 2019). Yet, the prevalence of ACEs among IPSO housed in UK prison establishments has not yet been explored, nor the relationships between PD and ACEs, and SP and ACEs among this population. Therefore, ACEs were also included for exploration within this thesis in order to fully understand the relationship between PD and SP among IPSO.
 
Through utilising a mixed-methods approach, this thesis offers the first in-depth exploration of the relationships between PD, SP, and ACEs among a sample of IPSO housed in two UK prison establishments. Study one (n = 203) explores the psychometric properties of two PD scales in a UK general population sample, before they were employed for use with a prison population. The second (n = 155) and third (n = 45) studies explore the prevalence of PD, SP, and ACEs among IPSO, as well as the relationships between PD and SP, PD and ACEs, and SP and ACEs. Finally, the fourth study (n = 5) explores the life trajectories and narrative identities of IPSO that experienced adverse environments during childhood and developed a preoccupation with sex and problematic personality traits.
 
The findings reveal that attempting to understand the underlying mechanisms of SP is a complicated process, as SP manifests differently for each individual. SP may be used as a way to regulate emotions and manage stress, and/or as a way of managing identity and self-worth. Although this thesis provides support for the impulsivity and compulsivity models of SP, as well as it being used as a coping mechanism for anxiety and depression, it also highlights the relationships between SP and emotion dysregulation, and SP and impaired identity. Furthermore, the results bolster Montaldi's (2002) claim that some presentations of SP may be better understood through the use of PDs, whereby this thesis highlights the possibility of two pathways for IPSO with SP (in relation to borderline and narcissistic PDs). Multiple kinds of SP presentation suggest the need for multiple treatment approaches, and it is important for clinicians to tailor treatment according to the individual’s motivation for SP.
 
In regard to the prevalence of PD among IPSO in the UK, a range of PDs (predominantly dependent, depressive, borderline, and avoidant PDs) were reported among IPSO housed in UK category C prison establishments. This has important implications for the current OPD pathway screening procedures, in that these may need amending to be more inclusive of the range of PDs present among IPSO, or specific services for IPSO with PD may need to be developed and implemented. Moreover, a large proportion of IPSO met the criteria for PD, and among these individuals, all of them experienced at least one ACE, with over half reporting four or more ACEs. Thus, this demonstrates the need for all services to adopt a trauma-informed and relational approach, whilst also highlighting how preventative measures are crucial in order to try and prevent the cyclical nature of ACEs, and to prevent individuals from coming into contact with the criminal justice system in the first place.
 
This thesis concludes that PD and SP symptomology may be better understood as effective survival strategies to abnormal circumstances, and it is important that clinicians address this aspect of an individual's sense-making during treatment. Furthermore, a common thread throughout all studies is regarding impairments in identity. Therefore, a useful treatment target among IPSO is in relation to incoherence in the self-narrative, as having a coherent, pro-social identity is thought to be crucial to rehabilitation and desistance (Maruna, 2001). Clinicians should work from a Good Lives Model (GLM; Ward, Mann & Gannon, 2007) perspective in order to help individuals identify appropriate values and goals, and work towards a more appropriate narrative identity (Ward & Marshall, 2007). An individual’s protective factors should also be taken into account, in which peer-support roles and religiosity may play an important part in protecting individuals from future offending. Implications and limitations of all studies are discussed extensively throughout, as are opportunities for further research.

Exploring the relationships between personality disorder, sexual preoccupation, and adverse childhood experiences among individuals who have previously sexually offended

The stigmatization of people with pedophilia was previously identified as a “blind spot” in stigma research. This systematic review updates and expands on Jahnke and Hoyer’s 2013 review to understa...

Understanding and Challenging Stigma Associated With Sexual Interest in Children: A Systematic Review

This brief think piece considers the uses of “people first” language in the context of incarceration, both from a historical and contemporary perspective, and offers some thoughts about the use of ...

https://journals.sagepub.com/doi/pdf/10.1177/2632666320940859

The language of incarceration

Perpetration of sexual violence is widespread in Australia, creating long-term negative effects on wellbeing. Community safety is enhanced through reducing the risk of reoffending by those who have sexually offended. A key avenue to reducing risk of reoffending is a community-based program model that aims to reintegrate sexual offenders into the community. Understanding how community-based programs impact recidivism rates is therefore very important. In Australia, few programs that provide this support have been the subject of research. The research project Community-based approaches to sexual offender reintegration looked at two such community-based programs, and documented program characteristics that are key to supporting reintegration and reducing the risk of reoffending.

/pdf/community-based-approaches-to-sexual-offender-reintegration-4f8flk87xp.pdf

Community-based approaches to sexual offender reintegration

The Attitudes to Sexual Offenders scale (ATS; Hogue, 1993) is one of the most widely-used measurement instruments for assessing views about sexual offenders. The ATS has been used in a variety of contexts, most commonly in comparing forensic professionals and non-professionals in relation to their views about this population. This paper offers a review of the methods used to examine attitudes toward sexual offenders currently available, before systematically outlining the validation of a 21-item shortened version of the ATS measure (the ‘ATS-21’). First, we analyzed the ATS with regards to its underlying factor structure using a general community sample (Study 1; n = 188). This identified three factors: ‘Trust’, ‘Intent’, and ‘Social Distance’. We subsequently supported this structure through confirmatory factor analysis in a new community sample (Study 2; n = 335) and Hogue’s (1993) original ATS development data (Study 3; n = 170) in order to provide further evidence of its reliability. We also offer preliminary evidence of the ATS-21’s test-retest reliability, consistency across multiple testing contexts, resistance to social desirability, and independence from related measures (Study 4; n = 59). We close by recommending the use of the ATS-21 for researchers examining attitudes toward sexual offenders and offer suggestions for a new unified research design to incorporate the ATS-21 into emerging research into the psychological underpinnings of attitudes and responses to sexual offenders. We offer open data at https://osf.io/ymhsw/ and open scoring resources for the ATS-21 at https://osf.io/34hsx/.

/pdf/development-of-a-21-item-short-form-of-the-attitudes-to-4tlam0tuvo.pdf

Development of a 21-item short form of the Attitudes to Sexual Offenders (ATS) Scale.

The present study examined the effect of offense-based labels on community members' willingness to volunteer with people convicted for varying offenses and any priming effect of labeling language. Participants (N = 310) were randomly assigned to a label condition or a neutral condition and completed an anonymous online survey about their willingness to volunteer with different groups. The labeling condition utilized labels (e.g., "sex offenders," "murderers"), whereas the control condition utilized neutral descriptors (e.g., "people who have committed crimes of a sexual nature"). Overall, findings supported the hypothesis that offense-based labels were associated with less willingness to volunteer, with findings most pronounced for the "sex offender" and "child sex offender" labels. Participants in the labeling condition showed greater voluntary use of labels compared with neutral language and were more likely to use labels compared with participants in the neutral condition. Implications for influencing public opinion are discussed.

"Sex Offender" Versus "Person": The Influence of Labels on Willingness to Volunteer With People Who Have Sexually Abused.

Most community members are not accepting of individuals convicted for sexual offenses living in their communities, let alone having regular contact with them. However, a select number of community members choose to give their time to assist these individuals reintegrate from prison into the community. Circles of Support and Accountability (CoSA) was developed as a way to address the issues that many individuals convicted of sex offenses face, that is, little to no prosocial support in the community. In-depth, semistructured interviews were conducted with 18 CoSA volunteers in New Zealand to gain a more thorough understanding of volunteers' motivation to be involved with CoSA. Thematic analysis was used to analyze the data. Three key themes of motivation were identified: (a) Restorative and Justice-Based Motivation, (b) Altruistic Motivation, and (c) Faith-Based Motivation. Findings are discussed in terms of their implications for future recruitment of volunteers for CoSAs.

You Do What? A Qualitative Investigation Into the Motivation to Volunteer With Circles of Support and Accountability.

In Circles of Support and Accountability (CoSA), trained volunteers support an individual convicted for sexual offenses to reintegrate safely into the community. Developed in Canada, CoSA has been ...

Maintaining an Effective Circle: Volunteer Experiences of Operational Aspects of Circles of Support and Accountability.

Circles of Support and Accountability (CoSA) is a promising reintegration framework whereby community volunteers support individuals convicted for sexual offenses to reintegrate safely into the community. CoSA has grown in popularity, yet little is known about volunteers' experiences of CoSA, including how they cope with their core member being recalled or reoffending. The aim of the current study is to explore the experiences of CoSA volunteers in New Zealand. In-depth interviews were used to explore experiences. The findings relating to general experiences explored balancing risk management and social support, questioning the place of religion in CoSA, confronting stereotypes, and volunteering in a risk-averse society. The findings also revealed both the commitment to CoSA, and the stress and guilt felt by the volunteers following a recall or re-offense. Findings are discussed in terms of their implications for current and ongoing volunteers, as well as for community approaches to criminal justice.

Looking inside a circle: volunteer experiences of circles of support and accountability.

Abstract Purpose of Review Legacy gambling harm refers to adverse consequences that extend past the period where people are actively gambling at harmful levels. These harms can affect the gambler, people close to them and the wider community. This article reviews current research that investigates legacy harms; the types of legacy harm, how long they last and whether evidence suggests these harms are real or instead imagined injuries or reflections on past regrets. Recent Findings Legacy harms to individuals can be broadly categorised as including financial, relationship, emotional/psychological, health, culture, work/study and criminal/deviance harms. In addition, legacy harms affect entire communities by drawing funds and social capital away from vulnerable communities, leaving them socially, culturally and materially impoverished. Most legacy harms that accrue to gamblers have a half-life of 4 years, although financial harms last somewhat longer at 5 years. Greater distance in time from a past gambling issue is reliably and positively related to health and well-being indicators, including the Health Utility Index and the Australian Unity Wellbeing Index, which suggests that legacy gambling harms are real and have a lasting impact on well-being, rather than just imagined hardship from prior gambling difficulties. Summary These findings suggest programme and policy development to support gamblers in reducing and managing their legacy harms, rather than focusing only on relapse prevention. 

/pdf/legacy-gambling-harms-what-happens-once-the-gambling-stops-16auef1h.pdf

Giulia Lowe

Papers

"Sex Offender" Versus "Person": The Influence of Labels on Willingness to Volunteer With People Who Have Sexually Abused.

You Do What? A Qualitative Investigation Into the Motivation to Volunteer With Circles of Support and Accountability.

Maintaining an Effective Circle: Volunteer Experiences of Operational Aspects of Circles of Support and Accountability.

Looking inside a circle: volunteer experiences of circles of support and accountability.

Legacy Gambling Harms: What Happens Once the Gambling Stops?