Sexual Dysfunctions and Their Association with the Dual Control Model of Sexual Response in Men and Women with High-Functioning Autism

Adults with an Autism Spectrum Disorder (ASD) are characterized by impairments in social interaction and communication, repetitive and stereotyped interests and behaviours as well as hyper- and/or hyposensitivities. These disorder specific symptoms could be associated with the development of sexual disorders. The Dual Control Model of Sexual Response presents one approach that is frequently used to explain the emergence of sexual dysfunctions. The aim of the present study was to assess the extent of symptoms of sexual dysfunctions in men and women with ASD and to evaluate their association with the individual propensity of sexual excitation and inhibition as defined by the Dual Control Mode…

The prevalence of mental disorders in incarcerated contact sexual offenders

OBJECTIVE Mental disorders in sexual offenders are relevant in terms of risk assessment and psychotherapeutic and pharmacological treatment. METHODS The present cross-sectional study was conducted between 2001 and 2017 and included 1511 sexual offenders who were assessed at the Federal Evaluation Center for Sexual and Violent Offenders in the Austrian Prison System. All sexual offenders were assessed with the Structured Clinical Interview for Axis I (SCID I) and Axis II disorders (SCID II). RESULTS N = 1250 (92.9%) sexual offenders were diagnosed with a mental disorder, whereby the great majority received multiple diagnoses. The most frequently found disorders were alcohol misuse (40.0%), p…

The Predictive Properties of Psychiatric Diagnoses, Dynamic Risk and Dynamic Risk Change Assessed by the VRS-SO in Forensically Admitted and Released Sexual Offenders.

Psychiatric diagnoses, static risk factors and criminogenic needs at time of admission and release were examined in a mentally ill sample of psychiatrically detained sexual offenders. Although clinically found to be at low or even very low risk at discharge, 12% reoffended sexually over an average follow up of 7 years. Psychotic disorders were present in only 5% of offenders, whereas 93% had a personality disorder diagnosis and 76%, a paraphilic disorder diagnosis. Only exhibitionism and alcohol misuse were associated with relapse. Static risk factors captured by the Static-99 also did not significantly predict recidivism; however, the VRS-SO – a structured risk assessment tool that assesse…

Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder

Like nonaffected adults, individuals with autism spectrum disorders (ASDs) show the entire range of sexual behaviors. However, due to the core symptoms of the disorder spectrum, including deficits in social skills, sensory hypo- and hypersensitivities, and repetitive behaviors, some ASD individuals might develop quantitatively above-average or nonnormative sexual behaviors and interests. After reviewing the relevant literature on sexuality in high-functioning ASD individuals, we present novel findings on the frequency of normal sexual behaviors and those about the assessment of hypersexual and paraphilic fantasies and behaviors in ASD individuals from our own study. Individuals with ASD see…

Pharmacological treatment of patients with paraphilic disorders and risk of sexual offending: An international perspective

Objectives: The present study aims to evaluate existing policy and practice relating to the use of pharmacological treatments with patients suffering from paraphilic disorders who are at risk of committing further sexual offences. Methods: A systematic literature search was conducted to document current legal policies across 26 different countries. In addition, a questionnaire assessing the practice of pharmacological treatment was sent to practitioners involved in the treatment of patients with paraphilic disorders. Results: Legal policies concerning the preconditions of using pharmacological treatments differ considerably between countries, and for most jurisdictions do not exist. Drawing…

Attention-Deficit/Hyperactivity Disorder (ADHD), antisociality and delinquent behavior over the lifespan

Attention-Deficit/Hyperactivity Disorder (ADHD) is closely linked to the development of conduct problems during socialization in early life and to an increased risk for antisocial activities and delinquency over the lifespan. The interaction between ADHD and common comorbid disorders like substance use disorders as well as changing environmental conditions could mediate the course of antisocial and delinquent behavior with increasing age. However, this complex interaction is only partially understood so far. This review presents current knowledge about the association of ADHD with antisociality and the development of delinquent behavior. Thereby, the relationships between ADHD, conduct diso…

Neuropsychological functioning in child sexual abusers: A systematic review

Abstract Impairments in neuropsychological functioning are emphasized among the core components in etiological models about sexual offending against children. In order to distinguish those neuropsychological deficits that can specifically be found in child sexual abusers, the present systematic review summarizes all studies published between 1980 and 2019 comparing neuropsychological functions of child sexual abusers with different control groups. The databases PubMed, Google scholar, and PsycInfo were used to find relevant studies. After applying certain inclusion criteria (e.g., at least one comparison group), 25 studies were identified as being relevant for the present review. Most evide…

Pharmacological treatment of sexual offenders in German outpatient treatment centers

In Germany, depending on a sexual offender's culpability and the severity of the offence, he/she can be placed either in the forensic-psychiatric or the correctional system. Numbers related to the pharmacological treatment of sexual offenders for the correctional system are missing so far. In sexual offenders, the pharmacological treatment of paraphilic disorders is of special importance. The present study aimed at assessing the prevalence of pharmacological sexual offender treatment in German outpatient treatment centers supervising mainly clients from the correctional sector. An online questionnaire was sent to 112 outpatient treatment centers and 21 provided data relevant for the present…

Sexual narcissism and its association with sexual and well-being outcomes

Abstract Theories on narcissism are traditionally closely related to sexuality. Most research on the association between narcissism and sexual behavior, however, has focused on harmful/maladaptive outcomes. The aim of the present two studies was to examine the possible health-promoting influence of both global and sexual narcissism on sexual function and genital self-image. In Study 1, sexual narcissism was positively associated with sexual functioning in both women and men (N = 505, online-recruited German participants). In the women's sample, sexual narcissism was related to a positive genital self-image. The facet sexual skill was identified as the most important predictor for sexual fun…

Pharmacological Approaches for Offenders with Intellectual and Developmental Disabilities

The Relevance of Sexual Biographies in Individuals Convicted of Child Sexual Abuse Offenses for the Development of Pedosexual Interests and Sexual Recidivism

In the literature concerning the etiology of pedosexual interests, the potential role of early sexual experiences in childhood and adolescence has been discussed. Several studies demonstrated a link between own sexually abusive experiences in childhood and sexual offending later in life which tends to be even stronger for pedosexual offenders. Furthermore, some findings indicate associations between other developmental factors and deviant sexual interests in adulthood. For the present study, sexual biographical data of N = 223 imprisoned men convicted of sexual offenses against children from Austria was analyzed to retrospectively examine whether own sexually abusive experiences and non-abu…

Violent offending in borderline personality disorder and attention deficit/hyperactivity disorder.

Abstract The prevalence of borderline personality disorder (BPD) and attention deficit/hyperactivity disorder (ADHD) is significantly higher among offenders compared to the prevalence found in the general population. Both disorders share important diagnostic characteristics and thus it has been suggested that they might follow a common developmental pathway. In this narrative review, we first discuss the potential links of disorder inherent symptoms such as impulsivity and emotion regulation difficulties and how they might elevate the risk of violent delinquency. We continue with highlighting that comorbidities particularly from the antisocial spectrum as well as comorbid substance use diso…

Testosterone-Lowering Medication and Its Association With Recidivism Risk in Individuals Convicted of Sexual Offenses

For a particular subgroup of individuals with severe paraphilic disorders and a high risk of sexual recidivism, the combination of sex drive–reducing medications and psychotherapy is a promising treatment approach. The present quasi-experimental study aims at comparing differences in clinical characteristics and dynamic risk factors between persons receiving (+TLM, n = 38) versus not receiving (−TLM, n = 22) testosterone-lowering medications (TLMs). Individuals receiving TLM were more frequently diagnosed with paraphilic disorders. Neither the criminal history nor average risk scores differed between the two groups. In the +TLM, Stable-2007 scores showed a stronger decrease after TLM treat…

Test–Retest Reliability and Temporal Agreement of Direct and Indirect Sexual Interest Measures

The Explicit and Implicit Sexual Interest Profile (EISIP) is a multimethod measure of sexual interest in children and adults. It combines indirect latency-based measures such as the Implicit Association Test (IAT), Viewing Time (VT), and explicit self-report measures. This study examined test–retest reliability and absolute temporal agreement of the EISIP over a 2-week interval in persons who were convicted of sexual offenses against children ( n = 33) and nonoffending controls ( n = 48). Test–retest reliability of the aggregated EISIP measures was high across the whole sample ( rtt = .90, intraclass correlation coefficient [ICC] = .90) with the IAT yielding the lowest retest correlations …