Not just a sex offender paraphilias and other complicating conditions l.jpg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 41

Not Just a Sex Offender: Paraphilias and Other Complicating Conditions PowerPoint PPT Presentation


  • 136 Views
  • Uploaded on
  • Presentation posted in: General

Not Just a Sex Offender: Paraphilias and Other Complicating Conditions. Donya L. Adkerson, MA, LCPC 2005. Consider the individual. Sex offenders are not all the same B Consider. P Paraphilia-specific issues P Concurrent/Complicating Conditions P Complicating Circumstances. Paraphilia.

Download Presentation

Not Just a Sex Offender: Paraphilias and Other Complicating Conditions

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Not just a sex offender paraphilias and other complicating conditions l.jpg

Not Just a Sex Offender: Paraphilias and Other Complicating Conditions

Donya L. Adkerson, MA, LCPC 2005


Consider the individual l.jpg

Consider the individual

Sex offenders are not all the same B Consider

PParaphilia-specific issues

PConcurrent/Complicating Conditions

PComplicating Circumstances


Paraphilia l.jpg

Paraphilia

What is it?

  • Recurrent thoughts, feelings or behaviors indicating arousal

  • For at least a 6 month duration

  • Involving nonconsenting being, nonsexual object, or body part

  • Early adolescents= arousal patterns may not be fixed enough to diagnose paraphilia


Common paraphilias among sex offenders l.jpg

Common paraphilias among sex offenders

PNot all sex offenders have a paraphilia

PPedophilia

PHebephilia/Ephebephilia

PBestiality


Common paraphilias among sex offenders5 l.jpg

Common paraphilias among sex offenders

  • Voyeurism

  • Exhibitionism

  • Sadism

  • Paraphilia NOS (Not Otherwise Specified) e.g., rape

  • MANY other less common . . . arousal to feet, diapers, urine, feces, underwear, shoes, fabrics, almost anything.


Implications of a paraphilia l.jpg

Implications of a Paraphilia

  • Associated with increased risk for re-offense

  • May require arousal modification treatment techniques

    • Compliance can be difficult

    • Can only suppress, not eliminate, the paraphilic arousal

  • May present issue in developing partner relationships

  • May cause feelings of shame, isolation


Paraphilia specific considerations l.jpg

Paraphilia-specific Considerations

Voyeurism

PHands-off offenses taken less seriously, but may not be the limit of the behavior

PVoyeurism is legal and sanctioned with consent (the porn/strip industries)

PLimited voyeurism in adolescence culturally normal


Paraphilia specific considerations8 l.jpg

Paraphilia-specific Considerations

Voyeurism

PStalking & voyeurism can look similar; must differentiate

PThe underlying fantasy is critical

<Is there fantasy of contact? Force?

<Voyeurism as a prelude to break & enter rape


Paraphilia specific considerations9 l.jpg

Paraphilia-specific Considerations

Exhibitionism

  • To adults, often seen as joke; to kids, now taken seriously

  • Higher correlation with hands-on when victim is child

  • High correlation with narcissistic traits when target strangers


Paraphilia specific considerations10 l.jpg

Paraphilia-specific Considerations

Exhibitionism

PHigh rates of relapse; ease of relapse

PUnderlying fantasy goalB where does the exposing lead?

<Approval/sex/relationship

<Sexual acknowledgment

<Negative response -fear/distress/anger/humiliation


Paraphilia specific considerations11 l.jpg

Paraphilia-specific Considerations

Pedophilia and Hebephilia

  • May still have arousal to adults -- or may have little to none

  • What age and gender span at risk?

  • Pedophiles are very heterogenous group

  • Parenting problems:

    • Arousal to own children

    • Their children attract other children


Paraphilia specific considerations12 l.jpg

Paraphilia-specific Considerations

Pedophilia and Hebephilia

  • Safety planning areas

    • Work

    • Leisure

    • Family gatherings

    • Public places

    • Worship

    • Media stimuli

    • Holidays & Special events


Paraphilia specific considerations13 l.jpg

Paraphilia-specific Considerations

Bestiality

  • Rarely exclusive in SO referrals

  • Some correlation of bestiality and increased risk of child molest

  • Screen for signs of sadism

  • Safety planning with family pets, farm animals, volunteering, work


Paraphilia specific considerations14 l.jpg

Paraphilia-specific Considerations

Sadism

  • Arousal to infliction of pain, suffering, humiliation

  • The ULTIMATE DANGER, especially when combined with Antisocial Personality Disorder

  • Most sadists offend at home, even if also offending on strangers


Paraphilia specific considerations15 l.jpg

Paraphilia-specific Considerations

Sadism

PVictims have EXTREME difficulty reporting and will be more fragile, more traumatized, than non-sadists= victims

<This means sadism may be more common than we realize

PIt is unclear if true sadists are treatable, at least through currently used treatment approaches


Recognizing sadism l.jpg

Recognizing Sadism

Common offense elements

  • Degradation tactics

    • Name calling, force begging, porn re-enactments, use of animals/urine/feces

  • Bondage and/or Object use

  • Infliction of pain & injury

  • Documenting

    • Photos/videos

    • Souvenirs


Childhood adolescent histories of sadistic offenders l.jpg

Childhood/Adolescent Histories of Sadistic Offenders

Elements often found

  • Aggression to peers (may include intentional pain infliction)

  • Cruelty to animals, animal killing/torture

  • Compulsive masturbation

  • Chronic lying

  • Enuresis

  • Fire setting


Childhood adolescent history of sadistic offenders l.jpg

Childhood/Adolescent history of Sadistic Offenders

Elements often found

PStealing

PDestruction of property

PDaydreaming (onset of repetitive violent sexual fantasies and themes of mastery/power over others)

PPoor relationship with parents

PAchievement lower than potential


Common family history factors l.jpg

Common Family History Factors

For Sadists

PAlcohol abuse

PPsychiatric disorders

PCriminal behavior

PInstability of residence

PLow family-community involvement


Paraphilia specific considerations20 l.jpg

Paraphilia Specific Considerations

Masochism B the flip side of Sadism

  • Uncommon in offenders, but does turn up at times

  • The masochist feels arousal to experiencing pain/shame/humiliation

  • Danger of eroticizing the entire S&M interaction

  • Danger of projecting the masochistic arousal onto victims

  • Desensitization of the pain & suffering of others


Co existing complicating conditions l.jpg

Co-existing Complicating Conditions

Among sex offenders

  • Developmentally Delayed/Mentally Retarded

  • Organic syndromes

  • Substance Abuse/Dependence

  • ADHD


Co existing complicating conditions22 l.jpg

Co-existing Complicating Conditions

Among sex offenders

PObsessive-Compulsive disorders

PPTSD

PPersonality Disorders


Dd mr l.jpg

DD/MR

Disability is a continuum, terms may vary

  • DSM-IV definitions:

    • Mild MR: IQ level 50-55 to approximately 70

    • Moderate MR: IQ level 35 - 40 to 50 - 55

    • (IQ of 100 is average)

  • Special programming will be needed

  • Keep expectations reasonable

  • If group living is required, educating the DD/MR home staff will be important


Organic syndromes l.jpg

Organic Syndromes

Pervasive Developmental Disorders

  • Asperger=s Syndrome - related to Autism, but with better language development

  • Severe social impairment - lacks understanding and ability of normal social interest, interaction

  • Standard SO treatment unlikely to be appropriate


Fetal alcohol syndrome l.jpg

Fetal Alcohol Syndrome

  • Associated features include facial appearance, organ effects, vision and hearing problems, poor coordination, slow growth

  • Features interacting with offending problems include poor reasoning skills, attention problems, trouble learning from education or experience, attachment problems, impaired impulse control


Organic syndromes26 l.jpg

Organic Syndromes

Traumatic Brain Injury

PCommon symptoms:

<Impaired social judgement, emotional volatility & violence

<Impaired ability to learn rules or grasp reasons behind rules

<From thought to act without Ascreening@

PIf severe, treatment won=t help


Attention deficit hyperactivity disorder l.jpg

Attention Deficit Hyperactivity Disorder

  • Up to 80% of JSOs in some studies; Adults can have it too

  • Increased impulsivity B more likely to act without reflection

  • Harder to focus in therapy, inattention decreases learning

  • Negative social reactions to the symptoms

  • Medications helpful


Obsessive compulsive disorder l.jpg

Obsessive - Compulsive Disorder

  • Obsession = thought; compulsion = behavior

  • May focus on sexual themes or something else

  • Increased alcohol/drug risk with self- medication attempts

  • Individual feels out of control to him/herself

  • Medication helpful


Post traumatic stress disorder l.jpg

Post-Traumatic Stress Disorder

  • Alternating intrusive/avoidance symptoms

  • Can impair life functioning - sleep disturbance, dissociation, emotional numbing, poor concentration, hypervigilance, distrust, anger, flashbacks

  • SO treatment can trigger trauma symptoms for abuse survivors

  • Treating the PTSD can facilitate SO treatment process

    • Victim therapy

    • Medication for symptom management


A word of caution regarding offenders reporting sexual victimization l.jpg

A word of caution regarding offenders reporting sexual victimization

PStudies using polygraph find that about half of the sex offenders claiming a history of sexual victimization are fabricated. Such claims can help take the heat off the offender and re-frame them as the victim. Proceed with caution.


Personality disorders l.jpg

Personality Disorders

General criteria

PEnduring pattern of both internal experiences and external behaviors

PMarkedly different from cultural expectations

POnset in teens or early adult

PPervasive, inflexible, stable over time

PLeads to distress OR impairment


Common personality disorders l.jpg

Common Personality Disorders

among sexual offenders

  • Borderline

  • Histrionic

  • Narcissistic

  • Antisocial

  • Other types exist, but less likely to turn up in SO treatment


Borderline personality disorder l.jpg

Borderline Personality Disorder

Key: Instability and impulsivity

  • Unstable and intense extremes in interpersonal relationships: AI hate you, don=t leave me!@

  • Unstable identity - may vacillate on religion, sense of self, even sexual orientation

  • Suicidal gestures, self injury, other destructive impulsive behaviors common

  • Emotionally volatile, intense and rapid shifts of mood

  • Watch for Borderline PARTNERS of offenders


Borderline personality disorder34 l.jpg

Borderline Personality Disorder

Implications for treatment & supervision

PThey will likely hate the therapist but fear leaving treatment

PTheir support systems will likely be frustrated and perplexed

PSuicide threats/gestures or other high drama are par for the course

PExpects steps back along with steps forward


Histrionic personality disorder l.jpg

Histrionic Personality Disorder

Key: Emotionality and Attention Seeking

PNot comfortable unless the center of attention

PSexually seductive or provocative for attention

PShallow, dramatic, shifting displays of emotion

PSpeech is often overly vague, excessively dramatic


Histrionic personality disorder36 l.jpg

Histrionic Personality Disorder

Implications for treatment & supervision

PHogging group time

PStruggle to pin down details

PLOTS of emotional displays


Narcissistic personality disorder l.jpg

Narcissistic Personality Disorder

Key: Grandiosity, need for admiration, lack of empathy

  • Grandiose view of self importance, talent, superiority

  • Sees self as Aspecial,@Aunique@

  • Sense of entitlement

  • Lacks empathy for others

  • May be exploitive, arrogant, and believes others are envious of him


Narcissistic personality disorder38 l.jpg

Narcissistic Personality Disorder

Implications for treatment & supervision

PYou probably don=t know as much as they do

PRules don=t apply to them

PExpectations of special treatment, attention, catering

PGroupmates may struggle with the huge ego


Antisocial personality disorder l.jpg

Antisocial Personality Disorder

Key: Disregard for, and violation of, others

  • Psychopathy and sociopathy are terms sometimes used

  • Repeated criminal behaviors

  • Deceitfulness, conning, lying - for profit or pleasure

  • Disregard for the rights and safety of others

  • Irritability/aggression

  • Irresponsibility, fails to meet obligations

  • Lack of remorse, lack of concern for others


Antisocial personality disorder40 l.jpg

Antisocial Personality Disorder

Implications for treatment & supervision

  • HIGHER RISK for recidivism

  • Risk of other crimes in addition to sex offending

  • Likely to have antisocial peer group


Antisocial personality disorder41 l.jpg

Antisocial Personality Disorder

Implications for treatment & supervision

  • Watch for using/manipulating groupmates

  • May frighten groupmates

  • Expect dishonesty, thinking errors, and unpaid bills

  • Controversy on teaching empathy with this population


  • Login