ObjectiveMental disorders in sexual offenders are relevant in terms of risk assessment and psychotherapeutic and pharmacological treatment.MethodsThe 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).ResultsN = 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%), paraphilic (43.3%), and personality disorders (53.6%) with a special emphasis on Cluster B personality disorders (47.8%). While sexual offenders against children were more likely to be diagnosed with paraphilic disorders, sexual offenders against adults were more likely to be diagnosed with a personality disorder.ConclusionPrevalence rates of mental disorders in sexual offenders are considerable. Besides specific risk reducing treatment, the psychological and social sequelae of the mental disorder have to be addressed in interventions in order to reach an effective and sustainable risk reduction.
Although much is currently known about hypersexuality (in the form of excessive sexual behavior) among sexual offenders, the degree to which hypersexual behavior is linked to paraphilic and especially pedophilic interests in non-forensic populations has not been established. The purpose of the present study was to elucidate the associations between total sexual outlets (TSO) and other sex drive indicators, antisocial behavior, pedophilic interests, and sexual offending behavior in a large population-based community sample of males. The sample included 8,718 German men who participated in an online study. Hypersexual behavior as measured by self-reported TSO, self-reported sex drive, criminal history, and pedophilic interests were assessed. In moderated hierarchical logistic regression analyses self-reported contact sexual offending against children was linked to sexual fantasizing about children and antisociality. There was no association between aggregated sex drive, and sexual abusive behaviour in the multivariate analyses. In contrast, self-reported child pornography consumption was associated with sex drive, sexual fantasies involving children, and antisociality. Nevertheless, in clinical practice an assessment of criminal history and pedophilic interests in hypersexual individuals and vice versa hypersexuality in antisocial or pedophilic men should be considered as particularly antisociality and pedophilic interest are important predictors of sexual offending against prepubescent children.
LHRH agonists are a useful treatment when combined with psychotherapy in patients with a paraphilic disorder and the highest risk of sexual offending. However, throughout treatment, close monitoring of side effects is needed and ethical concerns must always be kept in mind. Turner D, Briken P. Treatment of Paraphilic Disorders in Sexual Offenders or Men With a Risk of Sexual Offending With Luteinizing Hormone-Releasing Hormone Agonists: An Updated Systematic Review. J Sex Med 2018;15:77-93.
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