Breaking New Ground: Understanding and Preventing Sexual Abuse 2015 ATSA Conference Thursday October 15 1:30 PM - 3:00 PM T-1

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1 T-1 Sex Offender Research in the Era of Virtual Reality Symposium Co-Chair & Co-Discussant: Patrice Renaud, Ph.D. Université du Québec en Outaouais/Institut Philippe-Pinel de Montréal Symposium Co-Chair & Co-Discussant: Joanne-Lucine Rouleau, Ph.D. Université de Montréal/Centre d Etude et de Recherche de l U de Montréal In March 2014, Facebook bought the virtual reality head-mounted display (HMD) company Oculus rift for two billion dollars; this HMD (as well as others of the same type), now sold for less than $350, is compatible with mainstream game consoles. This anecdote is symptomatic of the pervading presence of virtual reality (VR) in our society as well as of the growing importance of immersive technologies in all aspects of our lives. This rapid democratization of VR, crossing with the fact that sex is one the first and most important subject of VR commercial applications, opens to interesting questions in sex offender research: How different from standard pornography is interactive sexual intercourse as mediated by VR? How does immersive VR will affect the shaping of sexual behavior in the future? Will we be facing the arrival of new VR-related paraphilias? How can we optimally harness this set of technologies to better understand and possibly help sex offenders control themselves? At the heart of VR sexual applications lies the use of computer-generated imagery, especially for computer-generated characters (CGC) depicting realistic human beings. These peculiar sexual stimuli, because of their malleability and their very nature, circumvent some ethical issues faced with images of real individuals while offering the possibility to fit sex offenders idiosyncrasies. They also allow for simulating situations that could not be simulated with real individuals, especially children in critical situations such as sexual coercion. Furthermore, because they are visual information, CGC and computergenerated imagery in general give way to the possibility of closely monitoring how they are scrutinized when used in sexual preference assessment. Indeed, in combination with other psychophysiological measurement means (such as penile plethysmography and brain imagery), CGC and eye-tracking devices can help unravel the etiological explanations of sex offense. Our symposium comprises four presentations in line with what precedes. First, Sarah Michelle Neveu (Quebec University in Montreal) and Jean Proulx (University of Montreal) will help us better understand how CGC-based sexual preference assessment can be used to draw distinct profiles for child molesters and rapists. Elissa Dennis, our second presenter, will address matters in line with using CGC expressing positive and negative emotions, and how these animated sexual stimuli can inform about sexual inhibition among individuals following avoidance or approach pathways in their sexual offenses. Thirdly, Shawn Marschall-Lévesque () will give a talk on how he developed a

2 series of CGC-based scenarios mimicking the standardized Quinsey audio stimuli for the assessment of child molesters, as well as how an audio-visual strategy is better than a simple audio one in assessing child molesters sexual preferences, using penile plethysmography and eye-tracking in a combined fashion. Finally, Kevin Nolet (University of Montreal) and Carla Harenski (The Mind Research Network) will share results coming from studies using CGC, eye-tracking and functional magnetic resonance imagery (fmri) in the assessment of sexual preferences of child molesters. Using a mobile fmri unit equipped with eye-tracking technology, their results are pointing toward two distinct functional networks of deviant sexual arousal associated respectively with visual approach and avoidance. Computer-Generated Characters as Sexual Stimuli for Phallometric Assessment: Comparing Child Molesters and Rapists Sarah Michelle Neveu, Ph.D. Candidate UQÀM Jean Proulx, Ph.D. Auditory scenarios are standardly used as sexual stimuli with penile plethysmography to assess deviant sexual interest of child molesters. In this research, computer-generated characters (CGC) are proposed as sexual stimuli. Child molesters (n = 18) and a control group composed of rapists (n = 9) were recruited. During the phallometric assessment, CGC depicting three developmental stages (6-7 years old, years old and 25 years old), and a neutral character, were presented on a standard monitor. A repeated measures factorial ANOVA was conducted. The dependent variables were the mean Z scores of the penile response to the three types of CGC (child 6,7 and years old, adult and neutral). The independent variable was the type of sexual abuser (child molester or rapist). Results suggest that there is a significant interaction between groups (child molesters and rapists) and the types of CGC (child, adult and neutral) (p <.05). T-tests were used to explore these findings. For the child CGC, child molesters had a significantly stronger penile response when compared to the rapists (p <.01). For the adult CGC, child molesters had a significantly lower penile response when compared to rapists (p <.01). For the neutral virtual character, there is no significant difference between groups (p >.05). These findings reveal distinct patterns of penile response between child molesters and rapists to CGC depicting different ages. CGC presented on a monitor can be easily added to phallometric assessment, and could provide a concomitant evaluation of deviant sexual interests for child molesters.

3 1. Demonstrate the utility of virtual characters in the assessment of deviant sexual interests of child molesters. 2. Develop a new technique of evaluation of deviant sexual interest with virtual characters, which is complementary to the auditory scenarios. 3. Explore differences between penile response of child molesters and rapists to virtual characters depicting different ages. Using Computer-Generated Characters Simulating Different Affordances to Assess Sexual Interests Elissa Dennis, Ph.D. Candidate Kevin Nolet, Ph.D. Candidate There are concerns regarding the reliability, realism, and validity of stimulus materials used in the assessment of sexual interests among sex offenders. In an effort to resolve the issue, new stimulus materials for use with penile plethysmography (PPG) assessments were developed at the Virtual Reality Applications in Forensic Psychiatry lab of the Philippe-Pinel Institute of Montreal. First, a pilot study where undergraduate students (N=121) rated virtual characters (male and female) on perceived age will be presented. In addition, the materials developed are unique in that they depict the characters exhibiting varying affective dispositions, including neutral, fearful, sad, joyful, and seductive. Participants were also asked to identify the affective disposition of the virtual characters, and results suggest that affective disposition was largely perceived as intended, especially in terms of identifying the general emotional valence of the affective dispositions (i.e., positive versus negative). Secondly, we used the computer-generated videos to measure sexual arousal responses in a group of non-deviant males (N=26) recruited in the community. Responses measured through penile plethysmography suggest that participants responded to the stimuli as expected, as the greatest amount of sexual arousal was recorded when participants were shown an adult female character. In addition, participants responded with significant arousal only when the adult female character was depicted as sexually open (joyful or seductive), rather than sexually closed (fearful or sad) or neutral. The results obtained by the group of control subjects were then compared to sexual arousal responses in a group of child molesters (N=10) recruited from the Centre d'étude et de Recherche de l'université de Montréal (CERUM), which dispenses treatment for sexual deviance in Montreal. Multivariate results suggest these materials discriminate sexual interests between control subjects and sex offenders. Finally, child molesters were allocated to different sub-groups depending on their initial goal regarding sexual offending

4 (i.e. avoidance versus approach) using Webster's (2005) interview schedule. Results suggest that individuals following different pathways also differed in terms of their sexual interests. We believe these materials may be an interesting addition to the assessment of sexual interests if applied within clinical forensic assessment of sex offenders. 1. Explore the relevance of using virtual characters presenting varying affective dispositions as new stimulus materials for use in the plethysmographic assessment of sexual interests. 2. Compare sexual arousal profiles to virtual characters of normals and child molesters. 3. Compare sexual arousal profiles to virtual characters of child molesters following avoidant or approach pathways. Impact of Audio and Visual stimuli and Audio-Visual stimuli in the Assessment of Child Molesters with Penile Plethysmography Shawn Marshall-Lévesque, Ph.D. Candidate Penile plethysmography using audio stimuli is considered the gold standard for evaluating sexual preferences. Recent technological advancements have, however, reintroduced the importance of using visual stimuli as well. The resurgence of visual stimuli raises an important methodological question as to which type of stimuli should be prioritized. The present study attempts to address this question by comparing both types of stimuli to one another (audio or visual) and by combining the two types (audio-visual) to see if this form is superior. The three types of stimuli were presented to a group of control subjects (n=10) and a group of child molesters (n=4). Measurements included penile plethysmography, oculometry and self-report questionnaires assessing the preference between stimuli and the sense of presence, i.e. the level of perceived realism associated to each stimulus modality. Preliminary results for the control group using standardized deviance indices as well as a repeated measures ANOVA showed a statistically significant difference between type of stimuli (F(1.278, ) = , p.01). Post hoc tests show a significant difference between the visual and audio-visual stimuli conditions (p.001) and indicate that participants in the control group showed a lower deviance score while viewing the deviant audio-visual stimuli than they did while viewing the visual stimuli. These results were corroborated by the participant s (n=14) self-reported preference of stimuli type, showing a significant difference in stimuli preference (F(2, 26) = p.001). Post hoc analyses showed that the audio-visual condition was significantly preferred

5 over the two other conditions. Similarly, a significant difference was found between the three types of stimuli and the sense of presence they generated with each participant (F( 2, 26) = 5,74 p.01). Again, post hoc analyses revealed that the audio-visual condition was significantly superior to the other two stimuli conditions. These preliminary results suggest that the new audio-visual stimuli condition could provide greater penile differences than the visual stimuli. Overall, participants preferred the audio-visual stimuli, a finding which was reinforced by the superior results for the combination of stimuli on the presence questionnaire. Final results will be presented at the symposium. 1. Learn which type of stimuli (audio, visual or audio-visual) is superior for the evaluation child molesters. 2. Explore how the sense of presence is associated with the type of stimuli presented. 3. Learn how the use of eye tracking can increase the validity of penile plethysmography. Sexual Arousal or Visual Avoidance? Understanding fmri Results Using Eye Tracking Technology Kevin Nolet, Ph.D. Candidate, Philippe-Pinel Institute of Montreal Kent A. Kiehl, Ph.D. Mind Research Network Keith A. Harenski, B.Sc. Mind Research Network David Thornton, Ph.D. Sand Ridge Secure Treatment Center Carla Harenski, Ph.D. Mind Research Network Sexual arousal toward children is central to the problem of sexual offending. Several neuroimaging studies have been conducted to identify functional differences between pedophiles and non-pedophiles, however with some inconsistencies. One possible source of confusion is to take the sexual response as a simple, straightforward process. Past studies assumed that presenting sexual stimuli equate with a sexually arousing condition. Yet, sexual arousal is a complex phenomenon associated with both approach and avoidance behaviors. Hemodynamics results alone can be ambiguous as no information is obtained on

6 how the participant is processing the stimuli. As a result, different processes of the sexual response, associated with different functional networks, could be confounded. The combination of eye-tracking technology (ET) and functional magnetic resonance imaging (fmri) could be a viable solution, as oculomotor data can be effectively used to identify information processing strategies of approach or avoidance toward a stimulus. It is proposed that ET could be used to identify two distinct functional network of deviant sexual arousal, associated respectively with visual approach and avoidance. Using a mobile fmri unit equipped with ET technology, 22 incarcerated SOAC have been scanned while viewing computer-generated characters (CGC) representing anatomically correct naked human of both sexes and of different sexual development stages (Taner s stage 1 and 5). The hemodynamic response was obtained using a gradient echo planar imaging technique. ET data was analysed by defining sexual (breast, genitals) and non-sexual (head, legs, feet) areas of interest (AOI) on the stimuli. Regression analyses were then performed on the child-neutral stimuli contrasts using dwell time percentage in the sexual AOIs as predictor. Although based on a relatively limited number of participants, results indicate that two distinct functional networks of deviant sexual arousal can be identified using ET data. Sexual approach was associated with a greater number of activation foci located throughout the brain, while sexual avoidance was associated with fewer foci limited to regions associated with top-down regulation processes, namely the left lateral dorsolateral and orbitofrontal cortices. ET should be included in future fmri studies as it can help to better understand sexual arousal by delineating approach and avoidance activation patterns. 1. Explore how eye tracking technology can complement fmri results. 2. Learn differences in activation patterns between approach and avoidance motivation in deviant sexual arousal. 3. Demonstrate how virtual reality can offer valid stimuli to access deviant sexual arousal.