Handbook of Sexual Assault. Issues, Theories, and Treatment of the Offender

Transcription

1 Handbook of Sexual Assault Issues, Theories, and Treatment of the Offender

2 APPLIED CLINICAL PSYCHOLOGY Series Editors: Alan S. Bellack, Medical College of Pennsylvania at EPPI, Philadelphia, Pennsylvania, and Michel Hersen, University of Pittsburgh, Pittsburgh, Pennsylvania Current Volumes in this Series THE AIDS HEALTH CRISIS Psychological and Social Interventions Jeffrey A. Kelly and Janet S. St. Lawrence BEHAVIORAL CONSULTATION AND THERAPY John R. Bergan and Thomas R. Kratochwill BEHAVIORAL CONSULTATION IN APPLIED SETTINGS An Individual Guide Thomas R. Kratochwill and John R. Bergan HANDBOOK OF BEHAVIOR MODIFICATION WITH THE MENTALLY RETARDED Second Edition Edited by Johnny L. Matson HANDBOOK OF THE BRIEF PSYCHOTHERAPIES Edited by Richard A. Wells and Vincent J. Giannetti HANDBOOK OF CLINICAL BEHAVIORAL PEDIATRICS Edited by Alan M. Gross and Ronald S. Drabman HANDBOOK OF SEXUAL ASSAULT Issues, Theories, and Treatment of the Offender Edited by W. L. Marshall, D. R. Laws, and H. E. Barbaree HANDBOOK OF TREATMENT APPROACHES IN CHILDHOOD PSYCHOPATHOLOGY Edited by Johnny L. Matson PSYCHOLOGY A Behavioral Overview Alan Poling, Henry Schlinger, Stephen Starin, and Elbert Blakely A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication. Volumes are billed only upon actual shipment. For further information please contact the publisher.

3 Handbook of Sexual Assault Issues I Theories I and Treatment of the Offender Edited by W. L. MARSHALL Queen's University Kingston, Ontario, Canada D. R. LAws University of South Florida Tampa, Florida and H. E. BARBAREE Queens University Kingston, Ontario, Canada SPRINGER SCIENCE+BUSINESS MEDIA. LLC

4 Llbrary of Congress Cataloglng-ln-Publlcatlon Data Handbook of sexual assault : issues. thaories, and treat.ant of the offender I edited by H.L. Marshall, D.R. Laws, and H.E. Barbaree. p. c. -- (Applied clinical psychologyl Includes bibliographical references. ISBN ISBN (ebook) DOI / Sex offenders--mental health. 2. Sex offenders--psychology. 3. Psychotherapy. 1. Marshall, H. L. II. Laws, D. Richard. III. Barbaree, H. E. IV. Series. [DNLM: 1. Paraphillas--therapy. 2. Sex Offenses. WM 610 H2361 RC560.S47H '83--dc20 DNLM/OLC for Library of Congress CIP 1990 Springer Science+Business Media New York Origina11y published by Plenum Press, New York in 1990 Softcover reprlnt of the bardcover 1 st edition 1990 AII rights reserved No part of this book may be reproduced, stored in a retrievai system, or transmiued in any form or by any means, electronic, mechanicai. photocopying, microfilming, recording, or otherwise, without written permission from the Publisher

5 Contributors Gene G. Abel Behavioral Medicine Institute, Atlanta, Georgia J. Bain Department of Endocrinology, Mount Sinai Hospital, Toronto, Ontario MSG lxs, Canada H. E. Barbaree Department of Psychology, Queen's University, Kingston, Ontario K7L 3N6, Canada J. M. W. Bradford The Royal Ottawa Hospital and the University of Ottawa, Ottawa, Ontario KlZ 7K4, Canada Juliet L. Darke Correctional Service Canada, Prison for Women, Kingston, Ontario K7L 4W7, Canada Christopher M. Earls Department of Psychology, University of Montreal, Montreal, Quebec H3C 3J7, Canada David Finkelhor Family Research Laboratory, University of New Hampshire, Durham, New Hampshire Kurt Freund Department of Psychiatry, University of Toronto, and Department of Behavioral Sexology, Clarke Institute of Psychiatry, Toronto, Ontario MST 1R8, Canada Roy Gillis Metropolitan Toronto Forensic Service, Toronto, Ontario M6J 1H4, Canada v

6 vi CoNTRIBUTORS Judith Lewis Herman Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts 02139; and Women's Mental Health Collective, Somerville, Massachusetts S. J. Hucker Forensic Division, Clarke Institute of Psychiatry, Toronto, Ontario M5T 1R8, Canada Raymond A. Knight Department of Psychology, Brandeis University, Waltham, Massachusetts ; and Research Department, Massachusetts Treatment Center, Bridgewater, Massachusetts Ron Langevin Clarke Institute of Psychiatry, Toronto, Ontario M5T 1R8, Canada D. R. Laws Department of Law and Mental Health, Florida Mental Health Institute, University of South Florida, Tampa, Florida W. L. Marshall Department of Psychology, Queen's University, Kingston, Ontario K7L 3N6, Canada Richard M. McFall Department of Psychology, Indiana University, Bloomington, Indiana William D. Murphy Department of Psychiatry, University of Tennessee, Memphis, Tennessee Mary R. Murrin Department of Law and Mental Health, Florida Mental Health Institute, University of South Florida, Tampa, Florida William D. Pithers Vermont Center for the Prevention and Treatment of Sexual Abuse, Vermont Department of Corrections, Waterbury, Vermont Robert A. Prentky Department of Psychology,.Brandeis University, Waltham, Massachusetts ; and Research Department, The Massachusetts Treatment Center, Bridgewater, Massachusetts 02324

7 CoNTRIBUTORS vii Vernon L. Quinsey Department of Psychology, Queen's University, Kingston, Ontario K7L 3N6, Canada Joanne-L. Rouleau Behavioral Medicine Institute, Atlanta, Georgia Zindel V. Segal Cognitive Behavior Therapies Section, Clarke Institute of Psychiatry, University of Toronto, Toronto, Ontario MST 1R8, Canada Lana E. Stermac Forensic Division, Clarke Institute of Psychiatry, University of Toronto, Toronto, Ontario MST 1R8, Canada Linda Meyer Williams Family Research Laboratory, University of New Hampshire, Durham, New Hampshire 03824

8 Preface At the close of the annual meeting of the International Academy of Sex Research held in Amsterdam in September 1986, we were sitting in an outdoor cafe considering what we had learned. In this beautiful city where it is possible to indulge a wide variety of intellectual and sensual appetites, and after having attended one of the most prestigious and information-filled conferences in our field of clinical and research endeavor, dissatisfaction was not what we wished to admit; but the sense that something was missing pervaded our discussions. While some of the topics considered at the conference were relevant to the issues of sex offenders, we were left feeling that a concentrated focus was absent. Indeed, it has largely been through the persistent efforts of the small North American group that has come to be known as the Association for the Behavioral Treatment of Sexual Abusers that research and clinical efforts dealing with sex offenders have blossomed on this continent; there is apparently no similar group on the other continents despite the widespread (albeit recent) acknowledgment by governments that the sexual assault of women and children is an extensive and serious social concern. While a careful search of the historical literature reveals the efforts of a limited few individuals, prior to the early 1970s very little was known about sex offenders, at least partly because public and scientific awareness of the problem was minimal. Since that time a considerable body of knowledge has been generated on the assessment and treatment of sexual offenders. However, most of this information is scattered throughout a wide range of academic journals; those books which have appeared have, for the most part, reflected the views and described the work of their authors. Certainly these books have been-and continue to be-very valuable, but it seemed to us that what was needed, to facilitate continuing efforts to learn more about this baffling problem, was a book that would bring readers up to date on current knowledge and thinking in the area. There was no such book presently available, and so we resolved, in a moment of bravado, to fill this gap. We could have chosen to write a book ourselves, but we recognized that it might be difficult to coordinate the views of three authors and that, in any case, the likely result would again reflect a narrow viewpoint. Accordingly, we decided that an edited book covering the various issues, with each chapter written by an acknowledged authority on the specific topic, would best meet our goal. With an optimism that was not justified by our editorial experience, we began the task, and, with the help of a number of people, the book has finally come to fruition. Covering, as it does, the important features involved in the assessment and treatment of sexual aggressors, as well as theories concerning the development ix

9 X PREFACE and maintenance of such offending, this book summarizes, in the words of experts in each area, current understanding of this pervasive and socially destructive problem. It is our hope that this book will prove to be valuable to researchers who are concerned with expanding our present understanding of sexual aggressors by encouraging present researchers not only to continue their valuable work, but also to recognize the broader context of their contributions. We also hope the book will spark the investigative interest of those clinicians who presently think that doing research is an impossible task given their workload; almost all the authors of our book are active clinicians as well as outstanding researchers, and their work provides a model of how valuable and manageable it is to combine these two activities. Similarly, clinicians and counsellors who deal with either the sexual aggressors or their victims should find this book to be a source of information which might otherwise be difficult to access. It will, we hope, also encourage them to see the value of their own work in a broader context and perhaps persuade them to expand their range of strategies in treatment. Students who are training in the various disciplines (e.g., psychiatry, psychology, social work, sociology, law, criminology) relevant to the scientific, clinical, and social response to sexual aggression will have available in this book a comprehensive summary of present research findings. Finally, governmental agencies responsible for dealing with sexual offenders and their victims might consider this book as a resource. We wish to thank all of those researchers, colleagues, and students, past and present, who have encouraged us, given us guidance and advice, and offered their support when needed. Many of them have contributed chapters to this book. In addition, our friends and families gave us their support throughout our careers and during the preparation of this book. We also owe a debt of gratitude to those at Plenum who made our task easier, particularly Eliot Werner, Alyce Hager, and Peter Strupp. Finally, we are grateful to our friend Michel Hersen for his early encouragement and direction. Kingston, Ontario, and Tampa W. L. Marshall D. R. Laws H. E. Barbaree

10 Contents PART 1: INTRODUCTION 1. Issues in Sexual Assault W. L. Marshall, D. R. Laws, and H. E. Barbaree Introduction Scope of the Work Origins of Sexual Assault Factors Influencing Sexual Assault The Bottom Line Purpose of This Project References The Nature and Extent of Sexual Assault Gene G. Abel and Joanne-L. Rouleau Introduction Incarceration versus Nonincarceration The Reliability of Self-Report The Present Study Recruiting Sexual Assaulters Assessment Methods Results and Recommendations Demographic Characteristics Age of Onset of Deviant Sexual Interest Deviant Sex Acts by Specific Category of Paraphilia Rape as a Paraphilia Conclusions References Classifying Sexual Offenders: The Development and Corroboration of Taxonomic Models Raymond A. Knight and Robert A. Prentky Classification Research Program Stage 1: Theory Formulation Stage ll: Implementation Stage lll: Validation Stage IV: Integration xi

11 xii CoNTENTS Child Molester Typology Rapist Typology Problems of the Revised Rapist Typology (MTC:R2) The Process of Revising MTC:R MTC:R3-The Revised Rapist Typology MTC:R3-The Generation of Prominent Structural Features MTC:R3-Solving the Problems of MTC:R Conclusions References PART II: FACTORS INFLUENCING SEXUAL ASSAULT 4. Sexual Aggression: Achieving Power through Humiliation Juliet L. Darke Sexual Gratification as a Primary Motivation Power and Humiliation Victim Reports Offender Reports Offender Behavior Future Research Directions Attitude Research Sexual Arousal Studies Treatment and Prevention References The Influence of Pornography on Sexual Crimes Mary R. Murrin and D. R. Laws Availability of Pornography and the Incidence of Sexual Crimes Cultural Values and Prevalent Pornography Themes Effects of Pornography on Nonoffender Males Pornography in the Life of the Sex Offender Conclusions References Androgenic Hormones and Sexual Assault S. ]. Hucker and]. Bain Basic Physiology of Sex Hormones in the Human Male Hormones and Sex Drive in Males Testosterone-Level Responses to Erotic Stimulation Treatment of Hypogonadal Men with Testosterone Behavioral Effects of Castration Testosterone and Aggression in Normal Males Testosterone and Aggression in Male Offenders

12 CoNTENTS xiii Hormones and Sexual Aggression Conclusions References Sexual Anomalies and the Brain Ron Langevin The Temporal Lobes and Sexual B'ehavior Animal Studies Human Studies Related Issues Criminal and Community Control Groups Substance Abuse General Violence Conclusions References Stimulus Control of Sexual Arousal: Its Role in Sexual Assault H. E. Barbaree Introduction Sexual Preferences Laboratory Assessments of Sexual Preferences Stimulus Control of Sexual Arousal Sexual Reflexes Sexual Stimuli and Stimulus Control Child Molesters Rapists Stimulus Inhibition of Sexual Arousal Mechanisms of Stimulus Inhibition Individual Differences Disinhibition of Rape Arousal Disinhibition by Victim Blame Disinhibition by Anger Disinhibition by Alcohol Intoxication Disinhibition by Preexposure to Aggressive Pornography Excitation by Nonsexual Violence The Preferential Rape Pattern in a Single Rapist... : Summary References Social and Cultural Factors in Sexual Assault Lana E. Stemzac, Zindel V. Segal, and Roy Gillis Sociocultural Factors Studies of Nonoffenders The Prevalence of Sexual Aggression and Harassment Social Attitudes and Beliefs

13 xiv CoNTENTS Studies of Offenders Attitudes of Offenders Social Skills of Offenders Conclusions References The Role of Cognition in Sexual Assault Zindel V. Segal and Lana E. Stermac Issues in Cognitive Assessment Sexual Assaulters of Adult Females Cognitive Factors Studies of Cognitive Products Studies of Cognitive Operation Variables Sexual Assaulters against Children Future Directions Conclusions References PART III: THEORIES OF SEXUAL ASSAULT 11. Sex Offenders: A Feminist Perspective Judith Lewis Herman A Feminist Social Analysis of Sexual Violence Psychological Studies of Sex Offenders A Model of Addiction Implications for Prevention References Courtship Disorder Kurt Freund Introduction Co-Occurrence of the Different Expressions of Courtship Disorder Co- Occurrence with Other Anomalous Erotic Preferences Conclusions References A Conditioning Theory of the Etiology and Maintenance of Deviant Sexual Preference and Behavior D. R. Laws and W. L. Marshall Acquisition Processes Basic Conditioning Processes Social Learning Processes

14 CoNTENTS xv Maintenance Processes Specific Autoerotic Influences Specific Social Learning Influences Intermittent Reinforcement Summary of Maintenance Processes: A Case Example Treatment Applications Conclusions References The Characteristics of Incestuous Fathers: A Review of Recent Studies Linda Meyer Williams and David Finkelhor The Studies Reviewed The Context of Incestuous Abuse The Characteristics of Incestuous Fathers Childhood Experiences Psychological Characteristics Sexuality Family and Social Relations Theoretical Implications Methodological Suggestions Summary and Conclusions References An Integrated Theory of the Etiology of Sexual Offending W. L. Marshall and H. E. Barbaree Biological Influences Childhood Experiences Sociocultural Context General Cultural Features Availability of Pomography Transitory Situational Factors Summary References PART IV: TREATMENT OF THE OFFENDER 16. The Modification of Sexual Preferences Vernon L. Quinsey and Christopher M. Earls Measurement of Sexual Preferences Interpretation of Deviant Sexual Arousal Methods of Reducing Inappropriate Sexual Interest Methods of Increasing Nondeviant Sexual Arousal

15 xvi CONTENTS Interpretation of Changes in Sexual Preference Specificity of Changes Process of Change Decisions Based on Sexual Preference Changes References The Antiandrogen and Hormonal Treatment of Sex Offenders f. M. W. Bradford Introduction Hormonal Controls over Sexual Behavior Hormones and Other Agents in Treatment Medroxyprogesterone Acetate Cyproterone Acetate Management Strategies of Antiandrogen Treatment Future Research References The Enhancement of Social Skills: An Information-Processing Analysis Richard M. McFall An Information-Processing Model of Social Skills Evaluation of the Social Information-Processing Model Previous Research Evidence Research Based on the Information-Processing Model Implications for the Enhancement of Social Skills References Assessment and Modification of Cognitive Distortions in Sex Offenders William D. Murphy Models of Cognitive Factors Clinical Assessment Approaches Approaches to Changing Cognitions Summary References Relapse Prevention with Sexual Aggressors: A Method for Maintaining Therapeutic Gain and Enhancing External Supervision William D. Pithers Past Theories Regarding Etiology of Sexual Aggression Sexual Aggression as an Impulsive Act Sex Offenders as "Sexual Psychopaths"

16 CoNTENTS xvii Relapse Prevention The Relapse Process Internal Self-Management Dimension Relapse Prevention Assessment Procedures Assessment of High-Risk Situations Assessment of Coping Skills Assessment of Determinants of Sexual Aggression Relapse Prevention Treatment Procedures Treatment Procedures for Avoiding Lapses Interventions to Prevent Lapses from Becoming Relapses Maintenance Manuals Shortcomings of the Internal Self-Management Dimension External Supervisory Dimension: A New Relapse Prevention Model Conclusion References Outcome of Comprehensive Cognitive-Behavioral Treatment Programs... ; W. L. Marshall and H. E. Barbaree Nature of Comprehensive Cognitive-Behavioral Programs Content of Programs Format of Programs Outcome Evaluations Institutional Programs Outpatient Programs Predicting Treatment Outcome Summary References PART V: CONCLUSION 22. Present Status and Future Directions W. L. Marshall, D. R. Laws, and H. E. Barbaree The Selectivity Issue Self-Management and the Prevention of Relapse Early Onset of Sexual Offending Misuse of Measurement Technology What is "Sexual Arousal"? Conclusion References Index