Deviant Sexual Arousal

Research on sex offenders has profited a great deal from advances in the study of sexual arousal. Since sex offending implies such a high degree of social disapproval, the reports of offenders regarding their interest in sexually deviant behaviours are considered very unreliable. Physiological measurements of sexual arousal are now used routinely in sex offender research and treatment (see box).

A number of studies conducted in laboratory settings have compared the arousal patterns of sex offenders with the arousal patterns of normal males. The overwhelming evidence is that sex offenders respond to deviant sexual cues to a much larger degree than individuals who have never committed sexual offences.

Men convicted for sex offences against children show substantially higher levels of arousal to sexual imagery involving children than normal men. Studies have also shown that some, although not all, pedophiles have a preference for child sexual partners over adult partners. Groups of men who have been convicted of rape can also be differentiated from groups of normal men in that they show less inhibition of arousal to sexual imagery that involves force. The patterns of arousal identified in the laboratory studies also indicate that some rapists prefer coercive sex over mutually consenting sex. Unlike normal men, rapists also have difficulty in laboratory tests which require them to distinguish between portrayals of sexual behaviour that involve consent and portrayals that involve force.

Deviant sexual preferences, however, may not play a major role in all sex offences. Many studies have found that arousal to inappropriate sexual activities does not necessarily imply a preference for such activities. With respect to men who offend against children, for example, research now points to the conclusion that crucial factors other than sexual preference may separate the crimes of many incest offenders from crimes committed by offenders who select non-relatives as their sexual victims.

Theorists have speculated that in some instances, incest takes place when a man's normal sexual outlet is unavailable, or following a decline in sexual satisfaction with his spouse.(3) In such circumstances, opportunistic fathers may pursue daughters, not so much out of the desire for a child sexual partner, but as an alternative source of sexual gratification. On the other hand, some child molesters, particularly those who choose victims outside their own families, may be driven by a strong erotic desire to have sex with children.

One line of support for this hypothesis comes from the finding that sex offenders who offend against non-relatives have a higher rate of reoffence than incest offenders. It has also been reported that non-incestuous offenders tend to be single men who have not established enduring relationships with adult females. This implies that the non-incestuous pedophile may be acting out of a well-established pattern of preference for children, while the incest perpetrator's act may be grounded to a larger extent in family and marital situation factors.

This hypothesis has also received support from laboratory studies in which arousal to sexual cues that involve children is found to be greater among pedophiles who choose non-family members than among incest offenders. In fact, research suggests diverse patterns of sexual preference among individuals who have committed sex offences against children.

In their study at the Kingston Sexual Behaviour Clinic, Drs. Barbaree and Marshall identified several unique "profiles" of sexual arousal in a sample of men who had sexually offended against children. The sex offenders included incestuous and non-incestuous men and they were compared with a group of normal men who had never committed sex offences. The most striking finding was that virtually none of the incest offenders showed sexual preferences for children. Their patterns of arousal were actually very similar to the patterns recorded for normal males. A well-defined preference for children was only observed among the non-incestuous child molesters.

There is also evidence implying that not all rapists possess distinct sexual preferences for violent or coercive sexual activity. It appears that a sub-group of rapists may be motivated by impulsive anger, rather than urges to derive erotic pleasure from violent sexual behaviour. It has been proposed that this type of rapist commits his crime in a sporadic fashion, often within a dating or marital context. The sexual assault may occur after an offender's anger has been provoked by his victim's refusal to engage in sex. Frequently, alcohol may also be involved in the offence.(4)

The impulsive sex offender, therefore, may not exhibit a preference for forced sex over sexual relations that involve consent. This explanation helps account for a finding that has been replicated in several studies; substantial numbers of rapists respond to laboratory portrayals of mutually consenting sex in the same way that normal males respond. Although it is true that men who have been convicted of rape show more excitement to sexual violence than normal males, a preference for this type of sexual activity is simply not present in all rapists. One recent study found that only 10% of rapists preferred violent sex over mutually consenting relations.(5)

The rapist who manifests a strong inclination toward coercive sex, however, may plan the details of a rape and carefully select his victim. In comparison with the impulsive sexual assault, this type of crime is more likely to be carried out by an individual who has a longstanding erotic preference for forced sex. One study that lends support to this position revealed that institutionalized offenders who were responsible for highly planned sexual assaults had more extensive histories of sexual misconduct than a comparison group who had committed unpremeditated acts of rape.(6) Men who exhibit the highest levels of arousal to rape cues in the laboratory commit a greater number of sexual assaults and are more likely to injure their victims than rapists who show less pronounced levels of arousal to rape scenarios.

Personality Attitudinal Factors

The search for causes of sex offending have led some researchers to examine whether or not sex offenders possess personality characteristics that are different from normal men. While numerous studies have been carried out, there is little evidence to substantiate the view that sex offenders possess unique personalities that predispose them to commit sexual crimes.(7)

Although there appear to be some personality differences between normal men and sex offenders, the same differences are often found when normals are compared to other types of criminal offenders. For example, several studies have found that rapists score high on tests designed to identify "psychopathic" personality traits. Terms such as "callous", "anti-social", and "remorseless" have been used to describe the psychopath. However, rapists share such traits with many other types of offenders who have never committed sex offences. For this reason, many researchers believe that explanations of rape that are based on the notion of the psychopathic personality do not help us understand what is unique about sexually assaultive behaviour.

Another avenue of research which initially appeared promising concerned theories about deficiencies in the social skills of rapists. Early studies suggested that rapists were socially dysfunctional in relating to females and that poor social skills resulted in inappropriate sexual behaviour. Recent studies, which have introduced more sensitive methods of measuring skill deficits, cast some doubt on the earlier hypotheses.

Dr. Lana Stermac of the Clarke Institute of Psychiatry and Dr. Vernon Quinsey of Queen's University studied the social competence of rapists in a variety of role-playing situations. The offenders in this study were drawn from the maximum security hospital in Penetanguishene, Ontario, and included rapists as well as offenders who had not committed sexual assault. A group of normal males was also included for comparison. Rapists and other offenders received ratings that were lower than the ratings obtained by normal men on the measures of social skills. However, Stermac and Quinsey found that rapists did not differ from other offenders on most of the measures of social competence. The one exception to the trend was that rapists were somewhat less assertive than the other two groups of men.

Although rapists appear to be very similar to other types of offenders on many characteristics, there is a need for further research in this area. It is possible that some rapists are propelled toward sexual aggression when their psychopathic traits and deficient social skills combine with other yet unidentified characteristics or situational factors.

The beliefs and attitudes held by rapists concerning rape have been examined in very few studies of sex offenders. However, some researchers believe that this area may be very important and needs to be subjected to much further scientific inquiry. At least one study found that in comparison with normal men, rapists believed that women desire forceful sex and often provoke or invite sexual attacks.(8) This finding confirms the experiences of clinicians who repeatedly encounter these types of distorted beliefs in the treatment of sex offenders. Rapists appeal to such explanations in their attempts to justify their sexual behaviour.

There is also a body of research that examines the personality characteristics and beliefs of child molesters. The child molester has often been stereotyped as a shy, insecure individual who suffers from loneliness. There is mixed research evidence for this stereotype. Using personality tests that measure such traits, some studies have supported this characterization of the pedophile while others have not. Furthermore, other studies have found groups of child molesters who are similar to rapists in that they score high on psychopathic personality measures. Hence, research in this area points more to the diversity of personality characteristics displayed by pedophiles than to a unique personality trait which might explain why some men engage in sex with children.

The possibility that child molesters may be less intelligent than normal men has been explored in numerous studies. Drs. Stephen Hucker and Ron Langevin and their associates at the Clarke Institute of Psychiatry conducted a study in which pedophiles were compared with a group of offenders who had not committed sexual or violent crimes. In addition to a standard intelligence test, the researchers administered a battery of tests designed to measure neurological impairment, including a CAT scan (Computerized Tomography). Hucker and Langevin discovered more abnormalities in the test results of the pedophiles. However, the study did not furnish evidence that the brain abnormalities could be linked to pedophilia in a causal fashion.

The Clarke Institute researchers also found that pedophiles scored lower than the non-sex offenders on the intelligence tests. Their results replicated the findings of several studies that had been reported earlier. However, a theory that reveals why pedophiles are less intelligent has not yet been proposed. One hypothesis is that the lower I. Q. scores can be explained by other characteristics which child molesters share in common as a group - characteristics which may not necessarily be directly related to their propensity to engage in deviant sexual behaviour.

Like rapists, child molesters have also been found to possess distorted attitudes and beliefs regarding the victims of their offences.(9) Research findings and the reports of clinicians both confirm that child molesters believe children can freely consent to having sexual relations and that many invite the sexual attentions of adults. The belief that early sexual experiences are a healthy component of a child's development is also commonly held by pedophiles. Treatment experts maintain that if undefeated, such distorted beliefs are a signal that the child molester is likely to reoffend.

Treatment of Sex Offenders

Research on the methods of treatment which are most effective in rehabilitating sex offenders is still in the very early stages of development. Researchers face difficult problems in designing studies that permit conclusive statements about the effective components of treatment.

Nevertheless, advances are beginning to appear and there is growing evidence that offenders who receive some form of treatment have reduced chances of recommitting sexual crimes. Based on the most recent Canadian studies, estimated recidivism rates for treated sex offenders fall in the vicinity of about 10%. If 20% is used as a rough estimate of the recidivism rate for untreated sex offenders, it appears that treatment can have an appreciable impact on sex offender recidivism.

Innovations in treatment techniques have been guided by developments occurring in research on sex offenders. A number of methods have been devised to address the problem of deviant sexual preferences. These techniques employ some of the methods which have been pioneered by behavioural psychologists. There has also been some experimentation with the use of drugs in the treatment of sex offenders (see box).

Behavioural approaches are based on principles of conditioned learning in which attempts are made to either reduce deviant sexual arousal or increase the offender's arousal to more appropriate sexual behaviours. The techniques used to achieve these treatment objectives vary. In one approach, the therapist monitors the offender's level of arousal to deviant sexual cues which are presented under laboratory conditions. Various forms of punishment are used to discourage responses to deviant sexual imagery. For example, when arousal to inappropriate cues reaches a predetermined level, the offender might receive a mild electric shock or be exposed to extremely noxious odours. Another method based on biofeedback procedures allows the offender to monitor his own responses by providing signals at the onset of arousal to deviant behaviours. By anticipating the signal the offender learns to reduce arousal to deviant cues and increase his arousal to more appropriate cues. An alternative method assists the offender to force the recall of unpleasant thoughts or experiences when sexual excitement to the wrong type of sexual behaviour begins to occur.

Generally, behavioural techniques have been found to be effective in many studies. Unfortunately, there has been concern among many experts that the methods produce only short-term changes in deviant sexual preferences. In a study conducted at the forensic psychiatric facility in Penetanguishene, Ontario, Dr. Vernon Quinsey and his colleagues used a combination of biofeedback and electric shock to treat a group of child molesters. Significant improvements were witnessed for most of the offenders who received the treatment. Offenders who had experienced a reduction in arousal to sexual cues involving children maintained lower rates of reoffence for two years following treatment. Unfortunately, the researchers discovered that initial treatment gains were reduced when the follow-up was extended beyond the two year period.

There is some evidence, however, that recidivism in treated offenders can be controlled for longer periods if periodic "booster' treatments are administered following termination of the initial treatment. A study conducted by University of Oregon researcher, Dr. Barry Maletzky, reported considerable success with a behavioural program designed for the treatment of pedophiles and exhibitionists. The offenders received weekly treatments for 24 weeks followed by booster treatment sessions every three months for a period of three years. For the most part, reductions in arousal to inappropriate sexual cues were maintained by the treated offenders over the three year period. More importantly, their rate of recidivism was less than 10%.

Behavioural methods for the treatment of sex offenders have focused primarily on the problem of deviant sexual arousal. Obviously, sex offenders who possess relatively normal sexual preferences will have little to gain from this type of treatment. For example, incest offenders and the more impulsive rapists may have treatment indications that are unrelated to sexual arousal. More recently additional treatment approaches have evolved to address some of the other factors which appear to be related to sex offending. A more comprehensive approach, which often includes a behavioural treatment component, has begun to emerge in many programs for sex offenders in Canada. Most therapists refer to this form of treatment as Cognitive Behavioural Therapy.

Psychologists use the term "cognitive" to refer to attitudes and thought processes which influence an individual's behaviour. Therapists who use cognitive treatment techniques with sex offenders attempt to modify distorted attitudes and beliefs which may contribute to the likelihood that a sex offender will reoffend.

Group and individual therapy sessions are used to confront distorted beliefs about the victims of sex offences and to assist offenders in the development of more socially acceptable expressions of sexuality. A principal component of many sex offender programs which are modeled on the cognitive behavioural framework is to teach program participants to identify the patterns of thought and sequences of behaviour that will lead them to become reinvolved in deviant sexual activities. This approach, often called "relapse prevention", helps the individual sex offender to develop knowledge about the risk factors that are likely to promote relapses.(10) Identification of risk factors becomes highly personalized so that a given offender focuses on the risks that are particularly relevant to his situation.

Cognitive behavioural treatments usually focus on a variety of behaviours which are viewed as requiring change if the offender is to become successfully rehabilitated. For example, anger control, alcohol abuse, social skill deficits, coping with stress, and lack of knowledge about normal sexual behaviour are factors which may be related to sex offending. For this reason, many treatment programs offer special skill-training sessions which allow sex offenders to address needs in these areas. In addition, behavioural treatments designed to reduce deviant sexual preferences are also incorporated in many of the more comprehensive treatment programs in Canada.

Tests of the effectiveness of the cognitive behavioural model of treatment await studies that will provide statistics on the recidivism of offenders treated with these new methods. Preliminary findings of studies which are in progress in Canadian treatment centres suggest that the treatments possess a great deal of promise. In addition, studies that have focused on the use of cognitive behavioural treatments for other types of psychological problems have produced very positive results.

One of the most encouraging signs of the newer, more comprehensive programs for sex offenders is that treatment strategies have taken into account a broad range of factors - factors which research has identified as potentially relevant to the control of sex offender behaviour. As researchers pursue the remaining unanswered questions about sex offending, designers of treatment programs will continue to benefit from the new advances.

In the meantime, the existing body of research on sex offenders points to a number of key areas which should be addressed by current treatment programs in Canada. There is a well-established need to carry out careful assessments on sex offenders who are being considered for treatment. Research findings are clear on the point that sex offenders are a very diverse group and that differences in their characteristics will have important implications for the development of individualized treatment programs. In particular, facilities for conducting assessments of sexual arousal are essential for identifying those offenders who possess deviant sexual preferences and who need special treatment that specifically targets this problem. The available research also suggests that institutionally-based programs which offer little in the way of follow-up may produce only short-term treatment gains. It appears that effective treatment of sex offenders must incorporate follow-up contact or "booster" treatments if long-term benefits are to be attained.

Regional Psychiatric Centre (Pacific)

The in-patient sex offender treatment program at the Regional Psychiatric Centre in Abbotsford is a two year intensive group psychotherapy program. Treatment includes a number of educational modules which include life skills, human sexuality, criminal thinking errors, alcohol and drug problems, and assertiveness training. Sex offenders may be involved in as much as five hours of group psychotherapy a day.

An evaluation of the effectiveness of the program at Abbots-ford is in progress. The study is profiling 200 male sex offenders with respect to age, type of offence, offence history, psychiatric diagnosis, length of sentence, length of treatment, prognosis on departure from the treatment program, and current status upon follow-up after two to six years. Approximately one third of the offenders were in treatment for one to two years, one third for six to 12 months and one third remained in treatment for less than six months.

Ten of the 88 offenders (approximately 9%) who had been released from prison were subsequently reconvicted for a new offence. However, 56% of the sample had not yet been released on their original sentence, highlighting the fact that the majority of offenders were serving sentences of more than 10 years. For comparison purposes, a sample of 70 untreated sex offenders released from a medium security facility were followed up two to four years after their return to the community. The research plans involve a comparison of the post-release successes of the untreated offenders with the outcomes of sex offenders released from the program.

For further information, contact W. Carson Smiley, Ph.D., Director of Psycho-Social Services, Regional Psychiatric Centre (Pacific).

Regional Psychiatric Centre (Prairies)

A series of studies evaluating the cognitive-behavioural sexual offender treatment program is underway at the Regional Psychiatric Centre (RPC) (Prairies). Previously it had been demonstrated that patients improved on a number of important psychological and behavioural measures following treatment. Data are now being collected that suggest that these clinical changes are maintained following treatment. A follow-up of 130 former patients who have been released from custody for an average of two years (maximum: seven years) indicates that only 10% have been convicted of a further sexual offence. An additional 30% of the sample commit non-sexual offences. Additional studies are planned to compare these recidivism rates with those of sexual offenders who have not received treatment, and to determine which factors predict both successful completion of the program and ultimate recidivism.

A second series of studies is evaluating the utility of sexual arousal testing with sexual offenders. The data suggest that pedophiles show distinct patterns of sexual arousal to children and it is important to target deviant arousal patterns during treatment. Contrary to previously reported research, the rapists in the current studies do not respond uniquely to depictions of rape and the preliminary findings suggest that sexual arousal to rape does not predict future sexual offending. Future research will study the role of sexual preferences in understanding and predicting sexual offences.

Other studies are underway to determine whether native sexual offenders have distinct treatment needs and whether the programming at RPC (Prairies) is meeting these needs. Another area of investigation concerns the contributions of attitudes about rape and child molestation to the commission of sexually deviant behaviour. The contribution of early dysfunctional experiences (e.g., abusive family environment, experience as victim of sexual abuse) to sexual offending is also being studied.

For further information, contact Arthur Gordon, Ph.D., Chief Psychology/Research, Regional Psychiatric Centre (Prairies).

Regional Treatment Centre (Ontario)

The Regional Treatment Centre's Sex Offender Program uses a multidisciplinary approach in delivering an 18 week program. Individual therapy and a combination of individualized and group therapy procedures are the two approaches used. Groups include Sex Education, Self-management, Victim Awareness, Social Skills (including conversation, assertiveness, empathy training and relationships), and Street Skills. Individual therapy involves a cognitive-behavioural approach. Short-term treatment effects are evaluated using psychometric and phallometric assessments and behavioural role-plays. Previous research has focused most notably on personality differences in offender subgroups, the efficacy of group Psychotherapy and Empathy Training (1986). Current interest is focused on evaluating the program's long-term efficacy at reducing sexual recidivism.

Follow-up data are currently being gathered on sex offenders assessed and treated at the Regional Treatment Centre with an admission date of January 1977 or later, and a discharge date of December 1986 or earlier. Treatment Centre records that included assessment and treatment reports, information from Finger Printing Service (F.P.S.) sheets, and Offender Information Service Records were used to obtain information on the following: general demographic data; information regarding offence and sentence being served at the time; pre-treatment assessment information, mental status, I.Q., indication of drug and alcohol problems, phallometric and psychometric assessment; treatment information - outcome and recommendation; and, finally, release data information - date and type of release, days at risk, date and type of failure and reoffence.

Preliminary analysis indicated that 8% of the 100 inmates assessed as not requiring the specialized services of the Sex Offender Program and released were reconvicted and returned to prison. Of these, 2% returned on a new sexual offence. Roughly 70% of the 146 inmates who had been treated and released had not been returned to prison. However, 18% were returned to prison on a reconviction for a new sexual offence and 12 % were reconvicted for a non-sexual offence. Looking at classification of offenders by offence, it was found that 67% of rapists had not been returned to prison, 18% were returned for a new sexual offence, and 14% were returned for other offences; 74% of pedophiles and hebophiles were still in the community, 20% were returned for new sexual offences and 6% for other offences. Most of the recidivists appeared to have re-offended within the first three years. Time between discharge from treatment and release, treatment outcome, release type, number of previous victims of sexual assault and substance abuse are also being studied for their association with relapse and successful integration into the community.

For further information, contact Jean Guy Leger, Associate Warden,Regional Treatment Centre (Ontario), Kingston Penitentiary.

Montreal Philippe-Pinel Institute

A study was undertaken to evaluate a group of 18 inmates of federal prisons who have been treated for sexual assault at the Montreal Philippe Pinel Institute between August 1981 and September 1983. The research emphasis was on sex offenders' psychiatric and criminal background, personal involvement in the treatment program, psychiatric relapse, criminal recidivism, lifestyle and mental status as reported during the interview which took place two years after their departure from the Institute. Out of the 18 men involved in the sexual offender treatment program, five were in treatment for three months or less, ten for an average of 456 days, and three successfully completed the whole therapy.

During the follow-up period, three of the five offenders involved in the program for three months or less were re-integrated into the community. All of them relapsed into violent offences and one was reconvicted for a sexual offence.

Ten individuals participated in the treatment program for an average of 456 days. None of them went through all the prerequisite stages of the treatment. Six of the ten offenders who were released did not recidivate. On the other hand, two of the remaining offenders did relapse into crime. Both of them committed rape - one during his escape from the Montreal Philippe-Pinel Institute and the other while he was still incarcerated. One of the rapists committed suicide.

Two of the three men who completed the treatment program were re-convicted for new offences one was charged with burglary and sexual assault, and the second with theft and possession of narcotics. A recent evaluation of the Montreal Philippe-Pinel Institute sex offender program is presently underway. Unfortunately, the results were not available at the time this publication was prepared.

For further information, contact Hodgins, S. et al., Research Centre, Montreal Philippe-Pinel Institute.

(1)These figures very likely underestimate the number of sex offenders in our federal penitentiaries. The figures refer to offenders who had "major" offences that were classified as sexual. A "major" offence is defined as an offence that received the longest sentence. Hence, sex offenders with multiple convictions who received their longest sentences for non-sex offences are not included in the figures.
(2)Furby, L., Weinrott, M.R., & Blackshaw, L. (1989). Sex offender recidivism: A review. Psychological Bulletin, 105, 3-30.
(3)Quinsey, V.L. (1986). Men who have sex with children. In D.N. Weistub (Ed.). Law and Mental Health: International Perspectives.
(4)Marshall, W L., & Barbaree, H. E. (1984). A behavioral view of rape. International Journal of Law and Psychiatry, 7, 51-77. (Vol.2). New York: Pergamon.
(5)Baxter, D.J., Barbaree, H.E., & Marshall, W.L. (1986). Sexual responses to consenting and forced sex in a large sample of rapists and non-rapist. Behavioural Research and Therapy, 24, 513-520.
(6)Prentky, R. A., & Knight, R. A. (1986). Impulsivity in the lifestyle and criminal behaviour of sexual offenders. Criminal Justice and Behaviour, 13, 141-164.
(7)Levin, S.M., & Stava, L. (1987). Personality characteristics of sex offenders: A review. Archives of Sexual Behaviour, 16, 57-79.
(8)Field, H. S. (1978). Attitudes toward rape: A comparative analysis of police, rapists, crisis counselors, and citizens. Journal of Personality and Social Psychology 36, 156-179.
(9)Langevin, R., & Lang, R. (1985). Psychological treatment of pedophiles. Behavioral Sciences and the Law, 3, 403-419.
(10)Pithers, W.D., Marques, J. K., Gibat, C.C., & Marlatt, A. (1983). Relapse prevention with sexual aggressives: A self-control model of treatment and maintenance of change. In J.G. Greer & L.R. Stuart (Eds.), The Sexual Agressor: Current Perspectives on Treatment. Toronto: Van Nostrand Reinhold.