In offending populations, prevalence rates of mental disorders are much higher than in the general population. Nevertheless, it is unclear whether mental disorders can improve the prediction of recidivism beyond actuarial risk assessment tools. The present prospective-longitudinal study was conducted between 2001 and 2021 and included 1066 men convicted of sexual offenses in Austria. All participants were evaluated with actuarial risk assessment tools for the prediction of sexual and violent recidivism and the Structured Clinical Interview for Axis I and Axis II disorders. Sexual and violent reconvictions were assessed. Exhibitionism and an exclusive pedophilia showed the strongest correlations with sexual recidivism in the total sample. In the child related offense subsample additionally a narcissistic personality disorder was correlated with sexual recidivism. The strongest correlation with violent recidivism was found for an antisocial and borderline personality disorder. None of the mental disorders could improve the prediction of recidivism beyond actuarial risk assessment tools. Common current actuarial risk assessment tools revealed good predictive accuracy in men convicted of sexual offenses. With few exceptions mental disorders were only weakly associated with recidivism, suggesting that there is no direct link between mental disorders and violent and sexual reoffending. Mental disorders should nevertheless be considered in treatment issues.

The current study examined the association between psychopathy, criminal behavior, and the role of verbal intelligence. One promising approach is to examine alternative links between psychopathic traits and criminality like moderation and mediation effects by considering the potential relevance of verbal intelligence as a possible moderating variable. We hypothesized that psychopathic traits linearly predict antisocial behavior (ASB) but that a conviction because of ASB is moderated by verbal intelligence. To test a path model of this hypothesis, N = 305 participants (42% women; n = 172 inmates of German correctional facilities) filled in questionnaires to assess psychopathic traits, ASB, criminal behavior, and verbal intelligence. The moderated mediation analysis revealed that high psychopathic traits go along with a higher number of ASB, whereas individuals with higher verbal intelligence were more likely to evade detection, thus being more successful in their antisocial acts. These results sheds further light on the construct of adaptive psychopathy, supporting the notion that also non-incarcerated psychopathic individuals act highly antisocial. Only separate factors like verbal intelligence might mitigate negative consequences. Further implications for the concept of successful psychopathy are discussed.

BackgroundThe number of individuals who sexually offended, and who are continued to be treated with pharmacological agents to reduce sex drive after their release from prison or forensic psychiatry, are not known. Furthermore, figures on the number of those who stop their sexdrive supressing antiandrogen treatment in the outpatient setting are unknown as well. This is of central importance though as it might be associated with an increased risk of recidivism. AimTo assess prescription patterns as well as adherence to pharmacological treatment in outpatient clinics in Germany for individuals who have sexually offended and were released from prison or forensic psychiatric hospital. MethodsA self-constructed online survey assessing the pharmacological treatment modalities was sent by e-mail to n = 103 forensic outpatient clinics in Germany. Thirty-three (32.0%) completed the questionnaire and reported about 834 patients. OutcomesPrevalence of the use of different pharmacological agents in the treatment of individuals convicted for sexual offenses as well as the number of patients who have discontinued testosterone-lowering medication (TLM). ResultsAmong all institutions, 22.4% (n = 187) of individuals received pharmacological treatment, with 40.1% receiving gonadotropin-releasing-hormone-agonists, 26.2% antipsychotics, 24.6% selective serotonin reuptake inhibitors, 6.4% cyproterone acetate, and 2.7% a combination of gonadotropin-releasing-hormone-agonists and cyproterone acetate. A significant positive correlation was found between the number of patients released from a forensic-psychiatric hospital and the number of patients treated with TLM. Within 1 year 8.6% (n = 16) stopped their TLM during or at the end of the supervision period, most of them against treatment providers advice. Clinical ImplicationsSubstantial regional differences indicate uncertainties regarding the prescription of pharmacological agents for outpatients who have committed sexual offences in Germany. The discontinuiation of TLM within the first year of treatment against treatment providers advise in a substantial proportion of patients could be associated with a serious risk for reoffending. Strengths & LimitationsThe present survey captures prevalences of the pharmacotherapy in forensic aftercare facilities for individuals who have offended sexually, and is the first to record the number of discontinuations. This is a cross-sectional survey covering only 1 country, but includes a large number of individuals. ConclusionEven though the number of treated individuals has increased in prisons, the majority of pharmacological treatment is still provided by forensic hospitals, which then translates into the outpatient setting. The number of those who stop taking such medication is a highly relevant topic for both forensic treatment providers and legal decision makersSauter J, Rettenberger M, Briken P, et al. Survey on the Prescription Patterns of Pharmacological Agents in Individuals Who Have Committed Sexual Offenses During Forensic Outpatient Treatment in Germany: How Many Discontinue Testosterone Lowering Medication Under Parole?. J Sex Med 2022;19:1147–1155.

Abstract This article explores some of the challenges to fighting against Italian mafias and mafia-type organized crime in Europe, specifically in eight countries—Germany, Switzerland, the Netherlands, Belgium, Spain, Romania, the UK, and Italy. Data have been collected and analysed in two phases: first, from open sources (including media and official reports) and judicial files; secondly, from 40 individual or collective interviews. European institutions still struggle to counter the mobility of Italian mafias because of conceptual asymmetries in policing mafia-type crimes/groups and procedural challenges. We present two analytical foci: first, the existence of a conceptual tension in the definition of mafia and mafia mobility between Italy and European countries and institutions; second, emerging procedural asymmetries in countering mafias across borders, which relate more broadly to cross-border countering of organized crime. This article wishes to screenshot the state of the art and advance some reflections, without pushing any specific theoretical framework. After exploring the two main analytical foci emerging in this research, we advance recommendations.

ABSTRACT Assessment reports about individuals charged/convicted of offenses have an influence on significant personal consequences for examinees by sentencing decisions regarding placement in a forensic hospital or prison. As there is evidence that unstructured clinical judgments have limited accuracy, research-based practice recommendations call for the use of standardised measures and for experts to base their assessments on empirically supported psychological tests. Previous findings on the actual use of psychometric tests indicate an increasing but still heterogeneous use of psychological tests, highlighting the continued relevance of a professional debate on best diagnostic practice. A potential shortcoming, however, is that these studies almost exclusively relied on clinicians’ self-reports. The present paper presents an analysis based on the actual (retrospectively assessed) usage in German risk (n = 489), criminal responsibility assessment reports (n = 272), and corresponding psychological test reports (n = 313) between 1990 and 2016. In accordance with previous survey data, results showed a frequent usage of a diverse range of psychological tests. Contrarily, performance-based personality tests, typically subsumed under so-called (semi-)projective personality tests, are still implemented regularly in forensic-clinical practice, although the number and frequency seem to be decreasing. Taken together, the findings gain an important insight into the psychological testing practive in forensic settings.

ABSTRACT Hypersexual disorder (HD) is characterized by an excessively increased frequency and intensity of sexual fantasies, urges, or behaviors and is a recidivsm risk factor for sexual offenses. The present study examined the relevance of HD in predicting sexual recidivism using previously proposed diagnostic criteria for DSM-5. First, we investigated the prevalence of HD in a sample of 418 adult men incarcerated for sexual offenses. Second, by using a follow-up period of M = 11.07 years (SD = 1.86), the accuracy of the HD criteria in predicting general sexual, contact sexual and violent recidivism was examined. Finally, the incremental predictive validity of HD beyond the Static-99 and the Stable-2007 was calculated. The proposed DSM-5 criteria were fulfilled by 6.6% of the sample. HD and two of its five diagnostic criteria exhibited significant correlations with sexual recidivism. A small significant predictive accuracy for contact sexual recidivism (AUC = .614) was found, which increased when a sum score of the five diagnostic criteria was used (AUC = .652). Finally, the HD sum score showed incremental predictive validity beyond the joint Static-99 and Stable-2007. Therefore, a more specific understanding of hypersexuality can contribute to risk management in the context of sexual (re-)offending.

Abstract The Domestic Abuse, Stalking and Honour Based Violence (DASH) form is a standardized risk assessment implemented across most UK police forces. It is intended to facilitate an officer’s structured professional judgment about the risk a victim faces of serious harm at the hand of their abuser. Until now, it has been an open question whether this tool works in practice. Here, we present the largest scale European study, making the case that the risk assessment tool is underperforming. Each element of the DASH questionnaire is, at best, weakly predictive of revictimization. Officer risk predictions based on DASH are little better than random and a logistic regression model that predicts the same outcome using DASH only provides modest improvement in performance.

The aim of the present study was to examine the psychometric properties of the German version of the revised Violence Risk Appraisal Guide (VRAG), the VRAG-R. Therefore, VRAG-R ratings were made retrospectively in an Austrian sample of 534 individuals convicted of a sexual offense who were followed up with an average of 7.62 years. The VRAG-R showed large effect sizes for the predictive accuracy of violent (AUC = .75) and general recidivism (AUC = .78) and significant but rather small effect sizes (AUC = .63 and .61, respectively) in predicting any sexual and sexual contact recidivism. Furthermore, for the prediction of violent recidivism but not for sexual recidivism the VRAG-R was incrementally predictive beyond the Sex Offender Risk Appraisal Guide (SORAG) and the Static-99. Finally, the VRAG-R absolute recidivism rates for the risk bins showed satisfactory calibration properties. Taken together, the results of the present study support the cross-national utility of the VRAG-R and its use in applied risk assessment settings also in German-speaking countries.

Mental disorders in sexual offenders are relevant in terms of risk assessment and psychotherapeutic and pharmacological treatment. The 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). N=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. Prevalence 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.