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Chapter 12 - Sexual Offences and Paraphilias

Published online by Cambridge University Press:  07 November 2024

By
Stuart Banham ,
Gemma Lewin  and
John Devapriam
Edited by
David M. L. Branford ,
Satheesh K. Gangadharan ,
Mary Barrett  and
Regi T. Alexander
David M. L. Branford
Affiliation:
Independent Pharmacy Consultant
Satheesh K. Gangadharan
Affiliation:
Leicestershire Partnership NHS Trust
Mary Barrett
Affiliation:
Leicestershire Partnership NHS Trust
Regi T. Alexander
Affiliation:
Hertfordshire Partnership University NHS Foundation Trust
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Summary

Although the terms ‘sexual offences’ and ‘paraphilias’ are often used interchangeably, and there is overlap between them, there needs to be clarity about what each means. Sexual offences are marked by breaches of statute law, determined largely by the justice system (although an individual’s behaviour can place them at risk of law breaking). Only a proportion of sex offenders suffer from paraphilias and not all individuals with a paraphilia are sex offenders. Frequently individuals suffering from paraphilias harbour extreme sexual fantasies and urges only, or their act does not cross the threshold of involving a non-consenting individual or child. The treatment of paraphilias is not solely based on minimising risk, but also can include the aim of reducing the severe distress that an individual can feel about their extreme sexual urges. Whether people with intellectual disability are more likely to offend sexually than the general population is the subject of much research. Exploration of the range of sexual problems and potential treatments are covered.

Keywords

paraphilic disorderssexual abuseantiandrogenscyproteroneantipsychoticsgonadotrophin-releasing hormone (GNRH) analogues
Type
Chapter
Information
The Frith Prescribing Guidelines for People with Intellectual Disability , pp. 169 - 179
Publisher: Cambridge University Press
Print publication year: 2024

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References

Alexander, R.T., Green, F.N., O’Mahony, B., et al. (2010). Personality disorders in offenders with intellectual disability: A comparison of clinical, forensic and outcome variables and implications for service provision. Journal of Intellectual Disability Research, 54(7), 650–8.CrossRefGoogle ScholarPubMed
Bradford, J. M. W. (1985). Organic treatments for the male sexual offender. Behavioural Sciences and the Law, 3, 355–75.CrossRefGoogle Scholar
Bradford, J. M. W. (2000). The treatment of sexual deviation using a pharmacological approach. Journal of Sex Research, 3, 248–257.CrossRefGoogle Scholar
Bradford, J., Greenberg, D. M., Gojer, J. J., Martindale, J. J., & Goldberg, M. (1995). Sertraline in the treatment of pedophilia – An open labelled study. Paper presented at the Annual American Psychiatric Association Congress, Miami, FL, May.Google Scholar
Bradford, J. M. W., & Fedoroff, P. (2006). Pharmacological treatment of the juvenile sex offender. In Barbaree, H. E. & Marshall, W. L. (Eds.), The Juvenile Sex Offender (2nd ed.) (pp. 358–83). New York, NY: Guilford.Google Scholar
Bradford, J. M. W. & Kaye, N. S. (1999). Pharmacological treatment of sexual offenders. American Academy of Psychiatry and Law Newsletter, 24, 16–17.Google Scholar
Callahan, P. A., Jeglic, E. L., & Calkins, C. (2021). Sexual offenders with intellectual disabilities: An exploratory comparison study in an incarcerated US sample. International Journal of Offender Therapy and Comparative Criminology. Advance online publication. https://doi.org/10.1177/0306624X211066825.CrossRefGoogle Scholar
Chester, V., Tharian, P., Slinger, M., Varughese, A., & Alexander, R. T. (2023). Overview of offenders with intellectual disability. In McCarthy, J. M., Alexander, R. T., & Chaplin., E. (Eds.), Forensic Aspects of Neurodevelopmental Disorders: A Clinician’s Guide (pp. 24–33). Cambridge University Press. https://doi.org/10.1017/9781108955522.003.CrossRefGoogle Scholar
Clarke, D. (1989). Antilibidinal drugs and mental retardation: A review. Medicine, Science and the Law, 29(2), 136–46.CrossRefGoogle ScholarPubMed
Craig, L. A., Lindsay, W. R., & Browne, K.D. (2010). Assessment and treatment of sexual offenders with intellectual disabilities: A handbook. John Wiley & Sons Ltd.CrossRefGoogle Scholar
Dennis, J. A., Khan, O., Ferriter, M., et al. (2012). Psychological interventions for adults who have sexually offended or are at risk of offending. Cochrane Database of Systematic Reviews, 12: CD007507. http://dx.doi.org/10.1002/14651858.CD007507.pub2.Google ScholarPubMed
Garcia, F. D. & Thibaut, F. (2011). Current concepts in the pharmacotherapy of paraphilias. Drugs, 71(6), 771–90.CrossRefGoogle ScholarPubMed
Greenberg, D. M., & Bradford, J. M. W. (1997). Treatment of the Paraphilic Disorders: A Review of the Role of the Selective Serotonin Reuptake Inhibitors. Sexual Abuse, 9(4), 349–360. https://doi.org/10.1177/107906329700900407.CrossRefGoogle Scholar
Green, L., McNeil, K., Korossy, M., et al. A. (2018). HELP for behaviours that challenge in adults with intellectual and developmental disabilities. Canadian Family Physician, 64(Suppl 2), S23–S31.Google ScholarPubMed
Griffiths, D., Hingsburger, D., Hoath, J., & Ioannou, S. (2013). ‘Counterfeit Deviance’ Revisited. Journal of Applied Research in Intellectual Disabilities, 26(5), 471–80.CrossRefGoogle ScholarPubMed
Gordon, H., & Grubin, D. (2004). Psychiatric aspects of the assessment and treatment of sex offenders. Advances in Psychiatric Treatment, 10, 73–80.CrossRefGoogle Scholar
Heppell, S., Jones, C., & Rose, J. (2020). The effectiveness of cognitive-behavioural therapy group-based interventions for men with intellectual disabilities and sexual offending histories: A meta-analysis. International Journal of Developmental Disabilities, pp. 1–14. https://pubmed.ncbi.nlm.nih.gov/35937162/p.Google ScholarPubMed
Hingsburger, D., Dalla Nora, M., & Tough, S. (2010). The key: A community approach to assessment, treatment and support for people with intellectual disabilities who sexually offend. Diverse City Press and Vita Community Services.Google Scholar
Holland, S., & Persson, P. (2010). Intellectual disability in the Victorian prison system: Characteristics of prisoners with an intellectual disability released from prison in 2003–2006. Psychology, Crime and Law, 17 (1), 25–41.CrossRefGoogle Scholar
Hogue, T., Steptoe, L., Taylor, J. L., et al. (2006). A comparison of offenders with intellectual disability across three levels of security. Criminal Behaviour and Mental Health, 16, 13–28.CrossRefGoogle ScholarPubMed
Hughes-McCormack, L. A., Rydzewska, E., Henderson, A., et al. (2017). Prevalence of mental health conditions and relationship with general health in a whole-country population of people with intellectual disabilities compared with the general population. BJPsych Open, 3(5), 243–8.CrossRefGoogle Scholar
Joyal, C. C., & Carpentier, J. (2016). The prevalence of paraphilic interests and behaviors in the general population: A provincial survey. The Journal of Sex Research, 54(2), 161–71.Google ScholarPubMed
Khan, O, Ferriter, M, Huband, N, et al. (2015). Pharmacological interventions for those who have sexually offended or are at risk of offending. Cochrane Database of Systematic Reviews, 2, CD007989. https://doi.org/10.1002/14651858.CD007989.pub2.Google Scholar
Latvala, A., Tideman, M., Søndenaa, E., et al. (2022). Association of intellectual disability with violent and sexual crime and victimization: A population-based cohort study. Psychological Medicine, 53, 3817–25. https://doi.org/10.1017/S0033291722000460.Google ScholarPubMed
Lindsay, W. R., Hastings, R. P., Griffiths, D. M. & Hayes, S. C. (2007). Trends and challenges in forensic research on offenders with intellectual disability. Journal of Intellectual and Developmental Disabilities, 32, 55–61.CrossRefGoogle ScholarPubMed
Lindsay, W. R. (2009). The treatment of sex offenders with developmental disabilities: A practice workbook. John Wiley & Sons.Google Scholar
Lindsay, W. R., Hastings, R. P., & Beech, A. R. (2011). Forensic research in offenders with intellectual & developmental disabilities 1: Prevalence and risk assessment. Special Issue: Forensic research in offenders with intellectual & developmental disabilities Part 1. Psychology, Crime & Law, 17(1), 3–7.CrossRefGoogle Scholar
Macneil, C. A., Hasty, M. K., Conus, P., & Berk, M. (2012). Is diagnosis enough to guide interventions in mental health? Using case formulation in clinical practice. BMC Medicine, 10, 111. https://doi.org/10.1186/1741-7015-10-111.CrossRefGoogle ScholarPubMed
Nixon, M., Thomas, S. D. M., Daffern, M., & Ogloff, J. R. P. (2017). Estimating the risk of crime and victimisation in people with intellectual disability: A data-linkage study. Social Psychiatry and Psychiatric Epidemiology, 52(5), 617–26.CrossRefGoogle ScholarPubMed
NHS England (2016). Stopping over-medication of people with a learning disability (STOMPLD) pledge. NHS England, London. www.england.nhs.uk/2016/06/over-medication-pledge.Google Scholar
Patterson, C. (2018). Does the adapted sex offender treatment programme reduce cognitive distortions? A meta-analysis. Journal of Intellectual Disabilities and Offending Behaviour, 9(1), 9–21.CrossRefGoogle Scholar
Rosler, A., & Witztum, E. (1998). Treatment of men with paraphilia with a long-acting analogue of gonatropin-releasing hormone. New England Journal of Medicine, 338, 416–22CrossRefGoogle ScholarPubMed
Schöttle, D., Briken, P., Tüscher, O., & Turner, D. (2017). Sexuality in autism: Hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder. Dialogues in Clinical Neuroscience, 19(4), 381–93. www.ncbi.nlm.nih.gov/pmc/articles/PMC5789215/.CrossRefGoogle ScholarPubMed
Thibaut, F., Bradford, J. M. W., Brikens, P., et al. (2016). The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the treatment of adolescent sexual offenders with paraphilic disorders. The World Journal of Biological Psychiatry, 2010(17), 2–38.CrossRefGoogle Scholar
Tomsa, R., Gutu, S., Cojocaru, D., et al. (2021). Prevalence of sexual abuse in adults with intellectual disability: Systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(4), 1980.CrossRefGoogle ScholarPubMed
Walker, N., & McCabe, S. (1973) Crime and Insanity in England (Vol. 2). Edinburgh University Press, Edinburgh.Google Scholar
Ward, T., & Beech, A. (2006). An Integrated Theory of Sexual Offending. Aggression and Violent Behavior, 11(1), 44–63. https://doi.org/10.1016/j.avb.2005.05.002.CrossRefGoogle Scholar
Ward, T., & Beech, A.R. (2016). The Integrated Theory of Sexual Offending-Revised. The Wiley Handbook on the Theories, Assessment and Treatment of Sexual Offending, [online], 123–37. https://doi.org/10.1002/9781118574003.wattso006.CrossRefGoogle Scholar
Yakeley, J., & Wood, H. (2014). Paraphilias and paraphilic disorders: Diagnosis, assessment and management. Advances in Psychiatric Treatment, 20(3), 202–13.CrossRefGoogle Scholar

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