Dariusz Juszczak1, Krzysztof Korzeniewski2
1 7Th Navy Hospital
2 Department of Epidemiology and Tropical Medicine in Gdynia, Military Institute of Medicine in Warsaw
Abstract
Introduction: The issue of the effect of alcohol on sex related offences is complex. A comprehensive theory describing the criminal behaviours committed under the influence of alcohol has not yet been developed.
Material and methods: The purpose of this paper was to evaluate and compare psychosocial and psychopathological factors characterising sexual offenders acting under or without the influence of alcohol.
The study dataset consisted of 180 court ordered psychiatric-sexuological assessments issued by forensic experts from the Mental Health Outpatient Unit between 2004 and 2012 in the 10th Military Clinic Hospital in Bydgoszcz (Poland). The assessments were done for the offenders who committed sexual offences as defined in Chapter XXV of the Criminal Code in Poland: Offences Against Sexual Freedom and Morality. This study used a specially designed questionnaire: Charter for Diagnosis of Factors Determining Criminal Activity.
Results: Relevant statistically significant differences have been observed between the study groups.
Conclusions:
1. The study confirmed the criminogenic effect of alcohol on sexual offences, especially rape, in both adults and adolescent population.
2. The alcohol induced disinhibition influencing the commission of sexual offence is characteristic for individuals with comorbid permanent personality disorders and organic personality disorders.
3. The offenders committing sexual offences under the influence of alcohol are found to exhibit low level of social functioning.
Key words: criminal sexual behaviour, alcohol influence, rape
Seksuologia Polska 2016; 14 (1): 7–12
Introduction
Crimes of a sexual nature are influenced by multiple factors and their interactions [1, 2]. The factors affecting the risk of commiting a sexual offence and the recidivism can be categorized in the following groups:
Distal factors: developmental and static − developmental factors including experiencing violence, rejection, difficulty in developing close interpersonal relations [3−13].
Static factors (unchangeable factors), such as the permanency and extent of violence, psychosocial problems, prior antisocial events [14−17].
Proximal factors: dynamic and precipitating − dynamic factors, which can under the effect of precipitating factors trigger acute factors. Dynamic factors include sexual self regulation, offensive attitudes, level of interpersonal functioning, general problems with self regulation [18−22].
Precipitating factors (triggers, contextual), including the access to a victim, effect of addictions, conflict relations, lack of cooperation with the supervision after release [23−27].
Acute factors − including physiological arousal, thoughts and deviant fantasies, the desire for closeness, and affective states such as anger [2].
A comprehensive description of the relationship between the factors initiating sexual violence was done by Beech and Ward [2].
Several diagnostic tools have been developed for the purpose of evaluating the risk of repeated sexual offence. The most widely used include Static-99, which is an actuarial assessment instrument for use with adult male sexual offenders [28], SORAG (Sex Offender Risk Appraisal Guide) [29], MnSOST-R (Minessota Sex Offender Screening Tool-Revised) [30], and SVR-20 (Sexual Violence Risk-20) [31].
Despite intensive research conducted to date, new factors previously not included in the widely used risk scales are being identified. The analysis of test items revealed additional risk factors positively correlated with sexual offences recidivism and violent crimes. These risk factors include past history of placement in foster care, problems with maintaining employment, school maladjustment [32].
The dynamics and complexity between the association of alcohol and criminal activity has been emphasized in literature [33, 34]. Alcohol consumption is influenced by social and cultural factors, such as the acceptance that violence is justified by the use of alcohol [35] and the issue of ”social stress” [36, 37]. Pernanen [38] who studied the link between alcohol and crime identified four mechanisms. First, alcohol reduces inhibitions and triggers deviant and criminal behaviours. Secondly, alcohol changes the activity of neurotransmitters, which is linked to aggressive behaviour. Next, chronic alcoholism leads to cerebral cortex dysfunction, in particular of the temporal lobe, which also facilitates pathological behaviour. Lastly, alcohol leads to hypoglycaemia and interrupts REM, which increases irritability and aggression.
Addictions are thought to be one of the precipitating factors (triggers, contextual) for criminal sexual behaviour [24−27]. Among the sexual offender population, the use of alcohol and psychoactive substances is common [39, 40]. Alcohol abuse is characteristic of 30% of offenders regardless of the presence of the diagnosis of paraphilia [41]. In 60% of persons committing paedophilia, there is documented abuse of psychoactive substances [42]. In sexual offenders with paraphilia, there is a comorbid overuse of alcohol and generalized anxiety disorder [43].
Over half of rape victims claimed the perpetrator was under the influence of alcohol or drugs during the crime [44]. Among sexual offenders, the authors underlined the co-existing overuse of psychoactive substances with personality disorders and low social functioning [45−51]. It is estimated that alcohol consumption is a direct cause of 50% of all homicides [50].
Material and methods
The objective of this paper is to examine the question which psychosocial and psychopathological factors are characteristic of sexual offenders acting under the influence of alcohol and which factors are characteristic for sexual offenders who acted without the influence of alcohol.
The study dataset consisted of 180 court ordered psychiatric-sexuological assessments issued by forensic experts from the Mental Health Outpatient Unit between 2004 and 2012 in the 10th Military Clinic Hospital in Bydgoszcz (Poland). The assessments were conducted for offenders who committed sexual offences as defined in Chapter XXV of the Criminal Code in Poland: Offences Against Sexual Freedom and Morality. Paraphilia (disorders of sexual preference) was recognized in 5 cases which constituted 2.8% of all offenders for whom expert opinion was issued. This study used a specially designed questionnaire: Charter for Diagnosis of Factors Determining Criminal Activity. This questionnaire was constructed based on clinical interviews and clinical knowledge. It included data regarding; characteristics of the committed offence (based on the relevant categories from the1997 Polish Criminal Code), prior criminal and regulatory offenses, sociological features (socio-demographics), psychomotor development during childhood and adolescence, relationship status of the offender at the time of the offense, upbringing, school records, military service, relationship to alcohol and other addictions, somatic diseases, psychiatric and sexuological treatments and clinical diagnoses according to ICD-10. The psychological assessment included the following diagnostic tests: a visuo-motor gestalt test (by Lauretta Bender), the Benton visual retention test and the Minnesota Multiphasic Personality Inventory. The questionnaire was completed by the researcher based on the opinion of the forensic experts. The data from the questionnaire was entered into a spreadsheet and all statistical calculations were done through Excel. To answer the questions posed in this paper, the chi-Pearson test was used. Only the correlations for which the p-value was less than 0.05 were taken into consideration.
Results
Based on the acquired results, characteristics of sexual offenders were identified with and without the influence of alcohol as shown in the following Tables 1−3.
Table 1. Summary of psychosocial factors characterizing sexual offenders acting under and without the influence of alcohol
Analyzed factor | Sexual offence under the influence of alcohol (n = 88) | Sexual offence without the influence of alcohol (n = 92) |
Type of the offence: | ||
rape of the adult victim (n = 41) | 68.3% | 31.7% |
sexual contact with the underaged partner (n = 89) | 32.6% | 67.4% |
rape of the underage victim (n = 42) | 57.1% | 42.9% |
other (n = 8) | 87.5% | 12.5% |
Prior criminal record | 43.2% | 25.0% |
Age of the perpetrator: | ||
< 18 years old 19−35 36−50 51−65 > 60 | 0.0% 45.5% 39.8% 8.0% 6.8% | 3.3% 31.5% 46.7% 17.4% 1.1% |
Marital status: | ||
single married divorced widower separated common law | 45.5% 33.0% 2.3% 6.8% 3.4% 9.1% | 25.0% 46.7% 16.3% 0.0% 3.3% 8.7% |
Level of education completed: | ||
elementary special needs elementary vocational high school university | 43.2% 4.5% 19.3% 18.1% 3.4% | 19.6% 8.7% 33.7% 20.7% 14.1% |
Occupational status: | ||
employed full time employed intermittently unemployed disability benefits | 26.1% 28.4% 20.5% 15.9% | 51.1% 10.9% 20.7% 17.4% |
p-value < 0.05 for chi square pearson’s test
Table 2. Summary of factors characterizing personal history of sexual development among the sexual offenders acting under and without the influence of alcohol
Analysed factor | Sexual offence under the influence of alcohol (n = 88) | Sexual offence without the influence of alcohol (n = 92) |
Current relationship conflict (marital, common law) | 40.9% | 22.8% |
Emotional bond with parents: | ||
strong weak | 47.7% 36.4% | 63.0% 15.25 |
Source of sexual education: | ||
parents peers media | 3.4% 78.4% 17.0% | 4.3% 84.8% 3.3% |
Age of sexual initiation: | ||
10−15 years old 16−18 years old > 18 years old | 13.6% 43.2% 40.9% | 6.5% 29.3% 54.3% |
Masturbation | 53.4% | 79.3% |
Number of intimate relationships to date: | ||
multiple (> 5) low (< 5) | 17.0% 83.0% | 16.3% 71.7% |
Frequency of sexual contacts (in marital and common law relationships): | ||
daily weekly monthly none | 2.3% 19.3% 27.3% 51.1% | 0.0% 33.7% 32.6% 33.7% |
Relationship conflict among parents | 35.2% | 20.7% |
Upbringing (family structure): | ||
both parents present single parent family foster care | 63.6% 26.1% 10.2% | 85.9% 10.9% 2.2% |
p-value < 0.05 for chi square pearson’s test
Table 3. Summary of psycho-biological factors characterizing sexual offenders acting under and without the influence of alcohol
Analyzed factors | Sexual offence under the influence of alcohol (n = 88) | Sexual offence without the influence of alcohol (n = 92) |
Amnesia regarding the committed offence | 21.6% | 3.3% |
Alcohol use: | ||
overuse/abuse moderate use abstinence | 27.3% 70.5% 2.3% | 12.0% 84.8% 3.3% |
Organic personality disorder | 25.0% | 14.1% |
Organic changes in CNS | 34.1% | 17.4% |
Clinical assessment of the alcohol use: | ||
overuse/abuse addiction syndrome | 11.4% 20.5% | 0.0% 8.7% |
Adaptation disorder | 0.0% | 5.4% |
Personality disorder: | ||
antisocial PD personality disorder not otherwise specified | 42.1% 31.8% | 27.2% 23.9% |
p-value < 0.05 for chi square pearson’s test
Discussion
In the group of sexual offenders studied (n = 180), 88 cases were identified as being committed under the influence of alcohol which is 48.9%. The largest proportion of offenders acting under the influence of alcohol was among the offenders committing rape for adults (68.3%) and under-aged individuals (57.1%). The results are significantly higher than expected [44]. Despite the fact that alcohol appears to be the strongest correlating factor with criminal sexual activity [23−27], its effect was highest on the group with previously diagnosed personality disorders. In the research, personality disorders were diagnosed among 73.9% of offenders acting under the influence of alcohol. The proportion was greater for antisocial personality disorder (42.1%) than other personality disorders not otherwise specified (31.8%). Characteristic was also the coexistence of organic changes in the central nervous system (34.1%), and their clinical sequelae in a form of organic personality disorders (25%). In needs to be pointed out that 20.5% of individuals in the study group were diagnosed with alcohol addiction, and 11.4% were diagnosed with alcohol overuse. This suggests that the committing of the offence under the effect of alcohol can be a consequence of either chronic or intermittent alcohol consumption. In addition, the results indicate that sexual offenders acting under the influence of alcohol are characterized by low level of social functioning, coexisting relationship conflicts, past criminal record, low education, early age of sexual initiation, low frequency of sexual activity in the relationships, alcohol overuse and a high prevalence of alcohol addiction.
The main limitation of the study is the lack of comparison between sexual offenders committing crime under the influence of alcohol with and without paraphilia. The presence of comorbid paraphilia was indentified among only 5 offenders (2.8% of the study group), therefore, we need to assume the results of the study are characteristic for sexual offenders without coexisting paraphilia.
Suggestions for future studies include the need for research exploring the issue of criminal offences under the influence of alcohol in the view of cultural aspects [35], biological [38], and psychological factors, among which of particular interest is the theory of „alcohol short sightedness” [50] and coexistence of psychopathological disorders among the sexual offenders.
Conclusions
The study confirmed the criminogenic effect of alcohol on the sexual offences, especially rape, in both adults and adolescent population.
The alcohol induced disinhibition influencing the commission of sexual offence is characteristic for individuals with comorbid permanent personality disorders and organic personality disorders.
The offenders committing sexual offences under the influence of alcohol are found to exhibit low level of social functioning.
References:
O’Shaughnessy R.J. Violent adolescent sexual offenders. Child Adolesc. Psychiatr. Clin. N. Am. 2002; 11: 749−765.
Beech A.R., Ward T. The integration of etiology and risk in sexual offenders: a theoretical framework. Aggression and Violent Behavior 2004; 10: 31–63.
Beitchman J., Zucker K., Hood J., DaCosta G., Akman D., Cassavia E. A review of the long-term effects of child sexual abuse. Child Abuse and Neglect 1992; 16: 101–118.
Briere J., Smiljanich K. Childhood sexual abuse and subsequent sexual aggression against adult women. Paper presented at the 101st annual convention of the American Psychological Association, Toronto, Ontario 1993.
Craissati J. The relationship between developmental variables and risk. Unpublished doctoral thesis. University of Birmingham, UK 2003.
Craissati J., McClurg G., Browne K.D. Characteristics of perpetrators of child sexual abuse who have been sexually victimised as children. Sexual Abuse: A Journal of Research and Treatment 2002; 14: 225–240.
Hanson R.K., Bussie`re M.T. Predicting relapse: A meta-analysis of sexual offender recidivism studies. Journal of Consulting and Clinical Psychology 1998; 66: 348–362.
Marshall W.L. Intimacy, loneliness and sexual offenders. Behaviour Research and Therapy 1989; 27: 491–503.
Marshall W.L., Hudson S.M., Hodkinson S. The importance of attachment bonds in the development of juvenile sex offending. In: Barbaree H.E., Marshall W.L., Hudson S.M. (ed.). The juvenile sex offender. New York 1993: 164–181.
Smallbone S.W., Dadds M.R. Childhood attachment and adult attachment in incarcerated adult male sex offenders. Journal of Interpersonal Violence 1998; 13: 555–573.
Smallbone S.W., McCabe B.A. Childhood attachment, childhood sexual abuse, and onset of masturbation among adult sexual offenders. Sexual Abuse: A Journal of Research and Treatment 2003; 51: 1–10.
Ward T., Hudson S.M., Marshall W.L., Siegert R. Attachment style and intimacy deficits in sexual offenders: a theoretical framework. Sexual Abuse: A Journal of Research and Treatment 1995; 7: 317–335.
Watkins B., Bentovim A. The sexual abuse of male children and adolescents: a review of current research. Journal of Child Psychology and Psychiatry 1992; 33: 197–248.
Doren D.M. Evaluating sex offenders: A manual for civil commitments and beyond. London: Sage 2002.
Grove W.M., Meehl P.E. Comparative efficiency of informal (subjective, impressionistic) and formal (mechanical, algorithmic) prediction procedures: The clinical statistical controversy. Psychology, Public Policy, and Law 1996; 2: 293–323.
Grove W.M., Zald D.H., Lebow B.S., Snitz B.E., Nelson C. Clinical versus mechanical prediction: a meta-analysis. Psychological Assessment 2000; 12: 19–30.
Hanson R.K., Morton K.E., Harris A.J.R. Sexual offender recidivism risk: what we know and what we need to know. In: Prentky R., Janus E., Seto M., Burgess A.W. (ed.). Sexually coercive behavior: Understanding and management. Annals of the New York Academy of Sciences 2003; 989: 154–166. NY: The New York Academy of Sciences.
Hall G.C.N., Hirschman R. Sexual aggression against children: a conceptual perspective of etiology. Criminal Justice and Behavior 1992; 19: 8–23.
Thornton D. Constructing & testing a framework for dynamic risk assessment. Sexual Abuse: A Journal of Research and Treatment 2002; 14: 139–154.
Ward T., Hudson S.M., Keenan T. A self-regulation model of the sexual offense process. Sexual Abuse: A Journal of Research and Treatment 1998; 10: 141–157.
Ward T., Hudson S.M., Marshall W.L. Attachment style in sex offenders: a preliminary study. Journal of Sex Research 1996; 33: 17–26.
Ward T., Siegert R.J. Toward a comprehensive theory of child sexual abuse: A theory knitting perspective. Psychology, Crime, and Law 2002; 8: 319–351.
Eccleston L., Brown M., Ward T. The assessment of dangerous behavior. In: S.P. Shohov (ed.). Advances in Psychology Research 2002; 11: 71–112. New York: Nova Sciences.
Eysenck M.W., Eysenck H.J. Mischel and the concept of personality. British Journal of Psychology 1980; 71: 191–204.
Hart S., Laws D.R., Kropp P.R. The risk-need model of offender rehabilitation. In: T. Ward, D.R. Laws, S.M. Hudson (ed.). Theoretical issues and controversies in sexual deviance. London: Sage 2003; 338–354.
McGuire J. Explanations of criminal behavior. In: J. McGuire, T. Mason, A. O’Kane (ed.). Behavior, crime and legal processes: a guide for legal practitioners. Chichester, UK Wiley 2000: 135–159.
Hanson R.K., Harris A.J.R. Where should we intervene? Dynamic predictors of sexual offence recidivism. Criminal Justice and Behaviour 2000; 27: 6−35.
Hanson R.K., Thornton D. Improving risk assessments for sex offenders: a comparison of three actuarial scales. Law and Human Behavior 2000; 24: 119–136.
Quinsey V.L., Harris G.T., Rice M.E., Cormier C. Violent offenders: appraising and managing risk. Washington, DC: American Psychological Association 1998.
Epperson D.L., Kaul J.D., Hesslton D. Final report on the development of the Minnesota Sex Offending Screening Tool-Revised (MnSOST-R). St. Paul: Minnesota Department of Corrections 1998.
Boer D.P., Hart S.D., Kropp P.R., Webster C.D. Manual for the Sexual Violence Risk Scale-20. Obtainable from the Mental Health, Law, and Policy Institute, Simon Fraser University, Burnaby, British Columbia, Canada, V5 1S6. 1997; www.sfu.ca/psychology/groups/mhlpi.
Craig L.A., Beech A., Browne K.D. Evaluating the predictive accuracy of sex offender risk assessment measures on UK Samples: A Cross-Validation of the Risk Matrix 2000 Scales 2003.
Pernanen K. Alcohol in human violens. New York: Gulford Press 1991.
Welte J.W., Abel E.L. Homicide − drinking by the victim. J. Stud. Alcohol 1989; 50: 197–201.
Griffith E., Anderson P., Babor T.F. et al. Alcohol policy and the public good. Oxford University Press, New York 1994.
Alonso-Fernandez F. Alcoologie transculturelle. Confrontations Psychiatriques 1982; 21: 57–78.
Wolff P.H. Ethnic differences in alcohol sesitivity. Science 1972; 175: 449–450.
Pernanen K. Theoretical aspects of the relationship between alcohol use and crime. Gulford Press: New York 1981.
Maden A., Taylor C.J.A., Brooke D. et al. Mental disorder in remand prisoners. Home Office, London 1995.
Williams L.M., Finkelhor D. The characteristics of incestuous fathers: a review of recent studies. In: Marshall W.L., Laws D.R., Barbaree H.E. (ed.). The handbook of sexual assault: issues, theories and treatment of the offender. Plenum Press, New York 1990; 231−255.
Kafka M.P., Prentky R.A. Attention-deficit/hyperactivity disorder in males with paraphilias and paraphilia-related disorders: a comorbidity study. J. Clin. Psychiatry 1998; 59: 388−396.
Raymond N.C., Coleman E., Ohlerking F. et al. Psychiatric comorbidity in pedophilic sex offenders. Am. J. Psychiatry 1999; 156: 786−788.
Kafka MP., Hennen J. A DSM-IV Axis I comorbidity study of males (n = 120) with paraphilias and paraphilia-related disorders. Sex Abuse 2002; 14: 349−366.
Bachman R. Violence against women. A national crime victimization survey raport. Washington 1994.
Leue A., Borchard B., Hoyer J. Mental disorders in a forensic sample of sexual offenders. Eur. Psychiatry 2004; 19: 123−130.
Harsch S., Bergk JE., Steinet T. et al. Prevalence of mental disorders among sexual offenders in forensic psychiatry and prison. Int. J. Law Psychiatry 2006; 29: 443−449.
Andrews D.A., Bonta J. The psychology of criminal conduct. 2nd ed. Cincinnati, OH: Anderson Publishing 1998.
Blackburn R. Risk assessment and prediction. In: J. McGuire, T. Mason, A. O’Kane (ed.). Behavior, crime and legal processes: a guide for legal practitioners. Chichester, UK: Wiley 2000; 178–204.
Hollin C.R. Treatment programs for offenders: Meta-analysis, ”what works” and beyond. International Journal of Law and Psychiatry 1999; 22: 361–372.
Wieczorek W.F., Welte J.W., Abel E.L. Alcohol, drugs and murder: a study of convictend homicide offenders. J Criminal Justice 1990; 18: 217–227.
Steel C.M., Josephs R.A. Alcohol myopia, its prized and dangerous effects. American Psychologist 1990; 45: 921−933.
Address for correspondence: Dariusz Juszczak
7th Navy Hospital
Polanki 117, 80−305
Gdańsk tel.: +48 605 109 730
e-mail: d.juszczak@7szmw.pl
Received: 14 03.2015
Accepted: 12.12.2015
