1. Joe Judge

2.  There are significant literatures on risk factors for recidivism in sexual offenders and on the predictive accuracy of different types of risk assessment tool.  Less is known about how risk factors are used and combined in clinical practice.  This is especially true of Structured Professional Judgement approaches.

3.  Hanson and Bussiere (1998) ◦ Recidivism best predicted by sexual deviancy and general criminological factors.  Hanson and Morton-Bourgon (2004, 2005) ◦ Uses cumulative meta-analytic technique ◦ Recidivism predicted by sexual deviance and antisocial orientation.  Mann et al. (2010) ◦ Conceptualises risk factors differently ◦ “Psychologically meaningful risk factors”

4. Empirically Supported  Sexual preoccupation  Sexual preference for pubescent or prepubescent children  Sexualised violence  Multiple paraphilias  Offence supportive attitudes  Emotional congruence with children  Lack of emotionally intimate relationships with adults  Lifestyle impulsiveness  Poor problem solving  Resistance to rules and supervision  Grievance / hostility  Negative social influence Promising  Hostile beliefs about women  Machiavellianism  Lack of concern for others  Dysfunctional coping  Sexualised coping  Externalised coping

5. Unsupported but with interesting exceptions  Denial  Low self esteem  Major mental illness  Loneliness  Adversarial sexual orientation  Fragile narcissism  Sexual entitlement Little or no relationship to sexual recidivism  Depression  Social skills deficits  Poor victim empathy  Lack of motivation for treatment (as assessed pre-treatment)

6.  Sexual deviance is an evidence based risk factor  Psychopathy is an evidence based risk factor  Inconsistent findings with respect to denial.  Also some gaps in the literature.

7.  Looked at data from NHS Lothian Sex Offender Liaison Service (SOLS)  Regression analysis of summary risk judgements.  Are the factors that predict risk judgement the factors that predict recidivism?  Or is something else important?

8.  Developed to provide clinical input to help criminal justice agencies manage sex offenders in the community.  Offers comprehensive clinical assessment of individuals whom CJ agencies are finding difficult to manage.  78% have personality disorder diagnoses (Russell & Darjee, 2012)  Assessment and management advice structured using Risk for Sexual Violence Protocol (RSVP)  Assessment process described in detail elsewhere (Russell & Darjee, 2012)  Responses of 96 individuals used in data analysis

9. 1. Psychopathy will be a statistically significant predictor of sexual violence risk score. 2. Sexual deviance will be a statistically significant predictor of sexual violence risk score. 3. Denial will not be a statistically significant predictor of sexual violence risk score. 4. Sexual preoccupation will be a statistically significant predictor of sexual violence risk score. 5. Problems with intimate relationships will be a statistically significant predictor of sexual violence risk score.

10.  Ordinal logistic regression  Dependent variables ◦ MAPPA Risk Score ◦ RMA Risk Score  Independent Variables ◦ Psychopathy (RSVP Item 12 – Coded 0-2) ◦ Sexual Deviance (RSVP Item 11 – Coded 0-2) ◦ Denial (RSVP Item 6 – Coded 0-2) ◦ Sexual Preoccupation (SARN-SO – Coded 0-2) ◦ Problems with intimate relationships (RSVP Item 16 – Coded 0-2)

11.  Psychopathy significantly associated with risk score.  Sexual deviance was not significantly associated with risk score.  Denial significantly associated with risk score.  Sexual preoccupation was associated with risk score.  Problems with intimate relationships was not associated with risk score.  Best model accounted for only 40 percent of variance in risk score.

12.  Explained by difficulty in assessing and measuring sexual deviance?  Notoriously difficult task.  Do different types of sexual deviance operate differently? (eg. Sexual sadism vs. paedophilia)  Outcome variables take into account imminence of risk  For example, possible that offender may meet criteria for paedophilia but have no access to children – influences score on outcome variable.

13.  Relationship between denial is complex  Harkins et al. (2010) – Denial protective?  Depends on whether denial viewed dichotomously or dimensionally.  Ware and Mann (2012) suggest overemphasis on challenging denial.  Blagden et al (2011) suggest professionals not always aware that they are challenging denial.  Is this operating in present study?  But again, denial difficult to assess and measure

14.  Closer scrutiny of the data revealed that only 5 percent of the offenders demonstrated no evidence of problems with intimate relationships  Unclear if this is true of sex offenders in general or limited to those referred to the SOLS.

15.  Best explanatory model accounted for only 40 percent of variance.  Possible that relevant independent variables not included in the analysis.  But what accounts for the other 60 percent?  The process of getting from item scores to formulation, risk scenarios is not well described.  Direction for future research?

16.  Research investigating the process of SPJ risk assessment.  How are risk judgements arrived at using this method?  Hart and Boer (2010) suggest qualitative analysis might be helpful.  Specific focus on risk formulation? (Reliability, validity etc)

17.  Difficulty in measurement of relevant variables.  Revision of RSVP?  Debate about inclusion of denial as a risk factor.