Dr Dawn Fisher St Andrew’s Healthcare & the University of Birmingham, UK Latvia March 2011

1. Why Prevention of Sexual Offences and the Rehabilitation of Sex Offenders’ Victims is so Important Dr Dawn Fisher St Andrew’s Healthcare & the University of Birmingham, UK Latvia March 2011

2. How many sex offenders are there? • As of September 2010 87,628 individuals in prison • With around 8000+ sexual offenders in prison (9%) • Similar number of rapists and child abusers in prison • Underestimate of real level of sexual offending UG sex offender theories 2010

3. Prevalence • There are problems in ascertaining the actual level of sexual offending • The primary difficulty being that only a small fraction of sexual offences are ever reported. Generally speaking, the more serious the type of offence and the more distant the relationship between victim and offender, the more likely the offence is to be reported (Myhill & Allen, 2002) UG sex offender theories 2010

4. Bias • Hence, there is a bias towards the reporting of what might be considered the fixated paedophilic, offences compared to, incestuous sexual offences or stranger rapes compared to date rape • Prentky and Burgess (2000) also note that underreporting tends to be greater when offences are carried out against males rather than against females, whether the victims are children, teenagers or adults • In addition to under-reporting of sexual offences, there is also the problem of sexual offences being difficult to prosecute satisfactorily and result in a conviction UG sex offender theories 2010

5. Difficulty in obtaining convictions • The nature of sexual offending often means that it is typically the victim’s word against the perpetrators with no corroborating evidence • Here, there are often problems in using children as witnesses and adult victims may retract their statements due to fear or pressure from others • Thus, relying on conviction figures and the number of men in prison or on probation for sexual offences at a given time, is likely to result in a gross underestimation of the true level of sexual offending against children and adults UG sex offender theories 2010

6. Prevalence of sexual abuse • Methods of detection • - Prevalence surveys - based on self-report • Allegations and Convictions • Information from sexual offenders – Abel et al. survey • Number of psychiatric patients with sexual abuse histories

7. Prevalence of child abuse • Victim survey data suggests that the prevalence of sexual offences against children is alarming • Probably the latest study in the U.K. (Cawson, Wattam, Brooker, & Kelly, 2000) found that 16% of girls and 7% of boys have been sexually assaulted before the age of 13 • More than twice the number reported that they had been abused by somebody they knew (parents or carers, other relatives, or by other known people) than had been abused by a stranger or by someone that they had just met • These results indicate that it is much more likely that a child will be abused by somebody they know UG sex offender theories 2010

8. Gender of perpetrator of CSA • Most known child abuse offences would appear to be committed by males • However, the reported rate of female offending may be a severe underestimation of the number of offences actually committed by women/ adolescent females • Current criminal statistics in the U.K. indicate that around 99% of convicted sexual offenders are male and 1% offenders are female • However, the l figures from Childline (A telephone helpline in the U.K. for those who are being abused or know about individuals who are being abused) for April 2002 – March 2003, suggest that the female perpetrator figures are actually far higher than the official conviction figures reveal UG sex offender theories 2010

9. Level of female perpetrators of CSA • According to ChildLine, the overall percentage of those calling about being abused by a female perpetrator has risen by 132% in the last five years • As for actual rates in 2008 ChildLine counsellors heard from 8765 children • 2142 children who had been abused by a female (about 25%) • 6623 reported they had abused by a female UG sex offender theories 2010

10. Prevalence of rape • Myhill and Allen in 2002 reported a study of the level of adult sexual victimization in a sample of nearly 7000 women aged 16 to 59 in the U.K • They found that nearly 10% reported some form of sexual victimization, since the age of 16, with half of the assaults being rape • The level of physical injury in these attacks was found to be extremely high with 74% of women who had been raped reported the use of physical force or violence • 37% of these attacks resulting in physical injury • 10% causing ‘severe’ injury, such as broken bones UG sex offender theories 2010

11. Effects of child abuse • As for its effect upon victims, sexual abuse has been related to a number of negative behavioral outcomes in children, such as fear, nightmares, regressive/withdrawn behavior, cruelty, delinquency, , running away, poor self-esteem, general behavior problems, and sexually inappropriate behavior ((Beitchman, et al., 1991; Kendall-Tackett, Williams, & Finkelhor, 1993) • Children reporting sexual abuse involving intercourse, compared with non-abused children, had an increased incidence of major depression and suicide attempts (Fergusson, Horwood, & Lynskey, 1996; Fergusson, Lynskey, & Horwood, 1996)

12. Effects of child abuse 2 • A variety of adult psychiatric conditions arising from child sexual abuse have also been reported including anxiety and acute stress disorders, bulimia nervosa, depression, dissociative identity disorder, personality disorders (such Borderline Personality Disorder), Post Traumatic Disorder, and substance abuse (Fergusson, Horwood, et al., 1996; Putnam, 2003; Spataro et al., 2004). • While, the lifetime prevalence for major depression in those who have been sexually abused, is three to five times more common in women than the non-abused population (Putnam, 2003).

13. Neurobiology of Trauma • Impact of high stress hormone levels (Cortisol) on the developing brain • Neural growth impaired • Critical periods • ‘Time-bomb’ • Emotional responding

14. Neurobiology of Trauma • Impact of high stress hormone levels (Cortisol) on the developing brain • Neural growth impaired • Critical periods • ‘Time-bomb’ • Emotional responding

15. Effects of rape • However, as for the impact upon victims of being, these can include physical injuries, secondary victimization, and psychological trauma. Physical injuries can include non-genital physical injuries, vaginal and/or anal lacerations, bleeding, and pain (Hampton, 1995) • While, secondary victimization can occur through post-assault medical investigations, such as injury detection, forensic medical examination, evidence collection, and screening and treatment for sexually transmitted infections and pregnancy, can also be extremely difficult for victims (Campbell, 2008).

16. Effects of rape 2 • As for psychological trauma symptoms, these can include increased risk of PTSD (Kilpatrick & Acierno, 2003), depression, substance abuse, suicidality, and panic attacks (Kilpatrick & Acierno, 2003) • Male victims of may rape experience many of the same symptoms that are observed in women, although heterosexual men also experience additional problems with reconciling their heterosexual masculine identity with their victim experience (Rentoul, & Appleboom, 1997) • Indeed, it has been noted that there are differences observed in how men and women react to being raps victims according to different forms of social conditioning they experience (Crome & McCabe, 2001).

17. Treatment • Need for alternative approaches • Non-talking therapies • EMDR • Arts therapies • Somatic therapies

18. Victim to offender levelsRossegger et al. (in press) • Child sexual abuse was documented for 13% of the sex offenders and 5.8% of the violent offenders • Child molesters displayed the highest prevalence rate with 18.9% • Multivariable analyses identified having stayed in a foster home and violence in the nuclear family as the strongest risk factors for child sexual abuse • In a second model, only offender characteristics from adulthood were taken into account as predictors: child molesters, offenders who prostituted themselves, and repeat violent and sex offenders had a significantly higher risk of belonging to the group of offenders who had experienced CSA in childhood • The results suggest that the experience of CSA leads to an elevated and chronic risk for committing child abuse

19. Why work with sexual offenders? • Prevention/reduction of offending • One offender may have many victims • Harm reduction • Risk management through learning about offenders • Message to victims – offender responsibility