APPENDIX 4.2
PSYCHOPATHOLOGY AND SEXUAL OFFENDING
Mental health problems such as depression are negatively associated with future offending among adolescent offenders (Katsiyannis, Zhang, Barrett, & Flaska, 2004; Vermeiren, Schwab-Stone, Ruchkin, De Clippele, & Deboutte, 2002), which suggests psychopathology may, in fact, have a protective effect. However, problems such as depression could still play a role in the onset of sexual offending if, for example, they led to the use of sex as a coping strategy and if using sex as a coping strategy increased the likelihood of having sexual contact with a child (Cortoni & Marshall, 2001).
Leue, Borchard, and Hoyer (2004) reported on the psychiatric morbidity of 55 adult sex offenders, 21 of whom had offended against children. The prevalences were high and probably reflected the fact that the sample was recruited from a forensic psychiatric setting; for example, 69% met diagnostic criteria for any anxiety disorder during their lifetime, and 56% met diagnostic criteria for any mood disorder during their lifetime. Dunsieth et al. (2004) also reported high prevalence rates in a sample of 113 male sex offenders seen at a residential treatment facility; for example, 58% met diagnostic criteria for a mood disorder, and 23% met diagnostic criteria for an anxiety disorder. The 84 paraphilic sex offenders, one half of whom were pedophiles, were more likely to have any mood disorder, anxiety disorder, or impulse control disorder than the 26 nonparaphilic sex offenders (3 men were not classified as either paraphilic or nonparaphilic). Långström, Sjöstedt, and Grann (2004) reported on the psychiatric comorbidity of all adult male sex offenders released from prison in Sweden between 1993 and 1997 based on hospital admissions (N
= 1,215 sex offenders; 522 had offended against children). Of those who offended against children, relatively few (4.8%) had any psychiatric disorder, and the most common diagnoses for both groups of sex offenders were substance abuse, substance dependence, and personality disorders. Långström et al. suggested that an explanation for the relatively low prevalences found in this study was that the diagnoses were based on hospital admissions, and only some diagnoses were the focus of the inpatient assessments. Finally, N. C. Raymond, Coleman, Ohlerking, Christenson, and Miner (1999) reported on the psychiatric diagnoses of 45 pedophilic sex offenders; a majority had a diagnosable mood disorder (67%) or anxiety disorder (64%) at some point in their lives, and one half (53%) met diagnostic criteria for another paraphilia.
All of these studies indicate there is a great deal of psychiatric comorbidity among adult sex offenders against children. What they do not indicate is whether sex offenders against children differ from other offenders. Only studies that directly compare adult sex offenders and other offenders, using the same measures and recruitment methods, would reveal if psychopathology might be a unique factor. In addition, studies would need to account for additional factors that might explain the comorbidity of psychopathology and sexual offending against children and establish that psychopathology was present before the onset of sexual offending against children (e.g., by reviewing prior mental health records).
