UNASSIGNED: Treatment of individuals who have committed sexual offences with Testosterone-Lowering Medication (TLM) is a comparatively intrusive kind of intervention, which regularly takes place in coercive contexts. Thus, the question of efficacy, but also the question of who should be treated, when and for how long, are of great importance.
UNASSIGNED: Recidivism rates of TLM-treated high-risk individuals (+TLM; n = 54) were compared with high-risk individuals treated with psychotherapy only in the same forensic outpatient clinic (-TLM; n = 79).
UNASSIGNED: Group differences suggested a higher initial risk of + TLM (e.g. higher ris-assessment, previous convictions). Despite the increased risk, after an average time at risk of six years, +TLM recidivated significantly less often and significantly later than - TLM (27.8% vs. 51.9%). Such an effect was also found for violent (1.9% vs. 15.2%), but not for sexual (5.6% vs. 10.1%) and serious recidivism (5.6% vs. 10.1%), which could be explained partly by the small number of cases. In the course of treatment, TLM proved to be a significant variable for a positive process, whereas a high risk-assessment score indicated a rather negative course. In total, n = 19 individuals had stopped their TLM treatment, of these 31.6% recidivated.
UNASSIGNED: The results support the efficacy of TLM, particularly in the group of high-risk offenders.

BACKGROUND: Disparities in evaluating readiness to change and recidivism risk across diverse cultural groups can profoundly affect rehabilitation program efficacy. This study examines readiness to change and recidivism risk disparities between Israeli-Arabs and Israeli-Jews entering a re-entry program by the Prisoner Rehabilitation Authority postrelease.
METHODS: The University of Rhode Island Change Assessment Scale questionnaire gauged readiness to change, whereas the Ohio Youth Assessment System-Residential tool assessed recidivism risk. The sample included 151 participants: 98 Israeli-Arabs and 53 Israeli-Jews. Mean differences in change readiness and recidivism risk were statistically assessed through t tests.
RESULTS: Significant differences emerged in change readiness levels between Israeli-Arabs and Jews upon rehabilitation program entry, with Israeli-Jews exhibiting higher readiness. Additionally, a noteworthy divergence in recidivism risk was noted, indicating elevated average risk for Israeli-Jews.
CONCLUSIONS: Findings underscore the vital need for cultural sensitivity during admission. Bias potential in assessing risk for Arab participants emphasizes the necessity of a comprehensive culturally sensitive approach. While focusing on admission, the Risk-Need-Responsivity model application could enhance risk evaluation and guide culturally tailored treatments.

The Historical-Clinical-Risk Management Scale 20 (HCR-20) is a structured tool to assess the risk of violence and assist in its management. French professionals are reluctant to use it because only a few studies have shown its psychometric qualities with French samples. The objective of this study is to test the psychometric qualities of the HCR-20 with samples of violent detainees in France. The HCR-20 and Level of Service/Case Management Inventory (LS/CMI) were administered to 128 violent offenders with an average age of (44.16±12.30) years. We evaluated the reliability, internal consistency and validity of the HCR-20 and conducted an exploratory factor analysis. The results show that the HCR-20 has good psychometric qualities with a sample of French prisoners. Only the Risk domain presents weak results due to the data collection locations and the participants\' age. Correlations were observed between certain factors. The exploratory factor analysis shows four factors explaining 44% of the variance. The continuation of this work will enable French professionals to use sound tools to assess the risk of recidivism.

The VRAG-R is a well-established actuarial risk-assessment instrument, which was originally developed for assessing violent recidivism risk in adult male offenders. Whether or not the VRAG-R can also predict violent recidivism in young offenders is unclear so far. In the emergence of juvenile offending, attention-deficit/hyperactivity disorder (ADHD) seems to be of major importance suggesting that it could be relevant for risk assessment as well. Thus, we examined the predictive accuracy of the VRAG-R in a high-risk sample of N = 106 (M = 18.3 years, SD = 1.8) young offenders and assessed the incremental predictive validity of ADHD symptomatology beyond the VRAG-R. Within a mean follow-up time of M = 13 years (SD = 1.2), n = 65 (62.5%) young offenders recidivated with a violent offense. We found large effect sizes for the prediction of violent and general recidivism and re-incarcerations using the VRAG-R sum scores. Current ADHD symptomatology added incremental predictive validity beyond the VRAG-R sum scores concerning the prediction of general recidivism but not of violent recidivism. The results supported the use of the VRAG-R for predicting violent recidivism in young offenders. Because ADHD symptomatology improves the predictive performance of the VRAG-R regarding general recidivism, we argue that addressing ADHD symptoms more intensively in the juvenile justice system is of particular importance concerning a successful long-term risk management in adolescents and young adults.

BACKGROUND: Sexual, violent and general recidivism risk scales are widely used in a number of countries. Their psychometric qualities are generally considered to be good. However, in practice they may vary in the quality of prediction of risk of sexual, violent and general recidivism, in particular because of the sources of the information collected. In France, the medical records of incarcerated patients are kept by health-care professionals. Although regulated, the content and quality of these records vary widely from one patient to another. The criminal justice system holds the criminal records of convicted and imprisoned persons. There is no set list of documents contained in these records. For caregivers and researchers, access to criminal records is difficult because of the confidentiality to which legal professionals are subject. The aim of our study was to investigate whether using medical files in addition to structured interviews can improve the assessment and management of the risks of sexual, violent and general recidivism.
METHODS: A total of 128 perpetrators of violence were assessed using three scales of risk of sexual, violent and general recidivism. Scores for the items of the scales were compared between (a) those that were based on medical records and an interview, and (b) those based only on an interview.
CONCLUSIONS: First, differences in scores between the two groups (assessed through interview only, and assessed through interview and use of medical records) were observed on the RSVP, HCR-20 and LS/CMI scales. Secondly, most of the results indicate that the overall level of risk was perceived as lower when medical records were used, which would, indirectly, lead to a reduction in false positives when evaluating perpetrators of sexual violence. Thirdly, the point-by-point analysis shows that the use of information contained in the medical records reduces the weight of present and future factors (e.g. the physical and psychological stress of recent events), increases the weight of past factors (e.g. history of sexual violence), and can increase the weight of certain factors that can lead to more negative emotions in the assessor (e.g. deviance). These results can be explained by (i) the emotional functioning of the persons assessed (particularly defensive processes or memory difficulties), (ii) the attitude of the aggressor (particularly the presence of emotional and cognitive biases), (iii) the nature of the information (particularly \"hot\" cognitions or those leading to greater social desirability). The limitations of the study concern the relatively small number of participants, the environment in which the file was transmitted and the very heterogeneous and sometimes relatively incomplete composition of the files.
CONCLUSIONS: The use of information contained in medical files impacts the results of recidivism risk scales and restores a balance to the factors. In France, risk scales are currently being introduced, although their use is still limited in the health field. However, ethical use of these scales raises the issue of the homogenisation of the content of medical records and access to criminal records in order to enable future research to confirm whether the use of information provided in medical and criminal records can improve the quality of assessment and treatment of offenders.

Sexual offender risk assessment practice is considered by many to be atheoretical. The identification of the most predictive risk factors and tools has typically overshadowed questions about etiology. To gain insight into the origins of criminal behavior among sexual offenders, we developed and validated an etiological model of risk based on the theoretical framework of Beech and Ward. Our model focused on persistence rather than onset, and encompassed both the sexual and nonsexual criminal activity of these offenders. It comprised two pathways. The first was characterized by sexual victimization, social isolation, and early deviant sexual fantasies. It led to a prolific involvement in sexual criminality (especially toward children) and predicted sexual recidivism. The second pathway was characterized by externalization problems, sexual promiscuity, and physical/psychological victimization, and was associated with nonsexual offending and serious sexual offenses directed (mostly) toward women. It predicted all types of recidivism.

Research has identified stable and dynamic characteristics in child sexual abusers working with children (CSA-W) that may distinguish them from other child sexual abusers (CSA). However, in previous research CSA-W have usually been included in the group of extra-familial CSA (CSA-E). Two hundred and forty-eight forensic-sexological reports about CSA conducted by the Federal Evaluation Centre for Violent and Sexual Offenders in the Austrian Prison System were evaluated retrospectively. One hundred and nineteen intra-familial CSA (CSA-I), 66 CSA-E, and 38 CSA-W were compared with regard to static risk factors, indicators of psychopathy, and pedophilic sexual interests. CSA-E had the highest risk of recidivism as measured by the Static-99 total score, followed by CSA-W. Furthermore, CSA-E had more previous convictions than CSA-W. Both CSA-E and CSA-I had higher total scores on the Psychopathy Checklist-Revised than CSA-W. CSA-W had the highest prevalence of pedophilia diagnoses according to DSM-IV-TR criteria, as well as the highest rate of pedophilia with an orientation toward male children, and the highest frequency of male victims. CSA-W also had the highest total scores in the Screening Scale for Pedophilic Interests. CSA-W seem to constitute a group with particular risk factors and criminogenic needs, that is, they show more indicators of pedophilic sexual interests but less general antisociality and psychopathy, and would thus seem to be distinguishable from other CSA. Future research should focus in particular on evaluating differences in the grooming strategies used by CSA-W to commit and disclose child sexual abuse, as well as on the resources of this particular offender group.

Estimating the risk for recidivism is important for many areas of the criminal justice system. In the present study, the Youth Actuarial Risk Assessment Tool (Y-ARAT) was developed for juvenile offenders based solely on police records, with the aim to estimate the risk of general recidivism among large groups of juvenile offenders by police officers without clinical expertise. On the basis of the Y-ARAT, juvenile offenders are classified into five risk groups based on (combinations of) 10 variables including different types of incidents in which the juvenile was a suspect, total number of incidents in which the juvenile was a suspect, total number of other incidents, total number of incidents in which co-occupants at the youth\'s address were suspects, gender, and age at first incident. The Y-ARAT was developed on a sample of 2,501 juvenile offenders and validated on another sample of 2,499 juvenile offenders, showing moderate predictive accuracy (area under the receiver-operating-characteristic curve = .73), with little variation between the construction and validation sample. The predictive accuracy of the Y-ARAT was considered sufficient to justify its use as a screening instrument for the police.