von Franqué Fritjof, Briken Peer
Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Front Psychiatry. 2021 Sep 30;12:708210. doi: 10.3389/fpsyt.2021.708210. eCollection 2021.
Child sexual abuse is associated with multiple and often severe consequences for people who are affected by it. From the perspective of indicative prevention, the treatment of people who have sexually abused children represents one important strategy, with the assumption that there is often a risk for sexual recidivism. However, there is still very limited knowledge about how men who have not been convicted of child sexual abuse but participate in voluntary treatment (here called non-forensic clients) differ from those who have been convicted and undergo mandated treatment (here called forensic clients). This study compared 22 forensic and 22 non-forensic clients regarding pedophilic interests, static and dynamic risk factors, responsivity features, and treatment progress during an individualized treatment based on the principles of risk, need, and responsivity. We found neither differences in the rates in the DSM-5 diagnosis of pedophilic disorder, nor in risk and responsivity associated scores at the beginning of treatment. In both groups, a low to moderate risk for sexual re-offending was estimated. Both groups improved their functioning on dynamic risk and responsivity factors under treatment, while age at the beginning of therapy also had a positive effect on all outcomes. Non-forensic clients had a higher amount of responsivity associated resources than forensic clients during treatment. The limitations of these results and their implications for further research and prevention approaches are discussed.
儿童性虐待会给受其影响的人带来多种且往往很严重的后果。从指示性预防的角度来看，对有儿童性虐待行为的人进行治疗是一项重要策略，因为通常存在性再犯的风险。然而，对于那些未被判定犯有儿童性虐待罪但参与自愿治疗的男性（这里称为非司法客户）与那些已被定罪并接受强制治疗的男性（这里称为司法客户）之间的差异，我们的了解仍然非常有限。本研究基于风险、需求和反应性原则，对22名司法客户和22名非司法客户在恋童癖兴趣、静态和动态风险因素、反应性特征以及个体化治疗期间的治疗进展方面进行了比较。我们发现，在治疗开始时，两组在《精神疾病诊断与统计手册》第五版（DSM - 5）中恋童癖障碍的诊断率、风险及反应性相关评分方面均无差异。两组的性再犯风险估计都处于低到中度。在治疗过程中，两组在动态风险和反应性因素方面的功能都有所改善，同时治疗开始时的年龄对所有结果也有积极影响。在治疗期间，非司法客户比司法客户拥有更多与反应性相关的资源。本文讨论了这些结果的局限性及其对进一步研究和预防方法的启示。
