Holper Lisa, Mokros Andreas, Habermeyer Elmar
Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland.
Department of Psychology, FernUniversität in Hagen, Hagen, Germany.
Sex Abuse. 2024 Apr;36(3):255-291. doi: 10.1177/10790632231159071. Epub 2023 Mar 16.
The present meta-analysis is an update of the meta-analysis by Schmucker and Lösel [Campbell Syst. Rev. 2017; 13: 1-75], which synthesized evidence on sexual recidivism as an indicator of treatment effectiveness in persons with sexual offense histories. The updated meta-analysis includes 37 samples comprising a total of 30,394 individuals with sexual offense histories, which is nearly three times the sample size reported by Schmucker and Lösel (2017: 28 samples, = 9781). In line with Schmucker and Lösel (2017), the mean treatment effect was small with an odds ratio of 1.54 [95% CI 1.22, 1.95] ( < .001). A moderator analysis suggested three predictors of importance, i.e., risk level, treatment specialization, and author confounding. Greater treatment effectiveness was suggested in high- and medium-compared to low-risk individuals and in specialized compared to non-specialized treatments. Authors affiliated with treatment programs reported larger effectiveness than independent authors. These findings were overall in line with Schmucker and Lösel (2017), though the effects of risk level and treatment specialization were stronger in the current meta-analysis. The findings of the updated meta-analysis reinforce the evidence for the first and second principle of the Risk-Need-Responsivity model. The results may support researchers and decision-makers in interpreting the current evidence on sexual recidivism as an indicator of treatment effectiveness, and, based on that, implement and carry out informative, methodologically sound evaluations of ongoing treatment programs in persons with sexual offense histories.
本荟萃分析是对Schmucker和Lösel[《坎贝尔系统评价》2017年;13: 1 - 75]所做荟萃分析的更新,该分析综合了关于性犯罪再犯作为有性犯罪史者治疗效果指标的证据。更新后的荟萃分析包括37个样本,共有30394名有性犯罪史的个体,这几乎是Schmucker和Lösel(2017年:28个样本,n = 9781)所报告样本量的三倍。与Schmucker和Lösel(2017年)一致,平均治疗效果较小,优势比为1.54[95%置信区间1.22,1.95](p <.001)。一项调节分析提出了三个重要的预测因素,即风险水平、治疗专业化和作者混杂因素。与低风险个体相比,高风险和中等风险个体以及与非专业化治疗相比,专业化治疗显示出更大的治疗效果。与治疗项目相关的作者报告的效果比独立作者更大。尽管在当前的荟萃分析中风险水平和治疗专业化的影响更强,但这些发现总体上与Schmucker和Lösel(2017年)一致。更新后的荟萃分析结果强化了风险 - 需要 - 反应性模型第一和第二个原则的证据。这些结果可能支持研究人员和决策者解释当前关于性犯罪再犯作为治疗效果指标的证据,并在此基础上对有性犯罪史者正在进行的治疗项目进行信息丰富、方法合理的评估并实施。