Exercise: Priming students to detect covert biases

In an eye-opening exercise in my graduate forensic psychology course, I had two groups separately analyze a sanitized forensic report. The subject of the report was a 16-year-old boy named "John" who had committed a relatively minor sex offense; the evaluation issue was treatment amenability. After independent group discussions, the two groups shared their impressions as follows:

Group A: "John has a conduct disorder and is narcissistic. His misconduct appears to be escalating. There are ominous warning signs of budding psychopathy. He is at a crossroads in his life; he could go bad fast."

Group B: "This report is biased. The evaluator has joined with John's mother, and is channeling the mother's antagonism toward John. There is evidence of racism, homophobia, and political conservatism. The evaluator’s antipathy toward John feels personal – perhaps he has a wayward teenage son?"

The two groups looked across the table at each other, flabbergasted. Some suspected a trick. "Did you really give us the same report to read?" one student queried.

Yes, everyone had read the identical report. And, in case you wondered, group selection was random; there were no baseline differences that would explain the groups' divergent opinions.

Rather, the difference was in how the two groups were primed to read the report. Their instructions:

Group A: "Read the report with the goal of trying to understand John. What makes him tick? Does he have any potential clinical diagnoses? What is your prognosis for his future?"

Group B: "Read the report with the goal of trying to understand the perspective of the report writer. Do you see any problems with his method or his analysis? If so, do they suggest any potential biases?"

This was no abstract academic exercise. Channeling John’s hateful mother, this seminal report reads like something torn from the pages of an Anne Rule novel, replete with enough (uncorroborated) animal torture and arson to excite any true believer in the infamous McDonald Triad. Going unchallenged at the time, the report had a hugely prejudicial impact on decision-makers. For years to come, institutional bureaucrats and forensic experts quoted liberally from it to bolster their opinions that John was dangerous.

This is not an isolated or unusual case. Alarmist reports like this have remarkable staying power, their uncorroborated claims taking on a life of their own as they ripple through their subjects' lives, eschewing rational analysis or contestation. The power of a single forensic evaluator is truly frightening at times.

Cutting through the hype

So how did a group of graduate students manage to see through the hype that had buffaloed seasoned professionals, to take the measure of the evaluator and expose his subterranean biases? Remarkably, all it took was a simple admonition to think critically, and to be alert to potential biases.

Ideally, we should always be exercising these analytical faculties. We should train ourselves to simultaneously process at least two units of analyses, asking ourselves both:

A. What does this report tell us about its subject?

B. What are the limitations of this report? How might its findings be unreliable, and perhaps flawed by unreliable or insufficient information, unconscious assumptions and biases, or other factors?

Cognitive biases

In the class exercise, Group A was focused only on Question A, whereas Group B focused on Question B. When forensic experts review a report, our approach should be bidirectional, and incorporate both perspectives.

Constructive skepticism benefits from an understanding of cognitive biases and how they work. In the instant case, the most obvious of these was confirmatory bias. This is the tendency to actively seek out and assign more weight to information that confirms one's prior beliefs, discounting or ignoring disconfirmatory data. Clinicians who fall under the spell of psychopathy theory, for example, tend to see psychopaths lurking behind every bush. A clue to the author's preconceptions in John's case was found in a footnote citing Stanton Samenow’s The Criminal Mind, an influential but decidedly polemic treatise that vigorously disavows social factors in crime and -- as its title implies -- caricatures criminals as a breed apart from normal human beings. 

Once you detect such selective perception in play, you may see related cognitive biases which the discerning expert should always be on the lookout for in forensic (and other) reports. These include, but are not limited to:

• Salience bias, in which inordinate attention is paid to exotic or highly distinctive information, at the expense of ordinary features of a case that may be important. In John's case, the evaluator overweighted the mother's fanciful tales about John's early childhood ("He never cried liked a normal baby!"), while ignoring more proximate evidence of John's confusion over his sexuality. In criminal cases, salience bias often contributes to racial stereotyping.

• Hindsight bias, or the tendency to see events as more predictable than they were before they took place. Using hindsight, forensic experts are prone to overvalue known facts that tend to explain an event; a countermeasure is to deliberately consider information that supports alternate conclusions. 

• Availability bias, in which the probability of an event is judged by how easy it is to think of examples. Especially when combined with ignorance of base rates, this can lead to a tendency to overpredict dramatic events, even when -- as in the case of black swans -- their likelihood is actually low.

• Illusory correlation, in which a relationship is imagined between variables that are in fact unrelated. In John's case, the mother's dramatic tales -- even if true -- may have had little or nothing to do with John's teenage misconduct. However, when read by subsequent decision-makers in a cultural climate that privileges psychopathy as an explanation for criminal conduct, they had an enormously prejudicial impact. 

(Wikipedia maintains an exhaustive list of these decision-making biases, along with links to their definitions.) 

To avoid perpetuating biases, forensic evaluators should train themselves to think like "Agent J" in Men in Black. Rather than jumping to superficially plausible conclusions, try to consciously develop alternate hypotheses and test their fit with the evidence. This scientific mindset kept Agent J (Will Smith) from assuming that little Tiffany, a blonde girl carrying quantum physics textbooks through the ghetto at night, was the innocent party just because she did not superficially resemble the monsters who were also out and about. Here is the scene from Men in Black that I show in my class, in which Agent J explains his logic in shooting Tiffany -- rather than the monsters -- during a simulation training:

Fremantle to host Australian forensic conference

I hope all of you Aussies out there are aware of the exciting forensic psychology conference coming up in April. The theme is timely: "The Times are a Changin': Controversies, Competencies, and DSM-5." Robert Krueger, a personality researcher at the University of Minnesota and a member of the Personality Disorders Workgroup for the DSM-5, will give a keynote focusing on issues specific to using the DSM-5 personality disorders in court. The other keynote speaker is Jane Goodman-Delahunty of Charles Sturt University, a prominent psychologist and attorney who will speak about psychological injuries from workplace harassment. The setting, for those of you who might want to travel to Australia to attend, is the western city of Fremantle, which bills itself as the best preserved 19th Century seaport in the world. (The conference alternates between eastern and western Australia; when I gave a keynote there two years ago, it was held in the idyllic resort setting of Noosa, in southern Queensland.) The website for the April 18-20 event is HERE; the full program  can be downloaded HERE. Don't procrastinate too long, as early-bird registration ends March 18.

Panorama of the Swan River Settlement (Fremantle), 1831 (Source: Wikipedia Commons)

Texas SVP jurors ignoring actuarial risk scores

Expert witness for defense makes a (small) difference, study finds

The fiery debates surrounding the validity of actuarial tools to predict violence risk begs the question: How much influence do these instruments really have on legal decision-makers? The answer, at least when it comes to jurors in Sexually Violent Predator trials in Texas:

Not much.

"Despite great academic emphasis on risk measures - and ongoing debates about the value, accuracy, and utility of risk-measure scores reported in SVP hearings - our findings suggest these risk measure scores may have little impact on jurors in actual SVP hearings."

The researchers surveyed 299 jurors at the end of 26 sexually violent predator trials. Unfortunately, they could not directly measure the relationship between risk scores and civil commitment decisions because, this being Texas, juries slam-dunked 25 out of 26 sex offenders, hanging in only one case (which ultimately ended in commitment after a retrial).  

Instead of the ultimate legal outcome, the researchers had to rely on proxy outcome measures, including jurors' ratings of how dangerous an individual was (specifically, how likely he would be to commit a new sex offense within one year of release), and their assessment of how difficult it was to make a decision in their case.

There was no evidence that jurors' assessments of risk or decision difficulty varied based on respondents' scores on risk assessment tools, which in each case included the Static-99, MnSOST-R and the PCL-R. This finding, by the prolific team of Marcus Boccaccini, Daniel Murrie and colleagues, extends into the real world prior mock trial evidence that jurors in capital cases and other legal proceedings involving psychology experts are more heavily influenced by clinical than actuarial testimony.

What did make a difference to jurors was whether the defense called at least one witness, and in particular an expert witness. Overall, there was a huge imbalance in expert testimony, with almost all of the trials featuring two state experts, but only seven of 26 including even one expert called by the defense.

"Skepticism effect"

The introduction of a defense expert produced a "skepticism effect," the researchers found, in which jurors became more skeptical of experts' ability to predict future offending. However, jurors' lower risk ratings in these cases could also have been due to real differences in the cases. In SVP cases involving legitimately dangerous sex offenders, defense attorneys often have trouble finding experts willing to testify. In other words, the researchers note, "the reduced ratings of perceived risk associated with the presence of a defense expert may be due to nonrandom selection … as opposed to these defense experts' influencing jurors."

A back story here pertains to the jury pool in the Texas county in which civil commitment trials are held. All SVP trials take place in Montgomery County, a "very white community," an attorney there told me. A special e-juror selection process for SVP jurors whitens the jury pool even more, disproportionately eliminating Hispanics and African Americans. Meanwhile, many of those being referred for civil commitment are racial minorities. The potentially Unconstitutional race discrepancy is the basis for one of many current legal challenges to the SVP system in Texas.

Once a petition for civil commitment as a sexually violent predator is filed in Texas, the outcome is a fait accompli. Since the inception of the state's SVP law, only one jury has unanimously voted against civil commitment. Almost 300 men have been committed, and not a single one has been released.

Overall, the broad majority of jurors in the 26 SVP trials were of the opinion that respondents were likely to reoffend in the next year. Based on this heightened perception of risk, the researchers hypothesize that jurors may have found precise risk assessment ratings irrelevant because any risk was enough to justify civil commitment.

In a previous survey of Texas jurors, more than half reported that even a 1 percent chance of recidivism was enough to qualify a sex offender as dangerous. To be civilly committed in Texas, a sex offender must be found "likely" to reoffend, but the state's courts have not clarified what that term means.  

Risk scores could also be irrelevant to jurors motivated more by a desire for retribution than a genuine wish to protect the public, the researchers pointed out. "Although SVP laws are ostensibly designed to provide treatment and protect the public, experimental research suggests that many mock jurors make civil commitment decisions based more on retributive motives - that is, the desire to punish sexual offenses—than the utilitarian goal of protecting the public…. Jurors who adopt this mindset may spend little time thinking about risk-measure scores."

All this is not to say that actuarial scores are irrelevant. They are highly influential in the decisions that take place leading up to an SVP trial, including administrative referrals for full evaluations, the opinions of the evaluators themselves as to whether an offender meets civil commitment criteria, and decisions by prosecutors as to which cases to select for trial.

"But the influence of risk scores appears to end at the point when laypersons make decisions about civilly committing a select subgroup of sexual offenders," the researchers noted.

Bottom line: Once a petition for civil commitment as a sexually violent predator is filed in Texas, it's the end of the line. The juries are ultra-punitive, and the deck is stacked, with government experts outnumbering experts called by the defense in every case. It remains unclear to what extent these results might generalize to SVP proceedings in other states with less conservative jury pools and/or more balanced proceedings.

• The study, "Do Scores From Risk Measures Matter to Jurors?" by Marcus Boccaccini, Darrel Turner, Craig Henderson and Caroline Chevalier of Sam Houston State University and Daniel Murrie of the University of Virginia, is slated for publication in an upcoming issue of Psychology, Public Policy, and Law. To request a copy, email the lead researcher (HERE).

Upcoming forensic training opportunities

American Psychology-Law Society, March 7-9

For those of you planning to attend the American Psychology-Law Society conference in Portland Oregon on March 7-9, early-bird registration ends on February 1. This year’s lineup is very exciting. The conference website is HERE; details on the March 8 symposium that I will be chairing, "Emergent controversies in civil commitment evaluations of sexually violent predators” (as well as the pre-conference continuing education lineup) are HERE. 

Juvenile sex offender training, Feb. 11

Coming right up at the Institute of Law, Psychiatry, and Public Policy in Charlottesville, Virginia is an advanced training on “Understanding and Treating Juvenile Sexual Offenders.” The presenter is nationally recognized expert John Hunter. Details are HERE.

Ethics in forensic practice training, May 3

Later in the spring, the Institute is offering another advanced workshop by nationally recognized presenter Alan Goldstein. Topics include competence to practice; confidentiality; roles of the expert; issues in assessment; responding to subpoenas; release of raw test data; report writing; and ultimate opinion testimony. The emphasis is on reducing the likelihood of potentially damaging cross-examination, ethics complaints and malpractice actions. Attendees are encouraged to prepare, in advance, a problem they encountered in their practice and submit it at the start of the workshop for review and possible discussion. More information is HERE.

Showdown looming over predictive accuracy of actuarials

Large error rates thwart individual risk prediction

Brett Jordan David Macdonald (Creative Commons license)

If you are involved in risk assessments in any way (and what psychology-law professional is not, given the current cultural landscape?), now is the time to get up to speed on a major challenge that's fast gaining recognition.

At issue is whether the margins of error around scores are so wide as to prevent reliable prediction of an individual's risk, even as risk instruments show some (albeit weak) predictive accuracy on a group level. If the problem is unsolvable, as critics maintain, then actuarial tools such as the Static-99 and VRAG should be barred from court, where they can literally make the difference between life and death.

The debate has been gaining steam since 2007, with a series of back-and-forth articles in academic journals (see below). Now, the preeminent journal Behavioral Sciences and the Law has published findings by two leading forensic psychologists from Canada and Scotland that purport to demonstrate once and for all that the problem is "an accurate characterization of reality" rather than a statistical artifact as the actuarials' defenders had argued.

So-called actuarial tools have become increasingly popular over the last couple of decades in response to legal demand. Instruments such as the Static-99 (for sexual risk) and the VRAG (for general violence risk) provide quick-and-dirty ways to guess at an individual's risk of violent or sexual recidivism. Offenders are scored on a set of easy-to-collect variables, such as age and number of prior convictions. The assumption is that an offender who attains a certain score resembles the larger group of offenders in that score range, and therefore is likely to reoffend at the same rate as the collective.

Responding to criticisms of the statistical techniques they used in their previous critiques, Stephen Hart of Simon Fraser University and David Cooke of Glasgow Caledonian University developed an experimental actuarial tool that worked on par with existing actuarials to separate offenders into high- and low-risk groups.* The odds of sexual recidivism for subjects in the high-risk group averaged 4.5 times that of those in the low-risk group. But despite this large average difference, the researchers established through a traditional statistical procedure, logistic regression, that the margins of error around individual scores were so large as to make risk distinctions between individuals "virtually impossible." In only one out of 90 cases was it possible to say that a subject's predicted risk of failure was significantly higher than the overall baseline of 18 percent. (See figure.)

Vertical lines show confidence intervals for individual risk estimates;
these large ranges would be required in order to reach the traditional 95 percent level of certainty.

The brick wall limiting predictive accuracy at the individual level is not specific to violence risk. Researchers in more established fields, such as medical pathology, have also hit it. Many of you will know of someone diagnosed with a cancer and given six months to live who managed to soldier on for years (or, conversely, who bit the dust in a matter of weeks). Such cases are not flukes: They owe to the fact the six-month figure is just a group average, and cannot be accurately applied to any individual cancer patient.

Attempts to resolve this problem via new technical procedures are "a waste of time," according to Hart and Cooke, because the problem is due to the "fundamental uncertainty in individual-level violence risk assessment, one that cannot be overcome." In other words, trying to precisely predict the future using "a small number of risk factors selected primarily on pragmatic grounds" is futile; all the analyses in the world "will not change reality."

Legal admissibility questionable 

The current study has grave implications for the legal admissibility of actuarial instruments in court. Jurisdictions that rely upon the Daubert evidentiary standard should not be allowing procedures for which the margins of error are "large, unknown, or incalculable," Hart and Cooke warn.

By offering risk estimates in the form of precise odds of a new crime within a specific period of time, actuarial methods present an image of certitude. This is especially dangerous when that accuracy is illusory. Being told that an offender "belongs to a group with a 78 percent likelihood of committing another violent offense within seven years" is highly prejudicial and may poison the judgment of triers of fact. More covertly, it influences the judgment of the clinician as well, who -- through a process known as "anchoring bias" -- may tend to judge other information in a case in light of the individual's actuarial risk score.

Classic '56 Chevy in Cuba. Photo credit: Franciscovies

With professional awareness of this issue growing, it is not only irresponsible but ethically indefensible not to inform the courts or others who retain our services about the limitations of actuarial risk assessment. The Ethics Code of the American Psychological Association, for example, requires informing clients of "any significant limitations of [our] interpretations." Unfortunately, I rarely (if ever) see limitations adequately disclosed, either in written reports or court testimony, by evaluators who rely upon the Static-99, VRAG, Psychopathy Checklist-Revised (which Cooke and statistician Christine Michie of Glasgow University tackled in a 2010 study) and similar instruments in forming opinions about individual risk.

In fact, more often than not I see the opposite: Evaluators tout the actuarial du jour as being far more accurate than "unstructured clinical judgment." That's like an auto dealer telling you, in response to your query about a vehicle's gas mileage, that it gets far more miles per gallon than your old 1956 Chevy. Leaving aside Cuba (where a long-running U.S. embargo hampers imports), there are about as many gas-guzzling '56 Chevys on the roads in 2013 as there are forensic psychologists relying on unstructured clinical judgment to perform risk assessments. 

Time to give up the ghost? 

Hart and Cooke recommend that forensic evaluators stop the practice of using these statistical algorithms to make "mechanistic" and "formulaic" predictions. They are especially critical of the practice of providing specific probabilities of recidivism, which are highly prejudicial and likely to be inaccurate.

"This actually isn’t a radical idea; until quite recently, leading figures in the field of forensic mental health [such as Tom Grisso and Paul Appelbaum] argued that making probabilistic predictions was questionable or even ill advised," they point out. “Even in fields where the state of knowledge is arguably more advanced, such as medicine, it is not routine to make individual predictions.”

They propose instead a return to evidence-based approaches that more wholistically consider the individual and his or her circumstances:

From both clinical and legal perspectives, it is arbitrary and therefore inappropriate to rely solely on a statistical algorithm developed a priori - and therefore developed without any reference to the facts of the case at hand - to make decisions about an individual, especially when the decision may result in deprivation of liberties. Instead, good practice requires a flexible approach, one in which professionals are aware of and rely on knowledge of the scientific literature, but also recognize that their decisions ultimately require consideration of the totality of circumstances - not just the items of a particular test. 

In the short run, I am skeptical that this proposal will be accepted. The foundation underlying actuarial risk assessment may be hollow, but too much construction has occurred atop it. Civil commitment schemes rely upon actuarial tools to lend an imprimatur of science, and statutes in an increasing number of U.S. states mandate use of the Static-99 and related statistical algorithms in institutional decision-making.

The long-term picture is more difficult to predict. We may look back sheepishly on today's technocratic approaches, seeing them as emblematic of overzealous and ignorant pandering to public fear. Or -- more bleakly -- we may end up with a rigidly controlled society like that depicted in the sci-fi drama Gattaca, in which supposedly infallible scientific tests determine (and limit) the future of each citizen.

* * * * *

I recommend the article, "Another Look at the (Im-)Precision of IndividualRisk Estimates Made Using Actuarial RiskAssessment Instruments." It's part of an upcoming special issue on violence risk assessment, and it provides a detailed discussion of the history and parameters of the debate. (Click HERE to request it from Dr. Hart.) Other articles in the debate include the following (in rough chronological order): 

• Hart, S. D., Michie, C. and Cooke, D. J. (2007a). Precision of actuarial risk assessment instruments: Evaluating the "margins of error" of group v. individual predictions of violence.  British Journal of Psychiatry, 190, s60–s65. 

• Mossman, D. and Sellke, T. (2007). Avoiding errors about "margins of error" [Letter]. British Journal of Psychiatry, 191, 561. 

• Harris, G. T., Rice, M. E. and Quinsey, V. L. (2008). Shall evidence-based risk assessment be abandoned? [Letter]. British Journal of Psychiatry, 192, 154. 

• Cooke, D. J. and Michie, C. (2010). Limitations of diagnostic precision and predictive utility in the individual case: A challenge for forensic practice. Law and Human Behavior, 34, 259–274. 

• Hanson, R. K. and Howard, P. D. (2010). Individual confidence intervals do not inform decision makers about the accuracy of risk assessment evaluations. Law and Human Behavior, 34, 275–281. 

*The experimental instrument used for this study was derived from the SVR-20, a structured professional judgment tool. The average recidivism rate among the total sample was 18 percent, with 10 percent of offenders in the low-risk group and 33 percent of those in the high-risk group reoffending. The instrument's Area Under the Curve, a measure of predictive validity, was .72, which is in line with that of other actuarial instruments.

Martin Luther King: Back by popular demand

For the third year in a row, in honor of Martin Luther King Day, I am excerpting a portion of a keynote speech the visionary civil rights leader delivered at the 1967 convention of the American Psychological Association. This was just seven months before he was gunned down, and at a time when he was drawing larger connections between racial oppression and the Vietnam War. I have made the entire speech, "The Role of the Behavioral Scientist in the Civil Rights Movement," available for download (HERE). Forensic psychologists who follow my blog have told me they appreciate it. Forty-six years old, the speech remains relevant today.

There are certain technical words in every academic discipline which soon become stereotypes and even clichés. Every academic discipline has its technical nomenclature. You who are in the field of psychology have given us a great word. It is the word maladjusted. This word is probably used more than any other word in psychology. It is a good word; certainly it is good that in dealing with what the word implies you are declaring that destructive maladjustment should be destroyed. You are saying that all must seek the well-adjusted life in order to avoid neurotic and schizophrenic personalities.

But on the other hand, I am sure that we will recognize that there are some things in our society, some things in our world, to which we should never be adjusted. There are some things concerning which we must always be maladjusted if we are to be people of good will. We must never adjust ourselves to racial discrimination and racial segregation. We must never adjust ourselves to religious bigotry. We must never adjust ourselves to economic conditions that take necessities from the many to give luxuries to the few. We must never adjust ourselves to the madness of militarism, and the self-defeating effects of physical violence....

Thus, it may well be that our world is in dire need of a new organization, The International Association for the Advancement of Creative Maladjustment. Men and women should be as maladjusted as the prophet Amos, who in the midst of the injustices of his day, could cry out in words that echo across the centuries, 'Let justice roll down like waters and righteousness like a mighty stream'; or as maladjusted as Abraham Lincoln, who in the midst of his vacillations finally came to see that this nation could not survive half slave and half free; or as maladjusted as Thomas Jefferson, who in the midst of an age amazingly adjusted to slavery, could scratch across the pages of history, words lifted to cosmic proportions, 'We hold these truths to be self evident, that all men are created equal. That they are endowed by their creator with certain inalienable rights. And that among these are life, liberty, and the pursuit of happiness.' And through such creative maladjustment, we may be able to emerge from the bleak and desolate midnight of man’s inhumanity to man, into the bright and glittering daybreak of freedom and justice.

I have not lost hope. I must confess that these have been very difficult days for me personally. And these have been difficult days for every civil rights leader, for every lover of justice and peace.

* * * * *

My longer excerpt, posted January 2011, is HERE.  The full speech is HERE.

Pornography and contact sex offending

Guest essay by Jon Brandt, David S. Prescott and Robin J. Wilson*

Many people have grave concerns about the potential for a relationship between pornography and inappropriate sexual behavior. For obvious reasons, there are apprehensions about the sexual behaviors of those who have sexually abused. As a result, it is not uncommon for persons who have sexually abused to be restricted from certain activities that would have remained available to them had they not sexually offended. However, questions remain as to whether we are using our professional energy and resources wisely in trying to prevent persons convicted of sexual crimes from being sexually active. This point extends to whether persons who have sexually abused should have access to sexually explicit materials.

There are many reasons not to like pornography. Perhaps women, more than men, are objectified by pornography. Both women and men have raised questions about how pornography cheapens and depersonalizes sex. As men dedicated to sexual violence prevention, we are concerned about both the demeaning representation of women and the unflattering portrayal of men (e.g., piggish, self-absorbed, or uncaring) in much commercial pornography. There are also concerns about the effects of the depiction of unhealthy, violent, or potentially harmful sexual behaviors. There is an open question about the long-term effects of exposure to sexually explicit media. These are important considerations, but as offensive as pornography is to many people, extant research does not support a causal relationship between pornography and sexual offending.

Not just academic

Defining pornography remains a challenge. In our field, this is not simply an academic discussion. Sexual offenders are typically restricted from possessing any type of pornography, but there are no clear demarcation points between artistic expressions of the human form, sexually suggestive images, erotica, or hardcore pornography. When the legal consequences for possession of any sexual media are so severe, defining pornography has never been more important.

Jon Brandt

In the US, numerous court decisions, presidential task forces, and various think tanks have been unable to produce an agreement or useful definition of "pornography." With the need for greater precision within our profession than perhaps elsewhere in public discourse, our field would benefit from fine-tuning and distinguishing between various types of sexual media. Using "pornography" to describe all forms of sexual media is both imprecise and emotionally loaded. It can obscure treatment needs and interventions. Missed opportunities of therapeutically beneficial sexual imagery could inadvertently lead to more harm.

Good science or moral panic?

The historical perspective that sexually explicit images are offensive and therefore must be harmful is such a powerful narrative that it is difficult to close the gap between what we know about private sexual behavior and widespread public perceptions. We wonder whether some restrictions imposed on our clients are the considered application of good science or a default result of moral panic. If the latter is true, are therapists complicit in the unwarranted enforcement of social controls more than the healing arts of rehabilitation?

Gone are the days when pornography originated in adult bookstores or arrived discreetly in the mail. Most sexual media today is user-produced and shared through cell phones and the Internet. The use of sexual media by male teens and adults today is not just normative, it is pervasive. Science has yet to show any key differences between those who "sext" and those who do not, except for the behavior itself. Consumption of sexually explicit imagery has been explosive in the last decade. Sexual content in cyberspace may account for more than 30 percent of the data transfer of the entire Internet. Starting as teenagers, consumers are overwhelmingly male, but also include a significant percentage of women.

David Prescott

Though controversial and perhaps even counterintuitive, evidence of the adverse effects of sexual media has not been established. Other than child pornography, broad sexual media restrictions for most persons who have sexually abused do not appear to be supported by research. Frequently, restrictions on "pornography" for such clients include prohibition of every type of sexual media. Without knowing whether some level of exposure to some form of sexual media might have some adverse effects on human behavior, we use a shotgun approach to such restrictions. These squishy definitions and operatives also compromise research.

We each entered the field of treating sexual aggression at a time when professionals assumed that all persons who had sexually abused were at high risk to persist. Not only has this turned out to be untrue, but the rates of sexual aggression and re-offense have declined at the very same time as access to sexually explicit imagery has never been easier. Although we know of no interactive relationship between these co-occurring trends, they should each cause us to reconsider our attitudes and beliefs about what is important in the treatment and supervision of persons who have sexually abused.

There has been limited research involving pornography's influence on sexual aggression. The strongest concerns in studies published in refereed journals include a potentially aggravating influence of routine pornography use by men already at high risk for re-offending (and/or higher in entrenched antisociality, sometimes referred to as psychopathy). Certain types of pornography with high-risk offenders may also increase risk. Researchers such as Drew Kingston and Neil Malamuth appear to support the cautious position that without more conclusive research we should evaluate higher risk situations on a case by case basis. To our knowledge, no studies have as yet produced a credible indictment of pornography usage among persons who have sexually abused.

No definitive link found

Two additional facts are worthy of consideration. First, both biased and impartial groups have been funding research for more than 50 years to find a connection between pornography and sexual offending, and none have been able to find any definitive link. Second, despite the explosion of sexual media since the advent of the Internet and rapid transfer of visual imagery, there has been no increase in rates of sexual offending—everywhere it has been studied, around the world. Arguably, the same information superhighway that provides access to pornography has also brought attention to the numerous media outlets that remind us that true sexual violence is intolerable.

Robin Wilson

Several researchers have suggested that the correlation between pornography and sexual offending is either absent or inverse. A noteworthy advocate for this theory is sexologist Milton Diamond of the University of Hawaii. His published research on pornography and sexual offending in the US, Japan, and Europe persuasively argues that the relationship between pornography and sexual offending is negatively correlated. Diamond's research appears to also hold true for the relationship between child pornography and engagement in contact offenses. If validated, consider the implications of such findings in mitigating contact offenses against children, as offensive as it may seem. Perhaps adult pornography really is more offensive than actually harmful in the treatment and supervision of people who have sexually abused.

What might account for a negative correlation between pornography and contact offenses? Diamond and others have theorized that sexual media may provide a vicarious satisfaction of sexual curiosity and/or a cathartic venting effect for libido. If this theory turns out to be correct, restricting most sexual offenders from having sexual media might not just be overly cautious, it might, in individual circumstances, be counterproductive.

Individual differences proposed

Kingston and Malamuth have challenged some of Diamond's research, but only to the extent that Diamond's aggregate data, while compelling, might not apply to certain individuals. Theirs is an important point for consideration. Michael Seto has raised similar concerns with respect to certain risk factors and child pornography. We can also see how this is an important aspect to consider. However, a ban on all sexual media for all persons who have sexually abused appears neither science-based nor justified.

At what point does research become conclusive? It may be that pornography currently remains too controversial and emotionally charged for effective public policy to emanate from good science. Nonetheless, our concern is that broad bans on sexual media may be squandering resources, at the expense of truly science-based treatment and supervision elsewhere. 

These are not simply academic points. Revoking a person's parole or violating their probation because of behaviors that are socially undesirable, rather than an established characteristic of risk or harm, can be costly to society as well as the individual. All too often, we implement public policies and impose restrictions on offenders because we feel better to believe we are doing something to help stop victimization. However, we should also consider that when we overreach with risk management, limited resources are stretched thin.

Recommendations

We are not suggesting that pornography use by clients should be ignored. Following the model of Risk-Needs-Responsivity, the risk and need principles may guide the formation of effective therapeutic and correctional interventions. To that end, clinicians would be wise to thoroughly assess the effects of sexual media on individual clients (see appendix). Professionals should avoid restricting clients' access to sexual media based only on personal values, unsupported professional beliefs, or undocumented theories. Therapeutic efforts should be focused on managing abuse-related sexual interests (as opposed to all sexual interests). Therapists can provide clients with education about healthy sexuality, with the end goal of a safe, fulfilling, and non-exploitive sex life.

Given that science continues to better inform us about the psychological and social dynamics of sexual behavior, we should periodically review status quo. When scientific trending suggests current policies or practices might be unfounded, outdated, or perhaps even counterproductive, we should gather the professional courage to explore better pathways that might more effectively prevent or mitigate sexual offending.

Appendix

In assessing the effects of sexual media with individual clients, clinicians might explore:

1) The client's history, current use, and experience with different types of sexual media.
2) The client's use of sexual media compared to normative data.
3) Possible connections between certain sexual media and problematic sexual behavior.
4) Escalating or compulsive patterns of the use of sexual media.
5) The possible relationships of sexual media to the index offense(s).
6) The use of sexual media as socially or psychologically protective measures.
7) How sexual media could be interfering with relationships.
8) The use of sexual media to explore or satisfy sexuality curiosity.
9) How sexual media is an element of libido management.
10) Whether clients might benefit from a modified use of sexual media.
11) The possible therapeutic or conditioning benefits of proscriptive sexual media.
12) Sexual media that might be contraindicated therapeutically or socially.
13) The legal hazards or consequences for accessing certain types of sexual media.
14) Limitations on certain sexual media for specific higher-risk offenders.
15) The various risk factors involved in client’s access to sexual media via the Internet, cell phones, digital cameras, Wi-Fi communication devices, and social networking websites.
16) The degree to which clients can exercise internal controls in managing sexual media or to what level external controls might be beneficial to aid in risk management.
17) How clients can move from external controls to internal controls prior to discharge from treatment or supervision in anticipation of independent management.

References

Andrews, D.A. and Bonta, J. (2010). The psychology of criminal conduct. 5th Ed. Cincinnati, OH: Anderson.

Bensimon, P. (2007). The role of pornography in sexual offending. Sexual Addiction and Compulsivity, 14.

Burton, D. (2010). Comparison by crime type of juvenile delinquents on pornography exposure: The absence of relationships between exposure to pornography and sexual offense characteristics. Journal of Forensic Nursing, 6.

D’Amato, A. (2006). Porn up, rape down. Northwestern Public Law Research Paper No. 913013.

Diamond, M. (1999). The effects of pornography: An international perspective. International Journal of Law and Psychiatry.

Diamond, M. (2009). Pornography, public acceptance and sex related crime: A review. International Journal of Law and Psychiatry.

Diamond, M., et al. (2010). Pornography and sex crimes in the Czech Republic. Archives of Sexual Behavior, 40, 1037-1043.

Diamond, M., et al. (2011) Rejoinder to Kingston and Malamuth. Archives of Sexual Behavior, 40, 1049-50.

Ferguson, C.J. and Hartley, R.D. (2009). The pleasure is momentary… the expense damnable?: The influence of pornography on rape and sexual assault. Aggression and Violent Behavior, 14, 323-329.

Kingston, D. and Fedoroff, P. (2008). Pornography use and sexual aggression: The impact of frequency and type of pornography use on recidivism among sexual offenders. Aggressive Behavior, 34, 1-11.

Kingston, D. and Malamuth, N. (2009). The importance of individual differences in pornography use: Theoretical perspectives and implications for treating sexual offenders. Journal of Sex Research, 46, 216-232.

Kingston, D.A. and Malamuth, N.M. (2011). Problems with aggregate data and the importance of individual differences in the study of pornography and sexual aggression: Comment on Diamond, Jozikova, and Weiss (2010). Archives of Sexual Behavior, 40.

Seto, M.C., et al. (2010). Contact sexual offending by men with online sexual offenses. Sexual Abuse: A Journal of Research and Treatment, Vol. 23.

Williams, K.M., et al. (2009). Inferring sexually deviant behavior from corresponding fantasies: The role of personality and pornography consumption. Criminal Justice and Behavior, Vol. 36, 198-222.

Winick, C. and Evans, J.T. (1996). The relationship between non-enforcement of state pornography laws and rates of sex crime arrests. Archives of Sexual Behavior, 25.

*Originally published at the Sexual Abuse: A Journal of Research and Treatment (SAJRT) blog. Republished by permission of the authors.

Of related interest: Salon - Did porn warp me forever? Like other boys my age, I grew up with unlimited access to smut. At 23, I wonder if it's totally screwed me up, by Isaac Abel.

Happy New Year’s – and thanks for your support!

Thanks very much to those of you who responded to my request for help, contributing money or subscribing. And a special thanks to you returning subscribers. Your kind assistance is much appreciated. You are fabulous!

I especially enjoy the notes some of you send, letting me know how you use the blog. Here's one I appreciated, for instance, from a contributor in a Midwestern city:

"Enjoy your blog. I supervise a number of psychology interns. They read your blog. Keep up the good work."

For those of you who meant to chip in but haven’t gotten around to it yet, check the earlier post (click HERE) for quick and easy ways to contribute. (The information can also be found in the right column of the blog's home page.) Please join in today, to help keep this blog thriving in 2013 ... and beyond.

Happy New Year’s to all of you!

SCOTUS: No right to competency in habeas cases

In April, I blogged about the legal controversy over whether a convicted prisoner awaiting execution has a right to be competent during the sometimes-lengthy course of habeas appeals. Yesterday, the U.S. Supreme Court gave its unanimous answer:

No. 

The opinion came in the consolidated cases of Ernest Valencia Gonzales of Arizona and Sean Carter of Ohio. Both men's mental health deteriorated as they languished on death rows while their appeals wound slowly through the courts.

"Given the backward-looking, record-based nature of most federal habeas proceedings, counsel can generally provide effective representation to a habeas petitioner regardless of the petitioner's competence," wrote Justice Clarence Thomas.

So, any of you forensic psychologists with pending evaluations of competency in habeas cases can close out those files and put them in storage.

The opinion is HERE. My blog post laying out the legal controversy is HERE. A lengthier report on yesterday's opinion can be found at Courthouse News Service (HERE).

Hat tip: Ken Pope

Special offer on groundbreaking group rape text

The Handbook on the Study of Multiple Perpetrator Rape: A multidisciplinary response to an international problem

Photo credit: Sajjad Hussain

Two current events, on opposite sides of the globe, signal encouraging changes -- dare I say even a tipping point -- in public attitudes toward sexual violence:

1. The giant waves of protest sweeping India in response to the vicious gang rape of a young woman (who died from her injuries) on a public bus in New Delhi. Protesters, spurred on by social media, are demanding that authorities address gender violence in a country in which police and prosecutors have often turned a blind eye to rampant violence against women, including rape, sexual harassment, dowry murders and honor attacks. As Shalini Nataraj of the Global Fund for Women notes in an op-ed in the San Francisco Chronicle,  what is remarkable is that "people of all backgrounds are coming out into the streets, they are bringing their young children, they are demanding accountability from their government for this culture of violence that goes unpunished. People in India today are talking about rape."

2. The uproar over a sexual assault by members of the high school football team in Steubenville, Ohio against an unconscious girl, and alleged attempts by local authorities to cover it up. After a tenacious crime blogger posted deleted tweets and was (unsuccessfully) sued by a young athlete, the New York Times published an excellent, in-depth piece. Now, in an unprecedented development, the underground hacker group Anonymous has entered the fray, digging up and publishing incriminating tweets and videos (including the disturbing one below, featuring an athlete who has not been arrested) and demanding more aggressive prosecution.

These are precisely the types of cases that I analyzed for an upcoming chapter in the first-ever book on multiple-perpetrator rape, due out next month. My analysis focuses on the subtexts pertaining to masculinity, social status and race that are embedded in media coverage of high-profile cases. But although some of the two dozen cases that I analyzed generated widespread public outrage, it typically focused narrowly on the perpetrators and, at times, their immediate communities. The current international uproar is qualitatively different, in that people are connecting the dots between patriarchal power and sexual victimization.

Given this current level of public interest, next month's publication date for The Handbook on the Study of Multiple Perpetrator Rape is timely. I just finished reviewing the galley proofs and found the book to be a highly informative compilation, written from an international and multi-disciplinary perspective.

From the publisher's promotional blurb:

"The contributions to this collection are written by leading academics and practitioners from a variety of disciplines who bring together research and practice on multiple perpetrator rape by presenting new data from a strong theoretical and contextual base. This book will be a key text for students and academics studying multiple perpetrator rape and an essential reference tool for professionals working in the field, including police officers, educationalists, forensic psychologists, youth workers, probation staff, lawyers, judges and policy makers."

Ad glorifying group rape; my web page with more examples is HERE.

Co-editors Miranda A. H. Horvath and Jessica Woodhams are phenomenal researchers who head an international consortium (of which I am proud to be a part) that focuses on the understudied problem of group rape. Horvath, who has published extensively on sexual violence and violence against women, is the David Jenkins Chair in Forensic and Legal Medicine at Middlesex University, where she is also deputy director of Forensic Psychological Services. Woodhams is a forensic psychologist who teaches forensic psychology at the University of Birmingham, UK and has also published extensively on sex offending.

Chapters include:

• Multiple perpetrator rape as an international phenomenon by Teresa Da Silva, Leigh Harkins and Jessica Woodhams
• Masculinity, status, and power: implicit messages in Western media discourse on high-profile multiple perpetrator rape cases by Karen Franklin
• Variations in multiple perpetrator rape characteristics relative to group size: Comparing duo and larger group MPR offences by Mackenzie Lambine
• Group sexual offending: comparing adolescent female with adolescent male offenders by Jan Hendriks, Miriam Wijkman and Catrien Bijleveld
• Busting the ‘gang-rape’ myth: girls’ victimisation and agency in gang-associated rape and peer-on-peer exploitation by Carlene Firmin
• Streamlining: understanding gang rape in South Africa by Rachel Jewkes and Yandisa Sikweyiya
• Multiple perpetrator rape during war by Elisabeth J. Wood
• Leadership and role-taking in multiple perpetrator rape by Louise Porter
• Offender aggression and violence in multiple perpetrator rape by Jessica Woodhams
• Multiple perpetrator rape victimization: how it differs and why it matters by Sarah Ullman
• Multiple perpetrator rape in the courtroom by Miranda A. H. Horvath and Jacqueline M. Gray
• Issues concerning treatment of adolescent multiple perpetrator rape offenders by Talia Etgar
• Girls and gangs: preventing multiple perpetrator rape by James Densley, Allen Davis and Nick Mason

This is the fourth volume in the book series Issues in Forensic Psychology, edited by Richard Shuker of the therapeutic prison community HMP Grendon in the UK. The series aims to provide analysis and debate on current issues of relevance to forensic psychology and associated fields. Routledge anticipates issuing the paperback in 2014.

To take advantage of a 20 percent pre-publication discount (until February 28), visit the book's web page and use the discount code CRIMHPR12 when placing your order. The same url can also be used to recommend the book to your institution's librarian.

SVP verdict overturned for prosecutorial misconduct -- again

Prosecutor impugned defense witness in hebephilia case

In a highly unusual development, a California appeals court has overturned the civil commitment of a convicted sex offender for the second time in a row due to egregious prosecutorial misconduct.

The prosecutor in the most recent trial engaged in a "pervasive pattern" of misconduct and "flagrantly" violated the law by implying that jurors would become social pariahs if they did not vote to civilly commit sex offender Dariel Shazier, the appellate court wrote.

Prosecutor Jay Boyarsky, now the second in command of the district attorney's office in Santa Clara County (San Jose), also improperly impugned the reputation of the forensic psychologist who testified for the defense, according to the scathing opinion by the Sixth District Court of Appeal.

Prosecutor Jay Boyarsky

"This is not a case in which the prosecutor engaged in a few minor incidents of improper conduct. Rather, the prosecutor engaged in a pervasive pattern of inappropriate questions, comments and argument, throughout the entire trial, each one building on the next, to such a degree as to undermine the fairness of the proceedings. The misconduct culminated in the prosecutor flagrantly violating the law in closing argument, telling the jury to consider the reaction of their friends and family to their verdict, implying they would be subject to ridicule and condemnation if they found in favor of defendant."

This was the second civil commitment verdict against Dariel Shazier to be overturned on appeal due to prosecutorial misconduct. The license of the previous prosecutor, Benjamin Field, was suspended in 2010 based on his severe misconduct in several cases, including Shazier's 2006 trial. In the first of Shazier's three trials, a jury deadlocked as to whether the convicted sex offender qualified for civil detention as a sexually violent predator.

The case revolves around the controversial diagnosis of hebephilia. Shazier served nine years in prison for sexual misconduct with teenage boys. At the end of his sentence, in 2003, the district attorney began efforts to commit him indefinitely to a locked hospital based on his risk of reoffense. At Shazier's most recent trial, two state evaluators testified that he suffered from hebephilia, thereby making him eligible for civil commitment. However, they admitted that hebephilia was highly controversial and had only come into vogue with the advent of civil commitment laws.

Incendiary questioning of defense expert witness

The appellate court chastised the prosecutor for stepping far over the line in his questioning of a psychologist who was called by the defense to rebut the diagnosis of hebephilia. Psychologist Ted Donaldson testified that hebephilia is not a legitimate mental disorder, and that socially unacceptable or immoral conduct does not constitute a mental illness.

On cross-examination, Boyarsky questioned Donaldson about previous cases in which he had testified that sex offenders were not mentally disordered. Naturally, Donaldson had not brought the files from all of his old cases to court with him. This, the appellate court wrote, gave the prosecutor an excuse to recite inflammatory facts from select cases, which the defense correctly complained "were only brought up to incite the passions and prejudice of the jury."

The appellate court also chastised Boyarsky for impugning Donaldson's character. In his closing argument, the prosecutor described Donaldson as "completely biased and not helpful," called his opinion "laughable," and implied that he was biased because he had repeatedly testified for the defense:

"He has got a streak that would make Cal Ripken jealous. Cal Ripken the baseball player and the Iron Man that played in something like 4,000 straight games. Dr. Donaldson’s streak of 289 straight times testifying exclusively for the defense. Now he would like to tell you that is not his fault, because he offered to teach the State of California all his wisdom. His brilliance has yet to be fully appreciated by this society. It is appreciated by defense attorneys who pay him...."

Boyarsky also improperly attacked a psychiatric technician at Atascadero State Hospital (where Shazier was undergoing sex offender treatment while awaiting the outcome of his case) who testified for the defense. The appellate court critiqued "rhetorical attempts to degrade and disparage" that witness during cross-examination. The justices highlighted Boyarsky's question: "Mr. Ross, you don't know what you’re talking about, do you?"

"Here, the prosecutor’s questioning … was clearly argumentative, and was not intended to glean relevant information. 'An argumentative question is a speech to the jury masquerading as a question. The questioner is not seeking to elicit relevant testimony. Often it is apparent that the questioner does not even expect an answer. The question may, indeed, be unanswerable. . . . An argumentative question that essentially talks past the witness, and makes an argument to the jury, is improper because it does not seek to elicit relevant, competent testimony, or often any testimony at all.'(People v. Chatman (2006) 38 Cal.4th 344, 384.)"

The appellate opinion strongly rebuked trial judge Alfonso Fernandez for overruling repeated objections by defense attorney Patrick Hoopes. "Defense counsel objected to all of the prosecutor's improper questions, statements and arguments. We observe that not one of counsel's well-taken objections was sustained by the court. The court erred in overruling these objections."

Who’s grooming who?

In a humorous twist, Boyarsky was also reprimanded for misusing the loaded term "grooming" during his closing argument.

During the trial, a government expert had testified that Shazier "groomed" his victims by slowly manipulating them into situations in which he could violate sexual boundaries with them.

The prosecutor tagged off this in his closing argument, warning the jury that Shazier had "groomed" them during his testimony. "The grooming behavior, the manipulation, it still continues," Boyarski stated.

The appellate court agreed with the defense that this statement was "intended to inflame the jury, making them each feel like victims in the case." The justices went even further, noting that Shazier was not necessarily the one doing the grooming:

"During trial, Dr. Murphy defined grooming as a 'slow, steady manipulation to get a person in a compromising position or violate boundaries without awareness.' The irony here is that the prosecutor's conduct toward the jury throughout the trial closely fit Dr. Murphy's definition of grooming."

The unanimous appellate ruling is HERE. San Jose Mercury News coverage is HERE; the San Francisco Chronicle's, HERE.

"America's Real Criminal Element: Lead"

There are dozens of competing theories about the causes of crime. But only one fits perfectly with the data, claims a bold new investigative report. And that is lead poisoning.

"An astonishing body of evidence" on the international, national, local and even individual levels shows that much of the rise and fall of violent crime over the past half century is attributable to atmospheric lead from leaded gasoline popular from the 1940s through 1970s, according to the report by Kevin Drum in the current issue of Mother Jones magazine.

The theory has been around for about a decade, but it has been marginalized by criminologists, according to Drum, a political blogger.

As many of you know, childhood lead exposure has been linked to a permanent loss of gray matter in the prefrontal cortex, which controls executive functioning (emotional regulation, impulse control, attention, verbal reasoning, and mental flexibility). Lead also degrades the myelin that is necessary for efficient communication among neurons. Drum calls this a "double whammy":

"[Lead] impairs specific parts of the brain responsible for executive functions and it impairs the communication channels between these parts of the brain.... Even moderately high levels of lead exposure are associated with aggressivity, impulsivity, ADHD, and lower IQ. And right there, you've practically defined the profile of a violent young offender."

Drum isn't arguing that lead exposure automatically turns youngsters into criminal automatons. Rather, he says, the neurological effects of lead pushed vulnerable youngsters who were "already on the margin" over the edge into crime.

"Once you understand that, it all becomes blindingly obvious. Of course massive lead exposure among children of the postwar era led to larger numbers of violent criminals in the '60s and beyond. And of course when that lead was removed in the '70s and '80s, the children of that generation lost those artificially heightened violent tendencies."

The leaded-gasoline hypothesis explains some other demographic features of crime, Drum asserts, such as the diminishment of urban-rural gaps in murder rates in recent decades.

Drum concludes with a spirited argument for government-funded programs to vanquish the remaining lead in soils and homes:

"We can either attack crime at its root by getting rid of the remaining lead in our environment, or we can continue our current policy of waiting 20 years and then locking up all the lead-poisoned kids who have turned into criminals. … Cleaning up the rest of the lead that remains in our environment could turn out to be the cheapest, most effective crime prevention tool we have. And we could start doing it tomorrow."

I'm not sure I'm completely sold on it, but it’s a fascinating thesis, and certainly worth reading. I’d love to hear blog readers' reactions


The piece, published today in the January/February 2013 issue of Mother Jones, is available HERE.