Documentary explores town's polarization over transgender murder

Forensic psychologist key element in gay panic defense

For 20 minutes, Brandon McInerney sat patiently behind Larry King in their junior high school computer classroom. Then, the budding white supremacist pulled out a handgun and shot his transgender classmate twice in the back of the head. Larry died two days later, on Valentine's Day.

The 2008 murder polarized the community of Oxnard, California. The chasm widened during the highly publicized trial three years later, when a pair of private defense attorneys managed to turn the homicide into a reverse civil rights case for beleaguered heterosexuals and white people. With the help of a forensic psychologist, they were able to convince seven out of 12 jurors that Larry King had provoked his own death through his gender transgression. After the mistrial, several jurors became outspoken advocates for Brandon, wearing "Save Brandon" bracelets and raising money for his retrial.

Director Marta Cunningham

"He [Brandon] was solving a problem," explained juror Diane Michaels, an OR nurse. “Where are the civil rights of the one being taunted by another person who’s cross-dressing? He had no one he could turn to because the school was so pro-Larry King’s civil rights, but where was Brandon’s civil rights?"

"It was the high heels, the makeup, the behavior," agreed Karen McElhaney, a fellow juror and a surgical nurse, as the jurors bonded over wine and hors d'oeuvres at one of their homes.

Through such candid interviews with family members, teachers, students (including two eyewitnesses), attorneys and jurors, first-time film director Marta Cunningham explores the conflicting ideologies regarding both gender diversity and social tolerance that Larry King’s murder graphically exposed. Cunningham spent four years and collected 350 hours of footage for Valentine Road (the name of the street on which Larry is buried), a Sundance award-winner debuting on HBO. She hopes that schools will use the film as an educational tool to promote tolerance. 

Forensic psychologist blames the victim

This blog's readers will be especially interested in the role of the forensic psychologist, who helped sell the victim-blaming theme at trial. The testimony of Donald Hoagland gave the jurors an "expert" imprimatur on which to hang their hat.

 ABC News trial coverage featuring voice of 

forensic psychologist Donald Hoagland as he testifies

"What Larry was doing was an extreme form of bullying, an extreme form of sexual harassment," Donald Hoagland told the filmmaker. "Guys don’t hit on guys. Brandon was thinking he needed to get rid of Larry. He needed to save everyone from this scourge that had come upon this school."

At the trial, Hoagland testified that the cross-dressing victim's flirtation threw 14-year-old Brandon into a fit of homicidal rage. He testified that King's declaration that he was changing his name to Leticia triggered a dissociative state in which Brandon temporarily lost track of reality, according to the Ventura County Star.

The fatal flaw with that gay panic theory of the crime is that McInerney made advance plans to kill King. He announced his plan to several people the day beforehand, according to testimony during the eight-week trial, and also acquired and loaded the gun and brought it with him to school. He shot King twice in the back of the head during a first-period class.

Jurors who voted against a murder conviction said that Larry King's request to be called by a girl's name gave Brandon a "green light" to execute him. One juror even wrote to the judge after the trial to protest the "witch hunt" against the killer, citing the victim’s "long history of deviant behavior."

"They made a murder victim the cause of his own murder," marvels Detective Dan Swanson, a hate crime expert who testified at the trial.

Prosecutor Maeve Fox, who ultimately agreed to a plea deal of 21 years for Brandon, said the case exposed the deep layer of intolerance in society, an intolerance that is even carried into the jury box.

Unfortunately, the documentary gives short shrift to another central factor in community support for Brandon. A decision by the prosecutor's office to try the 14-year-old suspect as an adult led to widespread public opposition. Brandon faced 51 years to life in prison if convicted in adult court. A coalition of dozens of gay and lesbian groups even joined the chorus of pleas to try the boy as a juvenile.

Cunningham's direction is understated. Rather than hitting the viewer over the head with a message or point of view, she allows the characters to speak for themselves, interspersing their dialogue with artful sketches, news footage and school surveillance video. The resulting nuanced tale forces audience members to think for themselves about the moral implications of the tragedy.

Ultimately, Valentine Road is a sad and haunting story about two lost boys struggling for identity in a violent world. For the two boys were alike in many ways, both of them abused, neglected and lacking competent adult mentorship as they navigated the perilous journey to adulthood. Larry had been bullied since the third grade for his effeminacy; Brandon was dependent on a bullying father who physically abused him, while his methamphetamine-abusing mother was homeless. 

Yet for all its pathos the film also shines a ray of hope. Even as the defense team vigorously promoted a victim-blaming narrative, youths from the local community came together to honor Larry King and to use his death to promote a message of tolerance. One can only hope that the film will be shown far and wide, and will contribute to that worthy endeavor.

VALENTINE ROAD WILL AIR OCTOBER 24 ON HBO. IT IS ALSO AVAILABLE ON DEMAND. CLICK HERE FOR THE FULL SCHEDULE.

RELATED STORY: "The Hidden War Against Gay Teens," Alex Morris, Rolling Stone, Oct. 10, 2013

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My prior coverage of the case: 

• What caused middle school tragedy? 14-year-old Brandon McInerney to be arraigned Thursday (June 10, 2008) 
• More on the McInerney antigay murder case: Defense may use emerging science of adolescent brain development (June 11, 2008)  
• Gay panic defense: Slain boy accused of provocation (Aug. 10, 2011) 
• Jury deadlocks in gay panic trial (Sept. 2, 2011)  
• Gay panic defendant gets 21 years (Nov. 23, 2011) 

Hat tip: John Lewis

Militarization: When the extraordinary becomes ordinary

In line with the human rights theme of this year's Blog Action Day (it's exciting to be coordinating with 2,000+ other bloggers from around the world!),* let me share four brief anecdotes. They may seem unrelated but, ultimately, they do connect. I promise.

#1: Cheye Calvo, mayor of the small town of Berwyn Heights, Maryland, was in his bedroom one night, changing clothes for a meeting. His mother-in-law was in the kitchen, cooking a tomato-artichoke sauce. Suddenly, Calvo heard an explosion and the sound of gunfire. Heavily armed men clad in black burst into the house. He saw his mother-in-law lying face-down on the kitchen floor at gunpoint. His two beloved black Labradors lay dead in pools of blood. Clad only his boxer shorts, the mayor was bound and forced to kneel on the floor. This was it, he thought. He was about to be executed, but he knew not why.

* * * * *

#2: In the Washington Heights neighborhood of New York City, an alert neighbor observed a man forcing a woman into her apartment. Police were called. They burst in and found the woman in handcuffs, a man hiding in her closet with rope and two pairs of women's panties in his backpack. Daryl Thomas was a resident of the neighborhood, a husband and a father, and a computer system manager for a Manhattan law firm. When questioned by Senior Detective Harold Hernandez, he was forthcoming. No, this was not his first sexual assault; he had committed seven or eight similar attacks in the neighborhood in recent months. Yes, he was willing to show police the precise locations. The detective had one major problem: He was unaware of any serial rape spree in the 33rd precinct. If the victims had reported the crimes, the Manhattan Special Victims Unit would have notified the precinct of the pattern, so police could be on the lookout for a suspect matching Thomas’s description.

* * * * * 

Police prepare to enter Carey apartment

#3: After dental hygienist Miriam Carey attempted to ram a barricade near the White House and was shot to death on Oct. 3, her one-year-old baby in the car, police descended upon her home town of Stamford, Connecticut, armed with helicopters, bomb trucks, Hazardous Materials trucks and machine guns. The 100-odd personnel from the U.S. Secret Service, the FBI and state and local police sealed off the area and evacuated nearby residents before donning Haz-Mat suits with self-contained breathing apparatuses and entering Carey’s apartment. Rather than bombs, guns or Al Qaeda literature, they reportedly found prescriptions for the antipsychotic risperidone and the antidepressant escitalopram, medications consistent with Carey's diagnosis of postpartum depression with psychosis.

* * * * * 

Ohio State University's MRAP

#4: Ohio State University has just obtained a military surplus Mine-Resistant, Ambush-Protected (MRAP) armored personnel carrier. Explaining the acquisition, the campus police chief points out that stadiums are at risk for terrorist attacks, according to the Department of Homeland Security. The MRAP may also be used for crowd control at football games. The vehicle cost about half a million dollars to produce and is designed to withstand "ballistic arms fire, mine fields, IED's, and Nuclear, Biological and Chemical environments." To make its appearance less ominous, its desert tan is being repainted black and its roof-mounted machine gun being removed. The university joins the ranks of cities across America -- from Preston, Idaho to Cullman, Alabama to Boulder, Colorado and Murrieta, California -- that are cashing in on Department of Homeland Security grant money to buy such intimidating vehicles. In Dallas County, Texas, for example, the sheriff’s department plans to use its new MRAP to serve drug warrants. 

So what's the connection?

All four anecdotes relate to an insiduous shift in U.S. policing over the past few decades, toward greater and greater militarization.

The emergence of SWAT

Young people born in the 1980s may find it hard to believe that back in 1970, there was only one SWAT team in the entire United States -- in Los Angeles, California. Today, SWAT teams are a cultural icon. Almost all cities and most small towns have these paramilitary forces. By and large, the role of SWAT teams is far removed from the Hollywood image of hostage rescue or mass shooting intervention. Rather, they are being deployed – tens of thousands of times per year – in drug raids and to serve routine warrants, according to a new book by award-winning in investigative journalist Radley Balko. 

Cheye Calvo, the mayor of Berwyn Heights, Maryland (Anecdote 1), was a victim of one such raid. Mistaken drug raids are far from rare. The judiciary's progressive weakening of checks and balances in regard to warrants and searches has fostered a police culture in which "extraordinary violence" is meted out with impunity. The shooting of dogs "at the slightest provocation," Balko writes, is part of a larger problem of an us-against-them "battlefield mentality" in which many police see the citizenry as the enemy.

Allure of the techno-warrior

"Why serve an arrest warrant to some crack dealer with a .38?" asked one U.S. military officer who trained police SWAT teams in the 1990s. "With full armor, the right shit, and training, you can kick ass and have fun."

As this quote implies, SWAT raids -- conducted hundreds of times per year in cities large and small -- foster a masculine culture of violence and a worship of a "techno-warrior" image of policing. SWAT raids are the ultimate in power, an adrenaline rush that is quickly habit-forming. Recruitment videos that emphasize this culture may, in turn, be changing the type of individual who seeks to become a police officer.

Texas SWAT team terrorizes organic farmers in August

Balko traces the militarization of police to the "drug war" ideology that began under President Nixon and escalated under Ronald Reagan. One specific clause in an omnibus crime bill of 1984, not considered particularly controversial at the time, ultimately produced a seismic shift in American policing. The asset forfeiture law allowed police to seize property, auction it off, and divide up the bounty, just so long as federal agents were even remotely involved in the investigation.

Asset forfeiture created a huge incentive for police to go after people in order to seize their property. Drug enforcement brought in boatloads of cash, much of which was reinvested into more battle gear. Police departments competed with each other for drug revenue, to the neglect of investigating violent crimes such as rape, robbery and murder. So, we end up with situations like the one a few years back in Oakland, California, in which a lack of investigative prioritization allowed a serial rapist on parole to remain free to prey on young African American girls until he finally made the mistake of gunning down four police officers.

Detective work is no fun

Many police officers are appalled by the insidious militarization of police. Betty Taylor, police chief of a small Missouri town, recalled how she became troubled by the economic disparity between the "drug guys," flush with property seizures and endless federal grants, and the struggling sex crimes unit that she had established.

"When you think about the collateral effects of a sex crime, of how it can affect an entire family, an entire community, it just didn’t make sense," she told Balko. "The drug users weren't really harming anyone but themselves. Even the dealers, I found much of the time they were just people with little money, just trying to get by." Her opinion solidified when she was recruited onto a SWAT team, and witnessed first-hand the lasting terror that the raids produced in vulnerable children.

"I thought, how can we be the good guys when we come into the house looking like this, screaming and pointing guns at the people they love? ... Good police work has nothing to do with dressing up in black and breaking into houses in the middle of the night…. When you get into that [us-versus-them] mentality, there are no innocent people. There's us and there's the enemy. Children and dogs are always the easiest casualties."

Downgrading crime

The case of Daryl Thomas (Anecdote 2) involved more than neglect of violent crimes. As Detective Hernandez discovered, police brass in his precinct -- and throughout New York City -- were systematically downgrading crimes from serious felonies to minor misdemeanors, in order to improve their CompStat crime statistics. A model that has been adopted throughout the United States as well as in England and Australia, CompStat had the unintended consequence of fostering competition among precincts for lower statistics. Only seven categories of major crime are counted in crime statistics and made publicly available, so police can reduce crime rates by, for example, reclassifying attempted rape as criminal trespass.

The Thomas case was handled quietly, with no media attention. Thomas was convicted and sentenced to 50 years in prison. But Hernandez, frustrated by the constant battles with his own superiors, took an early retirement. "Unfortunately, this is the culture for the young cop coming into the department. He doesn't see the bigger picture," he said. "If it's going to allow him to have a day off, and they won't ride him or harass him, he'll go along with it. And New Yorkers are being victimized, and no one responds to their complaints."

While major crimes were being downgraded to misdemeanors, Manhattan police were also being encouraged to trump up minor cases -- drinking in public or driving without a seatbelt -- in order to bolster their statistics. Police officer Adrian Schoolcraft surreptitiously recorded his superiors giving these directives; with the collusion of a department psychologist, he eventually found himself drummed out of the force on trumped-up psychiatric grounds. (You can hear excerpts from his secret tapes on This American Life.)

Culture of fear

Putting the case of dental hygienist Miriam Carey (Anecdote 3) in historical context illustrates just how much has changed in the past few decades. 

Back in 1976, Chester M. Plummer became the first person shot to death by White House guards. Plummer and Carey were similar in some respects. Both were African American. Both were described as apolitical. And both manifested signs of psychiatric decompensation. With her postpartum psychosis, Carey had apparently incorporated President Obama into a delusional belief system. Plummer, a decorated Army veteran, former high school football star and part-time cabbie, had been examined by a psychiatrist after being arrested for indecent exposure; the doctor thought Plummer's recent divorce had triggered a psychiatric crisis. On July 25, 1976, Plummer scaled a fence while holding a three-foot pipe. He was shot to death after ignoring the guards’ orders to stop.

What happened -- or didn't happen -- next is where the difference in culture emerges. Blogging at The Nation, Rick Perlstein compares the two cases to highlight the extreme overreaction of police today to any threat, however contained.

"There’s terrorism now, they say. But there was terrorism then, nearly every month -- 89 bombings attributed by the FBI to terrorism in 1975, culminating in that awful LaGuardia bomb; and a veritable wave in the winter and spring 1976, much of it around the trial of Patty Hearst: of an FBI office in Berkeley, Standard Oil of California headquarters in San Francisco. Americans didn’t freak out, or shut down, or exhibit symptoms of PTSD. They had a massive outdoor national 200th birthday party."

Writing in The Baffler, Chris Bray makes a similar point in regard to the shutdown of Boston after the explosion at the marathon that killed three people.

Police outside Carey residence in Stamford, CT

In the aftermath of the 1993 World Trade Center bombing, the 1995 Oklahoma City bombing, the 1996 bombing at the Atlanta Olympics, and the paired 2001 attacks on the World Trade Center and the Pentagon, here’s what didn’t happen: whole cities weren’t locked down, armored personnel carriers with police logos didn’t rumble in, and SWAT teams in combat uniforms and body armor didn’t storm through the suburbs for a loosely ordered set of (ultimately hapless) house-to-house searches. Somehow, though, 2013 was the year it became appropriate to close cities, turning off taxis, buses, and trains and telling residents that the governor was suggesting -- okay, strongly suggesting -- that they not leave their homes until the police said so. One of those familiar moments in which officials ask the public to be on the lookout turned into a remarkable new moment in which officials ask the public to cease to exist in its public form so that the police can have the streets.

That leaves Anecdote 4, about armored personnel carriers, which pretty much speaks for itself.

"We are in the midst of a historic transformation," wrote Eastern Kentucky University professor Peter B. Kraska in 2007 in regard to police militarization. "Attempting to control the crime problem by routinely conducting police special-operations raids on people’s private residences is strong evidence that the U.S. police, and crime-control efforts in general, have moved significantly down the militarization continuum." 

The irony is that this militarization is occurring simultaneously with a great diminution in violent crime in the United States. In particular, despite the public's perception of police work as dangerous, the job of law enforcement is getting safer all the time.

The American Civil Liberties Union is looking into the broader implications of the spread of military culture into domestic policing in the United States. The agency believes that militarization has come at the cost of trampled human rights and a greater risk of violence, according to a report in the Columbus (Ohio) Dispatch. The study is due out next year.

That strikes me as a bit too late. Pandora's box has long been opened, and there's no going back.

So, don’t be too surprised if you happen to spy a mine-resistant, ambush-protected, armored personnel carrier rolling down your street in the near future. It's only a matter of time.

Sources and recommended resources:

Radley Balko (2013), Rise of the Warrior Cop: The Militarization of America’s Police Forces 

Peter Kraska (2007), Militarizing the American Criminal Justice System: The Changing Roles of the Armed Forces and the Police

Graham Rayman (June 8, 2010), Village Voice, NYPD Tapes 3: A Detective Comes Forward about Downgraded Sexual Assaults: When even attempted rapes are being downgraded to misdemeanors, is the public safe?

Rick Perlstein (Oct. 3, 2013), Nation, Culture of Fear: Miriam Carey’s Tragedy, and Our Own

Ira Glass, This American Life, “Right to Remain Silent” (well worth a look or, better yet, a listen)

Sarah Stillman (August 12, 2013), New Yorker, Taken: Under civil forfeiture, Americans who haven’t been charged with wrongdoing can be stripped of their cash, cars, and even homes. Is that all we’re losing? 

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*Blog Action Day is an international event in which thousands of bloggers around the world pledge to participate. This year's theme, in coordination with Amnesty International, is human rights. If you want to see a true smorgasbord of human rights topics streaming in live, check out the web page.

Study: Risk tools don't work with psychopaths

If you want to know whether that psychopathic fellow sitting across the table from you will commit a violent crime within the next three years, you might as well flip a coin as use a violence risk assessment tool.

Popular risk assessment instruments such as the HCR-20 and the VRAG perform no better than chance in predicting risk among prisoners high in psychopathy, according to a new study published in the British Journal of Psychiatry. The study followed a large, high-risk sample of released male prisoners in England and Wales.

Risk assessment tools performed fairly well for men with no mental disorder. Utility was decreased for men diagnosed with schizophrenia or depression, became worse yet for those with substance abuse, and ranged from poor to no better than chance for individuals with personality disorders. But the instruments bombed completely when it came to men with high scores on the Psychopathy Checklist-Revised (PCL-R) (which, as regular readers of this blog know, has real-world validity problems all its own). 

"Our findings have major implications for risk assessment in criminal populations," noted study authors Jeremy Coid, Simone Ullrich and Constantinos Kallis. "Routine use of these risk assessment instruments will have major limitations in settings with high prevalence of severe personality disorder, such as secure psychiatric hospitals and prisons."

The study, "Predicting future violence among individuals with psychopathy," may be requested from the first author, Jeremy Coid (click HERE).  

California prisons careening closer to cliff

For a minute there, it looked like California's prisons were on the verge of positive reforms. But the current situation in the state's massive prison system -- one of the largest in the world -- is far from encouraging. It's been a kaleidoscope of bad news lately.

Chemical weapons

Private prison company annual report (credit Huff Post)

Guards have been videotaped tossing chemical grenades and pumping pepper spray into the cells of psychotic prisoners, some of them screaming and delirious. In one case, the prisoner's offense was not taking his psych meds; an asthmatic prisoner was sprayed for refusing to leave a holding cage, according to AP news coverage. A federal judge will rule next week on whether the public has a right to see the disturbing videos as part of a legal case challenging abusive discipline of mentally ill prisoners and inadequate mental health care for prisoners on death row. An expert observer described the chemical arsenals possessed by California guards as "shocking."

Realignment woes

Another snippet from the Correctional Corp of America

Meanwhile, things are getting worse in many of the state's 58 county jails. The state's "realignment plan," in which nonviolent offenders stay in county jails rather than going to prison, is causing lots of headaches for jails and prisoners alike. The idea was to reduce prison overcrowding while keeping prisoners closer to home and within range of reintegration services. But the plan shifts the burden onto cash-strapped counties that are ill-equipped to handle a large influx of convicts. In state prisons, convicts get yard time and some educational or vocational programming. In many jails, in contrast, they can sit in a room the size of your bathroom for five years or more. Sheriffs are complaining of a rise in violence, and forecasting a rash of lawsuits like those dogging the state prisons. According to an ACLU report, rather than reforming incarceration policies, counties are scrambling to add new jail beds. One exception is in progressive San Francisco, where jailers, prosecutors and defense attorneys alike have embraced realignment as an opportunity to create community-based alternatives to incarceration.


Hunger strike

Private prisons benefit from immigration crackdowns

After two months, prisoners ended their hunger strike over long-term isolation without any tangible victories. In a remarkable show of solidarity, the strike initially included more than 30,000 prisoners from around the state. By the end, the numbers had dwindled to about 100. The strike was called off after two legislators – Loni Hancock and Tom Ammiano -- announced they would hold public hearings into the prisoners’ complaints over the security housing units, or SHUs. Hancock said that concerns over the use and conditions of solitary confinement in California's prisons "can no longer be ignored."

Private prisons

Finally, and perhaps most disturbingly, on Monday a massive private prison corporation announced that state Governor Jerry Brown had signed a deal to ship 1,400 prisoners to its private facilities. The GEO Group, formerly the infamous Wackenhut Corrections Corporation, is a Florida-based corporation that manages 96 facilities with about 73,000 beds worldwide, including in the USA, Australia, South Africa and the United Kingdom.  

Click on image to visit Huffington Post infographic and related resources

The states of fiscal emergency in the public sector encourage governments to contract with private prisons that promise cost savings. But private prison corporations like Geo Group and the Corrections Corporation of America are short-sighted quick fixes. They encourage prison growth by mandating that governments guarantee them a certain minimum occupancy. It's kind of like when the American Psychological Association contracts with hotels in a convention city; if not enough psychologists rent rooms, the APA must pay the difference. In a report released this month, In the Public Interest found that nearly two-thirds of contracts between private prison companies and state and local governments included such quotas. Arizona recently paid $3 million to a prison company for failing to meet a 97 percent occupancy quota, the Huffington Post reported.  

The Post, one of the few media outlets to regularly cover this disturbing trend, has published an infographic illustrating the widespread nature of these contracts, which discourage criminal justice reform by "leaving taxpayers footing the bill for lower crime rates." As part of its coverage, the Post took a peak at annual shareholder reports of the Corrections Corp. of America that reveal its "aggressive business strategy based on building prison beds, or buying them off the government, and contracting them to government authorities." (The drop quotes in the post are just a few of the nuggets they unearthed.)

"Profits, after lining the pockets of shareholders, are used to create more beds and to lobby state and federal agencies to deliver inmates to fill them," the Post reports. "The resulting facilities can be violent and disgusting."

As one example, the Post reported on the horrendous conditions that quickly developed after the Corrections Corp. of America bought a formerly public prison in Ohio. Educational programming for prisoners and salaries of staff were slashed, violence and drug use skyrocketed, and correctional officers jumped ship en masse, leaving newcomers to run the facility. Prisoners in isolation were left to wallow in their own filth, with no access to running water or toilets.

Efficacy of sex offender treatment still up in the air

Sex offender group treatment, Larned State Hospital, Kansas

"Did he complete treatment?"

That is a front-burner question for judges and jurors in sexually violent predator trials. Understandably, before they decide to release someone who has been convicted of sexually molesting a child, they want reassurance that he is sincerely remorseful and has acquired the tools to turn his life around. In short, they want a certificate of rehabilitation attesting to his low risk.

But does formal sex offender treatment really lower risk?

A systematic review found no scientifically rigorous studies that establish a link between treatment completion and a reduced risk of reoffending among men who have sexually abused children.

This isn't altogether fresh news. We knew from earlier research reviews that:

• Any effect of treatment was modest, at best
• Treatment works best for the tiny minority of very high-risk offenders, while possibly aggravating risk for the broad majority of men at lower risk of recidivism 
• Older offenders, due mainly to their very low risk, derive no tangible benefits from treatment

But considering both the prevalence and the harm of child sexual abuse, there is surprisingly little high-quality research on effective interventions. Partly, this is because of the lock-'em-up-and-throw-away-the-key mentality of policy makers. And partly it is because of the ethical difficulties in implementing random-design procedures, a hallmark of the scientific method, because men assigned to a control group would be denied treatment that could reduce their risk and in some cases shorten their prison terms.

Patient at "treatment program" in Minnesota

Scouring research databases, a six-member, international research team was able to locate only three well-designed experimental studies. These included one with adults, one with adolescents and one with children. In only the study with adolescents was treatment shown to reduce recidivism. That project used multisystemic therapy, a very promising approach that integrates the family and larger community in the treatment. 

Even broadening the search to include observational studies that lacked experimental designs, the research team found only five studies with a low enough risk of research bias to be deemed reliable. None of the five observational studies demonstrated that formal treatment -- primarily cognitive behavioral therapy with relapse prevention -- impacts sexual reoffending.

High-bias studies, in which the study design introduced a high probability of unreliable findings, were excluded. An example of such research bias would be a study in which treated and untreated offenders differed on a variable known to affect risk. When subjects are  not randomly assigned to treatment or control groups, any observed differences between groups may be due to factors outside of the treatment itself.

Treatment in most formal sex offender programs is cognitive behavioral, and relies primarily on manual-based group therapy. For example, group exercises challenge distorted thinking, denial and minimization.

The research team found no  minimally adequate studies whatsoever on the efficacy of pharmacological treatment with antiandrogen drugs, more popularly known as "chemical castration." They found this omission "particularly striking," in light of the prominence of this method in public debates. 

Can treatment cause harm?

Given "the overall unimpressive treatment effects" that were found, the researchers cautioned clinicians working with sex offenders to consider the potential negative effects of treatment:

"Journeymen" by Ricky Romain (reproduced with permission)

"Under certain circumstances, with some people and some interventions, treatment could increase the risk of sexual reoffending. For instance, prolonged or intense interventions for offenders at low risk of relapse, or grouping low risk offenders with those at high risk for reoffending, could result in adverse outcomes."

They especially cautioned against unnecessary treatment of children. With recidivism risk very low among untreated children, treatment may lead to "unjustified stigmatization and could negatively affect the child’s development…. If these children are subjected to excessively intense or inappropriate therapy, this could increase the risk for future antisocial behavior."

The team was headed up by prominent researcher and professor Niklas Långström and included Canadian researcher R. Karl Hanson, psychologist Pia Enebrink, forensic psychiatrist Eva-Marie Laurén and researchers Jonas Lindblom and Sophie Werkö. The research was commissioned and partially funded by the Swedish government.

The Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse, ratified by 27 countries so far, mandates effective treatment to sexual abusers of children, individuals at higher risk of committing such offences, and children with sexual behavior problems.

This mandate is a bit of a problem, given the inconclusive evidence that the dominant treatment approach works.

Manualized, one-size-fits-all approach

My own belief is that the one-size-fits-all approach of manualized group therapy, driven in part by a shortage of highly qualified and talented clinicians in bureaucratic institutions, can never meet the needs of a heterogeneous population of offenders. Indeed, in the hands of poorly trained technicians, much of what passes for "treatment" is actually punishment in disguise. As anthropology professor Dany Lacombe noted in her insightful ethnographic study,  sex offender treatment can paradoxically cement deviance through its obsessional fixation on sex. As an 18-year-old patient told Lacombe:

"They want to hear that I always have fantasies and that I have more bad ones than good ones. But I don't have bad ones that often. I make up the bad ones. I make them really bad because they won’t leave me alone." 

"Contained" by Ricky Romain (with artist permission)

Genuine treatment, as we all should remember from our graduate school training, is all about the empathic relationship -- not the technique. Indeed, although more and more psychologists have internalized the insurance industry's mantra that cognitive-behavioral therapy (CBT) is the "evidence-based" treatment of choice for a variety of conditions, this is not actually true. For example, in a new randomized clinical trial published in the American Journal of Psychiatry, psychodynamic therapy performed just as well in the treatment of depression.

The research team cautioned that their failure to find significant effects of treatment should not be interpreted to mean that treatment as currently implemented is ineffective. The low base rates of recidivism among sex offenders make it difficult to find treatment effects without very large sample sizes and long follow-up periods, they point out.

Additionally, an early study out of California provided some evidence that it was not the formal completion of treatment per se that reduced risk but, rather, the internalization of treatment messages and a desire to change -- something that is harder to measure. 

The research team issued a call for large-scale, multinational randomized controlled trials. In the meantime, in the absence of solid proof that manualized cognitive-behavioral group therapy works as intended, they recommend a shift to more individualized assessment and treatment.

That's a solid, and very welcome, recommendation.

The study is: "Preventing sexual abusers of children from reoffending: Systematic review of medical and psychological interventions" by Niklas Långström, Pia Enebrink, Eva-Marie Laurén, Jonas Lindblom, Sophie Werkö and R Karl Hanson. It is freely available online from the British Medical Journal (HERE). 

Subscribers: View the conversation and add your comment by scrolling to the bottom of the original blog post (HERE). 

Free, one-stop shopping: Bulletin showcases new violence articles

The first monthly bulletin from the Alliance for International Risk Research just hit my email box, collating August's journal offerings on violence risk assessment and management. A quick sampling from the 17 articles listed:

• Large MM, Ryan CJ, Callaghan S, Paton MB, and Singh SP (2013) Can violence risk assessment really assist in clinical decisionmaking? Australian & New Zealand Journal of Psychiatry (online first Aug 2013)

• Rettenberger M, Haubner-Maclean T, and Eher R (2013) The contribution of age to the Static-99 Risk Assessment in a population-based Prison sample of sexual offenders. Criminal Justice & Behavior (online first June 2013)

• Lund C, Hofvander B, Forsman A, Anckarsater H, and Nilsson T (2013) Violent criminal recidivism in mentally disordered offenders: a follow-up study of 13-20 years through different sanctions. International Journal of Law and Psychiatry, 36, 250-257

• Caldwell MF (2013) Accuracy of Sexually Violent Person Assessments of Juveniles Adjudicated for Sexual Offenses Sexual Abuse (online first March 2013).

AIRR's goal is to make information about the latest research on violence risk assessment available to researchers, practitioners, and policymakers for free. I you don't have access to an academic database you still have to find a way to access the articles themselves, but that can generally be done through a request of the author.) If you haven't already signed up to receive your monthly email, you can do so by clicking HERE. 

'Authorship bias' plays role in research on risk assessment tools, study finds

Reported predictive validity higher in studies by an instrument's designers than by independent researchers

The use of actuarial risk assessment instruments to predict violence is becoming more and more central to forensic psychology practice. And clinicians and courts rely on published data to establish that the tools live up to their claims of accurately separating high-risk from low-risk offenders.

But as it turns out, the predictive validity of risk assessment instruments such as the Static-99 and the VRAG depends in part on the researcher's connection to the instrument in question.

Publication bias in pharmaceutical research
has been well documented

Published studies authored by tool designers reported predictive validity findings around two times higher than investigations by independent researchers, according to a systematic meta-analysis that included 30,165 participants in 104 samples from 83 independent studies.

Conflicts of interest shrouded

Compounding the problem, in not a single case did instrument designers openly report this potential conflict of interest, even when a journal's policies mandated such disclosure.

As the study authors point out, an instrument’s designers have a vested interest in their procedure working well. Financial profits from manuals, coding sheets and training sessions depend in part on the perceived accuracy of a risk assessment tool. Indirectly, developers of successful instruments can be hired as expert witnesses, attract research funding, and achieve professional recognition and career advancement.

These potential rewards may make tool designers more reluctant to publish studies in which their instrument performs poorly. This "file drawer problem," well established in other scientific fields, has led to a call for researchers to publicly register intended studies in advance, before their outcomes are known.

The researchers found no evidence that the authorship effect was due to higher methodological rigor in studies carried out by instrument designers, such as better inter-rater reliability or more standardized training of instrument raters.

"The credibility of future research findings may be questioned in the absence of measures to tackle these issues," the authors warn. "To promote transparency in future research, tool authors and translators should routinely report their potential conflict of interest when publishing research investigating the predictive validity of their tool."

The meta-analysis examined all published and unpublished research on the nine most commonly used risk assessment tools over a 45-year period:

• Historical, Clinical, Risk Management-20 (HCR-20)
• Level of Service Inventory-Revised (LSI-R)
• Psychopathy Checklist-Revised (PCL-R)
• Spousal Assault Risk Assessment (SARA)
• Structured Assessment of Violence Risk in Youth (SAVRY)
• Sex Offender Risk Appraisal Guide (SORAG)
• Static-99
• Sexual Violence Risk-20 (SVR-20)
• Violence Risk Appraisal Guide (VRAG)

Although the researchers were not able to break down so-called "authorship bias" by instrument, the effect appeared more pronounced with actuarial instruments than with instruments that used structured professional judgment, such as the HCR-20. The majority of the samples in the study involved actuarial instruments. The three most common instruments studied were the Static-99 and VRAG, both actuarials, and the PCL-R, a structured professional judgment measure of psychopathy that has been criticized criticized for its vulnerability to partisan allegiance and other subjective examiner effects.

This is the latest important contribution by the hard-working team of Jay Singh of Molde University College in Norway and the Department of Justice in Switzerland, (the late) Martin Grann of the Centre for Violence Prevention at the Karolinska Institute, Stockholm, Sweden and Seena Fazel of Oxford University.

A goal was to settle once and for all a dispute over whether the authorship bias effect is real. The effect was first reported in 2008 by the team of Blair, Marcus and Boccaccini, in regard to the Static-99, VRAG and SORAG instruments. Two years later, the co-authors of two of those instruments, the VRAG and SORAG, fired back a rebuttal, disputing the allegiance effect finding. However, Singh and colleagues say the statistic they used, the receiver operating characteristic curve (AUC), may not have been up to the task, and they "provided no statistical tests to support their conclusions."

Prominent researcher Martin Grann dead at 44

Sadly, this will be the last contribution to the violence risk field by team member Martin Grann, who has just passed away at the young age of 44. His death is a tragedy for the field. Writing in the legal publication Das Juridik, editor Stefan Wahlberg noted Grann's "brilliant intellect" and "genuine humanism and curiosity":

Martin Grann came in the last decade to be one of the most influential voices in both academic circles and in the public debate on matters of forensic psychiatry, risk and hazard assessments of criminals and ... treatment within the prison system. His very broad knowledge in these areas ranged from the law on one hand to clinical therapies at the individual level on the other -- and everything in between. This week, he would also debut as a novelist with the book "The Nightingale."

The article, Authorship Bias in Violence Risk Assessment? A Systematic Review and Meta-Analysis, is freely available online via PloS ONE (HERE).

Related blog reports:

• Violence risk instruments overpredicting danger (Aug. 2, 2012) 
• Violence risk in schizophrenics: Are forensic tools reliable predictors? (Sept. 14, 2011) 
• Violence risk meta-meta: Instrument choice does matter (June 19, 2011)
• Psychology rife with inaccurate research findings (Nov. 20, 2011)
• International violence risk researchers launch free news service (June 13, 2013) 

Violence prevention: DC to host major collaborative venture

From U.S. Attorney General Eric Holder to legal scholar Barbara Bennett Woodhouse, the speakers at next month's APA-ABA collaborative conference read like a who's who in the field of violence prevention.

To give a flavor:

• Carl Hart, the neuroscientist whose memoir I recently featured, will speak on the contribution of U.S. drug policy to violence
• James Garbarino, author of the terrific book Lost Boys: Why Our Sons Turn Violent and How We Can Save Them, will address the developmental effects of violence -- a topic that forensic psychologists confront daily in our practices
• Mary Ann Dutton, a leading researcher on domestic violence, will discuss preventing intimate partner violence
• Patrick Tolan and Dewey Cornell will address youth violence in the schools 
• Judge Jay Blitzman and colleagues will talk about disrupting the 'cradle to prison pipeline' by implementing alternatives to school suspension and exclusion 
• Charlotte Patterson, a pioneer in LGBT research, will focus on reducing violence against sexual minorities 
• Mark Soler, an attorney who taught my media law class way back in journalism school, will speak on alternatives to incarceration in juvenile justice 
• Edward Mulvey will address mental illness and substance abuse in violence 

And that's just for starters. With more than 40 plenary and invited sessions, the lineup goes on and on, with a wide array of programming that should appeal to psychologists, attorneys, judges, legal and social science scholars, and anyone else interested in the roles of law and psychology in addressing the effects of violence:

• Intergenerational transmission of violence
• Violence in Native American communities
• Offender reentry
• Risk assessment and threat assessment
• Hate crimes
• Poverty and race in violence
• Sexually violent offenders
• Violence among military veterans
• Elder abuse
• and much more

A major goal of the conference, entitled "Addressing the Unspeakable: Confronting Family and Community Violence, The Intersection of Law and Psychology," is to build on the momentum of Eric Holder's Defending Childhood initiative, which aims to address the effects of violence on children, youth and families.

The conference is co-sponsored by the American Psychological Association and the American Bar Association, and continuation education credits will be provided for both legal and mental health professionals. Early registration ends this week, so register now if you're planning to attend.

The preliminary program is HERE; an overview of the event and its logistics is HERE; the online registration form is HERE. 

8-year prison term in long-running Ayres saga

The up-and-down case of a child psychiatrist who sexually molested boys sent to him by the courts for counseling has finally concluded -- at least for now. William Ayres, 81, pleaded no contest to molesting five boys and was sentenced this week to eight years in prison.

The case has been slogging through the courts for as long as this blog has been around, in large part due to disputes over Ayres's competency. Ayres is suspected of molesting dozens of boys over a period of several decades, but many cases were beyond the statute of limitations.

The case had all of the elements of high drama: A once-respected child psychiatrist accused of molesting vulnerable boys sent to him by the courts. Allegations that prosecutors turned a blind eye. Pressure from victim's rights lobbyists. And, of special interest to this blog's readers, a bevy of mental health experts presenting contradictory evidence.

After a jury trial on the issue of competency ended in a deadlock in 2011, both sides stipulated that Ayres was incompetent due to dementia. He spent about nine months at Napa State Hospital -- where defendants in Northern California are sent for competency restoration treatment -- before the hospital decided that he was faking dementia in an elaborate ruse to avoid trial. He was finally found competent to stand trial after a four-day court hearing late last year.

At his sentencing hearing, victims -- now adults, some with children of their own -- spoke of the traumatic effects of being victimized by someone in a position of trust. As evidence that the former head of the American Academy of Child and Adolescent Psychiatry knew the damage he was inflicting, one former victim even read an excerpt from a journal article Ayres co-authored entitled "Practice Parameters for the Forensic Evaluation of Children and Adolescents Who May Have Been Physically or Sexually Abused."

Victims and their family members burst into applause when Ayres was sentenced, hugging and rejoicing over their victory in a lengthy and uphill struggle for justice, according to a news report in the San Mateo County Times.

But the fight may not be quite over yet: Ayres' attorney warned in court that the wheelchair-bound octogenarian may seek to withdraw his no contest pleas.

My prior blog posts on this case include: 

• Ayres case: Final act in long-running competency drama? Notorious psychiatrist found fit for trial on molestation charges (Nov. 24, 2012)
• Psychiatrist accused of faking dementia to thwart retrial (Aug. 5, 2012)
• Professionals behaving badly: Mistrial in psychiatrist molestation case (July 27, 2009)
• Lesson to abusers: Target socially disempowered (April 23, 2007)

Forensnips aplenty, forensnips galore

Everybody knows that the war is over
Everybody knows the good guys lost
Everybody knows the fight was fixed
The poor stay poor, the rich get rich
That's how it goes, Everybody knows

I can't seem to get Leonard Cohen’s haunting Everybody Knows out of my mind.

Perhaps it's because I was just down in Alabama, the belly of the beast, working on a tragic case. With the highest per capita rate of executions in the United States, the Heart of Dixie State kills people for crimes that other nations punish with probation. No exaggeration. It was jarring to drive around  Montomery and see the close proximity of historic mansions to abandoned homes and decaying housing projects. The juxtaposition is fitting, as Montgomery claims the dual distinctions of being the "cradle of the Confederacy" and the "birthplace of the Civil Rights Movement."  

Montgomery, Alabama (c) Karen Franklin 2013

Or maybe it's a flashback to Elysium, in which the one percenters have left Earth’s teeming masses to rot away while they luxuriate on an idyllic orbiting satellite. The scene in the parole office, with a robot parole agent delivering a quick risk assessment and then pushing meds, is worth the price of admission, although the film is marred by interminable hand-to-hand combat scenes and a ridiculous Hollywood ending.

David Miranda, held hostage
by British security forces

Or, it could be because I’m still riled up over the British government's abuse of David Miranda. He is the Brazilian partner of journalist Glenn Greenwald (think Edward Snowden). In what can only be called an outrageous effort to intimidate journalists, the Brits detained Miranda at Heathrow Airport for nine solid hours -- the maximum allowed under the British Terrorism Act -- before finally releasing him sans his laptop, cell phone and camera. Under the Terrorism Act, he was not entitled to counsel, nor to decline to cooperate. I sure hope it backfires and incenses journalists; it certainly fired up USA Today columnist Rem Rieder (whose column I highly recommend).

* * * * *

I feel bad about the dearth of posts recently. It's been a hectic period. I'll try to make up for my lapse by packing this post with lots of links to forensic psychology and criminology news and views from the past few weeks:

Evidence-based justice: Corrupted memory

Nature magazine's profile of Elizabeth Loftus and her decades-long crusade to expose flaws in eyewitness testimony is worth a gander.

Psychopathic criminals have empathy switch

New research published in the journal Brain indicates that psychopaths do not lack empathy, as is often claimed. Rather, they can switch it on and off at will. The study, out of the Netherlands Institute for Neuroscience, is freely available online. BBC also has coverage.  

The demographics of sexting

Sexting is becoming increasingly commonplace. But practices and meanings differ by gender, relationship and sexual identity, according to a new article, also available online, in the journal Cyberpsychology, Behavior, and Social Networking.

Brainwashed video discussion

New York Times columnist David Brooks just interviewed psychiatrist Sally Satel and psychologist Scott Lilenfield about their new book, Brainwashed, which is getting quite a bit of media buzz. The book is a workmanlike, if a bit superficial, exploration of the allure of "mindless neuroscience." If you’ve got 65 minutes, I recommend watching the video discussion.

Prison news: Hunger strike, juveniles, the elderly, women

On the prison front, a lot has been going on. California prisoners are into Day 50 or so of their hunger strike over solitary housing (a condition that the Department of Corrections denies, despite many men being kept in segregation units for years and even decades) and other cruel conditions. With prisoners' health deteriorating, a court order has been issued allowing force feeding if necessary to forestall deaths. Mainstream media reporting has been minimal, but at least Al Jazeera's got you covered.  

Even more local to me, a lawsuit has been filed over solitary confinement of juveniles in Contra Costa County. The lawsuit, filed in U.S. District Court, accuses county officials of flouting state laws mandating that juvenile detention facilities be supportive environments designed for rehabilitation.

Meanwhile, NBC news is sounding an alarm over the increasing number of elderly people in U.S. prisons. NBC sounds mostly worried about the cost to taxpayers of prisons teeming with upwards of 400,000 elderly prisoners by the year 2030. Read ithttp://usnews.nbcnews.com/_news/2013/06/29/.UeV62HppQL8.twitter, and weep. 

Piper Kerman, author of the memoir Orange Is the New Black that's become a trendy Netflix series, is also sounding an alarm. In a New York Times op-ed, she writes about a federal plan to ease overcrowding in men's prisons by shipping about 1,000 women from Connecticut down to Alabama and points beyond, where they will be even more estranged from their families. As Kerman notes: "For many families these new locations might as well be the moon." I recommend her thoughtful essay on alternatives for low-risk women prisoners. 

In a more promising development, the U.S. Justice Department has announced efforts to curtail the stiff drug sentences that have caused much of this overcrowding in the first place. The U.S. prison system is so bloated, so costly, and so irrational, that even conservatives are calling for reform. Better late than never, I suppose.

By the way, Florida has executed John Errol Ferguson, the prisoner whose controversial case I blogged about earlier this year, whose competency was contested in part because of his insistence that he was the "Prince of God." The American Bar Association had filed an amicus brief asking the U.S. Supreme Court to clarify the standard for competency for execution being applied in the case. 

Sex offender news

In yet another in a series of registry-facilitated vigilante attacks, a South Carolina man has been arrested for killing a sex offender and his wife in the mistaken belief that the man was a child molester. At the same time, there are signs that overzealous laws that contribute to such stigmatization are being scrutinized more closely. For example, a federal judge has struck down a Colorado city's ordinance restricting where registered sex offenders can live, ruling that it conflicts with a state law requiring parolees to be reintegrated into society. An appellate panel in North Carolina has also struck down a law that banned registered sex offenders from using social media sites. The state Court of Appeals agreed with the challenger that the law violated his Constitutional rights to free speech and freedom of association. 

Dispute over expert witness credentials

Finally, there's a big brouhaha in South Dakota over the credentials of a psychologist who frequently testifies as an expert witness in child custody cases. The credentials of the widely respected psychologist, Thomas Price, became an issue during a child custody dispute. It was ascertained that he had earned his PhD in behavioral medicine from an online degree mill called Greenwich University on Norfolk Island, Australia, that was subsequently shuttered by the Australian government. According to an expert on diploma mills quoted by the Sioux Falls Argus Leader, degree mills often adopt the names of respected English universities. Price's resumé says he earned a Ph.D. in behavioral medicine from Greenwich University, without noting the Norfolk Island location. "Typically," notes the article, "people don’t get caught using an unaccredited degree until they assume a high-profile position ... or they do something that causes another person to research their backgrounds…. If you stay under the radar, you can get by."

Science blogger

Finally (this time I really mean it), for those of you who are into offbeat science, I've just added a new blog, Mike the Mad Biologist, to my blog roll (which can be found a little ways down the right column of my blog site). Mike is prolific and wide-ranging in his news links, with a creative spin. 

Hat tips to Jane, Terry, Kirk and others