Historically, sexual offenses by adolescents have been minimized and viewed as innocent sex play, experimentation, curiosity, or a normal aspect of sexual development. In the early 1980s, however, clinicians and the judicial system determined that aberrant juvenile sexual behaviors were unacceptable and would be considered criminal actions in need of appropriate psychological treatment. Although incidence rates vary, Uniform Crime Report (UCR) statistics indicate that 20% of rapes and about 50% of reported cases of child molestation are committed by adolescents. Confirmatory data from treatment settings show that child victims of sexual abuse report an adolescent perpetrator in 40 to 60% of cases. Most adolescent sex offenders are male. The incidence rate is about 5% for females; such offenses predominantly occur with siblings or in baby-sitting situations.
The most common offenses among male offenders are fondling, rape, and exhibitionism, with 50% of the offenses involving some form of penetration. Nearly 66% of the victims are children under 10 years of age. Most of the victims of adolescent sexual offenses are known by the offender; the majority are either family members, extended family members, or acquaintances. It is noteworthy that the majority of adolescent sex offenders had themselves been sexually abused as children or came from families in which spousal violence, child abuse, or sexual molestation had occurred. The high incidence of childhood victimization suggests a reactive, conditioned behavior pattern that demonstrates the cyclical nature of sexual abuse. There is no evidence that adolescent sex offenders are more prevalent in the lower socioeconomic strata, although several studies implicate the problems of the father-absent household.
Earlier studies on the etiologies ofjuvenile sexual abuse revealed that the adolescent child molester is a loner, has few friends or social peers, prefers interaction with younger children, has a limited occupational history, is an under-achiever, is immature, and identifies with a dominating mother. More recent research has suggested other clinical dimensions of the adolescent offender (i.e., feelings of male inadequacy; low self-esteem; fear of rejection; anger toward women; aberrant erotic fantasies; and identification with adult models of aggression, violence, and intimidation). A central characteristic of the offender is poor psychological adjustment and adaptation, which is evident in poor social skills, social isolation, lack of appropriate assertiveness, and deficits in communication skills.
Differential diagnosis is a major concern in the evaluation of sex offenders. It is difficult to distinguish between the diagnosis of "sex offender" and related disorders of delinquency, impulsivity, conduct disturbances, hyperac-tivity, and Substance Abuse. Frequently, a dual diagnosis seems in order. A related problem arises when clinicians or researchers must differentiate between the psychological and criminal nature of the offense. Areview of the literature by G. E. Davis and H. Leitenberg emphasizes that empirical research on the characteristics and profile of the adolescent sex offender is still at the rudimentary stage.
In recent years, several studies have reported on the psychological assessment of juvenile sex offenders versus non-sex adolescent offenders. Studies using the Minnesota Multiphasic Personality Inventory and the Rorschach Inkblot Test found few differences between sex offenders and juvenile offenders. This has led researchers to conclude that adolescent sex offenders are actually a subgroup ofjuvenile delinquents or sociopaths. On the Rorschach, however, the former group gave more anatomy responses, which reflected repressed hostility and destructive impulses.
An increasing number of rehabilitation programs are now available for the specific treatment of the adolescent sex offender. A National Adolescent Perpetrator Network has been established with guidelines for treatment components and goals. These include confronting denial, accepting responsibility, understanding the pattern or cycle of sexually offensive behaviors, developing empathy for victims, controlling deviant sexual arousal, combating cognitive distortions that trigger offending, expressing emotions and the self, developing trust, remediating social skills deficits, and preventing relapse. In addition, these intensive treatment programs focus on didactic instruction on normal human sexuality, training in interpersonal and dating skills, and the teaching of anger control techniques. Psychodynamic-oriented therapy has shown disappointing results, whereas various behavioral, cognitive-behavioral, and prescriptive approaches have proved to be most efficacious. Many programs use a multicomponent treatment approach, which usually includes family therapy. However, biological treatment modalities such as antiandrogenic medications are not indicated in the treatment of adolescent offenders. Residential treatment and community-based programs are showing much promise. J. Bingham and C. Piotrowski discuss the usefulness and rehabilitative aspects of a house arrest program in Florida as an option to incarceration for young sex offenders. Unfortunately, few controlled outcome studies have been reported on the long-term effectiveness of these types of treatment programs.
See also: Adolescent Development; Antisocial Personality
Disorder; Sexual Deviations
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