Risk Levels, Treatment Duration, and Drop Out in a Clinically Composed Outpatient Sex Offender Treatment Group

Smid, Wineke; Kamphuis, Jan H.; Wever, Edwin C.; Verbruggen, Maud C. F. M.

doi:10.1177/0886260514536276

Cited by 5 publications

(5 citation statements)

References 22 publications

(40 reference statements)

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“…ADT is also used in male sex offenders with paraphilic or hypersexual disorder (10), either by using androgen receptor (AR) antagonists or GnRH agonists or antagonists. In contrast to prostate cancer patients, this patient group is generally younger, has less comorbidities, and is expected to need long-term treatment with ADT (11,12). However, research on adverse health effects of ADT is limited in these patients and only a few studies included data on bone health (3)(4)(5)(6)8).…”

Section: Introductionmentioning

confidence: 99%

Early effects of androgen deprivation on bone and mineral homeostasis in adult men: a prospective cohort study

Khalil

LʼAbbate

Laurent

et al. 2020

European Journal of Endocrinology

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Objective Long-term androgen deprivation therapy (ADT) negatively influences bone. The short-term effects on bone and mineral homeostasis are less known. Therefore, we aimed to investigate the early effects of ADT on calcium/phosphate homeostasis and bone turnover. Design Prospective cohort study. Methods Eugonadal adult, male sex offenders, who were referred for ADT to the endocrine outpatient clinic, received cyproterone acetate. Changes in blood markers of calcium/phosphate homeostasis and bone turnover between baseline and first follow-up visit were studied. Results Of 26 screened patients, 17 were included. The median age was 44 (range 20–75) years. The median time interval between baseline and first follow-up was 13 (6–27) weeks. Compared to baseline, an 81% decrease was observed for median total testosterone (to 3.4 nmol/L (0.4–12.2); P < 0.0001) and free testosterone (to 0.06 nmol/L (0.01–0.18); P < 0.0001). Median total estradiol decreased by 71% (to 17.6 pmol/L (4.7–35.6); P < 0.0001). Increased serum calcium (P < 0.0001) and phosphate (P = 0.0016) was observed, paralleled by decreased PTH (P = 0.0156) and 1,25-dihydroxyvitamin D3 (P = 0.0134). The stable calcium isotope ratio (δ44/42Ca) decreased (P = 0.0458), indicating net calcium loss from bone. Bone-specific alkaline phosphatase and osteocalcin decreased (P < 0.0001 and P = 0.0056, respectively), periostin tended to decrease (P = 0.0500), whereas sclerostin increased (P < 0.0001), indicating suppressed bone formation. Serum bone resorption markers (TRAP, CTX) were unaltered. Conclusions In adult men, calcium release from the skeleton occurs early following sex steroid deprivation, reflecting early bone resorption. The increase of sclerostin and reduction of bone formation markers, without changes in resorption markers, suggests a dominant negative effect on bone formation in the acute phase.

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Section: Introductionmentioning

confidence: 99%

Early effects of androgen deprivation on bone and mineral homeostasis in adult men: a prospective cohort study

Khalil

LʼAbbate

Laurent

et al. 2020

European Journal of Endocrinology

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“…In particular, use of structured risk assessment instruments is recommended but typically serves as merely one input in a larger, individualized clinical decision-making process. Recent research by Smid et al has demonstrated that these procedures can lead to treatment referrals (Smid, Kamphuis, Wever, & Van Beek, 2013) and treatment group composition (Smid, Kamphuis, Wever, & Verbruggen, in press) that are inconsistent with the RNR principles and, presumably, are associated with suboptimal outcome.…”

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confidence: 99%

A comparison of the predictive properties of nine sex offender risk assessment instruments.

Smid

Kamphuis

Wever

et al. 2014

Psychological Assessment

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Sex offender treatment is most effective when tailored to risk-need-responsivity principles, which dictate that treatment levels should match risk levels as assessed by structured risk assessment instruments. The predictive properties, missing values, and interrater agreement of the scores of 9 structured risk assessment instruments were compared in a national sample of 397 Dutch convicted sex offenders. The instruments included the Rapid Risk Assessment for Sexual Offense Recidivism, Static-99, Static-99R, a slightly modified version of Static-2002 and Static-2002R, Structured Anchored Clinical Judgments Minimum, Risk Matrix 2000, Sexual Violence Risk 20, and a modified version of the Sex Offender Risk Appraisal Guide; sexual and violent (including sexual) recidivism was assessed over 5- and 10-year fixed and variable follow-up periods. In general, the instrument scores showed moderate to large predictive accuracy for the occurrence of reoffending and the number of reoffenses in this sample. Predictive accuracy regarding latency showed more variability across instrument scores. Static-2002R and Static-99R scores showed a slight but consistent advantage in predictive properties over the other instrument scores across outcome measures and follow-up periods in this sample. The results of Sexual Violence Risk 20 and Rapid Risk Assessment for Sexual Offense Recidivism scores were the least positive. A positive association between predictive accuracy and interrater agreement at the item level was found for both sexual recidivism (r = .28, p = .01) and violent (including sexual) recidivism (r = .45, p < .001); no significant association was found between predictive accuracy and missing values at the item level. Results underscore the feasibility and utility of these instruments for informing treatment selection according to the risk-need-responsivity principles.

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“…In addition, the unnecessary prolonging of treatments should be highlighted, since shorter programs (one year or less) showed bigger effects (OR = .47; p < .001) than longer programs, which did not show a significant treatment effect (OR = .84; p > .05). Research regarding the most appropriate length of interventions is scarce, and practice varies substantially across jurisdictions (Smid, Kamphuis, Wever & Verbruggen, 2015;Yates, 2013); however, specialized literature suggests the adverse effect of long interventions may come about by the disruption of the prosocial activities and social circles (school, employment, etc.) of these individuals (Lowenkamp, Latessa, & Holsinger, 2006).…”

Section: Discussionmentioning

confidence: 99%

Effect of treatment on sex offenders’ recidivism: a meta-analysis.

Soldino

Carbonell-Vayá

2017

AN PSICOL-SPAIN

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Título: Efecto del tratamiento sobre la reincidencia de delincuentes sexuales: un meta-análisis. Resumen: Este meta-análisis tiene por objetivo medir el efecto del tratamiento en delincuentes sexuales. Tras una revisión sistemática de la literatura reciente, fueron seleccionados diecisiete estudios, contando con una muestra total de 6,681 delincuentes sexuales. Las tasas de reincidencia sexual (13.12% vs. 17.94%), violenta -incluyendo la sexual-(25.5% vs. 29.1%) y general -cualquier tipo de reincidencia-(46.53% vs. 52.41%) de los delincuentes tratados fueron inferiores a las de los grupos control. Se evidenció la eficacia del tratamiento en la reducción de las tasas de reincidencia sexual (OR = .69; p< .05) y general (OR = .66; p < .05) de los sujetos tratados, pero no en las tasas de reincidencia violenta. Estos resultados confirman la capacidad de los tratamientos psicológicos para reducir el riesgo de reincidencia sexual y general de los delincuentes sexuales. No obstante, la interpretación de tales resultados requiere cautela, pues el análisis independiente de los estudios con buena calidad metodológica no mostró efectos significativos del tratamiento. La necesidad de nuevos y mejores estudios resulta evidente, especialmente en Europa. Palabras clave: Delincuentes sexuales; Tratamiento; Reincidencia; Metaanálisis. Abstract:This meta-analysis has the aim of measuring the effect of treatment on sex offenders. After a systematic review of the recent literature, seventeen studies were selected, containing a total sample of 6,681 sex offenders. The rates of sexual recidivism (13.12% vs. 17.94%), violent -including sexual-(25.5% vs. 29.1%) and general -any type of recidivism-(46.53% vs. 52.41%) of treated offenders were less than those of the control groups. The effectiveness of the treatment was clear in reducing the rates of sexual (OR= .69; p < .05) and general (OR = .66; p < .05) recidivism of the subjects treated, but not the rates of violent recidivism. This results demonstrated the ability of psychological treatments for reducing the risk of sexual and general recidivism of sex offenders. However, the interpretation of such results requires caution, given that an independent analysis of the studies of a good methodological quality did not show significant effects of treatment. The need for new and better comparison studies to assess treatment effect is clear, especially in Europe.

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Risk Levels, Treatment Duration, and Drop Out in a Clinically Composed Outpatient Sex Offender Treatment Group

Cited by 5 publications

References 22 publications

Early effects of androgen deprivation on bone and mineral homeostasis in adult men: a prospective cohort study

Early effects of androgen deprivation on bone and mineral homeostasis in adult men: a prospective cohort study

A comparison of the predictive properties of nine sex offender risk assessment instruments.

Effect of treatment on sex offenders’ recidivism: a meta-analysis.

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