Psychiatric and Forensic Characteristics of Sex Offenders With Child and With Adult Victims

• Author: Goran Arbanas,Paula Marinovic,Nadica Buzina
• DOI: http://doi.org/10.1177/0306624X20944673
• Published date: 01 September 2022
• Date: 01 September 2022
• Subject Matter: Articles

https://doi.org/10.1177/0306624X20944673

International Journal of

Offender Therapy and

Comparative Criminology

2022, Vol. 66(12) 1195 –1212

© The Author(s) 2020

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/0306624X20944673

journals.sagepub.com/home/ijo

Article

Psychiatric and Forensic

Characteristics of Sex

Offenders With Child and

With Adult Victims

Goran Arbanas1,2 , Paula Marinovic3,

and Nadica Buzina1,4

Abstract

This study presents psychiatric and forensic characteristics of people accused of a

sexual crime and sent for evaluation. Data were drawn from the only institutional

psychiatric forensic assessment center in Croatia, during a 9-year period, from January

1, 2010 to December 31, 2018. There were 72 cases of sex offenses: 37 with child

victims and 35 with adult victims. People accused of sex offenses with child victims were

more often sexually abused during childhood and treated psychiatrically as inpatients.

They used alcohol less often. Sex offenders with child victims were diagnosed with

narcissistic and antisocial personality disorder, dementia, and pedophilic disorder.

Those with adult victims were diagnosed with antisocial personality disorder, alcohol

related disorders and dementia. Due to these differences, the management of these

two groups of offenders in both mental health and penal systems should be different.

Keywords

sex offenders, pedophilia, sex abuse, child sex abuse, forensic psychiatry, criminal

responsibility

Introduction

Sexual violence is a serious public health problem that has a major impact on the vic-

tim (Chen et al., 2010). The consequences of sexual violence may be physical (e.g.,

1University Psychiatric Hospital Vrapče, Zagreb, Croatia

2University of Rijeka, Croatia

3University Hospital Centre Zagreb, Croatia

4University of Zagreb, Croatia

Corresponding Author:

Goran Arbanas, Department of Forensic Psychiatry, University Psychiatric Hospital Vrapče, Klinika za

psihijatriju Vrapče, Bolnička cesta 32, 10000 Zagreb, Croatia.

Email: goran.arbanas@ka.t-com.hr

944673IJOXXX10.1177/0306624X20944673International Journal of Offender Therapy and Comparative CriminologyArbanas et al.

research-article2020

1196 International Journal of Offender Therapy and Comparative Criminology 66(12)

gynecological and pregnancy complications, chronic pelvic pain, premenstrual syn-

drome, etc.), psychological (depression, posttraumatic stress disorder, harmful behav-

ior), and social (strained relationships with family members, friends, and partners)

(Krug et al., 2002). While the victims may be of all ages (Saint-Martin et al., 2014),

child victims tend to suffer more profound outcomes, such as mood disorders, eating

disorders, dissociative disorders, and borderline personality disorder (Molnar et al.,

2001).

Research has shown that sex offenders have high rates of psychiatric disorders. Up

to 85% have at least one personality disorder and almost the same number have a life-

time diagnosis of a substance abuse (Harsch et al., 2006). Of the personality disorders,

antisocial personality disorder is the most prevalent (Novak et al., 2007). Mood disor-

ders and anxiety disorders are prevalent, while psychotic disorders (including schizo-

phrenia) are rare (Valenca et al., 2015).

As the prevalence of mental disorders in sex offenders is high, it is often important

to determine whether the offender has reduced or absent criminal responsibility. The

definition of criminal responsibility varies from country to country. For instance, in

the United States of America, the M’Naughten standard requires that to lack criminal

responsibility, the mental illness impairs one’s ability to understand the nature and

consequences of their actions and/or distinguish right from wrong (O’Shaughnessy,

2007). In Croatian law, full criminal responsibility requires that a person understands

the meaning of their actions and is in control of their volition; and therefore, lack of

criminal responsibility usually requires the diagnosis of a psychotic illness. Moreover,

in Croatia, apart from full responsibility and complete lack of criminal responsibility

(not guilty by reason of insanity [NGRI]), there are two levels of diminished criminal

responsibility (to a higher degree, and not to a higher degree) and people with dimin-

ished criminal responsibility still face legal consequences (unlike NGRI) and do not

receive non-voluntary outpatient or inpatient treatment in a forensic psychiatric insti-

tution (this is reserved for NGRI only; Buzina et al., 2018). Those found of diminished

responsibility may receive treatment in a psychiatric service for mental disorders or

substance misuse but this is not within a forensic psychiatric service. It is important to

gain understanding of sex offenders, given the medicolegal implications.

There are differences in the psychiatric profile of sex offenders depending on

whether their victim is a child or adult. Sex offenders with child victims have a high

prevalence of paraphilias, mainly pedophilia (Harsch et al., 2006; Holoyda et al.,

2018; Novak et al., 2007). The prevalence of psychotic disorders among pedophilic

offenders is very low, around 2% (Drake & Pathe, 2004). On the other hand, between

25% and 47% of individuals with pedophilia suffer from antisocial personality disor-

der (Garcia & Thibaut, 2011). Offenders with child victims have a high prevalence of

alcohol abuse (40%), but lower than in those with adult victims (Novak et al., 2007).

Between 23% and 57% of perpetrators of sex offenses are reported to be under the

influence of alcohol at the time of the crime, much more frequently than those with a

mental disorder (Valenca et al., 2015), and this was more common in those who vic-

timized boys than girls (Baltieri & de Andrade, 2008). However, drug use was less

common in child sex offenders compared to adult sex offenders (Koch et al., 2011).