Skip to main content

The Significance of Psychological Trauma and Brain Injury in the Treatment and Evaluation of Sex Offenders

  • Chapter
  • First Online:
Assessing Trauma in Forensic Contexts

Abstract

The relationship between adverse childhood events and sexual offending behaviors has received a growing amount of attention in the literature. Although findings have demonstrated such commonalities in the histories of sex offenders, a closer examination reveals differences in past experiences among those who offend against adults and those who offend against children. Further evidence suggests that factors related to the persistence of sexual offending may be different from those related to the initiation of such. For instance, there is little to support the fact that an adverse childhood environment is related to sexual recidivism. However, it is not just psychological trauma and its emotional sequelae that may impact one’s sexual behavior. Brain trauma impacts important components of sexual behavior such as libido, motivation, and impulse control. Multiple studies point out various areas and structures of the brain that may be involved in sexual deviant behaviors and/or hypersexuality, especially when affected by acquired brain injury. Traumatic brain injury that involves these areas may impact an individual’s libido intensity or change sexual preference, at times leading to sex offending. However, not every brain trauma leads to such substantial changes in one’s sexuality and sexual behavior. Neuroimaging techniques and neuropsychological assessment instruments can identify structural and functional changes and help to answer the questions of dangerousness, post-release management, and rehabilitation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Afifi, A. K., & Bergman, R. A. (1998). Functional neuroanatomy: Text and atlas (1st ed.). New York: McGraw-Hill Professional.

    Google Scholar 

  • Alnemari, A. M., Mansour, T. R., Buehler, M., & Gaudin, D. (2016). Neural basis of pedophilia: Altered sexual preference following traumatic brain injury. International Journal of Surgery Case Reports, 25, 221–224.

    PubMed  PubMed Central  Google Scholar 

  • Andrews, D. A., & Bonta, J. (2010). Rehabilitating criminal justice policy and practice. Psychology, Public Policy, and Law, 16, 39–55.

    Google Scholar 

  • Arns, M., De Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity, and hyperactivity: A meta-analysis. Clinical EEG and Neuroscience, 40(3), 180–189.

    PubMed  Google Scholar 

  • Beech, A. R., & Ward, T. (2004). The integration of etiology and risk in sexual offenders: A theoretical framework. Aggression and Violent Behavior, 10, 31–63.

    Google Scholar 

  • Blanchard, R., Christensen, B. K., Strong, S. M., Cantor, J. M., Kuban, M. E., Klassen, P., et al. (2002). Retrospective self-reports of childhood accidents causing unconsciousness in phallometrically diagnosed pedophiles. Archives of Sexual Behavior, 31, 511–526.

    PubMed  Google Scholar 

  • Blanchard, R., Kolla, N. J., Cantor, J. M., Klassen, P. E., Dickey, R., Kuban, M., & Blak, T. (2007). IQ, handedness, and pedophilia in adult male patients stratified by referral source. Sexual Abuse: A Journal of Research and Treatment, 19(3), 285–309.

    Google Scholar 

  • Blanchard, R., Kuban, M., Klassen, E., Dickey, P., Christensen, R., Cantor, B., & Blak, K. (2003). Self-reported head injuries before and after age 13 in pedophilic and nonpedophilic men referred for clinical assessment. Archives of Sexual Behavior, 32(6), 573–581.

    PubMed  Google Scholar 

  • Blumer, D., & Benson, D. F. (1975). Personality changes with frontal lobe lesions. In D. F. Benson & D. Blumer (Eds.), Psychiatric Aspects of Neurological Disease (pp. 151–170). New York: Gruneand Stratton.

    Google Scholar 

  • Braun, C. M. J., Dumont, M., Duval, J., Hamel, I., & Godbout, L. (2003). Opposed left and right brain hemisphere contributions to sexual drive: A multiple lesion case study. Behavioral Neurology, 14, 55–61.

    PubMed  Google Scholar 

  • Cantor, J. M., Blanchard, R., Christensen, B. K., Dickey, R., Klassen, P. E., Beckstead, A. L., et al. (2004). Intelligence, memory, and handedness in pedophilia. Neuropsychology, 18(1), 3–14.

    PubMed  Google Scholar 

  • Cantor, J. M., Kabani, N., Christensen, B. K., Zipursky, R. B., Barbaree, H. E., Dickey, R., et al. (2008). Cerebral white matter deficiencies in pedophilic men. Journal of Psychiatric Research, 42(3), 167–183.

    PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2013). Adverse childhood experience study: Prevalence of individual adverse childhood experiences. Retrieved from http://www.cdc.gov/ace/prevalence.htm

  • Cleckley, H. (1988). The mask of sanity: An attempt to clarify some issues about the so-called psychopathic personality (5th ed.). Retrieved from https://openlibrary.org/books/OL8518405M/The_Mask_of_Sanity

  • Cortoni, F., & Marshall, W. L. (2001). Sex as a coping strategy and its relationship to juvenile sexual history and intimacy in sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 13, 27–43.

    Google Scholar 

  • Darby, R. R., Horn, A., Cushman, F., & Fox, M. D. (2018). Lesion network localization of criminal behavior. Proceedings of the National Academy of Sciences of the United States of America, 115(3), 601–606.

    PubMed  Google Scholar 

  • Fazel, S., Lichtenstein, P., Grann, M., & Långström, N. (2011). Risk of violent crime in individuals with epilepsy and traumatic brain injury: A 35-year Swedish population study. PLoS Medicine, 8, e1001150. https://doi.org/10.1371/journal.pmed.1001150

    Article  PubMed  PubMed Central  Google Scholar 

  • Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Marks, J. S., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–355.

    Google Scholar 

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatrich Research, 12, 189–198.

    Google Scholar 

  • Gardner, A. J., & Zafonte, R. (2016). Neuroepidemiology of traumatic brain injury. In M. J. Aminoff, F. Boller, & D. F. Swaab (Eds.), Handbook of clinical neurology (Vol. 138, pp. 207–221). London: Elsevier.

    Google Scholar 

  • Geller, H. L. (2015). Executive functions. In P. Moglia (Ed.), Salem health: Psychology and behavioral health (4th ed., pp. 685–688). Amenia: Grey House Publishing. Retrieved from https://www.salempress.com/health_psychology_behavioral_health

    Google Scholar 

  • Grady, M. D., Levenson, J. S., & Bolder, T. (2017). Linking adverse childhood effects and attachment: A theory of etiology for sexual offending. Trauma, Violence, & Abuse, 18(4), 433–444. https://doi.org/10.1177/1524838015627147

    Article  Google Scholar 

  • Hanson, R. K., Bourgon, G., Helmus, L., & Hodgson, S. (2009). The principles of effective correctional treatment also apply to sexual offenders: A meta-analysis. Criminal Justice and Behavior, 36, 865–891.

    Google Scholar 

  • Hanson, R. K., Harris, A. J. R., Scott, T.-L., & Helmus, L. (2007). Assessing the risk of sexual offenders on community supervision: The Dynamic Supervision Project. (Corrections Research User Report No. 2007-05). Ottawa, ON: Public Safety Canada.

    Google Scholar 

  • Hanson, R. K., & Morton-Bourgon, K. E. (2005). The characteristics of persistent sexual offenders: A meta-analysis of recidivism studies. Journal of Consulting and Clinical Psychology, 73(6), 1154–1163. https://doi.org/10.1037/0022-006X.73.6.1154

    Article  PubMed  Google Scholar 

  • Hanson, R. K., & Slater, S. (1988). Sexual victimization in the history of sexual abusers: A review. Annals of Sex Research, 1, 485–499.

    Google Scholar 

  • Hare, R. D. (1993). Without conscience. The disturbing world of the psychopaths among us. New York: The Guilford Press.

    Google Scholar 

  • Hildebrand, M., de Ruiter, C., & de Vogel, V. (2004). Psychopathy and sexual deviance in treated rapists: Association with sexual and nonsexual recidivism. Sexual Abuse: A Journal of Research and Treatment, 16(1), 1–24.

    Google Scholar 

  • Iverson, G. L., & Lange, R. T. (2011a). Mild traumatic brain injury. In M. R. Schoenberg & J. G. Scott (Eds.), The little black book of neuropsychology: A syndrome-based approach (pp. 697–719). New York: Springer.

    Google Scholar 

  • Iverson, G. L., & Lange, R. T. (2011b). Moderate and severe traumatic brain injury. In M. R. Schoenberg & J. G. Scott (Eds.), The little black book of neuropsychology: A syndrome-based approach (pp. 663–696). New York: Springer.

    Google Scholar 

  • Jespersen, A. F., Lalumiere, M. L., & Seto, M. C. (2009). Sexual abuse history among adult sex offenders and non-sex offenders: A meta-analysis. Child Abuse & Neglect, 33(3), 179. https://doi.org/10.1016/j.chiabu.2008.07.004

    Article  Google Scholar 

  • Jennings, W. G., Zgoba, K. M., Maschi, T., & Reingle, J. M. (2014). An empirical assessment of the overlap between sexual victimization and sex offending. International Journal of Offender Therapy and Comparative Criminology, 58, 1466–1480.

    PubMed  Google Scholar 

  • Kiehl, K. A. (2006). A cognitive neuroscience perspective on psychopathy: Evidence for paralimbic system dysfunction. Psychiatry Research, 142(2–3), 107–128.

    PubMed  PubMed Central  Google Scholar 

  • Komisaruk, B. R., Whipple, B., Crawford, A., Grimes, S., Liu, W.-C., Kalnin, A., & Mosier, K. (2004). Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves. Brain Research, 1024, 77–88.

    PubMed  Google Scholar 

  • Langevin, R. (2006). Sexual offenses and traumatic brain injury. Brain and Cognition, 60(2), 206–207.

    PubMed  Google Scholar 

  • Langevin, R., & Curnoe, S. (2011). Psychopathy, ADHD, and brain dysfunction as predictors of lifetime recidivism among sex offenders. International Journal of Offender Therapy and Comparative Criminology, 55(1), 5–26.

    PubMed  Google Scholar 

  • Langevin, R., Wortzman, G., Wright, P., & Handy, L. (1989). Studies of brain damage and dysfunction in sex offenders. Annals of Sex Research, 2(2), 163–179.

    Google Scholar 

  • Lee, J. K. P., Jackson, H. J., Pattison, P., & Ward, T. (2002). Developmental risk factors for sexual offending. Child Abuse & Neglect, 26, 73–92.

    Google Scholar 

  • Levenson, J. S., & Grady, M. D. (2016). The influence of childhood trauma on sexual violence and sexual deviance in adulthood. Traumatology, 22(2), 94–103. https://doi.org/10.1037/trm0000067

    Article  Google Scholar 

  • Levenson, J. S., & Socia, K. M. (2016). Adverse childhood experiences and arrest patterns in a sample of sexual offenders. Journal of Interpersonal Violence, 31(10), 1883–1911. https://doi.org/10.1177/0886260515570751

    Article  PubMed  Google Scholar 

  • Levenson, J. S., Willis, G. M., & Prescott, D. S. (2016). Adverse childhood experiences in the lives of male sex offenders: Implications for trauma-informed care. Sexual Abuse: A Journal of Research and Treatment, 28(4), 340–359. https://doi.org/10.1177/1079063214535819

    Article  Google Scholar 

  • Lezak, M. D., Howieson, D. B., Bigler, E. D., & Tranel, D. (2012). Neuropsychological assessment (5th ed.). New York: Oxford University Press.

    Google Scholar 

  • Lichtenstein, P., Halldner, L., Zetterqvist, J., Sjölander, A., Serlachius, E., Fazel, S., & Larsson, H. (2012). Medication for attention deficit-hyperactivity disorder and criminality. New England Journal of Medicine, 367, 2006–2014.

    PubMed  Google Scholar 

  • Luria, A. R. (1966). Higher cortical functions in man. New York: Basic Books.

    Google Scholar 

  • Mann, R. E., Hanson, R. K., & Thornton, D. (2010). Assessing risk for sexual recidivism: Some proposals on the nature of psychologically meaningful risk factors. Sexual Abuse: A Journal of Research and Treatment, 22(2), 191–217.

    Google Scholar 

  • Marlowe, W. B., Mancall, E. L., & Thomas, J. J. (1975). Complete Klüver-Bucy syndrome in man. Cortex, 11(1), 53–59. https://doi.org/10.1016/s0010-9452(75)80020-7. PMID168031

    Article  PubMed  Google Scholar 

  • Marshall, W. L., & Barbaree, H. E. (1990). An integrated theory of the etiology of sexual offending. In W. L. Marshall, D. R. Laws, & H. E. Barbaree (Eds.), Handbook of sexual assault: Issues, theories, and treatment of the offender (pp. 257–275). New York: Plenum.

    Google Scholar 

  • Marshall, W. L., & Marshall, L. E. (2000). The origins of sexual offending. Trauma, Violence, & Abuse, 1(3), 250–263.

    Google Scholar 

  • Miller, B. L., Cummings, J. L., McIntyre, H., Ebers, G., & Grode, M. (1986). Hypersexuality or altered sexual preference following brain injury. Journal of Neurology, Neurosurgery, and Psychiatry, 49(8), 867–873.

    PubMed  PubMed Central  Google Scholar 

  • Morcos, N., & Guirgis, H. (2014). A case of acute-onset partial Klüver-Bucy syndrome in a patient with a history of traumatic brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 26(3), E10–E11.

    PubMed  Google Scholar 

  • Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I. … Chertkow, H. (2005). The montreal cognitive assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695–699.

    Google Scholar 

  • Nunes, K. L., Hermann, C. A., Malcom, R., & Lavoie, K. (2013). Childhood sexual victimization, pedophilic interest, and sexual recidivism. Child Abuse & Neglect, 37, 703–711. https://doi.org/10.1016/j.chiabu.2013.01.008

    Article  Google Scholar 

  • Paredes, R. G. (2003). Medial preoptic area/anterior hypothalamus and sexual motivation. Scandinavian Journal of Psychology, 44(3), 203–212.

    PubMed  Google Scholar 

  • Perr, I. N. (1991). Alleged brain damage, diminished capacity, mens rea, and misuse of medical concepts. Journal of Forensic Sciences, 36(3), 722–727.

    Google Scholar 

  • Pennington, B. F. (2002). The development of psychopathology: Nature and nurture. New York: Guilford Press.

    Google Scholar 

  • Phenix, A., Helmus, L., & Hanson, R. K. (2012). Static-99R & Static2002R evaluators’ workbook. Retrieved March 5, 2013, from http://www.Static99.org/pdfdocs/Static-99RandStatic-2002R_EvaluatorsWorkbook2012-07-26.pdf

  • Ponsford, J. (2003). Sexual changes associated with traumatic brain injury. Neuropsychological Rehabilitation, 13(1–2), 275–289. https://doi.org/10.1080/09602010244000363

    Article  PubMed  Google Scholar 

  • Randolph, C. (2012). RBANS Manual-Update: Repeatable battery for the assessment of neuropsychological status. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Randolph, C., Tierney, M. C., Mohr, E., & Chase, T. N. (1998). The repeatable battery for the assessment of neuropsychological status (RBANS): preliminary clinical validity. Journal of Clinical and Experimental Neuropsychology, 20(3), 310–319.

    Google Scholar 

  • Reavis, J. A., Looman, J., Franco, K. A., & Rojas, B. (2013). Adverse childhood experiences and adult criminality: How long must we live before we possess our own lives? The Permanente Journal, 17(2), 44–48. https://doi.org/10.7812/TPP/12-072

    Article  PubMed  PubMed Central  Google Scholar 

  • Reitan, R. M., & Wolfson, D. (1993). The Halstead-Reitan neuropsychological test battery: Theory and clinical applications (2nd ed.). Tucson: Neuropsychology Press.

    Google Scholar 

  • Rowlett, R. (2000). Glasgow coma scale. Chapel Hill, NC: University of North Carolina.

    Google Scholar 

  • Salloway, S., Malloy, P., & Cummings, J. L. (1997). The neuropsychiatry of limbic and subcortical disorders. Journal of Neuropsychiatry and Clinical Neuroscience, 9(3), 313–314. ISBN 0-88048-942-1.

    Google Scholar 

  • Seto, M. C. (2008). Pedophilia and sexual offending against children: Theory, assessment, and intervention. Washington, DC: American Psychological Association.

    Google Scholar 

  • Seto, M. C., & Lalumiere, M. L. (2001). A brief screening scale to identify pedophilic interests among child molesters. Sexual Abuse: A Journal of Research and Treatment, 13(1), 15–25.

    Google Scholar 

  • Schilz, K., Witzel, J., Northoff, G., Zierhut, K., Gubka, U., Fellmann, H., et al. (2007). Brain pathology in pedophilic offenders. Archives of General Psychiatry, 64, 737–746.

    Google Scholar 

  • Schoenberg, M. R., & Scott, J. G. (Eds.). (2011). The little black book of neuropsychology: A syndrome-based approach. New York: Springer.

    Google Scholar 

  • Scott, J. G., & Schoenberg, M. R. (2011). Frontal lobe/executive functioning. In M. R. Schoenberg & J. G. Scott (Eds.), The little black book of neuropsychology: A syndrome-based approach (pp. 219–248). New York: Springer.

    Google Scholar 

  • Shiroma, E. J., Ferguson, P. L., & Pickelsimer, E. E. (2010). Prevalence of traumatic brain injury in an offender population: A meta-analysis. Journal of Correctional Health Care, 16(2), 147–159.

    PubMed  Google Scholar 

  • Simons, D. A., Wurtele, S. K., & Durham, R. L. (2008). Developmental experiences of child sexual abusers and rapists. Child Abuse & Neglect, 32, 549–560.

    Google Scholar 

  • Stern, R. A., & White, T. (2003). Neuropsychological assessment battery (NAB). Lutz, FL: Psychological Assessment Resources.

    Google Scholar 

  • Terzian, H., & Ore, G. D. (1955). Syndrome of Klüver and Bucy; reproduced in man by bilateral removal of the temporal lobes. Neurology, 5(6), 373–380.

    PubMed  Google Scholar 

  • Thornton, D. (2002). Constructing and testing a framework for dynamic risk assessment. Sexual Abuse: A Journal of Research and Treatment, 14, 139–154.

    Google Scholar 

  • Turner, D., Schöttle, D., Krueger, R., & Briken, P. (2015). Sexual behavior and its correlates after traumatic brain injury. Current Opinion in Psychiatry, 28(2), 180–187.

    Google Scholar 

  • Varon, D., Pritchard, P. B., III, Wagner, M. T., & Topping, K. (2003). Transient Klüver–Bucy syndrome following complex partial status epilepticus. Epilepsy and Behavior, 4, 348–351.

    PubMed  Google Scholar 

  • Vaughn, M. G., Salas-Wright, C. P., Delisi, M., & Perron, B. (2014). Correlates of traumatic brain injury among juvenile sex offenders: A multi-site study. Criminal Behaviour and Mental Health, 24, 188–203.

    PubMed  Google Scholar 

  • Ward, T., & Beech, A. R. (2006). An integrated theory of sex offending. Aggression and Violent Behavior, 11, 44–63. https://doi.org/10.1016/j.avb.2005.05.002

    Article  Google Scholar 

  • Ward, T., Hudson, S. M., & Marshall, W. L. (1996). Attachment style in sex offenders: A preliminary study. The Journal of Sex Research, 33(1), 17–26. https://www.tandfonline.com/doi/abs/10.1080/00224499609551811

  • Weeks, R., & Widom, C. S. (1998). Self-reports of early childhood victimization among incarcerated adult male felons. Journal of Interpersonal Violence, 13(3), 346–361. https://doi.org/10.1177/088626098013003003

    Article  Google Scholar 

  • Williams, W. H., Chitsabesan, P., Fazel, S., McMillan, T., Hughes, N., Parsonage, M., & Tonks, J. (2018). Traumatic brain injury: A potential cause of violent crime? Lancet Psychiatry, 5, 836–844. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29496587

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sarah DeMarco Psy. D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

DeMarco, S., Geller, H.L. (2020). The Significance of Psychological Trauma and Brain Injury in the Treatment and Evaluation of Sex Offenders. In: Javier, R., Owen, E., Maddux, J. (eds) Assessing Trauma in Forensic Contexts. Springer, Cham. https://doi.org/10.1007/978-3-030-33106-1_17

Download citation

Publish with us

Policies and ethics