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Biomedical subjects

R A Prentky

Publications and source records attributed to R A Prentky.

At least 19 recordsLinked to original sources
PubMed2000

Sexual abuse of nursing home residents.

1. A new subgroup of rape victims resides in nursing homes. 2. Nursing home victims can suffer both compounded and silent rape trauma. 3. Innovative therapies are needed for treating elder rape trauma.

Aged↗
PubMed1998

Attention-deficit/hyperactivity disorder in males with paraphilias and paraphilia-related disorders: a comorbidity study.

BACKGROUND: We describe a study of DSM-III-R Axis I diagnoses of lifetime comorbid nonsexual disorders in 60 males with paraphilias (PAs; N = 42) and nonparaphilic forms of sexual impulsivity-designated paraphilia-related disorders (PRD; N = 18). METHOD: Subjects completed a semistructured intake questionnaire and sexual inventories, the Inventory to Diagnose Depression, and the Wender Utah Retrospective Scale for the diagnosis of childhood attention-deficit/hyperactivity disorder (ADHD). The lifetime prevalence of Axis I diagnoses of both sexual and nonsexual disorders was ascertained from the aforementioned data and follow-up psychiatric interviews. RESULTS: Subjects in both PA and PRD groups were diagnosed as having a lifetime prevalence of any mood disorder (71.7%), especially dysthymic disorder (66.7%); any anxiety disorder (43.3%), especially social phobia (28.3%); any psychoactive substance abuse disorders (45.0%), especially alcohol abuse (30.0%); and any impulse disorders NOS (25.0%), especially speeding/reckless driving (16.7%). The only diagnosis that statistically significantly distinguished the PA from the PRD sample (p = .01) was retrospectively diagnosed childhood ADHD, identified in 40.0% of the total sample (50.0% PA vs.16.7% PRD). Childhood ADHD was associated with the presence of educational and behavioral problems, lower current mean income, social/legal consequences associated with antisocial impulsivity, cocaine abuse, increased prevalence of comorbid lifetime mood and impulse disorder NOS, and more diagnoses of lifetime Axis I nonsexual and sexual disorders. CONCLUSION: Although depressive disorders were the most common Axis I diagnoses across groups, childhood ADHD was the only Axis I disorder statistically significantly associated with paraphilias, socially deviant and aggressive forms of sexual impulsivity.

Adolescent↗
PubMed1997

Recidivism rates among child molesters and rapists: a methodological analysis.

We address the high variability in sex offender recidivism rates by examining several of the critical methodological differences that underlie this variability. We used a dataset on 251 sex offenders (136 rapists and 115 child molesters) who were discharged over a 25-year period to examine changes in recidivism as a function of changes in dispositional definition of reoffense (e.g., arrest or conviction), changes in the domain of criminal offenses that are considered, and changes in the length of exposure time. The data indicate that: (a) both rapists and child molesters remain at risk to reoffend long after their discharge, in some cases 15-20 years after discharge; (b) there was a marked underestimation of recidivism when calculating a simple proportion (%) consisting of those who were known to have reoffended during the follow-up period, and (c) there was a marked underestimation of recidivism when the criterion was based on conviction or imprisonment. Forensic, clinical and policy implications of this high variability are discussed.

Adolescent↗
PubMed1997

Risk factors associated with recidivism among extrafamilial child molesters.

This study examined the predictive efficacy of 10 rationally derived, archivally coded variables for assessing reoffense risk among extrafamilial child molesters. Follow-up data on 111 child molesters who were discharged from the Massachusetts Treatment Center between 1960 and 1984 were used. Degree of sexual preoccupation with children, paraphilias, and number of prior sexual offenses predicted sexual recidivism. Juvenile and adult antisocial behavior, paraphilias, and low amount of contact with children predicted nonsexual victim-involved and violent recidivism. Area under the receiver-operating characteristic curves in all three analyses indicated discrimination that was substantially better than chance, ranging from .73 to .79.

Adult↗
PubMed1994

Preliminary observations of DSM-III-R axis I comorbidity in men with paraphilias and paraphilia-related disorders.

BACKGROUND: We describe a comorbidity study of DSM-III-R-defined Axis I diagnoses comparing male outpatient paraphiliacs to men with nonparaphilic forms of sexual impulsivity designated as paraphilia-related disorders. METHOD: Data were prospectively collected from 60 consecutively evaluated outpatient males, aged 21-53 years, seeking treatment for the principal disorders of paraphilias (N = 34) and/or paraphilia-related disorders (N = 26). Subjects completed a semistructured psychiatric Intake Questionnaire and Sexual Inventory. The lifetime prevalence of DSM-III-R Axis I diagnoses, including disorders of sexual impulsivity, was assigned by follow-up psychiatric interviews. RESULTS: Both groups of men were diagnosed with an elevated lifetime prevalence of mood disorders (76.7%), especially early-onset dysthymia (53.3%); psychoactive substance abuse (46.7%), especially alcohol abuse (40.0%); and anxiety disorders (46.7%), especially social phobia (31.6%). The predominant forms of sexual impulsivity reported by both groups were "nonparaphilic" paraphilia-related disorders: compulsive masturbation (73.3%), protracted promiscuity (70.0%), and dependence on pornography (53.3%). CONCLUSION: There were no major differences in lifetime Axis I diagnoses to differentiate men with paraphilic disorders from those with paraphilia-related disorders. Both groups were likely to acknowledge multiple paraphilias and/or multiple paraphilia-related disorders suggesting that sexual impulsivity has diverse manifestations, which can include culturally "deviant" as well as "normative" behaviors. Several hypotheses regarding the possible etiologic relationship between depressive disorders and sexual impulsivity are suggested.

Adult↗
PubMed1991

Identifying critical dimensions for discriminating among rapists.

Considerable evidence has amassed in studies of both nonoffender and offender samples that demonstrates both that sexual aggression is determined by a multiplicity of variables and that convicted sexual offenders are markedly heterogeneous (Knight, Rosenberg, & Schneider, 1985; Malamuth, 1986). Attempts both to identify sexually coercive men in normal samples and to assess etiology, concurrent adaptation, treatment efficacy, and recidivism for convicted sexually aggressive offenders have also suggested that the critical determining components of sexual aggression interact in complex ways. The purpose of this article is to survey both the offender and nonoffender sexual aggression research for evidence about which dimensions should be included in multivariate models that attempt to discriminate rapists from nonrapists, to identify subgroups among rapists, or to enhance the efficiency of dispositional decisions about these offenders.

Aggression↗
PubMed1991

Child molesters who abduct.

This study examined the differences between 97 abducting and 60 nonabducting child molesters on selected typological and antisocial/criminal variables. Although the results supported one a priori hypothesis, they disconfirmed two others and yielded an unpredicted but theoretically interesting abductor covariate. Our hypothesis that child abductors would more likely be classified as "low" in their contact with children (i.e., have little or no contact with children outside of their offenses) than the nonabductors was supported. In contrast, our hypotheses that the abductors were more likely to be characterized by a history of antisocial and criminal behavior as well as a greater degree of aggression were not supported. Abductors were found to be lower in social competence than the child molesters who never abducted their victims. The results were discussed in terms of abduction as in victim control strategy that is more likely employed by offenders with poor social and interpersonal skills. The complex interrelation among social competence, weapons, and sadism for abductors and nonabductors was explored.

Child↗
PubMed1989

The presumptive role of fantasy in serial sexual homicide.

The authors examined the role of fantasy as an internal drive mechanism for repetitive acts of sexual violence. A sample of 25 serial sexual murderers with three or more known victims each was compared with a sample of 17 single sexual murderers, with only one known victim each. The drive mechanism was hypothesized to be an intrusive fantasy life manifested in higher prevalences of paraphilias, documented or self-reported violent fantasies, and organized crime scenes in the serial murderers. All three hypotheses were supported.

Adult↗
PubMed1988

Validating the components of a taxonomic system for rapists: a path analytic approach.

This study was part of a series designed to validate a classification system for rapists developed at the Massachusetts Treatment Center. This system (MTC:R2) determines subtypes according to three major dimensions: the meaning of the aggression in the rapist's offenses (expressive versus instrumental), the meaning of the sexual behavior (compensatory, exploitative, displaced anger, or sadistic), and the degree of general lifestyle impulsivity (low or high). A total of 201 rapists were subtyped using this system. A path analytic approach was used to relate family, juvenile, and adult histories to the main decisions of subtype assignment. The classification of an offender on each of the three dimensions was informed by a developmental perspective. Results provided support for the use of the discriminators used and highlighted the deficiencies in our current knowledge regarding developmental precursors. These results were integrated with the findings from other studies using MTC:R2 and suggestions for revisions to the current classification system were discussed.

Aggression↗
PubMed1981

Habituation and conditioning of skin conductance responses in children at risk.

This investigation extends the findings reported by Salzman and Klein (1978) concerning the skin conductance response (SCR) of the offspring of parents who had been hospitalized for a psychiatric illness. Skin conductance during rest and during experiments testing habituation and conditioning of the SCR was recorded in 7-year-old (n = 42) and 10-year-old (n = 57) children. Among the 7-year-olds, 11 had a parent with a diagnosis of schizophrenia, 12 had a parent with a diagnosis of affective psychosis and 19 had a nonpsychotic parent. Among the 10-year-olds, the corresponding distribution was 13 (schizophrenic), 20 (affective), and 24 (nonpsychotic). The results indicate (1) no marked tendency toward either rapid or absent habituation in the offspring of schizophrenics; (2) evidence of significantly greater conditioning among the 10-year-old offspring of schizophrenics; (3) only very weak evidence of greater responsiveness to intense stimuli among the offspring of schizophrenics; (4) no evidence of differences in SCR recovery time among the three groups of children; and (5) differences between diagnostic groups among the 10-year-old children in the pattern of tonic skin conductance levels across experiments. Differences in results between the two age groups were unexpected, but may represent either heterogeneity of diagnosis in the parents or developmental trends in electrodermal activity in the children. In sum, the results of this study produce only partial confirmation of the findings reported in the earlier investigation.

Acoustic Stimulation↗
PubMed1979

Longitudinal social competence and adult psychiatric symptoms at first hospitalization.

Patterns of psychiatric symptoms of 141 patients at first hospital admission were correlated with social competence, as measured in childhood from school records and in adulthood by the Index of Social Competence, which is based on hospital records. Results confirmed the hypothesis that low social competence is associated with the more disintegrative symptoms of withdrawal, thought disorder, and antisocial acting out, but this conclusion held only when the measure of social competence was based upon adult premorbid behavior. A longitudinal perspective on social competence did not improve upon the symptomatic discrimination based on adult cross-sectional assessment alone, except that a cluster of schizoid symptoms (apathy, flat affect, hallucinations, resentfulness, and verbal hostility) was significantly associated with a longitudinal measure of social competence, though not with either cross-sectional measure by itself. Positive symptoms (delusions, hallucinations, and other florid processes) appeared not to be part of a longstanding, longitudinal process, but the negative symptoms included in the withdrawal cluster showed some association with childhood behavior.

Adolescent↗