MEGA ♪ —Empirical Support for Nomenclature on the Anomalies

Abstract

Applied are empirical findings supporting the authors’ previously presented nomenclature identifying two subsets of sexually abusive youth overlooked by most contemporary risk assessment tools: sexually violent and predatory sexually violent youth. The cross-validation findings on an ecologically framed risk assessment tool, MEGA^♪ (Multiplex Empirically Guided Inventory of Ecological Aggregates for Assessing Sexually Abusive Children and Adolescents [Ages 19 and Under]) (N = 1,056 male and female sexually abusive youth, ages 4-19, including youth with low intellectual functioning), from the United States, Canada, England, and Scotland, were utilized. Findings provided normative data, with cutoff scores according to age and gender. Most contemporary risk assessment tools have three levels (low, moderate, and high), which may in fact be limited in assessing the range of risk level. The MEGA^♪ cross-validation established a new range of risk level, with the fourth level (very high) definitively identifying the most dangerous youth, thus empirically supporting the nomenclature of sexually violent and predatory sexually violent youth.

Keywords

adolescent sex offender sexually abusive youth violent sex offender sexually violent predator risk assessment tools

Cases involving exceptionally violent, sometimes lethal, sexual crimes (e.g., rape at knifepoint, kidnapping, torture, strangulation, stabbing, and murder) are anomalies. Research on characteristics and risk factors of these youth is significantly limited, given that they are so rare (Caldwell, 2013). Nevertheless, available research is clear; sexually violent and predatory youth are most likely older male adolescents (16-19 years), with only a small number of females, younger youth, and youth with low intellectual functioning (Caldwell, 2013; Långström, 2002; Långström & Grann, 2000). Needed are accurate risk assessment tools that assess the various levels of risk; thereby the findings can be more efficiently utilized in specialized treatment programs for this unique population.

Miccio-Fonseca and Rasmussen (2009) differentiated youth who are sexually violent (YSV) and predatory sexually violent (YPSV) as qualitatively different groups, establishing an ecological nomenclature encompassing dynamic risk factors interwoven within multiple systems (e.g., neuropsychological functioning, family history and dynamics, relationships with peers and adults). Discussed are empirical data supporting the nomenclature from validation studies of MEGA^♪, a risk assessment tool that assesses risk for coarse sexual improprieties and/or sexually abusive behaviors in youth (Miccio-Fonseca, 2009, 2010, 2013).¹ Coarse sexual improprieties are behaviors that reflect an unsophisticated awareness of psychosexual conditions, environments, or social situations. Youth with coarse sexual improprieties engage in sexual behaviors that are crude, indecent, and outside the societal norms of propriety (e.g., crude sexual gestures, sexually suggestive and/or vulgar sexual comments, mooning, looking up skirts, a young child rubbing his or her genitals in public or trying to grab another’s genitals, a child looking over a stall in a public restroom; Miccio-Fonseca, 2010).

Sexually abusive behaviors and improprieties fall along a continuum of low, moderate, high, or very high (lethal) risk; this applies to sexually abusive youths who are adjudicated or non-adjudicated. Contemporary data from an international cross-validation sample (N = 1,056 males and females aged 4 to 19, including youth with low intellectual functioning) add considerably to the limited research on violent and predatory aspects of sexually abusive behavior in youth.

Identifying Very High Risk Sexually Abusive Youth

Professionals rightfully recoil when researchers or policy makers use terms such as sexually violent, predatory sexually violent, or sexually violent persons (SVP) to describe youth. Nevertheless, these terms (generally applied to adults) capture egregiousness of infrequently committed sexually violent crimes. Twenty states have civil commitment laws utilizing the term sexually violent persons to describe sex offenders who have “a mental abnormality or disorder that makes them likely to engage in future acts of sexual violence” (Caldwell, 2013, p. 517). Caldwell’s (2013) study of youth in secure custody evaluated for civil commitment found only 54 juvenile sex offenders in a 4-year period “qualifying for SVP commitment and held for a final commitment hearing” (p. 519). Only four juveniles were subsequently committed under the SVP law, one later “determined by a judge to be inappropriate for commitment” (Caldwell, 2013, p. 519), suggesting YSV and YPSV are indeed anomalies.

U.S. Department of Justice National Incident-Based Reporting System (NIBRS; consisting of sex crimes by 13,471 juveniles in 22 states) documented juveniles constitute a notable percentage of those known to police to have committed sex offenses (25.8% of total sex crimes and 35.6% of sex offenses against minors; Finkelhor, Ormrod, & Chaffin, 2009). Youth were predominantly older male adolescents (i.e., 46% aged 15-17; 16% children below 12; and 7% females). Specifics regarding type of violence used in a sex offense are not readily apparent, precluding estimates of how many youth were sexually violent and/or predatory. Nor is it possible to determine how many of the youth in the sample were adjudicated for sex offenses.

Differentiating Adjudicated and Non-Adjudicated Sex and Non-Sexual Offenders

A significant body of literature compares adolescent sex and non-sexual offenders (Driemeyer, Yoon, & Briken, 2011). For example, Leversee’s (2010) review of research on sexually abusive youth and general delinquency identified typologies purported by various researchers (i.e., as cited in Leversee, 2010: Hunter, 2006, 2008; Miner, 2008; Richardson et al., 2004). These typologies, however, relate to specific psychological and social factors that may answer questions of etiology of such youths. Absent is discussion of differences between youth who are adjudicated in the court system and those who are not. We suggest sexually abusive youth can be differentiated according to ad hoc categories (related to sex crimes or non-sexual crimes committed). These categories are not meant to represent a typology but rather to provide a much-generalized reference point: (a) non-delinquent youth, (b) non-adjudicated delinquent youth, (c) non-adjudicated sexually abusive youth, (d) adjudicated sex offenders whose crime history is predominantly composed of sex crimes and/or sexually related sex crimes, and (e) adjudicated non-sexual offenders whose crime history is predominantly composed of non-sexual crimes. The first two categories have had no contact with law enforcement, whereas the latter categories have come to the attention of law enforcement in some fashion and/or have gone through proceedings in juvenile or adult court systems.

Non-delinquent youth have no criminal history, may manifest coarse sexual improprieties, but not illegal sexual behaviors (e.g., an older adolescent bringing a Playboy magazine to the dinner table, a young child looking over a bathroom stall watching others going to the bathroom, a young female teasing a boy about his penis). These behaviors commonly occur in a passing social context, not rising to the attention of law enforcement and not typically reported. Children and younger adolescents (including youth with low intellectual functioning) engage in a variety of sexual behaviors, many of which are normative, making it difficult to differentiate when sexual behaviors reach coarse sexual improprieties.

Non-adjudicated delinquent youth have history of engaging in criminal behaviors that may be sexual and/or non-sexual but no contact with law enforcement (i.e., no referrals, arrests, or charges). This group is difficult to study, and information about them is obtained through indirect means (i.e., informal anonymous surveys or online victim reports).

Non-adjudicated sexually abusive youth have engaged in sexual criminal behaviors to the level of attention of law enforcement (i.e., incident report, may or may not have been arrested and/or charged). However, if charged, they were not True Found (i.e., convicted) and sentenced.

Adjudicated sex offenders have received court sanctions (i.e., arrested, charged, True Found, and sentenced) for sex crimes. Most crime data, empirical studies, and literature on juvenile sexual offending pertain primarily to these youth (Finkelhor et al., 2009). Their predominant criminal history is sex crime related and may involve adjudications for sex offenses only, or for both sex offenses and non-sexual offenses, a comparison often studied in the literature (Chu & Thomas, 2010; Rajlic & Gretton, 2010). These youth are predominantly males 13 and above, with only a small number of females. Children below 12 are sometimes identified by police (or child protective services) for having committed sex offenses, however not likely to be adjudicated for sex crimes unless very serious offenses. Adjudicated adolescent sex offenders are heterogeneous; some have a higher degree of antisocial behavior and prior non-sexual crimes (Gerhold, Brown, & Beckett, 2007). Research comparing juvenile sex offenders who commit sex offenses only with those who also commit non-sexual crimes found those offenders with a history of non-sexual crimes were (a) “more problematic in terms of the prediction of sexual recidivism” (Rajlic & Gretton, 2010, p. 1081) and (b) more likely to start sexually offending earlier, commit more crimes, and “partly continue their criminal career after their adolescence” (van Wijk, Mali, & Bullens, 2007, p. 407).

Adjudicated non-sexual offenders have received court sanctions (i.e., arrested, charged, True Found, and sentenced) for non-sexual offenses. Their predominant criminal history is non-sex crime related but may include a sex crime they may not have been charged or True Found.

Research literature has neither differentiated sexually abusive youth according to whether they are adjudicated or non-adjudicated nor empirically identified a discrete constellation of risk variables for coarse sexual improprieties and/or sexually abusive behavior applicable to each ad hoc category. Intuitively, youths who lack criminal history are different from those with a criminal history and/or adjudications for sexual and/or non-sexual crimes. Adjudicated youth are more likely than non-delinquent non-adjudicated youth to have negative peer groups and history of more serious antisocial behaviors that likely increased in degree of severity and activities, evolving into an extensive, ongoing criminal history. Researchers have an ongoing debate about whether male adjudicated adolescent sex offenders are similar to (or different from) adjudicated male adolescent non-sexual offenders (see Seto & Lalumière, 2010; van der Put, van Vugt, Stams, Dekovic, & van der Laan, 2013; van Wijk, Bullens, Maly, & Vermeiren, 2007). A systematic literature review related to this issue found the research to be contradictory (Driemeyer et al., 2011).

Studies often fail to differentiate whether youth are adjudicated, referring to youth as “sex offenders” when in fact, they were not True Found in Juvenile Court. Seto and Lalumière’s (2010) meta-analysis of 59 studies (3,855 male sex offenders and 13,393 male non-sexual offenders, some of whom may have been sexually abusive) referred to all sexually abusive youth as “adolescent sex offenders” although there were non-adjudicated youth in some studies examined. The groups had many similar risk variables: antisocial personality traits, antisocial attitudes (e.g., related to women), separation from parents, family communication problems, parent–child attachment, exposure to non-sexual violence in the family (i.e., spousal abuse, sibling abuse), exposure to non-sexual violence outside the family, social incompetence (social skills), conventional sexual experience, and level of intellectual functioning. However, adjudicated male adolescent sex offenders had less extensive criminal history and fewer conduct problems, fewer substance abuse problems, and less family history of criminality or substance abuse. They were more likely to have been sexually abused, exposed to sexual violence in their family, and/or experienced other types of abuse or neglect. They were also more likely to be socially isolated, have early exposure to pornography, show more atypical sexual interests, and have more anxiety and/or problems with low self-esteem.

A significant drawback of Seto and Lalumière’s (2010) meta-analysis is that almost three quarters (73%) of studies were published decades ago (1979-2000). Youth born and living in the 1960s, 1970s, 1980s, and 1990s represented a variety of Zeitgeist times. There have been profound anthropological and sociological changes in the collective’s psychosocial culture and/or psychosexual development, perhaps making Seto and Lalumière’s meta-analysis not entirely relevant to today’s psychosexual cultural issues. Cultural values related to sexuality, homosexuality, marriage, courtship, and child rearing are significantly different in today’s now interactive global society. A survey of adolescents (13-19 years) by the National Campaign to Prevent Teen and Unplanned Pregnancy (2008) showed 20% reported sending emails or text messages containing nude or nearly nude photos, 48% had received sexually suggestive text messages, and 31% reported receiving nude or nearly nude photos from someone else. Internet access is essential to education today and readily available in schools around the world, evidenced by routine use in the classroom. Social networking is embedded intricately in a vibrant, ever changing worldwide cyber culture, a vastly different world from the years of 1979 to 2000. Youth today are considerably more informed about sexual issues and at younger ages. Seto and Lalumière’s meta-analysis is limited because it did not specifically examine variables related to sexual violence and predatory behavior against strangers, thereby stopping short of providing sufficient data related to YSV and YPSV.

YSV

The most violent aspects of adolescent sexual offending (i.e., physical force and restraint, threats of bodily harm and/or lethal consequences [e.g., strangle, burn, cut, maim, torture, or dismember], use of weapons, removal from premises and/or kidnapping, predatory sexual abuse against strangers) lack extensive study. Gerhold et al.’s (2007) systematic review of male adolescent sex offenders (12 studies, N = 1,315) did not examine these variables. Seto and Lalumière’s (2010) meta-analysis gave cursory attention to variables indicative of sexual violence, reporting findings from only a few studies composed of small samples. Långström’s (2002) study found use of weapons and death threats associated with violent non-sexual recidivism, not sexual recidivism (N = 115 males, 2 females). Långström’s earlier study (Långström & Grann, 2000, as cited in Långström, 2002; N = 54 males, 2 females) found use of weapons and death threats not associated with sexual recidivism but with general criminality.

Terminology used when referring to sexual violence and predatory behavior often lumps sexually abusive youth together regardless of severity and/or statutory definition of the sex offense. “Violent sex offender” may be applied too broadly, not necessarily conveying egregiousness of youth who commit potentially lethal sex crimes or discerning specific gradations in higher levels of risk. van Wijk, Bullens, Mali, & Vermeiren (2007) used “violent sex offender” and “violent non-sex offender” to describe a sample consisting of “suspects” alleged by police to have committed serious, violent sex offenses and non-sexual offenses, according to statutory definitions (i.e., sex offenses = “rape or sexual assault”; violent offenses = “manslaughter, murder, assault, group violence” [p. 1344]). Relying on police records may overestimate seriousness, perhaps characterizing a youth’s offense as “violent” when it did not involve highly coercive elements (e.g., use of weapons or lethal threats). Police records may count youth who were innocent of the crimes alleged or, on the contrary, miss undetected offenses.

YPSV

Only 2.5% of Finkelhor et al.’s (2009) NIBRS sample sexually abused strangers, compared with 63.2% who abused acquaintances and 25% abused family members. Youth who sexually abused strangers had higher rates of sexual recidivism in a meta-analysis of 18 studies (N = 3,189; McCann & Lussier, 2008) as well as other research (Carpentier & Proulx, 2011; Långström, 2002). Gilby, Wolf, and Goldberg’s (1989) study of male adolescent “mentally retarded and non-retarded sex offenders” (Gilby’s term), reported “most adolescents in both groups had offended previously and most knew their victims, however, this was less often the case for the mentally retarded than non-retarded offenders” (p. 545).

Studies on adjudicated male adolescent sex offenders demonstrate wide disparity in defining “stranger.” Carpentier and Proulx (2011) found only 4.5% sexually abused strangers (defined as “a previously unknown victim” [p. 444]). A Singapore study reported 51.3% sexually abused strangers, defined as opposite of “acquaintance,” which were “[i.e., friends, family members, and relatives]” (Chu & Thomas, 2010, p. 221). The large percentage of strangers in the latter study may reflect unclear definitional criteria mistakenly including non-related individuals known to the family, therefore not strangers (e.g., family friends, neighbors, church members). Cultural factors may come into play in the Singapore study. Isolation in an overly crowded society is fertile ground for impersonal interactions. Emotional detachment in such societies may become a societal norm, possibly contributing to more youth sexually abusing strangers.

The MEGA^♪ cross-validation study established normative data (cutoff scores) according to age, gender, and a new range of risk level for sexually abusive youth. Most contemporary risk assessment tools have three levels (low, moderate, and high), which may in fact be limited in assessing the range of risk level. The MEGA^♪ cross-validation established a new range of risk level, with the fourth level (very high) definitively identifying the most dangerous youth, thus empirically supporting the nomenclature of sexually violent and predatory sexually violent youth.

Method

Sample

MEGA^♪ studies included adjudicated and non-adjudicated male adolescents and populations of females, children 4 to 12, and youth with low level of intellectual functioning. MEGA^♪ cross-validation study (2008-2012) reported a sample of N = 1,056 (males: n = 953, females: n = 102, transgendered: n = 1) in three age groups, 4 to 12 years (n = 152), 13 to 15 years (n = 429), and 16 to 19 years (n = 474). MEGA^♪ research study sites were national (Arizona, California, Kentucky, New Mexico) and international (Canada [London, Ontario], England [Liverpool, London], and Scotland [Glasgow]). Sites included outpatient child assessment centers, residential facility for adjudicated sexually abusive youth, residential facility for non-adjudicated youth, youth in correctional custody and/or psychiatric facilities, and/or youth in foster homes (Miccio-Fonseca, 2009, 2010, 2013).

Procedure

Youth were included if (a) seen at selected facilities at intake and (b) attending the program at 6 months and available for follow-up. Study sites were recruited in 2007, 2008, and 2009 via professional consultations at the annual research and treatment conferences of the Association for the Treatment of Sexual Abusers (ATSA) and the annual conferences of the California Coalition on Sexual Offending (CCOSO). A Master Research Protocol was signed requiring each facility to follow their respective Internal Review Board policies and procedures related to protection of human subjects. MEGA^♪ is completed by licensed mental health professionals or non-clinical professionals (e.g., child welfare workers, probation officers, group home, or residential staff); at least 2 years of experience working with sexually abusive youth is needed. The principal investigator (first author) trained individuals at each site to do the MEGA^♪ risk assessments.

Findings

Psychometric properties of MEGA^♪ are described elsewhere (validation study; Miccio-Fonseca, 2009, 2010), and prognostic utility findings for age groups (i.e., 4-12 and 13-19 years) were recently published (Miccio-Fonseca, 2013). Risk Scale score was the primary hypothesis test, using receiver operating characteristics (ROC) analysis. ROC results for the Risk Scale showed Area under the Curve (AUC) = 0.71 (95% confidence interval [CI] = [0.62, 0.80], p < .001) for 13- to 19-year-olds and AUC = 0.77 (95% CI = [0.60, 0.96], p = .016) for 4- to 12-year-olds. For full description of data analysis of prognostic utility, see Miccio-Fonseca (2013).

Gender and age distribution in MEGA^♪ Risk Scale categories (i.e., low, moderate, high, and very high) illustrate males were at significantly higher risk than females (p < .001). Both genders were in the very high risk level; females were considerably less so than males, and in smaller numbers (9% males, 4.9% females). As females got older (from 13-15 to 16-19), the percentage in very high risk level decreased; this was the opposite for males; percentage of youth in very high risk level increased with age (from 4-12 to 13-15 to 16-19 years). Risk Scale–Very High implies risk is likely at very critical levels requiring immediate intervention and presenting a danger to others, possibly to lethality levels. The youth’s sexually abusive behaviors were apt to incrementally progress, becoming significantly more troubling over time. All age groups included youth in very high risk level (i.e., 3.4% of males vs. 2.9% of females in 4-12 age group, 7.5% of males and 6.9% of females in 13-15 age group, and 12% of males and 5.3% of females in 16-19 age group). Comparisons of age groups (males and females) showed 3.3% of 4 to 12 age group, 8% of 13 to 15 age group, and 11.4% of 16 to 19 age group (the highest number of youth) were at very high risk.

Persistent Sexual Deviancy Scale assesses variables related to sexually abusive behaviors; females were consistently lower. Only 1% of females had a history of two or more adjudications for sex offense, compared with 9% of males. Three percent of females reported violating probation and/or parole with a sexually related charge versus 9% of males. Findings showed gender differences regarding sexual behaviors: 36% of females reported history of multiple diverse sexually deviant behaviors versus 57% of males. Almost two thirds in the overall sample reported age disparity (3-5 years age difference, either younger or older) with their victims, with significant difference between males (67%) and females (25%). For low intellectual functioning youth, difference was somewhat apparent (i.e., 65% for males and 58% for females). Age comparisons showed 4- to 12-year-old youth significantly lower on Persistent Sexual Deviancy Scale than other age groups (13-15 and 16-19 years; for both groups, p < .000).

Findings indicated males had significantly higher Protective Scale scores (p < .011). Females had markedly more psychological difficulties (i.e., impulsivity, concentration, and attention difficulties) than criminal behaviors. Females reported higher incidence of feeling depressed (51% females, 35% males) and experiencing more negative affect (49%) in the past 6 months than males (35%). Compared with males, females reported increase in temper tantrums in the past 6 months (41% females, 28% males). There were no significant differences among age groups on Protective Scale.

There were no differences between males and females or among the three age groups on the Estrangement Scale.

Discussion

Discussion focuses on cross-validation findings as related to youth assessed in the very high risk level, including potentially lethal youth (sexually violent and predatory sexually violent). Predictive validity of MEGA^♪ Risk Scale and applying MEGA^♪ to youth with low intellectual functioning are reported elsewhere (Miccio-Fonseca, 2013; Miccio-Fonseca & Rasmussen, 2013).

MEGA^♪ Risk Scale alerts for the small number of youth who are the most serious and need immediate attention. All levels of risk (i.e., low, moderate, high, and very high) were across all age groups and both genders. A key finding was that for the overall sample, risk increases with age; 13- to 15-year-olds scored higher risk than 4- to 12-year-olds, and 16-19-year-olds scored higher risk than 13- to 15-year-olds. As expected, only a small number of youth were at very high risk level (8.6%), consistent with research indicating very high-risk youth (who may qualify in some states for an SVP petition) are small in number (Caldwell, 2013), thus fitting the criteria of Miccio-Fonseca and Rasmussen’s (2009) nomenclature: sexually violent and predatory sexually violent youth. For example, this was seen in two cross-validation research sites reporting youth assessed as very high risk egregiously reoffended sexually shortly thereafter. One youth assaulted and attempted to rape a female staff; another ran away from a treatment program, broke into a home, and sexually assaulted a young child.

The very high risk group included young children ages 4 to 12 of both genders, affirming few children engage in very serious sexually abusive behaviors. This finding is likely not surprising to those professionals working in juvenile correctional settings. Such children may reoffend, stressing need for preventive interventions sensitive to developmental considerations, including developmental sexology (Miccio-Fonseca, 2014). Providing sex education as part of therapeutic work with the youth’s family likely helps parents increase their understanding of human sexual development and the child’s possible sexual proclivities.

Consistent with research literature and crime statistics (Finkelhor et al., 2009; Miccio-Fonseca, 2000), males were in larger numbers and consistently significantly higher risk than females. Långström’s studies reflect the scarcity of risk assessment research on violent sexual offending for female sexually abusive youth; only two subjects in each study were females (Långström, 2002; Långström & Grann, 2000). Likewise, Worling and Långström (2003) were unable to find “any study focused specifically on risk factors for sexual recidivism among adolescent females who have offended sexually” (pp. 355-356).

Distinct risk factors differentiating females from male youth must be considered when evaluating the very limited population of females who are very high risk. Females have increased risk of sexual abuse and depression (Miccio-Fonseca, 2013; Robinson, 2006; Roe-Supowitz & Krysik, 2008), significantly more suicide attempts (Miccio-Fonseca, 2000), and specific concerns (i.e., significantly higher number of sexual illnesses and reproductive concerns [e.g., abortions, unwanted pregnancies, history of sexually transmitted diseases]; Miccio-Fonseca, 2000). Some have delinquent histories (e.g., truancy, running away, stealing); however, compared with sexually abusive boys, girls engage in “less fighting,” have “less problem with peers” (Robinson, 2006, p. 285), and “violent behavior is less common” (p. 287).

MEGA^♪ Risk Scale assesses variables related to illegal antisocial behaviors that come to attention of law enforcement, as well as antisocial behaviors that are problematic but not illegal (e.g., truancy, disruptive behavior in school). Consistent with above research, MEGA^♪ Risk Scale findings revealed males were considerably more antisocial and violent and at younger ages. Males more often than females were arrested or faced charges before the age of 16 years (61% males vs. 26% females), were more likely to have victims of both genders (21% for males, 6% for females), and were more likely to have more than two victims (26% for males, 4% for females). van der Put, van Vugt, Jan, Stams, and Hendriks (2013) compared 40 adolescent female sex offenders with 733 adolescent male offenders, finding them to be “remarkably similar” (p. 2) in number of misdemeanor and felony offenses (sexual and non-sexual), as well as several psychosocial characteristics (i.e., behavior problems, truancy, poor academic performance, dropping out), social relationships (i.e., antisocial friends, gang involvement, social isolation), family problems (i.e., parental substance abuse and/or mental health problems, family member in detention, poor parental authority and control, out of home placement, mental health problems), and history of child maltreatment (i.e., physical abuse or neglect). However, females were significantly more likely to have substance abuse problems, history of running away, and (similar to other research cited above) history of sexual abuse (by a non-relative).

Studies of female sexually abusive youth typically consist of very small samples, making it difficult to identify salient risk factors for females who are very high risk. The preponderance of evidence indicates female adolescent sex offenders of all risk levels are similar to males in many respects, however, with distinct differences. Utilizing non-gender specific tools that cannot make fine distinctions between females and males raises legitimate questions regarding accuracy and validity of risk assessment findings.

Persistent Sexual Deviancy Scale findings showed males scored higher than females on risk variables associated with youth in very high risk range. Males had a higher percentage than females regarding age disparity (3-5 years) with their victims (67% of males vs. 25% of females). They were more likely to have two or more non-sexually related offenses (males 16%, females 11%) and considerably more likely to have a probation and/or parole violation (20% males and 16% females). Males were also more apt than females to have a sexually related probation violation (males 9%, females 3%).

Results on lethality potential were consistent with Miccio-Fonseca and Rasmussen’s (2009) nomenclature. Only a small percentage of youth were sexually violent, including using a weapon during sexually abusive behavior (2% males, 2% females). Males were more prone to threaten bodily harm during sexually abusive behavior (10% males vs. 2% females) and twice as likely to have history of combined coercive elements (threats, force, and/or lethal consequences and/or bodily harm and/or use of a weapon) during sexually abusive behavior (5% of males and 2% of females) and more apt to lure their victims (15% of males, 5% of females). There was no difference between males and females on history of stalking their victims (5% each).

Youth engaging in these behaviors (i.e., using weapons, threatening bodily harm, luring, stalking) during sexually abusive behavior meet nomenclature criteria for YSV, and if these behaviors are directed against a stranger or casual acquaintance, for YPSV. They may be found in any of the suggested ad hoc categories (related to sex crimes or non-sexual crimes committed) described above. Some may be delinquent youth committing violent crimes (e.g., murder, robbery, assault and battery, breaking and entering, assault with a deadly weapon) and may have only one egregious sex offense. They are neither typically viewed as sex offenders because their antisocial crime history primarily includes non-sexually related crimes nor predominately found in treatment programs for sexually abusive youth. However, likely these youth need such specialized sex offender treatment.

Antisocial behaviors not related to law enforcement but resulting in disciplinary actions at school are often seen in male and female sexually abusive youth. More males (58%) than females (46%) had history of two or more disciplinary actions (e.g., detentions, school suspensions, and expulsions), although for disciplinary actions (two or more) in past 6 months, differences appeared nearly equivalent (males 23%, females 21%). Having any history of behavioral problems (e.g., disruptive behavior at school, instigating fights) was likewise notable for both genders (69% males and 68% females).

Compared with other sexually abusive youth, very high-risk youth are likely to have early history of behavior difficulties that evolved into chronic ongoing behavioral and disciplinary problems throughout their educational history. Those professionals working in prison systems and/or with criminal populations are well aware that serious antisocial behaviors are frequently reported in the early history of such individuals. Very high-risk youth typically fail to adhere to rules and/or respect authority figures. The long-standing history of not getting along with others likely results in their becoming socially isolated and perhaps ostracized (Seto & Lalumière, 2010). These difficulties may be apparent later in the youth’s development in various domains (i.e., poor employment history, poor family interactions, and dysfunctional platonic and/or romantic relationships; Miccio-Fonseca, 2014). Lack of a prosocial support system may be a recipe for the youth migrating to antisocial peers and/or activities (e.g., stealing, lying, fraud, assault with a deadly weapon, rape). Findings related to disciplinary actions at school are a call for educators to join professionals involved with intervention, treatment, and monitoring of sexually abusive youth, including identifying and intervening with very high-risk youth (to include YSV and YPSV).

Early intervention when youth begin to show very high-risk indicators may have important advantages. The youth’s family may be accessible to become actively involved in the youth’s interventions, treatment, and monitoring. Family investment for the identified problematic sexually abusive youth may be a positive variable facilitating effectiveness of interventions. However, for some youth, the family’s involvement may bring additional unforeseen complications hindering interventions. For example, the cross-validation found family history of legal difficulties for sexual habits was notably present for both males and females (15%). In some cases of very high-risk youth, preventive interventions may already be in place (for the possible adult sex offender within the family that may be participating in a treatment program); however, these interventions may need further fortification and/or adjustment for greater effectiveness.

Accuracy in risk assessment may be related to assessing intensity and/or severity of risk level at a more precise level; this is particularly true for youth below age 12 and females. Other risk assessment tools (i.e., Juvenile Sex Offender Assessment Protocol–II [J-SOAP-II; Prentky & Righthand, 2003]; Estimate of Risk of Adolescent Sexual Offense Recidivism, Version 2.0 [ERASOR; Worling & Curwen, 2001]; Juvenile Sexual Offense Recidivism Risk Assessment Tool–II [J-SORRAT-II; Epperson, Ralston, Fowers, DeWitt, & Gore, 2006]) have only three levels of risk (i.e., low, moderate, and high), possibly limiting the tools’ ability to differentiate considerably more troubling youth. Rajlic and Gretton (2010) found that J-SOAP-II and ERASOR lacked the ability to predict recidivism for youth who were more antisocial. Their study compared adolescents with a sex offense only with those who also had non-sexual offenses (referred to as “delinquent ASO” [p. 1067]). For the sex offense-only adolescent sex offender (ASO) group, “total scores of both instruments predicted sexual recidivism (equivalent to large effect sizes)” whereas for the delinquent ASO group, “total scores of the two measures did not predict sexual recidivism beyond chance levels” (Rajlic & Gretton, 2010, pp. 1080-1082). In the delinquent ASO group, “53.6% were charged or convicted for at least one violent non-sexual offense in addition to their sexual offense(s)” (Rajlic & Gretton, 2010, p. 1070), suggesting J-SOAP-II and ERASOR may not be as sensitive in assessing youth whose sex offenses include violence. Recall Carpentier and Proulx’s (2011) findings that youth who sexually abused strangers had higher rates of violent recidivism. In contrast, MEGA^♪ Risk Scale, designed to identify the highest risk youth, establishes a fourth level of risk, very high risk. The very high risk level was present for all age groups and both genders in the cross-validation sample, likely differentiating YSV and YPSV who may recidivate at higher levels and require more immediate attention with regard to intervention and/or treatment.

The Estrangement Scale relates to relationships the youth has with others and the manner and/or behaviors in those relationships. Variables associated with positive and enduring relationships with others include elements of being understanding, considerate, kindhearted, compassionate and/or empathic; all are aspects of intimacy (non-sexual; Miccio-Fonseca, 2014). Early disruptions such as death and/or separation of a parent can have a profound impact on a youth. This in turn affects bonding with others and how relationships of all kinds are sustained over time, regardless of duration and degree of intensity. The MEGA^♪ cross-validation found the great majority of youth experienced a death or separation of a parent before age 16 years (83% for males, 85% for females), and a significant number of youth experienced unstable residence before 16 years (59% males, 59% females). Experiencing such upheaval significantly challenges a youth to cope and deal with ongoing stressors, often affecting kernel aspects of a relationship (e.g., trust). An early history of loss of a parent, coupled with chronic history of unstable residence (perhaps including foster care), likely contributes to ongoing problematic behaviors and relationships, increasing risk of sexually abusive behavior. Very high-risk youth typically have such histories, to include out-of-home placement in residential care or, in the case of serious offenses (sexual and non-sexual), placement in secure custody.

Although there were no significant differences on the Estrangement Scale among age groups, scores were high, indicative of sexually abusive youth in general having a chronic history of deficiencies in self-navigation and self-governance. This likely reflects a consistent combination of problematic operating variables (i.e., chronic high levels of stress, poor self-regulation, and problems being honest and trustworthy, not being reliable or dependable). Problems being honest and trustworthy with others often begin early in development and relate to the non-sexual aspect of intimacy, a most intimate aspect of the individual.

Likely there is a predisposition to learning intimacy triggered and beginning at birth with first imprinting (i.e., mother–child bonding). From early bonding, the youth’s ability to demonstrate intimacy (non-sexual and sexual) is shaped and evolves from where it is rooted in the family’s historical tapestry of relationships (i.e., Family Lovemap). Family Lovemap is an empirically based, multifaceted conceptual paradigm related to different aspects of familial relationships (e.g., courtship, marital/cohabitation history, reproductive history, separation/divorce, death/widowhood, sexual abuse, etc.; Miccio-Fonseca, 2014). Very high-risk youth frequently have problematic early childhood history in getting along with others (both peers and adults) progressing into long-term problems in relationships (i.e., employers, socially, with romantic partners). This may include sexual dysfunctions, perhaps also, contributing to atypical sexual interests and possibly a sex disorder (Miccio-Fonseca, 2014). Seto and Lalumière’s (2010) meta-analysis found atypical sexual interests to be highly significant in differentiating adolescent sex offenders from adolescent non-sexual offenders, a finding that has important implications when assessing sexually violent and predatory sexually violent youth.

Protective Scale measures prosocial behaviors (i.e., youth is rule bound, getting along better with others [both peers and adults at school]). Findings showed no differences among different age groups. It is probable that protective factors do mitigate risk to some degree; however, the degree of influence may be overvalued. The MEGA^♪ findings may imply we have yet to discover anchoring elements of protective factors definitively related to mitigating risk. Protective factors likely are static and dynamic, and gender- and age-specific. Just as developmental differences are obviously seen among sexually abusive individuals (i.e., youth vs. adults, adolescents vs. children), protective factors are likely to be different for the respective different age groups and gender. It is also likely there are in fact domains of protective factors that probably change in their prominence due to developmental changes. It may be that there are also certain protective factors related to intimate aspects of the individual. If this in fact is the case, it suggests particular protective factors are more idiosyncratic.

Spice, Viljoen, Latzman, Scalora, and Ullman’s (2013) 7-year longitudinal findings on risk and protective factors followed 193 juvenile sex offenders post discharge from a residential facility, showing no protective factors associated with sexual recidivism (as assessed by the ERASOR). However, “strong attachments and bonds” (p. 348; as assessed by the Structured Assessment of Violence Risk in Youth [SAVRY—Borum, Bartel, & Forth, 2006, as cited in Spice et al., 2013]) negatively related to non-sexual recidivism. This finding perhaps supports the contention that very high-risk youth (including YSV and YPSV) have notable problems with intimacy (Miccio-Fonseca, 2014). Other related protective variables have yet to be identified, particularly for the younger aged youth.

This study identified a number of salient variables associated with very high-risk sexually abusive youth. A limitation is the small sample size (n = 91) of youth in very high risk range. These extreme cases often trigger implementation and or revisions of new public policy and interventions in managing sexual offenders (i.e., sexually violent predatory petitions, registration as a sex offender, etc.). Extreme cases of sexual assault rising to the level of very high risk (i.e., possibly to lethality) are generally not seen in outpatient facilities. Legislators likely fare better if they rely on contemporary research, with generalizable, applicable findings that are more definitive on variances relating to different levels of risk (i.e., low, moderate, high, very high). MEGA^♪ studies of a combined sample of 2,240 youth (Miccio-Fonseca, 2009, 2010, 2013) were completed by the author. Longitudinal studies independent of the author of MEGA^♪ have begun and include a predictive validity study (Rasmussen, 2014), as well as a study assessing salient variables (i.e., Diagnostic and Statistical Manual of Mental Disorders [4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000] diagnoses) related to risk level (Fagundes, 2013). Ongoing longitudinal research will continue to evaluate MEGA^♪’s ability to discriminate levels of risk among sexually abusive youth, including identifying youth who manifest sexually violent or predatory sexually violent behavior.

The dearth of research on sexually violent or predatory sexually violent youth is an invitation for researchers to conduct risk assessment studies focusing specifically on this very high-risk population. The present study provides the initial groundwork for professionals in identifying and intervening with these dangerous youth.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Notes

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

Caldwell

M. F.

(2013). Accuracy of sexually violent person assessment of juveniles adjudicated for sexual offenses. Sexual Abuse: A Journal of Research and Treatment, 25, 516-526. doi:10.1177/1079063213480818

Carpentier

Proulx

(2011). Correlates of recidivism among adolescents who have sexually offended. Sexual Abuse: A Journal of Research and Treatment, 23, 434-455. doi:10.1177/1079063211409950

Chu

M. C.

Thomas

S. D. M.

(2010). The relationship between typology and recidivism. Sexual Abuse: A Journal of Research and Treatment, 22, 218-233. doi:10.1177/1079063210369011

Driemeyer

Yoon

Briken

(2011). Sexuality, antisocial behavior, aggressiveness, and victimization in juvenile sexual offenders: A literature review. Sexual Offender Treatment, 6(1), 1-26. Retrieved from http://www.sexual-offender-treatment.org/

Epperson

D. L.

Ralston

C. A.

Fowers

DeWitt

Gore

K. S.

(2006). Actuarial risk assessment with juveniles who offend sexually: Development of the Juvenile Sexual Offense Recidivism Risk Assessment Tool–II (JSORRAT-II). In Prescott

(Ed.), Risk assessment of youth who have sexually abused: Theory, controversy, and emerging strategies (pp. 118-169). Oklahoma City, OK: Woods ‘N’ Barnes.

Fagundes

(2013, September). DSM-IV-TR diagnoses and risk assessment for sexually abusive youth. Poster presentation at the 18th International Conference and Summit on Violence, Abuse, and Trauma, San Diego, CA.

Finkelhor

Ormrod

Chaffin

(2009, December). Juveniles who commit sex offenses against minors (Juvenile Justice Bulletin). U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention. Retrieved from http://www.ncjrs.gov/pdffiles1/ojjdp/227763.pdf

Gerhold

C. K.

Brown

K. D.

Beckett

(2007). Predicting recidivism in adolescent sexual offenders. Aggression and Violent Behavior, 12, 427-438. doi:10.1016/j.avb.2006.10.004

10.

Gilby

Wolf

Goldberg

(1989). Mentally retarded adolescent sex offenders: A survey and pilot study. Canadian Journal of Psychiatry, 34, 542-548.

11.

Långström

(2002). Long-term follow-up of criminal recidivism in young sex offenders: Temporal patterns and risk factors. Psychology, Crime & Law, 8, 41-58. doi:10.1080/10683160290000888

12.

Långström

Grann

(2000). Risk for criminal recidivism among young sex offenders. Journal of Interpersonal Violence, 15, 855-871. doi:10.1177/088626000015008005

13.

Leversee

(2010). Typology research: Refining our understanding of a diverse population. In Ryan

Leversee

Lane

(Eds.), Juvenile sexual offending: Causes, consequences, and correction (3rd ed., pp. 70-79). Hoboken, NJ: John Wiley.

14.

McCann

Lussier

(2008). Antisociality, sexual deviance, and sexual reoffending in juvenile sex offenders: A meta-analytical investigation. Youth Violence and Juvenile Justice, 6, 363-385. doi:10.1177/1541204008320260

15.

Miccio-Fonseca

L. C.

(2000). Adult and adolescent female sex offenders: Experiences compared to other females and male sex offenders (Special ed.). Journal of Psychology & Human Sexuality, 11, 75-88.

16.

Miccio-Fonseca

L. C.

(2009). MEGA^♪: A new paradigm in protocol assessing sexually abusive children and adolescents. Journal of Child & Adolescent Trauma, 2, 124-141. doi:10.1080/19361520902922434

17.

Miccio-Fonseca

L. C.

(2010). MEGA^♪: An ecological risk assessment tool of risk and protective factors for assessing sexually abusive children and adolescents. Journal of Aggression, Maltreatment & Trauma, 19, 734-756. doi:10.1080/10926771.2010.515542

18.

Miccio-Fonseca

L. C.

(2013). MEGA^♪: A new paradigm in risk assessment tools for sexually abusive youth. Journal of Family Violence, 28, 623-634. doi:10.1007/s10896-013-9527-8

19.

Miccio-Fonseca

L. C.

(2014). Family Lovemap, eroticized children, and a constellation of sexually related risk variables. Journal of Forensic Practice, 16(1), 3-17. doi:10.1108/JFP-03-2013-0019

20.

Miccio-Fonseca

L. C.

Rasmussen

L. A.

(2009). New nomenclature for sexually abusive youth: Naming and assessing sexually violent and predatory offenders. Journal of Aggression, Maltreatment & Trauma, 18, 106-128. doi:10.1080/10926770802616431

21.

Miccio-Fonseca

L. C.

Rasmussen

L. A.

(2013). Applicability of MEGA^♪: Cross-validation study to youth with low intellectual functioning. Journal of Mental Health Research in Intellectual Disabilities, 6, 42-59. doi:10.1080/19315864.2011.650788

22.

National Campaign to Prevent Teen and Unplanned Pregnancy. (2008). Sex and tech: Results from a survey of teens and young adults. Retrieved from http://www.thenationalcampaign.org/sextech/pdf/sextech_summary.pdf

23.

Prentky

Righthand

(2003). Juvenile Sex Offender Assessment Protocol–II (J-SOAP-II) Manual (NCJ 202316). Office of Juvenile Justice and Delinquency Prevention, Juvenile Justice Clearinghouse. Available from http://ncjrs.gov

24.

Rajlic

Gretton

H. M.

(2010). An examination of two sexual recidivism risk measures in adolescent offenders: The moderating effect of offender type. Criminal Justice and Behavior, 37, 1066-1085. doi:10.1177/0093854810376354

25.

Rasmussen

L. A. L.

(2014, May). Longitudinal study of sexual recidivism in youth in residential care: Comparing JSORRAT-II and MEGA♪ risk assessment tools. Annual Conference of the California Coalition on Sexual Offending, San Diego, CA.

26.

Robinson

(2006). Adolescent females with sexual behavior problems: What constitutes best practice. In Longo

R. E.

Prescott

D. S.

(Eds.), Current perspectives: Working with sexually aggressive youth and youth with sexual behavior problems (pp. 273-324). Holyoke, MA: NEARI.

27.

Roe-Supowitz

Krysik

(2008). Examining the sexual offenses of female juveniles: The relevance of child maltreatment. American Journal of Orthopsychiatry, 78, 405-412. doi:10.1037/a0014310

28.

Seto

M. C.

Lalumière

M. L.

(2010). What is so special about male adolescent sexual offending? A review and test of explanations through meta-analysis. Psychological Bulletin, 136, 526-575. doi:10.1037/a0019700

29.

Spice

Viljoen

J. L.

Latzman

N. E.

Scalora

M. J.

Ullman

(2013). Risk and protective factors for recidivism among juveniles who have offended sexually. Sexual Abuse: A Journal of Research and Treatment, 25, 347-369. doi:10.1177/1079063212459086

30.

van der Put

van Vugt

E. S.

Jan

Stams

J. M.

Hendriks

(2013). Psychosocial and developmental characteristics of female adolescents who have committed sex offenses. Sexual Abuse: A Journal of Research and Treatment. Advance online publication. doi:10.1177/1079063213492342

31.

van der Put

C. E.

van Vugt

E. S.

Stams

G. J. J. M.

Devokic

van der Laan

P. H.

(2013). Differences in the prevalence and impact of risk factors for general recidivism between different types of juveniles who have committed sexual offenses (JSOs) and juveniles who have committed nonsexual offenses (JSOs). Sexual Abuse: A Journal of Research and Treatment, 25(1) 48-68. doi: 10.1177/1079063212452615

32.

van Wijk

Bullens

B. R. F.

Maly

R. A. R.

Vermeiren

R. R.

(2007). Criminal profiles of violent juvenile sex and violent juvenile non-sex offenders: An explorative longitudinal study. Journal of Interpersonal Violence, 22, 1341-1355. doi:10.1177/0886260507304802

33.

van Wijk

Mali

S. R. F.

Bullens

R. A. R.

(2007). Juvenile sex-only and sex-plus offenders: An exploratory study on criminal profiles. International Journal of Offender Therapy and Comparative Criminology, 51(4), 407-419.

34.

Worling

J. R.

Curwen

(2001, February). The ERASOR: Estimate of Risk of Adolescent Sexual Offense Recidivism (Version 2.0). Toronto, Canada: Sexual Abuse Family Education and Treatment (SAFE-T) Program, Thistletown Regional Center for Children and Adolescents, Ontario Ministry of Community and Social Services.

35.

Worling

J. R.

Långström

(2003). Assessment of criminal recidivism risk with adolescents who have offended sexually. Trauma, Violence, & Abuse, 4, 341-362. doi:10.1177/1524838003256562