Abstract
Adolescents adjudicated for sexual offenses are a heterogeneous group. The identification of more homogeneous subgroups of offenders may enable improved treatment, as the specific risks and needs presented by each group could be more effectively targeted. The current study examines three subgroups derived based on the age of victim(s), a popular method of subtyping that has mixed empirical support, using a sample of 176 males adjudicated for a sexual offense and court-ordered to participate in a community-based collaborative intervention program that integrates treatment and probationary services. Differences expected between groups based on theories regarding victim-age based subtypes are examined, in addition to differences consistently identified in prior research. Results indicate that these three subgroups are more similar than different, although some expected differences were found. Juveniles with child victims were more likely to have male victims and biologically related victims. Juveniles with peer/adult victims were more likely to have poor monitoring by their parents and more likely to have been arrested again. Juveniles with mixed types of victims appeared similar to juveniles with child victims on some variables and similar to those with peer/adult victims on others. Treatment implications and future directions for research are discussed. Typologies based on clinical characteristics of the youth rather than offense characteristics may have more promise for identifying meaningful subgroups.
The serious problem presented by juveniles who engage in sexually abusive behavior is now well recognized. Juvenile offenders represented more than 16% of arrests for sexual crimes in 2009 (U.S. Department of Justice, Federal Bureau of Investigation, 2010) and are responsible for more than a third of sexual crimes against children (Finkelhor, Ormrod, & Chaffin, 2009). Juveniles adjudicated for sexual offenses (JSOs) are now viewed as uniquely dangerous and are subject to specialized legal and clinical interventions (Chaffin, 2008; Letourneau & Miner, 2005; Zimring, 2004). These public policy and clinical approaches, such as the inclusion of JSOs on public registries and the application of relapse-prevention treatment strategies, have outpaced empirically based knowledge about this population of offenders. JSOs are known to be a heterogeneous population (e.g., Fehrenbach, Smith, Monastersky, & Deisher, 1986; Graves, Openshaw, Ascione, & Ericksen, 1996; Herkov, Gynther, Thomas, & Myers, 1996, Jacobs, Kennedy, & Meyer, 1997), therefore a greater understanding of this population would be provided by the development of an empirically based typology (e.g., Becker & Hunter, 1997; Veneziano & Veneziano, 2002). Such a typology would provide important information for clinical interventions by identifying key constructs for assessment, possible etiological factors specific to each subtype of offender, and unique risks and needs for each subtype that should be targeted in treatment. Treatment efforts could therefore be more effective and more efficient through targeting treatment by subtype. Furthermore, recent research suggests that the identification of relevant subtypes may improve risk assessment practices (Rajlic & Gretton, 2010), potentially allowing social control interventions like inclusion on public registries to be limited to the highest risk youth. Several methods of subtyping offenders have been suggested, and the validity of such subtyping schemes can be evaluated by determining whether subgroups differ on theoretically relevant variables.
Subtypes of Adult Offenders Based on Victim Age
One frequently studied method of subtyping adult sex offenders uses the age of their victim(s) to establish subgroups. Several models of the etiology of sexual offending against children highlight the role of sexual victimization (e.g., Hall & Hirschman, 1992; Seto, 2008; Ward & Siegert, 2002), with such victimization being hypothesized to lead to offending against children through the adoption of deviant sexual scripts (Ward & Siegert, 2002), modeling, conditioning, or other disruptions to normal sexual development (Seto, 2008). Other commonly identified etiological factors related to offending against children include social skills deficits (e.g., Hall & Hirschman, 1992; Marshall & Barbaree, 1990; Ward & Siegert, 2002), cognitive distortions (Hall & Hirschman, 1992; Ward & Siegert, 2002), and problems in self-regulation (Hall & Hirschman, 1992; Ward & Siegert, 2002). Some of the same factors have been hypothesized to be related to the development of all sex offending regardless of victim age (e.g., sexual victimization, Marshall & Marshall, 2000; self-regulation problems, Stinson, Sales, & Becker, 2008). Others suggest that adults who commit sexual offenses against postpubescent victims have negative views of women, substance abuse problems, condone violence, are hypermasculine (Robertiello & Terry, 2007) and are similar to violent nonsexual offenders (Harris, Mazerolle, & Knight, 2009).
Research on adult sex offenders has supported the existence of some expected differences between groups, as adults who select child victims are more likely to have been sexually abused (e.g., Jespersen, Lalumière, & Seto, 2009), have greater perceived deficits in social skills, and greater social anxiety (e.g., Segal & Marshall, 1985), whereas adults who offend against postpubescent victims are more generally antisocial (e.g., Olver & Wong, 2006; Porter, Fairweather, Drugge, Hervé, Birt, & Boer, 2000; Quinsey, Rice, & Harris, 1995) and have higher violent (nonsexual) recidivism rates (e.g., Prentky, Lee, Knight, & Cerce, 1997; Quinsey et al., 1995). Comparisons between subtypes of adult sex offenders based on victim age have thus consistently demonstrated meaningful differences between groups that are expected based on existing theory. These differences suggest potentially unique etiologies as well as treatment approaches for the subgroups. The success of this method of subtyping adult offenders has led to research examining the validity of this distinction among juveniles adjudicated for sexual offenses.
Subtypes of Juveniles Adjudicated for Sexual Offenses Based on Victim Age
Although this method of subtyping has intuitive appeal, the meaning of the selection of a child victim when the perpetrator is himself (or herself) still a minor is not entirely clear. It appears that theories regarding these subtypes of adult offenders have simply been extended downward to juveniles. Robertiello and Terry (2007) described the typically expected differences between these groups:
Those who abuse children . . . rely on opportunity, trickery, bribes, and threats, and often experience deficits in self-esteem and social competence. They lack social skills and show signs of depression. Juveniles who victimize peers and adults often commit sexual offenses in conjunction with other criminal behavior and exhibit a more generalized type of delinquency. These offenders are more likely to target strangers, use weapons, and cause injuries to their victims. (p. 515)
In addition, Seto and Lalumière (2010) hypothesized that “sexual victim age might . . . be an important moderator for some special explanations of adolescent sexual offending” (p. 532); therefore, theories regarding the etiology of sexually abusive behavior in juveniles might be specific to the etiology of offenses against children. Seto and Lalumière (2010) identified factors commonly theorized to contribute to the development of sexual offending in adolescents, which therefore may be associated specifically with the development of abuse of children: sexual victimization, poor childhood attachment, social incompetence, disruptions in sexual development, atypical sexual interests, psychopathology, and cognitive limitations. Support for these theories would thus be provided by demonstrating greater problems in these areas among juveniles who have victimized children.
Research regarding these expected differences has been largely inconsistent, however, in both methods and results. Studies differ in their operational definition of child victims (e.g., below age 12 and at least 3 years younger than offender: Carpenter, Peed, & Eastman, 1995; 4 or more years younger than offender: Richardson, Kelly, Bhate, & Graham, 1997); however, these definitional differences neither significantly alter the composition of subgroups nor the differences found between groups (Kemper & Kistner, 2010). In addition, existing studies differ in the assessment measures used (e.g., different measures of mental health functioning in Carpenter et al., 1995; Hunter, Figueredo, Malamuth, & Becker, 2003; Ronis & Borduin, 2007) and whether structured assessments are used at all (e.g., ‘t Hart-Kerkhoffs, Doreleijers, Jansen, van Wijk, & Bullens, 2009). Perhaps such methodological inconsistencies between studies have contributed to the inconsistent results produced to date.
Brief descriptive information and major findings of studies on victim-age-based subgroups are presented in Tables 1 and 2. As noted above, subtyping schemes can be validated by demonstrating theoretically expected differences between groups. The variables used to examine theoretically expected differences may be considered “psychologically meaningful” (Mann, Hanson, & Thornton, 2010, p. 194). The victim-age-based method of subtyping has not yet been accepted as a valid typology for JSOs because the few consistent differences identified to date are not related to etiology, treatment outcome, or recidivism. The review below highlights results related to theoretically expected differences (i.e., psychologically meaningful variables) which have produced largely inconsistent findings to date, results that have been consistent across studies, and results regarding risk and recidivism. The potential role of disruptions in sexual development, atypical sexual interests, and cognitive limitations will not be included in the review below as they could not be addressed in the current study.
Previous Findings Regarding Differences Between Subgroups in Individual and Family Characteristics
Note: CV = Juveniles with child victims; PV = Juveniles with peer/adult victims; MV = Juveniles with mixed victim types. Some samples included nonsexual offenders; in these instances, only the number of sexual offenders are included in the N. A meta-analysis by Graves, Openshaw, Ascione, and Ericksen (1996) is excluded because the “sexual assault offender” group is described as including victims of varying age, including victims younger than the offender.
(K. L. Kaufman, et al., 1996) did not create two categories (child vs. peer/adult). Victims divided into the following age ranges: 0-3, 4-6, 7-9, 10-12, 13-17.
Rasmussen (1999) did not compare based on victim age categories but used age of victim as a predictor of recidivism.
Previous Findings Regarding Differences Between Subgroups in Offense Characteristics, Victim Characteristics, and Risk to Reoffend
Note: CV = Juveniles with child victims; PV = Juveniles with peer/adult victims; MV = Juveniles with mixed victim types. The following studies were excluded from this table as they did not include information relevant to either offense characteristics, victim characteristics, or risk to reoffend/recidivism: Carpenter, Peed, and Eastman (1995), Ford and Linney (1995), Hummel, Thömke, Oldenbürger, and Specht (2000), Kempton and Forehand (1992), Ronis and Borduin (2007), van Wijk and colleagues (2005, 2007), and Worling (1995).
Kaufman et al. (1996) did not create two categories (child vs. peer/adult). Victims divided into the following age ranges: 0-3, 4-6, 7-9, 10-12, 13-17.
Rasmussen (1999) did not compare based on victim age categories but used age of victim as a predictor of recidivism.
Research Regarding Psychologically Meaningful Variables
Juveniles who offend against children are expected to have higher rates of sexual victimization than those who offend against peers or adults. A number of studies demonstrate such a finding, although they differ regarding whether the effect was noted for all juveniles with child victims (Ford & Linney, 1995; ‘t Hart-Kerkhoffs et al., 2009; Hummel, Thömke, Oldenbürger, & Specht, 2000), only those with male child victims (Worling, 1995), or those that have offended against both child and peer/adult victims (Richardson et al., 1997), and some studies did not find a significant difference (‘t Hart-Kerkhoffs et al., 2009; Hendriks & Bijleveld, 2004; Ronis & Borduin, 2007). A recent meta-analysis did find that juveniles with child victims were significantly more likely to have a history of sexual (but not physical) abuse than juveniles with peer/adult victims (Seto & Lalumière, 2010). Further evidence of differences between victim-age based subgroups is needed, given the mixed results to date, to support theories that propose a major etiological role for child sexual victimization in the development of offending against children.
Juveniles who offend against children are expected to have higher rates of mental health problems as well. Currently, evidence regarding differences in problems with anxiety is mixed (Hunter et al., 2003; Kempton & Forehand, 1992; Ronis & Borduin, 2007), although there is some consistent evidence that those with child victims are more likely to have internalizing problems (‘t Hart-Kerkhoffs et al., 2009; Hendriks & Bijleveld, 2004; van Wijk, van Horn, Bullens, Bijleveld, & Doreleijers, 2005). Research to date has found not found significant differences in externalizing symptoms between groups (‘t Hart-Kerkhoffs et al., 2009; Hendriks & Bijleveld, 2004; Kempton & Forehand, 1992; Richardson et al., 1997; Ronis & Borduin, 2007). Consistent findings that JSOs with child victims are more likely to have internalizing problems would demonstrate a potentially important difference in the etiology of offending against children that has implications for treatment planning.
Juveniles who offend against children are expected to have lower self-esteem and greater deficits in social skills than juveniles who offend against peers/adults. Although there is some support for greater problems in peer relationships among those who select child victims (Gunby & Woodhams, 2010; Hendriks & Bijleveld, 2004; Hunter et al., 2003; van Wijk, van Horn, et al., 2005), other research has not confirmed this hypothesis (Ford & Linney, 1995; Ronis & Borduin, 2007). The literature regarding differences in self-esteem is also inconsistent (Ford & Linney, 1995; Gunby & Woodhams, 2010). The inconsistent results cast doubt on the theory that poor social skills or peer relationships play a role in the etiology of offending against children, and further research is needed to clarify the mixed results to date.
Juveniles adjudicated for sexual crimes against peer/adult victims have been hypothesized to be more generally delinquent and antisocial than those who commit crimes against children. Some research demonstrates the expected difference in prior arrests (Ford & Linney, 1995; Kemper & Kistner, 2007; Richardson et al., 1997); however, other studies have not found a significant difference (Carpenter et al., 1995; Hendriks & Bijleveld, 2004; Hunter, Hazelwood, & Slesinger, 2000) or have found the reverse (Hunter et al., 2003). A recent meta-analysis found that those with only peer/adult victims were more likely to have indicators of delinquency risk or a history of arrests than those with any child victims (Seto & Lalumière, 2010). It is somewhat difficult to interpret these findings given the lack of differences identified when externalizing symptoms are studied; it is possible that a difference in arrest history or delinquency risk factors is more likely to be detected in correctional samples, although such differences were not found in all studies with such samples. Further research is needed to clarify whether JSOs with peer/adult victims are more generally antisocial.
If juveniles who offend against peers/adults are hypothesized to be similar to general delinquents, then the characteristics commonly seen in families of delinquents may be seen in this subgroup more frequently. Family risk factors for delinquency include poor parental monitoring, punitive or inconsistent discipline, emotionally distant parents, child physical abuse, low family income (Murray & Farrington, 2010), and witnessing family violence (Zinzow et al., 2009). There is some initial evidence that those who select peer/adult victims are more likely to have been exposed to inconsistent discipline and socioeconomic deprivation (Gunby & Woodhams, 2010). Findings regarding differences in exposure to family violence (Ford & Linney, 1995; Gunby & Woodhams, 2010; Richardson et al., 1997) and exposure to family criminality (Ford & Linney, 1995; Gunby & Woodhams, 2010) are inconsistent. Seto and Lalumière’s (2010) meta-analysis found no difference between these subtypes on family problems. If a consistent body of literature shows differences between subgroups in family characteristics, this would provide further evidence for the validity of the distinction between these groups. Additional research is needed given the inconsistent results to date.
Differences Consistently Found Between Victim-Age-Based Subgroups
Much of the research to date on victim-age-based subgroups focuses on subgroup differences that are not clearly tied to any theoretical expectations, yet these comparisons have produced the most consistent findings across studies. There is a variety of research suggesting that juveniles with peer/adult victims are more likely to use force or violence (Gunby & Woodhams, 2010; ‘t Hart-Kerkhoffs et al., 2009; Hendriks & Bijleveld, 2004; Hunter et al., 2000, 2003; cf. Richardson et al., 1997). There is also substantial evidence that juveniles with peer/adult victims are more likely than those with child victims to offend against strangers (Gunby & Woodhams, 2010; ‘t Hart-Kerkhoffs et al., 2009; Hendriks & Bijleveld, 2004; Hunter et al., 2000, 2003; Richardson et al., 1997). Juveniles who have any child victims (including mixed offenders) are more likely to offend against family members (Hunter et al., 2003; Kemper & Kistner, 2007) or acquaintances (Richardson et al., 1997). In addition, juveniles who have any child victims are consistently found to be more likely than those with only peer/adult victims to have offended against at least one male (‘t Hart-Kerkhoffs et al., 2009; Hendriks & Bijleveld, 2004; Hunter et al., 2000; Kemper & Kistner, 2007; Richardson et al., 1997). Although the importance of such differences is currently unclear, demonstrating similar differences in new samples suggests some comparability to prior research.
Risk to Reoffend/Recidivism
Theories regarding victim-age-based subgroups could reasonably lead to a hypothesis that those who offend against peers/adults will have higher general recidivism rates due to higher overall antisociality; however, the research to date has not found any significant differences in general or nonsexual rearrest rates (Hagan & Cho, 1996; Kemper & Kistner, 2007; Långström & Grann, 2000; Parks & Bard, 2006; Smith & Monastersky, 1986). In addition, there is evidence that juveniles with child victims and those with mixed victims score higher than juveniles with peer/adult victims on a risk assessment instrument designed for JSOs (Parks & Bard, 2006), yet research has consistently failed to demonstrate significant differences in sexual recidivism (Hagan & Cho, 1996; Hagan, Gust-Brey, Cho, & Dow, 2001; Kemper & Kistner, 2007; Långström & Grann, 2000; Parks & Bard, 2006; Rasmussen, 1999; Smith & Monastersky, 1986). Selecting male child victims is believed to be a risk factor for sexual recidivism in JSOs (Prentky & Righthand, 2003), perhaps because research has demonstrated that sexual interest in children (Hanson & Morton-Bourgon, 2005) and selection of male child victims (Hanson & Bussière, 1998) are associated with higher recidivism rates. In addition, the selection of child victims may be perceived as indicative of increased risk for sexual recidivism because child victims are more easily intimidated or coerced and less capable of making effective reports. Therefore, a potential difference in recidivism between victim-age-based subgroups is an important area for continued study, especially given the heightened emphasis in recent years on identifying high-risk youth (e.g., Elkovitch, Viljoen, Scalora, & Ullman, 2008; Prentky, Li, Righthand, Schuler, Cavanaugh, & Lee, 2010).
Study Rationale and Aims
Although there are a number of theoretically expected differences between victim-age-based subgroups of JSOs, consistent findings (or consistent null results) have been elusive to date. The most consistent results are for differences that are not clearly connected to etiological theory, treatment outcome, or recidivism, and thus the validity of making distinctions between groups based on victim age is uncertain. Additional research is needed to provide more evidence, where results have been inconsistent to date, and to shift the focus to theoretically relevant variables.
In addition, further research is required to address the limitations of the existing research. Many studies have been limited to juveniles in residential or correctional settings (e.g., Ford & Linney, 1995; Hagan & Cho, 1996; Hagan et al., 2001; Hunter et al., 2003; K. L. Kaufman, et al., 1996; Kemper & Kistner, 2007; Parks & Bard, 2006). Other studies have included youth not yet adjudicated for sexual offenses (‘t Hart-Kerkhoffs et al., 2009; Långström & Grann, 2000). Concerns regarding the generalizability of these types of samples suggest that additional research regarding juveniles participating in outpatient treatment is needed. In addition, a number of studies do not explicitly articulate the method used to classify victims as children or peers (e.g., Graves et al., 1996; Hagan & Cho, 1996; Hagan et al., 2001; Kempton & Forehand, 1992; van Wijk, van Horn, et al., 2005). Furthermore, many studies have relied exclusively on file reviews rather than interviews or assessment measures completed by the child or parent (e.g., Gunby & Woodhams, 2010; Hunter et al., 2000; Richardson et al., 1997). The inclusion of parent-report and the use of standardized assessment measures has been a rarity to date, and most studies include relatively few of the variables described above (for an exception, see Ronis & Borduin, 2007). Finally, the majority of studies have excluded offenders with both child and peer/adult victims.
The current study seeks to build on this existing literature by comparing JSOs from an outpatient treatment sample who were classified into one of three groups based on the age(s) of their victim(s): child victims (at least 4 years younger than offender), peer/adult victims, or both types of victims (referred to as mixed). The study draws on a comprehensive database that includes a wide range of variables gathered using a variety of methods and informants (i.e., self-report, parent-report, semistructured clinical interview, and legal documentation). The study focuses first on theoretically relevant variables, as differences on these variables inform the validity of this method of subtyping juvenile offenders. Second, we will examine some of the victim characteristics commonly studied in prior research, to demonstrate the comparability of our sample with previous studies. Finally, we will examine risk and recidivism, given the importance of identifying high-risk youth.
As compared to those with peer/adult victims, juveniles with child victims were hypothesized to: 1) have higher rates of sexual victimization but not physical abuse; 2) be more likely to be diagnosed with anxiety and affective disorders, but not other mental health diagnoses; 3) have more severe symptoms of depression, anxiety, posttraumatic stress, and general internalizing problems but will not differ in symptoms of externalizing problems or anger; 4) have more peer problems and lower social competence.
Given the theory- and research-based expectations that juveniles who offend against peer/adult victims are more generally antisocial, we hypothesize that that this group will: 5) be more likely to have a history of prior arrests; 6) score higher on a measure of antisocial tendencies; 7) demonstrate more problematic scores on scales assessing parenting practices and activities; 8) have higher rates of witnessing domestic violence.
Based on prior consistent findings in the literature, we hypothesize that juveniles with child victims will: 9) be more likely to have male victims and to have offended against a biological relative and 10) score higher on the Juvenile Sexual Offender Assessment Protocol–II (J-SOAP-II; and 11) not differ in recidivism rates.
Few studies have included offenders who have both child and peer/adult victims and a theoretical basis for making predictions regarding this group is lacking. Therefore, the current study will examine differences between this group and the other two groups of offenders in an exploratory manner, comparing groups on only those domains that have been studied in prior research with mixed offenders: mental health functioning, antisocial tendencies, victim characteristics, and recidivism.
Method
Participants
The participants in the current study included 176 males adjudicated for a sexual offense and court-ordered to participate in an outpatient treatment program. This treatment program is offered by the Services for Adolescent and Family Enrichment program at Western Psychiatric Institute and Clinic in collaboration with the Special Services Unit of the Allegheny County Juvenile Probation Department (hereafter the SAFE/SSU Program). This program has been described in detail previously (Kolko, Noel, Thomas, & Torres, 2004). Female offenders (n = 2) and youth with no identifiable victim (e.g., child pornography offenders, n = 19) were excluded from all analyses. Of the 176 youth included in this study, 114 (65%) selected only child victims, 50 (28%) selected only peer/adult victims, and 12 (7%) had mixed victims. Participants were classified into these groups based on information from legal records, rather than self-report.
The average age of the JSOs in this study was 15.27 (SD = 1.96) with a range from 10 years, 11 months to 19 years, 7 months. There were no significant differences between groups in age at the time of the baseline assessment, F(2, 173) = 0.07, p = .928. A total of 14 juveniles (8% of total sample) were age 18 or 19 at the time of their intake into the treatment program. In such circumstances, the youth committed the referral offense prior to his 18th birthday. Some data regarding race and ethnicity was not recorded (n = 37), but those who reported primarily indicated they were White, non-Hispanic (48%) or Black, non-Hispanic (44%). Only 1% of youth indicated Hispanic ethnicity, 1% were Asian/Pacific Islander, 4% were biracial, and 1% categorized themselves as Other. There was not a significant difference in the proportion of racial/ethnic minority youth between groups, likelihood ratio (2) = 3.64, p = .163. Very few participants had a prior nonsexual (9%) or sexual (0.6%, n = 1) conviction. Based on legal records, the juveniles in this sample had an average of 1.22 victims each, with a range from 1 to 8 and a mode of 1 (86% of juveniles). The victims of these youth ranged from 2 to 74 years of age. When using the age of the youngest victim for offenders with multiple victims, the average victim age was 9.81 years (SD = 4.55). The majority of juveniles had only female victims (74%), with almost a quarter offending against only males (24%) and only 2% offending against both females and males. Very few juveniles offended against a stranger (3%), 26% offended against a biological relative, and the remainder offended against acquaintances or nonbiological relatives. A substantial minority of the participants were diagnosed upon intake (using the K-SADS-PL, see below, available for 168 participants) with a disruptive behavior disorder (41%), with 34% of the sample meeting criteria for attention deficit hyperactivity disorder, 9% for conduct disorder, and 12% for oppositional defiant disorder. Other mental health diagnoses were less common (7% met criteria for an anxiety disorder, 3% for an affective disorder, 2% for a substance use disorder). Overall, 66% of the sample met diagnostic criteria for at least one mental health diagnosis.
Program Orientation and Assessment Procedures
Juveniles adjudicated for a sexual offense were referred to the SAFE/SSU treatment program based on a judge’s decision that the juvenile required sex offender–specific treatment and could be treated safely in the community. Each family was invited to participate in a separate, completely voluntary research protocol which was approved by the University of Pittsburgh Institutional Review Board. Both parental consent and youth assent were required for use of the data for research purposes. The intake and discharge assessments were part of the routine treatment protocol and were completed by all juveniles who entered treatment. Follow-up assessments were conducted solely for research purposes for the 2 years following treatment discharge. The juvenile and caregiver received compensation for participating in all assessments (US$10 each at intake, US$20 each at discharge and both 1-year and 2-year follow-up assessments).
Measures
Participants in the study completed a wide range of measures (see Kolko et al., 2004). Only those used in the current analysis are reviewed here.
Abuse history
To address Hypothesis 1, we used information about participants’ history of maltreatment as drawn from several sources.
Items from the Schedule for Affective Disorders and Schizophrenia for School Aged Children–Present and Lifetime Version (K-SADS-PL)
When clinicians completed the K-SADS-PL (J. Kaufman, Birmaher, Brent, Rao, & Ryan, 1996) section on PTSD (see detailed description of K-SADS-PL below), they first provided a present/absent rating for a variety of traumatic experiences, including physical abuse, sexual abuse, and witnessing domestic violence. This rating was made independently of ratings of posttraumatic stress symptoms. This was the most inclusive (i.e., had least missing data) of all measures that assessed child maltreatment. We rated each type of maltreatment as present if the clinician indicated the experience happened based on their interview of either the parent or the child. Ratings regarding whether the juvenile witnessed domestic violence will be used to address Hypothesis 8.
Items from the Adolescent Clinical Sexual Behavior Inventory (ACSBI)
In addition, parent- and self-report will be examined based on specific items from the ACSBI (Friedrich, Lysne, Sim, & Shamos, 2004). The ACSBI “was designed for use in a clinical sample to assess sexual risk tasking, nonconforming sexual behaviors, sexual interest, and sexual avoidance/discomfort” (Friedrich et al., 2004, p. 241). In three individual items on the ACSBI (Items 47, 48, and 49), participants and their parents were asked to rate the likelihood the participants experienced physical, sexual, and emotional abuse on a scale from 0 (not likely) to 4 (definitely). These scores were dichotomized into no abuse (score of 0) or possible abuse (score of 1 to 4) based on parent report and child report separately.
Mental health
Several sources will be used to test Hypotheses 2 and 3, including mental health diagnoses as well as symptom rating scales.
Mental health diagnoses based on K-SADS-PL
Diagnoses were made at the time of intake based on the K-SADS-PL (J. Kaufman, et al., 1996), a semistructured interview designed to assist in the assessment of major mental disorders in school aged children. Clinicians made diagnoses based on information from both the child and parent, as well as any collateral information available. The K-SADS-PL has been demonstrated to have concurrent validity and excellent interrater and test-retest reliability (Kaufman et al., 1997).
Symptom severity, Trauma Symptom Checklist for Children (TSCC)
In addition, juveniles completed the TSCC (Briere, 1996). The TSCC was developed to provide a self-report evaluation of current trauma-related symptoms or distress in children and adolescents (ages 8-16) who have been exposed to unspecified traumatic events. The TSCC was standardized on a large sample of diverse children and provides norms according to age and gender, as well as clinical cutoff scores. In general, studies of the TSCC have demonstrated good internal consistency, concurrent validity, and predictive validity (Lanktree & Briere, 1995; Sadowski & Friedrich, 2000). The sample included 35 participants above age 16, for whom scores were derived using the age 16 norms. There are no hypotheses for two scales (Dissociation and Sex Concerns), but they are included for exploratory purposes. In addition, given the high likelihood of underreporting by many juveniles participating in intake evaluations for a court-ordered treatment program, scores on the Underreporting scale of the TSCC will also be investigated.
Symptom severity, Child Behavior Checklist (CBCL)/Strengths and Difficulties Questionnaire (SDQ)
The child’s primary caretaker completed either the CBCL (Achenbach & Rescorla, 2001) or the SDQ (Goodman, 1997). The CBCL provides a dimensional assessment of an array of behavioral and emotional problems and competencies (Achenbach & Rescorla, 2001). This instrument has been used in a multitude of studies, with strong support for its utility (Achenbach, 2005). In this study, only the higher order scales of externalizing and internalizing symptoms are used. For 35 participants, the CBCL was replaced by the briefer SDQ. The SDQ also yields a comprehensive set of ratings regarding the severity of the child’s clinical problems and competencies. These two instruments have demonstrated similar accuracy in screening for psychiatric disorders, with good sensitivity and specificity in identifying disruptive behavior disorders (Warnick, Bracken, & Kasl, 2008), and scores on the externalizing and internalizing problems scales on the SDQ are highly correlated with the equivalent scores on the CBCL (r = .84, r = .74, respectively; Goodman & Scott, 1999). Therefore, to include as much data as possible, the CBCL Externalizing and Internalizing T-scores and the SDQ Externalizing and Internalizing raw scores were each standardized, and whichever standardized score was available was used. Although these variables are not equivalent given that the T-score is based on normative data, this was considered the most useful way to include all of the data.
Social skills
To test Hypothesis 4, information regarding social competence and peer problems were drawn from two measures.
Social competence
For those youth whose parents completed the CBCL, groups are compared on the Social Competence scale. The Prosocial scale of the SDQ was not combined with the Social Competence scale due to significant differences in item content.
Social/peer problems
In addition, as was done regarding the externalizing and internalizing scales, the CBCL Social Problems and the SDQ Peer Problems scales were standardized and then combined into one variable. These two scales are moderately highly correlated (r = .59; Goodman & Scott, 1999).
Criminal history/antisocial tendencies
Legal records of prior arrests and scores on the Antisocial Process Screening Device will be used to address Hypotheses 5 and 6.
Prior arrests
The intake packet includes information about prior court involvement and any prior arrests. A dichotomous variable reflecting any prior arrest will be used rather than a continuous measure of number of arrests because the vast majority of youth had either zero or one prior arrest.
Antisocial Process Screening Device (APSD)
The APSD (Frick & Hare, 2001) was developed to assess psychopathy-related characteristics in young children based on parent ratings. The measure includes 20 items (0-2 scale) that form three factors (callous/unemotional traits, narcissism, impulsivity; Frick, Bodin, & Barry, 2000). The measure has acceptable psychometric properties, including test-retest reliability, internal consistency, and concurrent and predictive validity (e.g., Frick et al., 2000; Poythress, Dembo, Wareham, & Greenbaum, 2006). This measure has been standardized in a large sample of community youth (Frick et al., 2000). The APSD manual indicates that the instrument is designed for youth aged 6 to 13, but prior research has demonstrated acceptable psychometric properties of the self- and parent-report versions of this measure to assess youth up to age 21 (e.g., Bijttebier & Decoene, 2009; Kruh, Frick, & Clements, 2005; Muñoz & Frick, 2007; Sadeh, Verona, Javdani, & Olson, 2009).
Family functioning/parenting practices
To test Hypothesis 7, the Alabama Parenting Questionnaire (APQ; Shelton, Frick, & Wootton, 1996) was used to gather information about family functioning. The APQ is a parent-reported measure and evaluates six common dimensions of parenting practices and activities (e.g., involvement, positive parenting, corporal punishment) related to antisocial behavior. The APQ has demonstrated good internal consistency and construct validity in a variety of cultures (e.g., Dadds, Maujean, & Fraser, 2003; Essau, Sasagawa, & Frick, 2006; Shelton et al., 1996).
Victim characteristics
Victim characteristics, including the gender of victims and the presence of a biological relationship between victim and offender, were coded from legal documentation provided by the court to test Hypothesis 9.
Risk to reoffend/recidivism
To test Hypotheses 10 and 11, data from the J-SOAP-II and from legal records regarding rearrest were used.
J-SOAP-II
A small subset of the participants (n = 32; 21 with child victims, 9 with peer/adult victims, 2 with mixed victims) were scored on the J-SOAP-II (Prentky & Righthand, 2003) at treatment intake. The J-SOAP-II has evidence of reliability and construct validity, although further research is needed to establish predictive validity for sexual reoffending (Caldwell & Dickinson, 2009; Caldwell, Ziemke, & Vitacco, 2008; Elkovitch et al., 2008; Martinez, Flores, & Rosenfeld, 2007; Parks & Bard, 2006; Prentky, Harris, Frizell, & Righthand, 2000; Prentky et al., 2010; Righthand, Prentky, Knight, Carpenter, Hecker, & Nangle, 2005; Viljoen et al., 2008). Given the small number of youth with J-SOAP-II scores available, only the total score will be examined.
Rearrest
At the time of this analysis, 149 of the 176 youth included in this study had been discharged from the treatment program, and recidivism data were available for 102 juveniles. Recidivism data were collected from official juvenile court records at approximately the same time as the follow-up evaluations (1 year and 2 years after discharge from the program). Recidivism data were unavailable for 47 youth, either because they had not reached the 1-year follow-up time point or their records were not able to be located. Overall, 15% of participants had any posttreatment arrests and 2% had any posttreatment arrests for sexual offenses. Information about subsequent incarceration or treatment in residential facilities was not available; therefore, recidivism analyses do not account for time at risk in the community.
Data Analysis
Juveniles with child victims and those with peer/adult victims were compared first, followed by a more limited set of analyses comparing both groups with those with mixed victims. Comparisons between juvenile with child victims and those with peer/adult victims were made using chi-square analyses to test for differences in categorical variables, and t tests were used to test for differences in continuous variables. In all analyses involving continuous variables, Levene’s test of homogeneity of variance was first examined; if significant, the t test with equal variances not assumed was used. The Levene’s test is only reported if it indicated significantly different variance between groups. The current study is quite exploratory in nature, despite the reliance on past research to select variables of interest. As a result, a large number of comparisons are made, increasing the risk of Type I error. Therefore, significance values below .01 will be considered significant rather than the more traditional .05 significance value. Significance will be indicated at the .05 level for the Levene’s test of homogeneity of variance to ensure that appropriately conservative tests are used. Analyses that included all three subgroups (those with child victims, peer/adult victims, and mixed victims) used ANOVA for continuous variables and the likelihood ratio test for categorical variables, which is more appropriate than a chi-square test when at least one cell of the analysis has an expected value less than 5 (Field, 2009).
Results
Juveniles With Child Victims Compared With Juveniles With Peer/Adult Victims
Abuse history
There were no significant differences between groups on self- or parent-reported physical, sexual, or emotional abuse based on the ACSBI abuse items or based on clinicians’ ratings of the presence of each type of maltreatment on the K-SADS-PL (see Table 3). There is a nonsignificant trend for the parents of juveniles with child victims to report that their child was a victim of sexual abuse on the relevant ACSBI item more often than the parents of juveniles with peer/adult victims.
Comparisons Between Juveniles With Child Victims and Those With Peer/Adult Victims
Note: K-SADS-PL = Schedule for Affective Disorders and Schizophrenia for School Aged Children–Present and Lifetime Version, ACSBI = Adolescent Clinical Sexual Behavior Inventory, APSD = Antisocial Process Screening Device, TSCC = Trauma Symptom Checklist for Children, CBCL = Child Behavior Checklist, SDQ = Strengths and Difficulties Questionnaire, APQ = Alabama Parenting Questionnaire, J-SOAP-II = Juvenile Sex Offender Assessment Protocol–II. °Fisher’s Exact Test used because at least one cell has an expected count less than 5. Maximum scores on the APSD scales are 14 for Narcissism, 10 for Impulsivity, and 12 for Callous-Unemotional. TSCC scores are T-scores (M = 50). CBCL/SDQ Internalizing, Externalizing, and Social/Peer Problems are z scores. CBCL Social Competence score is a T-score (M = 50). Maximum scores on the APQ scales are 50 for Involvement, 30 for Positive Parenting, 50 for Poor Monitoring, 30 for Inconsistent Discipline, and 15 for Corporal Punishment.
Levene’s test F = 4.15, p = .044.
Levene’s test F = 4.16, p = .044.
Mental health
There were no significant differences between juveniles with child victims and juveniles with peer/adult victims on any mental health variables (see Table 3). Juveniles with child victims were marginally more likely to have an anxiety disorder diagnosis, and juveniles with peer/adult victims were marginally more likely to have a substance use disorder. In addition, juveniles with child victims scored marginally higher on the Depression scale of the TSCC.
Social skills
There were no significant differences between groups on the Social Competence scale of the CBCL or on the combined CBCL/SDQ variable indicating social/peer problems (see Table 3).
Criminal history/antisocial tendencies
There were no significant differences between groups on any indicators of criminal history or antisocial tendencies (see Table 3).
Family functioning/parenting practices
There was a significant difference between groups on poor monitoring on the APQ. The parents of juveniles with peer/adult victims reported greater problems in monitoring than the parents of juveniles with child victims. There were no other significant differences between groups on family functioning or parenting practices. Clinicians indicated that juveniles with child victims had witnessed domestic violence at a marginally higher rate than juveniles with peer/adult victims.
Victim characteristics
There were significant differences between groups on both victim characteristics studied: any male victims and any biological relative victims (see Table 3). Juveniles with child victims were more likely to have a male victim and more likely to have a biologically related victim.
Risk to reoffend/recidivism
There was not a significant difference between groups on J-SOAP-II total score (see Table 3). There was not a significant difference in rearrest for sexual offenses, but there was a difference in general recidivism rates, with juveniles with peer/adult victims having a higher rearrest rate than juveniles with child victims.
Comparisons Including All Three Subgroups
Mental health
There were no significant differences between groups in rates of mental health diagnoses when juveniles with mixed victims were included in analyses (see Table 4). There were marginal differences in rates of anxiety disorder and substance use disorder. In both categories of diagnosis, juveniles with mixed victims appeared to be more similar to juveniles with child victims than those with peer/adult victims.
Select Comparisons of Juveniles With Child Victims, Peer Victims, and Both Types of Victims
Note: LR = Likelihood Ratio statistic, used when ≥1 cell had an expected count less than 5. K-SADS-PL = Schedule for Affective Disorders and Schizophrenia for School Aged Children–Present and Lifetime Version, APSD = Antisocial Process Screening Device. Maximum scores on the APSD scales are 14 for Narcissism, 10 for Impulsivity, and 12 for Callous-Unemotional.
Criminal history/antisocial tendencies
There were no significant differences between groups on rates of previous arrests or scores on the APSD (see Table 4).
Victim characteristics
Differences in rates of offending against males and against biological relatives remained significant when mixed offenders were included in the analyses (see Table 4). Juveniles with mixed victims appeared more similar to those with peer/adult victims in victim selection.
Recidivism
There was a marginal difference between groups in general rearrest rates, with juveniles with peer/adult victims having the highest rate of general rearrest. There was not a significant difference in sexual rearrest rates.
Discussion
In a sample of juveniles adjudicated for sexual offenses mandated to an outpatient treatment program, a comparison of subgroups based on the ages of their victim(s) revealed more similarities than differences. The few differences identified, however, were consistent with hypotheses drawn from theory and prior research. The results relevant to each hypothesis will be discussed in the context of the existing literature. The study’s limitations and clinical implications will also be addressed.
There were no significant group differences in rates of sexual victimization, which was contrary to Hypothesis 1 but not unprecedented (‘t Hart-Kerkhoffs et al., 2009; Hendriks & Bijleveld, 2004; Ronis & Borduin, 2007). There are several possible explanations for this. First, Worling (1995) noted that juveniles who offend against male children are more likely than other juveniles to have a history of sexual victimization. The current sample included relatively few youth with male victims, perhaps limiting the ability to detect such a difference. Second, it is possible that sexual abuse serves as a risk factor for engaging in sexually abusive behaviors in general rather than specifically for committing offenses against children (e.g., Johnson & Knight, 2000; Seto et al., 2010; Sigurdsson, Gudjonsson, Asgeirsdottir, & Sigfusdottir, 2010). Consistent with this hypothesis, the rate of experiencing child sexual abuse was higher across groups than that found in general population males (7.5% lifetime prevalence; Finkelhor, Turner, Ormrod, & Hamby, 2009) regardless of informant (12% based on child report, 14% based on clinician ratings that abuse occurred, 24% based on parent report). The marginal effect regarding sexual victimization based on parent report may be the result of parents reporting that their child may have been abused because it is a potential explanation for their child’s behavior rather than because they are aware of a specific incident of sexual abuse. Indeed, of the parents who indicated possible sexual abuse, only 34% indicated their child was “definitely” abused, with the majority indicating that such abuse might have happened. Overall, the current results do not support theories that postulate a major role for childhood sexual victimization in the development of sexual offending against children (e.g., Hall & Hirschman, 1992; Seto & Lalumière, 2010; Ward & Siegert, 2002), although findings from previous research suggest this variable may be important (Seto & Lalumière, 2010).
Contrary to Hypotheses 2 & 3, there were no significant differences between groups in mental health problems, including internalizing symptoms and disorders. There was a marginal difference in rates of anxiety disorder diagnosis, and it is notable that no juveniles with peer/adult victims met criteria for an anxiety disorder. Unexpectedly, there was also a marginal difference in rates of substance use disorder, and again, although not significant, it is notable that no juveniles with child victims met criteria for a substance use disorder. Prior research on mental health differences between juveniles with child victims and those with peer/adult victims has been mixed, although there is more support for differences in internalizing than externalizing problems. The lack of significant differences in externalizing symptoms and disorders in the current study is consistent with Hypothesis 3 as well as prior research on externalizing symptoms (Kavoussi, Kaplan, & Becker, 1988), in that overall rates of disruptive behavior disorder diagnosis were high (with general population prevalence rates of ODD and CD being estimated at 3.2% and 3.3%: Canino, Polanczyk, Bauermeister, Rohde, & Frick, 2010; 3.3% prevalence rates for ADHD: Polanczyk et al., 2010), but there were no differences between groups on externalizing symptoms or diagnoses. The implications of potential differences in mental health problems between groups for theories positing a role for psychopathology in the development of sexual offending against children is unclear as all research that has studied this question, including the present study, relied on assessments made after the offense occurred. Nonetheless, there is a pattern across studies suggesting greater anxiety and internalizing problems in juveniles with child victims, which suggests that internalizing symptoms may be more likely to be a focus of treatment in this subgroup.
There were no significant differences between groups on peer problems and social competence in the current study, contrary to Hypothesis 4, and prior research on this topic is mixed. Social skills training is commonly included in treatment programs for adolescents (used by 94% of community and 99% of residential programs; McGrath, Cumming, Burchard, Zeoli, & Ellerby, 2010). Such treatment may be justified by a possible link to recidivism in juvenile populations (Kenny, Keogh, & Seidler, 2001; although not in adult sex offenders, Mann et al., 2010), but given the inconsistency of research on this topic to date, there is little basis for assuming that juveniles with child victims have a greater need for such treatment than those with peer/adult victims.
Based on theory and research on both juveniles (e.g., Seto & Lalumière, 2010) and adults (e.g., Harris et al., 2009; Olver & Wong, 2006), we hypothesized that juveniles with peer/adult victims would be more generally antisocial than those with child victims (Hypotheses 5 and 6). The current study did not detect any differences between groups in past arrests or in antisocial tendencies; however, very few participants had a history of arrests. It is possible that juveniles with more arrests were considered too dangerous for outpatient treatment, resulting in a highly selected, low-risk sample. If this is the case, the low scores on the APSD in the current sample would also be expected, and thus the lack of significant differences should be interpreted very cautiously. If further research supports the hypothesis that juveniles with peer/adult victims are more generally antisocial (e.g., Seto & Lalumière, 2010), the application of empirically supported interventions designed for the treatment of general delinquency, such as multisystemic therapy (MST) and functional family therapy (e.g., Henggeler & Sheidow, 2003), may be especially effective in the treatment of juveniles with peer/adult victims. Such approaches may prove useful with all JSOs regardless of victim type, given research that suggests all JSOs have similarities to general delinquents (e.g., Ronis & Borduin, 2007; van Wijk, Loeber, et al., 2005) and given that MST has been shown to be efficacious in treating JSOs (e.g., Letourneau et al., 2009). Alternatively, outpatient samples like those in the current study may have relatively little in common with general delinquent samples, given the rarity of prior arrests and low scores on a measure of antisocial tendencies. Less intensive interventions may therefore be warranted, and empirically supported treatments for low-risk delinquents may prove useful.
The current study found only one significant difference on a standardized measure of parenting practices consistent with Hypothesis 7: the parents of juveniles with peer/adult victims reported more problems in monitoring their children. Poor monitoring has been associated with general delinquent activity in a variety of research (e.g., Hoeve et al., 2009); the current findings suggest it might play a similar role in sex offenses committed against peers/adults. Recent longitudinal research has found that active efforts to monitor adolescents’ behavior has no effect on future delinquency, suggesting that previous results may be more indicative of the effect of youth disclosure rather than active monitoring activities (Kerr, Stattin, & Burk, 2010). Nonetheless, changes in parenting practices have been shown to partially mediate the effect of MST on reoffense in general delinquent offenders (Huey, Henggeler, Brondino, & Pickrel, 2000) as well as problematic sexual behaviors in a sample of JSOs (Henggeler et al., 2009). Thus, despite current controversies in the field regarding parental monitoring efforts, treatment focused on parenting practices is likely to improve outcomes for JSOs. This may be particularly important for juveniles with peer/adult victims; however, treatment that includes the family has been shown to be effective for mixed samples of JSOs (e.g., Borduin, Schaeffer, & Heiblum, 2009; Letourneau et al., 2009; Worling & Curwen, 2000), therefore family functioning is an appropriate treatment target regardless of victim type.
Contrary to Hypothesis 8, there was not a significant difference between groups in rates of witnessing domestic violence. Furthermore, the marginal effect suggested that those with child victims, rather than those with peer/adult victims, had somewhat higher rates of this experience. Potential explanations for an association between witnessing domestic violence and offending against children are not clear, however, and further research is needed to clarify the role of this experience. In addition, it is notable that there were high rates of witnessing domestic violence and emotional abuse (parent reported) across groups. The rates of these forms of maltreatment in the current sample (47% and 56%, respectively) appear markedly higher than in the general population, as 20.3% of a large, nationally representative sample reported witnessing a family assault and 10.9% reported experiencing emotional abuse (Finkelhor, Turner, Ormrod, & Hamby, 2009). Witnessing domestic violence and experiencing emotional abuse both have been shown to have serious long-term consequences for children (e.g., Chan & Yeung, 2009; Kitzmann, Gaylord, Holt, & Kenny, 2003; Spinhoven et al., 2010; van Harmelen et al., 2010). Witnessing domestic violence is a risk factor for general delinquent behavior (e.g., Zinzow et al., 2009) and has been found to be a risk factor for sexual coercion in a community sample (Sigurdsson et al., 2010). Experiencing emotional abuse has also been shown to be associated with sexual aggression perpetration (among females) and victimization (among males; Zurbriggen, Gobin, & Freyd, 2010). Future research on JSOs should include these forms of child maltreatment, given their potentially important etiological role and the relative dearth of research on each in the JSO literature. In addition, in providing treatment for the child’s own traumatic experiences, clinicians should explore potential traumatization subsequent to witnessing family violence and experiencing emotional abuse, just as for sexual and physical abuse.
Consistent with prior research and with Hypothesis 9, juveniles with child victims were more likely to offend against biological relatives and males than juveniles with peer/adult victims. Neither of these differences support any particular theoretical explanation of the etiology of sexually abusive behaviors nor are there clear indications that such victim characteristics are associated with unique risks or needs that should be addressed in treatment. These victim characteristics may reflect situational factors (e.g., ease of access to young family members) rather than indicating anything particular about the offender in question. Additional research is needed to clarify the significance of these differences in victim characteristics and to determine whether they merit different treatment approaches.
There were no differences in J-SOAP-II scores in the current study, in contrast to prior research and Hypothesis 10. Very few participants had been scored on the J-SOAP-II, and therefore this may be due to lack of power rather than a lack of true differences between groups. In contrast to Hypothesis 11, juveniles with peer/adult victims had higher general rearrest rates than those with child victims. This difference is consistent with the hypothesis that juveniles who select peer/adult victims are more generally antisocial than those who select child victims, but no other studies to date have found higher general recidivism rates among juveniles with peer/adult victims (see Table 2). Thus, there is not sufficient basis to assume this group presents greater risk. The lack of significant differences in sexual recidivism is consistent with prior research directly comparing subtypes; however, a meta-analysis found that offending against any victims significantly different in age (i.e., any victim other than a peer) was associated with sexual recidivism (McCann & Lussier, 2008). As most studies, including the current one, did not separate juveniles with adult victims from those with peer victims, existing comparisons may underestimate the relevance of victim age for recidivism risk. Based on existing research, there is little reason to recommend that one group receive more intensive treatment or be subject to more restrictive social control policies than another.
Comparisons including offenders with both types of victims were included for exploratory purposes, focusing on characteristics that have been included in previous research. The results indicate that those with mixed victims appear similar to offenders with child victims in some respects (e.g., mental health diagnoses) and appear more similar to offenders with peer/adult victims in other respects (e.g., victim characteristics). We were unable to examine some characteristics that appear specific to those with mixed victims based on prior research (e.g., those with mixed victims have been found to have an earlier age of onset and longer duration of offending than both other groups; Richardson et al., 1997). More research is needed, with larger samples of mixed offenders, before conclusions can be drawn regarding this group.
Clinical Implications
In low-risk outpatient samples, juveniles may be quite similar in their maltreatment experiences, antisocial tendencies, mental health functioning, family functioning, and recidivism risk regardless of victim type and thus may benefit from participation in largely similar intervention programs. Existing research indicates that these interventions should be based in a cognitive-behavioral (e.g., Worling & Curwen, 2000) or multisystemic approach (e.g., Borduin et al., 2009; Letourneau et al., 2009). It is likely that low-risk outpatient samples similar to this one would benefit from MST, but it seems important to empirically examine whether less intensive interventions based on parallel treatment methods or principles would be comparably efficacious with this population. Among all JSOs, posttraumatic stress symptoms, histories of child maltreatment, and exposure to negative parenting may be a focus of clinical attention in the case of a given adolescent. It is possible that adolescents with child victims could benefit from additional programming to address the motivation for targeting children and from cognitive behavioral interventions targeting symptoms of depression and anxiety. In contrast, interventions focused on improved family functioning, including increased parental monitoring, may be particularly beneficial for adolescents with peer/adult victims. As noted above, however, such treatment may benefit all JSOs, as improved family functioning has been shown to reduce recidivism, out-of-home placements, and inappropriate sexual behaviors in general samples of JSOs (e.g., Borduin et al., 2009; Letourneau et al., 2009). For all adolescents, treatment should be individualized to address the risks and needs presented by each juvenile. It is not clear that the selection of a particular type of victim is indicative of unique risks and needs, and thus victim selection may not have a major influence on treatment planning in low-risk outpatient samples.
Limitations
The current study has several limitations. First, the sample includes only youth who were considered appropriate for outpatient treatment. Low-risk, community-treated youth have been studied less often than those in residential or correctional settings; therefore, although the results of the current study may not generalize to higher risk samples, the study provides important information about juveniles treated in community contexts. Another limitation, possibly related to the first, is the small number of mixed offenders included in the current sample. Individuals with both types of victims may have been perceived to present a greater risk and may have been ordered into a secure treatment setting more frequently than to outpatient treatment. The current study is not able to draw any firm conclusions about mixed offenders given how few were present in the sample. Third, much of the information included in this study relied on self- or parent-report. The youth and their families may have been motivated to underreport problem behaviors, as they were hoping for a short course of treatment and seeking to avoid any negative consequences from disclosure (e.g., a report to child protective services of a new victim). About 20% of the sample scored in the clinically significant range on the Underreporting scale of the TSCC. Underreporting could have limited the ability of the current study to detect true differences, particularly in mental health variables, although this is notably also the case for the majority of research on JSO subgroups. Fourth, it is impossible to determine based on the current data whether mental health symptoms and diagnoses existed prior to adjudication (i.e., at the time of the offense) or developed subsequent to adjudication. Differences that exist at the time of the offense could be related to the etiology of the offending behaviors, whereas the importance of differences that emerge later is unclear. A fifth limitation of the current study is the presence of missing data. Using data from a program that has treatment delivery (rather than research) as a primary goal may be associated with such missing data, as other interests must take priority at times. There is no reason to suspect that one group was less likely to complete any particular measure than another group. Some measures were changed over time to serve the needs of the treatment program (e.g., to shorten intake assessments, the SDQ replaced the CBCL). Thus, the missing data are not likely to create any bias in the current results. Finally, the current study is unable to control for time at risk in the community in the analysis of recidivism and only includes juvenile referrals in Allegheny County. Some juveniles may have remained in facilities for the majority or the entirety of the follow-up period, giving them little or no opportunity to reoffend. Some may have reached the age of majority before reoffending, with the resulting charge being processed in criminal, rather than juvenile, court or may have offended in another jurisdiction. Results regarding recidivism should thus be interpreted particularly cautiously.
Conclusions and Future Directions
Overall, few of the theoretically based hypotheses regarding differences between these subtypes were supported in the current study. Combined with the inconsistent results of previous research, the current study casts doubt on the validity of theories hypothesizing differences between victim-age-based subgroups, at least as applied in a low-risk outpatient setting. This distinction has proven meaningful in adult offenders, but the current study adds to a literature that does not consistently demonstrate that these subgroups are different on psychologically meaningful variables.
Several future research directions follow from the relative lack of significant differences between victim-age-based subgroups. First, research on these subgroups has been limited by the reliance on selected samples. A large court-based study that includes juveniles who present a wide range of backgrounds, risk levels, and dispositions would enable a more definitive determination of differences between groups. Such research should include standardized measures assessing theoretically relevant constructs. Such research would provide a more definitive test of theories regarding differences between these subtypes. Second, the lack of consistency of findings regarding victim-age-based subgroups suggests that other methods of subtyping may prove more meaningful, such as using criminal history (e.g., Butler & Seto, 2002; Chu & Thomas, 2010) or personality measures (e.g., Smith, Monastersky, & Deisher, 1987; Worling, 2001). Further research on subtypes may be more productive if these methods, rather than a continued focus on victim type, are used. Finally, future research should focus on whether risk-assessment measures function differently in different subgroups (Rajlic & Gretton, 2010) and whether subgroups demonstrate a differential response to treatment as in research conducted with children with sexual behavior problems (Pithers, Gray, Busconi, & Houchens, 1998). Such research has the potential to more directly demonstrate the treatment needs of these juveniles, improve risk assessment methods, and enhance treatment practices with this population.
Footnotes
Acknowledgements
The authors acknowledge the support of the Allegheny County Juvenile Court, probation officers from the Special Services Unit, and the clinical and research staff of the Services for Adolescent and Family Enrichment (SAFE) program, especially Eunice Torres, MS.
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article:
This treatment program was supported, in part, by the Allegheny County Juvenile Court.
