Theory-Based Assessment, Treatment, and Prevention of Sexual Aggression

263 Pages·1996·13.22 MB·English

by  Gordon C. Nagayama Hall

Theory-Based Assessment,
Treatment, and Prevention
of Sexual Aggression
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Theory-Based Assessment,
Treatment, and Prevention
of Sexual Aggression
GORDON C. NAGAYAMA HALL
New York Oxford
OXFORD UNIVERSITY PRESS
1996
Oxford University Press
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Copyright © 1996 by Oxford University Press, Inc.
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All rights reserved. No part of this publication may be reproduced,
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without the prior permission of Oxford University Press.
Library of Congress Cataloging-in-Publication Data
Hall, Gordon C. Nagayama.
Theory-based assessment, treatment, and prevention of sexual
aggression / Gordon C. Nagayama Hall.
p. cm.
Includes bibliographical references and index.
ISBN 0-19-509039-X
1. Sex crimes. 2. Sex offenders. I. Title.
[DNLM: 1. Sex Offenses —prevention & control. 2. Aggression-
psychology. 3. Models, Psychological. WM 611 H176t 1996]
RC560.S47H35 1996
616.85'83-dc20
DNLM/DLC 95-14353
for Library of Congress
987654321
Printed in the United States of America
on acid-free paper
To Uni, Zomi, and Nathan
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Preface
Sexual aggression is a pervasive social problem, with devastating and
sometimes permanent effects on victims. Unlike other problems of ag-
gression, however, there has been a disproportionate amount of atten-
tion paid to victim-based methods of preventing sexual aggression. Per-
haps the lack of emphasis on perpetrators of sexual aggression reflects
society's denial of responsibility for sexually aggressive behavior. Sexu-
ally aggressive behavior is interpreted by some perpetrators as simply an
assertion of the masculine role. Thus, a societal emphasis on perpetrators
would constitute an admission, particularly on the part of males, of a
shared responsibility for the existence of sexually aggressive behavior.
The emphasis in this book is on perpetrators and potential perpetra-
tors of sexually aggressive behavior. Insofar as the vast majority of sex-
ual aggressors are male, the focus of this book is on male perpetrators.
In the introduction, I make a case for an emphasis on perpetrators in
addressing the problem of sexual aggression.
The literature on the assessment and treatment of sexually aggressive
behavior has reached a level of development that warrants critique as
well as integration. There is a relatively large body of literature on clini-
cal interventions with sexual offenders. However, there have been few
attempts to integrate this literature into a theoretical framework. Those
attempts at building theoretical frameworks have tended to be too com-
plex to guide clinical applications. The goal of this book is to develop
the quadripartite model of sexual aggression (Hall & Hirschman, 1991,
1992; Hall, Shondrick, & Hirschman, 1993a) that is comprehensive, yet
sufficiently parsimonious for research, clinical, and preventive appli-
cations. The quadripartite model suggests that physiological sexual
arousal, cognitive distortions, affective dyscontrol, and developmentally
related personality problems are motivational precursors of sexually ag-
gressive behavior. In addition, I attempt to integrate theory and research
from the developmental, sexuality, aggression, and social psychological
literature that is relevant to sexual aggression.
The sexual offenders who have been studied in the clinical interven-
tion literature constitute a minority of all sexual aggressors. Most sexual
aggressors are not apprehended and convicted of their offenses and,
consequently, are not seen in clinical settings. Thus, the majority of
sexual aggressors do not receive any form of intervention, and preventive
efforts that encompass large groups of males are needed. However, simi-
viii Preface
lar to most treatment interventions, most prevention programs have tar-
geted potential victims of sexual aggression. The section in this book on
prevention is an attempt to review what is known from prevention sci-
ence and to apply it to the prevention of sexually aggressive behavior.
The book is divided into four parts: theories, assessment, treatment,
and prevention. Chapters 2, 4, and 6 review the general literature on
theories, assessment, and treatment of sexually aggressive behavior.
Chapters 3,5, and 7 review my own work in these areas in the context
of the quadripartite model. Because theory development of sexually ag-
gressive behavior has been somewhat limited, I integrate aspects of theo-
ries of nonsexual aggressive behavior, many of which are quite sophisti-
cated and carefully articulated, in chapters 2 and 3. The material in
chapters 4, 5, 6, 7, and 8 specifically focuses on the assessment and
treatment of sexual aggressors. I describe specific clinical applications of
the quadripartite model to assessment of sexual aggressors in chapter 5
and to treatment of sexual aggressors in chapter 7.
Given the paucity of literature on the prevention of sexually aggressive
behavior among potential perpetrators, part IV on prevention is the most
speculative section of the book. Potential protective factors against sexually
aggressive behavior are reviewed in chapter 8, as are general programs to
prevent risk factors from developing, which are covered in chapter 9. In
that various disorders may share the same risk factors, most of these pro-
grams were designed to prevent antisocial behavior in general. But a few
programs are reviewed that have been specifically designed to prevent sexu-
ally aggressive behavior among potential perpetrators.
I thank Temi Moffitt, Stan Sue, and Mieko Yoshihama for their
feedback during the writing of the manuscript. I also thank my suite-
mates Mike McBeath and Aloen Townsend for their help with statistical
issues. Richard Hirschman, Maria Root, and Bill George provided im-
portant input on an earlier draft of the book. Joan Bossert of Oxford
University Press has been particularly encouraging about the value of
writing this book.
Most of all, I thank Jeanne Nagayama Hall, who has been a constant
source of encouragement and feedback throughout my career and during
the writing of this book, and Jacquelyn Nozomi Nagayama Hall, whose
playfulness has provided a respite from my toils. I hope that the issues I
raise in this book will make the world better for them in at least a small
way.
January 1995 G. C. N. H.
Kent, Ohio
Contents
1. Introduction, 3
Societal Acceptance of Sexual Aggression, 4
A Focus on Perpetrators, 8
Research Approaches, 12
The Importance of Parsimony, 14
1. TOWARD A THEORY OF SEXUAL AGGRESSION
2. Theories of Sexual Aggression, 21
Physiological Models of Sexual Aggression, 22
Cognitive Models of Sexual Aggression, 26
Affective Models of Sexual Aggression, 34
Developmental Models of Sexual Aggression, 38
Conclusion, 49
3. A Quadripartite Model of Sexual Aggression, 51
Inhibitory Thresholds for Sexually Aggressive
Behavior, 53
Empirical Evidence for the Quadripartite Model, 58
Clinical Psychopathology and Motivational Precursors
of Sexually Aggressive Behavior, 59
Experimental Psychopathology and Disinhibitory
Variables, 63
Conclusion, 70
II. THEORY-GUIDED ASSESSMENT
4. Predicting Sexually Aggressive Behavior, 75
Personality Profiles of Sexual Aggressors, 76
Physiological Assessment of Sexual Arousal, 79
Clinical Prediction of Sexually Aggressive
Behavior, 83
Actuarial Prediction of Sexually Aggressive
Behavior, 86
Conclusion, 90
5. Assessment of Motivational Precursors of Sexually
Aggressive Behavior, 93
Veracity of Perpetrators' Self-Reports, 94