202212 8 Lussier Blokland 2014 Juvenile sex offender

2022/1/2 8 (Lussier & Blokland, 2014)

Juvenile sex offender VS. Non-sex offender

2022/1/2 少年性侵害犯罪概況分析（ 法務部， 2015） 犯罪 類型 人 竊盜罪 傷害罪 數 百分 比 妨害性 自主罪 殺人罪 強盜搶奪盜匪罪 恐嚇取躡罪 毒品犯罪 贓物罪 其他 合計 473 212 5 509 2 3 196 302 204 177 6 554 2 3 2 2 181 302 208 228 6 591 2 3 187 247 209 416 6 611 2 3 2 4 121 223 198 623 7 695 1 2 2 7 108 145 274 904 7 798 1 1 3 9 2 23 100. 0 83 60 348 1061 170 2906 11373 7 968 1 1 3 9 1 26 100. 0 133 96 317 1087 144 2728 12031 8 1031 1 1 3 9 1 23 100. 0 107 101 223 1257 141 2721 11025 9 947 1 1 2 11 1 25 100. 0 2407 97 77 195 1166 113 2572 10025 24 9 1 1 2 12 1 26 100. 0 2005年 3678 41 18 2006年 3594 1807 40 20 2007年 3388 1796 37 20 2008年 3338 1955 35 21 2009年 3110 1967 33 21 2010年 3226 2045 32 21 2011年 3003 2944 26 26 2012年 3181 3377 26 28 2013年 2768 2676 25 24 2014年 2431 24 1657 312 198 255 234 2044 9063 3 23 100. 0 219 2056 9064 2 23 100. 0 205 2196 9058 2 24 100. 0 160 2327 9430 2 25 100. 0 164 2283 9300 2 25 100. 0 211 2327 9935 14

犯罪次數隨年齡分佈的拋物線 (Lussier, Tzoumakis, Cale, Amirault, 2010 ) (Lussier, Tzoumakis, Cale, Amirault, 2010)

四個類型與三種不同犯罪 (Lussier, Tzoumakis, Cale, Amirault, 2010)

FOUR GROUP TRAJECTORIES OF ANY OFFENDING Hight-rate limited High-rate persistent Low-rate limited Low-rate persistent

FOUR GROUP TRAJECTORIES OF SEXUAL OFFENDING High-rate accelerator(8%) High-rate limited(25%) Low-rate persistent(56%) Late-onset Accelerator(12%)

年齡層： 性侵再犯、暴力再犯 Craig, 2011, The effect of age

性犯罪再犯風險的病因學模式(AETIOLOGICAL MODEL OF RISK)(BEECH & WARD, 2004)

侵害(犯罪)行為成(病)因 ․基因的先天特性(genetic predisposition) ․負面發展經驗(adverse developmental experience) : 受虐、 被拒絕、依附困難( abuse, rejection, attachment difficulties) ․心理(人格)特質(psychological disposition/trait): empathy deficit、attitudes supportive of sexual assault ․社會與文化結構、歷程(social-cultural structures and process) ․脈絡(情境狀態)因素(contextual factors) : sever stress、 intoxication

Neuropsychological Functioning: Trait Systems Action Selection & Control Motivation/ Emotion Perception & Memory Biological Inheritance Genetics Evolution Biological functioning Arousal Social Learning Brain Development 發展來源 Clinical Symptoms: State Factors 1. Emotion/behavioral Regulation problems 2. Social difficult (need for intimacy/control) 3. Offense supportive Cognition (distortion) 4. Sexual Deviance/ Ecological Niche: Proximal and Distal Social cultural environment Personal circumstances Physical environment Offending Action Maintenance and Escalation 性侵害整合架構圖(修改自Laws & O’Donohue, 2008)

化約成性侵害(犯罪)因子： 再犯危險評估 n Historical/static risk factor n Disposition factor or dynamic risk factor n Contextual antecedent (acute dynamic risk factor) n Clinical factor

遠 因 早年發展因子 ．Abuse ．Rejection ．Attachment – problems 脆弱因子 個人經驗史 心理特質 靜態因子 穩定動態因子 e. g. , Persistence and range of offending Psychosocial problems (e. g. , never married) criminal / antisocial history Sexual self regulation Offense supportive Cognitions Level of interpersonal functioning General selfregulation problems 狀態因子 急性動態 因子 Physiolog -ical Arousal 犯 Deviant Thought and fantasies 危 Need for intimacy+/ive 險 Affective states 觸發因子/狀態因子 再犯危險病理模式 ．Victim access ．Non-cooperation with supervision ．Social dislocation ．Substance abuse ．Relationship conflict ．Anti-social peers 再 程 度

(Craig, 2011)

靜態再犯預測 Amirault & Lussier, 2011

靜態再犯危險預測 (Amirault & Lussier, 2011)

被性衝動支配(性慾) - 心不由己 Lateral geniculate nucleus Pulvinar 色 Stimulus 識 4 識 Conscious experience 識 識 3 行 prefrontal integration 2 想 cognitive processing 1 受 affective processing 海馬 1 2 3 4 Affective processing Cognitive processing Prefrontal integration Conscious experience Phelps, E. A. & Le. Doux, J. E. (2005). Contributions of the amygdala to emotion processing: from animal models to human behavior. Neuron,

The executive control of voluntary action involves not only choosing from a range of possible actions but also the inhibition of responses as circumstances demand. Recent studies have demonstrated that many clinical populations, such as people with attention-deficit hyperactivity disorder, exhibit difficulties in inhibitory control. One prefrontal area that has been particularly associated with inhibitory control is the presupplementary motor area (Pre. SMA). Here we applied noninvasive transcranial direct current stimulation (t. DCS) over Pre-SMA to test its role in this behavior. t. DCS allows for current to be applied in two directions to selectively excite or suppress the neural activity of Pre-SMA. Our results showed that anodal t. DCS improved efficiency of inhibitory control. Conversely, cathodal t. DCS showed a tendency towards impaired inhibitory control. To our knowledge, this is the first demonstration of non-invasive intervention t. DCS altering subjects’ inhibitory control. These results further our understanding of the neural bases of inhibitory control and suggest a possible therapeutic intervention method for clinical populations. FIG. 3. THE PRE-SMA STIMULATION SITE SHOWN IN ONE PARTICIPANT. THE LOCATION CORRESPONDING TO THE STANDARD COORDINATES OF − 4, 32, 51.

Fig 1. Thalamo-cortical circuitry. Parvocellular (P) neurons in layers 3– 6, and magnocellular (M) neurons in layers 1– 2 of the LGN, project to layer 4 of. V 1. Koniocellular (K) neurons in the thin layers of the LGN project to the superficial layers of the visual cortex (not shown). V 1 provides feedback from layer 6 to the LGN. The pulvinar is thought to receive largely feedforward input from layer 5 of the cortex, that is, information destined for more advanced levels of processing, and feedback input from layer 6. The pulvinar projection to the cortex terminates in layer 4 and in more superficial layers. Many different cortical areas are connected via the pulvinar; however, here we only show V 1 and extrastriate cortex for clarity. FF = putative feedforward (green); FB = putative feedback (red).

GAIN CONTROL IN THE VISUAL THALAMUS (SAALMANN &KASTNER, 2011) The thalamus has traditionally been thought to passively relay sensory information to the cortex. By showing that responses in visual thalamus are modulated by perceptual and cognitive tasks, recent f. MRI and physiology studies have helped revise this view. The modulatory input to the visual thalamus derives from functionally distinct cortical and subcortical feedback pathways. These pathways enable the lateral geniculate nucleus and pulvinar to regulate the information transmitted to cortical areas according to cognitive requirements. Emerging evidence suggests that such regulation involves changing the degree of synchrony between neurons as well as changing the magnitude of thalamic activity. These findings support a role for the thalamus that extends as far as contributing to the control of visual attention and awareness.

犯罪危險因子的(向度)結構 Demographic Crime type Age group Follow-up(追蹤年限) Risk level Antisocial Tendency(Anti-sociality) Crime Conviction Impulsivity Juvenile delinquency Substance abuse Violence continued

性侵害危險因子的(向度)結構 Deviant Interest/Sexual Interest Ø Self-regulation/Sexual self-regulation Ø Atypical l (Male victim, child abuse) Number of pre-sexual crime Distant or non-existent personal with victim Ø Intensity l Interest/Sexual Interest(Preference) of Sexuality Degree of sexual interest and activity

(Craig, 2011)

Craig, 2011

(Craig, 2011)

(Olver & Wong, 2011)

犯罪危險因子如何使用在治療中 1. 加害人的基本背景 n Demographic n Crime type, Age group, Follow-up(追蹤年限) , Risk level 2. 危險因子 n Antisocial Tendency(Anti-sociality) n Crime Conviction, Impulsivity , Juvenile delinquency , Substance abuse, Violence n Deviant Interest/ (e. x. Sexual Interest) Ø Self-regulation (e. x. Sexual Self-regulation) Ø Atypical Interest (e. x. Sexual Interest(Preference) l l l Ø (Male victim, child abuse) Number of pre-sexual crime Distant or non-existent personal with victim Intensity of Sexuality l Degree of sexual interest and activity 3. 治療師協助個案畫出其犯案路徑及循環圖(之前個案要先做功課)。

為何中止犯罪？治療發生效果？ 中止犯罪(Desistance): exhibit abstinence from offending last 3 -6 years, after 7 -10 years same as None-Offender Ø Natural Desistance: 1. Biological perspective 2. Maturation and aging Ø Cognitive Transformation: 1. Personal agency& cognitive transformation in life 2. Conscious decision and ability to change Ø Informal Social Control: 1. Conformity and community investment 2. Negative reinforcement, retribution, deterrence (Harris, 2014)

第二階段: REHABILITATION

第四階段: NORMALCY AND REINTEGRATION