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Sexuelle Totungsdelikte durch Jugendliche sind kriminalstatistisch sehr selten und noch weitgehend unerforscht. Mittels einer retrospektiven Gutachtenanalyse und einer Auswertung aktueller Bundeszentralregisterauszuge wurde die Delinquenz einer Stichprobe 19 jugendlicher Sexualmorder von der Kindheit bis zum durchschnittlichen Alter von 45 Jahren erfasst. Mehr als die Halfte (58%) hatte schon vor dem sexuellen Totungsdelikt sexuelle Ubergriffe begangen oder versucht. Von 13 aus dem Gewahrsam entlassenen Tatern verubten sieben (54%) ein neues Sexual- oder Gewaltdelikt. Im Langzeitverlauf waren vergleichbar viele gunstige und ungunstige Delinquenzentwicklungen unterscheidbar. Die Ergebnisse weisen darauf hin, dass Personen, die als Jugendliche ein sexuelles Totungsdelikt begehen, haufig schon vorher sexuell Ubergriffe veruben und langfristig ein hohes einschlagiges Ruckfallrisiko haben.

For about 15 years selective serotonine reuptake inhibitors (SSRI) have been used in the treatment of paraphilias. In an open, uncontrolled, retrospective study, which was the first in the German speaking countries we investigated 16 male outpatients, who have been treated for different paraphilias with SSRI and psychotherapy. There was a marked reduction in paraphilic symptoms. Despite high rates of sexual side effects most patients reported a high overall treatment satisfaction. SSRI are an important addition in pharmacological treatment of paraphilic patients, especially with a risk of so called "hands-off" delinquency.

Controversies exist about the diagnostic concept of “sexual addiction.” The aim of this study was to investigate if German specialized sex therapists are confronted with patients who possess sexual addiction symptoms and to obtain information about diagnoses, comorbidity and treatment. A 12-item questionnaire was sent to all members of the German Society of Sex Research asking them about diagnoses, comorbidity and treatment of patients who experienced sexual addiction problems. Forty-three out of 149 members (28.9%) responded to the survey and reported about 97 patients with sexual addiction symptoms. Most common were pornography dependence, compulsive masturbation, and protracted promiscuity. Using ICD-10 definition “excessive sexual drive” was diagnosed more often in women while “disorder of sexual preference” was mainly diagnosed in men. In women neurotic (e.g., anxiety disorders) and eating disorders were most commonly diagnosed as comorbid disorders, while in men substance disorders were most commonl...

Background: Sexual homicides – and particularly offenders with multiple victims – receive much attention in the general public as well as among forensic experts. The aim of this study was to assess psychiatric disorders in a large sample of sexual murderers and to identify disorders related to multiple sexual homicides. Sampling and Methods: Psychiatric court reports from 20 German forensic psychiatrists on 166 men who had committed a sexual homicide were evaluated for psychiatric disorders according to DSM-IV, including standardized instruments for personality disorders (criteria from the Structured Clinical Interview) and psychopathy (Psychopathy Checklist-Revised). Offenders with a single sexual homicide victim (n = 130) were compared to those with multiple victims (n = 36). Results: High lifetime prevalence rates were found for substance abuse or dependence, paraphilias (especially sexual sadism), sexual dysfunctions and personality disorders (especially antisocial, borderline, sadistic and schizoid). In the multiple sexual murderer group sexual sadism, voyeurism, sadistic, antisocial and schizoid personality disorders were more frequent than in the single-victim group; none of the multiple offenders was diagnosed with a mood disorder. Conclusions and Limitations: Multiple sexual murderers are characterized by disorders in three major psychopathological domains: sexual as well as ‘character’ sadism, antisociality and schizoid personality. A thorough diagnostic evaluation of Axis I as well as Axis II disorders should be part of risk assessments in sexual homicide perpetrators. Although the study was a retrospective investigation on psychiatric court reports, the size of the sample and consistency with results from previous studies give confidence that the identified group differences are unlikely to be due to methodological limitations.

Paraphilic disorders (PAs) and sexual preoccupation are known risk factors for recidivism in sexual offenders. Nonparaphilic sexual excessive behaviors-so-called paraphilia-related disorders (PRDs), like paraphilias, are also characterized by sexual preoccupation and volitional impairment and can be diagnosed in paraphilic men. The prevalence and clinical significance of PRDs in sexual homicide perpetrators, however, is unknown. We investigated the relationship between PAs and PRDs retrospectively in a sample of 161 sexual murderers. Four groups were compared: men without a PA or a PRD diagnosis, men with at least one PRD but no PA, men with at least one PA but no PRD, and finally, those with a combination of both (PA+PRD). The PA+PRD group had the most lifetime cumulative sexual impulsivity disorders, more developmental problems, the highest persistent frequency of sexual activity, the highest number of previous sexual offences, more sexual sadism, and compulsive masturbation. Men of the PRD subsample had suffered more from childhood sexual abuse, showed more promiscuity, psychopathy, and alcohol problems. The use of the PRD concept in this special offender group should be further investigated with prospectively designed studies.

The aim of this study was to investigate the number and type of brain abnormalities and their influence on psychosocial development, criminal history and paraphilias in sexual murderers. We analyzed psychiatric court reports of 166 sexual murderers and compared a group with notable signs of brain abnormalities (N = 50) with those without any signs (N = 116). Sexual murderers with brain abnormalities suffered more from early behavior problems. They were less likely to cohabitate with the victim at the time of the homicide and had more victims at the age of six years or younger. Psychiatric diagnoses revealed a higher total number of paraphilias: Transvestic fetishism and paraphilias not otherwise specified were more frequent in offenders with brain abnormalities. A binary logistic regression identified five predictors that accounted for 46.8% of the variance explaining the presence of brain abnormalities. Our results suggest the importance of a comprehensive neurological and psychological examination of this special offender group.

To examine the predictive accuracy of four well established risk assessment instruments (PCL-R, HCR-20, SVR-20, and Static-99) in an important subgroup of sexual offenders, these instruments were assessed retrospectively based on information from forensic psychiatric court reports in a sample of 90 released male sexual homicide offenders (out of an original sample of 166) in Germany. Follow-up information about criminal reconvictions after release were obtained from the federal criminal records. Total scores as well as subscales and single items of these risk assessment instruments did not predict sexual recidivism, and only some of them had moderate predictive power regarding nonsexual violent recidivism. Possible explanations for these unexpected results are the retrospective study design with missing information about influences during the long duration of detention and time after release, the small sample size as well as the possibility that the risk assessment instruments investigated were valid for general sex offender samples, but not for the particular subgroup of offenders with sexually motivated homicides.

This study investigates characteristics differentiating sexually motivated murderers targeting child victims (CV; n = 35) from those with only adult victims (AV; n = 100). In the initial phase, psychiatric court reports were evaluated using standardized instruments (SCID-II, PCL-R, HCR-20, SVR-20, Static-99). In the second phase, data on duration of detention and reconviction rates were obtained from German federal criminal records. The CV group showed more often diagnostic criteria of pedophilia (43% vs. 4%) and less often alcohol abuse and drug dependency (31% vs. 55%), sexual dysfunctions (9% vs. 29%) and narcissistic personality disorder (0% vs. 13%). No significant differences were found regarding PCL-R and total risk assessment scores. Child victim perpetrators were more likely to have committed acts of sexual child abuse before the sexual homicide (46% vs. 16%) but were less likely to have committed rape or sexual assault (17% vs. 42%) or caused bodily injury (26% vs. 50%). The CV group was detained more frequently in forensic psychiatric hospitals (59% vs. 26%), but the two groups showed the same rates of release and reconviction for sexual (22% for both groups), nonsexual violent (CV 25% vs. AV 15%) and nonviolent offenses (CV 63% vs. AV 59%). Although well-known differences between nonhomicidal sexual child abusers and rapists were replicated in this study on sexual homicide perpetrators, the groups showed more similarities than differences. The high prevalence of violence and antisocial personality disorder in both groups seem to be important risk factors for committing a (sexual) homicide and might have outweighed other differences.

Forensic psychiatric reports on 166 sexual homicide perpetrators in Germany were retrospectively analyzed for criminal risk factors. Follow-up information about release and reconvictions from federal criminal records was available for 139 offenders; 90 (64.7%) had been released. The estimated recidivism rate (Kaplan—Meier analyses) for 20 years at risk was 23.1% for sexual and 18.3% for nonsexual violent reoffences. Three men (3.3%) were reconvicted for attempted or completed homicide. Only young age at the time of sexual homicide resulted in higher sexual recidivism, whereas increased nonsexual violent recidivism was related to previous sexual and nonsexual delinquency, psychopathic symptoms, and higher scores in risk assessment instruments. Increased recidivism with any violent reoffence was associated with age-related factors: young age at first sexual offence, at homicide, and at release and duration of detention. The impacts of the results for risk assessment, relapse prevention, and supervision are discussed.

Controversies exist about the diagnostic validity of sexual sadism and its relation to sadistic personality disorder in sex offenders. The aim of this study was to investigate which diagnostic, developmental, and criminal characteristics differentiate sexual sadistic from non-sadistic sexual homicide perpetrators. Psychiatric court reports on 166 men who had committed a sexual homicide were evaluated regarding psychiatric, sexual and criminal history. Sixty-one offenders (36.7%) with sexual sadism (SeSd) were compared with 105 (63.3%) offenders without this diagnosis (NSeSd). Besides the sexual sadistic symptoms, there were seven factors that discriminated best between the two groups (sexual masochism, sadistic personality disorder, isolation in childhood, multiple sexual homicide, previous rape, previous tendencies for similar behavior, and long duration of the homicidal act). Sexual sadism is connected with circumscribed other characteristics and has to be considered in risk assessment and treatment of sex offenders.