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The amendment to the law of forced detention in psychiatric hospitals has strengthened the role of experts in criminal law proceedings. Experts have specific specialist knowledge and exert a guarantor function in relation to the court. These interdisciplinary processes hold risks that have to be encountered by critical interaction preserving boundaries between different disciplines and competencies. Transgressing competencies and violating boundaries can result in intrusions upon fundamental rights of those affected that may also raise liability questions. This article discusses the framework of this interdisciplinary cooperation, in particular the relevance of competence boundaries in criminal court proceedings

About 1% of sentenced sexual offenders are female. Investigations on victims of child molestation reveal at least a participation of female perpetrators in one-fourth of cases of male victims and in 13% of female victims. The spectrum of offenses of female offenders reaches from minor forms of indecency, exhibitionism, different forms of child molestation, and incest to all forms of aggressive acts, including rape and murder. Male and female children are the most prominent victims. In a high percentage of offenses, the female offender acts together with a male accomplice. Only in rare cases is the diagnosis of paraphilia reported; far more frequent are different forms of depression, alcohol and drug abuse, and personality disorders (borderline, antisocial, dependent). Most authors agree that a high percentage (more than 50%) of female sexual offenders were themselves victims of sexual and/or physical abuse. Conflicts with the mother and resulting problems with women—especially mother identity—are reported by psychodynamic-oriented authors. Only a few case reports exist on effective medical treatment with selective serotonin reuptake inhibitors and antiandrogens. A carefully differentiated psychotherapeutic treatment program, including group, individual, and social therapeutic strategies, should take into consideration the good lives model (GLM), but also specific factors of female offending: The importance of female identity problems, the higher importance of relationship aspects, and the victim–victimizer circle.

ZusammenfassungDie forensische Psychiatrie sieht sich mit einem neuen Phänomen der Internetsexualdelinquenz konfrontiert, dem „webcam child sexual abuse“ (WCSA), der mittels des Internets erfolgenden Anstiftung zur sexuellen Ausbeutung von Minderjährigen. Der Begriff umfasst jegliche Form sexueller Ausbeutung von Minderjährigen per Internet-Livestream, wobei das Spektrum der übertragenen Handlungen vom Posieren bis hin zu sexuell-sadistischen Übergriffen reicht. Während Schätzungen des Kinderhilfswerkes Terre des Hommes seit 2009 auf eine hohe Prävalenz solcher Handlungen verweisen, stieg die Zahl der Verurteilungen wegen WCSA erst in den letzten Jahren an. Die Anonymität des Internets und das weitgehende Fehlen von Datenspuren erschweren nicht nur die Überführung der Täter, sondern bergen auch Herausforderungen für die forensisch-psychiatrische Begutachtung. Anhand von WCSA-Fällen in der hiesigen Gutachtenstelle erfolgen Überlegungen zur kriminologischen Einordnung der Tathandlungen sowie zu Herausforderungen im Rahmen des Begutachtungsprozesses. Mithilfe einer idealtypischen Kasuistik werden Hypothesen zur Fallkonzeption gebildet und daraus Empfehlungen für die diagnostische Einordnung, Beurteilung der Einsichts- und Steuerungsfähigkeit, Prognose und Behandlung abgeleitet.

Die Rolle von Sachverständigen im Erkenntnis- und Vollstreckungsverfahren wurde mit der Novellierung des Rechts der Unterbringung in einem psychiatrischen Krankenhaus erneut gestärkt. Sachverständige verfügen über ein spezifisches Fachwissen und haben insoweit eine Garantenstellung gegenüber dem Gericht. Dieses interdisziplinäre Zusammenwirken birgt Gefahren, die zu kritischem und die Fach- und Kompetenzgrenzen wahrendem Zusammenwirken führen müssen. Kompetenzüberschreitungen und Grenzverletzungen können zu Eingriffen in die Grundrechte von Betroffenen führen, die auch haftungsrechtlich relevant werden können. Im Folgenden werden die Rahmenbedingungen der interdisziplinären Zusammenarbeit und insbesondere die Bedeutung der Kompetenzentrennung in foro verdeutlicht.The amendment to the law of forced detention in psychiatric hospitals has strengthened the role of experts in criminal law proceedings. Experts have specific specialist knowledge and exert a guarantor function in relation to the court. These interdisciplinary processes hold risks that have to be encountered by critical interaction preserving boundaries between different disciplines and competencies. Transgressing competencies and violating boundaries can result in intrusions upon fundamental rights of those affected that may also raise liability questions. This article discusses the framework of this interdisciplinary cooperation, in particular the relevance of competence boundaries in criminal court proceedings.

New tools for application of two-phase sampling in forest inventory practice Sample-based forest inventories provide reliable information on the status and development of the forest. The sample sizes are thereby chosen in order to meet high estimation precisions for forest attributes on the national, cantonal or forest district level. In order to provide sufficient precision for regions where the sample size is limited, the combination of the terrestrial information with auxiliary data such as derived from remote sensing sources can constitute a cost-saving alternative compared to increasing the terrestrial sample size. Design-based estimation methods developed at ETH Zurich which implement such two-phase inventory concepts have lately been provided by the open-source software package “forestinventory” in the statistical software R. This article explains the principle of a two-phase inventory of small-area estimation and illustrates the workflow by the example of a case study in Embrach (Canton of Zurich). Target variable to be estimated for 22 subregions (small areas) located in the study area (503 ha) was the average timber volume density. The main work steps were (A) the enlargement of the one-phase inventory to a two-phase inventory, (B) the derivation of explanatory variables from remote sensing data (mean vegetation height, standard deviation of the vegetation heights and broadleaf tree proportion), (C) the formulation of a regression model to link these explanatory variables to the terrestrial information, and (D) the calculation of small area estimates (average timber volume density) using forestinventory. Despite average model accuracy (R̂2 = 0.533), it was possible to reduce the variance (as a measure of the estimation accuracy) in the 22 small areas by 40% on average.

Der Artikel „Webcam child sexual abuse“. Eine neue Facette der Begutachtung von Internetsexualdelinquenz von Fanny de Tribolet-Hardy, Andreas Hill und Elmar Habermeyer wurde ursprünglich am 2. Juli 2020 ohne „Open Access“ online auf der Internetplattform des Verlags publiziert. Die Autoren haben …

Managing forests for ecosystem services and biodiversity requires accurate and spatially explicit forest inventory data. A major objective of forest management inventories is to estimate the standing timber volume for certain forest areas. In order to improve the efficiency of an inventory, field based sample-plots can be statistically combined with remote sensing data. Such models usually incorporate auxiliary variables derived from canopy height models. The inclusion of forest type variables, which quantify broadleaf and conifer volume proportions, has been shown to further improve model performance. Currently, the most common way of quantifying broadleaf and conifer forest types is by calculating the proportions of the corresponding areas of the canopy cover. This practice works well for single-layer forests with only a few species, but we hypothesized that this is not best practice for heterogeneously structured and mixed forests, where the area proportion does not accurately reflect the timber volume proportion. To better represent the broadleaf and conifer volume proportions, we introduced two new auxiliary variables in which the area proportion is weighted by height information from a canopy height model. The main objectives of this study were: (1) to demonstrate the advantage of including forest type (broadleaf/conifer distinction) information in ordinary least squares regression models for timber volume prediction using widely available data sources, and (2) to investigate the hypothesis that including the broadleaf and conifer proportions, weighted by canopy height information, as additional auxiliary variables is favourable over including simple area proportions. The study was conducted in three areas in Switzerland, all of which have heterogeneously structured and mixed forests. Our main findings were that the best model performance can generally be achieved: (1) by deriving conifer and broadleaf proportions from a high-resolution broadleaf/conifer map derived from leaf-off airborne laser scanning data, and (2) by using broadleaf/conifer proportions weighted by height information from a canopy height model. Incorporating the so-derived conifer and broadleaf proportions increased the model accuracy by up to 9 percentage points in root mean square error (RMSE) compared with models not using any forest type information, and by up to 2 percentage points in RMSE compared with models using conifer and broadleaf proportions based solely on the corresponding area proportions, as done in current practice. Our findings are particularly relevant for mixed and heterogeneously structured forests, such as those managed to achieve multiple functions or to adapt effectively to climate change. peerReviewed

Sexual sadism is a paraphilia considered to be associated with a proneness to violence. In contrast to consensual sadomasochistic role play, forensically relevant forms of sadism include the humiliation, coercion, and possibly the injury, of involuntary victims. Consequently, the perpetrators tend to be regarded as high-risk offenders who are difficult (or maybe even impossible) to treat. The current chapter first provides an overview of past developments in treating sexual sadism within a forensic framework. Behaviour and cognitive behaviour therapy, psychodynamic treatment, and surgical and pharmacological interventions will be reviewed. Given the lack of studies with sufficiently large samples (let alone randomized controlled studies), mostly case descriptions and small-sample studies will be reviewed. Based on this overview, recommendations for an integrative treatment routine (combining psychotherapy and pharmacological treatment) will be delineated. Finally, case vignettes from our own practice will be presented in order to highlight the particular problems and pitfalls of treating sexual sadists in a correctional or forensic-psychiatric setting. In this regard, the co-occurrence of sexual preference disorders and of personality disorders will be discussed.

A timber volume regression model applicable to the state and communal forest area of the federal German state of Rhineland-Palatinate is identified using a combination of airborne laser scanning (ALS)-derived metrics and information from a satellite-based tree species classification map available on the federal state level. As is common in many forest inventory datasets, strong heterogeneity in the ALS data due to different acquisition dates and misclassifications in the tree species classification map had noticeable effects on the regression model’s performance. This article specifically addresses techniques that improve the performance of ordinary least square regression models under such restricting conditions. We introduce a calibration technique to neutralize the effect of misclassifications in the tree species variable that originally caused a residual inflation of 0.05 in adjusted R2. Incorporating the calibrated tree species information improved the model accuracy by up to 0.07 in adjusted R2 and suggests the use of such information in forthcoming inventories. We also found that including ALS quality information as categorical variables within the regression model considerably mitigates issues with time lags between the ALS and terrestrial data acquisition and ALS quality variations (increase of 0.09 in adjusted R2). The model achieved an adjusted R2 of 0.48 and a cross-validated root-mean-square error (RMSEcv) of 46.7% under incorporation of the tree species and ALS quality information and was thus improved by 0.12 in adjusted R2 (5% in RMSEcv) compared to the simple model only containing ALS height metrics (adjusted R2=0.36, RMSEcv=51.7%)., European Journal of Forest Research, 137 (4), ISSN:1612-4677, ISSN:1612-4669

Remote Sensing, 9 (7), ISSN:2072-4292

Little is known about personality disorders (PDs) in offenders with histories of both sexual and (nonsexual) violent offenses. This study aimed to identify possible differences of PD profiles across three different offender groups with both sexual and violent (S+V), only sexual (S), and only violent (V) offenses. Nonviolent (N) offenders were used as a comparison group. Typing of individuals according to their offensive histories was performed on the basis of 259 psychiatric court reports that included the Structured Clinical Interview (SCID)-II for PD diagnostics. Men from the S+V group committed significantly more acts of rape and sexual coercion than the mere sexual offenders. Furthermore, S+V offenders showed the highest rates of PDs overall (68.3%), with every second offender being diagnosed with an antisocial PD and every third offender with a borderline PD. In summary, the results suggest that S+V offenders form a group of individuals with remarkable differences regarding PD profiles, the relatively highest frequencies of conduct disorders, familial addictive problems, and PDs overall.

Introduction. The present study investigates the relevance of genital abnormalities (GA) like cryptorchidism, hypospadias, and phimosis usually diagnosed in early childhood for the development of psychosexual problems and deficits in a sample of N = 163 convicted sexual homicide perpetrators. Aims. The first aim was to investigate the prevalence of early childhood GA in a sample of sexual homicide perpetrators. The second was to explore differences in the psychosexual development of participants with GA in early childhood compared with those without GA. It was expected that offenders with GA show specific problems in their psychosexual development compared with offenders without GA. Methods. The data for the present study were obtained by reanalyzing an existing database derived from a large‐scale research project about sexual homicide. Using a predominantly exploratory design we, therefore, divided the total sample into two subgroups (with vs. without indicators of GA). Main Outcome Measures. Main outcome measures were the number of sexual homicide perpetrators showing GA in early childhood and the differences of subjects with and without GA with regard to their psychosexual development (i.e., according to sexual deviant interests or sexual dysfunctions). Results. The prevalence of GA is substantially higher in this sample than epidemiological studies indicated in the normal population. This result provided first support for the importance of GA in the population of sexual homicide perpetrators. Further analyses indicate significant differences between both subgroups: Offenders with GA in early childhood showed indicators for more sexual dysfunctions (e.g., erectile dysfunction) in adulthood and a distinct tendency of more masochistic sexual interests. Conclusion. Even if the exploratory design of the present investigation allows no causal conclusions between GA and sexual homicide offenses, the result provided support for the relevance of early childhood sexual diseases in the assessment (and treatment) of offenders who have committed severe sexual violence.

The aims of this study were to compare the prevalence of psychiatric disorders and "psychopathy" in homicidal and nonhomicidal sexual offenders and to investigate the specificity of previous studies on psychiatric morbidity of a sample of sexual murderers. Information from court reports of 166 homicidal and 56 nonhomicidal sex offenders was evaluated using standardized instruments (SCID-II, PCL-R) and classification systems (DSM-IV). Sexual murderers were diagnosed more often with a personality disorder (80.1% vs. 50%; p0.001), especially schizoid personality disorder (16.3% vs. 5.4%; p0.05), as well as with sexual sadism (36.7% vs. 8.9%; p0.001) and sexual dysfunctions (21.7% vs. 7.1%; p0.05). Additionally, they had more often used alcohol during the offense (63.2% vs. 41%; p0.05). The results indicate that sexual murderers have more and a greater variety of psychiatric disorders when compared to nonhomicidal sex offenders.

Das Internet birgt durch seine mehr oder weniger spezifischen Eigenschaften, v. a. leichter Zugang, Anonymitat, niedrige Kosten, weltweite Vernetzung und Interaktionsmoglichkeiten, sowohl Chancen als auch Risiken fur die Entwicklung von Sexualitat und sexuellen Beziehungen. Zu den kaum untersuchten Chancen des Internet zahlen die Erleichterung sexueller und sozialer Kontakte, besonders fur Menschen mit sozialen Schwierigkeiten, fur sexuelle Minderheiten (z. B. Schwule, Lesben, Transgender, Sadomasochisten, Fetischisten), der Abbau von Vorurteilen und Stereotypen, eine bessere Abstimmung von Interessen bei der Partnerwahl sowie die zahlreichen, auch seriosen Informationen und Beratungsangebote zu sexuellen Themen. In der psychotherapeutischen Praxis ist man haufig mit den problematischen Auswirkungen von Internetpornografie und Cybersex konfrontiert, v. a. Vermeidung von „realen“ – sexuellen und nichtsexuellen – zwischenmenschlichen Kontakten, Belastung von Partnerschaften (z. B. durch „Cyberuntreue“), Verstarkung selbst- oder fremdschadigender Fantasien und Impulsen bis hin zu strafrechtlich relevantem Verhalten, wie dem Konsum und der Verbreitung von Kinderpornografie. In dieser Ubersicht wird – auch anhand eines Fallbeispiels – die Rolle des Internet bei der Entwicklung einer sexsuchtigen Symptomatik, einschlieslich der Behandlungsoptionen, erortert. Nur mit einer differenzierten Darstellung von Chancen und Risiken kann einer in den letzten Jahren sich verstarkenden Damonisierung und Pathologisierung der Nutzung des Internet fur sexuelle Zwecke entgegengewirkt werden.

OBJECTIVE: Evaluation of the relationship between antiandrogenic therapy of sexual offenders and home leave steps in a forensic psychiatric hospital. METHODS: Retrospective evaluation of all sexual offenders (n = 79) who were treated in the forensic psychiatric hospital Berlin between the 1.1.1998 and the 1.1.2005. RESULTS: There is an increase in the number of patients treated with antiandrogenic medication during the observed time period. Patients under this kind of pharmacotherapy receive higher grades of home leave steps. CONCLUSIONS: As possible reasons for the observed changes we discuss the contemporaneous implementation of a new pharmacotherapeutic treatment option (LHRH-agonists) and an aggravation of the German criminal law for sexual offenders. Language: de

This study estimates the lifetime prevalence of physical violence during pregnancy and examines risk and protective factors among women ( N = 390) attending reproductive health clinics in Jordan. Approximately 15% reported physical violence during pregnancy. The husband was the sole perpetrator in 83% of the cases. A high frequency of quarreling, the husband's use of alcohol, attitudes supportive of a woman's duty to obey her husband, infrequent communication between the respondent and her family, and exposure to violence as a child increased the risk of violence. Consanguinity (marriage to a blood relative) and higher education levels were protective against violence during pregnancy.

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.

In einer Untersuchung an 166 in der Zeit zwischen 1963 und 1991 verurteilten Straftatern, deren Sexualdelikt fur die Opfer todlich endete, ergaben sich zunachst beim Vergleich von Einfach- mit Mehrfachtatern ahnliche Verhaltnisse, wie aus Voruntersuchungen mit kleineren Stichproben bekannt war. Bei den Mehrfachtatern wurden haufiger sexueller Sadismus und andere Storungen der Sexualpraferenz sowie antisoziale, schizoide und sadistische Personlichkeitsstorungen gefunden. Katamnestische Daten aus dem Bundeszentralregister lagen von 139 Tatern vor. Wahrend die Entlassenen (n=90) durchschnittlich 12,2 Jahre in Gewahrsam verbrachten, waren die Nicht-Entlassenen (n=49) bis zur Erstellung der Bundeszentralregister-Auszuge im Durchschnitt seit 20,6 Jahren ununterbrochen in Haft oder im Masregelvollzug. Bei den Nicht-Entlassenen waren signifikant mehr Storungen der Sexualpraferenz und mehr antisoziale und sadistische Personlichkeitsstorungen zu verzeichnen. Storungen der Sexualpraferenz und Antisozialitat stellen ein empirisch gut belegtes besonderes Risiko fur einschlagige Ruckfalligkeit bei Sexualstraftatern dar. Auserdem zeigten samtliche angewandten Prognose-Instrumente (PCL-R, HCR-20, SVR-20, Static-99) bei den Nicht-Entlassenen hohere Werte. Vor diesem Hintergrund muss es gesehen werden, dass bei den entlassenen Tatern nur 1,1% (n=1) Ruckfalligkeit in vollendeten und 2,2% (n=2) Ruckfalligkeit in versuchten Totungsdelikten gefunden wurde. Die Ruckfalligkeit mit Sexual- und Gewaltdelikten war mit den Ergebnissen der Metaanalyse von Hanson und Morton-Bourgon (4) vergleichbar. Nachdem die bekannten Risikofaktoren offensichtlich schon bei der Entscheidung fur oder gegen eine Entlassung „verbraucht“ worden waren, blieben in der Katamnese nur mehr das Alter beim Delikt und das Alter bei der Entlassung als weitere Risikofaktoren zur Erklarung von Ruckfalligkeit mit Sexual- und anderen Gewaltdelikten uber. Das heist, je junger der Tater beim sexuellen Totungsdelikt und je junger bei der Entlassung, umso wahrscheinlicher ist ein Ruckfall im Katamnese-Zeitraum.

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.

Free cortisol was investigated in BPD patients and healthy controls. A positive association was found between cortisol and depression scores, while the number of PTSD symptoms was negatively correlated with cortisol release. These findings suggest that alterations in cortisol release in BPD are strongly associated with the severity of psychopathology.

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...

Internet pornography has been regarded as either stimulating sexual aggression and abuse or as serving as a safety valve. This controversy is an important issue in health, media and legal politics. According to empirical studies on pornography in general, soft-core pornography and nonviolent pornography can be regarded as harmless, whereas non-violent hard-core pornography and violent pornography may increase aggression. Individuals with a high risk for sexual aggression show more interest in violent pornography and are stimulated more strongly through such material. Two case histories illustrate the characteristics of internet pornography and "cybersex": easy access, anonymity, affordability, wide range and deviation of the material, unlimited market, blurring the borders between consumer and producer, interactive communication, space for experimenting between fantasy and in real-life behavior, virtual identities, easy contact between offender and victim or among offenders, and low risk of apprehension. The phenomenon of "sexual addiction" (or paraphilia- related disorder) is particularly relevant for the problematic use of internet pornography. Preventive measures to protect possible victims are presented as well as treatment strategies for offenders. Beside limiting access to the internet, these include therapy of comorbid psychiatric disorders and psychological problems (social isolation, bereavement, stress- and anger-management, guilt and shame, childhood traumata, cognitive distortion, victim empathy), psychopharmacotherapy and the enhancement of a more integrative and relationship-oriented sexuality.

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.

Little is known about the aetiology, course and therapy of obscene telephone calls as a paraphilic behaviour. Overlaps to other paraphilias like voyeurism, paraphilia related disorders and the concept of stalking are reported in the literature. In case reports we describe the paraphilic development and course with a focus on the relationship to the victim. We discuss this on the background of different concepts regarding risk assessment and therapy.

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.

Previous research may have underestimated physicians' detection rates of alcohol dependence or abuse because case findings have been based on screening questionnaires instead of using in-depth diagnostic criteria and detection rates have been assessed by analyzing patient records instead of directly interviewing the physician. To test this hypothesis, consecutive patients of a general hospital ( N =436) and of 12 randomly selected general practices ( N =929) were examined. A two-step diagnostic procedure included screening questionnaires and a diagnostic interview (SCAN). The analysis compares detection rates based on methods used in previous studies to data using more precise methods. Physicians' detection rates ranged from 37.0% to 88.9% in the general hospital and from 11.1% to 74.7% in general practices depending on methods used. The physicians' detection rates could be improved by 10% (general hospital) and 20% (general practice) through the additional use of a screening questionnaire. Of those patients assessed by the physicians as problem drinkers in the general hospital, 13.9% were referred to an addiction consultation-liaison service. Data reveal that physicians' abilities to detect problem drinkers have been underestimated. Routine screening procedures could play a major role in improving detection rates and reminding the physician to intervene.

Die meisten Menschen versuchen, ihre psychischen Probleme mit Gesprachen, Entspannung oder Medikamenten in den Griff zu bekommen. Einige greifen zum Alkohol. Wieder andere verfangen sich in sexuellen Exzessen verschiedenster Art, die sie jedoch immer weiter in die Isolation treiben. Fur sie ist Sexualitat eine Art „psychisches Analgetikum“ mit Suchtcharakter.

The purpose of the present study was to investigate the impact of post-traumatic stress disorder (PTSD) symptoms on hypothalamic-pituitary-adrenal axis feedback regulation in 18 female patients with borderline personality disorder (BPD) and 21 healthy controls. Reduced feedback sensitivity was found in BPD patients with a low number of PTSD symptoms, while findings in the BPD group with a high number of PTSD symptoms did not differ from those in controls. The results suggest a hypo-suppression in the dexamethasone suppression test in BPD with few PTSD symptoms.