Measures

Systematic code book

Prior to data assessment, the author of the present thesis has contributed to the devel- opment of a systematic code book (Aebi, Bessler, & Barra, 2014)4. The code book represents an advancement of a documentation system used in previous studies (Aebi, 2009; Aebi et al., 2012) that had been based on the Forensic Psychiatric Documentation System (Nedopil, Grassl, & Mende, 1986). In total, the 50-page document contains 17 sections for the detailed assessment of (a) basic administrative as well as personal and family-related demographic data; (b) details of the sexual index offense; (c) specifications of prior crime histories; (d) aspects of a JSO’s general and sexual development (including intra-and extra-familial ACEs);

4 _{The comprehensive code book is not attached to the present thesis for lack of space but may be requested by} the author.

(e) criteria for the evaluation of the quality of psychiatric/psychological expert opinions; (f) type and course of court decisions/measures; (g) risk of reoffending; and (h) actual rates of reoffending. Including re-offenses reported in the case files that may not have led to criminal charges in addition to the reoffending rates recorded in official registries allowed for the ap- proximation toward the dark figure of crime (e.g., Maier et al., 2013).

The four empirical studies will each describe accordant variables of interest in more detail. However, because the current thesis places emphasis on the role of ACEs, the follow- ing paragraphs will shortly outline the present operationalization of ACEs.

Table 1

Descriptions and Distributions of Sexual Offenses According to the Swiss Penal Code in the Total Sample of Male and Female JSOs

Article (num- ber in Swiss penal code) Description Male (N = 673) Female (N = 14) n % n %

187 Sexual offense against a child (i.e., victim younger than 12 years and at least 3 years younger than the perpetrator)

246 36.6 4 28.6

188 Sexual offense within a relationship of dependence 1 0.1 0 0.0 189 Sexual coercion (i.e., forcing victim into sexual activities; in-

cludes digital and/or anal penetration)

245 36.4 0 0.0

190 Rape (i.e., forcing a female victim into vaginal intercourse) 44 6.5 0 0.0 191 Performance of sexual activities with a victim who is known to

the perpetrator as not judicious or unable to offer resistance

31 4.6 1 7.1

194 Exhibitionism 14 2.1 0 0.0

197 Pornography (i.e., consumption, production, and distribution of illegal pornographic material [including children, animals, or violence], or provision of pornographic material to a person below the age of 16 years)

34 5.1 3 21.4

198 Sexual harassment (i.e., provoking distress in victim by noncon- sensual performance of sexual activities in front of victim, touch- ing the victim with sexual intention, or offending the victim by sexual speech)

198 29.4 8 57.1

200 Increased penalty for committing offenses of any of the above- mentioned categories within a group of offenders

4 0.6 0 0

Note. Total N = 687. No offenses were coded in the present sample with regard to Article 192 (sexual activities with victims in institutional or criminal justice institutions), 193 (sexual offenses against victims in state of emergency), 195 (promotion of prostitution), 196 (sexual activities with minors for money), and 199 (illegal prostitution).

ACEs

ACEs were assessed following the 10 intra- and extra-familial ACE categories intro- duced in the German version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale (Isele et al., 2014; Teicher & Parigger, 2015; see, e.g., Table 2). Based on the review of a range of instruments for the assessment of ACEs, the MACE scale displays an alternative to the original ACE questionnaire (Dong et al., 2004; Felitti et al., 1998), yet over- coming potential shortcomings such as the confounding of direct experiences “with shared inheritance” (p. 2) in case of intra-familial substance, psychological, and criminal problems (Teicher & Parigger, 2015). On top, it considers ACEs mostly omitted by other ACE scales, such as peer victimization, intraparental violence toward a male caregiver, and violence against siblings (Teicher & Parigger, 2015). By dividing parental psychological abuse into two subtypes (verbal versus nonverbal), the MACE scale meets recent calls to examine dif- ferent forms of emotional maltreatment in more detail (Armour, Elklit, & Christoffersen, 2014; Paul & Eckenrode, 2015). The MACE scale was originally constructed as a self-rating and/or interview instrument (Isele et al., 2014; Teicher & Parigger, 2015). Each of the 10 ACE categories is reflected by a specific subscale that consists of several items that describe events corresponding to the overall ACE category represented in the subscale. The occur- rence of an event described by each item is coded dichotomously. An ACE category/subscale is considered fulfilled when the sum of its affirmed items exceeds a certain cut-off value. By summing up the number of fulfilled subscales, a cumulative score can be built as an index of the variety of ACEs similar to the original ACE score (Felitti et al., 1998).

Since the present thesis relied on data from an extensive case file analysis, the given data may not meet the accuracy and differentiation that self-reported data may offer. There- fore, the item-dependent cut-off approach was not used in the present thesis. Instead, an ACE category was considered to be fulfilled when there was information in the case files pointing to the overall occurrence of respective experiences as indicated by at least one according item.

To code whether a JSO himself had been a victim of sexually abusive behavior, fur- ther information from the Child Sexual Abuse Questionnaire (CSAQ; Mohler-Kuo et al., 2014) was used. This approach appeared beneficial to include a wider range of experiences of sexual victimization because besides attempted and performed physical sexual assaults (e.g., forced touching, forced oral, vaginal, and/or anal penetration), the CSAQ also covers non- contact sexual victimization, including harassment by electronic means (e.g., in chat-rooms, via cell-phone, or via e-mail) which displays a growing type of sexually abusive behavior

among adolescents (e.g., Mohler-Kuo et al., 2014). Similar to the MACE, the 15 items from the CSAQ were dichotomously rated as present or not present. No distinction was made in the present thesis between attempted and conducted sexual victimization. An overall ACE category of sexual victimization was considered fulfilled when any form of sexual victimiza- tion according to CSAQ or MACE items was reported in the case files. Finally, a cumulative ACE score was built by adding up the 10 resulting categories of present ACEs.

Both the MACE scale and the CSAQ have been successfully implemented in previous research and findings have pointed to their reliable and valid applicability (Aebi, Landolt, et al., 2015; Isele et al., 2014; Khan et al., 2015; Pechtel et al., 2014; Polcari, Rabi, Bolger, & Teicher, 2014; Radtke et al., 2015; Schalinski et al., 2016; Teicher & Parigger, 2015). Alt- hough no estimates of reliability and validity have yet been reported for the use of these in- struments in file analyses, the implementation of respective ACE categories has been sup- ported by the interrater agreements found within the present thesis (see empirical studies be- low for more details).