Diagnosing Michael Jackson

You have probably seen some of the postmortem efforts to pin psychiatric diagnoses on Michael Jackson, in the wake of his untimely demise. It's a pedantic enterprise, with no shortage of diagnostic contenders: Pedophilia, anorexia, body dysmorphic disorder, and a dual diagnosis (that's a psychiatric disorder plus a substance abuse disorder). Most recently, we've got J. Michael Bailey, the man transgender activists love to hate, wading into the fray with erotic identity disorder and a paraphilia called autogynephilia.

"Whoa, folks! Not so fast!" say others.

Calling for a little reflection on this whole paraphilia-hebephilia-whateverphilia diagnostic craze is Scientific American columnist Jesse Bering, a research psychologist at Queen's University Belfast:

Would you really have wanted Oscar Wilde euthanized as though he were a sick animal? Should André Gide, whom the New York Times hailed in their obituary as a man 'judged the greatest French writer of this century by the literary cognoscenti,' have been deprived of his pen, torn to pieces by illiterate thugs? It's complicated. And although in principle we know that all men are equal in the eyes of the law, just as we did for Michael Jackson during his child molestation trials, I have a hunch that many people tend to feel (and uncomfortably so) a little sympathy for the Devil under such circumstances.
I highly recommend Bering's muse, "Pedophiles, Hebephiles, and Ephebophiles, Oh My: Erotic Age Orientation" (which, by way of full disclosure, cites yours truly).

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Monday, July 6, 2009

Brits agog over U.S. sex offender practices

A spate of media coverage of wacky U.S. sex offender policies is encouraging a sense of smug superiority among the British public. From sex offenders dumped under bridges on one side of the country to those locked in high-tech prevention detention facilities on the other, it isn't the most flattering portrait of the Land of the Free.

Most recently, BBC aired a special report on the ongoing disaster under the Julia Tuttle Causeway in Florida (which I’ve blogged about several times over the past two years). The community living in squalid conditions in makeshift huts and tents under the bridge, with no running water, electricity or toilets, has hit about 70 and just keeps growing.

"Welcome to American justice," Dr. Pedro Jose Greer of Florida International University told the visiting European journalist. "This is the stupidest damn law I have ever seen…. We have people living together with mental and physical illnesses in an environment where people can't possibly sleep because of the cars going by overhead -- where you can smell the urine and see the trash mounting all around us."

If that dirty laundry isn't bad enough, the other recent coverage of U.S. sex offender policies is no more flattering to us Yanks.

Filmmaker Louis Theroux, a quirky British-American best known for his television series Louis Theroux's Weird Weekends, was granted unprecedented access to the infamous Coalinga State Hospital in California, home to about 800 men serving "indefinite sentence for offences that they haven't yet committed and might never," in the words of the review in the (London) Independent.

The resultant documentary aired on BBC, "A Place for Paedophiles," depicts "a Kafkaesque place" where not just the sex offenders but also many members of the staff look pretty darned "creepy," says the Independent.

A Sun profile of Theroux and his film took the opportunity to paint an even kookier picture for the British public:

"They have karaoke nights, put on plays, and on their birthday are thrown a party with cake, ice-cream and gifts…. [They] spend their days at the £268 million centre playing ping-pong or watching DVDs, and they even stage Coalinga Idol contests based on Simon Cowell's talent show American Idol."

After experiencing Coalinga up close and personal, Louis expressed doubt that the Americans know what they are doing when it comes to sex offenders:

"The British system is that when an offender finishes his sentence, he is released on the sex offenders' register. If he then puts a foot wrong he is hauled back to prison. It's a lot cheaper than a system like Coalinga -- and a little bit more realistic."

"Coalinga is the weirdest place I've ever been to," Theroux says in the film. "I can't quite believe it exists. In America this is the latest way of getting a handle on sex offenders…. You assume the people who run this place know what they are doing, but you do question it."

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Saturday, June 27, 2009

Restorative justice expanding for juveniles

After more than a year in juvenile hall, 18-year-old Dante Green was given the chance of a lifetime: Join a Circle of Support and Accountability (COSA) and turn his life around. That was six months ago. Dante is now out of custody, attending college, and hoping to major in political science at UC Berkeley.

Dante was the first of 15 offenders to enter an ambitious pilot program in Oakland (Alameda County), California, which processes more than 6,000 juveniles through the juvenile justice system each year.

Restorative Justice for Oakland Youth, modeled on successful restorative justice projects in South Africa, New Zealand, Canada, and elsewhere, aims to rehabilitate miscreant youth by holding them accountable to their victims and their larger community rather than simply blaming and punishing them.


Each youth is surrounded by a personally tailored network, his Circle of Support and Accountability, which helps him accept responsibility and design a method to repair the harm he has caused.

Gail Bereola, the presiding juvenile judge, told a reporter she has been surprised at how many victims are more interested in seeing their victimizers rehabilitated rather than just punished: "They're interested in how the young person is going to improve themselves. They want to know what happens when they return to the community."

A Restorative Justice program in New Zealand is credited with a dramatic reduction in youth incarceration, and similar programs in an Oakland school and in Minnesota schools have been credited with reducing suspensions and expulsions, often the early warning signals of a life of alienation and crime.

I have been impressed with the success of the Circles of Support approach with hard-core serial sex offenders. Perhaps the longest-running program with sex offenders was begun by Mennonites in Ontario, Canada, back in 1994, and it has become world-renowned. Recently completed empirical research indicates that surrounding offenders with firm but caring adults makes them far less likely to reoffend as compared with matched controls. Based on the success of Canadian programs, similar Circles of Support are being initiated for paroling sex offenders elsewhere, including in England and, most recently, in the California Central Valley town of Fresno.

The moral: We know what works to rehabilitate criminals. Now we just have to find the resources and the compassion to implement it.

Related resources:

Graphics Credit: Extern, Northern Ireland

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Monday, June 22, 2009

CA court: SVP defendant must be competent

Appellate court bucks national trend

In another important SVP decision, a California appellate court has ruled that it is Unconstitutional to civilly commit a sex offender who is incompetent to stand trial.

The courageous decision in the case of Ardell Moore tackles head-on the fiction that merely labeling something as "civil" takes away the due process protections that automatically confer to criminal defendants:

"Irrespective of the fact a commitment under the SVPA [Sexually Violent Predator Act] is labeled civil rather than criminal, the defendant’s liberty is severely curtailed," the Court pointed out.

Ardell Moore is diagnosed with paranoid schizophrenia. Mental health evaluators have described him as floridly psychotic and delusional.

In its well-articulated decision, the court detailed much the same rationale as has long been recognized for criminal defendants. When a defendant is put on trial while incompetent, he becomes "a mere spectator," not able to correct erroneous information, assist his attorney, or testify effectively on his own behalf. All of this substantially increases the probability of a sham proceeding and a resultant miscarriage of justice.

"An incompetent defendant will have no opportunity to discuss his prior behavior and motivating reasons for such behavior with the state's evaluator or with a defense expert, or be able to explain to a jury why the state expert’s rationale for the diagnosis and volitional impairment is not justified. A defendant who is incompetent is at a great disadvantage, as he cannot meaningfully testify in his own behalf, cannot cooperate with his own counsel, nor assist his defense experts in understanding the basis for his behavior or provide evidence to rebut an evaluator’s potentially erroneous conclusion."
The appearance of a kangaroo court has not bothered courts in four other states -- Massachusetts, Iowa, Missouri and Texas -- which have all approved trials of incompetent SVP defendants based on the legal fiction that the proceedings are "civil."

Those cases are:
  • Massachusetts: Commonwealth. v. Nieves (2006) 846 N.E.2d 379
  • Iowa: In re Detention of Cubbage (2003) 671 N.W.2d 442
  • Missouri: State ex rel. Nixon v. Kinder (2003) 129 S.W.3d 5
  • Texas: In re Commitment of Fisher (2005) 164 S.W.3d 637
The unanimous opinion by the Court of Appeal in the Second Appellate District (Los Angeles) was a case of first impression, meaning the issue had not previously been addressed by a California appellate court.

Leaning heavily on last year's opinion in People v. Allen, in which the California Supreme Court held that defendants in SVP proceedings have a Constitutional right to testify over the objection of their attorneys, the court reiterated that "in every case" an SVPA defendant has the constitutional right to testify and to present his side of the story, and "mental competence is a prerequisite to the exercise of that due process right. Absent mental competence, a defendant cannot testify or participate meaningfully in the SVPA proceeding."

Moore was convicted in 1987 of kidnapping, forcible rape and forcible rape in concert and was sentenced to 25 years in state prison. As his parole date neared, he was flagged by state evaluators as a possible Sexually Violent Predator.

Two state evaluators, licensed psychologists Beryl Davis and Gary Zinik, testified against him at his trial. Both testified that he suffered from paranoid schizophrenia and was off his medications and too incoherent to talk with them when they tried to evaluate him. Despite his inability to rationally engage with them, they opined that he would likely reoffend sexually if released.

Testified Davis, "When we talk about volition and somebody's ability to control their behavior, when you're florid psychotic, you lose that volitional control, and somebody with a sexually [sic] preoccupation and inability to control themselves sexually would be a significant high risk."

Not surprisingly, after waiving his right to a jury trial Moore lost his trial and was civilly committed. The trial judge ruled that his incompetency did not matter, because the proceeding was civil and not criminal. Quoting from the Massachusetts case of Nieves, the court held:
"We see no reason why the public interest in committing sexually dangerous persons to the care of the treatment center must be thwarted by the fact that one who is sexually dangerous also happens to be incompetent."
Since 2000, Moore has been housed off and on at Atascadero State Hospital, where he has remained floridly psychotic, according to subsequent evaluators.

In early 2007, psychologist Vianne Castellano, Ph.D. evaluated Moore and opined that he was incompetent to stand trial: "He is neither able to understand the nature and the purpose of these proceedings nor is he able to cooperate in a rational manner with his counsel or the psychological evaluators."

The appellate ruling means his case will be remanded to the trial court for a new determination of whether he is competent to stand trial. If he is found incompetent, he will be entitled to competency restoration treatment at a state hospital.

As the appellate justices pointed out in their unanimous opinion, there is no real down side. In the event that an SVP defendant is found incompetent to stand trial, neither public safety nor state finances are affected. The defendant remains in custody in a state hospital, as he would have been had he been civilly committed, and "the fiscal burden to the state remains essentially the same."

The ruling is HERE. A previous appellate opinion in the case is HERE.

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Tuesday, June 9, 2009

Hebephilia struck by third blow

Down but not out?

It may be too soon to call it the death knell, but this week's ruling by a federal judge in Massachusetts certainly dealt a reeling blow to the highly contested pseudo-diagnosis of hebephilia and its ever-more-marginalized adherents.

In the third of three back-to-back decisions in federal court, U.S. District Judge Joseph Tauro said hebephilia just doesn't pass muster as a basis for civilly committing someone as a "sexually dangerous offender."

Hebephilia -- sexual attraction to adolescents -- certainly exists in nature, but the Government failed to meet is burden of establishing by clear and convincing evidence that it amounted to "a serious mental illness, abnormality, or disorder" as required for civil commitment, wrote the judge. Simply put, "hebephilia is not generally recognized as a serious mental illness by the psychological and psychiatric communities."

The case involved Todd Carta, who was due to be released from federal prison after serving time for computer-based child pornography. Carta has a lengthy history of sex with underage males, ages 13 on up, and has acknowledged an attraction to adolescent boys.

The Government's expert, psychologist Amy Phenix, diagnosed Carta with "Paraphilia Not Otherwise Specified: Hebephilia," which she defined as a sexual preference for "young teens . . . 'till about age seventeen."

Phenix's position was countered by psychologist Leonard Bard, who testified that Carta had no diagnosable mental disorder. Bard identified numerous problems with the diagnosis of hebephilia, including its absence from the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the prevalence of sexual attraction to adolescents among normal men.

The judge got it. In a thorough and well reasoned decision, he deconstructed the legal use of this nebulous diagnosis brick by brick. Perhaps most impressive was his clearly articulated understanding of the importance of adequate empirical research to support a diagnosis:

"Most importantly, the Government has failed to demonstrate that a diagnosis of hebephilia or paraphilia NOS: hebephilia is supported by research in the field of psychology…. Most of the articles put forward by the Government were published by coauthors Dr. Blanchard and Dr. Cantor. Dr. Bard criticized the work of Dr. Blanchard and Dr. Cantor, testifying that they are both on the editorial board of the journal that publishes their findings, which has at least the potential to damage the integrity of the peer-review process. Dr. Bard also criticized the research underlying their conclusions for failing to include a control group and for eliminating a large portion of the samples, among other problems. The five replies criticizing Dr. Blanchard's recent article proposing inclusion of hebephilia in the DSM-V suggest that Dr. Blanchard's work is not widely accepted. Dr. Bard testified that 'it’s the same group that is published over and over again trying to justify [a diagnosis of hebephilia], and they have failed.' "
The judge acknowledged that by ordering Carta's release he was not suggesting the convicted sex offender is a model citizen, but just drawing a line in the sand between criminality and mental disorder: Absent a widely recognized mental disorder it is Unconstitutional to "order indefinite commitment on the basis of the offensiveness of Respondent's conduct alone."

This is the third federal ruling in a row against hebephilia. The only other federal courts to address its use both rejected it as a basis for civil commitment. Those cases were U.S. v. Shields and U.S. v. Abregana, both decided last year.

Normally, this might be a "Three Strikes and You're Out" situation. Put the tired old construct to bed.

But fans are frantically trying to rehabilitate and rejuvenate hebephilia by getting it added to the next edition of the DSM (DSM-V). This would get around at least one of the many concerns expressed by Judge Tauro and others, over "the lack of any clear criteria" for making the diagnosis. Spearheading the DSM-V effort is Raymond Blanchard of the Centre for Addiction and Mental Health in Canada, who not only sits on the editorial board of the journal that published his research (as Judge Tauro pointed out in his opinion), but also serves on the DSM-V Sexual and Gender Identity Disorders Work Group. From that influential position, he is lobbying for the addition of hebephilia or a newly minted term – pedohebephilic disorder (what a mouthful!) to the diagnostic bible.

With the DSM-V work groups stacked (see my related posts HERE), we may just have to wait and see. But in the meantime, All Hail to Massachusetts, for landing a solid blow against pseudoscience in the forensic arena.

Judge Tauro's decision is HERE. A list of articles on "Hebephilia and the DSM-V Controversy" is HERE; for more on hebephilia see my essay, "Invasion of the hebephile hunters: Or, the story of how an archaic word got a new lease on life."

Photo credit: Noel Kerns' "Closed," Creative Commons license (entrance to the defunct Mission Four Outdoor Theatre in San Antonio, Texas)

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Saturday, June 6, 2009

New entry in porn-rape debate

With the controversy raging over whether pornography encourages sexual aggression, an important article has gone to press. Based on a review of the existing evidence, the authors say it is time to discard the hypothesis that pornography leads to sexual violence. Despite the theory's inherent appeal, the evidence to back it up just isn't there.

That's according to Christopher Ferguson of the Criminal Justice Department at Texas A&M and Richard D. Hartley of the University of Texas in San Antonio. As they summarize it in their Abstract:

The effects of pornography, whether violent or non-violent, on sexual aggression have been debated for decades. The current review examines evidence about the influence of pornography on sexual aggression in correlational and experimental studies and in real world violent crime data. Evidence for a causal relationship between exposure to pornography and sexual aggression is slim and may, at certain times, have been exaggerated by politicians, pressure groups and some social scientists. Some of the debate has focused on violent pornography, but evidence of any negative effects is inconsistent, and violent pornography is comparatively rare in the real world. Victimization rates for rape in the United States demonstrate an inverse relationship between pornography consumption and rape rates. Data from other nations have suggested similar relationships. Although these data cannot be used to determine that pornography has a cathartic effect on rape behavior, combined with the weak evidence in support of negative causal hypotheses from the scientific literature, it is concluded that it is time to discard the hypothesis that pornography contributes to increased sexual assault behavior.
The article, forthcoming in Aggression and Violent Behavior, is available online pending print publication, but it requires a subscription.

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Thursday, June 4, 2009

Essential reading on sex offender civil commitment

Failure to Protect: America's Sexual Predator Laws and the Rise of the Preventive State
by Eric S. Janus, William Mitchell College of Law


I just got around to reading this insightful book, and I wanted to recommend it to all of my blog readers. Law professor Eric Janus cogently explains why sexual predator legislation, despite its allure of zero tolerance for sexual violence, makes for very bad public policy.

Predator laws will never work, he argues, because they target only a tiny fraction of sexual violence. An empty "cleansing ritual," they require no fundamental societal change. But they are far from harmless. They siphon vast sums of money away from other programs that could do more good for more people. And they reinforce a distorted notion of sexual assailants as mainly stranger rapists with abnormal psychological makeups.

On a potentially more dangerous level, they provide a template for the resurrection of preventive laws on a massive scale. Janus reminds us of the historical struggle that went into dismantling earlier preventive detention laws that locked up outsiders for what they might (or might not) do. These included slave laws, the internment of Japanese-Americans during World War II, and eugenic programs to forcibly sterilize and incapacitate "mental defectives." Sexual predator civil commitment laws are especially dangerous because we can all unite around hating the archetypal sexual bogeyman, and the "science" of risk prediction has a scientific and naturalized veneer that makes preventive detention seem more palatable.

One of Janus' most interesting arguments is that -- perhaps accidentally-- the sexual predator laws have become a powerful force for the politically conservative agenda of dismantling hard-fought feminist rape reforms. The "tabloid model of gender violence" epitomized in these laws favors biological and psychological explanations over sociocultural ones, and supports the patriarchal rape myth that rapists "lack control" over their sexual impulses.

My review continues HERE. (As always, I appreciate "Yes" votes at Amazon, as they help with my ratings and the placement of my book reviews.)

Excerpts from the book are online HERE.

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Saturday, May 30, 2009

Brave judge tosses sexual assault conviction

Jessica's Law: Cruel and unusual punishment?

Jurors in criminal cases are generally kept blind as to the punishment that will be imposed if they find someone guilty. For that reason, one juror was dismissed during deliberations in a trial in Sonoma County, California, when he learned the potential outcome. The juror said he could not sleep once he realized that his guilty vote on a sexual assault charge could send the young defendant to prison for life.

Apparently, the judge in the case was similarly troubled.

Instead of sentencing 24-year-old Jaime Hernandez Gonzalez to life in prison yesterday, Judge Gary Medvigy dismissed the jury's conviction of assault with the intent to commit a sex crime during a burglary. He replaced it with a lesser conviction, residential burglary, which carries a maximum of six years in prison.

But the judge -- a former prosecutor and an Army reserves brigadier general who was decorated for his service in Iraq -- didn't stop there. In tossing the conviction, he read a lengthy statement questioning prosecutors' commitment to justice in light of the facts of the case.

Sentencing a young man with no prior criminal record to spend the rest of his life in prison for a crime that involved no violence or completed assault is so "grossly disproportionate" that it constitutes cruel and unusual punishment, the judge ruled.

In the rather bizarre case, Gonzalez entered a home through an unlocked sliding door, stripped naked, and accosted two sleeping women, removing the pajama bottoms of one. When the women screamed and ran away, Gonzalez fled too. The women testified that Gonzales appeared "zombie-like" or "comatose" during the assault, even when they screamed at him.

The judge slammed the 2006 Jessica's Law expansion under which Gonzalez was convicted, which mandates life imprisonment for sexual assault during a burglary, as "poorly drafted." He said it may be so overly broad as to be unconstitutional, because it requires the same punishment for crimes "involving minimal misconduct" as those involving severe violence and danger.

The District Attorney’s Office expressed outrage and threatened an appeal.

Meanwhile, the legal community in sleepy Sonoma County was abuzz over the judge's highly unusual action, according to news reporter Lori Carter, who covered the trial for the Santa Rosa Press-Democrat. Carter quoted a veteran attorney as calling the decision "gutsy":

"A lot of judges wouldn't do that because of politics. They're worried about reelection," said defense attorney Walter Risse.

Medvigy's conscientious stance will definitely cost him. The public hysteria over sex offending is manifested in the online comments to the Press-Democrat coverage, with vitriolic attacks and calls for the judge's ouster far overshadowing the few attempts at rational discourse.

The Press-Democrat article and related background coverage is HERE.

Photo credit: Press-Democrat

Hat tip: Tim Derning

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Thursday, April 16, 2009

 
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