ABSTRACT
Child pornography is generally considered an almost unspeakable perversion. John Doe is a 21-year old Caucasian male that has been arrested and tried for possession and distribution of this material. A postarrest mental health assessment shows that his main problems are social and emotional in nature. The criminal postarrest assessment hypothesizes that this criminal activity may be due to social awkwardness. These two differ in nature because the former looks to establish a mental evaluation, exploring the personal aspects of this activity, while the second looks for motives in order to contrast his behavior with the law. He has an introverted personality and does not seem to cope well with stress, making him implosive and possibly suicidal. Doe could be treated in many different ways, but psychodynamic individual treatment would seem to be the most appropriate and obvious; nevertheless, the complexity could justify using any theory and modality available. Finally, there are various tests that could be useful in this case, including the Personality Assessment Inventory and the second edition of the Trauma Symptom Inventory.
Keywords: Child Pornography, Forensic Psychology, Criminal Psychology, Personality.
Mental Health Postarrest Assessment
The subject is a 21-year-old Caucasian male with social and cognitive problems, being tried for possession and distribution of child pornography. He was sexually molested at 9 years old, has a history of substance abuse and is mildly depressed.
His most affected area is the social one, as he does not seem to have significant relationships with others. His speech impediment is a probable contributor to this, as well, if not a symptom. His first sexual experience was at the age of 19 and unsatisfactory. He has never had a job and mostly enjoys activities he can do by himself. The diffusion of the material could have been motivated by a need for social acceptance, which he would only find in those chat rooms if he diffused pornographic material.
Another area that he has difficulties with is the cognitive one. He probably received very little stimulation as a child, being raised in a semi-rural environment. This may have been the cause of him being held back in second grade, being enrolled in special education classes until he was nineteen, when he graduated from high school. This could also be the source of the speech impediment, making it not a linguistic problem, but a cognitive one.
Nevertheless, a more thorough examination process would have to be done in order to accurately assess the extension of the problem. There is no further mention of his cognitive skills, and he accepted a plea agreement and was able to adequately use a computer for chatting. Nevertheless, he may not have been aware that this was a crime and could lead for him to be imprisoned.
The relationship of both of these areas to the emotional one implies that the risk of suicide should be examined with careful detail. While there is no information as to him having attempted this act before, it should be noted that he does engage in self-harming behavior, as can be seen in the consumption of alcohol and marihuana since the age of 14. This could possibly be interpreted as a consequence of his sexual molestation five years before, which would make self-harm a coping mechanism, putting him at a medium to high risk of self-harm.
Therefore, it is very important to explore the possibility of suicide with him both before and after the trial, including the presence of suicidal ideation. It would be imperative to monitor him during the trial and for the first weeks after his sentence to see how he reacts to this trying experience. His lack of social and cognitive skills that would help him cope through this process may prove too fragile to withstand such a traumatic experience.
Line of questioning to determine personality type:
What are your favorite activities?
Would you rather be alone or with other people?
How do you feel when you are with others?
What do other people think about you?
How do you feel about yourself?
Line of questioning to determine suicide risk:
How do you handle stress?
How often do you have thoughts about dying?
Many people sometimes think about doing harm to themselves. Have you ever thought about it?
Has the thought of ending your life ever passed through your head?
Investigative Postarrest Assessment
Doe is a 21-year-old male being charged with possession and distribution of child pornography. He belongs to chat rooms that share child pornography, both photographs and videos. Hundreds of these were found that depicted lewd acts by adult males with underage children.
The only two other people in the household are his parents and his sister. The computer where all of this material has been found is his. He is facing a possible prison sentence of between 15 and 20 years. If he pleads guilty, this can be significantly reduced through supervised release.
He seems to be mildly depressed, and is socially awkward. Legal sanity should be explored before having him stand trial. This social awkwardness may also be one of the factors that led him to commit this crime. He does not seem to have many social relationships that would lead to sexual intercourse. Furthermore, his favored way of relating to others appears to be playing video games on his computer. His only known sexual experience was under the effect of alcohol with a girl, and this was not satisfactory. His sexual interest in younger people may be related to him being molested as a child.
With regards to the distribution of the material, the motivation seems somewhat fuzzier. He could have just participated in the chat rooms where he was sent the pornographic material, without having actually distributed it himself. Furthermore, the defense attorney may argue that Doe was not actually aware that he were doing this, especially taking into account his diminished intellectual faculties.
Differences between Law Enforcement and Forensic Mental Health Care Assessments and Criminal Investigation
Even though they are both treating the same subject, there are many differences in the approach that law enforcement personnel and forensic mental health care staff would undertake when handling this case. This is mainly due to the conceptualization that each of them has of crime and the objectives that they seek.
With regards to the first of these, law enforcement workers would seek to determine whether or not the person actually committed the crime, while mental health care workers would look to relate this supposed fact to the patient’s mental health. This latter approach would including taking into account the person’s social, emotional and cognitive motivations for his or her actions, looking into their life history for the possible emotionally-charged events that would explicate the crime. Therefore, the sexual abuse and social problems that Doe has had would be more interesting for the mental health care assessor than for the law enforcement official.
On the other hand, law enforcement personnel would seek to have justice done according to the Constitution, which mental health workers do not take into account. Obviously, this does not mean that they act against the law; they simply consider other factors when conceptualizing and describing the case. Meanwhile, the law enforcement officials are interested in establishing whether or not the persona actually committed the act in question, looking for possible motivations in order to strengthen their case and make it logically sound. As such, the presence of this incriminating material in Doe’s personal computer would be the main fact that the law enforcement officials would take into account when making their case.
Accordingly, their criminal investigation would be different, as the law enforcement officials would seek evidence as to if the person committed the crime or not, while the mental health worker would explore the individual’s inner world to associate it to the case. The former seeks to establish whether the person actually did the action, while the latter attempts to locate it within the person’s experience as a human. The latter would check the person’s relationship to reality, while the former would investigate whether the person actually intervened in reality itself. These two conceptions of crime and the human lead to different roles for the mental health professional and the law enforcer.
Personality Characteristics and Motivational Dynamics
Child pornography collectors and distributors have many different characteristics. There are no special traits that differentiate them from the rest of the population. “There is no one type of Internet child pornography user, and there is no easy way to recognize an offender” (Wortley & Smallbone, 2006, p. 13). Nevertheless, psychologists have attempted to obtain certain patterns within this almost infinite variation.
In general, John Doe has many of the personality traits that users of child pornographers possess; he fits the profile almost perfectly. “Among the few distinguishing features of offenders are that they are likely to be white, male, and between the ages of 26 and 40, and may be heavy Internet users to the extent that it interferes with other aspects of their lives” (Wortley & Smallbone, 2006, 14). John Doe fits all of these categories except for the age bracket. It is especially important to note that Internet use has an important correlation, as it seems to be inhibiting Doe’s other life domains as well. Nevertheless, it is important to note that this is a rather broad profile, and that Internet use is so widespread now that this would end up being more of an ethnic and demographic segregation than a properly psychological one.
In this sense, Doe also has some distinct personality characteristics that are common in Internet sex offenders. Specially, Laulik, Allam & Sheridan (2007) found that Internet sex offenders have problems in the social and emotional spheres of their life, which seem to be the most affected in this case. Perhaps the greatest personality characteristic of child pornography users that Doe has is fantasy and underassertiveness (Elliot, Beech, Mandeville-Norden & Hayes). The former is evident in the case through the favored use of video games. The latter would have to be explored, but is a likely correlate of his diminished social skills.
With regard to motivation, this line of questioning would have to be pursued with the subject. This is due to the fact that there are many reasons why one would collect and distribute child pornography. Only through a proper interview with him could one determine his reasons for using it. His history of child abuse and lack of other sexual escapes are possible factors, yet it would be important to check this with Doe.
Postconviction Treatment
It is important to think of prison as an opportunity for rehabilitation, instead of mere punishment. After being convicted, people should be led to reintegrate themselves into society in a better way. Some would suggest that treatment is imperative in this case because child pornography may lead to physical sexual offenses on children (Burke, Sowerbutts, Blundell & Sherry, 2011). Even though there is no conclusive evidence towards this, it is still a very complicated behavior that would benefit from professional help.
Nevertheless, it must be stated that psychotherapeutic treatment may be difficult for John Doe. First, his cognitive, social and emotional skills are not the best for the establishment of the therapeutic link. Furthermore, as Craissanti and McClurg (1997) have shown that a history of child abuse usually leads to poor treatment compliance. Therefore, his past experience would also make it more difficult for him to get better with respect to others. However, this does not mean that this treatment should not be pursued, just that results are expected to be slower.
Type of Treatment
There are three main types of treatment that would be recommended in this case. The first of these is cognitive-behavioral, which is based on the ideas and actions that the person may have. The second is psychodynamic, based on the work of Sigmund Freud, contemplating unconscious drives and desires. Finally, medication could also be used to treat many of the symptoms, especially anxiety and depression.
Cognitive-Behavioral. There has been some research that has evidenced the efficiency of the cognitive-behavioal model for online sexual compulsivity (Putnam, 2004). By conceptualizing the access of pornographic material online as an impulse control disorder, it has been associated to both classical and operant conditioning. Burke, Sowerbutts, Blundell & Sherry (2011) have found that working with cognitive distortion to also be effective at treating this type of compulsion; especially, they have evidenced that this is important so that Doe does not go on to actually molesting children.
Psychodynamic. Another way to treat the case would be through psychodynamic therapy. Even though there is still much empirical validation to be achieved with this current, it would be an almost textbook example of two of its main concepts: trauma and repetition. A psychodynamic therapist would conceptualize his sexual abuse as a child to be a very emotional experience that he has still not processed, having gone into his unconscious. This leads him to try to reenact this in his life with other boys, trying to get control of this first situation.
Medication. The main use of medication in this case would be against his mild depression. Furthermore, it could also be used against the anxiety that the case could produce, especially with the possibility of suicidal ideation and attempts. Finally, psychotic symptoms could be explored and treated by the medication as well.
Modality
There are two main psychotherapeutic modalities that could be used in order to help the situation. Probably, due to the intimate and personal nature of the case, individual psychotherapy would be most useful, especially in terms of the collection and distribution of child pornography. Nevertheless, group therapy could also be beneficial for the social and emotional aspects of the case, which could be important underlying factors for the child pornography.
Outcome Measures
There are many ways to measure the efficacy of the treatment. The first and most basic of these is subjective testimony: the person could be asked if he or she feels better or not. Furthermore, the impulse to collect and distribute child pornography could be observed and measured as well, to see if it is diminishing. Furthermore, different personality tests could be administered to see if the social and emotional aspects are improving.
Psychological Tests
There are various psychological tests that can be employed in this case. These are especially useful to establish John Doe’s psychological profile. Even though interviews are important and very valuable, tests may provide data that was not perceived before, and in an objective, scientific way.
One possible questionnaire would be the Personality Assessment Inventory, which could be used to asses John Doe’s personality and psychopathology. It uses a 4-point scale and has four varieties: validity, clinical, treatment consideration and interpersonal. These would be very useful in the case because they measure psychiatric diagnoses; other treatable factors, such as treatment rejection, suicidal ideation and stress; and social functioning. All of these areas are obviously very important in the evaluation of John Doe. Furthermore, the results could be compared to those of Laulik, Allam & Sheridan (2007), who employed this test to assess Internet sex offenders as well.
The second edition of the Trauma Symptom Inventory would be another useful tool. It is a multi-scale instrument that measures trauma/related symptoms, as well as giving information about the attitude that the taker has had towards the test. This would help see if and how John Doe has handled the sexual abuse he suffered as a child.
Reference List
Burke, A., Sowerbutts, S., Blundell, B., & Sherry, M. (2002). Child pornography and the internet: Policing and treatment issues. Psychiatry, Psychology and Law, 9(1), 79-84. DOI: 10.1375/pplt.2002.9.1.79.
Craissati, J. & McClurg, G. (1997). The Challenge Project: A treatment program evaluation for perpetrators of child sexual abuse. Child Abuse & Neglect, 21(7), 637-548. DOI:10.1016/S0145-2134(97)00028-8.
Elliott, I. A., Beech, A. R., Mandeville-Norde, R., & Hayes, E. (2009). Psychological profiles of internet sexual offenders. Comparisons with contact sexual offenders. Sex Abuse, 21, 176-92. DOI: 10.1177/1079063208326929.
Laulik, S., Allam, J., & Sheridan, L. (2007). An investigation into maladaptive personality functioning in Internet sex offenders. Child Abuse and Neglect, 15(5), 523-535. DOI: 10.1080/10683160701340577.
Putman, D. E. (2004). Initiation and maintenance of online sexual compulsivity: Implications for assessment and treatment. CyberPsychology & Behavior, 3(4), 553-563. DOI:10.1089/109493100420160.
Wortley, R. & Smallbone, S. (2006). Child Pornography on the Internet. Problem-Oriented Guides for Police Problem-Specific Guides Series, 41. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.501.4289&rep=rep1&type=pdf
