Selected Annotated Bibliography on Denial

Abel, G., Becker, J, Cunningham-Rathner, J., Kaplan, M., & Reich, 3. (1984). The treatment of child molesters (SBC-TM, 722 West 168th Street, Box 17, New York, NY 10032).

Abel, G. G., Gore, D. K., Holland, C. L., Camp, N., Becker, J. V., & Rathner, J. (1989). The measurement of the cognitive distortions of child molesters. Annals of Sex Research, 2, 135-153.

Describes the Abel and Becker Cognitions Scale. It is a 29-item questionnaire designed to assess the cognitive distortions held by adults who sexually abuse children.

Barbaree, H. (1991, November). Denial and minimization among sexual offenders: Assessment and treatment methodologies and outcome. Paper presented to a Plenary Session at the ATSA Research and Treatment Conference on the Treatment of Sexual Abusers, Fort Worth, TX.

Barbaree develops a typology of the denial and minimization observed in sex offenders. He believes that denial and minimization represent different degrees of the same self-serving cognitive process; whereas denial is extreme and categorical, minimization is graded. Denial usually concerns the facts in the case or whether the offender has a "problem" for which he needs treatment, whereas minimization concerns the extent of the man's responsibility, the extent of his past offending, and the degree of harm his victims(s) have suffered. Between 50% and 60% of the offenders they evaluated deny they are sex offenders. The vast majority of the remainder minimize their offending in some way.

Bradshaw, T. L., & Marks, A. E. (1990). Beyond a reasonable doubt: Factors the influence the legal disposition of sexual abuse cases. Crime & Delinquency, 36(2), 276-285.

This was an archival study. The authors note that cases are most likely to be prosecuted when the victims are between ages 7 and 12. Although many offenders suggest that the child was the aggressor in the act, and others deny sexual intent, most perpetrators admit to touching the child. There was a high conviction rate in cases that go to trial. Of their 350 cases, 35% plead guilty or were convicted at trial and 65% were dismissed, no billed, or acquitted.

Bumby, K. M. (1996). Assessing the cognitive distortions of child molesters and rapists: Development and validation of the MOLEST and RAPE scales. Sexual Abuse: A Journal of Research and Treatment, 8(1), 37-54.

Bumby developed the scales using 69 sexual offenders in a cognitive-behavioral sexual offender treatment program. There were 25 offenders convicted of rape and 44 convicted of sexual contact with a child. All of the members of the child molester group were intrafamilial offenders. The control group was 20 males incarcerated for nonsexual offenses. He reports acceptable internal consistency and reliability for both scales and satisfactory validity and believes these scales are promising clinical and research measures.

Davidson, 3. (1994, March). Child molesters. Self pp.162-165, 180, 182, 187.

Written by a journalist who attended a NAMBLA conference. He notes that the pedophile has become our society's monster and observes that several pedophile organizations exist in the United States, including Rene Guyon society, The Childhood Sensuality Circle, and NAMBLA. NAMBLA's officially stated purpose is "to organize support for boys and men who have or desire consensual sexual and emotional relationships and to educate society on their positive nature." The conference only had 50 attendees. NAMBLA is based on the gay liberation model and points to other cultures and eras (i.e. ancient Greece and Japan) where love between men and boys was accepted. Most of the attendees claimed to be celibate.

Eisenman, R. (1993). Adolescent and young adult sex offenders: Are they sexually addicted? Louisiana Journal of Counseling, 4(1), 6-67.

Eisenman reports on his work with adolescent and young adult sex offenders in a prison treatment program. The offenders were from ages 16 to 28 years old. Juvenile offenders had no remorse. The ones he worked with typically were quite happy with their sexual victimization of others, and the only regrets they had were being captured and imprisoned. Eisenman feels that only through therapy did these sex offenders come to see that there was anything wrong with their sexual behavior.

Elliott, M., Browne, K., & Kilcoyne, J. (1995). Child sexual abuse prevention: What offenders tell us. Child Abuse & Neglect, 19(5), 579-594.

Child sexual offenders (N = 91) from a variety of sources were interviewed about their abusive behavior patterns. Offenders gained access to children through caretaking, targeting children by using bribes, gifts, and games; used force, anger, threats, and bribes to ensure their continuing compliance and systematically desensitized children through touch, talk about sex, and persuasion. Nearly half of the offenders had no bad feelings about sexually abusing children. They claimed that the child had shown no distress. Two-thirds claimed that they had been sexually abused themselves as children.

Freund, K., Watson, R., & Dickey, R. (1990). Does sexual abuse in childhood cause pedophilia: An exploratory study. Archives of Sexual Behavior, 19(6), 557-568.

Freund et al. studied 344 males-homosexual pedophiles, heterosexual pedophiles, nonpedophilic offenders against children, sex offenders against adult females, heterosexual clients were preferred mature females, and homosexual clients who preferred mature males. They used the plethysmograph for a diagnosis of erotic preferences and analyzed self-report and conclude that the reliability of self-reports is questionable and that the empirical basis of the abuse cycle theory of pedophilia is unreliable. They note that "that the majority of sex offenders against children do not deny the offense(s), but do blame it on particular external circumstances, having been drunk at that time, or just say they do not understand how it could have happened and subsequently deny any erotic attraction towards children" (p.567).

Freund, K., Watson, R., & Dickey, R. (1991). Sex offenses against female children perpetrated by men who are not pedophiles. The Journal of Sex Research, 28(3), 409~23.

Freund et al. studied nonadmitters — that is, sex offenders against children who denied an erotic preference for minors and who claimed that they did not have erotic fantasies about children or pubescents. Subjects were divided into single-case victimizers and multi-case victimizers and were given the plethysmograph. The non-incestuous, multi-case offender was more often diagnosed as a pedophile on the basis of the plethysmograph. The authors speculate that with gynephilic offenders against children-such offenders who erotically prefer physically mature females-indictment and incarceration may effect a "cure" for life.

Fromuth, M. E., Gold, S., & Conn, V. (1993). Adolescent child abuse perpetrators in nonclinical samples: Paper presented at the annual meeting of the American psychological Association, Toronto, Canada.

Fromuth et al. report that in their college sample (N=692), 7% described sexually abusing a child according to the criterion. Their average age was 14, the average age of victims was 8, most victims were female. Fondling was most common behavior. Most did not not view what they did as sexual abuse-when asked to rate the perceived effect on the other person, 15% rated it as positive, 67% as neutral, and only 18% as negative.

Happel, R. M., & Auffrey, J. J. (1995). Sex offender assessment: Interrupting the dance of denial. American Journal of Forensic Psychology, 13(2), 5-22.

Happel and Auffrey note that it is rare to find incarcerated sex offenders who are completely honest about their sexual deviance or history of sexual offending. Instead, they deny culpability and minimize their behavior. They fail to understand the traumatic impact of their abusive behaviors. They note that pedophiles say their victims were too seductive and too interested in sex while claiming their deviance was educational, beneficial, and in the best interest of their victims. They deny to avoid feelings of shame confusion, embarrassment, inadequacy, responsibility, and guilt. They are afraid of disapproval and rejection and deny their deviance to avoid people believing there is something wrong with them. They describe 12 steps in the denial process.

Hartley, C. C. (1998). How incest offenders overcome internal inhibitions through the use of cognitions and cognitive distortions. Journal of Interpersonal Violence, 13(1), 25-39.

Suggests four types of cognitive distortions and how they work to disinhibit.

1. Cognitions related to sociocultural factors.

2. Cognitions used to overcome the fear of disclosure.

3. Cognitions used to diminish responsibility.

4. Cognitions related to permission seeking.

Hindman, J. (1988). Research disputes assumptions about child molesters. National District Attorneys Association Bulletin, 7(4), 1, 3.

Hindman compared paroled male sexual offenders against children in two periods. In the second period, the patients were told that they would have to submit to a polygraph test and if their self-reports were contradicted they would be returned to jail. In the first period, during which patients were not threatened with polygraph testing, 67% said they themselves had been abused as children but in second period, only 29% said this. The implication is that some offenders may fabricate such an event as an excuse for their erotic attraction to children. In the period before the polygraph, the average number of victims was 1.5; afterwards, it was 9.0.

Maletzky, B. M. (1996). Denial of treatment or treatment of denial? Sexual Abuse: A Journal of Research and Treatment, 8(1), 1-5.

Maletzky collected data on offenders who maintained denial at entry into treatment and those who continued to deny, as opposed to those who admitted during treatment that they were responsible. The treatment they used was a cognitive/behavioral group and individual. Several findings:

1. Just over 60% who entered treatment completely denying admitted something by the end of their program.

2. Group was more effective at producing this verbal change than was individual.

3. The men who made this verbal change were somewhat more successful in treatment than those who did not.

4. Men who admitted crimes at entry into treatment were more successful than those who denied.

5. The vast majority of men who did not admit, yet completed the program were successful at not relapsing.

6. Men in total denial who completed the program were overwhelmingly safer to be at large than those who admitted but did not complete treatment.

Marshall, W. L., & Eccles, A. (1991). Issues in clinical practice with sex offenders. Journal of Interpersonal Violence, 6(1), 68-93.

Marshall and Eccles report that 46% of the men referred to their outpatient clinic deny the accusation, but after the evaluation (including the plethysmograph), 54% of these deniers change their position and admit. They stress the importance of assessing and addressing denial and minimization regarding the offense and attributing responsibility for offending to factors outside the offender's control. They note that the degree to which an offender denies or minimizes his behavior will reflect his motivation to participate actively in treatment. They observe that when the offender minimizes the significant of his sexually abusive behavior, he makes recurrence more likely. They note that child molesters are believed to hold distorted cognitions that maintain their deviant behavior.

Nelson, R. M., & Fitzgibbon, R. M. (1992, April). Why I'm every mother's worst fear. Redbook, 85-87, 116.

Written by a convicted pedophile for Redbook Magazine. Nelson presents his attitudes and justifications. He sees himself as a "loving friend" to the boys he abused. He blames the fact that his mother and teachers didn't properly discuss his sexuality with him when he was young and blames parents for not giving their children the affection and recognition they crave. He does not really believe that what he did was wrong.

Nichols, H. R., & Molinder, I. (1984). Multiphasic Sex Inventory manual. A test to assess the psychosexual characteristics of the sexual offender. (Available from Nichols & Molinder, 437 Bowes Drive, Tacoma, WA 98466.)

The Multiphasic Sex Inventory (MSI) is a self-report questionnaire designed to assess psychosexual characteristics of sexual offenders. It is designed for clinicians who evaluate and treat sexual offenders and should not be used with individuals who deny the offense. It contains two scales which assess the cognitive distortions of the offender and the excuses and justifications that the offender believes caused or contributed to his sexual behavior.

O'Donohue, W., & Letourneau, E. (1993). A brief group treatment for the modification of denial in child sexual abusers: outcome and follow-up. Child Abuse & Neglect, 17(2), 299-304.

O'Donohue and Letourneau developed a brief structured group treatment for deniers. There were 7 sessions: victim empathy, irrational beliefs, sex education, assertiveness skills, a guest speaker who had once denied but now admitted, victim empathy, and a discussion session where the group members talked about their reactions to the group. They report that the 17 subjects who have gone through the group (in two group sessions) were almost all in complete denial prior to the group. Post-treatment, 13 (76%) were rated as being at least partially out of denial, 5 of the 13 only partially admitted, 8 fully admitted, and 4 maintained their denial.

Pollock, N. L., & Hashmall, J. M. (1991). The excuses of child molesters. Behavioral Sciences and the Law, 9(1), 53-59.

Pollock and Hashmall examined the 4ecords of 86 child molesters and examined over 250 justificatory statements. They found a total of 21 distinct excuses and six thematic categories. They note that there are no empirical data to answer the question of whether the excuses and rationalizations are a cause of the abusive behavior or a consequence of the abusive behavior. The six categories are:

1. Mitigating factors: situational (intoxication, family stress, financial stress, deprived of conventional sex)

2. Sex with children is not wrong (victim consented, sex with children is not wrong).

3. Incident was nonsexual (Nonsexual touching, just being affectionate, just trying to help the victim, acting out of anger, punishing the victim)

4. Mitigating factors: psychological (don't know what's wrong with me, fear of adult females, childhood sexual abuse, sexual preference for children, childhood physical abuse).

5. Blaming the victim (victim initiated)

6. Denial (nothing happened, victim was lying, someone is out to get me, victim's parents were lying).

Stermac, L., & Segal, Z. (1989). Adult sexual contact with children: An examination of cognitive factors. Behavior Therapy, 20, 573-584.

Vignettes describing sexual contact between an adult and a child were abstracted from actual cases and constructed to vary the degree of sexual contact and the child's response. Groups (total N was 186) of child molesters, rapists, clinicians, lay persons, lawyers, and police officers responded to questions following each vignette which assessed their view of the adult's and the child's behavior. The results indicated that child molesters differed from other groups in perceiving more benefits resulting from sexual contact, greater complicity on the child's part, and less responsibility on the adult's part. They note that these cognitions could be either post hoc rationalizations for initial episodes of sexual misbehavior, or dimensions which come to mind before the behavior occurs.

Schlank, A. M., & Shaw, T. (1996). Treating sexual offenders who deny their quilt: A pilot study. Sexual Abuse: A Journal of Research and Treatment, 8(1), 17-23.

Schlank and Shaw used a sample of 10 offenders who were judged unamenable to treatment due to total denial of their offenses. Their approach was a brief structured module combining elements of relapse prevention and victim empathy training with paradoxical intentions and positive reinforcement. They report that 2 of the 10 clients admitted their guilty for the offense during the victim empathy part of the program and 3 others by the end of the module, resulting in a 50% success rate for their small sample. Included in the offenders who admitted were 3 of the 3 clients who had previously been dismissed from group for failing to respond to the peer pressure of a regular treatment group.

Silva, D. C. (1990). Pedophilia: An autobiography. In I. Feierman (Ed.), Pedophilia: Biosocial dimensions (pp. 464~87). New York: Springer Verlag.

Silva notes about himself: "I believe I was born a pedophile, because I have had feelings of sexual attraction toward children and love for them for as long as I can remember." He presents a brief autobiography which includes his sexual relationships with boys. These sexual relationships are presented as loving and caring and not harmful to the boys. He them as "beautiful and precious," "precious rarities" and "incredibly beautiful." He stresses the emotional bonds he claims to have had with the boys. He was eventually arrested, convicted, and incarcerated.

Winn, M. E. (1996). The strategic and systematic management of denial in the cognitive/behavioral treatment of sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 8(1), 25-36.

Winn describes seven overlapping types of denial:

1. Denial of facts (denies the offense or admits it but says this is the only time it ever happened)

2. Denial of awareness (drug or alcohol blackouts, memory lapses)

3. Denial of impact (minimizes the ramifications of the abusive behavior; focuses on the impact to the offender but not the victim or family)

4. Denial or responsibility (blames the victim, their spouse, claims he was educating the child)

5. Denial of grooming oneself and the environment (denies planning, fantasies, etc., describes the abuse as spontaneous and without any planning)

6. Denial of deviant sexual arousal and inappropriate sexualization of nonsexual problems.

7. Denial of denial

He stresses that the therapist should speculate on the protective function of a given denial-laden behavior or cognitive distortion and compassionately challenge the offender's denial at the level of self-preservation. When denial is understood as a form of self-preservation, it allows the clinician to maneuver in ways which transcend the traditional methods of direct confrontation. Not all people respond positively to confrontation, especially those who are vulnerable and dependent on their defenses. Some will respond rebelliously to the mechanical application of confrontation. He describes treatment techniques that avoid this.

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