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Vol. XVIII, No. 3
Summer 2006
Risk Assessment in the 21st Century: Towards an Integrative Model of Risk



Risk assessment has made great strides in the last few years. However, the lack of clear guidelines on how to integrate current ideas has meant that the very real commonalties between current theorizing, clinical expertise, and empirical knowledge are only now gaining recognition. Therefore, this article describes a work in progress that attempts to integrate some of these concepts in a useful conceptual framework for clinicians to use in risk assessment and clinical formulation. Having presented this framework a few times at conferences, we have received generally good feedback on its face validity and conceptual utility. Of course, we welcome feedback on what readers think are useful (and not so useful) parts of this framework, and are available by email at the addresses given at the end of the article. We will now outline the ideas that led us to the generation of the framework outlined below, and would like to thank Jackie Craissati for providing the starting point for this approach, through her work examining the relationship between developmental factors and subsequent risk. We also note that the model draws heavily upon the work of David Thornton, Karl Hanson, Andrew Harris, and others in the field.


Current concepts in risk assessment



Clinicians typically use clinical judgment, actuarial prediction, or some combination of these approaches to assess the future risk of a convicted sexual offender. Clinical judgment may, or may not, be rooted in theory depending upon the clinician's knowledge of the field. In the worst case scenario, they may even be based on idiosyncratic clinical judgments about the most important variables to consider in a report. In contrast, the most commonly employed actuarial risk prediction instruments rely almost exclusively on historical or static risk factors that cannot change, such as previous convictions for sexual offenses, identified lack of long-term intimate relationships, and general criminality. These, and other, factors have been identified in various empirical studies reported by the risk assessment developers, i.e., Hanson and Thornton (2000) who describe the development and validation of Static-99; and Thornton et al. (2003) who describe the development and validation of Risk-Matrix 2000.


In an attempt to overcome the limitations of purely static actuarial instruments, and to take into account the fact that risk may be reduced by treatment, some researchers have developed classification schemes that additionally incorporate dynamic factors, i.e., clinical/psychological risk factors that are amenable to change (Beech, Fisher & Thornton, 2003). Probably the most up-to-date published thought in this area, by Thornton (2002), suggests that four domains of psychological problems can be identified as related to the future commission of sexual offenses. These are: (1) sexual intereststhat are broadly deviant, such as arousal to children or to sexualized violence; (2) distorted attitudesthat are supportive of sexual assault, such as child abuse supportive beliefs or adversarial sexual attitudes; (3) a level of socio-affective functioning that leads to lack of emotionally intimate relationships with adults and excessive emotional over-identification with children; (4) self-management problems, leading to lifestyle impulsiveness and/or dysfunctional coping.



In the general criminological literature such long-term psychological problems are characterized as criminogenic need factors (i.e. such items have been identified as being broadly related to recidivism, and hence are legitimate treatment targets, where treatment can hopefully reduce dynamic risk; Andrews & Bonta, 2003). Hanson & Harris (2000a) have described another set of risk factors, which they term acute dynamic risk factors, as opposed to stable risk factors (Hanson & Harris, 2000b). These include evidence of severe emotional disturbance or crisis, hostility, substance abuse, and rejection of supervision, and hence can be regarded as proximal/contextual characteristics that signal the onset of offending, as opposed to more the stable dynamic/criminogenic need factors (outlined above), that broadly are unchangeable unless targeted in therapy.




However, even though risk assessment has to have made great strides in the last few years, a lot of this work is essentially atheoretical. This is because risk assessment instruments have been developed through statistical analysis of large data sets (in order to identify items related to future risk), and meta-analysis of various studies in order to identify the most predictive factors (e.g., Hanson & Bussière, 1998; Hanson & Morton-Bourgon, 2005). This work has been incredibly important to the field. However, without a clear conceptual framework, and by taking items in isolation, there is a very real danger of this work sending treatment providers the message that it is only really worth focusing on the items that have shown the clearest relationship to reconviction, i.e. deviant sexual interest and general impulsivity/self-management problems. This can result in other areas typically targeted in therapy, but without convincing evidence that they are directly related to recidivism (such as increasing levels of self-esteem and inculcating victim empathy in an offender) being no longer regarded as promising treatment targets. Similarly, some argue that abuse history, as it does not appear to have a strong relationship with future risk, should not be dealt with in treatment. We believe that an argument where only items strongly identified with recidivism are worthy of treatment is a logical fallacy. It is not possible to take items regarded as putatively associated with risk in isolation. This approach leads to therapeutic reductionism and does not allow for new approaches to treatment, such as the Good Lives model (Ward & Gannon, 2006).


Risk, as clinicians know, is a complex interaction between psychological factors and an individual's history and current life circumstances. Although self-esteem, for example, may not have an established relationship with subsequent offending, a question remains. If an individual's self-esteem is at rock bottom, how will that person be able to take on board the messages imparted in therapy and action them in his life? Therefore, not focusing on this area makes it much more likely that treatment will have little or no effect.


Similarly, although a history of sexual abuse does not have an easily demonstrable association with future offending, it can clearly have an identifiable negative effect while an individual is in treatment (due to the issues raised in treatment reminding an individual of his own abuse history). As we know, treatment dropout has been associated with increased risk of sexual recidivism (Hanson & Bussière, 1998). Therefore, not dealing with such a problem this can lead to increased risk of recidivism.


We think it is now time to take a wider view of risk assessment and begin to put together the disparate pieces of this jigsaw puzzle. We are not claiming to have the complete answer, but hope to provide food for thought on how risk fits within an etiological/developmental framework informed by current theories of sexual offending.


An etiological model of risk



This model draws upon some of the theoretical ideas outlined in the field. By doing this we hope to demonstrate that a lot of what has been talked about theoretically, observed in practice, and measured clinically, can potentially be pulled together. We have reconfigured some of the concepts briefly outlined in the last section, taken some ideas from mainstream psychology, and drawn upon theoretical ideas within the field. These ideas were first formulated in our article in Aggression and Violent Behavior (Beech & Ward, 2004), with a shorter version appearing in the ATSA journal shortly after (Ward & Beech, 2004). As noted earlier, we have now been in a position to get feedback from clinicians on this framework; hence, there have been a few modifications to the original. However, the model is essentially the same as originally proposed, and contains the following elements that we think may help us to move towards a more coherent risk assessment framework:


·        An integration of developmental factors by consideration of Marshall and Barbaree’s (1990) theoretical idea that developmental adversity can result in increased vulnerability to sexual abuse of children;


·        Stable dynamic risk factors, such as deviant sexual arousal to children, denote psychological vulnerability, while static risk factors, such as previous convictions for sexual abuse of children, really act as historical markers for stable dynamic risk factors (Mrazek & Haggerty, 1994). Hence, both static and dynamic risk factors pick up on an overall vulnerability factor, one in the here and now, and the other at some point in the past.


·        The distinction between stable dynamic and acute dynamic risk factors might be better reframed in terms of the more psychologically rigorous definitions of trait risk factors (e.g., enduring personality problems) and transient state risk factors, or the temporary (usually extreme) expression of the more enduring stable dynamic risk factors.


·        Acute risk factors identified by Hanson and Harris (2000b), such as emotional collapse, collapse of social supports, hostility, and substance abuse would be better conceptualized as triggering risk factors;


·        Finally, states of high risk are due to psychological traits/stable dynamic risk factors being pushed into states of imminence by an interaction with these triggering risk factors.



The model itself, as shown in Figure 1, contains a chain of events from a distal developmental factors section, through a vulnerability factors section (as measured by historical markers of risk and stable dynamic/ psychological measures of risk at the time assessment took place), a triggering factors or contextual events section, and finally an acute risk factors section at some immediate point in history where an offense is likely to take place.




We will now look at each of the areas shown in the model.


Figure 1.



Developmental factors



The measurement of developmental problems in current risk assessments is rather vague and underspecified, even though – theoretically and empirically – a  number of variables have been predicted or identified as being clear precursors to sexual abuse. These include the offender having been sexually abused, parental rejection, and a history of attachment problems. These developmental variables are technically historical variables, yet the literature on static risk assessment has hardly examined them[1]. Craissati is one of the few researchers to have considered in detail the relationship between developmental variables and risk assessment (Craissati & Beech, 2005, 2006). She notes that such variables are implicated in both treatment dropout and compliance in treatment. Specifically, she has reported that having two or more childhood adaptive difficulties (plus never having been a long-term relationship) correctly identified 87% of poor treatment attendees. At the same time, childhood difficulties (coupled with contact with mental health services as an adult) correctly classified 83% of non-compliers in treatment.


Developmental factors and their etiological relationship to psychological risk factors



The mechanisms by which developmental variables relate to subsequent risk are far from straightforward. Watkins and Bentovim (1992) and Beitchman et al. (1992) report that the long-term effects of sexual abuse can clearly be seen as problems in psychological functioning/disorder, such as alcohol and drug misuse, disturbed adult sexual functioning, poor social adjustment, and confusion over sexual identity. Craissati, McClurg, and Browne (2002), among others, have found parental rejection highly prevalent amongst the parents of sexual offenders. This childhood rejection is likely to result in problems regulating affect in intimate relationships. As for childhood attachment problems, Smallbone and Dadds (1998) found that poor paternal attachments predicted sexual coercion in adulthood, and that poor maternal relationships were predictive of general antisocial behavior. Such attachment difficulties, one could argue, can lead to offenders having difficulties in forming relationships with age-appropriate adults. Marshall, Hudson, and Hodkinson (1993), for example, noted that attachment difficulties can lead adults to seek emotional intimacy through sex, even if they have to force a partner to participate. Therefore, rejection, sexual abuse, and attachment problems leading to substance misuse, disturbed sexual functioning, poor social adjustment, confusion over sexual identity, inappropriate attempts to reassert masculinity, and recapitulation of the abuse experience, can be precursors of the psychological predisposition to sexually offend. The possible sequelae to such adverse childhood events are dynamic risk problems such as intimacy deficits (due to poor attachment), cognitive distortions, self-management problems, and deviant arousal. We will now examine these vulnerability factors in more detail.


Vulnerability Factors



In the second section of our model shown in Figure 1, we note the usefulness of Mrazek & Haggerty’s (1994) distinction between those factors that play a causal role in offending, and those that act as marker variables of risk. This idea clearly maps onto the static/dynamic risk distinction. Stable dynamic factors (such as deviant interests and self-management problems) play a causal role in offending, while the so-called static/historical risk factors identified in risk assessment schedules, such as Static-99, are essentially markers of psychological vulnerability. We will now look at the two aspects of the vulnerability factors section of the model in more detail.


Measurement of vulnerability factors in the here and now – stable dynamic risk factors



Thornton (2002) defines stable dynamic risk factors as: sexual interests (sexual preoccupation, offense-related sexual preferences), distorted attitudes (generalized beliefs, rather than specific cognitions), socio-affective functioning (problems leading to a lack of emotionally intimate relationships with adults and an accompanying emotional over-identification with children in child molesters), and self-management problems (lifestyle impulsiveness; dysfunctional coping). We would argue that these are in fact psychological traits. Trait theory gives a more theoretical grounding to dynamic risk assessment. Some useful considerations here are that traits can only be inferred from behavior or overt responses that are indicative of deeper causal properties of a person's functioning (Cattell & Kline, 1977). Trait theory suggests that identifying the level of a particular genetic, physiological, or cognitive trait in an individual is likely to help predict a person's future behavior (Matthews & Deary, 1998). Thus, by conceptualizing stable dynamic risk factors as traits, the temporary state versions of these traits (i.e., deviant sexual arousal, deviant thoughts and fantasies, need for intimacy and control, and impulsive behavior/emotional regulation problems) can be considered as the real acute dynamic risk indicators (or state aspects) of stable dynamic risk factors.



We also propose that theory has a lot to offer in terms of explaining the etiological underpinning of each of the four risk domains. Space precludes any detailed description of these ideas. However, Table 1 shows how theory can be employed to begin to derive an etiological explanation of each of the four risk domains. Here, we have drawn extensively upon Ward and Siegert’s (2002) theory knitting approach, which has taken the best of theories, such as those of Marshall and Barbaree (1990), Finkelhor (1984,) and Hall and Hirschman (1992).


Table 1. Etiological Explanation of Psychological Vulnerability from Ward and Siegert’s (2005) Theory of Child Sexual Abuse



Risk Domain


 Etiological Explanation



Domain 1: Sexual interests:



Child preference




Problems arise from problems in the three other domains below, which, in conjunction with sexual desire (a basic physiological drive), leads to the individual to abuse




Domain 2: Distorted attitudes:



Child abuse supportive beliefs




Problems arise out of a set of core schema or implicit theories held by the offender and generate the cognitive distortions that are measured at the surface level. These beliefs will centre on entitlement to sex, whenever, and with whom ever, they want. These beliefs, in conjunction with sexual desire and opportunity, will result in sexual offending




Domain 3: Socio-affective functioning:



Emotional congruence with children



Lack of emotionally intimate relationships with adults





Problems arise from insecure attachment and subsequent problems establishing intimacy with adults, leading to the substitution of children for adult sexual partners. This will result in sexual arousal in the context of a sexual encounter with a child, possibly intimate and ‘loving’ emotions, and an attempt to create an adult-like relationship with the child.



Domain 4: Self- management



Lifestyle impulsiveness


Dysfunctional coping




Problems arise from an inability in identifying emotions, modulating negative emotions, or an inability to utilise social supports at times of emotional distress. This inability to effectively manage mood states may result in a loss of control, which, in conjunction with sexual desire, might lead an individual to either become disinhibited or else opportunistically use sex with a child as a soothing strategy to meet his emotional and sexual needs



Measurement of vulnerability factors in the past – static/ historical risk factors

In the model, we have tried to make the relationship between static risk and dynamic risk factors more explicit, under the heading of psychological vulnerabilities. To clarify this, we have mapped some of the static risk factors employed in the better-known risk assessment schedules onto the four risk domains described above. These include Static 99 (Hanson & Thornton, 2000), the Sex Offender Risk Appraisal Guide (SORAG; Quinsey, Harris, Rice, & Cormier, 1998), the Minnesota Sex Offender Screening Tool-Revised (MnSOST-R; Epperson, Kaul, & Hesselton, 1998), and the Sexual Violence Risk-20 (SVR-20; Boer, Hart, Kropp, & Webster, 1997). This mapping is shown in Table 2.


Table 2: Static/ Historical Risk Markers Contained in Static-99, SORAG, MnSOST-R, SVR-20 of Developmental Problems and Dynamic Risk Domains




















Developmental variables



Not lived with


parents until 16




Victim of


child abuse







Domain 1:


Sexual Interest






















Prior sex






Male or male +


female victims


Previous sexual




Multiple acts


on single








Young age of




Length of sex






Number of






Different age


group of






frequency of


sex offenses


Range of sex




Escalation in frequency and severity of sex offenses


Domain 2: Distorted attitudes






Domain 3: Socio-affective-functioning


Lack of








Never married










Domain 4: Self-management



Index non






Prior non-sexual violence

















Failure on







Anti-social behavior as adolescent




history while




Offender under supervision when offense committed


Threat/ use of


force in





Violent non












Table 2 shows that Static-99, SORAG, Mn-SOST-R, and the SVR-20 contain items that are historical risk markers of sexual interests and self-management problems, indicating that they are proxy measures of the level of these problems in an offender's history. However, Table 2 also clearly indicates that these schedules contain no historical items measuring distorted attitudes (although both SVR-20 does contain a clinical item indicating that it is important to measure current level of pro-offending attitudes). Few items tap past levels of socio-affective functioning. This is not surprising, as there would not appear to be many historical items that could actually do this. We note that doing this illustrates how static and dynamic factors are, to some extent, two aspects of what we would term psychological vulnerability. The static risk factors identify strong evidence of [deviant] sexual interests and self-management problems in an individual's past, while the four dynamic risk domains indicate an individual's current level of problems.


In the next section of the model, we outline how stable dynamic factors become transient states of high risk that act as acute precursors to offending.


Transient states of high risk



In our model, we suggest that underlying traits can be activated to produce transient mental states (Eysenck & Eysenck, 1980) by triggering factors (which we outline in the next section of the model). Table 3 illustrates how, if we take each psychological disposition or stable dynamic risk domain, each trait is pushed into a state that acts as a precursor to sexual offending.


Table 3. Mappings of Vulnerability (Trait) Factors to Contextual (State) Factors through the Operation of Triggering Factors


Psychological risk domains


Triggering factors operate on the particular disposition in the following way


State risk factors – Acute Dynamic



Domain 1: Sexual interests


Promotes sexual arousal in the probable presence of: distorted sexual attitudes; inter-personal problems; and positive or negative moods states




Deviant sexual arousal



Domain 2: Distorted attitudes (or underlying schemas)


Deviant thoughts/ fantasies produced from the core set of schema held by the offender in interaction with specific triggers



Deviant thoughts and fantasies



Domain 3: Socio-affective problems (e.g., for many the pedophilic molester s this would be the lack of emotionally intimate relationships with adults coupled emotional congruence with children)


Inter-personal problems particular to the offender (in many cases underpinned by problematic attachment) activated in times of stress


Need for intimacy/ control



Domain 4: Self- management: Lifestyle impulsiveness; and/ or dysfunctional coping




Triggering events produce states of tension


Experiences of negative emotional state if cognitive appraisal is negative or positive feelings if outcome is desired





It can be seen from Table 3, that in the model presented here, deviant sexual arousal, deviant thoughts and fantasies, the need for intimacy/control, and negative or positive emotional states can arise from the core underlying risk domains.


In the last section of the model, we consider the triggering or contextual events that that produce the transient acute states of risk outlined here.


Triggering factors


Hanson and Harris (2000a) identified seven types of acute risk factors indicating increased risk in a group of sexual offenders under supervision. These factors, identified clinically, can be grouped under the following categories: cognitive (sexual pre-occupations), affective (hostility, emotional collapse), behavioral (victim access behaviors, rejection of supervision, substance abuse), environmental (collapse of social supports). Hanson and Harris (2000a) also note that there may be unique factors to the individual that can also be regarded as triggering events. These can be environmental (e.g., being made homeless, a specific date or event that causes an emotional response, contact with a specific family member), cognitive (e.g., being bothered by intrusive thoughts regarding their own victimization), or health problems.




We suggest in our model that these items are better conceptualized as triggering thoughts, feelings, behaviors, or events that interact with stable dynamic risk factors to generate states likely to produce sexual offending behaviors. A revision to our original model is to indicate in Figure 1 a clear interaction between these triggering events and the stable dynamic risk factors outlined earlier.


Clinical Utility of the Model



We believe this risk-etiology model represents the first explicit attempt to integrate etiological theory with the different types of risk factors. One of our purposes for this was to be useful to clinicians in the field. We hope that this work may provide an explanation of why certain types of factors increase an individual's risk of committing a sexual offense in the future. For example, an offender who was sexually abused as a child might have learned to cope with stressful interpersonal events through masturbating, a means of soothing himself. The reliance on sex as a means to control negative mood states constitutes a deficit in emotional and self regulation, and is hypothesised to constitute a vulnerability factor. For example, following an argument with someone at work, the offender might resort to deviant sexual fantasies and masturbation to reduce his feelings of anger and to induce feelings of pleasure. Unfortunately, the resultant high levels of sexual arousal in certain circumstances might increase his chances of sexual offending, particularly if his masturbatory fantasies contain aggressive themes.


An advantage to thinking about risk variables in etiological terms is that it encourages clinicians to consider a wider range of vulnerability factors that correspond to different types of risk markers. This enables practitioners to develop case formulations more clearly linked to the different risk domains. In a sense, it could improve the quality of risk assessment and help to tailor risk assessment procedures to the unique set of causes relevant to individual offenders. This approach also suggests, perhaps, a novel approach to risk assessment. Rather than taking a clinically adjusted actuarial approach, it might be better to start with a dynamic risk assessment and then adjust the level of risk based on the levels of historic risk based on actuarial risk instruments.


Of course, it would be wrong not to also assess the framework's current weaknesses. Perhaps the most significant is that the model has not yet been subject to empirical testing. While this is the obvious next stage of development, we also hope to test this framework against other ideas that it may generate.





Anthony Beech, email: a.r.beech@bham.ac.uk



Tony Ward, email: tony.ward@vuw.ac.nz







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[1] Although we would note that poor relationship with mother, perhaps indicating parental rejection, has been identified as a risk factor for sexual offenders by Hanson and Bussière (1998).



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