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Research ArticleRegular Article

The State of Forensic Literature on Persons with Intellectual Disability Who Sexually Offend

Kathryn Ann Baselice and Sara West
Journal of the American Academy of Psychiatry and the Law Online September 2022, JAAPL.210154-21; DOI: https://doi.org/10.29158/JAAPL.210154-21
Kathryn Ann Baselice
Dr. Baselice is a Forensic Psychiatry Fellow, University of Virginia, Department of Psychiatry, Charlottesville, VA
MD
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Sara West
MD
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Tables

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    Table 1

    Paraphilic Disorders2

    Paraphilic disorder
    Voyeuristic disorder
    Exhibitionistic disorder
    Frotteuristic disorder
    Sexual masochistic disorder
    Sexual sadistic disorder
    Pedophilic disorder
    Pedophilic disorder
    Fetishistic disorder
    Transvestic disorder
    Other specified paraphilic disorder (i.e., zoophilia, necrophilia)
    Unspecified paraphilic disorder
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    Table 2

    States with Sexually Violent Predator/Offender Commitment Laws

    Arizona69
    California70
    Florida71
    Illinois72
    Iowa73
    Kansas74
    Massachusetts75
    Minnesota76
    Missouri77
    Nebraska78
    New Hampshire79
    New Jersey80
    New York81
    North Dakota82
    Pennsylvania (juveniles only)83
    South Carolina84
    Texas85
    Virginia86
    Washington87
    Wisconsin88
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    Table 3

    Chemical/Surgical Castration Laws by State

    StateChemical or SurgicalTreatment Provided ByInformed Consent?
    Alabama109ChemicalDepartment of HealthMedical professional must inform individual of effects and potential side effects. Individual must sign acknowledgement of receipt of such information.
    California110Chemical (MPA or equivalent) or SurgicalDepartment of CorrectionsPerson must be informed of side effects of chemical treatment and must acknowledge receipt of this information.
    Florida111Chemical or surgical (choice of defendant)Department of CorrectionsMedical provider must determine whether defendant is a candidate. Informed consent is necessary if the defendant elects physical castration.
    Iowa112Chemical (MPA or other “approved” drug) or surgical (choice of defendant)Department of CorrectionsNo information in the law regarding informed consent or involvement of medical professional.
    Louisiana113Chemical or surgical (choice of defendant)Department of Public Safety and CorrectionsMedical provider must determine whether defendant is an appropriate candidate. Informed consent is necessary if the defendant elects physical castration.
    Montana114Chemical (MPA or its chemical equivalent)Department of CorrectionsPerson must be “medically informed of its effects.”
    Texas115Surgical (elective)Physician employed or retained by the departmentInmate must be evaluated by a psychologist or psychiatrist. A physician must obtain informed, written consent.
    Wisconsin116Chemical (antiandrogens or equivalent)Licensed PhysicianMust be assessed by a licensed physician. Treatment is monitored by a physician, who must also discuss the risks and benefits with the offender.
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    Table 4

    Summary of Needed Areas of Research

    Competency to Stand Trial (CST) Assessments in PWID/SC
     Assess whether prior education affects evaluators’ comfort in detecting intellectual disabilities and understanding how they manifest in CST assessments
     Assess the degree to which PWID/SC understand disclosures made prior to CST assessments and to what degree lack of understanding affects their engagement in these evaluations and what they disclose to examiners
     Determine rates of incompetency to stand trial among PWID/SC
     Explore the role of bias in CST assessments in PWID/SC
    Defenses of Mental Illness or Impairment in PWID/SC
     Evaluate how often PWID/SC raise an NGRI defense and how often it is successful
     Explore whether lack of appreciation of societal standards and lack of sexual education may, at times, meet insanity defense standards
     Determine appropriate guidelines for the evaluation of diminished capacity in defendants with PWID/SC
    SVP Assessments for PWID/SC
     Determine the prevalence of PWID/SC who are committed under these statutes
     Determine how often competency to consent to be interviewed is determined by forensic evaluators for these evaluations
     Assess whether forensic clinicians feel comfortable evaluating the role an intellectual disability may have on determining whether a person is at risk for violent recidivism
     Assess how accurate psychiatrists are in diagnosing a paraphilic disorder in a PWID/SC
    “Chemical Castration” for PWID/SC
     Determine how often these agents are being used on PWID/SC
     Determine the process for obtaining informed consent (written, verbal) and how well those with ID understand the agents that they are receiving
     Determine how comfortable psychiatrists are in treating those with PWID/SC with anti-libidinal agents
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Journal of the American Academy of Psychiatry and the Law Online: 53 (2)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 53, Issue 2
1 Jun 2025
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The State of Forensic Literature on Persons with Intellectual Disability Who Sexually Offend
Kathryn Ann Baselice, Sara West
Journal of the American Academy of Psychiatry and the Law Online Sep 2022, JAAPL.210154-21; DOI: 10.29158/JAAPL.210154-21

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The State of Forensic Literature on Persons with Intellectual Disability Who Sexually Offend
Kathryn Ann Baselice, Sara West
Journal of the American Academy of Psychiatry and the Law Online Sep 2022, JAAPL.210154-21; DOI: 10.29158/JAAPL.210154-21
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Keywords

  • civil commitment
  • competency to stand trial
  • criminal law
  • insanity defense
  • intellectual disability
  • sex offenders

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