J Forensic Sci, January 2015, Vol. 60, No. S1 doi: 10.1111/1556-4029.12652 Available online at: onlinelibrary.wiley.com
PAPER PSYCHIATRY & BEHAVIORAL SCIENCES
Ignazio Grattagliano,1 Ph.D.; Rosalinda Cassibba,2 Ph.D.; Alessandro Costantini,2 Ph.D.; Giovanni Michele Laquale,2 Ph.D.; Alessandra Latrofa,2 Ph.D.; Sonia Papagna,2 Ph.D.; Giovanna Sette,2 Ph.D.; Alessandro Taurino,2 Ph.D.; and Maria Terlizzi,2 Ph.D.
Attachment Models in Incarcerated Sex Offenders: A Preliminary Italian Study Using the Adult Attachment Interview
ABSTRACT: A group of sex offenders (clinical group: n = 19) was compared to a nonclinical sample matched by age, years of education,
and gender (control group A: n = 19) to verify a higher incidence of insecure attachment models among sex offenders. In addition, we tested whether sex offenders were characterized by specific childhood experiences, compared to control adults (control group B: n = 19) with the same secure/insecure attachment classification. Results showed significant differences between offenders and control adults on both the AAI continuous score and the distribution of the two-way attachment classifications. Furthermore, sex offenders reported more intense experiences of rejection by the father figure and abuse in the family context during early childhood compared to not offenders subjects with the same attachment classification.
KEYWORDS: forensic science, sexual offenders, adult attachment interview, negative childhood experiences
Descriptive and empirical research, along with clinical observations, has indicated the presence of disruptive or dysfunctional family experiences in the early childhood of sex offenders (1,2). Most of the offenders describe their interactions with caregivers as involving high levels of neglect and rejection together with low levels of supervision, discipline, and consistency (3,4). The quality of attachment relationships that sex offenders experience in the past with their caregiver is one of the relational aspects recently taken into account as a factor of vulnerability. Marshall (5) outlined a theory suggesting that sexual offenders attempt, in their offenses, to achieve the intimacy they lack in the rest of their lives. Marshall’s paper generated a burst of research activity that has focused on intimacy deficits and poor adult attachments in sexual offenders. This research has convincingly demonstrated serious deficits in these skills among sexual offenders (3,5–8). Moreover, there is now convincing evidence that treatment directed to sexual offenders can be effective (9,10). According to Bowlby (11), the relationship with caregivers in early childhood influences the construction of internal working models, which guide individuals in their interpersonal relationships and lead to the development of expectations and beliefs concerning the self and the others (12). These representational models, which are largely based on attachment experiences in 1 Department of Criminology and Forensic Psychiatry, University of Bari, Bari, Italy. 2 Department of Education, Psychology and Communication, University of Bari, Bari, Italy. Received 8 May 2013; and in revised form 9 Sept. 2013; accepted 13 Oct. 2013.
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childhood and adolescence, continue to exert an influence in contexts that activate the attachment system in adulthood, such as romantic relationships (13), religious behavior (14), or psychotherapy relationship (15). An important factor facilitating the study of adult attachment is the availability of the Adult Attachment Interview (16), a validated and replicable assessment procedure to assess adults’ state of mind regarding attachment. During the course of this interview, individuals are asked both to describe their attachmentrelated childhood experiences, especially their early relations with parents or parenting figures, and to evaluate the influence of these experiences on their development and current interpersonal functioning. Main et al. (16) found that transcribed verbatim responses from these interviews could be systematically placed into one of three adult attachment classification categories. The first was termed “Secure-autonomous” (“valuing of attachment relationships and experiences, and yet apparently objective regarding any particular relationship experience”); a second category was labeled “Insecure-Dismissing” (“dismissing, devaluing, or cutoff from attachment relationships and experiences”); the third type of interview classification category is the “Insecure-Preoccupied” (“with or by early attachments or attachment-related experiences”) (17). Main and Hesse (18) added other two insecure categories: “Unresolved” for the individuals that spoke in unusual ways about traumatic experiences and “Cannot Classify” for individuals whose transcripts failed to meet criteria for placement in one of the three organized attachment categories. In adulthood, the activation of the attachment behavioral system is deeply linked to the activation of sexual and care systems; therefore, the disorganization of the attachment system could © 2014 American Academy of Forensic Sciences
GRATTAGLIANO ET AL.
lead to inappropriate and dysfunctional activation of the sexual one (19,20). In individuals with a secure attachment style, the sexual behavioral system is activated in situations characterized by the perception of security, trust, and reciprocity, whereas in insecurely attached individuals, those behaviors are linked to negative affective and cognitive states, rather than commitment and trust. For example, a disorganized attachment style can be characterized by confusion between sexual and attachment behaviors, a condition which could lead to the activation of contradictory or coercive sexual strategies and behaviors (5,6,20). A number of studies have demonstrated a high incidence of insecure attachment among samples of sex offenders. In this regard, Smallbone and Dadds (20) found that the insecure attachment style was significantly higher in subjects incarcerated for sex offenses compared to those incarcerated for other types of crimes. In addition, insecure childhood attachment, particularly insecure attachment to father, was associated with higher levels of antisocial behavior, aggression, and coercive sexual behavior (1,21). More specifically, a link between the type of sexual offense and the style of attachment of sex offenders has also been reported (7,8,22). Based on Bartholomew’s two-dimensional model (23), Ward et al. (22) found that child sex offenders were predominantly classified as having worried or fearful styles of attachment, whereas rapists were predominantly characterized by dismissingavoidant attachment styles. All the above-mentioned studies focused on attachment have mainly implemented self-reported instruments to assess attachment styles. These measures have been criticized for their limited ability to work through the defensiveness known to be prevalent among sex offenders (6). Indeed, very few studies have used the Adult Attachment Interview (AAI: 17), a semistructured interview which allows, compared to self-report measures, to collect more valid and reliable assessments, as it is able to “take the unconscious by surprise.” Moreover, we must consider that romantic attachment styles, assessed through self-report measures, have not been shown to arise from the individual’s history of early affective relationships, unlike the state of mind in relation to attachment, assessed through AAI, which has consistently demonstrated developmental roots (24,25). Likewise, few studies have involved samples of sex offenders on full prison terms. The aim of this study was twofold. First, it aimed at verifying the existence of a higher percentage of insecure attachment models, by the use of the AAI, among sex offenders compared to a control group; second, we aimed to ascertain whether sex offenders were characterized by specific childhood experiences, compared to control adults with the same attachment classification (1,21). Participants and Procedure A total of 57 subjects (12 females), aged between 28 and 78 (M = 46.89; SD = 12.29), subdivided into three groups, took part in the study. The first group (offenders group) consisted of 19 subjects (four female; age: M = 47.21; SD = 12.91; years of education: M = 8.93; SD = 3.91), all convicted of violent sex crimes, recruited from prisons based on agreements made with the Justice Ministry and the warden of each institute participating in the project. The length of the sentences ranged from 5 to 10 years. The second group (comparison group A), consisting of 19 (age: M = 47.37; SD = 12.79; years of education: M = 9.21; SD = 3.96) not offenders subjects, was recruited to match the offenders
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group in terms of age (t (38) = 0.03, p = n.s.), years of education (t (38) = 0.20, p = n.s.), and gender (four female). The third one (comparison group B) was constituted of 19 not offenders subjects (age: M = 46.11; SD = 11.77; years of education: M = 8.95; SD = 3.48), matched to the offenders group based on the attachment category (four secure, 15 insecure), gender (four secure), and age (t (38) = 0.27, p = n.s.). The comparison between this latter control group and the offenders one allowed us to verify whether, given the same attachment categories, sex offenders would be characterized by specific childhood experiences with their parents, as hypothesized above. We scheduled a meeting in prison with the offenders group for the administration of the Adult Attachment Interview (AAI: 17), while participants in the comparison group were interviewed at home. All participants were informed about the confidentiality of participation and signed the same consent form. Prison officials authorized the use of AAI, but they did not have access to the data collected by the researchers. The AAI is a semistructured interview aimed at evaluating the adult state of mind related to attachment based on the discourse coherence displayed during the interview. The protocol includes approximately 20 questions, some referring to general descriptions of childhood relationships with parents (i.e., Now I’d like you to try to describe your relationship with your parents as a young child, starting as far back as you can remember), others on the recollection of specific episodes to support the general descriptions; moreover, adults are asked about what happened when the interviewee as a child was emotionally upset, ill, and in pain (i.e., Could you give me some specific incidents when you were upset emotionally?); lastly, they are asked to speculate on the effect of childhood experiences with parents on their present personality (How do you think your overall early experiences have affected your adult personality?). Coding of the interviews yielded two different measurements; the first regarding classifications expressing the adult mental status in terms of one of the three organized attachment categories: Secure/Autonomous, Insecure/Dismissing, and Insecure/ Preoccupied. The discourse of participants assigned an insecure/dismissing (Ds) classification is most often characterized by structural inconsistency between positive/generalized portrayals of parents and the failure to support these portrayals with specific episodes. The discourse of participants assigned to an insecure/preoccupied (E) classification is characterized by an ongoing, mentally upsetting anger against the parent and/or vagueness of mental processes concerning attachment. The discourse of participants assigned to a secure/autonomous (F) classification is characterized by a collaborative attitude and credibility; whether or not their past experiences were primarily positive or negative: the transcript provides an internally consistent picture of the participant’s experiences, feelings, and viewpoints regarding attachment. A fourth category, Unresolved (U/CC), can be selected in the presence of specific indexes of unresolved mourning or trauma. The reliability of the AAI classification system is well established, as well as its convergent and discriminant validity, see Hesse, for a review, (17). Also, independent estimates of probable parental behaviors in participants’ childhoods, as derived in the AAI system, have been found to be related to their infant attachment classifications (26). Based on scores on a set of continuous scales for idealization, anger, derogation, and coherence of transcript, see Main et al. (25) for details of the coding system; we were also able to calculate a continuous attachment security score using the
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discriminant function equation as used in previous published work e.g., Cassibba et al. (27). Interview transcripts were coded by two coders blinded to all other data. The coders were trained in Rome by Nino Dazzi and Deborah Jacobivitz and achieved full AAI reliability across 30 consecutive transcripts with Mary Main and Eric Hesse at University of California, Berkeley. The inter-rater reliability computed on n = 19 (33%) of the interviews was Cohen’s K = 85; p < 0.001.
Offenders Group AAI F Ds E CC/U Total
4 11 1 3 19
( 2.0) (1.0) (.0) (1.8)
Comparison Group 10 8 1 0 19
(2.0) ( 1.0) (.0) ( 1.8)
Values in brackets are adjusted standardized residuals. F = Secure/Autonomous, Ds = Insecure/Dismissing, E = Insecure/Preoccupied, CC/U = Cannot Classify/Unresolved.
Results Conducting independent samples t-tests on the AAI continuous scores with group (offenders vs. comparison A) as a factor, we found a significant difference. More specifically, security scores obtained by sexual offenders were significantly lower than those obtained by the comparison group (offenders group: M = 1.13; SD = 1.62, comparison group A: M = 0.11; SD = 1.88; t = 2.17; p < 0.05). Cross-tabulating categorical attachment representations (secure vs. insecure) and group (offenders vs. comparison A) also showed significant differences (v2 (1, n = 38) = 4.07, p < 0. 05; Table 1) in that 10 of 19 not offenders were assessed as secure, whereas only four of 19 offenders obtained a secure classification. By cross-tabulating four-way AAI classifications (F, Ds, E, and CC/U) and group (offenders vs. comparison A), we failed to find a significant difference (v2 (1, n = 38) = 6.04, p = n.s.; Table 2); in fact, the two groups did not differ with respect to the distribution of specific patterns of attachment. Second, we performed a set of independent group t-test analyses to determine whether sex offenders and comparison group B (paired to offenders group in terms of attachment category, gender, years of education, and age) differed on probable childhood attachment experiences (i.e., loving, rejecting, neglecting, pressure to achieve, and role reversing in relation to each parent). Results showed significant differences between the two groups (offenders vs. comparison B) on rejecting for father (offenders group: M = 5.03, SD = 2.45, comparison B: M = 2.42, SD = 2.21, t (38) = 3.25, p < 0.01), role reversing for both mother (offenders group: M = 1.27, SD = 0.82, comparison B: M = 2.94, SD = 2.20, t (38) = 3.01, p < 0.01) and father (offenders group: M = 1.14, SD = 0.42, comparison B: M = 2.00, SD = 1.49, t (38) = 2.27, p < 0.05) and pressure to achieve for mother (offenders group: M = 1.41, SD = 0.93, comparison B: M = 3.00, SD = 2.42, t (38) = 2.53, p < 0.05). We also found a significant difference between the two groups (offenders vs. comparison B) in terms of scoring of unresolved abuse (offenders group: M = 1.97, SD = 2.03, comparison B: M = 1.0, SD = 0.00, t (38) = 2.09, p < 0.05). More specifically, the sex offenders during the AAI referred to have experienced a more intense direct rejection and greater minimization of their needs by the father figure during their early childhood compared to control subjects with the same attachment classification. On the contrary, control subjects referred more indirect unloving TABLE 1––AAI distribution of attachment patterns across the two groups.
AAI Secure Insecure Total
TABLE 2––Four-way AAI distribution of attachment patterns across the two groups.
Offenders Group
Comparison Group (A)
4 ( 2.0) 15 (2.0) 19
10 (2.0) 9 ( 2.0) 19
Values in brackets are adjusted standardized residuals.
experiences with parents, such as pressure to achieve and role reversing. Furthermore, sex offenders reported more unresolved abuse experiences with respect to the comparison B group. Discussion The aim of this study was twofold. First, we aimed to investigate whether an Italian group of incarcerated sex offenders showed a higher incidence of insecure attachment models compared to a control group; second, we verified whether the childhood experiences of sexual offenders were characterized by high levels of rejection and lower levels of loving compared to control adults with the same attachment classification. Our study also aimed at overcoming some methodological limitations present in most research on this topic. In this respect, attachment models were assessed using the AAI, instead of selfreport measures, frequently used in previous research, which has been shown to provide more reliable and valid measures of attachment representations (25). Differently from self-report measures, in fact, the AAI protocol has the potential to “surprise the unconscious” (17). As scoring and final classifications depend mainly of the degree of coherence of mental and discourse processes on attachment topics, more than on content, it is extremely difficult for the interviewee to provide socially desirable answers. Moreover, the AAI has good cross-cultural validity, although it is also able to highlight some specificities of the cultural background of the interviewee (26). Lastly, unlike studies which determined the presence of sex crimes through telephone interviews or subjective evaluations, our sex offenders group included only incarcerated subjects subsequent to full conviction for a sexual offense. Results showed a higher incidence of insecure attachment, particularly in the dismissing category, in sex offenders compared to the control group. These results are in agreement with those reported by several previous studies (8,20,21), which found a higher frequency of insecure attachment in subjects incarcerated for sex offenses compared to those imprisoned for other types of crimes. The finding that did not match with previous ones, however, was the frequency of unresolved/disorganized attachment, as we found a very low frequency in our offenders group, although this classification appears to be very common in clinical samples and in subjects who have had problems with the law (26). In fact, despite the fact that sex offenders reported a higher incidence of abuse, compared to control adults with the same attachment classification, this condition did not generate a significantly higher level of disorganization of their own attachment models. This result could partly be attributed to the Italian cultural context within which the study was carried out. Indeed, as shown in a meta-analytic study on the
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distribution of attachment categories among the Italian culture (28), the CC/U category in Italian samples is underrepresented to a statistically significant extent when compared to those of other countries. Results on the quality of childhood relationships of sex offenders with both parents highlighted that, in the presence of a similar incidence of insecure attachment, sexual offenders differ from the control group B because of the presence of repeated experiences of rejection from the fathers and abuse in the family context. On the contrary, the negative childhood experiences characterizing not sexual offenders insecure adults include more indirect unloving experiences, such as excessive pressure to gain achievements in the cognitive domain (pressure to achieve) or having an inconsistent parent which expects to be protected and cared by the child (e.g., role reversing). These results are in-line with those reported by several published studies highlighting the presence of dysfunctional and/or traumatic experiences in the birth families of sexual offenders. In fact, their families have been shown to be characterized, above all, by the absence of a stable and caring family environment, by conflicts between the parents, the use of harsh punishment by the parents, and the absence of a relationship with the father figure (1,3). In sum, our findings are consistent with the predictions from attachment theory and, even though our sample size is small, they highlight the importance of early affective experiences with parents in sexual offenders. Nevertheless, some limits need to be addressed. First of all, the choice to include in the offenders group only participants with full convictions for sex crimes had significant repercussions on the size sample. Because of small sample, we believe that our findings, while intuitive and logical, should be considered as preliminary ones and certainly require further support. Second, our study failed to take into account some relevant information about criminal status (i.e., number of past offenses, length of criminal career) or SES and individual experiences (i.e., relationship status), which limit the possibility to generalize the results. In fact, the warden of prisons did not allow us to administer other tests, other than the AAI. This limitation reduced our possibility to take into account other potentially confounding variables which may have affected our results and to use a more complex statistical analytic plan. To conclude, and notwithstanding the above limitations, the present study adds an important piece to understand the link between early affective experiences and the internal working models with respect to attachment in sex offenders, offering interesting suggestions for future research and for the implementation of educational and prevention programs. Future research should focus on other relevant variables which may play a role as, for example, gender and personality and/or psychopathological traits. To our knowledge, there are no studies available up to now testing attachment status through the AAI on female sexual offenders. In our study, we decided to include also female sexual offender as no data in the literature report gender differences among low-risk as well as clinical ones with respect to attachment status. To the best of our knowledge, this is the first study on attachment in sexual offenders including female participants (26). Lastly, it should be convenient for future studies to implement appropriate assessments to prevent malingering: In this respect, it would be appropriate to verify whether the subjects, for whatever reasons, tend to over report (exaggerate) or underreport (deny) psychopathological difficulties and/or try deliberately avoid answering psychological assessments in a frank manner (29–31).
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References 1. Smallbone SW, Dadds MR. Attachment and coercive sexual behaviour. Sex Abuse 2000;12:3–15. 2. Greco R, Curci A, Grattagliano I. Juvenile criminality: general strain theory and the reactive-proactive aggression trait. Riv Psichiatr 2009;44 (5):328–33. 3. McCormack J, Hudson SM, Ward T. Sexual offenders’ perception of their early interpersonal relationships: an attachment perspective. J Sex Res 2002;39:85–93. 4. Grattagliano I, Cassibba R, Greco R, Laudisa A, Torres A, Mastromarino A. Stalking: old behaviour new crime. Reflections on 11 cases assessed in the judicial district of Bari. Riv Psichiatr 2012;47(1):65–72. 5. Marshall WL. Intimacy, loneliness and sexual offenders. Behav Res Ther 1989;27:491–503. 6. Marshall WL. The role of attachment, intimacy, and loneliness in the etiology and maintenance of sexual offending. Sex Marital Ther 1993;8 (2):109–21. 7. Marsa F, O’Reilly G, Carr A, Murphy P, O’Sullivan M, Cotter A, et al. Attachment styles and psychological profiles of child sex offenders in Ireland. J Interpers Violence 2004;19(19):228–51. 8. Stirpe T, Abracen J, Stermac L, Wilson R. Sexual offenders’ state-of-mind regarding childhood attachment: a controlled investigation. Sex Abuse 2006;18:289–302. 9. Marshall WL, McGuire J. Effect sizes in treatment of sexual offenders. Int J Offender Ther Comp Criminol 2003;46:653–63. 10. Marshall WL, Marshall LE, Serran GA, Fernandez YM. Treating sexual offenders: an integrated approach. New York, NY: Taylor & Francis, 2006. 11. Bowlby J. Attachment and loss, vol. 1. New York, NY: Basic Books, 1969. 12. Bretherton I. New perspectives on attachment relations: security, communication, and internal working models. In: Osofsky I, editor. Handbook of infant development. New York, NY: Wiley, 1987;1061–100. 13. Hazan C, Zeifman D Sex and psychological tether. In: Bartholomew K, Perlman D, editors. Advances in personal relationships: Vol. 5. Attachment processes in adulthood. London, U.K.: Jessica Kingsley, 1994; 151–77. 14. Cassibba R, Granqvist P, Costsantini A, Gatto S. Attachment and God representations among lay Catholics, priests and religious: a matched comparison study based on the Adult Attachment Interview. Dev Psychol 2008;44:1753–63. 15. Mallinckrodt B, Porter MJ, Kivlighan DM Jr. Client attachment to therapist, depth of in-session exploration, and object relations in brief psychotherapy. Psychother Theory Res Prac 2005;42:85–100. 16. Main M, Kaplan N, Cassidy J Security in infancy, childhood and adulthood: a move to the level of representation. In: Bretherton I, Waters E, editors. Growing points of attachment theory and research. Monographs of the Society for research in Child Development 1985:50(1-2 Serial No. 209);66–104. 17. Hesse E The adult attachment interview. Protocol, method of analysis and empirical studies. In: Cassidy J, Shaver PR, editors. Handbook of attachment. Theory, research and clinical applications. New York, NY: The Guilford Press, 2008;552–98. 18. Main M, Hesse E. Disorganized infant, child, and adult attachment: collapse in behavioural and attentional strategies. J Am Psychoanal Assoc 2000;48:1097–127. 19. Sawle GA, Kear-Colwell J. Adult attachment style and pedophilia: a developmental perspective. Int J Offender Ther Comp Criminol 2001;45:32–50. 20. Smallbone SW, Dadds MR. Childhood attachment and adult attachment in incarcerated adult male sex offenders. J Interpers Violence 1998;13:555–73. 21. Lyn TS, Burton DL. Adult attachment and sexual offender status. Am J Orthopsychiatry 2004;74(2):150–9. 22. Ward T, Hudson SM, Marshall WL. Attachment style in sex offenders: a preliminary study. J Sex Res 1996;33(1):17–26. 23. Bartholomew K, Horowitz L. Attachment styles among adults: a test of a four category model. J Per Soc Psychol 1991;61:226–44. 24. Belsky J. Developmental origins of attachment styles. Attach Hum Dev 2002;4(2):166–70. 25. Main M, Hesse E, Kaplan N. Predictability of attachment behavior and representational processes at 1, 6, and 19 years of age: the Berkeley longitudinal study. In: Grossmann KE, Grossmann K, Waters E, editors. Attachment from infancy to adulthood: the major longitudinal studies. New York, NY: Guilford Press, 2005;245–304.
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26. Bakermans-Kranenburg MJ, Van Ijzendoorn MH. The first 10,000 adult attachment interviews: distributions of adult attachment representations in non-clinical and clinical groups. Attach Hum Dev 2009;11:223–63. 27. Cassibba R, van Ijzendoorn MH, Coppola G. Emotional availability and attachment across generations: variations in patterns associated with infant health risk status. Child Care Health Dev 2012;38(4):538–44. 28. Cassibba R, Sette G, Bakermans-Kraneburg MJ, van Ijzendoorn MH. Attachment the Italian way: in search of specific patterns of infant and adult attachments in Italian typical and atypical samples. Eur Psychol 2013;18(1):57–8. 29. Martino V, Campobasso F, Cannito A, Massaro Y, Lisi A, Grattagliano I, et al. The Mmpi-2 Test, a useful instrument to analise distorted behaviours: dissimulation. Riv It di Med Leg 2013;1:133–45.
30. Grattagliano I, Corbi G, Catanesi R, Ferrara N, Lisi A, Campobasso CP. False accusations of sexual abuse as a mean of revenge in couple disputes. Clin Ter 2014;35(2):e119–24. 31. Grattagliano I. Pas e metodologia peritale. Psicologia Clinica dello Sviluppo 2013;17(2):340–4. Additional information and reprint requests: Ignazio Grattagliano, Ph.D. Department of Criminology and Forensic Psychiatry University of Bari Bari, Italy E-mail: [email protected]
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PAPER PSYCHIATRY & BEHAVIORAL SCIENCES
Ignazio Grattagliano,1 Ph.D.; Rosalinda Cassibba,2 Ph.D.; Alessandro Costantini,2 Ph.D.; Giovanni Michele Laquale,2 Ph.D.; Alessandra Latrofa,2 Ph.D.; Sonia Papagna,2 Ph.D.; Giovanna Sette,2 Ph.D.; Alessandro Taurino,2 Ph.D.; and Maria Terlizzi,2 Ph.D.
Attachment Models in Incarcerated Sex Offenders: A Preliminary Italian Study Using the Adult Attachment Interview
ABSTRACT: A group of sex offenders (clinical group: n = 19) was compared to a nonclinical sample matched by age, years of education,
and gender (control group A: n = 19) to verify a higher incidence of insecure attachment models among sex offenders. In addition, we tested whether sex offenders were characterized by specific childhood experiences, compared to control adults (control group B: n = 19) with the same secure/insecure attachment classification. Results showed significant differences between offenders and control adults on both the AAI continuous score and the distribution of the two-way attachment classifications. Furthermore, sex offenders reported more intense experiences of rejection by the father figure and abuse in the family context during early childhood compared to not offenders subjects with the same attachment classification.
KEYWORDS: forensic science, sexual offenders, adult attachment interview, negative childhood experiences
Descriptive and empirical research, along with clinical observations, has indicated the presence of disruptive or dysfunctional family experiences in the early childhood of sex offenders (1,2). Most of the offenders describe their interactions with caregivers as involving high levels of neglect and rejection together with low levels of supervision, discipline, and consistency (3,4). The quality of attachment relationships that sex offenders experience in the past with their caregiver is one of the relational aspects recently taken into account as a factor of vulnerability. Marshall (5) outlined a theory suggesting that sexual offenders attempt, in their offenses, to achieve the intimacy they lack in the rest of their lives. Marshall’s paper generated a burst of research activity that has focused on intimacy deficits and poor adult attachments in sexual offenders. This research has convincingly demonstrated serious deficits in these skills among sexual offenders (3,5–8). Moreover, there is now convincing evidence that treatment directed to sexual offenders can be effective (9,10). According to Bowlby (11), the relationship with caregivers in early childhood influences the construction of internal working models, which guide individuals in their interpersonal relationships and lead to the development of expectations and beliefs concerning the self and the others (12). These representational models, which are largely based on attachment experiences in 1 Department of Criminology and Forensic Psychiatry, University of Bari, Bari, Italy. 2 Department of Education, Psychology and Communication, University of Bari, Bari, Italy. Received 8 May 2013; and in revised form 9 Sept. 2013; accepted 13 Oct. 2013.
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childhood and adolescence, continue to exert an influence in contexts that activate the attachment system in adulthood, such as romantic relationships (13), religious behavior (14), or psychotherapy relationship (15). An important factor facilitating the study of adult attachment is the availability of the Adult Attachment Interview (16), a validated and replicable assessment procedure to assess adults’ state of mind regarding attachment. During the course of this interview, individuals are asked both to describe their attachmentrelated childhood experiences, especially their early relations with parents or parenting figures, and to evaluate the influence of these experiences on their development and current interpersonal functioning. Main et al. (16) found that transcribed verbatim responses from these interviews could be systematically placed into one of three adult attachment classification categories. The first was termed “Secure-autonomous” (“valuing of attachment relationships and experiences, and yet apparently objective regarding any particular relationship experience”); a second category was labeled “Insecure-Dismissing” (“dismissing, devaluing, or cutoff from attachment relationships and experiences”); the third type of interview classification category is the “Insecure-Preoccupied” (“with or by early attachments or attachment-related experiences”) (17). Main and Hesse (18) added other two insecure categories: “Unresolved” for the individuals that spoke in unusual ways about traumatic experiences and “Cannot Classify” for individuals whose transcripts failed to meet criteria for placement in one of the three organized attachment categories. In adulthood, the activation of the attachment behavioral system is deeply linked to the activation of sexual and care systems; therefore, the disorganization of the attachment system could © 2014 American Academy of Forensic Sciences
GRATTAGLIANO ET AL.
lead to inappropriate and dysfunctional activation of the sexual one (19,20). In individuals with a secure attachment style, the sexual behavioral system is activated in situations characterized by the perception of security, trust, and reciprocity, whereas in insecurely attached individuals, those behaviors are linked to negative affective and cognitive states, rather than commitment and trust. For example, a disorganized attachment style can be characterized by confusion between sexual and attachment behaviors, a condition which could lead to the activation of contradictory or coercive sexual strategies and behaviors (5,6,20). A number of studies have demonstrated a high incidence of insecure attachment among samples of sex offenders. In this regard, Smallbone and Dadds (20) found that the insecure attachment style was significantly higher in subjects incarcerated for sex offenses compared to those incarcerated for other types of crimes. In addition, insecure childhood attachment, particularly insecure attachment to father, was associated with higher levels of antisocial behavior, aggression, and coercive sexual behavior (1,21). More specifically, a link between the type of sexual offense and the style of attachment of sex offenders has also been reported (7,8,22). Based on Bartholomew’s two-dimensional model (23), Ward et al. (22) found that child sex offenders were predominantly classified as having worried or fearful styles of attachment, whereas rapists were predominantly characterized by dismissingavoidant attachment styles. All the above-mentioned studies focused on attachment have mainly implemented self-reported instruments to assess attachment styles. These measures have been criticized for their limited ability to work through the defensiveness known to be prevalent among sex offenders (6). Indeed, very few studies have used the Adult Attachment Interview (AAI: 17), a semistructured interview which allows, compared to self-report measures, to collect more valid and reliable assessments, as it is able to “take the unconscious by surprise.” Moreover, we must consider that romantic attachment styles, assessed through self-report measures, have not been shown to arise from the individual’s history of early affective relationships, unlike the state of mind in relation to attachment, assessed through AAI, which has consistently demonstrated developmental roots (24,25). Likewise, few studies have involved samples of sex offenders on full prison terms. The aim of this study was twofold. First, it aimed at verifying the existence of a higher percentage of insecure attachment models, by the use of the AAI, among sex offenders compared to a control group; second, we aimed to ascertain whether sex offenders were characterized by specific childhood experiences, compared to control adults with the same attachment classification (1,21). Participants and Procedure A total of 57 subjects (12 females), aged between 28 and 78 (M = 46.89; SD = 12.29), subdivided into three groups, took part in the study. The first group (offenders group) consisted of 19 subjects (four female; age: M = 47.21; SD = 12.91; years of education: M = 8.93; SD = 3.91), all convicted of violent sex crimes, recruited from prisons based on agreements made with the Justice Ministry and the warden of each institute participating in the project. The length of the sentences ranged from 5 to 10 years. The second group (comparison group A), consisting of 19 (age: M = 47.37; SD = 12.79; years of education: M = 9.21; SD = 3.96) not offenders subjects, was recruited to match the offenders
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group in terms of age (t (38) = 0.03, p = n.s.), years of education (t (38) = 0.20, p = n.s.), and gender (four female). The third one (comparison group B) was constituted of 19 not offenders subjects (age: M = 46.11; SD = 11.77; years of education: M = 8.95; SD = 3.48), matched to the offenders group based on the attachment category (four secure, 15 insecure), gender (four secure), and age (t (38) = 0.27, p = n.s.). The comparison between this latter control group and the offenders one allowed us to verify whether, given the same attachment categories, sex offenders would be characterized by specific childhood experiences with their parents, as hypothesized above. We scheduled a meeting in prison with the offenders group for the administration of the Adult Attachment Interview (AAI: 17), while participants in the comparison group were interviewed at home. All participants were informed about the confidentiality of participation and signed the same consent form. Prison officials authorized the use of AAI, but they did not have access to the data collected by the researchers. The AAI is a semistructured interview aimed at evaluating the adult state of mind related to attachment based on the discourse coherence displayed during the interview. The protocol includes approximately 20 questions, some referring to general descriptions of childhood relationships with parents (i.e., Now I’d like you to try to describe your relationship with your parents as a young child, starting as far back as you can remember), others on the recollection of specific episodes to support the general descriptions; moreover, adults are asked about what happened when the interviewee as a child was emotionally upset, ill, and in pain (i.e., Could you give me some specific incidents when you were upset emotionally?); lastly, they are asked to speculate on the effect of childhood experiences with parents on their present personality (How do you think your overall early experiences have affected your adult personality?). Coding of the interviews yielded two different measurements; the first regarding classifications expressing the adult mental status in terms of one of the three organized attachment categories: Secure/Autonomous, Insecure/Dismissing, and Insecure/ Preoccupied. The discourse of participants assigned an insecure/dismissing (Ds) classification is most often characterized by structural inconsistency between positive/generalized portrayals of parents and the failure to support these portrayals with specific episodes. The discourse of participants assigned to an insecure/preoccupied (E) classification is characterized by an ongoing, mentally upsetting anger against the parent and/or vagueness of mental processes concerning attachment. The discourse of participants assigned to a secure/autonomous (F) classification is characterized by a collaborative attitude and credibility; whether or not their past experiences were primarily positive or negative: the transcript provides an internally consistent picture of the participant’s experiences, feelings, and viewpoints regarding attachment. A fourth category, Unresolved (U/CC), can be selected in the presence of specific indexes of unresolved mourning or trauma. The reliability of the AAI classification system is well established, as well as its convergent and discriminant validity, see Hesse, for a review, (17). Also, independent estimates of probable parental behaviors in participants’ childhoods, as derived in the AAI system, have been found to be related to their infant attachment classifications (26). Based on scores on a set of continuous scales for idealization, anger, derogation, and coherence of transcript, see Main et al. (25) for details of the coding system; we were also able to calculate a continuous attachment security score using the
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discriminant function equation as used in previous published work e.g., Cassibba et al. (27). Interview transcripts were coded by two coders blinded to all other data. The coders were trained in Rome by Nino Dazzi and Deborah Jacobivitz and achieved full AAI reliability across 30 consecutive transcripts with Mary Main and Eric Hesse at University of California, Berkeley. The inter-rater reliability computed on n = 19 (33%) of the interviews was Cohen’s K = 85; p < 0.001.
Offenders Group AAI F Ds E CC/U Total
4 11 1 3 19
( 2.0) (1.0) (.0) (1.8)
Comparison Group 10 8 1 0 19
(2.0) ( 1.0) (.0) ( 1.8)
Values in brackets are adjusted standardized residuals. F = Secure/Autonomous, Ds = Insecure/Dismissing, E = Insecure/Preoccupied, CC/U = Cannot Classify/Unresolved.
Results Conducting independent samples t-tests on the AAI continuous scores with group (offenders vs. comparison A) as a factor, we found a significant difference. More specifically, security scores obtained by sexual offenders were significantly lower than those obtained by the comparison group (offenders group: M = 1.13; SD = 1.62, comparison group A: M = 0.11; SD = 1.88; t = 2.17; p < 0.05). Cross-tabulating categorical attachment representations (secure vs. insecure) and group (offenders vs. comparison A) also showed significant differences (v2 (1, n = 38) = 4.07, p < 0. 05; Table 1) in that 10 of 19 not offenders were assessed as secure, whereas only four of 19 offenders obtained a secure classification. By cross-tabulating four-way AAI classifications (F, Ds, E, and CC/U) and group (offenders vs. comparison A), we failed to find a significant difference (v2 (1, n = 38) = 6.04, p = n.s.; Table 2); in fact, the two groups did not differ with respect to the distribution of specific patterns of attachment. Second, we performed a set of independent group t-test analyses to determine whether sex offenders and comparison group B (paired to offenders group in terms of attachment category, gender, years of education, and age) differed on probable childhood attachment experiences (i.e., loving, rejecting, neglecting, pressure to achieve, and role reversing in relation to each parent). Results showed significant differences between the two groups (offenders vs. comparison B) on rejecting for father (offenders group: M = 5.03, SD = 2.45, comparison B: M = 2.42, SD = 2.21, t (38) = 3.25, p < 0.01), role reversing for both mother (offenders group: M = 1.27, SD = 0.82, comparison B: M = 2.94, SD = 2.20, t (38) = 3.01, p < 0.01) and father (offenders group: M = 1.14, SD = 0.42, comparison B: M = 2.00, SD = 1.49, t (38) = 2.27, p < 0.05) and pressure to achieve for mother (offenders group: M = 1.41, SD = 0.93, comparison B: M = 3.00, SD = 2.42, t (38) = 2.53, p < 0.05). We also found a significant difference between the two groups (offenders vs. comparison B) in terms of scoring of unresolved abuse (offenders group: M = 1.97, SD = 2.03, comparison B: M = 1.0, SD = 0.00, t (38) = 2.09, p < 0.05). More specifically, the sex offenders during the AAI referred to have experienced a more intense direct rejection and greater minimization of their needs by the father figure during their early childhood compared to control subjects with the same attachment classification. On the contrary, control subjects referred more indirect unloving TABLE 1––AAI distribution of attachment patterns across the two groups.
AAI Secure Insecure Total
TABLE 2––Four-way AAI distribution of attachment patterns across the two groups.
Offenders Group
Comparison Group (A)
4 ( 2.0) 15 (2.0) 19
10 (2.0) 9 ( 2.0) 19
Values in brackets are adjusted standardized residuals.
experiences with parents, such as pressure to achieve and role reversing. Furthermore, sex offenders reported more unresolved abuse experiences with respect to the comparison B group. Discussion The aim of this study was twofold. First, we aimed to investigate whether an Italian group of incarcerated sex offenders showed a higher incidence of insecure attachment models compared to a control group; second, we verified whether the childhood experiences of sexual offenders were characterized by high levels of rejection and lower levels of loving compared to control adults with the same attachment classification. Our study also aimed at overcoming some methodological limitations present in most research on this topic. In this respect, attachment models were assessed using the AAI, instead of selfreport measures, frequently used in previous research, which has been shown to provide more reliable and valid measures of attachment representations (25). Differently from self-report measures, in fact, the AAI protocol has the potential to “surprise the unconscious” (17). As scoring and final classifications depend mainly of the degree of coherence of mental and discourse processes on attachment topics, more than on content, it is extremely difficult for the interviewee to provide socially desirable answers. Moreover, the AAI has good cross-cultural validity, although it is also able to highlight some specificities of the cultural background of the interviewee (26). Lastly, unlike studies which determined the presence of sex crimes through telephone interviews or subjective evaluations, our sex offenders group included only incarcerated subjects subsequent to full conviction for a sexual offense. Results showed a higher incidence of insecure attachment, particularly in the dismissing category, in sex offenders compared to the control group. These results are in agreement with those reported by several previous studies (8,20,21), which found a higher frequency of insecure attachment in subjects incarcerated for sex offenses compared to those imprisoned for other types of crimes. The finding that did not match with previous ones, however, was the frequency of unresolved/disorganized attachment, as we found a very low frequency in our offenders group, although this classification appears to be very common in clinical samples and in subjects who have had problems with the law (26). In fact, despite the fact that sex offenders reported a higher incidence of abuse, compared to control adults with the same attachment classification, this condition did not generate a significantly higher level of disorganization of their own attachment models. This result could partly be attributed to the Italian cultural context within which the study was carried out. Indeed, as shown in a meta-analytic study on the
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distribution of attachment categories among the Italian culture (28), the CC/U category in Italian samples is underrepresented to a statistically significant extent when compared to those of other countries. Results on the quality of childhood relationships of sex offenders with both parents highlighted that, in the presence of a similar incidence of insecure attachment, sexual offenders differ from the control group B because of the presence of repeated experiences of rejection from the fathers and abuse in the family context. On the contrary, the negative childhood experiences characterizing not sexual offenders insecure adults include more indirect unloving experiences, such as excessive pressure to gain achievements in the cognitive domain (pressure to achieve) or having an inconsistent parent which expects to be protected and cared by the child (e.g., role reversing). These results are in-line with those reported by several published studies highlighting the presence of dysfunctional and/or traumatic experiences in the birth families of sexual offenders. In fact, their families have been shown to be characterized, above all, by the absence of a stable and caring family environment, by conflicts between the parents, the use of harsh punishment by the parents, and the absence of a relationship with the father figure (1,3). In sum, our findings are consistent with the predictions from attachment theory and, even though our sample size is small, they highlight the importance of early affective experiences with parents in sexual offenders. Nevertheless, some limits need to be addressed. First of all, the choice to include in the offenders group only participants with full convictions for sex crimes had significant repercussions on the size sample. Because of small sample, we believe that our findings, while intuitive and logical, should be considered as preliminary ones and certainly require further support. Second, our study failed to take into account some relevant information about criminal status (i.e., number of past offenses, length of criminal career) or SES and individual experiences (i.e., relationship status), which limit the possibility to generalize the results. In fact, the warden of prisons did not allow us to administer other tests, other than the AAI. This limitation reduced our possibility to take into account other potentially confounding variables which may have affected our results and to use a more complex statistical analytic plan. To conclude, and notwithstanding the above limitations, the present study adds an important piece to understand the link between early affective experiences and the internal working models with respect to attachment in sex offenders, offering interesting suggestions for future research and for the implementation of educational and prevention programs. Future research should focus on other relevant variables which may play a role as, for example, gender and personality and/or psychopathological traits. To our knowledge, there are no studies available up to now testing attachment status through the AAI on female sexual offenders. In our study, we decided to include also female sexual offender as no data in the literature report gender differences among low-risk as well as clinical ones with respect to attachment status. To the best of our knowledge, this is the first study on attachment in sexual offenders including female participants (26). Lastly, it should be convenient for future studies to implement appropriate assessments to prevent malingering: In this respect, it would be appropriate to verify whether the subjects, for whatever reasons, tend to over report (exaggerate) or underreport (deny) psychopathological difficulties and/or try deliberately avoid answering psychological assessments in a frank manner (29–31).
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