M e d
s
-
Printed
c i . Law ( 1 9 7 9 ) Vol. 19, N o . 1
in Great
Britain
55
£h'ld Molestation: a Comparison of Hong Kong and Western Findings ^· Κ. LAW, M B , BS, MRCPsych, M R A N Z C P , D P M Seni, ' Medical Officer, Mental Health Service, Hong Kong 0 r
SU|
WMARY r
e
METHOD
r o s
ρ ' P e c t i v e s t u d y of all d e f e n d a n t s referred for Per· ! ' evaluation b y t h e c o u r t s over a 10-year out ° " y m o l e s t i n g children was carried ass , were m o r e o f t e n o f a y o u n g age, and* " children in places accessible t o t h e public dem 8 t o r e s o r t t o violent m e a n s if t h e i r " were n o t m e t . Middle-aged a n d elderly sex ι " y suffered from social isolation a n d i ' l u s t r a t i o n a n d inclined t o a p p r o a c h n e i g h b o u r disoH ' ~ rnanner. Cases of severe laben ' 'g 'f' n u m b e r were har . o i d or of p s y c h o p a t h i c p e r s o n a l i t y . T h e (jjj * ^ i s t i c s of t h e victims closely r e s e m b l e d t h o s e mon" series. F o n d l i n g was t h e c o m c
a t r
c
f
0
r
f
f
e
n
d
m
s e x u a
n
d
e
r
s
1
t
e
a
d s
o f f e
u
s
u
a
a
n
e
v a r
a b
The records of all defendants charged with sexual offences and referred to the Prisons Department Psychiatric Centre were carefully reviewed for the years 1968-77. Most of the case records contained reasonably detailed clinical information made by a qualified psychiatrist, the results of Raven's Standard Progressive Matrices, as well as a detailed police summary of the offence. All the cases charged with 'indecent assault' and 'incest' involving a victim or victims of 15 years of age or under of both sexes were reviewed and coded for various offender, victim and offence characteristics, as detailed below. All cases charged with 'rape' and 'attempted rape' were excluded from the study. The chances of defendants being charged with a sexual crime involving a child victim being allowed bail and being ordered to attend a psychiatric outpatient clinic for mental assess ment were extremely low and over 90% of those remanded in custody for psychiatric evaluation were seen at the Prisons Department Psychiatric Centre.
l l t v
RESULTS
l m
m
S
t
o
r e
o r t
ar
A total of 141 heterosexual offenders and 14 homosexual offenders were referred for psy chiatric assessment in the 10-year period studied, involving a total of 165 girl victims and 18 boy victims.
e s t a
a n
The Offender
e h
latr
c
0 g S a r e t h e n
c
0
w
a
c o r n
a r e c !
w
The offenders were more often of a young age, but the differential age effect became slight when it was realized that the general population of Hong Kong in fact contains
56
Med. Sci. Law (1979) Vol. 19, N o . 1
Table I. Age d i s t r i b u t i o n of offenders c o m p a r e d with census data Age (yr) 15-19 20-24 25 - 29 30-34 35-39 40 - 44 45-49 50-54 55-59 60-64 65-69 over 6 9
Census %
Total no. %
17.2 13.5 8.4 9.1 10.1 10.4 8.8 7.9 5.9 4.1 2.2 2.4
33 32 22 17 13 10 7 6 6 4 3 2
21.4 21.3 14.2 10.1 8.4 6.5 4.5 3.9 3.9 2.6 1.9 1.3
Table II. O c c u p a t i o n s of offenders
Occupation
Total no. %
Hetero. Homo-
Hetero. Homo. 32 26 20 16 12 9 6 6 5 4 3 2
1 6 2 1 1 1 1 0 1 0 0 0
proportionately more young people, as the 1971 Census indicates (Table I). Psychological testing by the Raven's Progressive Matrices revealed 3 offenders in grade 1, 24 in grade 2, 62 in grade 3, 30 in grade 4 and 3 1 in grade 5. Results were not available for the remaining 5 of the total 155 offenders. As for their educational achievements, 78% had only received primary education or none at all, 20% had studied up to secondary level and the remaining 2% had received further education. Comparable figures for the general population, according to the 1971 Census, were 52%, 40% and 8% respectively. Offenders as a group thus received less schooling. Table II shows the offenders' occupations, modified from Mohr and co-workers' Toronto Forensic Clinic study classification (1964). The dominant occupation was indicated if the offenders were engaged in more than one job. While all offenders came from all occupational groups, unskilled workers constituted the single largest group. It was noteworthy that all 3 offenders in the professions came from the homosexual subgroup. Work effort was assessed according to the length of time and continuity of holding a major job and the results were: 5 excessive, 108 adequate, 35 deficient and 7 unknown. Concerning the offenders' religious affiliations, 8 were Protestants or Catholics representing 5.2% of the sample-, no offender claimed to be a believer in other religions. Since no norms were available, one could only speculate that religious belief per se did not have
Student
7
5
7
Professional
3
2
0
Business Owner Clerical Sales Storekeeper
15 5 3 5 2
10
15 5 3 5 2
Trades Mechanics, p l u m b i n g Barber Tailor Cobbler
18 8 4 3 3
12
15 8 2 3 2
Semi-skilled C o m m e r c i a l driving Construction Knitting, weaving
11 2 4 5
7
9 2 3 4
Unskilled Labourer, odd jobs Farmhand Hawking
58 43 4 11
36
55 40 4 11
Service R e s t a u r a n t waiter Kitchen orderly
18 12 6
12
15 10 5
Retired, unemployed
15
10
15
Unknown
10
6
10
t n £
a major effect in deterring or encouraging commission of paedophilic offences. Ninety-five of the 141 heterosexual offended and 12 of the 14 homosexual offenders we * single and had not previously married, represent ing 67% and 86% respectively of the tw° subgroups. A breakdown of the data if* '' different age groups is shown in Table ·' ' Offenders tended to remain single more o ^ j than non-offenders of the same age group the discrepancy became more marked in t * older age groups. Of the married heteroseX offenders, only 21 still lived with their spouse*' while the other 25 had been leading a bachelor life (Table IV), often because their spouS * lived in Mainland China and were not alloW to migrate, while the offenders preferred make a living in Hong Kong, a more afflue 1
1
a n
h
ui
e
e
1 0
nt
Law: Child Molestation
57
7 a o / e ///, Marital s t a t u s of offenders c o m p a r e d with census d a t a Age (vr)
Census % single
15-19 20 - 2 4 25-29 30 - 3 4 35-39 40 - 44 over 4 4
99 92 64 34 19 11 5
Total single no. % 33 31 18 11 6 4 4
Hetero. single 32 25 16 10 6 3 3
100 97 82 65 46 40 14
Homo. single 1 6 2 1 0 1 1
Table IV. Spouses of married h e t e r o s e x u a l offenders Offender age (yr) 15-29 30 - 44 over 4 4
a c e
Spouse dead
Spouse in China
0 1 5
^ by comparison, and paid their spouses 1 j . . visits a year. Among the 21 offenders j 8 i t h their spouses, 10 reported cessation Xual intercourse for some time prior to committing offences. Of these 10, 5 were ... 4-5 years of age, 2 feared pregnancy for c ' ' asons and 3 had wives suffering from °nic illnesses. The other 5 were over 44 of age and all reported a dwindling in κ P ° y d a lessened sexual interest 'heir ageing partners for 2 to 10 years prior "»e offence. Regarding the sibling distribution, the 141 "«erosexuai offenders' families had altogether f„ . ildren, a mean of 4.1 children per ^ y- The homosexual offenders' families had child mean of 4.4 children per family. . . . ^ heterosexual offenders were the only in the family, 31 the oldest child and 38 th ^ ° 8 child; corresponding figures for homosexual subgroup were 1, 2 and 1 Pectively. ^Concerning the offenders' own children, the j r i e d offenders of both subgroups had children, a mean of 2.5 per family. ^Th j records of the offenders studied, ln the 15-29 age group, 11 harj non-sexual crime records, 12 had ' m e records of child molesting, 1 diff kind of sexual crime record r
2
l n
w
o
Se
C l r
u
e r
a n c
a
re
n
r
e a r s
s
t e n c
a n
C 0
cn
renj
a
en
c
U d
t h
u n
e s t
6
r
Cs
m a r
2 o
e
p a s t
c r
m i n a l
Spouse divorced /separated
S p o u s e living together
1 2 2
3 10 8
1 5 8
and 3 had both sexual and non-sexual crime records. In the 30-44 age group, 3 offenders had a non-sexual crime record, 4 had a record of child molesting and 1 had both non-sexual and sexual crime records. In the 45-69 age group, only 1 offender had a non-sexual crime record and none had a sexual crime record. For all offenders 15-69 years of age, 9.8% had a non sexual crime record only, 11.1% had a sexual crime record only and 2.6% had both. Any association between deviant sexual behaviour and mental disorder should be obvious, as all the offenders had been referred for psychiatric assessment. Exactly half of the sample had no diagnosis given, psychiatric or physical. Diagnostic categories of the other half are shown in Table V. It was significant that 12% of the sample were labelled psychopathic personality according to Feighner and co workers' criteria of antisocial character (1972). Those labelled as remitted schizophrenics, schizoid individuals and mental subnormals seemed to share a common characteristic, namely, difficulties in initiating and maintaining contacts with the opposite sex. The Victim
r e
o f f
n d c r s
S C X U a l
h
a
d
c r
a
e r e n t
All victims ranged from 3—15 years of age, but boys had a mean age (12.8 years) that was higher than girls (8.6 years).
58
Med. Sci. Law (1979) Vol. 1 9 , N o . 1
Table
V. Psychiatric diagnoses of o f f e n d e r s
Table
Total Hetero. Homo, o. %
Diagnosis
F u n c t i o n a l psychoses Schizophrenia (remitted) Schizophrenia (relapsed) E n d o g e n o u s depression
15
1
5
5
0
10 1
9 1
1 0
2
0
1 1
0 0
16
10
1
Organic brain s y n d r o m e Postconcussional syndrome Brain t u m o u r
2
C h r o n i c alcoholism
7
5
6
1
Reactive depression
2
1
2
0
Stuttering
1
1
1
0
Schizoid p e r s o n a l i t y
14
9
13
1
Psychopathic personality
19
12
18
1
1 1
VI. R e l a t i o n s h i p b e t w e e n victim a n d offend^ Relationship
Total (183)
Own child Nephew/niece Distant relative Total
5 1 3 9 (5%)
F r i e n d ' s child Own child's friend School pupil Neighbour/co-tenant Total
6 2 1 63 72 (39%)
Casual a c q u a i n t a n c e Stranger Total
26 76 102 (56%)
Hetero. (165)
Homod 8 )
Over half of the victims were hardly know* to the offenders, being particularly so for * boys. As shown in Table VI, victims » " offenders as next-door neighbours and tenants of the same flats were c o m m " ^ encountered; this reflects the fact that Ηο ϋ Kong is a very densely populated place and tb ποίο* majority of the population lives in m" storey buildings. tn
η
c < r
14
9
13
1
Physical disorders Scoliosis Diabetes insipidus Deaf-mutism
3 1 1 1
2
3 1 1 1
0 0 0 0
No definite diagnosis
77
50
68
9
Mental s u b n o r m a l ity
0
η
e
The Offence
Since slightly more than half of the victims was offenders were unknown to each other, it not surprising to find that just over half of th incidents occurred in places accessible to the public and could be readily detected by patrolling police or passers-by. For examp' ' most incidents taking place in a public build» ^ referred to the staircases, corridors, elevators and public lavatories of the building. Again, d] chance of the offence being committed "Î public was higher among the homoseX ^ offenders (Table VII). Fondling the genitals constituted the com monest heterosexual act, but intercrural simulated vaginal intercourses, i.e. the offend using his own penis to touch the girl's thig and genitalia without attempting actual penetr* tion, also contributed a substantial number. comparison, homosexual acts were more orga in nature, as witnessed by the high proporti° of anal intercourse and masturbation (To" VIII). e
t n e
Table
VII. Place of offence
e
Place
H o m e of offender H o m e of offender and victim H o m e of victim Total
Place of w o r k Car of offender Public building Public place Total
Total (183)
Hetero. (165)
24
24
IH o m o . (18) 0
1
e
26 25 75 (41%)
26 23 73 (44%)
0 2 2 (11%)
10 1 64 29 104 (57%)
7 1 58 23 89 (54%)
3 0 6 6 15 (88%)
4 (2%)
3 (2%)
1 (1%)
u
a n
er
nS
stlC
Not k n o w n
n
Law: Child Molestation W//. Acts c o n s t i t u t i n g t h e offence Acts
Total
Hetero.
94 5
90 2
3 9
3 6
V e 8
20
15
V a e
25
25
5 3 3
5 3 3
0 0 0
1 5 10 183
1 4 8 165
0 1 2 18
9
v
i
c
t
i
m
M ,^ Ex „ · °ntact ' n g Ipaedophilic context) 0
n i t a l
c
D X p 0 s
An
al/intercrural intercourse ' " 8 l intercourse, w emulated ' " a l intercourse, executed S " " fondled
„. eemtals
Homo.
victim',
^SSing
f ^ i f i e d attempts
a
s o
i ' informative to divide the offenders asp ' t age groups and compare some (und ° * ' °^ - Young offenders — ignificantly rtiorp significantly ten to molest more than one victim at thf. „ r n t o
e r e n
ect
S
Γ
f
l
e
h e
a g e
r
e n c e s
o f
w e r e
f
o
u
n
d
, c
a
^ j ^
,
same or at different times, more often °r threaten to use violent means to e their ends (e.g. by carrying a knife), '"ore likely to be a stranger to the * and thus more often only had one e of molesting a single victim (Table IX).
U s e
l e y
C r e
V
U T n
n c
SSI ON
°tabl
e
Slm
"""en h i ' a r i t i e s and differences emerge fi Ji findings are compared with Western Ho ' e profile of child molesters suggests Particui; ar age, which is also the conclusion of He and his co-workers in an American tUd' ( 7 6 ) . Offenders came from diverse e
nr
n
g s
T n
D
n n
s
l 0
educational groups, which was also the finding of Mohr and his colleagues (1964). A scrutiny of the family and marital data reveals the salient importance of long term sexual frustra tion as well as lack of social contacts, in keeping with Virkkunen's Finnish study (1976). The mean ages of boy and girl victims are also similar to Western studies, as is the commonest act of offence, namely, fondling. Differences, however, are not hard to find. The present sample consists of proportionately more people who have received less schooling and who scored lower in intellectual assessment. Since no local norms are available for Raven's Progressive Matrices, no firm conclusion could be drawn regarding the apparently fair perform ance of the offenders, despite this test being described as 'heavily loaded with a factor common to most intelligence tests (identified with Spearman's g by British psychologists)' (Anastasi, 1961). With regard to the offendervictim relationship, 56% of incidents occurred between strangers or casual acquaintances in contrast with 26% in the series of Mohr and co-workers (1964). The present series also contains many incidents of intercrural and simulated vaginal intercourse and many incidents that took place where the public had easy access. The general public in Hong Kong have rightly expressed alarm at the situation and local laws have recently been amended enabling the courts to impose heavier penalties for sex offenders. Despite the fact that the present series must be biased towards the finding of mental disorders, less than 10% of the defendants showed active symptoms of a psychosis. Thus mental disorders per se bore no clear-cut relation to deviant sexuality. On the other hand,
mparison of s o m e characteristics of h e t e r o s e x u a l offenders of different age g r o u p s Offender No.
Victims one > one
78 37 26
58 34 23
20 3 3
x = 6.100 d.f. = 2 /> once once 67 25 8
11 12 18
x = 28.804 d.f. = 2 Ρ < 0-001 2
59
Violence yes no 23 6 1
55 31 25
x = 8.385 d.f. = 2 P< 0 - 0 2 5 J
Relationship unknown known 56 18 2
22 19 24
x • 32.832 d.f. = 2 Ρ < 0-001 J
60
Med. Sci. Law (1979) V o l . 1 9 , N o . 1
psychosocial factors appeared crucial. As a group, offenders under 30 years of age showed impaired social relationships, poor academic achievements and fair work records. Finding themselves unable to establish heterosexual contacts on a mature level, they resorted to satisfying their erotic desires by turning to innocent girl strangers. Offenders aged 30 to 44 years tended to have marital problems, job discontent and alcoholism and had generally known the victims for some time. Offenders over 44 years were often socially isolated and had usually known the victims for a long period of time. They often claimed to have treated the victims as their own children, who in fact kept them company, and violence was almost never resorted to. Last but not least, many elderly offenders showed no definite evidence of intellectual impairment, indicating that in the elderly sexual interest is often present despite a realistic decline in sexual desire and ability (Freedman et al., 1976).
REFERENCES Anastasi A. ( 1 9 6 1 ) Psychological Testing, 2nd ed. Ne* Y o r k , Macmillan, p . 2 4 8 . . Feighner J. P., R o b i n s E., G u z e S. B. et al. ( I ? * ' Diagnostic criteria for use in p s y c h i a t r i c researc Arch. Gen. Psychiatry 26, 5 7 - 6 3 . . F r e e d m a n A. M., Kaplan H. I. and Sadock B. >· ( 1 9 7 6 ) Modern Synopsis of Comprehensive T* book of Psychiatry, 2nd e d . Baltimore, William* Wilkins, p . 7 2 6 . ?7 Henn F. A. , Herjanic M. and V a n d e r p e a r l R. H. U * Forensic p s y c h i a t r y : profiles of t w o types of * offenders. Am. J. Psychiatry 133, 6 9 4 - 6 9 6 . . Hong Kong Census a n d Statistics D e p a r t m e n t O Hong Kong Population and Housing Census &> ' Tables. . M o h r J. W., T u r n e r R. E. and J e r r y M. B. d ' * ' Pedophilia and Exbibitionsim. T o r o n t o , Univers' " of T o r o n t o Press. Radzinowicz L. ( 1 9 5 7 ) Sexual Offences. Lond "' Macmillan. State of California, D e p a r t m e n t of Mental H y g ' ( 1 9 5 3 ) California s e x u a l deviation research. State of California, D e p a r t m e n t of Mental H y g i ( 1 9 5 4 ) California s e x u a l deviation research. .. V i r k k u n e n M. ( 1 9 7 6 ) T h e p e d o p h i l i c offender * ' antisocial c h a r a c t e r . Acta Psychiat. Scand. ' ' 401-405.
World Congress o n Medical Law — Belgium T h e 5th World Congress o n Medical Law will b e held at t h e University of G h e n t , Belgium, from 19 - 23 August 1 9 7 9 . A m o n g t h e subjects t o b e discussed will b e : a m n i o c e n t e s i s , a b o r t i o n , sterilization, c o n t a g i o u s diseases, alcohol a n d d r u g a d d i c t i o n , p s y c h i a t r y , p e n o l o g y , genetic engineering, a b o r t i o n , suicide, e u t h a n a s i a , t h e rights a n d obligations of t h e S t a t e , t h e rights of t h e p a t i e n t a n d liability in h e a l t h care. Medicolegal aspects of nursing and d e n t i s t r y will also b e covered. I n f o r m a t i o n and registration f o r m s are available from t h e Secretary-General Professor R. Dierkens, A p o t h e e k s t r a a t 5, B - 9 0 0 0 G e n t , Belgium.
7
e
9 7
s
4
1
0
efl
en
t n
s
-
Printed
c i . Law ( 1 9 7 9 ) Vol. 19, N o . 1
in Great
Britain
55
£h'ld Molestation: a Comparison of Hong Kong and Western Findings ^· Κ. LAW, M B , BS, MRCPsych, M R A N Z C P , D P M Seni, ' Medical Officer, Mental Health Service, Hong Kong 0 r
SU|
WMARY r
e
METHOD
r o s
ρ ' P e c t i v e s t u d y of all d e f e n d a n t s referred for Per· ! ' evaluation b y t h e c o u r t s over a 10-year out ° " y m o l e s t i n g children was carried ass , were m o r e o f t e n o f a y o u n g age, and* " children in places accessible t o t h e public dem 8 t o r e s o r t t o violent m e a n s if t h e i r " were n o t m e t . Middle-aged a n d elderly sex ι " y suffered from social isolation a n d i ' l u s t r a t i o n a n d inclined t o a p p r o a c h n e i g h b o u r disoH ' ~ rnanner. Cases of severe laben ' 'g 'f' n u m b e r were har . o i d or of p s y c h o p a t h i c p e r s o n a l i t y . T h e (jjj * ^ i s t i c s of t h e victims closely r e s e m b l e d t h o s e mon" series. F o n d l i n g was t h e c o m c
a t r
c
f
0
r
f
f
e
n
d
m
s e x u a
n
d
e
r
s
1
t
e
a
d s
o f f e
u
s
u
a
a
n
e
v a r
a b
The records of all defendants charged with sexual offences and referred to the Prisons Department Psychiatric Centre were carefully reviewed for the years 1968-77. Most of the case records contained reasonably detailed clinical information made by a qualified psychiatrist, the results of Raven's Standard Progressive Matrices, as well as a detailed police summary of the offence. All the cases charged with 'indecent assault' and 'incest' involving a victim or victims of 15 years of age or under of both sexes were reviewed and coded for various offender, victim and offence characteristics, as detailed below. All cases charged with 'rape' and 'attempted rape' were excluded from the study. The chances of defendants being charged with a sexual crime involving a child victim being allowed bail and being ordered to attend a psychiatric outpatient clinic for mental assess ment were extremely low and over 90% of those remanded in custody for psychiatric evaluation were seen at the Prisons Department Psychiatric Centre.
l l t v
RESULTS
l m
m
S
t
o
r e
o r t
ar
A total of 141 heterosexual offenders and 14 homosexual offenders were referred for psy chiatric assessment in the 10-year period studied, involving a total of 165 girl victims and 18 boy victims.
e s t a
a n
The Offender
e h
latr
c
0 g S a r e t h e n
c
0
w
a
c o r n
a r e c !
w
The offenders were more often of a young age, but the differential age effect became slight when it was realized that the general population of Hong Kong in fact contains
56
Med. Sci. Law (1979) Vol. 19, N o . 1
Table I. Age d i s t r i b u t i o n of offenders c o m p a r e d with census data Age (yr) 15-19 20-24 25 - 29 30-34 35-39 40 - 44 45-49 50-54 55-59 60-64 65-69 over 6 9
Census %
Total no. %
17.2 13.5 8.4 9.1 10.1 10.4 8.8 7.9 5.9 4.1 2.2 2.4
33 32 22 17 13 10 7 6 6 4 3 2
21.4 21.3 14.2 10.1 8.4 6.5 4.5 3.9 3.9 2.6 1.9 1.3
Table II. O c c u p a t i o n s of offenders
Occupation
Total no. %
Hetero. Homo-
Hetero. Homo. 32 26 20 16 12 9 6 6 5 4 3 2
1 6 2 1 1 1 1 0 1 0 0 0
proportionately more young people, as the 1971 Census indicates (Table I). Psychological testing by the Raven's Progressive Matrices revealed 3 offenders in grade 1, 24 in grade 2, 62 in grade 3, 30 in grade 4 and 3 1 in grade 5. Results were not available for the remaining 5 of the total 155 offenders. As for their educational achievements, 78% had only received primary education or none at all, 20% had studied up to secondary level and the remaining 2% had received further education. Comparable figures for the general population, according to the 1971 Census, were 52%, 40% and 8% respectively. Offenders as a group thus received less schooling. Table II shows the offenders' occupations, modified from Mohr and co-workers' Toronto Forensic Clinic study classification (1964). The dominant occupation was indicated if the offenders were engaged in more than one job. While all offenders came from all occupational groups, unskilled workers constituted the single largest group. It was noteworthy that all 3 offenders in the professions came from the homosexual subgroup. Work effort was assessed according to the length of time and continuity of holding a major job and the results were: 5 excessive, 108 adequate, 35 deficient and 7 unknown. Concerning the offenders' religious affiliations, 8 were Protestants or Catholics representing 5.2% of the sample-, no offender claimed to be a believer in other religions. Since no norms were available, one could only speculate that religious belief per se did not have
Student
7
5
7
Professional
3
2
0
Business Owner Clerical Sales Storekeeper
15 5 3 5 2
10
15 5 3 5 2
Trades Mechanics, p l u m b i n g Barber Tailor Cobbler
18 8 4 3 3
12
15 8 2 3 2
Semi-skilled C o m m e r c i a l driving Construction Knitting, weaving
11 2 4 5
7
9 2 3 4
Unskilled Labourer, odd jobs Farmhand Hawking
58 43 4 11
36
55 40 4 11
Service R e s t a u r a n t waiter Kitchen orderly
18 12 6
12
15 10 5
Retired, unemployed
15
10
15
Unknown
10
6
10
t n £
a major effect in deterring or encouraging commission of paedophilic offences. Ninety-five of the 141 heterosexual offended and 12 of the 14 homosexual offenders we * single and had not previously married, represent ing 67% and 86% respectively of the tw° subgroups. A breakdown of the data if* '' different age groups is shown in Table ·' ' Offenders tended to remain single more o ^ j than non-offenders of the same age group the discrepancy became more marked in t * older age groups. Of the married heteroseX offenders, only 21 still lived with their spouse*' while the other 25 had been leading a bachelor life (Table IV), often because their spouS * lived in Mainland China and were not alloW to migrate, while the offenders preferred make a living in Hong Kong, a more afflue 1
1
a n
h
ui
e
e
1 0
nt
Law: Child Molestation
57
7 a o / e ///, Marital s t a t u s of offenders c o m p a r e d with census d a t a Age (vr)
Census % single
15-19 20 - 2 4 25-29 30 - 3 4 35-39 40 - 44 over 4 4
99 92 64 34 19 11 5
Total single no. % 33 31 18 11 6 4 4
Hetero. single 32 25 16 10 6 3 3
100 97 82 65 46 40 14
Homo. single 1 6 2 1 0 1 1
Table IV. Spouses of married h e t e r o s e x u a l offenders Offender age (yr) 15-29 30 - 44 over 4 4
a c e
Spouse dead
Spouse in China
0 1 5
^ by comparison, and paid their spouses 1 j . . visits a year. Among the 21 offenders j 8 i t h their spouses, 10 reported cessation Xual intercourse for some time prior to committing offences. Of these 10, 5 were ... 4-5 years of age, 2 feared pregnancy for c ' ' asons and 3 had wives suffering from °nic illnesses. The other 5 were over 44 of age and all reported a dwindling in κ P ° y d a lessened sexual interest 'heir ageing partners for 2 to 10 years prior "»e offence. Regarding the sibling distribution, the 141 "«erosexuai offenders' families had altogether f„ . ildren, a mean of 4.1 children per ^ y- The homosexual offenders' families had child mean of 4.4 children per family. . . . ^ heterosexual offenders were the only in the family, 31 the oldest child and 38 th ^ ° 8 child; corresponding figures for homosexual subgroup were 1, 2 and 1 Pectively. ^Concerning the offenders' own children, the j r i e d offenders of both subgroups had children, a mean of 2.5 per family. ^Th j records of the offenders studied, ln the 15-29 age group, 11 harj non-sexual crime records, 12 had ' m e records of child molesting, 1 diff kind of sexual crime record r
2
l n
w
o
Se
C l r
u
e r
a n c
a
re
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r
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s
t e n c
a n
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cn
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a
en
c
U d
t h
u n
e s t
6
r
Cs
m a r
2 o
e
p a s t
c r
m i n a l
Spouse divorced /separated
S p o u s e living together
1 2 2
3 10 8
1 5 8
and 3 had both sexual and non-sexual crime records. In the 30-44 age group, 3 offenders had a non-sexual crime record, 4 had a record of child molesting and 1 had both non-sexual and sexual crime records. In the 45-69 age group, only 1 offender had a non-sexual crime record and none had a sexual crime record. For all offenders 15-69 years of age, 9.8% had a non sexual crime record only, 11.1% had a sexual crime record only and 2.6% had both. Any association between deviant sexual behaviour and mental disorder should be obvious, as all the offenders had been referred for psychiatric assessment. Exactly half of the sample had no diagnosis given, psychiatric or physical. Diagnostic categories of the other half are shown in Table V. It was significant that 12% of the sample were labelled psychopathic personality according to Feighner and co workers' criteria of antisocial character (1972). Those labelled as remitted schizophrenics, schizoid individuals and mental subnormals seemed to share a common characteristic, namely, difficulties in initiating and maintaining contacts with the opposite sex. The Victim
r e
o f f
n d c r s
S C X U a l
h
a
d
c r
a
e r e n t
All victims ranged from 3—15 years of age, but boys had a mean age (12.8 years) that was higher than girls (8.6 years).
58
Med. Sci. Law (1979) Vol. 1 9 , N o . 1
Table
V. Psychiatric diagnoses of o f f e n d e r s
Table
Total Hetero. Homo, o. %
Diagnosis
F u n c t i o n a l psychoses Schizophrenia (remitted) Schizophrenia (relapsed) E n d o g e n o u s depression
15
1
5
5
0
10 1
9 1
1 0
2
0
1 1
0 0
16
10
1
Organic brain s y n d r o m e Postconcussional syndrome Brain t u m o u r
2
C h r o n i c alcoholism
7
5
6
1
Reactive depression
2
1
2
0
Stuttering
1
1
1
0
Schizoid p e r s o n a l i t y
14
9
13
1
Psychopathic personality
19
12
18
1
1 1
VI. R e l a t i o n s h i p b e t w e e n victim a n d offend^ Relationship
Total (183)
Own child Nephew/niece Distant relative Total
5 1 3 9 (5%)
F r i e n d ' s child Own child's friend School pupil Neighbour/co-tenant Total
6 2 1 63 72 (39%)
Casual a c q u a i n t a n c e Stranger Total
26 76 102 (56%)
Hetero. (165)
Homod 8 )
Over half of the victims were hardly know* to the offenders, being particularly so for * boys. As shown in Table VI, victims » " offenders as next-door neighbours and tenants of the same flats were c o m m " ^ encountered; this reflects the fact that Ηο ϋ Kong is a very densely populated place and tb ποίο* majority of the population lives in m" storey buildings. tn
η
c < r
14
9
13
1
Physical disorders Scoliosis Diabetes insipidus Deaf-mutism
3 1 1 1
2
3 1 1 1
0 0 0 0
No definite diagnosis
77
50
68
9
Mental s u b n o r m a l ity
0
η
e
The Offence
Since slightly more than half of the victims was offenders were unknown to each other, it not surprising to find that just over half of th incidents occurred in places accessible to the public and could be readily detected by patrolling police or passers-by. For examp' ' most incidents taking place in a public build» ^ referred to the staircases, corridors, elevators and public lavatories of the building. Again, d] chance of the offence being committed "Î public was higher among the homoseX ^ offenders (Table VII). Fondling the genitals constituted the com monest heterosexual act, but intercrural simulated vaginal intercourses, i.e. the offend using his own penis to touch the girl's thig and genitalia without attempting actual penetr* tion, also contributed a substantial number. comparison, homosexual acts were more orga in nature, as witnessed by the high proporti° of anal intercourse and masturbation (To" VIII). e
t n e
Table
VII. Place of offence
e
Place
H o m e of offender H o m e of offender and victim H o m e of victim Total
Place of w o r k Car of offender Public building Public place Total
Total (183)
Hetero. (165)
24
24
IH o m o . (18) 0
1
e
26 25 75 (41%)
26 23 73 (44%)
0 2 2 (11%)
10 1 64 29 104 (57%)
7 1 58 23 89 (54%)
3 0 6 6 15 (88%)
4 (2%)
3 (2%)
1 (1%)
u
a n
er
nS
stlC
Not k n o w n
n
Law: Child Molestation W//. Acts c o n s t i t u t i n g t h e offence Acts
Total
Hetero.
94 5
90 2
3 9
3 6
V e 8
20
15
V a e
25
25
5 3 3
5 3 3
0 0 0
1 5 10 183
1 4 8 165
0 1 2 18
9
v
i
c
t
i
m
M ,^ Ex „ · °ntact ' n g Ipaedophilic context) 0
n i t a l
c
D X p 0 s
An
al/intercrural intercourse ' " 8 l intercourse, w emulated ' " a l intercourse, executed S " " fondled
„. eemtals
Homo.
victim',
^SSing
f ^ i f i e d attempts
a
s o
i ' informative to divide the offenders asp ' t age groups and compare some (und ° * ' °^ - Young offenders — ignificantly rtiorp significantly ten to molest more than one victim at thf. „ r n t o
e r e n
ect
S
Γ
f
l
e
h e
a g e
r
e n c e s
o f
w e r e
f
o
u
n
d
, c
a
^ j ^
,
same or at different times, more often °r threaten to use violent means to e their ends (e.g. by carrying a knife), '"ore likely to be a stranger to the * and thus more often only had one e of molesting a single victim (Table IX).
U s e
l e y
C r e
V
U T n
n c
SSI ON
°tabl
e
Slm
"""en h i ' a r i t i e s and differences emerge fi Ji findings are compared with Western Ho ' e profile of child molesters suggests Particui; ar age, which is also the conclusion of He and his co-workers in an American tUd' ( 7 6 ) . Offenders came from diverse e
nr
n
g s
T n
D
n n
s
l 0
educational groups, which was also the finding of Mohr and his colleagues (1964). A scrutiny of the family and marital data reveals the salient importance of long term sexual frustra tion as well as lack of social contacts, in keeping with Virkkunen's Finnish study (1976). The mean ages of boy and girl victims are also similar to Western studies, as is the commonest act of offence, namely, fondling. Differences, however, are not hard to find. The present sample consists of proportionately more people who have received less schooling and who scored lower in intellectual assessment. Since no local norms are available for Raven's Progressive Matrices, no firm conclusion could be drawn regarding the apparently fair perform ance of the offenders, despite this test being described as 'heavily loaded with a factor common to most intelligence tests (identified with Spearman's g by British psychologists)' (Anastasi, 1961). With regard to the offendervictim relationship, 56% of incidents occurred between strangers or casual acquaintances in contrast with 26% in the series of Mohr and co-workers (1964). The present series also contains many incidents of intercrural and simulated vaginal intercourse and many incidents that took place where the public had easy access. The general public in Hong Kong have rightly expressed alarm at the situation and local laws have recently been amended enabling the courts to impose heavier penalties for sex offenders. Despite the fact that the present series must be biased towards the finding of mental disorders, less than 10% of the defendants showed active symptoms of a psychosis. Thus mental disorders per se bore no clear-cut relation to deviant sexuality. On the other hand,
mparison of s o m e characteristics of h e t e r o s e x u a l offenders of different age g r o u p s Offender No.
Victims one > one
78 37 26
58 34 23
20 3 3
x = 6.100 d.f. = 2 /> once once 67 25 8
11 12 18
x = 28.804 d.f. = 2 Ρ < 0-001 2
59
Violence yes no 23 6 1
55 31 25
x = 8.385 d.f. = 2 P< 0 - 0 2 5 J
Relationship unknown known 56 18 2
22 19 24
x • 32.832 d.f. = 2 Ρ < 0-001 J
60
Med. Sci. Law (1979) V o l . 1 9 , N o . 1
psychosocial factors appeared crucial. As a group, offenders under 30 years of age showed impaired social relationships, poor academic achievements and fair work records. Finding themselves unable to establish heterosexual contacts on a mature level, they resorted to satisfying their erotic desires by turning to innocent girl strangers. Offenders aged 30 to 44 years tended to have marital problems, job discontent and alcoholism and had generally known the victims for some time. Offenders over 44 years were often socially isolated and had usually known the victims for a long period of time. They often claimed to have treated the victims as their own children, who in fact kept them company, and violence was almost never resorted to. Last but not least, many elderly offenders showed no definite evidence of intellectual impairment, indicating that in the elderly sexual interest is often present despite a realistic decline in sexual desire and ability (Freedman et al., 1976).
REFERENCES Anastasi A. ( 1 9 6 1 ) Psychological Testing, 2nd ed. Ne* Y o r k , Macmillan, p . 2 4 8 . . Feighner J. P., R o b i n s E., G u z e S. B. et al. ( I ? * ' Diagnostic criteria for use in p s y c h i a t r i c researc Arch. Gen. Psychiatry 26, 5 7 - 6 3 . . F r e e d m a n A. M., Kaplan H. I. and Sadock B. >· ( 1 9 7 6 ) Modern Synopsis of Comprehensive T* book of Psychiatry, 2nd e d . Baltimore, William* Wilkins, p . 7 2 6 . ?7 Henn F. A. , Herjanic M. and V a n d e r p e a r l R. H. U * Forensic p s y c h i a t r y : profiles of t w o types of * offenders. Am. J. Psychiatry 133, 6 9 4 - 6 9 6 . . Hong Kong Census a n d Statistics D e p a r t m e n t O Hong Kong Population and Housing Census &> ' Tables. . M o h r J. W., T u r n e r R. E. and J e r r y M. B. d ' * ' Pedophilia and Exbibitionsim. T o r o n t o , Univers' " of T o r o n t o Press. Radzinowicz L. ( 1 9 5 7 ) Sexual Offences. Lond "' Macmillan. State of California, D e p a r t m e n t of Mental H y g ' ( 1 9 5 3 ) California s e x u a l deviation research. State of California, D e p a r t m e n t of Mental H y g i ( 1 9 5 4 ) California s e x u a l deviation research. .. V i r k k u n e n M. ( 1 9 7 6 ) T h e p e d o p h i l i c offender * ' antisocial c h a r a c t e r . Acta Psychiat. Scand. ' ' 401-405.
World Congress o n Medical Law — Belgium T h e 5th World Congress o n Medical Law will b e held at t h e University of G h e n t , Belgium, from 19 - 23 August 1 9 7 9 . A m o n g t h e subjects t o b e discussed will b e : a m n i o c e n t e s i s , a b o r t i o n , sterilization, c o n t a g i o u s diseases, alcohol a n d d r u g a d d i c t i o n , p s y c h i a t r y , p e n o l o g y , genetic engineering, a b o r t i o n , suicide, e u t h a n a s i a , t h e rights a n d obligations of t h e S t a t e , t h e rights of t h e p a t i e n t a n d liability in h e a l t h care. Medicolegal aspects of nursing and d e n t i s t r y will also b e covered. I n f o r m a t i o n and registration f o r m s are available from t h e Secretary-General Professor R. Dierkens, A p o t h e e k s t r a a t 5, B - 9 0 0 0 G e n t , Belgium.
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