Preliminary Study of Effect of Leuprolide Acetate Treatment on Sexual Fantasy of Sex Offenders

Jinhyung Ahn; Geumsook Shim; Jaewoo Lee; Janggyu Lee; Taejun Lee; Ilseok Roh

doi:10.7580/kjlm.2013.37.3.139

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Ahn, Shim, Lee, Lee, Lee, and Roh: Preliminary Study of Effect of Leuprolide Acetate Treatment on Sexual Fantasy of Sex Offenders

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Korean J Leg Med 2013;37(3):139-144.

Published online: 17 January 2013

DOI: https://doi.org/10.7580/kjlm.2013.37.3.139

Preliminary Study of Effect of Leuprolide Acetate Treatment on Sexual Fantasy of Sex Offenders

Jinhyung Ahn¹, Geumsook Shim¹, Jaewoo Lee¹, Janggyu Lee², Taejun Lee², Ilseok Roh²

¹Department of Psychiatry, National Institute of Forensic Psychiatry, Ministry of Justice, Gongju-si, Chungcheongnam, Korea

²Clinical Psychology Laboratory, National Institute of Forensic Psychiatry, Ministry of Justice, Gongju-si, Chungcheongnam, Korea

책임저자 : 안진형 (314-920) 충청남도 공주시 반포면 반포 초교길 253 국립법무병원 정신건강의학과 전화 : +82-41-840-5400 FAX : +82-41-840-5498 E-mail : ahn8378@daum.net

Received 26 July 2013 Revised 14 August 2013 Accepted 23 August 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This study investigated the effect of leuprolide acetate treatment on sex offenders’ sexual fantasies and behaviors, as well as on their criminogenic psychological character and the risk of second conviction. The study participants consisted of 22 sex offenders who were confined to the National Institute of Forensic Psychiatry. Among them, 9 patients were given off-label leuprolide acetate for three months to inhibit sexual impulses, whereas the others were not given any medication. All sex offenders underwent two psychological evaluations; the first evaluation was conducted before starting medication, and the second was conducted after medication. Wilson’ s Sex Fantasy Questionnaire (WSFQ), the Rape Myth Acceptance Scale (RMAS), and the Endorsement of Violence Scale (EVS) were used for evaluation. Leuprolide acetate-treated sex offenders showed a statistically significant decline in the total WSFQ score (p < 0.05). However, the RMAS and EVS scores did not differ after leuprolide acetate treatment, indicating that cognitive distortions like rape myth acceptance and endorsement of violence were unchanged after leuprolide medication. Leuprolide acetate may reduce deviant sexual impulses and fantasies, as suggested by previous research form Korea and other countries. However, it probably cannot alter cognitive distortion. On the basis of these findings, we recommend a combination of leuprolide medication and other therapies, like cognitive behavioral therapy, for the treatment of paraphilic sex offenders.

Keywords: Key Words, Sex offender, Paraphilia, Leuprolide acetate, Chemical castration

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Table 1.

Demographic Characteristics

Variables		Leuprolide injected group (n=9, %)	Control group (n=13, %)	Total
Age		44.5 ± 15.0	35.4 ± 8.3	39.1 ± 13.2
Marriage state
	Married	4 (44.4)	5 (38.5)	9 (40.9)
	Unmarried	4 (44.4)	5 (38.5)	9 (40.9)
	Divorced	1 (11.2)	3 (23.0)	4 (18.2)
Education level
	Elementary school or less	3 (33.3)	5 (38.5)	8 (36.4)
	Middle school	0 (0)	2 (15.5)	2 (9.1)
	High school	6 (66.7)	3 (23.0)	9 (40.9)
	College	0 (0)	3 (23.0)	3 (13.6)
Crime history
	First time	3 (33.3)	5 (38.5)	8 (36.4)
	Second times	0 (0)	3 (23.0)	3 (13.6)
	Third or more times	6 (66.7)	5 (38.5)	11 (50.0)
Diagnosis
	Paedophilia	3 (33.2)	6 (46.5)	9 (40.9)
	Voyeurism	1 (11.2)	1 (7.5)	2 (9.1)
	Fetishism	1 (11.2)	1 (7.5)	2 (9.1)
	Exhibitionism	0 (0.0)	2 (15.5)	2 (9.1)
Other disorders of sexual preference		4 (44.4)	3 (23.0)	7 (31.8)

Table 2.

Changes in WSFQ Score of Leuprolide Injected Group and Control Group

	WSFQ^∗ score	Pre-treatment		Post-treatment		t-score	p-value
	WSFQ^∗ score	Mean	SD	Mean	SD	t-score	p-value
Leuprolide injected group	Exploratory	16.78	11.33	4.11	4.62	3.395	0.009
	Intimate	24.89	16.17	11.11	8.04	3.39	0.01
	Impersonal	18.56	12.87	5.89	4.76	3.113	0.014
	Sadomasochistic	6.44	7.52	2.00	3.04	1.481	0.177
	Total	66.67	45.65	23.11	18.21	3.145	0.014
Control group	Exploratory	4.31	4.59	4.23	18.68	0.045	0.965
	Intimate	7.00	7.12	8.46	4.78	-0.693	0.501
	Impersonal	4.23	4.51	5.00	7.34	-0.553	0.591
	Sadomasochistic	2.62	3.95	2.77	4.30	-0.119	0.907
	Total	18.15	16.91	20.46	18.68	-0.39	0.703

^∗ WSFQ: Wilson’ s sex fantasy questionnaire

Table 3.

Rape Myth Acceptance Scale (RMAS) Score and Endorsement of Violence Scale (EVS) Score

		Pre-treatment		Post-treatment		t-score	p-value
		Mean	SD	Mean	SD	t-score	p-value
RMAS^∗ score	Leuprolide injected group	51.22	24.29	52.67	27.61	-0.28	0.786
RMAS^∗ score	Control group	64.23	35.10	60.38	31.32	0.693	0.501
EVS¹ score	Leuprolide injected group	84.11	14.48	86.67	13.40	-1.468	0.18
EVS¹ score	Control group	74.46	10.57	75.69	12.73	-0.786	0.447

^∗ RMAS: Rape myth acceptance scale;

^† EVS: Endorsement of violence scale

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