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Screenshot 2023-07-24 ABel Screening_edi
  • Can having others present in the room influence an individual’s Visual Reaction Time™?
    It is very likely that having others present in the room can influence or invalidate the Visual Reaction Time™ data. In the fall of 1996, Abel Screening was evaluating 125 normal males. To accommodate this large number of normals, and because of space limitations, we ran these normals four at a time with the four units arranged in the same room, so no individual could see another individual’s images or the rating process. The resultant data was markedly different than any other data we had obtained with normal males, and we strongly suspected that the presence of others in the room invalidated the testing procedure. We searched the literature and found the article by Marvin Brown, et al, entitled “Factors Affecting Viewing Time of Pornography,” located in The Journal of Social Psychology, 1973, 90, 125-135. This is a study of forty male college students asked to make various ratings of slides that depicted increasingly graphic, erotic material while their viewing was measured. The experimenters anticipated that the presence of others in the room would contaminate viewing time. The experiment involved measuring viewing time; half of the subjects viewed the images alone in the room and rated them for their erotic-pornographic content, while the other half did a similar rating with three individuals in an audience. When subjects were alone, there was a clear positive relationship between the images’ reported erotic content and the subjects’ viewing the images longer. When the audience was present, this very clear effect was lost (see Figure 1 on page 132 in the reference). In every case of the fifteen images viewed, the presence of the audience dramatically reduced viewing time and destroyed the relationship between the increased erotic ratings and increasing looking time. Based upon these two experiences, we have made it clear in our manual that once a client is trained up on using the computer/image unit during the practice images, the client should be alone in a room by themselves when viewing the images. Having others in the room can influence or invalidate viewing time measurement. (Question originally submitted 7/8/99.)
  • How should a clinician administer the Abel Assessment for sexual interest™ (AASI) when an observer must be in the room with the test taker?
    Some clinicians evaluate incarcerated clients in settings where the client is not allowed to be in a room unattended. These clinicians were concerned whether having the administrator remain in the room would impact on the Visual Reaction Time™ (VRT™) and the self-reported sexual arousal to the images. To investigate this issue, Abel Screening completed a study. Thirty clients undergoing assessment or treatment at the Behavioral Medicine Institute of Atlanta were recruited to participate in the study. The study was designed to determine if any change occurred in VRT™ and self-reported arousal if the technician remained in the room but ignoring the client undergoing testing and focusing on clerical work. The setting was a windowless room 13’ 6” x 10’ 6”. Along one wall was an 8’ x 2’ counter where technicians normally do their clerical work. The Abel Assessment for sexual interest™ computer was located 5’ 6” from the end of the counter with the client facing towards the technician while doing the Visual Reaction Time™ portion of the test. After giving instructions to the client, the technician sat at the end of the counter and completed clerical tasks. The technician was not able to see the images the client was looking at, nor his responses. The sample of 30 adult males was divided into two groups. Group 1 took the test with the technician in the room for the first set of images. For the second set of images, Group 1 took the test with the technician outside the room. The 15 subjects in Group 2 completed the test in reverse order. Group 2 completed the first set of images with the technician outside the room, and the second set of images with the technician in the room. ASI’s greatest concern was whether the ratio of the average VRT™ of images of children divided by the average VRT™ of images of adults changed or remained the same with the technician in or out of the room. And, whether the ratio of self-reported sexual arousal to child images divided by the self-reported sexual arousal to adult images remained the same with the technician in or out of the room. The results were analyzed as a one-way repeated measures ANOVA. The difference between subjects in the two conditions was not statistically significant (P<=.42, t=-.82, DF=29) for the ratio of VRT of images of children divided by the VRT of images of adults (see Table 1 and Figure 1). The difference between subjects in the two conditions was also not statistically significant (P<=.48, t=-.78, DF=29) for the ratio of self-reported arousal to images of children divided by the self-reported arousal to images of adults (see Table 2 and Figure 2). Table 1. Results of mixed model repeated measures ANOVA for VRT ratio Solution for Fixed Effects Figure 1. The average ratio of VRT of children slides to VRT of Adult slides. Table 2. Results of mixed model repeated measures ANOVA for self-report ratio Solution for Fixed Effects Figure 2. The average ratio of self-reported attraction to child slides to adult slides These results indicated that when a technician remains in the room (unable to see the computer images or the client’s answers and focused on clerical work), the relative interest in children versus adults as measured by VRT™, and the relative self-reported arousal to children versus adults is not significantly different when compared to results when the technician is out of the room. In a previous study by Brown, et al in 1973, three graduate students were asked to observe individuals doing a procedure similar to Visual Reaction Time™. Presumably, these graduate students looked at the images being presented to the client and to the client’s responses. It is expected that the graduate students would be next to or in back of the client and observing directly what the client was observing. This type of close observation of the client during VRT-like assessment nullifies the testing. The study ASI conducted demonstrates that when a technician is not directly observant of the client, but instead, is attending to clerical duties, his or her presence does not impact on VRT™ measurement. For those settings in which it is required that the technician remain in the room with the client during VRT™ testing, we recommend that the assessment be conducted as described in our study for continued validity of the VRT™ assessment procedure.
  • Our team does Abel Assessments of clients who are all incarcerated in prison settings. You recommend that no one be in the room with the client when they are looking at the Actual Images. The prison requires that someone be in the room with the offender at all times for security reasons. How do you recommend that the prisoner be isolated under these circumstances?
    We first recommend that you talk to the prison officials and explain that during the thirty-five minute Visual Reaction Time™ assessment, it is important that no one else be in the room. Explain that this is a test dealing with attention, and that is why it is so critical that during this phase of the Abel Assessment, the client be alone. Determine if the prison authorities will allow you to be outside of the room, given the requirements of the test. If in spite of your best efforts the institution requires that you remain in the room, then you must make your presence there as inconspicuous as possible. The equipment should be placed so that no one else can see the images that the client is looking at while the client is doing the VRT™ assessment. You must also position yourself so that you are not able to see the images. Furthermore, you should occupy yourself with work that demonstrates your apparent lack of concern for the testing the client is doing. It would be best if your back is to the client, and you are far in front of the laptop (so the back of the laptop screen is facing you) on which the images are shown. Make your activity consistent throughout the time that he is completing the VRT™ testing so that if your presence in the room is a potential contaminant, your behavior is constant throughout the VRT™ assessment and you don't appear to be scrutinizing the client's performance. (Question submitted 08/25/99.)
  • How do I answer Question No. 1 in the Adult Therapist Section: “Client admits sexual behavior (sexual interaction, touching or non-touching), with an individual 17 years of age or younger.”
    If there are questions regarding how to answer Question No. 1, specifically, “Client admits sexual behavior (sexual interaction, touching, or non-touching with an individual 17 years of age or younger),” this requires an answer of “yes” if the individual touches, carries out voyeuristic behavior or exposes themselves to a child. It does not include individuals viewing sexual images of children 17 years of age or younger. Under those conditions, if the client admits “yes” to “Using Internet sexual materials excessively”), then when the client gets to the Internet Behavior Section in the AASI-3 or AASI-2 Questionnaire, they have the opportunity to clarify who the individual is that they are looking at. In the questions related to the Internet, if the client denies looking at Internet child pornography, then we miss the images that they were accused of looking at. There is no further solution at this time. If they lie on the inner questions related to the Internet, the conflict between what they have said on page 2 of the Therapist Section Questions will show up and they can then be questioned further by the therapist. (Question originally submitted 2/8/07.)
  • Which of the Abel Assessments Should I Use to Evaluate Clients Who Cannot Read?
    Since the Abel-Blasingame Assessment System for individuals with intellectual disabilities™ (ABID) was developed specifically to be read out loud to clients, if you have the ABID it is recommended that you use it with all clients who are illiterate. The reason for using the ABID with illiterate clients, even if they have no intellectual disabilities, is that you are able to use the standardized instructions, which for the ABID include reading the test to the client. For clinicians who do not have access to the ABID, read the Adult AASI-3 or AASI-2 Questionnaire to adult clients who are illiterate, but are not intellectually disabled. Read the Adolescent AASI-2 Questionnaire to adolescent clients who are illiterate and adults who are illiterate and intellectually disabled. It is important to realize that reading the AASI-3 or AASI-2 to a client represents a deviation from the standardized administration instructions. AASI-3 and AASI-2 results from tests not administered in the standardized manner should be interpreted with a greater amount of caution. For all Hispanic/Latino clients who neither read Spanish nor understand spoken English, read the age-appropriate Spanish version of the AASI-3 for adults or AASI-2 (adult or adolescent). (Question originally submitted 2/7/07.)
  • Do the questions in the Abel Assessment for sexual interest™ (AASI) Questionnaire for Adults that ask about sexually touching a child or adolescent refer only to those behaviors the client has done since he or she was 18 years of age?
    The AASI Questionnaire for adults is primarily concerned about those behaviors where the client has sexually touched a child or sexually touched an adolescent since the client was an adult. However, if the client as an adolescent sexually touched a minor who was three or more years younger than the client, this would also be problematic and potentially constitute sexual abuse of the minor. If a client admits to sexually touching a child or adolescent in the Questionnaire, then the therapist should question the client further to establish the degree of inappropriate sexual touching that occurred, and what the age difference was between the client and the minor. (Question originally submitted 8/31/05.)
  • I have a client who read a New York Times Magazine article which referenced the Abel Assessment for sexual interest™ (AASI) and how it works. Would that automatically disqualify him from taking the AASI?
    First of all, Abel Screening was happy that The New York Times chose to describe the AASI because they identified it as a standard test for evaluating individuals with sexual behavior problems. We feel this exposure in The New York Times confirms what we know to be true, that the AASI is a “strong diagnostic” test. If you read the article, you will see that specific details about the AASI are not given. They do mention that it involves looking at images, but as we have discussed in another Clinician FAQ the test is very difficult to fake. Let us tell you the history of this. In 1987, when Gene G. Abel, M.D. was testing the AASI regarding this issue, he would tell the clients involved in the testing that different people have different ideas as to how the test works. They were told there are three primary ways people believed it worked. They were then asked to select one of those numbers (1, 2 or 3). Once selected, he would tell the client what the premise was of that particular group (1, 2 or 3), and that he wanted the client to assume that premise was correct and to falsify the results. No matter whether they selected group 1, 2, or 3, Dr. Abel said that group believed Abel Screening was measuring how long the person looks at the slide. He told the client that if he looked at the slide longer it meant he had a greater sexual interest, and if he looked at it for a shorter time, it means that he had less sexual interest. Dr. Abel then asked the client to repeat the premise to ensure his understanding. Then Dr. Abel had the client retake the test; the test results didn’t change much. Let us assume the results of the AASI only measure attention to the images and let us assume a person had read the details of internal Abel Screening documents about how the measurement of sexual interest by viewing time works. Since there are multiple images per category (160 images total), the individual would have to first make a decision as to how many milliseconds they were going to look at any given category. As the images are displayed, the client would have to immediately identify which category an image belonged to. Therefore, the client would have to know how many milliseconds they were going to look at the images, and then be able to categorize these images immediately. Finally, they would have to distinguish between the images that were being used from the ones that weren’t being used in the data calculation. Among other things, The New York Times article does not distinguish which images are used and which ones are not. Other important aspects of the AASI that The New York Times article doesn’t address are the probability values and the logistic regression model. Perhaps they didn’t because they are difficult concepts to explain. For example, the logistic regression model is made up of a variety of variables which makes it problematic for a person to falsify. The client would have no way of knowing which variables (categories) are used or the coefficients assigned to those variables. As you can see, while The New York Times article identifies that the AASI measures Visual Reaction Time™, it did not invalidate results of individuals who take the test after reading the article. (Question originally submitted 3/3/05.)
  • We are a mental health agency treating the seriously and persistently mentally ill clients suspected of inappropriate sexual behavior towards children and non-consenting adults. We understand that the Abel Assessment for sexual interest™ (AASI) would be inappropriate during psychotic breaks, but can we use the instrument when clients are in remission?
    The AASI has been used for a number of years to evaluate individuals with schizophrenia and other psychotic disorders once they were in remission. In many cases, the clients tested had been committed to an institution after they had been found not guilty of a sex crime by reason of insanity. Following treatment for their psychosis, they were tested on the AASI as part of an overall evaluation. The question to be answered: Was their inappropriate sexual behavior with children (a) a product of their primary psychosis with a resultant breakdown of their sexual impulsivity, or (b) secondary to a persistent chronic sexual interest in children? There are no absolute guidelines as to which psychiatric symptoms (or lack of) indicate that it is an appropriate time to evaluate the individual with a psychosis. However, we would suggest two criteria. One criterion would be when your agency has to make a decision regarding moving a client to a less restrictive environment and you have to determine the risk involved. A second criterion would be your patient's ability to understand the process of completing the Practice Images. Since there is no cost to running the Practice Images, we recommend that you give the client the instructions for the Practice Images and stay in the room while he completes the Practice Images. You should be able to determine whether he is following your instructions or not. If he can follow your instructions, then it is appropriate to go ahead with the test. Our experience of the AASI’s use with patients who have a serious and persistent mental illness indicates that a surprisingly high percentage of these patients have sustained chronic sexual interest in children once their psychotic illness is controlled with medication. However, there are a few individuals with psychoses, who once they have responded to anti-psychotics, do not have such persistent sexual interest in children. (Question originally submitted 3/22/2000.)
  • How do I evaluate a VRT™ assessment when the client answers all 1's or all 4's? Is the test valid under these circumstances?
    The Abel Assessment for sexual interest™ is an objective test. It measures the client's sexual interest to various stimuli. That is important to remember. A secondary measure that is not objective is the client’s self-report. We ask the client to rate each image from 1 to 7, with 1 being "highly sexually disgusting," 4 being "neutral," and 7 being "highly sexually arousing." We have this self-report measure because we want to know how aware the client is of his sexual interests and/or how willing he is to reveal his sexual interests. We know that sex offenders sometimes lie. That is why we need the Visual Reaction Time™ (VRT™) objective measure of their sexual interest in children. At the time you are evaluating both the objective and the self-report measures, it is the bars, the Z-scored VRTs, that are the most important. Often, while the client is answering all 1's or 4's, the test's primary function of <u>objectively</u> measuring his sexual interest is unaffected. However, when a client rates his sexual arousal to the slides as all 1’s or all 4's (on the 7-point scale), it strongly suggests that the individual is attempting to invalidate this self-reported ratings part of the test. He is reporting no differences in his sexual arousal irrespective of the age, gender, or ethnicity of the model in the image. Such an answering style indicates that the person does not discriminate between various categories of models in the images, which is extremely unlikely. The best way to avoid this kind of non-discriminatory answering is to train the individual, during the practice images, that such non-discriminatory answers are unacceptable because they are illogical. During the practice images, stand next to the client and observe his ratings of sexual arousal to the images. If you see this non-discriminatory responding of all 1's (sexually disgusting) or all 4's (neutral) or no numbers greater than 4, you should immediately confront the individual with how you interpret his responses and what it suggests to you. Possible comments could include: "How could it be that every one of your answers is the same?" "How can it be that none of the slides are arousing to you when you already told me that you are aroused to some age and gender categories?" "Are you really saying that as a human being you have no sexual arousal to any person of any age or any gender?" The client expects you to advise him during the practice images and your advice may stop the client from giving non-discriminatory answers. When you have finished training the client on the Practice Images, you should be able to say that the client understands the process and understands the inappropriateness of giving non-discriminatory answers. Of course, once the client begins rating the actual images, you should not be in the room. If the client, when he is alone, goes back to using non-discriminatory responses, you should interpret the meaning of such responding as probably an attempt to invalidate the test. This is a logical conclusion once you have made sure during the Practice Image training that the client knew the inappropriateness of such responding. If during the practice images training, the client changed his non-discriminatory responding to indicate some arousal to some categories of slides and less to other categories, but then went back to non-discriminatory responding on the Actual Images, there are a number of possible interpretations. The first might be that he is attempting to invalidate his self-report on the test, and therefore, further interpretation of that part of the test (beyond attempts to invalidate it) is not indicated. A second interpretation might be to explain exactly what the client’s answers were. For example, if the client indicates that every image category is highly sexually disgusting, simply write that the client finds every image category highly sexually disgusting. By indicating this fact, the person reading the report can appreciate the unlikely validity of the client's self-reported arousal to the various images. Some sex offender clients attempt to invalidate the clinical history they provide, the results of questionnaire they complete, and measures incorporated into the images portion of the Abel Assessment. The attempts on the client's part to invalidate such testing should be used to reflect on the client's cooperativeness with testing, his willingness to provide honest answers, the likelihood of his obstructing attempts to understand his problem and, of course, what all that means to his evaluation. Ultimately, the clinician providing the assessment must make interpretations as to the meaning of the client's attempts to invalidate the various elements of any assessment. • • • Please note that two therapists who regularly use the Abel Assessment also gave excellent answers to your question. Their answers follow. • • • Posted: December 4, 1999 Author: Gerry D. Blasingame, MA LMFT Site 1013 Redding, CA I have run about 250 Abel Assessments, and have had numerous clients try to not give up any information by pressing only the 1 or 4 key. However, their self-report response is not all that is being measured, so I am able to compare their attempt to fake me out with the objective data. When their self-report rating is not consistent with the objective data, I am able to interpret this as either (a) they are trying to deceive me, (b) they lack insight as to their sexual interests, or (c) they did not understand the procedure. Since I have them explain to me what the numbers mean during the practice images, I omit option (c), and note that the self-report data could be interpreted the other two ways. I also explain this very thing to the clients before running the actual images, so it becomes even more meaningful when they persist to score everything with one number only. Also, since there are categories of interest might be very expected, to not rate any adult females or males (for example) as interesting would be a giveaway that they are not being cooperative. Regardless of the clients' attempts to falsify the self-report ratings, I confront them with what the computer measured. I have had very rare disagreement from the clients when I confront them with both sets of data. By the way, we polygraph after administering the Abel Assessment, so perhaps we get a different response set. I hope this is helpful. Posted: December 14, 1999 Author: Dean Fazekas, LISW Site 1090 Cleveland, OH I would like to thank Gerry for his posting. At our site, we have been successful in moving guys off 4. We often discover that the move was to 1. This often comes after they "accurately" rated the practice images and provided a varied range of responses. When I see all images rated in the disgusting range, I expect the social desirability scale to be high. Since one of the things I am looking for is the agreement between his mind and objective measures, I would not say the objective measures are invalid. I expect that he has tried to conceal his sexual interest, especially when he gave a wide range of responses on the practice images. In discussing the results with the individual, I often state that perhaps his mind does not appreciate what his objective measures are telling him. "That's OK for now. That is why you're here. Let's explore this together." I have not had many pedophiles rate children in the arousing range, yet their objective measures show high sexual interest in children. I would not say that the objective measures are invalid solely based on his unwillingness to reveal such information, especially with a sentencing pending. In our elderly population who are experiencing a lowered drive or erectile dysfunction, they will often give lowered ratings to the images. What I find guys objecting to the most is their sexual attraction to adolescent females; even after it is explained to them that it's "normal." When they persist in objecting, I ask them (taking away the Female Adult category) which would they like to pick as their 2nd category: Female 6-13, Female 5 or less, Male 5 or less, Male 6-13, Male 14-17, or Male Adult. They always ask for the Female 14-17 back. As with any assessment, one should use all tools at their disposal. The clinical interviews and a detailed sexual history can provide important information
  • How do the Health Insurance Portability and Accountability Act (HIPAA) regulations apply
    We have conducted an internal review of the HIPAA requirements in an attempt to determine the applicability of the Act as it pertains to the transmission of client data related to the AASI. We have concluded that HIPAA does not apply in this situation provided the client ID numbers used by the customer sites are not unique identifying numbers such as social security numbers. It is clear that the data transmitted probably qualifies as “Protected Health Information” as defined under HIPAA, but it is not being transmitted in a fashion that is identifiable provided the client ID number is a number generated by the site, such as is the case when simple sequential numbers are used. In summary, as long as unique identifying numbers such as social security numbers are not used, there does not appear to be any danger of violating the HIPAA requirements.
  • I ran a client on VRT™, and there had to be a break between the practice images and actual images that lasted 30 minutes. Does this pose problems regarding the validity of the test?
    Abel Screening has testing assumptions that are required to receive an accurate test result. For example, the Abel Assessment for sexual interest™ VRT testing requires that you only use the images provided by Abel Screening, Inc. (ASI), that you'll only use the computers recommended by ASI, that testing is done in a room that is both dimly lit and quiet, that there be no one in the room after the practice images while the client completes the testing, (for an exception to there being no one in the room, see Q: How should a clinician administer the Abel Assessment for sexual interest™ (AASI) when an observer must be in the room with the test taker?, that the individual can see well enough to identify the images before him or her, that the administrator has been trained on the proper administration of VRT™, that once the individual begins the practice images and the actual images, he does not take breaks in between image sets, etc. The administration of the test and subsequent results are based upon this and other test assumptions not being violated. Since there was greater than 15 minutes between the practice images and actual images, the test assumption was invalidated. We are unable to quantify how much test results will be invalidated when the test assumptions are broken. Instead, we focus on clarifying the test assumptions in our training so that everyone can administer the testing in the same fashion. Doing so ensures the validity of the testing.
  • I have read on the internet that the Abel Assessment for sexual interest-2™ for Boys and Girls can be used to diagnose an adolescent boy as having pedophilia. Is that correct?
    The Abel Assessment for sexual interest-2™ for Boys and Girls cannot be used to diagnose anyone with pedophilia; indeed, there is no psychological test that can diagnose anyone. Diagnosis is only made by licensed clinicians trained regarding the diagnostic criteria for a disorder. Only a clinician can make a diagnosis, not psychological testing, including the Abel Assessment for sexual interest-2™ for Boys and Girls. (Question submitted 3/14/12.)
  • I was asked to evaluate a client who had previously had an Abel Assessment at another site. The client told me that, at the other site, no mouse was used and no practice slides were shown before the actual VRT™ Assessment. What would you recommend under these circumstances?
    You were told by the client that the procedures used by the other site were not those that you were trained to follow. Your task is to evaluate the client using the methodology you have been trained to follow. If you become accusatory of the previous site’s evaluation methodology, you are stepping outside of your task of evaluating your client and getting into an investigative procedure that you are no doubt not trained in. We recommend that you complete the assessment you were asked to do, using the standard methodology and report those results. If an unusual methodology was used by the other site, that is between your client and the previous site. (Question submitted 07/13/09.)
  • I did an AASI-3 evaluation on an individual diagnosed with high-functioning Asperger’s Syndrome. He is in his 20s and had been arrested for molesting a young girl (he admits to the child molestation). I supervised his completing the practice images and he did well. Attorneys involved in the case are concerned that because of his Asperger’s Syndrome, he may not have understood the AASI-3 testing. He reports that he still has fantasies about sexually touching a child, his cognitive distortion ...
    score is 37, and his social desirability score is 35%. Attached is a copy of his AASI-3 Visual Reaction Time™ results. Do you see evidence that his Asperger’s Syndrome impacted on his understanding the AASI-3? It was excellent that you watched him complete the practice images and since he did well, one should assume that the rest of the testing was valid. His reporting that he still has sexual fantasies of young girls suggests his need for cognitive-behavioral treatment which is further suggested by his high cognitive distortion score. It is not surprising that his social desirability score is low, since he was forthcoming about various inappropriate sexual behaviors. I ran a correlation between his VRT™ scores and his self-report scores from his bar graph, which showed a correlation of .718. This is exceedingly high and indicates a strong correlation between what he says he is aroused to and what the objective Visual Reaction Time™ measure indicates he is interested in. If Asperger’s Syndrome disrupted his understanding, one would not expect him to have such a high correlation between his VRT™ and self-report measures. There is no obvious reason why you should not accept his AASI-3 results as valid. (Question submitted 04/27/11.)
  • I was evaluated by a therapist who administered the Abel Assessment for sexual interest™. My test results were referred to by the therapist in their report summarizing my assessment. I would like Gene G. Abel, M.D. to review my test results and comment on whether my test results were correctly interpreted. Is this possible?
    Your dilemma brings up a number of issues regarding the Abel Assessment for sexual interest™ administration and interpretation. These issues include: 1. The most important point is that The Abel Assessment for sexual interest™ is a psychological test that adds to all the information the therapist collects on a client. Sexual interest is NOT a criterion for a diagnosis of any DSM-IV paraphilia; therefore, this assessment cannot make a diagnosis. 2. The AASI clinical guides clearly delineate that the assessments are not to be used to determine guilt or innocence, but instead to be used as a guide for the client's treatment needs and determination for risk. 3. The client's individual clinical history as collected by a licensed, objective therapist is a vital component of the interpretation of the Abel Assessment test results. This means that the only one qualified to interpret the graph is the therapist who has collected the clinical history and therefore is able to place the client's test results within that overall clinical context. 4. Test results produced by the Abel Assessment for sexual interest™ MUST be interpreted within the context of the therapist's total assessment of the client. 5. Graphs are identified by numbers only: the number of the customer site where the test is administered, and the test identification number assigned to the client. 6. Abel Assessment for sexual interest™ graphs are anonymous. Confidentiality is built into the Abel Assessment testing system. No one, including Dr. Abel nor or any of the Abel Screening staff, can connect a specific client to a specific test. The client's therapist is the only one who can match the client's test identification number to the client's name. 7. Dr. Abel does not give consultations on test results. His policy is that he only discusses Abel Assessment for sexual interest™ test results with the licensed, objective therapist who has completed a clinical interview. He does not discuss specific Abel Assessment test results with anyone in the judicial system, with any family member, or with any client who has been given the Abel Assessment by anyone other than his own staff. In answer to your question, neither Dr. Abel nor Abel Screening staff can help you for the reasons identified above. (Question originally submitted 10/10/99.)
  • I have read on the internet that the Abel Assessment for sexual interest-2™ for Boys and Girls can be used to diagnose an adolescent boy as having pedophilia. Is that correct?
    The Abel Assessment for sexual interest-2™ for Boys and Girls cannot be used to diagnose anyone with pedophilia; indeed, there is no psychological test that can diagnose anyone. Diagnosis is only made by licensed clinicians trained regarding the diagnostic criteria for a disorder. Only a clinician can make a diagnosis, not psychological testing, including the Abel Assessment for sexual interest-2™ for Boys and Girls. (Question originally submitted 3/14/12.)
  • I recently had what I considered a dangerous child sex abuser terminate therapy without completing treatment. He is not on probation and his sex offenses involving children occurred in the distant past beyond the statute of limitations. I have no way of forcing him back into treatment and he chose to terminate his treatment. What do you recommend?
    This appears to be a unique situation since you have what you consider a dangerous client who has terminated therapy. Since he has terminated with you, it is imperative that you also clarify the termination with him. You should also clarify to him that you consider him dangerous to others unless he is in treatment and under supervision when around any children. Ideally, it would be best for you to send him a letter, with a copy to his family (provided you have a release for same), specifying why you think he is dangerous to others, what you believe he should do and that you will cover him for emergencies for the next four weeks (so that you could not be accused of abandoning your client). It is important that you communicate to this former client that you are terminating with him, so that the client (and others) don’t get the false impression that the client is continuing in treatment with you. Unless this is made clear to the client, you might be held liable for any inappropriate behavior that the client commits after he has left your treatment program, and at a time when he doesn’t have a new therapist. (Question originally submitted 6/21/06) The following is a prototype letter that we have frequently used at the Behavioral Medicine Institute of Atlanta (BMI): Dear __________________: We are concerned that you have terminated treatment with us because, as we have indicated to you, you have a sexual interest in children and reportedly have sexually touched children in the past. This interest indicates to us that you pose a risk to the community. We believe that it is very dangerous for you to be around children under the age of 18. If you are, you must be supervised by an adult who is aware of your sexual interest in children. We have sent a copy of this letter to your family because you have signed a release of information for us to do this and we believe that it is important that your family be aware of our recommendations. You were referred to us because of your poor control over your sexual urges and you have yet to complete a full course of treatment. Therefore, in addition to your sexual interest, your poor impulse control makes this issue even more problematic and you pose a greater safety to the public. We do not know if you are currently seeing a sex-specific treatment provider. If you are, we strongly recommend that you give this letter to your therapist. There are a number of ways that you can find a sex-specific therapist including calling your county mental health center or looking at the statewide listing of psychiatrists or psychologists licensed in the state, or calling me for a referral to another therapist. Also, you can contact the Association for the Treatment of Sexual Abusers (ATSA) at 503-643-1025. They will refer you to another therapist in this area who specializes in treating individuals with problematic sexual interests. If you are not seeing a therapist, we will cover you for the next 30 days for emergencies; after that time, you should have made arrangements for coverage of your severe psychiatric problems. Sincerely, Dr. Smith
  • How should the sadomasochism VRT™ How should the sadomasochism VRT™ results from the Abel Assessment for sexual interest™ be used and interpreted?results from the Abel Assessment for sexual interest™ be used and interpreted?
    Based on research findings in 2005, we revised our interpretation guidelines for the sadomasochism images in the Abel Assessment for sexual interest™ from what had been stated earlier. An earlier analysis performed on a small data set indicated that subjects with z-scores on sadomasochism VRT™ slides towards Caucasian females or males that were 1 standard deviation greater than the z-score of the adult Caucasian female or male categories indicated high sexual interest in violence against females or males. A 2005 analysis on a much larger data set confirmed a relationship between the sadomasochism towards female category of VRT™ and violence against women. The sample consisted of 21,042 adult males who had taken the AASI. Of the 1,785 who had z-scores for sadomasochism towards Caucasian females of 1 standard deviation or greater than adult Caucasian females, 4.9% had committed violence against women compared to 2.9% of the 19,257 who had Z-scores below 1. The difference between these two percentages was significant at the p<.0001 level (Chi-square=22.0, DF=1). The findings indicated a statistically significant difference, but the effect size was small. Cohen’s effect size was .19 which is classified as small, (an effect size of .20 is classified as small). Therefore, we concluded that while an analysis of the sadomasochism VRT™ slides may be instructive from a clinical viewpoint, caution should be used in reporting these data. Based on these findings, we revised our guidelines for interpreting the sadomasochism slides: 1. Score the categories as always – for males and females (the revised instructions will continue to appear on the AASI graph). 2. If the difference between the adult bars and the sadomasochism bars is equal to or greater than one standard deviation, you should consider it a significant concern and an area that should be explored more closely. 3. No conclusions regarding sadomasochistic interests should be made exclusively from the sadomasochism VRT™ graph. (Question originally submitted 7/1/05.)
  • How do the Health Insurance Portability and Accountability Act (HIPPA) regulations apply to the use of the AASI?
    We have conducted an internal review of the HIPPA requirements in an attempt to determine the applicability of the Act as it pertains to the transmission of client data related to the AASI. We have concluded that HIPPA does not apply in this situation provided the client ID numbers used by the customer sites are not unique identifying numbers such as social security numbers. It is clear that the data transmitted probably qualifies as “Protected Health Information” as defined under HIPPA, but it is not being transmitted in a fashion that is identifiable provided the client ID number is a number generated by the site, such as is the case when simple sequential numbers are used. In summary, as long as unique identifying numbers such as social security numbers are not used, there does not appear to be any danger of violating the HIPPA requirements.
  • I was told that individuals who show sexual interest (by Visual Reaction Time™) in adult females also show sexual interest in adolescent females, and those who show sexual interest in adult males also show sexual interest in adolescent males. Is this correct? If it is correct, what data supports this?
    What you have been told is correct. This was determined was by a factor analysis of Visual Reaction Time™. Factor analysis is used when you have many variables (for example the Abel Assessment VRT™ graphs show 16 variables related to age, gender and ethnicity; Visual Reaction Time™ to 2-5 year olds, 6-13 year olds, 14-17 year olds and adult females and males, Caucasian and African-American images). Factor analysis is done to see if some of the variables are actually measuring the same thing. If factor analysis shows a smaller number of variables, it suggests that there is something common to the variables that go into a single factor. In the case of the 16 visual reaction time variables, we might wonder whether some sex offenders respond to images of Caucasian girls 2-5 years old and 6-13 years old and slides of African-American girls 2-5 years old and 6-13 years old as if they were a single category. <table border=1 class="ASI_table" A sample of 6,078 adult males between the ages of 18 and 95 were used to perform a factor analysis of the Visual Reaction Time™ measures from the Abel Assessment, gathered from sites throughout North America. The factor analysis used the maximum likelihood method and a non-orthogonal Promax rotation. The 16 VRT™ categories loaded onto four factors. The four factors were Adult Female, Child Male, Child Female and Adult Male. Fifteen of the 16 variables loaded primarily on only one factor (a variable was considered to have loaded onto a factor if the loading was .4 or higher). Fifteen of the variables had loadings of 0.7 or higher. This indicates that there was strong evidence for these four factors, due to the very high loading. Table 1. Factor Loadings for the VRT™ Variables The factors were then allowed to rotate and the correlation between the factors ranged between 0.44 (Adult Male and Adult Female) and 0.87 (Child Male and Child Female). Table 2. Factor Correlations <table border=1 class="ASI_table"> The Adult Female factor included the Caucasian 14-17 year old, African-American 14-17 year old, Caucasian Adult, and African-American Adult categories. The Child Male factor included the Caucasian 2-5 year old, African-American 2-5 year old, Caucasian 6-13 year old, and African-American 6-13 year old categories. The Child Female factor included the Caucasian 2-5 year old, African-American 2-5 year old, Caucasian 6-13 year old, and African-American 6-13 year old categories. The Adult Male factor included the Caucasian 14-17 year old, African-American 14-17 year old, Caucasian adult, and African-American adult categories. Thus, males who show significant sexual interest in adult females are highly likely to also show significant sexual interest in adolescent females; and those who show significant sexual interest in adult males are highly likely to show concurrent significant sexual interest in adolescent males. (Question originally submitted 3/27/2000.)
  • I’m evaluating a client who has been charged with child pornography (he had child pornography pictures on his computer when he was investigated). His graph showed that the Female 6-13 bar was very close to the vertical line (I could still see white on the graph between the bar and the vertical line). Since the bar was to the left of the vertical line, but very close, could I still interpret these results as the client showing sexual interest in Females 6-13?
    No, unless the bar touches the vertical line, it cannot be interpreted as showing sexual interest in Females 6-13. You indicate that the investigation has shown that the client had hundreds of child pornography images on his computer. If it has been proven that it was his computer, this, by itself, shows that he has interest in such child pornography. We would refer you to an excellent article on this subject, entitled, “The Criminal Histories and Later Offending of Child Pornography Offenders,” by Michael Seto and Angela Eke, which appeared in Sexual Abuse, Volume 17, 2, April, 2005, pg. 2001. This article discussed those arrested for child pornography with an examination of aspects of their criminal history that is important in making recommendations. (Question originally submitted 6/15/2009.)
  • How do I evaluate a VRT™ assessment when the client answers all 1's or all 4's? Is the test valid under these circumstances?
    The Abel Assessment for sexual interest™ is an objective test. It measures the client's sexual interest to various stimuli. That is important to remember. A secondary measure that is not objective is the client’s self-report. We ask the client to rate each image from 1 to 7, with 1 being "highly sexually disgusting," 4 being "neutral," and 7 being "highly sexually arousing." We have this self-report measure because we want to know how aware the client is of his sexual interests and/or how willing he is to reveal his sexual interests. We know that sex offenders sometimes lie. That is why we need the Visual Reaction Time™ (VRT™) objective measure of their sexual interest in children. At the time you are evaluating both the objective and the self-report measures, it is the bars, the Z-scored VRTs, that are the most important. Often, while the client is answering all 1's or 4's, the test's primary function of objectively measuring his sexual interest is unaffected. However, when a client rates his sexual arousal to the slides as all 1’s or all 4's (on the 7-point scale), it strongly suggests that the individual is attempting to invalidate this self-reported ratings part of the test. He is reporting no differences in his sexual arousal irrespective of the age, gender or ethnicity of the model in the image. Such an answering style indicates that the person does not discriminate between various categories of models in the images, which is extremely unlikely. The best way to avoid this kind of non-discriminatory answering is to train the individual, during the practice images, that such non-discriminatory answers are unacceptable because they are illogical. During the practice images, stand next to the client and observe his ratings of sexual arousal to the images. If you see this non-discriminatory responding of all 1's (sexually disgusting) or all 4's (neutral) or no numbers greater than 4, you should immediately confront the individual with how you interpret his responses and what it suggests to you. Possible comments could include: "How could it be that every one of your answers is the same?" "How can it be that none of the slides are arousing to you when you already told me that you are aroused to some age and gender categories?" "Are you really saying that as a human being you have no sexual arousal to any person of any age or any gender?" The client expects you to advise him during the practice images and your advice may stop the client from giving non-discriminatory answers. When you have finished training the client on the Practice Images, you should be able to say that the client understands the process and understands the inappropriateness of giving non-discriminatory answers. Of course, once the client begins rating the actual images, you should not be in the room. If the client, when he is alone, goes back to using non-discriminatory responses, you should interpret the meaning of such responding as probably an attempt to invalidate the test. This is a logical conclusion once you have made sure during the Practice Image training that the client knew the inappropriateness of such responding. If during the practice images training, the client changed his non-discriminatory responding to indicate some arousal to some categories of slides and less to other categories, but then went back to non-discriminatory responding on the actual images, there are a number of possible interpretations. The first might be that he is attempting to invalidate his self-report on the test, and therefore, further interpretation of that part of the test (beyond attempts to invalidate it) is not indicated. A second interpretation might be to explain exactly what the client’s answers were. For example, if the client indicates that every image category is highly sexually disgusting, simply write that the client finds every image category highly sexually disgusting. By indicating this fact, the person reading the report can appreciate the unlikely validity of the client's image rating responses. Some sex offender clients attempt to invalidate the clinical history they provide, the results of questionnaire they complete, and measures incorporated into the images portion of the Abel Assessment. The attempts on the client's part to invalidate such testing should be used to reflect on the client's cooperativeness with testing, his willingness to provide honest answers, the likelihood of his obstructing attempts to understand his problem and, of course, what all that means to his evaluation. Ultimately, the clinician providing the assessment must make interpretations as to the meaning of the client's attempts to invalidate the various elements of any assessment. • • • Please note that two therapists who regularly use the Abel Assessment also gave excellent answers to your question. Their answers follow. • • • Posted: December 4, 1999 Author: Gerry D. Blasingame, MA LMFT Site 1013 Redding, CA I have run about 250 Abel Assessments, and have had numerous clients try to not give up any information by pressing only the 1 or 4 key. However, their self-report response is not all that is being measured, so I am able to compare their attempt to fake me out with the objective data. When their self-report rating is not consistent with the objective data, I am able to interpret this as either (a) they are trying to deceive me, (b) they lack insight as to their sexual interests, or (c) they did not understand the procedure. Since I have them explain to me what the numbers mean during the practice images, I omit option (c), and note that the self-report data could be interpreted the other two ways. I also explain this very thing to the clients before running the actual images, so it becomes even more meaningful when they persist to score everything with one number only. Also, since there are categories of interest might be very expected, to not rate any adult females or males (for example) as interesting would be a giveaway that they are not being cooperative. Regardless of the clients' attempts to falsify the self-report ratings, I confront them with what the computer measured. I have had very rare disagreement from the clients when I confront them with both sets of data. By the way, we polygraph after administering the Abel Assessment, so perhaps we get a different response set. I hope this is helpful. • • • Posted: December 14, 1999 Author: Dean Fazekas, LISW Site 1090 Cleveland, OH I would like to thank Gerry for his posting. At our site, we have been successful in moving guys off 4. We often discover that the move was to 1. This often comes after they "accurately" rated the practice images and provided a varied range of responses. When I see all images rated in the disgusting range, I expect the social desirability scale to be high. Since one of the things I am looking for is the agreement between his mind and objective measures, I would not say the objective measures are invalid. I expect that he has tried to conceal his sexual interest, especially when he gave a wide range of responses on the practice images. In discussing the results with the individual, I often state that perhaps his mind does not appreciate what his objective measures are telling him. "That's OK for now. That is why you're here. Let's explore this together." I have not had many pedophiles rate children in the arousing range, yet their objective measures show high sexual interest in children. I would not say that the objective measures are invalid solely based on his unwillingness to reveal such information, especially with a sentencing pending. In our elderly population who are experiencing a lowered drive or erectile dysfunction, they will often give lowered ratings to the images. What I find guys objecting to the most is their sexual attraction to adolescent females; even after it is explained to them that it's "normal." When they persist in objecting, I ask them (taking away the Female Adult category) which would they like to pick as their 2nd category: Female 6-13, Female 5 or less, Male 5 or less, Male 6-13, Male 14-17, or Male Adult. They always ask for the Female 14-17 back. As with any assessment, one should use all tools at their disposal. The clinical interviews and a detailed sexual history can provide important information.
  • What information does Abel Screening, Inc. (ASI) have on ephebophilia?
    Ephebophilia is the term used to identify individuals with sexual interest in 14 to 17 year old males or females. Accusations against priests in the Roman Catholic Church have predominantly involved ephebophilia with victims who were boys. This problem dates back to the early 80’s and is described in considerable detail in the book, Lead Us Not Into Temptation, by Jason Barry, published in 1992. The problem of ephebophiles has been identified in a number of organizations such as the Boy Scouts (read Scouts Honor, by Patrick Boyle, 1994), the Big Brothers and Big Sisters, the Civil Air Patrol, and a number of youth organizations. Jay Feierman, in Pedophilia: Social Dimensions, 1990, describes the inter-relationship of ephebophilia to pedophilia. Data gathered by ASI sites throughout North America indicate that the ratio of admitted pedophiles to admitted ephebophiles is 4.1 to 1. Male ephebophiles who molest adolescent boys report that about 30% are exclusively heterosexual, about 20% are exclusively homosexual, and the remaining group has varying amounts of bisexuality. Of male ephebophiles who molest adolescent girls, 91% report they are exclusively heterosexual, 1% exclusively homosexual, and the remaining group has varying amounts of bisexuality. Male ephebophiles who involve themselves with boys are also involved in other types of sexual behavior with minors. Approximately 50% report involvement with boys under 14, approximately 30% report sexual involvement with girls under 14, and approximately 20% report sexual involvement with girls 14 to 17. Male ephebophiles involved with adolescent females also report sexual behavior with other categories of children. Approximately 10% report sexual involvement with boys under 14, approximately 5% with boys 14 to 17, and approximately 40% report involvement with girls under 14. In other words, one should never assume that ephebophiles only involve themselves with victims who are adolescents. (Question originally submitted 8/12/02).
  • I have heard that a study has demonstrated that visual reaction time changes as a result of treatment. Can you provide the reference for that?
    Gene G. Abel, M.D. presented a study at the Association for the Treatment of Sexual Abusers (ATSA) meeting in Chicago in November 1996. The study was updated in 2002. The results are essentially the same and presented as follows: Can Changes in Visual Reaction Time™ Change with Treatment, August 2002? A group of male child molesting and non-child molesting sex offenders were treated with a standard cognitive-behavioral treatment, including covert sensitization, masturbatory satiation, ammonia aversion, anger management, assertive skills training, sex education, victim empathy, cognitive restructuring and relapse prevention. Each participant received five 1-1/2 hour treatment sessions in each of these treatment categories, plus an additional nine sessions to improve his coping skills. Each participant had visual reaction time™ (VRT™) measures before and after treatment, using the Abel Assessment for sexual interest™ (AASI). The question being examined was whether Visual Reaction Time™ was responsive to this cognitive-behavioral treatment. Using a sample of 20 non-molesters and 62 child molesters, we tested the hypotheses that (A) child molesters would show significant decrease in sexual interest as measured by Visual Reaction Time™ (VRT™), (B) non-molesters would not show significant improvement, and (C) the rates of improvement for child molesters and non-molesters would be significantly different. Sexual interest was defined by the mean of the logged unstandardized VRT™ (measured in seconds) from the eight children categories, divided by the mean of the logged unstandardized VRT™ from the eight adult and adolescent categories. Results • Hypothesis A – Child Molesters would show significant decrease in sexual interest. The mean decrease in the child interest ratio was 14.8 with a standard deviation of .35. This is significantly different from zero (t=3.34, df=61,P<.0014). • Hypothesis B – Non-Molesters would not show significant decrease in sexual interest. The mean decrease in the child interest ratio was 14.4 with a standard deviation of .59. This is not significantly different from zero (t=1.58, df=61,P<.13). • Hypothesis C – The rates of improvement for child molesters and non-molesters would be significantly different. The rates of improvement were not significantly different (t=-.04, df=80, P<.9658) in that both child molesters and non-child molesters improved. 1. The results partially replicate previous results performed on a smaller sample size in 1996 (presented at the 1996 ATSA Convention). In the previous study the decrease in the sexual interest was significantly higher for child-molesters than for non-child molesters. A problem with this 2002 study is that non-molesters were included in groups with child-molesters where treatment occurred. Patients were asked to adjust the treatment to decrease their deviant interest (covert sensitization, masturbatory satiation, and ammonia aversion) to their specific deviant sexual behavior. But, since the majority of patients were child molesters, there was a heavy emphasis on specifically how to reduce sexual interest in children. This might explain why non-molesters’ sexual interest in children also decreased with treatment. An alternate explanation is that a larger number of offenders must be treated to statistically demonstrate preferential child-molester decreases in sexual interest. (Question originally submitted 8/22/02).
  • I’m evaluating a sex-offender who, on the AASI for Adults, had a social desirability that is high (80%). Does this value in validate the AASI results?
    We have included a social desirability score within the AASI-3 and AASI-2 to provide you with some idea of how your client answers social desirability questions. The social desirability score in the AASI-3 and AASI-2 correlates 0.6 with the L Scale (Lie Scale) of the MMPI-2. Many individuals recently arrested or accused of sex crimes have elevated social desirability values, as they attempt to paint themselves in the best light. Look for other evidence of their trying to put themselves in a positive light, for example, reporting that they have no interest in any category of the sexual behaviors ratings, or the sexual fantasy ratings. Furthermore, on the graphs they will sometimes report having no sexual interest in any category of images shown them (they report 1.00, after each of the bars). Having a high social desirability score does not invalidate the test, but instead, it cautions you about interpreting your client’s self-report. Instead, you must rely more upon an objective measure, such as VRT™. Frequently we see clients having very high social desirability scores when they enter treatment, but as time progresses, this usually drops down to a more respectable level, as they have greater trust with the therapist. (6/10/09)
  • I recently asked for some information about the Affinity. The documents I received included a soon-to-be-published chapter by Dr. Susan Sachsenmaier and Dr. Carmen Gress, titled “The Abel Assessment for Sexual Interest-2™ (AASI-2): A Critical Review,” which is scheduled to appear in D. Thornton and D.R. Laws (Eds.) Cognitive approaches to the assessment of sexual interest in sexual offenders. Chichester, UK: Wiley. In the chapter, the authors make a number of strong criticisms about the AASI-2
    In reading this chapter, you should first be aware that the co-editor of the book and both authors have a financial conflict of interest regarding the Abel Assessment of sexual interest-2™ (AASI-2). Co-editor Richard Laws, Ph.D., and author, Carmen Gress, Ph.D. have a financial conflict of interest in writing and publishing the article, as they are co-directors of the company, Pacific Psychological Assessment Corporation, that sells the Affinity, a one measure product that competes with Abel Screening’s AASI, a 15 measure testing product called the AASI-2 (now re-configured as the AASI-3) - specifically its Visual Reaction Time™ technology. The first author of the chapter, Susan Sachsenmaier, Ph.D., also has a financial conflict of interest as she appears frequently in court as a professional critic of the Abel tests. While writing and publishing an article of a competing product is a legitimate enterprise, to write and publish without acknowledgement of such an explicit conflict of financial interest is unethical. This financial conflict of interest was not mentioned in the advance copy of the chapter. Dr. Abel respectfully wrote to co-editor D. Thornton and called his attention to this matter. Further, your receipt of the article prior to publication as part of an Affinity information package may indicate co-editor Laws’ and co-writer Gress’ intentions to publish such an article primarily as a marketing tool to aid in promoting the Affinity and financially advance their company, Pacific Psychological Assessment Corporation. Readers should also be aware that the footnote for the chapter title, which indicates Gene G. Abel, M.D. declined to write the chapter and declined to provide information for review, is inaccurate. Dr. Abel declined because he was under contractual agreement to write a chapter for a different book with similar content, target audience, and press date. The reference for this chapter is: Abel, G.G. & Wiegel, M. (2009) Visual Reaction Time: Development, Theory, Empirical Evidence and Beyond. In F.M. Saleh, A.J. Grudzinskas Jr. & J.M. Bradford (Eds.), Sex Offenders: Identification, Risk Assessment, Treatment, and Legal Issues. Oxford University Press, Inc. Sachsenmaier and Gress make repeated inaccurate assertions throughout their 48 page article. The authors appear confused on a number of issues regarding the AASI-2 (now AASI-3): 1. Visual Reaction Time™ (VRT™) Methodology 2. Published Research 3. Probability Models 4. The Rule of Thirds 5. Use of the AASI / AASI-2 (now AASI-3) in Court 6. Special Populations and Directions for Future Research Incorrect Assertion No. 1: the Visual Reaction Time™ (VRT™) Methodology Sachsenmaier and Gress state: “The Abel Screen was developed to detect adult males’ sexual interest in children using a VT procedure (mislabeled as Visual Reaction Time; Maletsky, 2003).” Correction: Visual Reaction Time™ (VRT™) is the correct name of Abel Screening’s objective testing methodology. VRT™ uses a complex methodology which is an advance on simple viewing time. The authors cite Maletsky, 2003, which refers to a letter-to-the-editor of a Journal called, Sexual Abuse, objecting to the use of the name of Visual Reaction Time™. Since the authors cite ten references that have Visual Reaction Time™ in the title in the paper itself or in the case of talks, the presentation slides for a research presentation, they are aware of the field’s acceptance of the term Visual Reaction Time™ as an ASI methodology. Further, Sexual Abuse: A Journal of Research and Treatment commissioned a research project and subsequent article reporting on the validity of Visual Reaction Time™ with VRT™ in the title. Co-editor Laws’ and co-author Gress’s product, Affinity uses Viewing Time (VT). Sachsenmaier and Gress went so far as to present charts based on ASI’s 1995 research article changing the research data to say viewing time instead of Visualization Reaction Time™. In doing this, the authors demonstrate their intention to misrepresent ASI’s product. Incorrect assertion No. 2: Published Research A good portion of their article focuses criticism on an article published by Dr. Abel and his research staff in 1998: Abel, G.G. Huffman, J., Warberg, B.W., and Holland, C.L. (1998). Visual reaction time and plethysmography as measures of sexual interest in child molesters. Sexual Abuse: A Journal of Research and Treatment, Vol. 10, No. 2, pp.81-95. Abstract: It is important to determine the sexual interests of those accused of child molestation. Visual reaction time and plethysmography are two means of measuring sexual interest with some objectivity, but there has been no direct comparison of these methodologies. The reliability and validity of visual reaction time and plethysmography were evaluated in groups of individuals with sexual interest in children of various ages and genders. Results showed that both methods of assessment had a high reliability and validity. Visual reaction time has the added advantages that it can be used without nude slides and is a briefer assessment. In their critique of this study, Sachsenmaier and Gress assert four major points, each one incorrect. Published Research incorrect assertion number one: Sachsenmaier and Gress state: “…non-child-molesting offenders were then excluded (to maximize the likelihood of finding clearer sexual interest in one of the four groups of child molesters) and used as a control group.” Correction: The use of the word “excluded” is pejorative and untrue. In fact, in their criticism they contradict their own point. In this study, Abel et. al. did not exclude non-child-molesting offenders. They used the non-child-molesting offenders as a control group. Furthermore use of the non-child-molesting offenders would not “maximize the likelihood of finding clearer sexual interest in one of the four groups of molesters”; use of a control group of men with other sexual deviancies to compare with a group of men who sexually abuse children means the two groups are closer in behavior, thus a comparison would not be likely to yield “maximum” results. Due to the similarity of the two groups, findings of differences in the AASI’s ability to distinguish between the two groups would be robust. The researchers did report that they chose men who admitted to molesting a child in order to maximize their reaction to the categories of sexual interest in children or teens. Published Research incorrect assertion number two: Sachsenmaier and Gress state: [Results from Abel et. al (1998)] “…are contradictory to those reported by Harris et. al. (1996), where child molesters’ VTs were inconsistent with self-rated attractiveness of the models.” Correction: Abel et. al. (1998) correlated sexual behavior and sexual interest, not attractiveness, so comparison to Harris et. al. (1996) is not useful. Rating a person as highly attractive is not the same as indicating a sexual interest in the person. Published Research incorrect assertion number three: Sachsenmaier and Gress state: [A traditional discriminate analysis was not used because] “…it appears that the independent variable, “all stimulus categories,” includes the dependent variable, “stimulus specific category.”…” Correction: Unfortunately, Sachsenmaier and Gress have misinterpreted the science on two counts: (1) VRT indices were used to predict classification by victim type, not "the highest VRT interest category" and (2) (2) Abel et. al. clearly state, “the discriminant analyses used all of the stimulus categories as independent variables and treated stimulus-specific interest categories (victim type) as the dependent variable"[page 90]. Furthermore, a continuous dependent variable cannot be used in a discriminant analysis. Published Research incorrect assertion number four: Sachsenmaier and Gress state: [Conclusions are limited because of:] “The lack of a comparison group of non-offending males, the exclusion of alleged but denying offenders, and including adolescent victims in the definition of “child molesters”…” <strong> Correction These criticisms disregard the scientific method inherent in publishing in peer-reviewed scientific journals. While they wrote a 48 page book chapter, Dr. Abel had to meet the space limitations of 10 to 14 pages imposed by scientific journals in which research submissions are peer reviewed and held to scientific standards. Because of this limitation, most research papers have to narrowly define the research presented. One study examines one area of research and the next study builds on what the researchers have already published or what is known from other researchers. The first criticism a) “The lack of a comparison group of non-offending males, <strong> Correction:This comparison of non-offending men, “normals,” versus child molesters had already been done in an Abel article in 1994, the results were published, and there was no need to repeat the same research in the 1998 study that was already proven in the 1994 study about the ability of the AASI to discriminate men who sexually abuse children from men who do not sexually abuse children—or non-offenders. (Abel G.G., Lawry, S.S., Karlstrom, E.M., Osborn, C.A., & Gillespie, C.F. (1994). Screening tests for pedophilia. Criminal Justice and Behavior, 21(1), 115-131.) To advance the clinical utility of the 1998 research, Dr. Abel chose to make a narrower comparison using men who sexually abuse children and teens vs. men with other sexual deviancies. <strong><em> The second criticism b) the exclusion of alleged but denying offenders, <strong> Correction: What is important to realize, something Sachsenmaier and Gress seem to miss, is the purpose of the 1998 research study. The purpose of the 1998 study was to directly compare the efficacy of Visual Reaction Time™ with the efficacy of plethysmography with a population of admitting child molesters who also report sexual interest in children. In 2001, Abel et. al. progressed to investigate adults who deny child related offenses, but are presumed to have committed the behaviors. Careful selection of these “liar/deniers” included qualifying them by using three measures: they had been convicted of child sexual abuse, they had been accused by more than one family, and their therapist believed they were lying about their behavior. (Abel, G.G., Jordan, A., A. Hand, C.G., Holland, L.A. and Phipps, A. (2001). Classification models of child molesters utilizing the Abel Assessment for sexual interest™. Child Abuse & Neglect: The International Journal, 25(5), 703-718.) This is the most difficult population on which to gather data. Before 2001, to our knowledge, no one in the field had enough of a population of lying, denying qualifying child molesters to do the study. However, Dr. Abel had published a study using this population, as Sachsenmaier and Gress well knew, in 2001, years before they wrote their book chapter. Note: the citation appears in the next section. <strong><em> The third criticism c) including adolescent victims in the definition of “child molesters”…” Correction: For this study, Dr. Abel defined child as under 14 years of age. He and his research staff followed the American Psychiatric Association’s DSM4-TR, diagnostic manual that defines a pedophile as someone who sexually abuses a child of 13 years of age or younger. The inclusion of an adolescent of 13 is in line with the medical model. The researchers also have an adolescent category for the molesters’ sexual interest in teens 14 to 17 years of age. As was stated earlier, child molesters often exhibit sexual interest in more than one deviant behavior. This was explained as part of this study, “crossing of diagnosis.” Incorrect assertion number three: Probability Models Abel G.G., Jordan A., Hand C.G., Holland L.A., Phipps A. (2001).Classification models of child molesters utilizing the Abel Assessment for sexual interest™. Child Abuse and Neglect, 25 (5), 703-718. Abstract: Objective: The aims of this study are to demonstrate 1) the criterion validity of the Abel Assessment for sexual interest™ (AASI) based on its ability to discriminate between non-child molesters and admitting child molesters, and 2) its resistance to falsification based on its ability to discriminate between liar-denier child molesters and non child molesters. Method: A group of 747 participants matched by age, race, and income was used to develop three logistic regression equations. The models compare a group of non child molesting patients under evaluation for other paraphilias to three groups: 1) a group of admitting molesters of girls under 14 years of age, 2) a group of admitting molesters of boys under 14 years of age, and 3) a group believed to be concealing or denying having molested. Results: Both of the equations designed to discriminate between admitting child molesters and non child molesters were statistically significant. The equation contrasting child molesters attempting to conceal or deny their behavior and non child molesting patients was also statistically significant. <strong> Conclusions: The models classifying admitting child molesters versus non child molesters demonstrate criterion validity, while the third model provides evidence of the AASI’s resistance to falsification and its utility as a tool in the detection of child molesters who deny the behavior. Results of the equations are reported and suggestions for their use are discussed. In the section reviewing “Methodology of the Abel Assessment for sexual interest™,” Sachsenmaier and Gress make it repeatedly clear that neither have they ever been trained on interpreting the 15 measures included in the AASI, nor have they ever used the AASI. They give an incorrect summation of the process by which a clinician receives a report following an Abel Assessment, including misnaming the company as Abel Screen, Inc. Their description of the test and equipment is incorrect, outdated and derogatory in nature. Despite making these most basic of errors, they proclaim to understand how the test works and their account is abhorrently incorrect. Those sex-specific therapists who are licensed and trained to use the AASI will recognize these errors. Probability Models incorrect assertion number one: Sachsenmaier and Gress state: [The probability score] “…has changed in form from an earlier Risk Prediction Score (RPS, Abel Screening News, September/October, 1997; for further discussion, see Fischer, 2000).” Correction: This is untrue. One score has nothing to do with the other. Even they disagree with this assertion later by stating: “These two probability scores are entirely unrelated.” Probability Models Incorrect assertion number two: Sachsenmaier and Gress state: “The Liar-Denial Model was developed using offenders who denied sexually molesting a boy or girl under age 14…” Correction: To qualify for the liar/denier child sexual abusing group, men and women had to meet three criteria: they had been convicted of child sexual abuse, they had been accused by more than one family, and their therapist believed they were lying about their behavior. To list only one criterion denigrates the strength of the research by making the group appear less qualified. Probability Models incorrect assertion number three: Sachsenmaier and Gress state: The areas under the Receiver Operator Curve (ROC) are not reported in the article “Although the (ROC Receiver Operator Characteristic) is not reported for overall classification accuracy, the authors report sensitivity and specificity indices at two coefficient cut-points: at a cut point of .48, this equation correctly identified 74% of true positives and 73% of true negatives, leaving 26% false positives 27% false negatives.”. Correction: Abel et. al. (2001) reported the Mann-Whitney statistics for the classification models, which are equivalent to the areas under the ROC curve (Cortes & Mohri, 2005). The areas under the ROC curves as reported in the article are: for the Girls Under 14 Model—0.81; for the Boys Under 14 Model—0.83; and for the Liar-Denier Model—0.82. Areas over 0.80 are considered excellent in a methodology’s ability to discriminate. Probability Models Incorrect assertion number four: Sachsenmaier and Gress refer to: The probability values in the Abel et. al., 2001 article were not cross-validated. <strong> Correction: Split-half cross-validation (build the model on one half and use the other half as a hold out sample) was used in that article and clearly explained. It is possible that the authors have confused cross-validation with replication. Probability Models Incorrect assertion number five: Sachsenmaier and Gress refer to: The error of reversing conditional probabilities is a problem with the AASI-2 Probability of Past Child Sexual Behavior score. Correction: The error of reversing conditional probabilities is not a problem for the Probability of Past Child Sexual Behavior score. This is a scientific concept whose complexities the authors appear to be unfamiliar. It is rather complex so we have provided an explanation to prove that the authors’ assumption is in error. The error of reversing conditional probabilities occurs when one wants to decide whether a person belongs to one of two groups, but makes a decision by comparing the person to members of only one group. For example, asserting that because child sexual abusers on average have characteristics A, B, and C, that any person with characteristics A, B, and C therefore must be a child sexual abuser. The error is in not considering that many people; including people who have never sexually abused children may also have characteristics A, B, and C. This is an easy error to avoid. A researcher must look at a range of characteristics of child sexual abusers and of non-child sexual abusers and find the characteristics that discriminate between the two groups. When a classification model is built using members of both groups, the error of reversing conditional probabilities is eliminated. The models used in the Probabilities of Past Child Sexual Behaviors score were based on the characteristics that discriminated a large sample of child sexual abusers from a sample of community controls. Therefore, the error of reversing conditional probabilities was completely eliminated from the Probability of Past Child Sexual Behavior score. On page 17 of the article, Sachsenmaier and Gress question how the true positive rate for the Liar-Denier Probability Value could have been raised to 80%” (from 75% published true-positive rate). It appears they may have misunde but rstood that the associated probability for having sexually abused a child in the past for that which is the percent found within the higher probability category. Incorrect Assertion No. 4: The Rule of Thirds The rule of thirds is a simple rule used in the AASI sexual interest graph to identify those more likely to have a sexual interest in children. Child categories beyond the one third point between the highest and lowest categories are generally considered indicative of sexual interest in children. Rule of Thirds incorrect assertion number one: Sachsenmaier and Gress refer to Fisher and Smith’s (1998) assertion that the Rule of Thirds is invalid because the data are ipsative (2-scored). Fischer and Smith (1998) state the Rule of Thirds “represents a different strategy than has been used in the past, and while it would appear to allow clinicians to interpret ipsative scores as though they were norm-referenced, the essential nature of AAIP ipsative scores disallows such interpretation.” What both sets of authors fail to understand is that the Rule of Thirds would be the same if one used the raw data or an ipsative score. This is demonstrated with a little high school algebra. In fact, Fisher and Smith would have discovered this if they had tried the calculations on any data. The basic calculation of the Rule of Thirds involves using an actual ASI VRT graph to find the lowest time within an ethnicity (call this L), the highest appropriate (adult or adolescent) time within an ethnicity (call this H) and the highest child time within an ethnicity (call this C). Calculate R=(C-L)/ (H-L) and if R > .3333 then the client is considered to have sexual interest in children. For each client, the ipsative scores are calculated by subtracting the client’s mean time (call this M) and then dividing the difference by the standard deviation of the client’s times (call this S). In ipsative scores R would be calculated as: Using simple algebra, both the M and the S cancel out leaving the expression Which is exactly the same if one had used the raw times. This shows that the rule gives the same answer whether one uses the ipsative scores or raw data. Rule of Thirds incorrect assertions numbers two and three: Further questioning a methodology they clearly do not understand, Sachsenmaier and Gress present conflicting statements about the scoring of the VRT™ Graph, using an unrelated study by Karpatshof and Elkjaer (2000) which states that one should be careful of “comparing a person only to himself….” They further state that ASI’s use of ipsative scores appear as though they could be compared to group normative data so that the inevitable result is that “clinicians, and non-mental health professionals such as probation officers, lawyers, and judges, make interpersonal comparisons” that “…lead clinicians to compare and decide that one person shows more deviance than another based on the results of the AASI VRT chart.” They then criticize ASI for not providing any normative data and further caution users that “a person’s primary sexual interest may not be represented by any of the slides in the test set.” Correction: First, the intent of the AASI Visual Reaction Time™ portion of the test is to determine whether an individual has sexual interest in children relative to their sexual interest in adults. To determine sexual interest in children, they must be compared to themselves. Whether or not images of an individual’s “primary” sexual interest are included is irrelevant. Perhaps an individual has a primary sexual interest in pigs; if that is the question the clinician needs to answer, the AASI-2 VRT™ portion will not be helpful. However, if the clinician needs to assess whether this individual, who is primarily attracted to pigs, also has a sexual interest in children, the VRT™ will be helpful to the clinician. Second, “non-mental health professionals such as probation officers, lawyers, and judges…” do not receive AASI test results, they receive a report by a clinician who has interpreted the results and only licensed mental health practitioners may be designated to oversee interpretation of AASI test results. Both of these facts are included in the license agreement with Abel Screening. Third, clinicians licensed to use the AASI are trained in interpreting the VRT™ graph correctly. In addition, clinicians receive ongoing free clinical support and documentation specifying that VRT™ graphs are not to be used to compare one client with another. While ASI takes steps to prevent it, if non-mental health professionals receive actual AASI test results or if an ASI licensed clinician misinterprets the test results, then the test is being misused and ASI has the option to terminate the license agreement with the clinician or organization responsible. Incorrect Assertion No. 5: AASI’s Use in Court and Child Custody Cases Sachsenmaier and Gress, (Dr. Sachsenmaier appears frequently in court as an expert in opposition to the use of the AASI.) spend time opposing the use of the AASI in court. This is an unusual subject to include in a supposedly academic article. AASI’s Use in Court and Child Custody Cases incorrect assertion number one: Abel et. al. state that the probability values “should not be used in legal contexts,” In actuality Abel et. al. clearly write, “In the litigious environment of the courtroom, probability values cannot be treated as if they represent certainty about whether or not an individual has committed a specific act of child molestation. This would be an inappropriate use of probability values” (page 715). This is a cautionary note, not a recommendation that the Probability of Past Sexual Behavior should be excluded from court. The intent of this cautionary note and the text both preceding and following it in the 2001 article is to alert clinicians to the manner by which courts attempt to turn such indices into black and white answers of certainty when they are not. The probability values represent one piece of an assessment testing instrument that is part of an overall evaluation by a clinician. Clinicians trained to use Abel Tests receive training and documentation on this matter. They also have free-of-charge access to clinical consultations with M.D.’s and Ph.D.’s, experienced in AASI test interpretation and its use in court proceedings. AASI’s Use in Court and Child Custody Case incorrect statement number two: Sachsenmaier and Gress state: “AASI’s use in child custody battles where incest is alleged has recently been forbidden by Abel Screening, Inc.; this is stated on the website and on AASI Summary reports.” Abel Screening, Inc. has no knowledge of any such statement on any of its materials as the assertion is grossly incorrect. The likelihood is that, as with other important concepts, Sachsenmaier and Gress, have only bothered to take a cursory and partial look at the available information. Correction: The AASI is appropriate to use in court cases that involve child custody disputes, regardless of whether incest has been alleged or not. ONLY one measure of the 15 measures on the AASI, the Probability of Past Child Sexual Abusing Behaviors Score, should not be used in custody dispute cases. (With the reconfiguring of the AASI for the AASI-3, the Probability measure can be used in court). Professionals have always been able to use the VRT™ graph, Cognitive Distortion scale, Social Desirability scale and all of the remaining measures of the AASI-2 summary report in court cases, as alleged incest or custody disputes are not contraindications. Sachsenmaier and Gress have confused the entire 15 measures as presented on each test-taker’s summary report with one small section—the Probability of Past Child Sexual Abusing Behaviors Score on the AASI-2. Again, clinicians who have received training, have documentation on this matter. <strong><em> AASI’s Use in Court and Child Custody Cases incorrect statement number three: Sachsenmaier and Gress state: “Recommend that use in litigious contexts should be clearly forbidden by the test manufacturer and so stated on reports,” and they cite two cases where the AASI was not allowable into evidence. Correction: Again offering only a snippet of accuracy, the authors cite the rejection of the AASI in one Massachusetts court, but fail to mention its acceptance four times in Massachusetts courts. The authors failed to recognize the long and continually increasing list where the AASI has met the Daubert Standard at federal and state levels as well as within states that use Kelly and/or Frye. Four federal courts have approved the AASI’s use in courts; 14 state courts have approved the use of the AASI and Visual Reaction Time™. Condition for acceptance under Daubert is whether the technique is empirically testable and has it been tested, has the theory been subjected to peer review and publication, what the known or potential error rate is and what are the safeguards to control the operation of the method, and general acceptance by the scientific community. Several independent Federal and State courts by manner of a special hearing, have found the AASI to meet all the above criteria. This is evidence to the contrary of the authors’ suppositions in this matter. <strong><em> Incorrect Assertion No. 5: AASI Accepted by Courts: Some of the federal courts that have accepted the AASI into evidence: Washington, D.C., the Ninth Circuit Central District of California, the Western District of Louisiana, and the Federal Court, US Air Force. Some of the state courts that have accepted the AASI into evidence: California, Illinois, Florida, Louisiana, New Mexico, Massachusetts, and Missouri. Incorrect Assertion No. 6: Special Populations and Directions for Future Research Sachsenmaier and Gress discuss use of The Abel-Blasingame Assessment System for individuals with intellectual disabilities TM and criticize Abel Screening, Inc. for not allowing Gerry Blasingame, MA, LMFT to share preliminary results “as data are owned by Abel Screening, Inc.“ However, Blasingame has presented the preliminary results at the national Association for the Treatment of Sexual Abusers conferences as has Dr. Abel, and Dr. Markus Wiegel. The correct statement would be that Abel Screening advised Blasingame against sharing preliminary results with Sachsenmaier and Gress due to the likelihood they would be misrepresented. Abel Screening was correct in this assumption as seen by the delineation of the published works by Abel and others throughout the article. Readers should note that a publication on the ABID is in progress with a sample size of 600. Due to the significantly lower number of individuals with intellectual disabilities being assessed, a larger n collected prior to publication was an important consideration. Summary: Unfortunately, due to the negative slant evidenced by the dominance of pejorative language, false assumptions and erroneous information used by Sachsenmaier and Gress, any potentially constructive value their criticisms had has been lost. Thus, it appears their goal was not to offer a document as a contribution to the field, but to smear the development and utility of the AASI. As mentioned in the introduction, Sachsenmaier, Gress, and Laws are not forthcoming about their financial conflict of interest in regard to the Affinity, a product in direct competition to the AASI. While this Q and A addresses several of the larger inaccuracies and errors, it certainly does not address each one as it would result in a much longer document that contains a great many complex details. Conclusion: Abel Screening regrets that Sachsenmaier and Gress disagree with the numerous published scientific articles in peer-reviewed journals reporting the effectiveness of the Abel Assessment for sexual interest™ and its VRT™ measurement. We also regret that they also disagree with the four independent research sites that replicated the positive VRT™ findings that Dr. Abel and his research staff had previously published. Finally, it is most unfortunate that they disagree with the federal and state judges who admitted the AASI into their courts. (Provided 5/09, Updated 4/11.)
  • How is client data handled from the time the Abel Assessment for sexual interest™ (AASI) is administered through to AASI report preparation to ensure data integrity? I anticipate having to address this issue in an upcoming court case.
    The Abel Screening system consists of two main elements. The Administrator Software package, which is a Windows-based interactive test administrator for end-users, and the Production System, which is a centralized, demand based, Administrator test data capture, storage, cataloging and reporting system that runs on servers at the Abel Screening, Inc. (ASI) data center. The flow of information is as follows: 1. The Abel Screening customer (or site) administers a Questionnaire or Visual Reaction Time™ test or suite of tests to a client. 2. The site submits the results of these tests to the Abel Screening Production System. This submission may be in the form of automated file transfer (FTP) over the Internet to the ASI data center, embedding the test data in an email that is sent to a special email address at the ASI data center, or written to a diskette to be submitted manually. 3. Email and file transfer test data is automatically submitted for processing as soon as it arrives. Staff at the ASI data center submits manually submitted diskette data. 4. The test data is submitted to a rigorous set of error checks which includes checking the data for any corruption or dropouts and validity checks on each field by context which ensures the no answers to questions in the test are out of range or invalid. If the test data fails any of these error checks, then the test data is rejected and placed in a holding area for ASI staff to review, and possibly correct for re-submission. 5. Data that passes the above validity testing is then loaded to the master processing database where it is cataloged by site, client, test type, and various event date/times, including test taken, data submitted, date processed, and other pertinent information. 6. Under normal processing circumstances, when a test dataset is successfully loaded to the database, the reporting process is automatically triggered, which generates the reports appropriate for the type of test submitted. These reports are then automatically routed back to the site by email or file transfer through FTP. Data Integrity As mentioned above, submitted test data is rigorously checked for validity, and for any corruption, or missing elements. This is accomplished by stepping through each element (or individual question) of a test and checking the element identification and the corresponding end user supplied answer are valid, in sequence, and are within allowable ranges. The Production System has an exact copy of the database that is used to control the test when administered, and so, can verify that the data is sound. Because of the complex structure of the test data as encoded in a submission data file, it is highly unlikely that any randomly corrupted data would pass the error checks. Each test data file also has checksums that are used to detect data corruption or dropouts. The data transport mechanisms used are also inherently error-free. Submission by FTP and email over the Internet involve use of the TCP/IP protocol, which contains its own transparent data integrity scheme. Submission of data on diskette involves CRC checking of the data, which will detect any errors. End To End Integrity The final issue in ensuring data integrity is determining that the answers the test subject gave while being administered a test are what actually arrive at the ASI data center, and subsequently into the processing database and reports. Towards that end, ASI has developed a battery of both computer automated and manual quality assurance procedures that are routinely applied to the system from end to end, as software enhancements or modifications are made. These procedures include: 1. Automated comparison of results between a release candidate of the loading and error checking process, and the known good production version. 2. Automated comparison of reports between a release candidate of the reporting process and the known good production version. 3. Manual test data entry from documents and comparison of the submitted results to the source documents. 4. An automated process that enters randomly generated data into an Administrator test by a remote control process. This process maintains a copy of all data submitted by remote control. The Administrator test data is then submitted to the Processing System for normal processing. After processing, the copy of the submitted data is compared with the Processing database. Methods 1 and 2 above are performed anytime there is any modification or software enhancement to the Processing System. This works out to about once or twice a month. If any errors are detected, the source of the error is corrected, and the procedure is run again. New software is not installed until the error rate is zero. Methods 3 and 4 are performed when there are modifications or enhancements to the Administrator software package. Even if the package is not released to sites, these methods are performed for internal confidence testing
  • I ran a client on VRT™, and there had to be a break between the practice images and actual images that lasted 30 minutes. Does this pose problems regarding the validity of the test?
    Abel Screening has testing assumptions that are required to receive an accurate test result. For example, the Abel Assessment for sexual interest™ VRT testing requires that you only use the images provided by Abel Screening, Inc. (ASI), that you'll only use the computers recommended by ASI, that testing is done in a room that is both dimly lit and quiet, that there be no one in the room after the practice images while the client completes the testing, (for an exception to there being no one in the room, see Q: How should a clinician administer the Abel Assessment for sexual interest™ (AASI) when an observer must be in the room with the test taker?), that the individual can see well enough to identify the images before him or her, that the administrator has been trained on the proper administration of VRT™, that once the individual begins the practice images and the actual images, he does not take breaks in between image sets, etc. The administration of the test and subsequent results are based upon this and other test assumptions not being violated. Since there was greater than 15 minutes between the practice images and actual images, the test assumption was invalidated. We are unable to quantify how much test results will be invalidated when the test assumptions are broken. Instead, we focus on clarifying the test assumptions in our training so that everyone can administer the testing in the same fashion. Doing so ensures the validity of the testing. (Question originally submitted 12/7/04.)
  • How does the Abel Assessment for sexual interest™ technician respond to a client when the client says, “My attorney says that you are going to measure the amount of time I look at the slides?”
    First, note in the client’s chart that he has been advised by his attorney about the Abel Assessment for Sexual Interest™. Be aware, therefore, that the client may try to obviate the test results. Ask the client why he wanted to know how the testing worked and how that was going to help him. Don’t be rattled by what the client says. Remember that the lawyer probably has only a superficial knowledge of the testing and is unlikely to understand logistical equations. Then, treat the client like any other client. Tell him there are several things being tested and he needs to pay careful attention to your instructions. Give your instructions. Remind him to follow your instructions carefully and be sure to stay in the room during the Practice Images.
  • I have a client who read a New York Times Magazine article which referenced the Abel Assessment for sexual interest™ (AASI) and how it works. Would that automatically disqualify him from taking the AASI?
    First of all, Abel Screening was happy that The New York Times chose to describe the AASI because they identified it as a standard test for evaluating individuals with sexual behavior problems. We feel this exposure in The New York Times confirms what we know to be true, that the AASI is a “strong diagnostic” test. If you read the article you will see that specific details about the AASI are not given. They do mention that it involves looking at images, but as we have discussed in another Clinician FAQ the test is very difficult to fake. Let us tell you the history of this. In 1987, when Gene G. Abel, M.D. was testing the AASI regarding this issue, he would tell the clients involved in the testing that different people have different ideas as to how the test works. They were told there are three primary ways people believed it worked. They were then asked to select one of those numbers (1, 2 or 3). Once selected, he would tell the client what the premise was of that particular group (1, 2 or 3), and that he wanted the client to assume that premise was correct and to falsify the results. No matter whether they selected group 1, 2, or 3, Dr. Abel said that group believed Abel Screening was measuring how long the person looks at the slide. He told the client that if he looked at the slide longer it meant he had a greater sexual interest, and if he looked at it for a shorter time, it means that he had less sexual interest. Dr. Abel then asked the client to repeat the premise to ensure his understanding. Then Dr. Abel had the client retake the test; the test results didn’t change much. Let us assume the results of the AASI only measure attention to the images, and let us assume a person had read the details of internal Abel Screening documents about how the measurement of sexual interest by viewing time works. Since there are multiple images per category (160 images total), the individual would have to first make a decision as to how many milliseconds they were going to look at any given category. As the images are displayed, the client would have to immediately identify which category an image belonged to. Therefore, the client would have to know how many milliseconds they were going to look at the images, and then be able to categorize these images immediately. Finally, they would have to distinguish between the images that were being used from the ones that weren’t being used in the data calculation. Among other things, The New York Times article does not distinguish which images are used and which ones are not. Other important aspects of the AASI that The New York Times article doesn’t address are the probability values and the logistic regression model. Perhaps they didn’t because they are difficult concepts to explain. For example, the logistic regression model is made up of a variety of variables which makes it problematic for a person to falsify. The client would have no way of knowing which variables (categories) are used or the coefficients assigned to those variables. As you can see, while The New York Times article identifies that the AASI measures Visual Reaction Time™, it did not invalidate results of individuals who take the test after reading the article. (Question originally submitted 3/3/05.)
  • Can having others present in the room influence an individual’s Visual Reaction Time™?
    It is very likely that having others present in the room can influence or invalidate the Visual Reaction Time™ data. In the fall of 1996, Abel Screening was evaluating 125 normal males. To accommodate this large number of normals, and because of space limitations, we ran these normals four at a time with the four units arranged in the same room, so no individual could see another individual’s images or the rating process. The resultant data was markedly different than any other data we had obtained with normal males, and we strongly suspected that the presence of others in the room invalidated the testing procedure. We searched the literature and found the article by Marvin Brown, et al, entitled “Factors Affecting Viewing Time of Pornography,” located in The Journal of Social Psychology, 1973, 90, 125-135. This is a study of forty male college students asked to make various ratings of slides that depicted increasingly graphic, erotic material while their viewing was measured. The experimenters anticipated that the presence of others in the room would contaminate viewing time. The experiment involved measuring viewing time; half of the subjects viewed the images alone in the room and rated them for their erotic-pornographic content, while the other half did a similar rating with three individuals in an audience. When subjects were alone, there was a clear positive relationship between the images’ erotic content and the subjects’ viewing the images longer. When the audience was present, this very clear effect was lost (see Figure 1 on page 132 in the reference). In every case of the fifteen images viewed, the presence of the audience dramatically reduced viewing time and destroyed the relationship between the increased erotic ratings and increasing looking time. Based upon these two experiences, we have made it clear in our manual that once a client is trained up on using the computer/image unit during the practice images, the client should be alone in a room by themselves when viewing the images. Having others in the room can influence or invalidate viewing time measurement. (Question originally submitted 7/8/99.)
  • I have received a subpoena to turn over records of my Abel Assessment results to the court. What should I consider under these circumstances?
    As with any legal matter, you should consult your attorney to ensure that your practice is protected. Check to be certain that the subpoena is valid. This generally means that it has been signed by a judge or a clerk of the court for the judge. If it is not signed by the judge, contact the judge and determine the validity of the subpoena. If it is concluded that you must bring the records to court, and they may be asking you to give the Abel test results to someone who has not been trained to evaluate them, it is best to: 1. Place the requested documents in a sealed envelope and deliver it to the court 2. Have a written letter attached to the sealed envelope, indicating that it is your opinion that psychological test results should not be provided to individuals who are untrained in interpreting the test results, in accordance with the APA professional ethics (for more information see FAQ: How do I handle requests for ASI Test Materials and Results from clients, the judicial system, or mental health professionals?). Additionally, the distribution of copyrighted psychological test materials should be restricted in order to maintain the future utility of the test. Discuss (preferably with your attorney) the possibility requesting that the courts doing an “in camera” review of the records. This means that the judge will review the contents and decide if they can be excluded from the transcribed record, which protects your client’s results and the test materials. To comply with your signed ASI License Agreement, you may turn over the test results, but not the actual test materials. This will protect the future utility of Abel Tests. For clarification on the difference between test results (test data) and test materials see FAQ: How do I handle requests for ASI Test Materials and Results from clients, the judicial system, or mental health professionals? After the case is resolved, please contact Abel Screening and tell us the outcome, so we can be up-to-date on such court cases.
  • How do I handle requests for ASI Test Materials and Results from clients, the judicial system, or mental health professionals?
    A frequently occurring situation when doing an evaluation that involves litigation and/or the courts, involves receiving requests to turn over all of the materials related to the ASI tests, including, but not limited to, your particular client’s results, the testing materials, the images used to assess sexual interest, scoring algorithms used in interpretation of results, etc. What are you allowed to release and what not, and to whom? There are numerous issues including professional standards/codes, laws, and contractual obligations that you need to be aware of and understand. We encourage you to contact your professional organization or an attorney for specific guidance as issues arise. An important distinction must be made between ASI Test Results (also referred to as test data) and ASI Test Materials (also referred to as test materials). The accuracy and validity of the ASI Test Materials, like most psychological tests, is partially dependent on the test-taker not knowing how the test works. Release of ASI Test Materials to unqualified persons, including attorneys and the courts could potentially jeopardize the validity of the ASI tests and their future use in the assessment of alleged sexual abusers. The ASI Test Materials include (but are not limited to): the Questionnaire items, VRT™ images, and information about how VRT™ is measured. As a result, it is critically important that you understand the issues involved in the release of test results versus the release of test materials. If anyone is attempting to compel you to release ASI Test Materials or trade secrets, PLEASE CONTACT ABEL SCREENING, INC. IMMEDIATELY. There are relevant passages from the APA Ethical Principles of Psychologists and Code of Conduct as well as HIPPA and The Standards for Educational and Psychological Testing and others that apply to the sharing of test data that apply to sharing test materials. The APA Ethical Principles of Psychologists and Code of Conduct have this to say about sharing of test data (i.e., ASI Test Results): 9.04 Release of Test Data (a) The term test data refers to raw and scaled scores, client/patient responses to test questions or stimuli, and psychologists’ notes and recordings concerning client/patient statements and behavior during an examination. Those portions of test materials that include client/patient responses are included in the definition of test data. Pursuant to a client/patient release, psychologists provide test data to the client/patient or other persons identified in the release. Psychologists may refrain from releasing test data to protect a client/patient or others from substantial harm or misuse or misrepresentation of the data or the test, recognizing that in many instances release of confidential information under these circumstances is regulated by law. (See also Standard 9.11, Maintaining Test Security.) (b) In the absence of a client/patient release, psychologists provide test data only as required by law or court order. 9.10 Explaining Assessment Results Regardless of whether the scoring and interpretation are done by psychologists, by employees or assistants, or by automated or other outside services, psychologists take reasonable steps to ensure that explanations of results are given to the individual or designated representative unless the nature of the relationship precludes provision of an explanation of results (such as in some organizational consulting, pre-employment or security screenings, and forensic evaluations), and this fact has been clearly explained to the person being assessed in advance. Prior to HIPPA (1996) and its associated rules and regulations (2001; Privacy Rules effective 4/14/03), as well as the 2002 Revision of the APA Code of Ethics (which is also in our licensure law and therefore has the force of law), inquiries regarding the release of psychological testing were handled in accordance with the 1992 APA Ethical Code. The 1992 Code had a standard regarding the release of “raw test data” which broadly prohibited the misuse of assessment techniques, results or interpretations by psychologists and others not qualified to use such information. As a result, psychologists and mental health practitioners almost never released raw test data, preparing instead a summary of test results and interpretations for patients. Where the raw data was released (e.g., litigation), the data was sent to another qualified psychologist working for the particular attorney requesting the information, so that the raw test data was released in a fashion consistent with the APA Ethical Code and licensing law. However, HIPPA regulations and regulations regarding the Privacy Rules in 2001 changed mental health clinicians’ handling of the release of psychological test data. HIPPA gives patients the right to access and even amend their designated mental health record. Psychotherapy notes are excluded from the federal law delineating the contents of the “designated mental health record;” however psychological testing is not excluded. In effect, providers can no longer simply give patients a summary of their scores and test results/interpretations. Patients can acquire the actual raw data of their psychological testing upon their request. That same opportunity is available when litigation is an issue at hand. Given these HIPPA regulations, APA rewrote its 2002 Code of Ethics using the above mentioned language in Sections 9.04 and 9.10. Importantly, there is a difference between test materials and test data. HIPPA rights refer to test data, not test materials which involve copyright and trade secret considerations, protection of the public so that only qualified individuals secure the test materials, etc. While a patient request for test data or a litigation situation may result in test data being released, you are under no obligation of any sort to release test materials. In fact, our 2002 Code of Ethics compels psychologists to maintain the integrity and security of test materials. You would be breaking part of professional licensing law TCA 63-11-214 if you released test materials to unqualified individuals. As you know, in order to protect the public as well as the integrity of psychological tests, not just anyone can order and secure these psychological test materials. Commonly, to secure test materials one has to demonstrate completion of the appropriate professional degree, possess a license to practice health care in the state of residence, and some demonstration of professional competency, education, and training in these matters. The relevant APA ethics code section states as follows: 9.11. Maintaining Test Security, the term test materials refers to manuals, instruments, protocols, and test questions or stimuli and does not include test data as defined in Standard 9.04, Release of Test Data. Psychologists make reasonable efforts to maintain the integrity and security of test materials and other assessment techniques consistent with law and contractual obligations, and in a manner that permits adherence to this Ethics Code. In addition, the protection of copyrighted material is also addressed by The Standards for Educational and Psychological Testing. Standards 11.7 and 11.8 state: 11.7: Test users have the responsibility to protect the security of tests, to the extent that developers enjoin them to do so. 11.8: Test users have the responsibility to respect test copyrights” (Standards for Educational and Psychological testing, 1999, p. 115). For these reasons, if in litigation, if one side obtains the test data but requires the test materials in order to make sense of the test data, that party commonly hires a qualified professional to interpret the data for the untrained parties reviewing the test data. Specifically, the attorney litigating the case makes the request for test data. If that attorney then feels he or she needs the test materials in order to make sense of the test data, that attorney secures the services of another psychologist to review the test data with this second psychologist working in the employ of the attorney making the request for the test data. When it comes to the ASI Test Materials, you also signed a license agreement with Abel Screening, Inc. that states: For purposes of this Agreement, “Confidential Information” shall mean information or material proprietary to ASI or designated as “Confidential Information” by ASI, and not generally known by non-ASI personnel, which Licensee may obtain knowledge of or access to as a result of its use of or exposure to the Software, the Documentation, the Test Sheets or the Photographic Images. The Confidential Information includes, but is not limited to, the following types of information or other information of a similar nature (whether or not reduced to writing): all documentation (including the Documentation) and other tangible or intangible discoveries, ideas, concepts, software, designs, drawings, specifications, techniques, models, information, source code, object code, diagrams, flow charts, procedures and “know-how” comprising all or any portion of the Software, the Documentation, the Test Sheets or the Photographic Images or revealed to Licensee in connection with any negotiations or testing of the same. Confidential Information also includes any information described above that ASI obtains from another party that ASI treats as proprietary or designates as Confidential Information, whether or not owned or developed by ASI. Information publicly known and that is generally employed by the computer software industry or any profession at the time that Licensee learns of such information or knowledge shall not be deemed part of the Confidential Information. Licensee shall not directly or indirectly disclose, display, provide, transfer or otherwise make available all or any part of the Confidential Information or the Licensed Materials to any person or entity at any time during the period in which Licensee has access to the Confidential Information and the Licensed Materials or thereafter, unless Licensee has received prior written permission from ASI. Licensee shall not make copies of the Confidential Information, the Licensed Materials or any portion thereof. At no time and under no circumstances shall Licensee reverse-engineer, decompile or disassemble the Software or the Confidential Information or attempt to use the Software in any form other than machine-readable object code. Licensee shall allow only its employees to have access to the Confidential Information and the Licensed Materials. Licensee shall not provide access to the Confidential Information or the Licensed Materials to any third parties, including consultants and independent contractors. As a result of the APA Ethics Code, Standards for Educational and Psychological Testing, copyright law, and Abel Screening Incorporated’s License Agreement, “qualified psychologists” to which you can send the ASI Test Materials include only individuals who have been trained in the use and interpretation of the ASI Test Materials, which are other ASI licensed individuals (who should already have a copy of the ASI Test Materials, and therefore do not require you to send them the ASI Test Material).
  • My client was recently arrested for sexual communication with a 13-year-old girl over the Internet. They communicated back and forth for over four months discussing explicit sexual behavior between the two of them. They arranged to meet in her city. When my client went to that meeting, he was arrested by the FBI. As you might suspect, there was no 13-year-old girl, but rather an FBI agent representing himself as a 13-year-old girl. My client assures me that he has never molested a child and ....
    did not intend to be sexual with the 13-year-old girl. Is there any way that I can specifically use the AASI results as a possible mitigating factor regarding this case? : In our experience the girls (FBI agents) in this case carry out graphic sexual communication with the person arrested. An important issue frequently arises post-conviction, and that is, has the perpetrator ever actually molested a child? This becomes a perfect opportunity to use the Denier-Dissimulator Probability Value. The Denier-Dissimulator equation estimates the probability, or likelihood, that the client has touched a child, male or female, under the age of 18, inside or outside of the home. If the client’s Denier-Dissimulator Probability is low, it provides scientific support that the client’s not touched a child. Many times this finding is accepted as a mitigating factor post-conviction, but this varies from jurisdiction to jurisdiction. The Visual Reaction Time™ graph is less helpful in answering this specific question. Many individuals who carry out sexual communication with children under 14 will show sexual interest in children under 14, but objectively, measuring his sexual interest doesn’t answer the specific question that might be of concern at mitigation. The criminal justice system is primarily concerned about whether touching of a child has occurred and Visual Reaction Time™ (VRT™) only identifies sexual interest, not whether touching of the child has occurred. The Denier-Dissimulator Probability is ideal for providing scientific support for whether the client has actually touched a child under 14. (Question submitted 10/25/04.)
  • I anticipate that I will be testifying in court regarding the results of my evaluation of a client who underwent the Abel Assessment for sexual interest™ (AASI). I want to be certain that I am up-to-date regarding the issues about the reliability and validity of the AASI as it applies to court testimony. Could you please outline the evidence that I might present in court?
    Individual states have different criteria for the admissibility of a test in legal proceedings. Many state standards have been superseded by the Daubert Standard, that is, the standard used in federal court for the admissibility of testing as being reliable and valid. On April 17, 2000, the U.S. District Court of the Western District of Louisiana (federal court) concurred that the AASI passed the federal Daubert Standard. The elements making up the criteria for meeting the Daubert Standard include the following four: 1. Is the underlying theory or technique (methodology or reasoning) at issue empirically testable, and has it been tested? There is an underlying theory supporting the Visual Reaction Time™ assessment, and it has been empirically tested. The empirical test can be found in Sexual Abuse, Vol. 10: 81-95, 1998. This study compares Visual Reaction Time™ with plethysmography and was authored by Abel, et al, from the Behavioral Medicine Institute of Atlanta. The participants in that study were outpatient legal cases of possible sex offenders. Four independent studies have also been completed. The first is by Listiak and Johnson (the participants were sex offenders incarcerated in the Minnesota state prison system); another is by Gray (involving outpatient sex offenders); another by Seghorn and Wiegel (outpatient sex offender cases); and a final one by Letourneau (subjects were federal prisoners). All of these research studies were completed independently and were presented at the Association for the Treatment of Sexual Abusers meeting September 20, 1999. All found the AASI to be valid, and those studies examining reliability also found it to be reliable. 2. A second issue regarding the Daubert Standard is whether the theory or technique has been subjected to peer-review and publication. Evidence for peer-review and publication is that the Abel, et al, article was reviewed by the editorial staff of Sexual Abuse and had completed the customary editorial scrutiny. Visual Reaction Time™ was also reviewed in a publication of the American Psychiatric Association entitled Dangerous Sex Offenders, by Zonana, published in 2000 by the American Psychiatric Association Press. The four independent research centers that presented their findings at a national meeting were also considered peer-review, since their results were available for public scrutiny. 3. A third series of issues deals with what is known about the potential error rate of the technique in question, and are there standards and safeguards controlling the operation of the technique or device? The measures of reliability entitled “Test-Retest for Visual Reaction Time™” showed that the test-retest reliabilities for the various categories of Caucasian and African-American images were primarily in the .8 range. A second measure of reliability involved Cronbach’s alpha. The Cronbach’s alphas for Caucasian and African-American images, irrespective of the eight age and gender categories, all fell in the .8 range. Regarding the validity of Visual Reaction Time™, the bivariant analysis reported in Sexual Abuse 10: 81-95, 1998, showed the sensitivity varying from 66% to 91% (depending on specificity), and the four independent studies described above also showed significant validity for Visual Reaction Time™. Regarding whether standards and safeguards led to consistency of administration, the evidence in support of this included a systematic two-day training program and manual, ten telephone calls to Dr. Abel for assistance in interpreting results within the context of the histories provided by the therapist on site, annual half-day training in conjunction with the Association for the Treatment of Sexual Abusers meeting (ATSA) and concomitant updates of information related to the use of the AASI on the website. To ensure consistency of operation, all sites use exactly the same images and administer the AASI using the identical software and equipment. 4. Lastly, was the question of whether there has been general acceptance of the AASI. The AASI has been used over 150,000* times throughout North American by approximately 2,500* mental health providers. It has been included in the training of psychiatrists at the American Psychiatric Association each year for the last ten years. After issues related to reliability and validity are dealt with, a further issue can come to bear regarding the Daubert Standard. If a test passes the Daubert Standard, its use must still be relevant to the case. For example, examining the validity and reliability of how fast a car can travel may have little to do with how fast a car was traveling at the time of an accident. The findings regarding reliability and validity of a test must be applicable to an issue of the case before the court. Abel Screening is very interested in any occasion that the reliability and validity of the AASI is being presented in court. Please contact ASI should these situations arise, especially during any planned Daubert Hearing, so that we might determine the availability of an expert to come from Abel Screening, Inc., to present these issues to the court. (Question originally submitted 8/25/2000; * updated 9/15/13.)
  • Does a higher probability value mean my client is a more severe or a more dangerous child sexual abuser?
    No. A higher probability value means a greater likelihood that the person is correctly classified as a child sexual abuser. It means that his responses match the responses of other child sexual abusers more closely. The probability value is not an index of dangerousness or severity of being a child sexual abuser (for example, a higher probability value does not mean that the client has abused a greater number of children).
  • How should the sadomasochism VRT™ results from the Abel Assessment for sexual interest™ be used and interpreted?
    Based on research findings in 2005, we revised our interpretation guidelines for the sadomasochism images in the Abel Assessment for sexual interest™ from what had been stated earlier. An earlier analysis performed on a small data set indicated that subjects with z-scores on sadomasochism VRT™ slides towards Caucasian females or males that were 1 standard deviation greater than the z-score of the adult Caucasian female or male categories indicated high sexual interest in violence against females or males. A 2005 analysis on a much larger data set confirmed a relationship between the sadomasochism towards female category of VRT™ and violence against women. The sample consisted of 21,042 adult males who had taken the AASI. Of the 1,785 who had z-scores for sadomasochism towards Caucasian females of 1 standard deviation or greater than adult Caucasian females, 4.9% had committed violence against women compared to 2.9% of the 19,257 who had Z-scores below 1. The difference between these two percentages was significant at the p<.0001 level (Chi-square=22.0, DF=1). The findings indicated a statistically significant difference, but the effect size was small. Cohen’s effect size was .19 which is classified as small, (an effect size of .20 is classified as small). Therefore, we concluded that while an analysis of the sadomasochism VRT™ slides may be instructive from a clinical viewpoint, caution should be used in reporting these data. Based on these findings, we revised our guidelines for interpreting the sadomasochism slides: 1. Score the categories as always – for males and females (the revised instructions will continue to appear on the AASI graph). 2. If the difference between the adult bars and the sadomasochism bars is equal to or greater than one standard deviation, you should consider it a concern and an area that should be explored more closely. No conclusions regarding sadomasochistic interests should be made exclusively from the sadomasochism VRT™ graph. (Question originally submitted 7/1/05.)
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